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Section 1 Hyperemia or congestion Hyperemia: increased volume of blood in cardiovascular vessels Arterial hyperemia(active -): augmented arterial inflow. Such as that occurs in the muscles during exercise, at sites of inflammation and in the pleasing neurovascular dilatation termed blushing The organ or tissue is warm, red, and the symptoms are temporally Venous hyperemia (congestion): diminished venous outflow, such as cardiac failure or obstructive venous disease The tissue is cool, edema, dusky bluegray (参照武忠弼 病理学规划教材第一版 人民卫生出版社 修改 ) Consequences of chronic congestion: 1 parenchyma cell: atrophy degeneration necrosis 2 interstitial hyperplasia: fibrosis cirrhosis 3 edema 4 hemorrhage Left-sided heart failure chronic congestion of lung lung edema, hemorrhage:weight increased, sogginess subcrepitant, sectioning permits the free escape of a frothy hemorrhagicfluid, microscope showed alveolar walls are dilated and alveolar space edema,full with red cells and can find “heart failure cell” brown induration of the lung “heart failure cell” macrophages phagocytose red cell then the red cell was broken down into hemosiderin granules Acute congestion of the lung with pulmonary edema. Chronic congestion with heart failure cells Right-sided heart failure nutmeg liver:liver congestion in centrilobular areas surrounded by fatty degeneration peripheral regions persistence cardiac sclerosis nutmeg liver (photo is offered by Prof. Orr ) Histologic appearance of atrophy and necrosis of cells in the central part of the liver lobule in chronic congestion (photo is from Robbins Basic Pathology,2003 )