Chapter 3
Disorders of
vascular flow
Department of pathology longjie
Hyperemia (充血）
Hemorrhage （出血）
Thrombosis （血栓形成 ）
Embolism （栓塞）
infarction （梗死）
Local increased volume of blood in an
affected tissue or organ.
Arterial ~ (active ~) hyperemia (充血 )
Venous ~ (passive ~) congestion (淤血 )
Hyperemia (充血 )
Arterial hyperemia
Active process resulting from
augmented blood flow due to
arteriolar dilation.
Types:
1,Physiological,muscle exercise
2,Inflammatory,
3,decompressing,Morphology,
redder
hotter
mild turgid
congestion
Passive process resulting
from block (obstruction)of
venous drainage (outflow).
Causes,
1,Compression of veins
2,Obstruction of venous lumen,thrombi
3,Heart failure
Morphology
Micro,
engorgement of
capillaries and venules,minute
hemorrhage.
Cut surface,excessively bloody
Body surface,cyanosis (nail,lip)
lower temperature
Gross:
swollen
heavier
blue-red
hyperemia
sequels
1,Congestive adema
2,Congestive hemorrhage
3,Parenchyma degeneration or necrosis
4,Congestive sclerosis
Congestion of
important organs
lung liver
Pulmonary congestion
1,left heart failure
2,acute ~, congestion of alveolar cap.
minute hemorrhage,edema,heart failure cells
3,Chronic~, fibrosis and hemosiderin
deposition,pulmonary hypertension.
edema
Symptoms,dyspenea (呼吸困难）
hypoxia （ 缺氧）
Cyanosis （紫绀）
Bloody or tinged rusty sputum（铁锈痰）
Congestion of liver
right heart failure
Morphology:
1.central ( red-blue color grossly):
Dilatation of central veins and blood sinusoids,
Minute hemorrhage,atrophy and necrosis of local liver cells
2.peripheral ( yellow-brown)
Slight congestion,fatty degeneration of liver cells,Nutmeg liver
3,Heart cirrhosis
Netmeg li
Hemorrhage (出血 )
Extravasation of blood due to
rupture of blood vessel.
hematoma
petechia
echymosis血肿 淤点
淤斑
Rupturing Hemorrhage ( 破裂性出血）
Transudatory Hemorrhage ( 漏出性出血）
出血灶
破
裂
性
出
血
小腿皮下出血
thrombsis (血栓形成 )
The process of formation of
a solid mass from
constituents of the blood
within vessels or the heart
in a living body.
thrombus
血栓
Predisposing factors of thrombosis
thrombosis
Endothelial injury
Abnormal blood flow hypercoagulability
Vascular and cardiac endothelial
injury
phlebitis
Rheumatic endocarditis
Bacterial endocarditis
Atherosclerotic plaque
Cardiac infarction
exposure of subendothelial
collagens and PL aggregation
Initiates thrombosis
Slowing and turbulence of blood flow
Left atria of miral stenosis of
rheumatic endocarditis
Aneurysm (动脉瘤 )
Patients prolonged bed rest
Bring PL into contact with endothelium
Causes mild injuty of endothelium and collagen exposure
Prevents dilution and clearance of blood clotting factors
in loction
Hypercoagulability of
blood
postpartum
pastoperation
Post-trauma
Atherosclerosis
DIC
Increase in amount of and viscosity of
platelets and blood clotting factors
Process of thrombosis
Types of thrombi
Pale thrombus
Mixed thrombus
Red thrombus
microthrombus
1.formd under high speed of blood flow in
arteries or heart.
2.composed of PL,trabecula,less fibrin network
and white,red cells trapped,
3.gross,dry,friable,gray polyp-like mass.
4.tightly attached to the endothelium injured.
Pale thrombus
1.formd under slower-moving blood in A,V or
heart.
2,Head tail
PL,trabecula + fibrin network + WBC + RBC.
body
3,Gross,gray layers + red layers
Mixed thrombus
1,Closely resembles to blood clot,RBC+
fibrin network.
2,Tail part of mixed thrombus.
3,Thrombi in systemic veins,portal veins,
heart and aorta.
1.seen undermicroscopy
2,Occure in microcirculation
3.mainly composed of fibrin
透明血栓
The fate of thrombi
1,Softening,dissolving
2,Organization,replaced by granulation tissue
3,Calcification,phlebolith (静脉石 )
机化
organization
再通
recanalization
Recanalization (再通）
The effects of thrombi
to the body
1.occlusion of vessels
2.thrombi-embolism
3.distorted cardiac valves
4,DIC
embolism (栓塞 )
The process of a detached
intravascular solid,
liquid,gaseous mass that is
carried by the blood to a site
distant from its point of
origin.
embolus
栓子 99%, thrombus1%,air,amniotic fluid,fat,tumor
Types of embolism
1,Thromboembolism (血栓栓塞 )
2,Gas embolism (气体栓
塞 )
3,Amniotic fluid embolism (羊水栓塞 )
4,Fat embolism (脂肪
栓塞 )
5,Other,tumor,bacteria… …
1.Thromboembolism
Pulmonary thromboembolism
Systemic thromboembolism
Pulmonary thromboembolism
1) Thromboemboli originate from deep leg veins.
