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Blood Vessel & Blood Pressure Pathophysiology

NRS 232 - Pathophysiology I
by

Katrina Dielman

on 16 March 2018

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Transcript of Blood Vessel & Blood Pressure Pathophysiology

Blood Vessel & Blood Pressure Pathophysiology
Virchow's Triad
1. Stasis of blood
Immobility
2. Rough endothelium/endothelial damage
Atherosclerosis
Chronic hypertension
Diabetes
3. Hypercoagulability
Oral contraceptives
Alterations in Arterial Flow
Atherosclerosis
1.

Endothelial dysfunction
- Inhibition of
nitric oxide
/other chemicals release results in increased resistance, smooth muscle proliferation, platelet aggregation, WBC adherence to endothelium
2.

Fatty streak formation
- Macrophages filled with lipid/
Foam cells
3.

Fibrous plaque development
- Narrows lumen; core becomes necrotic
4.

Plaque rupture or ulceration
- Thrombus formation & possible acute occlusion
True Aneurysms
All 3 layers of the
arterial tunica
involved
Alterations in Blood Pressure
Hypertension
vs.
Orthostatic Hypotension
Alterations in Venous Flow
Thrombophlebitis:
Deep vs. Superficial
Other Venous Disorders
Valvular incompetence
- Do not shut properly
Varicose veins
- Raised, ugly veins due to incompetence
Chronic venous insufficiency
- Incompetence of the deep veins of the legs
NRS 232 - Pathophysiology I
Thrombus!!
Principles of Flow
Resistance vs. Reservoir/Capacitance
Laminar vs. Turbulent Flow
Blood flow is
inversely
proportional to resistance and area
BP = CO x SVR
Risk factors:
Virchow's Triad!
Complication:
Pulmonary embolus!
Prevention:

Mobilization
Pneumatic compression devices
Prophylactic anticoagulation
Arterial Insufficiency
Acute Arterial Occlusion
Chronic

ischemia of the lower extremities
Causes
atrophic
changes
Atrophy of tissue
Thick nails
Thin, shiny skin
Decreased hair growth
Ulceration & gangrene
Postural color changes
Cool to touch
Intermittent Claudication
Acute

ischemia in an extremity
Signs & symptoms
- "The 6 Ps"
1.
Palor
2.
Paresthesia
3.
Paralysis
4.
Pain
5.
Polar
6.
Pulseless
A medical emergency!
Local arterial dilations
Cerebral > thoracic/abdominal aorta
Saccular
(one sided) vs.
fusiform
(circumferential)
BP = CO x SVR
Hypertension & Atherosclerosis
Copstead, L. & Banasik, J. (2013).
Pathophysiology
(5th ed.). St. Louis, MO: Elsevier.

Felver, L. (2013). Online Materials:
PROP- Pathophysiology online.
Retrieved from https://evolve.elsevier.com/

Lehne, R. (2013).
Pharmacology for nursing care
(8th ed.). St. Louis, MO: Saunders Elsevier.
Atherosclerosis
MAP = (2 x DBP) + SBP
3
DVT Ultrasound
PREVENTION
Nitric oxide/EDRF
Principal physiologic stimulus for endothelial nitric oxide (NO) synthesis is blood flow-induced shear stress resulting in vasodilitation
Inhibits platelet adhesion and aggregation
Blocks monocyte adhesion to the endothelium
Modulates the prothrombotic potential of the endothelial cell
Full transcript