Study, draw and describe the slides
JVe 1 — «nutmeg» liver (stained with hematoxylin and eosin). Under low magnification determine the condition of the central veins and interbeam capillaries lumen, under high magnification study the outlook of the liver beams in the center of the lobule and periphery, paying attention to the volume decrease (atrophy) in the beams in the lobule center and to the presence of lipid degeneration in hepatocytes in the peripheral part of the lobule.
JNfe 4 — thrombophlebitis (stained with hematoxylin and eosin) — at low magnification find inflammation infiltration in the vein wall, the place of thrombus connection, pay attention to the constituent parts of the thrombus - leukocytes, fibrin, erythrocytes, agglutinated masses of thrombocytes; determine the type of the thrombus according to the relation with the lumen. Enumerate general processes of thrombus formation. Name possible consequences of thrombosis.
N° 6 — organization and canalization of thrombus (stained according to van-Gieson). At low magnification of a microscope find a vessel of arterial type with obturating thrombus; in a mass of thrombus find newly-created vessels, covered by endothelium with erythrocytes at the lumen.
N° 7 — hemorrhagic lung infarct (stained with hematoxylin and eosin). At low magnification find a focus of necrosis in the lung; in this focus alveoles are filled with blood, interalveolar septi have necroses. Pay attention to the presence of pigmented macrophages in the periinfarct zone (in the alveoles and stroma of the lung). Name the characteristics of lung infarct and its possible outcomes.
JVe 11 — diapedesis cerebral hemorrhages (stained with hematoxylin and eosin). At low magnification find punctate hemorrhages localized mainly around small capillaries in the brain tissue.
N° 12 — stases in capillaries of the brain (stained with hematoxylin and eosin). At low and high magnifications find and study the plethoric capillaries. Pay attention to the fact, that erythrocytes lie in capillaries like a column of coins («sludge»-phenomenon).
Study the ellectronograms
Brown induration of the lung, x 16 000.
Pay attention to the great number of the siderophags and collagen fibers in the periendothelial area.
Three stages of thrombus formation, x 10 000.
Pay attention to localization and structure of thrombus mass into the lumen of vessel.
1. Give the definition of stasis.
2. Name the types of local arterial hyperemia: a)..., b)..., c)...,d)...,e)...,f)....
3. Characterize the morphogenesis of brown induration ofthelung:a)...,b)...,c)...,d)...,e)...,f)...,g)...,h)...,i)..., j)...
4. Name the types of local ischemia: a)..., b)..., c)..., d)....
5. On autopsy of the patient aged 52 with decompensated cardiac defect (constricted left atrioventricular orifice) an enlarged, variegated liver, brown induration of the lungs, dense kidneys and spleen; cyanotic skin and visible mucous membranes have been revealed. In the abdominal cavity there are 1500 ml of transparent fluid; in the pleural cavities there are 300 ml of similar fluid. Name the morphological terms, which characterize pathological processes in the organs.
Answers: 1. It is arrest of blood circulation in capillaries and small veins with changes in physicochemical characteristics of the blood and with erythrocyte agglutination. 2. a) angioneurotic, b) collateral, c) hyperemia after anemia, d) vacant, e) inflammatory, f) caused by arteriovenous fistula. 3. a) pulmonary hypertension, b) hypoxia, c) reflective spasm of arteries and arterioles, d) vascular sclerosis,
e) dilatation and plethora of capillaries, f) diapedesis, g) hemosiderosis, h) plasm proteins exiting into the tissues, i) pneumosclerosis, j) insufficiency of the lymphatic system. 4. a) obturation, b) compression, c) angiospastic, d) ischemia as a result of blood redistribution. 5. The patient had a cardiac defect, constricted left atrioventricular orifice, general venous plethora: «nutmeg» liver, cyanotic induration of kidneys and spleen, brown induration of the lungs. Ascites.
1. What is thrombosis?
2. Peculiarities of infarct in the heart (type, localization): a)...,b)...,c)...,d)....
3. Name the mechanism of thrombus formation: a)..., b)...,c)...,d)....
4. Types of thrombi according to their constituents: a)..., b)...,c)...,d)....
5. Origins of thromboembolism in the arteries of the general system: a)..., b)..., c)..., d)..., e)... .
6. Problem. The patient died because of rheumatic cardiac defect (stenosis of the mitral orifice). In the cavity of the left atrium, there is a rounded grayish-red object with smooth surface, not attached to the wall of the atrium was revealed. The latter is locally roughed, greyish-reddish. What is it? What conditions caused its formation?
Answers: 1. Alive blood agglutination in the vessels and heart cavities. 2. a) anemic with haemorrhagic crown, b) subendocardial,
c) subepicardial, d) transmural. 3. a) erythrocyte agglutination, b) precipitation of blood plasma proteins. 4. a) white, b) red, c) mixed,
d) hyaline. 5. a) thrombi on the cusps of the left heart in endocarditis, b) intertrabecular thrombi in the left ventricle, c) thrombus in the aneurysm of the left heart ventricle, d) thrombosis of the left atrium auricle,
e) thrombosis of the aorta and other arteries. 6. It is spherical thrombus, polished by moving of the blood after tearing from the wall as a result of free rotation in the atrium cavity.
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