2) Small emboli,clinically silent.
Left failure +lung congestion + emboli infarction
3) large or more emboli,sudden death,right failure.
肺动脉内
血栓
肺动脉内
血栓
左心 (SBE) 房缺、室缺
右心、Ｖ下肢、脑、肾
脾梗死
Systemic thromboembolism
2,gas embolism
1) Air embolism
2) decompression sickness
3,Amniotic fluid embolism
Infusion of amniotic fluid into the
maternal circulation via a tear in
the placental membranes and
rupture of uterine veins.
角化上皮
4,Fat embolism
1) After fractures of long bones.
2) In the setting of soft tissue
trauma and bums.
肺血管内的脂肪
（苏丹 Ⅲ 染色红色）
5,Other embolism
1) tumor
2) parasitism
3) becteria
infaction
Tissue necrosis resulting from
extreme reduction or loss of
blood supply( vascular
occlusion).
ischemia
缺血
Thrombosis
Embolism
of arteries
Compression
and
obliteration
Arteria
l
spasm
causes
Factors that influence
development of an infaction
1,nature of the vascular supply
2,rate of development of occlusion
3,vulnerability to hypoxia
4,oxygen content of blood
Morphology
Types of necrosis:
Coagulative~,Solid organ,heart,kidney,spleen,lungs and intestine
Liquefective~,cerebral malacia
shapes:
1.depend on vascular distribution of the organ.
2,Kidneys,lung,spleen,pyramid shaped
3,Heart,brain,irregular,map shaped
梗死区
Types of infarction
Ischemic(white) infarct
Hemorrhagic(red) infarct
Ischemic infarct
1) Solid organs with deficient collateral
circulation of arteries.
2) gross,wedge-like,triangle-like,map-like
necrotic foci with hemorrhagic zone.
3) micro,coagulative necrosis
liquefactive necrosis(brain)
The fate of ischemic
infarction
The infact will be organized,scar form eventually.
Hemorrhagic infarct
Occure in organ:
1,With venous occlusion
2,Be composed of loose tissues,lung
3,With dual circulation (lung,small intestine)
4,Associate with congestion
5,Flow is re-established to a site of previous
arterial occlusion and necrosis.
lung
Morphology
Gross,blue-red,wet,bloody
necrosis foci
Micro,necrosis + hemorrhage
肠出血性梗死
的梗死区
Fate of infaction
1,Scar formation
2,death
Disorders of
vascular flow
Department of pathology longjie
Hyperemia (充血）
Hemorrhage （出血）
Thrombosis （血栓形成 ）
Embolism （栓塞）
infarction （梗死）
Local increased volume of blood in an
affected tissue or organ.
Arterial ~ (active ~) hyperemia (充血 )
Venous ~ (passive ~) congestion (淤血 )
Hyperemia (充血 )
Arterial hyperemia
Active process resulting from
augmented blood flow due to
arteriolar dilation.
Types:
1,Physiological,muscle exercise
2,Inflammatory,
3,decompressing,Morphology,
redder
hotter
mild turgid
congestion
Passive process resulting
from block (obstruction)of
venous drainage (outflow).
Causes,
1,Compression of veins
2,Obstruction of venous lumen,thrombi
3,Heart failure
Morphology
Micro,
engorgement of
capillaries and venules,minute
hemorrhage.
Cut surface,excessively bloody
Body surface,cyanosis (nail,lip)
lower temperature
Gross:
swollen
heavier
blue-red
hyperemia
sequels
1,Congestive adema
2,Congestive hemorrhage
3,Parenchyma degeneration or necrosis
4,Congestive sclerosis
Congestion of
important organs
lung liver
Pulmonary congestion
1,left heart failure
2,acute ~, congestion of alveolar cap.
minute hemorrhage,edema,heart failure cells
3,Chronic~, fibrosis and hemosiderin
deposition,pulmonary hypertension.
edema
Symptoms,dyspenea (呼吸困难）
hypoxia （ 缺氧）
Cyanosis （紫绀）
Bloody or tinged rusty sputum（铁锈痰）
Congestion of liver
right heart failure
Morphology:
1.central ( red-blue color grossly):
Dilatation of central veins and blood sinusoids,
Minute hemorrhage,atrophy and necrosis of local liver cells
2.peripheral ( yellow-brown)
Slight congestion,fatty degeneration of liver cells,Nutmeg liver
3,Heart cirrhosis
Netmeg li
Hemorrhage (出血 )
Extravasation of blood due to
rupture of blood vessel.
hematoma
petechia
echymosis血肿 淤点
淤斑
Rupturing Hemorrhage ( 破裂性出血）
Transudatory Hemorrhage ( 漏出性出血）
出血灶
破
裂
性
出
血
小腿皮下出血
thrombsis (血栓形成 )
The process of formation of
a solid mass from
constituents of the blood
within vessels or the heart
in a living body.
