tailieunhanh - Ebook Basic pathology (4th edition): Part 2

Part 2 book "Basic pathology" presentation of content: presentation of content: Vascular occlusion and thrombosis, atherosclerosis and hypertension, circulatory failure, benign grown disorders, menign grown disorders, what causes cancer, molecular genetics of cancer, the behaviour of tumours, the clinical effects of tumours. | Prologue: What is a disease? 163 PART 3 CIRCULATORY DISORDERS Introduction: Features of circulatory disorders 165 Chapter 7: Vascular occlusion and thrombosis 169 Vascular occlusion Thrombosis Embolism Disseminated intravascular coagulation Chapter 8: Atherosclerosis and hypertension Clinical case: atherosclerosis Hypertension Aneurysms Chapter 9: Circulatory failure 169 169 180 186 189 189 203 207 Shock Clinical case: myocardial infarction Anaemia Organ damage due to poor perfusion Strokes Clinicopathological case study: circulatory failure 211 211 211 220 227 229 236 This page intentionally left blank INTRODUCTION FEATURES OF CIRCULATORY DISORDERS When I first applied my mind to observation from the many dissections of Living Creatures as they came to hand, that by that means I might find out the use of the motion of the Heart and things conducible in Creatures; I straightways found it a thing hard to be attained, and full of difficulty, so with Fracastorius I did almost believe, that the motion of the heart was known to God alone. William Harvey (1578–1657) It is extraordinary to think that diseases whose effects are as diverse as those of gangrene, strokes, heart attacks and divers’‘bends’ are all disorders of the circulatory general features of circulatory disorders are almost the opposite of the cardinal features of inflammation, which are covered in part 1: for ‘calor (heat), rubor (redness), tumor (swelling) and dolor (pain)’ read ‘coldness, pallor/cyanosis, pain and loss of sensation’. Why is this? The drop in temperature and change in colour are easily understood, since blood carries body heat from the core and dissipates it in the extremities and it is the red colour of the oxygenated haemoglobin pigment in the red blood cells which makes pale-skinned persons look pink. Anything decreasing blood flow to a finger or toe will decrease the tissue perfusion by warm blood, making it cold and pale, and any delay in delivery of red