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This document discusses cyanosis, an abnormal bluish discoloration of the skin and mucous membranes caused by low oxygen levels in the blood. It defines cyanosis and explains that a minimal amount of deoxygenated hemoglobin is needed to produce the blue color. The document outlines the causes of central and peripheral cyanosis and differentiates conditions like methemoglobinemia that cause abnormal hemoglobin pigments but not true hypoxemia. Pseudocyanosis is also discussed, which is a blue skin discoloration not caused by abnormal blood oxygen levels.
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Cyanosis refers to a bluish color of the skin and mucous membranes resulting from an increased quantity of reduced hemoglobin/deoxyhemoglobin or abnormal hemoglobin derivatives, in the small blood vessels of those areas.
2 General 1 SCS.pptx ggggggggggggggggggg
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2 General Examination.pptx77777777777777777777777777777
This document summarizes key aspects of jaundice, cyanosis, anemia, clubbing, edema, and the lymphatic system. It describes:
1) The types and causes of jaundice including prehepatic, hepatic, and post-hepatic jaundice.
2) The definition and causes of cyanosis including central and peripheral cyanosis from cardiac or pulmonary diseases.
3) The definition and types of anemia including microcytic, macrocytic, and normocytic anemia from various underlying conditions.
4) The definition and major causes of clubbing involving the lungs, GI tract, and heart.
5) The physiology of edema formation and causes like heart failure
1. hemodynamic disorders edema, congestion.pptx
This document discusses various hemodynamic disturbances including congestion, hemorrhage, and edema. It defines these conditions and describes their morphological features. Congestion is a passive increase in blood volume due to impaired outflow, causing tissues to appear cyanotic or red-brown. Hemorrhage can be external or internal, and results from vessel rupture. Edema is the accumulation of fluid in interstitial spaces or cavities, and can be localized or generalized. It results from increased hydrostatic pressure, decreased oncotic pressure, lymphatic obstruction, sodium retention, or inflammation. The morphology of congestion, hemorrhage and edema in various organs is described.
Cyanosis & nail abnormalities
This document discusses cyanosis, defined as a bluish discoloration of the skin and mucous membranes due to high amounts of deoxygenated hemoglobin in the blood. Cyanosis can be central, occurring in the tongue and oral cavity due to low oxygen saturation in the lungs, or peripheral, occurring in the extremities due to reduced blood flow and oxygen extraction. Causes of central cyanosis include congenital heart defects and lung diseases, while peripheral cyanosis can be caused by exposure to cold, heart failure, or shock. Mixed cyanosis involves both central and peripheral features. Diagnosis involves blood tests and imaging exams, while treatment focuses on the underlying condition causing the cyanosis.
Disseminated intra vascular coagulation
disseminated intravascular coagulation is an abnormal blood clot in the blood vessels called dic. causes of this are any infection, cancer, liver disease, abnormal pregnancy, etc. signs and symptoms of this fever, petechiae, purpura, etc .treatment of this id anticoagulant agent like aspirin, plasma transfusion, etc
Disseminated intra vascular coagulation
In disseminated intravascular coagulation, abnormal clumps of thickened blood (clots) form inside blood vessels. These abnormal clots use up the blood's clotting factors, which can lead to massive bleeding in other places. Causes include inflammation, infection and cancer.
Symptoms include blood clots and bleeding, possibly from many sites in the body.
The goal is to treat the underlying cause and provide supportive care through intravenous fluids and blood transfusions.
The cv system
The document discusses the cardiovascular system and high cholesterol. It describes the main parts of the cardiovascular system including capillaries, veins, the heart, and blood vessels. It then discusses several conditions related to high cholesterol, including coronary heart disease, arteriosclerosis, and atherosclerosis. Diagnostic procedures for detecting high cholesterol like serum lipoprotein levels are mentioned. The document concludes by outlining some surgical procedures used to treat conditions caused by high cholesterol, such as endarterectomy and intracoronary artery stents, as well as medications and lifestyle changes that can help treat and prevent coronary artery disease.
Veeu gangrene ppt 5 th term
Gangrene is the death of body tissue due to lack of blood supply or infection. There are two main types - dry gangrene which occurs when arterial blood supply is cut off but venous drainage is intact, and wet gangrene where both arterial inflow and venous outflow are obstructed, leading to infection and putrefaction. Causes include arterial occlusion, venous obstruction, trauma, and infection. Treatment depends on the type and severity, and may include antibiotics, debridement, amputation, or limb salvage procedures to restore blood flow.
Shock
Shock is characterized by impaired cellular metabolism and decreased tissue perfusion. There are four main types of shock: hypovolemic, vasogenic, cardiogenic, and neurogenic. The stages of shock progression include initial, compensatory, progressive, and irreversible. Management aims to restore fluid volume, increase cardiac output, and remove the precipitating cause. Nursing care focuses on monitoring vital signs, administering IV fluids and oxygen, maintaining perfusion, preventing complications, and supporting organ function.
Arterial occlusion
This document discusses arterial occlusion of the blood supply to the eye. It notes that embolism is the most common cause, often originating from carotid artery stenosis, heart conditions, or local atheroma. Systemic conditions like hypertension and diabetes can also increase risk. Emboli form centrally or in branch retinal arteries and can be fibrin platelet, cholesterol, or calcific. Patients experience sudden painless vision loss or transient episodes. Examination may reveal emboli in retinal arteries or later ischemic changes. Investigations include ophthalmoscopy, angiography, and cardiovascular exams. Treatment focuses on dilating arteries using medications or techniques to pass emboli or restore flow. Outcomes range from full recovery with transient episodes to permanent
Patofisiologi edema
Oedema, or swelling, is caused by an abnormal accumulation of fluid in the interstitial tissue spaces. There are two main types - localized oedema affecting an organ or limb, and generalized oedema known as anasarca. The physiology of oedema involves a balance between hydrostatic pressure pushing fluid out of blood vessels and oncotic pressure pulling fluid back in. Disruptions to this balance that can cause oedema include decreased oncotic pressure, increased hydrostatic pressure, lymphatic obstruction, and increased capillary permeability. Common causes of oedema include cardiac, renal, and hepatic diseases.
