Edema
presence of fluid in the body tissues
-either localized or generalized
Causes of Edema
-increased capillary permiability (inflammation)
-increased capillary pressure (hypertension)
-lymphatic obstruction
-hyporproteinemia (not enough protein)
-electrolyte imbalance
-liver disease
-kidney disease
-heart disease
Pitting edema
most severe edema
-if you press on tissue your displacing so much fluid causing an imprint in the skin
Ascites
presence of edema in abdominal cavity
-liver disease, kidney disease, pancreatic disease
Hydrothorax
presence of fluid in the chest cavity
-lung issues
Hydropericardium
fluid occumulation in the pericardium sac
Lymphedemia
interruption in the lymphatic system, occumulating in the extremities
Hydrocele
occumulation of fluid in the scrotum
-birth or result of injury
Hydrocephaly
occumulation of fluid in the brain (ventricals, sub dural space)
-inlarge the infants heads
-in an adult, increased intercranial pressure results to brain damage
anasarca
generalized edema, due to liver, kidney and heart disease
Hyperemia
increased amount of blood in a part of the body
-vasodilation
-increased arterial flow
-decreased venous return
Physiologic Hyperemia
an erection; blushing
Pathologic Hyperemia
congestion; cut
Active Hyperemia
arterial
Passive Hyperemia
venous (always pathological)
Ischemia
localized deficiency of the blood
Causes of ischemia
-thrombus/embolus
-arteriosclerosis
-external pressure
-failure of vasodilation when needed (neural) vessal is not recieving neurological stimulus to dilate
Transient ischemic attack
mini stroke, no lasting effects
Angina
temporary decrease blood flow to the heart, extreme chest pain (localized)
Loss of sensation (ischemic)
cross your legs for a certain amount of time
Thrombosis
process of clot formation
-Thrombis (actual clot name)
-are attached to vessal walls
Causes of Thrombi
-damage to vessels (disease)
-stasis of blood
-cardiac disorders (blood gets thicker)
-changes in blood composition
-sepsis
Location and consequences of Thrombi
-arterial blockage (dry gangrene)
-poor venous return
-cardiac: can kill you immediatly
Changes in Thrombi
-Lysis is desired
-Fibrinolysin
-Heprin
-Fragmentation is (trouble) traveling and get stuck somewhere causing lack of blood flow
Consequences of Thrombi
-ischemia
-passive hyperemia
-infarction: death of tissue
-gangrene
Embolus
anything that is moving through the bloodstream
-fragments of thrombi (most common)
-pyogenic Bacteria (sepsis)
-tumor cells
-parasites
-fat embolus
-gas/air
-foreign bodies (glass from car accident)
Thrombus vs Embolus
Thrombus stays stationary
Embolus can move anywhere
Hemorrhage (extravastation)
Per rhexis: vessal wall is interrupted
Per diapedesis: moving out of vascular system into tissue
Types of hemmorrhages
External: (evident, overt): leaving the body
Internal: (concealed, covert): staying in body going to the organ
Petechia
small pin point hemorrhages into skin or mucous membranes. associated with pressure (throwing up = eye) (birth = eye)
Ecchymosis
-bruise
-blunt force, larger area of bleeding into the skin
Purpura
larger areas of bleeding in the skin, in the site of injury
-hemophilia
Senile purpura
happens with elderly, because their skin is thinner, hyaline degeneration, capillary walls are thinner
Hematoma
swelling of blood, quite large
-excised and drained
Epistaxis
nose bleed
Hemoptysis
coughing up blood from the respiratory system
Hematemesis
throwing up blood, coming from the dygestive system
Melena
blood in the feces
Hematuria
blood in the urine
Menorrhgia
excessive bleeding during mentral period
Meterrhagia
excessive bleeding between menstral period
Shock
decreased blood pressure and decreased tissue perfusion (decreased blood to tissues)
Hypovolemic shock
decreased blood volume (burns, loss of fluid)
Cardiogenic shock
occurs as a result of a problem with the heart (heart attack)
Peripherial circulatory shock
issue with blood vessels staying dilated when they should (hearing back news)
Septic shock
gram positive infections
Anaphylactic Shock
severe allergic reaction
Signs and symptoms of shock
Hypotension: decreased blood pressure
Tachycardia: increased heart rate
Hypothermia: body temp falls
-increased persperation, pale, cool and clammy
Oliguria: decreased urine output
Polydypsia: decreased thirst
Facial expressions of shock
blank stare or extremely anxious
Behavior of shock
very still and weak or very agitated
Categories of shock
Primary
-mild, comes on immediatly, usually lasts a short time
Secondary
-serious, long term, takes time to develop
SIDS
unexpected death of a child less than a year old
-usually happens between 2 and 4 months
-no other health issues usually
-african and native american have 2 to 3 times more likely
Diagnosis of SIDS
-thorough death scene investigation
-autopsy
-personal and family history
-known as diagnosis of "exclusion
Effects on the family (SIDS)
-lacking of understanding
-shock at suddenness
-possible involvement of law officials
Continuing factors of SIDS
-Back to sleep reduces the risk by 50%
-exposure to smoke (during or after pregnancy)
-overheating
-bedding (no pillows, toys, light cover)
Maternal Risk factors
-younger moms
-frequent pregnancies (less than one year apart)
-little or no pre natal care
-internal smoking
-didnt gain much weight during pregnancy
-substance abuse issues
-history of SIDS
Infant risk factors
-males
-late fall or winter (overheating)
-ethnicity
-immature brain stem (regulation of breathing)
-siblings who died of SIDS
-premature babies
Abrasion
superficial grazing of the skin (has it scabbed over or wet) (if wet, use hair dryer to dry area)
Contusion
extravasation with blunt trauma (not going to come out) (cosmetize)
Laceration
splitting of the skin (suture)
Avulsion
tearing away of skin (or body part)
Asphyxia
lack of oxygen
-suffocation (obstruction of air passages)
-smothering (external)
-choking (solid in airway)
-gagging (fluid in airway)
-traumatic (damage to the chest wall "flail")
-strangulation (manual or by ligation)
Coroner
-elected for 2 to 4 years
-voting age and member in the political party
-living in county of service
Medical examiner
-physician (board certified)
-appointed until resigns
Manor of death
Homicide
Unknown
Medical misadventure
Accidental
Natural
Suicides
Death by gunshot
-Accidental (need an eye witness)
-Suicide (range, location, less than 3 ft away)
-Homicide (range, location, more than 3 ft away)
Thermal injuries
-electrocution
entry and exit wounds
electric marks : patecial hemorrhages that the electricity traveled
Heat exhaustion
very hot, sweating, flushed
Heat stroke
no longer perspiring, body temp keeps rising
How to cool off someone with heat exhaustion or stroke?
-fan
-room temp water
-do not use ice
Rule of nines
percentage of burned body
9% for each body area
Munchhausen
causes injury to themselves just to get attention from others
Munchhausen by proxy
making someone else ill to get attention (not intentionally trying to kill them)
-usually happens with young (20s) mothers to their children