Virchow'sTriad

Lindie Metz
Mind Map by Lindie Metz, updated more than 1 year ago
Lindie Metz
Created by Lindie Metz over 4 years ago
5
1

Description

? Pathology Mind Map on Virchow'sTriad, created by Lindie Metz on 03/21/2016.

Resource summary

Virchow'sTriad
1 ENDOTHELIAL INJURY
1.1 Exposure of subEN ECM
1.2 Platelet adhesion
1.3 Release of Tissue factor
1.4 NB cause of arterial thrombus formarion
1.5 d/t MI, atherosclerosis leading to ulcerated plaques, vasculitis
1.6 Prothrombotic
1.6.1 Hypertension
1.6.2 Bacterial endotoxins
1.6.3 Hypercholesterolaemia
1.6.4 Radiation
1.6.5 Cigarette smoking
1.7 Mural thrombi – in chambers of heart d/t abnormal contraction
1.7.1 Rheumatic heart dx > mitral valve stenosis > LA dilation > atrial fibrilation
1.8 In aorta d/t anuerism, ruptured atherosclerotic plaque, often occludes
2 BLOOD HYPERCOAGULABILITY
2.1 Primary – inherited
2.2 Secondary – aquired
2.3 High risk
2.3.1 Prolonged immobilisation/bed rest
2.3.2 Atrial fibrilation
2.3.3 Tissue damage – surgery, fracture, burns
2.3.4 Disseminated cancer – release coagulation factors
2.4 Low risk
2.4.1 Cardiomyopathy
2.4.2 Nephrotic syndrome
2.4.3 Hyper-oestrogenic states – OCP,pregnancy, HRT
2.4.4 Sickle cell anaemia
2.4.5 Smoking (+ EN damage so double risk)
2.4.6 ↑ age > ↑ platelet aggregation > ↓ prostacyclin
3 BLOOD STASIS/TURBULENCE
3.1 Turbulence
3.1.1 Atherosclerosis – counter currents and pockets of stasis
3.1.2 EN damage/dysfuntion
3.2 Stasis
3.2.1 NB cause of venous thrombus formation
3.2.1.1 Usually occlusive, mostly DVT > oedema + distal swelling
3.2.1.2 Superficial Saphenous system > visible swelling/pain > rarely embolises
3.2.1.3 Deep thrombi above knee (popliteal/femoral/illiac) >usually asymptomatic > can embolise
3.2.1.4 d/t CCF, ↑ age, immobilisation, obesity, post-surgery, migratory thrombophlebitis
3.2.2 Pockets of stasis behid obstruction, cause further enlargement
3.3 Laminar flow disrupted
3.3.1 Platelets come into contact with EN
3.3.1.1 ↓ dilution of coagulation factors, ↓ inflow of clotting inhibitors
3.3.1.1.1 ↑ EN activation > leukocyte edhesion > thrombus formation
4 PT
4.1 Extrinsic pathway, 11-13 sec
4.2 Add Ca+ to form quick fibrin clot
4.3 Sensitive to Coumadin
4.4 Prothrombin Time
5 PTT
5.1 Partial Thromboplastin Time
5.2 Add Ca+ and surface phospholipids
5.3 Intrinsic pathway, 28-35 sec
5.4 Sensitive to Heparin
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