Questions to prepare for classes and examination
• Arterial hyperemia: definition, causes, types (physiological and patholocic), mechanisms (neurogenous, neuromyoparalytic and humoral), and consequences. Reactive hyperemia. Manifestations of arterial hyperemia and its mechanisms.
• Venous hyperemia: definition, causes, and consequences. Manifestations of venous hyperemia and their mechanisms.
• Ischemia: definition, causes and consequences. Manifestations of ischemia and their mechanisms, factors that influence on the consequences of ischemia.
• Stasis: types and causes.
• Disturbances of microcirculation: types and causes.
• Types of transmural disturbances of microcirculation, mechanisms of an increased vascular permeability. Mechanisms of extra and intravascular disturbances.
• Sludge syndrome: types, causes, and mechanisms.
N 16
A 68-year-old male patient D. presented with chronic hepatitis and liver cirrhosis. The doctor introduced a needle into the abdominal cavity to perform aspiration of ascitic fluid. By the fifteenth minute, after 5 l of fluid had been removed, the patient felt bad, complaining of weakness, dizziness, and nausea. But the procedure was continued. After 1,5 l more fluid had been evacuated the patient developed syncope and lost consciousness. Several minutes later, after the emergency treatment, the patient regained total consciousness but still complained of weakness, dizziness, and nausea.
Questions
• What was the doctor's mistake during the performance of ascitic fluid aspiration?
• What are the mechanisms of syncope after the removal of ascitic fluid?
• What are the possible mechanisms of adaptation of the brain circulation in this case?
• Why did the adaptive mechanisms turn out to be insufficient in this patient?