- 1. 10/19/2010Pathology Hemodynamic Disorders,Thrombosis, and
Shock Edema 60% - (3/2 ) 5%- Edema; : Hydrothorax :
Hydropericardium : Hydroperitoneum = Ascites : anasarca1
2. 10/19/2010 () () (), (), (), (),() ()-() (),(),() () ()() ()
()2 3. 10/19/2010 1. INCREASED HYDROSTATIC PRESSURE2. REDUCED
PLASMA OSMOTIC PRESSURE (HYPOPROTEINEMIA)3. LYMPHATIC OBSTRUCTION4.
SODIUM RETENTION5. INFLAMMATION 3 4. 10/19/2010 INCREASED
HYDROSTATIC PRESSURE Impaired venous return - Congestive heart
failure - Constrictive pericarditis - Ascites (liver cirrhosis) ()
Venous obstruction or compression - Thrombosis - External pressure
(e.g., mass) (, ) - Lower extremity inactivity with prolonged
dependency Arteriolar dilation - Heat - Neurohumoral dysregulation
CHF ; Chronic Heart Failure Chronic heart failure symptoms
Shortness of breath (dyspnea) when you exert yourself or when
youlie down Fatigue and weakness Swelling (edema) in your legs,
ankles and feet Rapid or irregular heartbeat Reduced ability to
exercise Persistent cough or wheezing with white or pink
blood-tingedphlegm Swelling of your abdomen (ascites) Sudden weight
gain from fluid retention Lack of appetite and nausea Difficulty
concentrating or decreased alertness4 5. 10/19/2010 REDUCED PLASMA
OSMOTIC PRESSURE(HYPOPROTEINEMIA) () Protein-losing
glomerulopathies (nephroticsyndrome) -() Liver cirrhosis (ascites)
() Malnutrition Protein-losing gastroenteropathy - LYMPHATIC
OBSTRUCTION Inflammatory Neoplastic Postsurgical Postirradiation 5
6. 10/19/2010SODIUM RETENTION Excessive salt intake with renal
insufficiency Increased tubular reabsorption of sodium Renal
hypoperfusion Increased renin-angiotensin-aldosteronesecretion -- 6
7. 10/19/2010 INFLAMMATION Acute inflammation Chronic inflammation
Angiogenesis 7 8.
10/19/2010http://www.cancer.gov/cancertopics/understandingcancer/angiogenesis
8 9. 10/19/2010 . - - - , - - 9 10. 10/19/2010 , , (Subcutaneous
edema) (dependent edema)- ( Cardiac edema) (Periorbital edema)
(Pitting edema) (Pulmonary edema)- (AcuteRespiratory Distress
Syndrome)Pitting Edema 10 11. 10/19/2010 - 11 12. 10/19/2010 Obese
abdomenAscites Hyperemia and Congestion , - * - 12 13.
10/19/2010Nutmeg Liver( ) Chronic Passive Congestion Hyperemia13
14. 10/19/2010 Cupping Action Contraindication 1. warming and 1.
Skin Ulcer, Edema,promoting the free flow Large blood vessel,
highof Qi and Blood fever and convulsion 2. Dispelling cold 2.
Abdominal and sacraldampnessregions of pregnant 3. Diminishing
Swelling womanand Pains 3. If the patient issusceptible
tospontaneous bleeding orendless bleeding aftertrauma Hemorrhage -
(Hematoma)- - (Patechia)- 1~2 mm - (Purpura)- 3~5 mm - (
Ecchymoses)- 1~2 cm14 15. 10/19/2010Hematoma ( Cupping and Gua Sha)
( Ecchymoses)- 1~2 cm15 16. 10/19/2010 , , 20% , 16 17. 10/19/2010
Hemostasis and Thrombosis , : Normal Hemostasis : (Thrombosis)
Hemostasis1. Vasoconstriction 2. Platelet plug formation 3.
Clotting of blood 17 18. 10/19/2010 A. B. C. D. ( : t-PA)
Thrombin18 19. 10/19/2010 : Factor X Clotting factor X, or
Stuart-Prower factor, is avitamin Kdependent serine protease
thatserves as the first enzyme in the commonpathway of thrombus
formation. Factor X deficiency is a bleeding disorder thatcan be
inherited or acquired. This disorder isone of the worlds most rare
factordeficiencies.19 20. 10/19/2010 Thrombosis * Virchow Triad 1.
(Endothelial Injury) 2. (Abnormal blood flow) 3.
(Hypercoagulability)Virchow Triad20 21. 10/19/2010 , , , .21 22.
10/19/2010 (Embolism) 1. , , (Thromboembolism) (Infarction )
(Pulmonary Thromboembolism) - - 60% : , , (Cardiovascular
collapse)22 23. 10/19/2010 (Fat Embolism) S/S 1~3(Long bone)
pulmonary (shortness of breath, hypoxemia) neurological (agitation,
delirium, or coma) dermatological (petechial rash) haematological
(anaemia, low platelets) Air Embolism 100ml ( ) , , , Decompression
sickness , , Grecian Bend 23 24. 10/19/2010 (Amniotic Fluid
Embolism) Homeostasis ( , , , ) = 24 25. 10/19/2010 , (), ( )25 26.
10/19/2010 Cellular adaptation to stress A. , B.26 27. 10/19/2010
(Hypertrophy)A. (), () 27 28. 10/19/2010 : hypertrophy :
hyperplasia : atrophy : , metaplasia : 28 29. 10/19/2010 1.
(hypoxia, oxygen deficiency)2. (, , CO, , )3. (, , , )4. ( )5. (,
sickle cell anemia)6. ( , )7. (, , , )8. 29 30. 10/19/2010 - - - .
- : , , , , ER, ( RNA ) - : ; , , ; ; ; - : ; ( )30 31. 10/19/2010
Acute and chronic inflammation o , o : o : o , . 31 32. 10/19/2010
Intracellular Accumulations 1. 2. 3. 4. Pathologic Calcification
Dystrophic calcification atheroma - (Aortic Stenosis) 32 33.
10/19/2010 Metastatic Calcification Hypercalcemia 4 1. 2. --
Parathyroid Hormone , PTH 3. D 4. () 33 34. 10/19/2010 A. B. C. ; ,
, , - , , .34 35. 10/19/2010 , , , , , . 35 36. 10/19/2010 36
