Embolism

Question 1

Embolism Definiton ?

Answer 1

Formation of an embolus & its subsequent impaction in a vessel distant from its point of origin

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Question 2

Embolus definiton ?

Answer 2

Its a detached solid liquid gaseous mass that is carried by the blood from its point of origin to a distant site where it causes tissue dysfunction and infraction

157

Question 3

Embolus classification ??

Answer 3

Solid
1. Thromboembolism
2. fat E
3. tumor fragments
4. bone marrow

Liquid
1.Amniotic fluid E

Gaseous
1.Air E-Bubbles of air or N2

page-158

Question 4

Pulmonary Embolism ??

Pathogenesis ?////

Answer 4

=Deep vein thrombosis ORIGIN
=Carried through large channels
=Pass through RIGHT SIDE OF THE HEART
=May occlude PULMONARY ARTERY – straddle bifurcation
=Saddle embolus
=Multiple emboli from a single large mass
=Venous emboli——Pass through—InterAtrial/InterVentricular septum————–Systemic arterial circulation—Paradoxical E

PAGE-158

Question 5

Pulmonary Embolism Clinical features ?

Answer 5

1. 60-80% = Cl;inically silent
2. Sudden death/Right HF(COR PULMONALE)-60%
3. Medium size artery—-Hemorrhage
4. Small size artery—–Hemorrhage /Infraction

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Question 6

Medium size artery outcome ??

Answer 6

Lung=Dual artery supply
thats why Middle size artery—Hemorrhage
no INFRACTION

159

Question 7

Systemic Thromboembolism ??

Answer 7

1. 80%=Intracardiac mural thrombi
   2/3=left ventricular wall infract
   1/3=left atrial dilation & fibrillation
   Others–Aortic aneurysms,Vulvar vegetations ,Atherosclerotic plaques2.10-15%=UNKNOWN

Question 8

Fat Embolism ?

Answer 8

1. Fracture of long bone
2. Soft tissue trauma and burn
3. FAT enters into the circulation by rupture of the marrow vascular sinusoids or of venules
4. Occlusion of pulmonary and cerebral microvasculature
5. release of FFA from the fat globules
6. casue local tissue injury

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Question 9

Air Embolism ?

Answer 9

Cause Depression Sickness

Question 10

Depression Sickness Mechanism ??

Answer 10

=Deep sea drive=High pressure Air
=inc amount of gas dissolved in the blood and tissues
=Ascends too Rapidly
=N2 comes out of solution in the tissues and the blood
=Gas bubble
=Obstruct blood flow
=Distal ischemic injury

page-162

Question 11

Air embolism Air amount ?

Answer 11

100 cc air

162

Question 12

Caisson disease ???

Answer 12

Chronic form of decompression sickness

gas emboli in the skeletal muscle – multiple foci of ischemic necrosis

Question 13

Bends ??

Answer 13

Rapid formation of gas bubbles within skeletal muscles and supporting tissue /Joints —–Painful condition

163

Question 14

Chokes ?

Answer 14

Pulmonary edema +Focal atelectasis + Hemorrhage
respiratory distress

163

Question 15

Fate of emboli ?

Answer 15

1. infraction
2. infection
3. Inflammation
4. edema
5. dissolution

Question 16

Causes of DIC ?

Answer 16

1. Obstetric complication
2. Advanced maliganancy

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Question 17

Key features of DIC ?

Answer 17

1. Serious bleeding
2. thrombocytopenia
3. consumption of clotting factor
4. widespread microthrombi

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Question 18

clinical effects of caisson disease ?

Answer 18

persistance of gas bubble in the skeletal system leasds to multiple foci of ischemic necrosis

Question 19

fate of pulmonary emboli ?

Answer 19

sudden death
right heart failure
cardiovascular collapse

Question 20

thromboembolism >

Answer 20

embolism of fragments of thrombi and it is the most frequent form of embolism

Question 21

causes of fat embolism ?

Answer 21

fracture of long bone
soft tissue trauma
Burn

Question 22

risk factor of pulmonary thromboembolism ?

Answer 22

prolonged immobalization

Question 23

causes of air embolism ?

Answer 23

chest wall injury
underwater construction workers
during haemodialysis
obstetric/laparoscopic procedure

Question 24

factors of infraction ?

Answer 24

Factors Influencing Development of an Infarct:

1. Occlusion Type:
   
   • Sudden vs. gradual blockage (e.g., thrombus, embolus).
2. Tissue Vulnerability:
   
   • High metabolic demand (e.g., brain, heart).
   • Low collateral blood supply.
3. Duration of Ischemia:
   
   • Prolonged lack of blood flow increases damage.
4. Oxygen Demand:
   
   • Tissues with high oxygen needs (e.g., myocardium) are more susceptible.
5. Collateral Circulation:
   
   • Presence or absence of alternative blood supply.
6. Systemic Factors:
   
   • Hypotension, anemia, or hypoxia worsen outcomes.
7. Vessel Size:
   
   • Larger vessel occlusion causes larger infarcts.
8. Underlying Conditions:
   
   • Atherosclerosis, diabetes, or hypertension increase risk.

1.39AM
13.3.2025