This document discusses hemodynamic disorders and thrombosis. It covers several topics including edema, congestion, hemorrhage, thrombosis, embolism, and infarction. Edema is an accumulation of fluid in tissues and organs, and can occur in the lungs (pulmonary edema), abdomen (ascites), and brain. Congestion and hyperemia involve increased blood volume in organs and tissues, seen in conditions like heart failure and liver disease. Thrombosis is the formation of a clot (thrombus) in a blood vessel. Key factors in thrombosis are described by Virchow's triad. Thrombi can embolize and block vessels in other organs, potentially leading to infarction or tissue death.

1. HEMODYNAMIC DISORDERS
&
THROMBOSIS

2. Edema

3. Edema

6. Normal alveoli

7. Pulmonary Edema

8. Fluid in Trachea/Bronchi

9. Abdominal Ascites

11. Edematous Brain

12. Normal Brain

14. Hyperemia and Congestion

15. Congestion and Hyperemia

16. CONGESTION AND HYPEREMIA

17. Congested Lungs

18. Acute Pulmonary Congestion

19. Heart Failure Cells” in Alveoli“
Chronic Pulmonary Congestion

21. Congested and Enlarged Spleen

22. Nutmeg Liver
• A descriptive term for a liver with chronic
passive congestion, a hepatopathy due to
cardiac decompensation and failure.
• If the congestion is severe, these changes may
be accompanied by haemorrhagic necrosis

24. Nutmeg liver

25. Microscopically, the nutmeg pattern results from congestion
around the central veins, as seen here.
This is usually due to a "right sided" heart failure
.

26. • Liver is divided histologically into lobules.
• The center of the lobule is the central vein.
• At the periphery of the lobule are portal triads.

28. • Functionally, the liver can be divided into
three zones, based upon oxygen supply.
• Zone 1 encircles the portal tracts where the
oxygenated blood from hepatic arteries enters.
•
• Zone 3 is located around central veins, where
oxygenation is poor. Zone 2 is located in
between.

29. Hemorrhage

30. • Petechiae measure less than 3 mm.
• Purpura measure 0.3–1 cm.
• Ecchymoses greater than 1 cm.

33. • Here are petechial
hemorrhages seen
on the epicardium
of the heart.
• Petechiae (pinpoint
hemorrhages)
represent bleeding
from small vessels
and are classically
found when a
coagulopathy is due
to a low platelet
count.
• They can also
appear following
sudden hypoxia.

34. • The blotchy areas of hemorrhage in the skin are
called ecchymoses (singular ecchymosis), or also as
areas of purpura.
• Ecchymoses are larger than petechiae.
• They can appear with coagulation disorders.

36. Intracerebral Hemorrhage
Photo: Kumar, Cotran, Robbins. Robbins Basic pathology, 7 th ed., Saunders, Philadelphia, 2003.

37. Intracerebral Hemorrhage

38. Pericardial Hemorrhage

39. Hemostasis and Thrombosis

40. THROMBOSIS -Virchow triad

41. Thrombus - Morphology
Venous
Arterial
 Arise in arteries
 Arise in deep veins and
superficial veins (popleteal 
Femoral Iliac),
 Grow in retrograde fashion
(towards the heart)
 Antigrade
 Forms at site of Endothelial
injury (AS), turbulence
(aneurysms)
 At site of stasis (lower
extremities)
 Pale/ white
 Red / dark
 Lines of Zahn
 No lines of Zahn

42. • These are "lines of Zahn" which are the alternating
pale pink bands of platelets with fibrin and red
bands of RBC's forming a true thrombus.

43. Venous Thrombi: Clinical

44. Thrombotic Vegetations
Mitral Valve
Photo: Stevens A, Lowe J. Slide atlas of pathology. Mosby, London, 1995.

45. Abdominal Aortic Aneurysm Thrombus

46. (Deep Vein Thrombosis (DVT

47. Plaque with Recent Thrombus

48. Thrombosis
Outcomes
Photo: Kumar, Cotran, Robbins. Robbins Basic pathology, 7 th ed., Saunders, Philadelphia, 2003.

49. Early Organizing Thrombus

50. Embolism

51. Embolization (Embolus(
Thromboembolism of Pulmonary Artery
Photo: Kumar, Cotran, Robbins. Robbins Basic pathology, 7 th ed., Saunders, Philadelphia, 2003; . Stevens A, Lowe J. Slide atlas of pathology. Mosby, London, 1995.

52. Infarction

53. Infarction (Infarct(
(Lung (Left(; Spleen (Right
Photo: Kumar, Cotran, Robbins. Robbins Basic pathology, 7 th ed., Saunders, Philadelphia, 2003.

54. Pulmonary Infarction

55. Small Intestine Infarction

57. Kidney Infarction
(Replaced by Fibrotic Scar (Left

58. Pale Infarct (Wedge( of Spleen

59. Thanks