HAEMODYNAMIC DISORDERS SESSION 1.pdf
This document discusses haemodynamic disorders and covers topics like hyperemia, congestion, edema, and hemorrhage. It begins by explaining how blood circulation and fluid homeostasis are important for tissue health and outlines some key abnormalities that can occur when these are disrupted, including edema, vascular congestion, hemorrhage, thrombosis, embolism, and infarction. It then focuses on hyperemia and congestion, defining them and describing their gross and microscopic morphological changes. Next, it covers the different types of edema like localized vs generalized and pitting vs non-pitting. The document concludes by defining hemorrhage and outlining its clinical manifestations like hematomas, petechiae, and purpura.
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cyanosis_1.pptx
- 1. Cyanosis Dr Kevin Zammit MD FRCEM Emergency Medicine Consultant Lister Hospital, Stevenage
- 2. Cyanosis
- 3. Cyanosis
- 5. Cyanosis • Abnormal bluish discolouration of the skin and mucous membranes. • Increased amounts of bluish-coloured haemoglobin – deoxygenated haemoglobin. • Superficial vessels of the skin. • Best appreciated – lips, nose, cheeks, oral cavity (vessels abundant and overlying dermis is thin). • Central vs Peripheral – bedside decision – implies different aetiologies.
- 6. History • 1761 – Morgagni described cyanosis first in relation to pulmonary stenosis. • 1869 – Bernard described the qualitative difference in blood gases between blue venous blood and red arterial blood. • 1919 – Lundsgaard quantified how much deoxygenated haemoglobin is needed to produce cyanosis.
- 7. The blue colour • Minimal amount of deoxygenated blood is reached (2.38g/dL in arterial blood). • Blue blood can be seen through the opaque dermis. • Cyanosis will remain if absolute amount of deoxygenated blood stays the same – oxyhaemoglobin concentration irrelevant. • Colour of skin depends on colour of blood flowing through dermal capillaries. • Blanches in response to pressure on skin.
- 8. The blue colour • Appearance of cyanosis depends on the absolute quantity of deoxyhaemoglobin NOT the relative amount. • If anaemic, a patient has less haemoglobin and will reach the minimal amount of deoxyhaemoglobin later than a polycythaemic patient! • Cyanosis appears later in anaemic patients than in polycythaemic patients. • Anaemic patient will be more hypoxic once cyanosis appears.
- 9. Cyanosis and Haemoglobin Concentration Haemoglobin Concentration (g/dL) CYANOSIS APPEARS Oxygen Sats (%) CYANOSIS APPEARS Arterial PO2 (KPa) 6 60 4.1 8 70 4.8 10 76 5.3 12 80 6.0 14 83 6.26 16 85 6.66 18 87 7.19 20 88 7.47
- 10. Central vs Peripheral CENTRAL • Blood leaving heart coloured blue. • Lips, hands, feet. • Long standing – associated clubbing. PERIPHERAL • Blood leaving heart is red but becomes blue by the time it reaches peripheries. • Hands and feet. • Increased extraction of oxygen by peripheral tissues. • Deoxygenated blood in capillaries increases. • Rubber band around finger. • Warming.
- 11. Pulse oximetry / ABGs • Central cyanosis – abnormal ABGs and pulse oximetry readings. • Peripheral cyanosis – normal ABGs (proximal sampling) BUT abnormal oximetry readings.
- 13. Causes of cyanosis • ANY DISORDER CAUSING HYPOXAEMIA enough to achieve the minimum absolute amount of abnormal haemoglobin (>2.38 g/dL arterial deoxyhaemoglobin). • INTRACARDIAC RIGHT TO LEFT SHUNTS • PERIPHERAL – low cardiac output, arterial disease, Raynaud’s disease, venous disease. • ABNORMAL HAEMOGLOBINS
- 14. Methemoglobinaemia The Fugates of Kentucky (“The Blue Fugates”)
- 15. Methemoglobinaemia • Congenital or Acquired • Chocolate cyanosis (brownish hue) • ABGs will show normal PaO2. • Does not improve with oxygen therapy. • Severity of symptoms depends on quantity, rapidity of onset and presence of comorbidities. • Reversible with Methylene blue.
- 17. Causes Sulfhemoglobinaemia • Phenacetin • Industrial aniline compounds • Rare due to improved occupational health standards • Irreversible. Methemoglobinaemia • Hereditary – NADH methemoglobin reductase • Benzocaine • Nitrates • Nitrites
- 18. Carboxyhaemoglobinaemia • Does not cause real cyanosis • Cherry red colour of the skin?
- 19. Flexman AM. Dark green blood in the operating theatre. Lancet. 2007 Jun 9;369(9577)1972
- 20. Pseudocyanosis
- 21. Pseudocyanosis • “Papa Smurf” • Drank and applied colloidal silver for a skin condition.
- 22. Pseudocyanosis
- 23. Pseudocyanosis • Does not blanch with pressure. • Colour is not from abnormally coloured blood but from abnormal deposition of blue pigments in the skin. • Mucous membranes of mouth are pink. • Normal ABGs and normal pulse oximetry readings. • Causes include – silver therapy, gold therapy, amiodarone, minocycline, chloroquine.
- 25. Summary • LATE SIGN – prevent it if possible. • OXYGEN! • If no improvement with oxygen, think of differential diagnosis.