General Pathology. Hemorrhage (Web)

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1 General Pathology Hemorrhage (Web) Paul Hanna Feb 2015

2 Hemorrhage escape of blood from the cardiovascular system may be external or internal

3 Hemorrhage Causes Trauma Sepsis, viruses or toxins Coagulation disorders Platelet disorders

Hemorrhage Fig. 2-21 (McGavin) Hemorrhage, anticoagulant (warfarin-containing) rodenticide toxicosis, skin and subcutis, medial aspect of the right hindleg, dog.

4 Hemorrhage Fig (McGavin) Hemorrhage, anticoagulant (warfarin-containing) rodenticide toxicosis, skin and subcutis, medial aspect of the right hindleg, dog. There is a large area of extensive hemorrhage in the subcutis. This lesion was attributed to decreased production of coagulation factors II, VII, IX, and X and proteins C and S resulting from a deficiency of vitamin K induced by warfarin.

5 Hemorrhage Significance Site CNS heart Rate how fast Volume of Blood Loss hemorrhagic shock bleeding into the intestinal lumen in a hemorrhagic enteritis or enteropathy; which can be caused by bacteria (eg Salmonella spp), viruses (eg parvovirus), toxins ( eg arsenic), etc

6 Hemorrhage Subdural (or Epidural) Hematoma blood accumulation beneath (or above) the dura compresses brain

7 Hemorrhage Cardiac Tamponade heart failure due to massive accumulation of fluid in pericardial sac compresses atrium and ventricles (restriction of cardiac filling) Hemopericardium - blood present within the pericardial sac

8 Terminology Hemorrhage by Rhexis hemorrhage from a tear in blood vessel or heart moderate to marked flow of blood out of cardiovascular system

9 Hemorrhage by Diapedesis bleeding from a small defect rbc s passing through vessel wall in hyperemia of inflammation eg rbc s entering alveoli with chronic congestion of the lung

Hemorrhagic Diathesis increased tendency to hemorrhage from usually insignificant injuries in wide variety of clinical disorders platelet disorder coagulation deficiency

10 Hemorrhagic Diathesis increased tendency to hemorrhage from usually insignificant injuries in wide variety of clinical disorders platelet disorder coagulation deficiency Hemophilia is a type of coagulation disorder. It includes several hereditary disorders in which the blood fails to clot normally because of a deficiency or abnormality of clotting factors.

Trauma to the spleen has caused damage to the splenic red pulp and its vessels, resulting in bleeding into the

11 Hematoma extravascular, 3-D blood clot, enclosed within a tissue Splenic hematoma, dog Fig (Zachary) Organizing hematoma, spleen, horse. Trauma to the spleen has caused damage to the splenic red pulp and its vessels, resulting in bleeding into the splenic parenchyma, forming a hematoma. Note that this hematoma is not acute but is several days old, because the blood clot is being degraded. The hematoma is contained by the splenic capsule.

12 Hemothorax blood in the pleural cavity Hemoperitoneum blood in the peritoneal cavity

13 Hemarthrosis blood present in joint spaces

14 Hemoptysis coughing of blood from the lungs or airways

15 Epistaxis bleeding from the nose

16 Petechia (pl. petechiae): minute, up to 1-2 mm, hemorrhages, esp skin / mucosa / serosa

17 Purpura hemorrhage 3 mm 1cm, often scattered on body surfaces (skin, mucosa) often with diseases which cause petechiae; vascular inflammation / damage

18 Ecchymosis (pl. ecchymoses) hemorrhage larger than petechiae / purpura (> 1 cm) often blotchy or irregular

19 Agonal hemorrhages refer to petechiae and ecchymoses that are associated with the death struggle (terminal hypoxia).

20 Suffusive Hemorrhage areas of hemorrhage larger than ecchymoses and contiguous

21 Paint Brush Hemorrhage hemorrhage which looks like red paint was applied with a brush

22 Resolution of Hemorrhage Dependent on amount small amount can be reabsorbed larger areas require breakdown & removal of rbc s

23 Resolution of Hemorrhage Hemoglobin Bilirubin Hemosiderin Red - Blue Blue-Green Yellow-Brown

Organizing Hematoma Centre fibrin & rbc s phagocytosed and degraded by macrophages

com Cut surface of a partially organized hematoma in the ear of a dog.

scar tissue as the end result. http://itsthedogslife.

24 Organizing Hematoma Centre fibrin & rbc s phagocytosed and degraded by macrophages Outside vascularized fibrous tissue Fallsvetclinic.com Cut surface of a partially organized hematoma in the ear of a dog. If left untreated an aural (ear) hematoma will heal by organization, with a lump of scar tissue as the end result. The preferred treatment for aural hematomas is surgical removal followed by insertion of multiple drains and sutures to keep it from filling back up with blood

25 Coelomic cavity of male turkey with ruptured aorta what term would you use?.. 1. Hemorrhage by diapedesis 2. Hemorrhage by rhexis 3. Hemarthrosis 4. Petechial hemorrhage 5. Hemorrhagic diathesis

26 What s your diagnosis??? 1. Hemothorax 2. Hydrothorax 3. Chylothorax 4. Hemopericardium 5. Hydropericardium

Morphologic Diagnosis and Speculate on cause... 1. Hydroperitoneum - Ruptured small intestine 2.

27 Morphologic Diagnosis and Speculate on cause Hydroperitoneum - Ruptured small intestine 2. Ascites - Left Heart Failure 3. Hydroperitoneum - Liver Failure 4. Ascites / Right Heart Failure

28 This aortic rupture would have resulted in)... (tissue from a horse) 1. Hemothorax 2. Cardiac tamponade 3. Cor pulmonale 4. Hemoptysis

Intestinal volvulus (torsion), results in the following... 1. Acute, local congestion 2.

29 Intestinal volvulus (torsion), results in the following Acute, local congestion 2. Chronic, local congestion 3. Acute, local hyperemia 4. Chronic, generalized congestion

5 DISTURBANCES IN CIRCULATION. Congestion / Hyperemia Haemorrhage Thrombosis Embolism Ischemia Infarction Oedema Shock Sludged blood Model Questions

5 DISTURBANCES IN CIRCULATION. Congestion / Hyperemia Haemorrhage Thrombosis Embolism Ischemia Infarction Oedema Shock Sludged blood Model Questions 5 DISTURBANCES IN CIRCULATION Congestion / Hyperemia Haemorrhage Thrombosis Embolism Ischemia Infarction Oedema Shock Sludged blood Model Questions CONGESTION/ HYPEREMIA Hyperemia is increased amount of