tulburari circulatorii (1)

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 1/28

Disciplina Anatomie Patologica

Facultatea de Medicina

Universitatea ³Ovidius´ Constanta

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 2/28

Sinonime ± hiperemie pasiva, congestia

Definitie ± cresterea masei sangvine la nivelul venelor si

capilarelor in conditiile unei circulatii arteriale normale.

Tipuri:

- locala

- regionala- generalizata

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 3/28

- marite de volum si greutate

- consistenta cresuta

- cianotice- capsula in tensiune

- la sectionare se scurge sange venos in cantitatevariabila

- + aspecte macroscopice particulare specifice fiecaruiorgan

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 4/28

Cauze:

- stenoza mitrala (cauza cea mai frecventa)

- afectiuni insotite de cresterea debitului sangvin deintoarcere, altele decat HTA.

Clinic:

- dispnee

- ortopnee

- tuse productiva- raluri umede

- facies caracteristic

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 5/28

- plaman marit de volum si greutate

- cianotic (rosu-violaceu)

- consistenta cresuta

- crepitatii diminuate- la docimazie fragmentele de tesut pulmonar plutesc la

suprafata vasului cu apa/intre doua ape

- la sectionare se scurge sange venos si lichid de edem

- zone de culoare bruna si consistenta ferma pesuprafata de sectiune

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 6/28

Staza pulmonara

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 7/28

Forma recenta:

- hiperemia capilarelor alveolare

- hematii extravazate in numar redus in spatiile alveolare

- cantitate variabila de lichid de edem in spatiile alveolaresi interstitiu

Forma veche prezinta in plus:

- fibroza la nivelul peretilor alveolari- macrofage incarcate cu hemosiderina

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 8/28

Plaman aspect microscopic normal

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 9/28

Plaman cu staza recent instalata

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 10/28

Staza pulmonara cronica.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 11/28

Staza pulmonara cronica macrofage incarcate cu hemosiderina

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 12/28

Staza pulmonara acuta edem pulmonar.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 13/28

Edem pulmonar.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 14/28

Cauze:

- insuficienta cardiaca dreapta

- insuficienta cardiaca globala.

Clinic:

- ficat marit mult sub rebordul costal

- jena dureroasa hipocondrul drept

- circulatie colaterala prezenta (³cap de meduza´)

- reflux hepato-jugular - alte semne si simptome ale ICD/ICG

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 15/28

- marit de volum si greutate

- cianotic

- capsula in tensiune

- la sectionare se scurge sange venos

S uprafata de sectiune cu urmatoarele aspecte:

- ficat muscad (staza recenta ± ficat pestrit)

- ficat in cocarda (staza prelungita)

- ficat intervertit (staza avansata)- fibroza hepatica de origine cardiaca (ciroza cardiaca).

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 16/28

Ficat de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 17/28

Ficat de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 18/28

Ficat de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 19/28

- hiperemia venelor centrolobulare

- hiperemia capilarelor sinusoide

- distrofie grasa la nivelul zonei mediolobulare (ficat incocarda)

- atrofia si necroza hepatocitelor pericentrolobulare,

leziuni accentuate de distrofie grasa mediolobulara,hepatocitele zonei I indemne (ficat intervertit)

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 20/28

Ficat de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 21/28

Ficat de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 22/28

Cauze:

- unilaterala ± tromboza de vena renala (compresiuni,

stenoze, etc).

- bilaterala ± insuficienta cardiaca dreapta, insuficienta

cardiaca globala.

Clinic:

- fara manifestari specifice

- nicturie.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 23/28

- marit de volum si greutate

- capsula in tensiune

- se decapsuleaza cu usurinta- la sectionare se scurge sange venos

- hiperemia intensa a medularei (rosie-violacee)

- hemoragii punctiforme la nivelul corticalei, care persista

la spalarea piesei

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 24/28

Rinichi de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 25/28

Rinichi de staza.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 26/28

- hiperemia capilarelor glomerulare care determina

marirea ghemurilor glomerulare

- reducerea spatiului subcapsular 

- hematii extravazate in spatiul subcapsular 

- hiperemia capilarelor peritubulare

- leziuni distrofice tubulo-epiteliale.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 27/28

Staza renala.

5/12/2018 Tulburari circulatorii (1) - slidepdf.com

http://slidepdf.com/reader/full/tulburari-circulatorii-1 28/28