血液循环障碍教学课件.pptx

血液循环系统障碍Hemodynamic Disorders;《心血运动论》 威廉·哈维 An Anatomical Study of the Motion of the Heart and of the Blood in Animals, 1628; Containing Heart, artery, Vein General circulation Pulmonary circulation Functions Deliver oxygen and nutrients Carry away metabolic wastes ;血液稳态 Normal homeostasis 血管壁完整性 vessel wall integrity 静水压 intravascular pressure 胶渗压 osmolarity 正常凝血 normal hemostasis ;Circulation Disturbance;Words and Vocabularies ;EDEMA (水肿);EDEMA;EDEMA;特殊类型 Hydrothorax 胸腔积液 hydropericardium 心包腔积液 hydroperitoneum (ascites) 腹腔积液 Anasarca 全身性水肿 ;HYPEREMIA CONGESTION 充血和淤血;Hyperemia: active process 主动过程; red, raised temperature, increased volume （红 热 肿） enhanced function 功能增强; ;机制： 血管舒张神经兴奋性↑ 血管收缩神经兴奋性↓ 类型： 生理性： 如害羞时，运动时，进餐后 病理性：炎性充血，减压后充血 利弊： － plenty supply of O2, functional enhancement, nutrition substance － headache , hemorrhage, stroke ;Pathologic changes Gross — Florid in color － Raised temperature － Enlarged volume of organ or tissue LM －Dilation of arteriole and capillary stuffing with RBC;Causes: 全身性: 体循环淤血，肺循环淤血 cardiac dysfunction (right or left) 局灶性: 局部静脉受压或阻塞 external compression --- tumor, bandage occlusion of lumen --- thrombosis, embolism thickening of venous wall paralysis of neurogenic modulation --- burn, frostbite ;CONGESTION;CONGESTION;Morphology 大体 镜下小血管内富含红细胞 ;肺 急性肺淤血 acute pulmonary congestion Gross: 肺饱满肿胀，胸膜光亮，切面流出泡沫状红色水肿液体 (edematous fluid) LM: 肺泡壁毛细血管高度扩张充血——串珠样、玫瑰样 肺泡腔“虚实不一”，充满嗜酸性水肿液 临床病理联系 气促、发绀、粉红色泡沫痰 foamy pinky sputum;慢性肺淤血 chronic pulmonary congestion 多由风湿性心瓣膜病伴心功能不全引起 Gross: 质地较硬，棕褐色，散在分布有棕色小点 —— 褐色硬化 (Brown Induration) LM: 肺泡壁(septa)增厚纤维化 心衰细胞 (heart failure cells) ——吞噬红细胞并将血红蛋白分解形成棕黄色的含铁血黄素（hemosiderin）的巨噬细胞 — hemosiderin-laden macrophage 临床病理联系： 咳嗽，咳铁锈色痰，呼吸困难;肝 急性肝淤血 acute hepatic congestion 大体：肝脏体积增大，呈暗红色 镜下： 小叶中央静脉和肝窦(sinus