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Lecture notes

Pathology of shock, hemorrhage and edema

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This note provides a better understanding and easy to understand knowledge on shock, hemorrhage and edema. I assure you distinction in your pathology just follow me as I give you best reading materials on different courses.

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SHOCK
Definition
Failure of circulation resulting in impaired tissue perfusion and circular hypoxia.
A. Hypovolemic Shock
● Reduction in volume of blood or plasma
● Hemorrhage (there's loss of whole blood)
● Extensive burns, peritonitis (where there's loss of plasma)
● Severe diarrhea (This involves the loss of fluid and electrolytes)
● Severe vomiting: Loss of fluid and electrolyte.
B. Normovolemic shock
The blood volume is normal
Examples
Cardiogenic shock
There's failure of cardiac pump
● Myocardial infarction
● Rupture cardiac aneurysm
● Arrhythmia
● Cardiac tamponade
● Massive pulmonary embolism.


Neurogenic Shock
● Excess nervous stimulation causes widespread reflux vasodilatation, hence blood accumulates
in the dilated capillaries with reduction in venous return and full of blood pressure.
cerebral anorexia may cause loss of consciousness as in
a. Severe burns
b. Visceral perforation
c. Renal colic
d. Emotional disturbances fear.
Anaphylactic shock
Marked vasodilatation and increased permeability.
Septic shock
Endotoxic shock caused by Gram-negative bacteria.
Gram-positive septicemia.
Hemorrhage
Definition
It is defined as the escape of blood from the vascular system.

, TYPES OF HAEMORRHAGE
A. External to outside of the Body
B. Interstitial into tissue spaces
C. Internal into body cavities.
External HEMORRHAGE
1. Epistaxis: This is defined as Bleeding from the nose
2. Hematemesis: This is defined as vomiting blood.
3. Hemoptysis: This is defined as coughing blood
4. Melena: This is defined as Dark color of partially digested blood in stool.
5. Hematuria: This is defined as Blood in urine
6. Menorrhagia: This is defined as Heavy menstrual bleeding.
7. Bleeding per rectum: This is defined as Fresh blood in the stools.
8. Hemorrhage from Skin.
B. INTERSTITIAL HAEMORRHAGE
1. Petechial hemorrhage: This is a small sports of hemorrhage
2. Ecchymosis: This is a moderate amount of blood
3. Haematoma: accumulation of Large amounts of blood causing swelling.
C. INTERNAL HAEMORRHAGE
1. Haemothorax: Hemorrhage into the pleura
2. Hemopericardium: Hemorrhage into the pericardium.
3. Hemoperitoneum: Hemorrhage into the peritoneum
4. Haematocele: Hemorrhage into the tunica vaginal is
5. Haemarthrosis: Hemorrhage into a Joint cavity
6. Cerebral Hemorrhage.
CAUSES OF HAEMORRHAGE
A. Physiological as menstruation
B. Pathological as:
1. Diseases of the vascular wall as atheroma and aneurysm, varicose veins.
2. Vascular erosion by Tuberculosis, malignant tumor, peptic ulcer, typhoid ulcer.
3. Inflammation as Bilharzia cystitis
4. Venous congestion
5. Hypertension
6. Accidental or surgical trauma to the vascular-wall.
7. Blood disease as hemophilia, purpura and leukemia
8. Vitamin C and K deficiency
EFFECTS OF HAEMORRHAGE
1. Small amounts do not affect because it is naturally arrested.

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