thrombus
血栓
Predisposing factors of thrombosis
thrombosis
Endothelial injury
Abnormal blood flow hypercoagulability
Vascular and cardiac endothelial
injury
phlebitis
Rheumatic endocarditis
Bacterial endocarditis
Atherosclerotic plaque
Cardiac infarction
exposure of subendothelial
collagens and PL aggregation
Initiates thrombosis
Slowing and turbulence of blood flow
Left atria of miral stenosis of
rheumatic endocarditis
Aneurysm (动脉瘤 )
Patients prolonged bed rest
Bring PL into contact with endothelium
Causes mild injuty of endothelium and collagen exposure
Prevents dilution and clearance of blood clotting factors
in loction
Hypercoagulability of
blood
postpartum
pastoperation
Post-trauma
Atherosclerosis
DIC
Increase in amount of and viscosity of
platelets and blood clotting factors
Process of thrombosis
Types of thrombi
Pale thrombus
Mixed thrombus
Red thrombus
microthrombus
1.formd under high speed of blood flow in
arteries or heart.
2.composed of PL,trabecula,less fibrin network
and white,red cells trapped,
3.gross,dry,friable,gray polyp-like mass.
4.tightly attached to the endothelium injured.
Pale thrombus
1.formd under slower-moving blood in A,V or
heart.
2,Head tail
PL,trabecula + fibrin network + WBC + RBC.
body
3,Gross,gray layers + red layers
Mixed thrombus
1,Closely resembles to blood clot,RBC+
fibrin network.
2,Tail part of mixed thrombus.
3,Thrombi in systemic veins,portal veins,
heart and aorta.
1.seen undermicroscopy
2,Occure in microcirculation
3.mainly composed of fibrin
透明血栓
The fate of thrombi
1,Softening,dissolving
2,Organization,replaced by granulation tissue
3,Calcification,phlebolith (静脉石 )
机化
organization
再通
recanalization
Recanalization (再通）
The effects of thrombi
to the body
1.occlusion of vessels
2.thrombi-embolism
3.distorted cardiac valves
4,DIC
embolism (栓塞 )
The process of a detached
intravascular solid,
liquid,gaseous mass that is
carried by the blood to a site
distant from its point of
origin.
embolus
栓子 99%, thrombus1%,air,amniotic fluid,fat,tumor
Types of embolism
1,Thromboembolism (血栓栓塞 )
2,Gas embolism (气体栓
塞 )
3,Amniotic fluid embolism (羊水栓塞 )
4,Fat embolism (脂肪
栓塞 )
5,Other,tumor,bacteria… …
1.Thromboembolism
Pulmonary thromboembolism
Systemic thromboembolism
Pulmonary thromboembolism
1) Thromboemboli originate from deep leg veins.
2) Small emboli,clinically silent.
Left failure +lung congestion + emboli infarction
3) large or more emboli,sudden death,right failure.
肺动脉内
血栓
肺动脉内
血栓
左心 (SBE) 房缺、室缺
右心、Ｖ下肢、脑、肾
脾梗死
Systemic thromboembolism
2,gas embolism
1) Air embolism
2) decompression sickness
3,Amniotic fluid embolism
Infusion of amniotic fluid into the
maternal circulation via a tear in
the placental membranes and
rupture of uterine veins.
角化上皮
4,Fat embolism
1) After fractures of long bones.
2) In the setting of soft tissue
trauma and bums.
肺血管内的脂肪
（苏丹 Ⅲ 染色红色）
5,Other embolism
1) tumor
2) parasitism
3) becteria
infaction
Tissue necrosis resulting from
extreme reduction or loss of
blood supply( vascular
occlusion).
ischemia
缺血
Thrombosis
Embolism
of arteries
Compression
and
obliteration
Arteria
l
spasm
causes
Factors that influence
development of an infaction
1,nature of the vascular supply
2,rate of development of occlusion
3,vulnerability to hypoxia
4,oxygen content of blood
Morphology
Types of necrosis:
Coagulative~,Solid organ,heart,kidney,spleen,lungs and intestine
Liquefective~,cerebral malacia
shapes:
1.depend on vascular distribution of the organ.
2,Kidneys,lung,spleen,pyramid shaped
3,Heart,brain,irregular,map shaped
梗死区
Types of infarction
Ischemic(white) infarct
Hemorrhagic(red) infarct
Ischemic infarct
1) Solid organs with deficient collateral
circulation of arteries.
2) gross,wedge-like,triangle-like,map-like
necrotic foci with hemorrhagic zone.
3) micro,coagulative necrosis
liquefactive necrosis(brain)
The fate of ischemic
infarction
The infact will be organized,scar form eventually.
Hemorrhagic infarct
Occure in organ:
1,With venous occlusion
2,Be composed of loose tissues,lung
3,With dual circulation (lung,small intestine)
4,Associate with congestion
5,Flow is re-established to a site of previous
arterial occlusion and necrosis.
lung
Morphology
Gross,blue-red,wet,bloody
necrosis foci
Micro,necrosis + hemorrhage
肠出血性梗死
的梗死区
Fate of infaction
1,Scar formation
2,death
