HYPERAEMIA,HYPERAEMIA,and CONGESTION and CONGESTION

Hyperaemia and CongestionHyperaemia and Congestion

Both terms indicates increase Both terms indicates increase volume of blood inside the vessels, in volume of blood inside the vessels, in other words too much blood inside other words too much blood inside the vessels the vessels

HyperaemiaHyperaemiaActive processActive processBlood is brought to the area due to Blood is brought to the area due to

arteriolar dilatationarteriolar dilatation

CongestionCongestionPassive processPassive processBlood is not efficiently drained form the Blood is not efficiently drained form the

area and thus accumulates inside the area and thus accumulates inside the vesselsvessels

Types of HyperaemiaTypes of Hyperaemia

PhysiologicalPhysiologicalAfter meal (blood is brought to digestive After meal (blood is brought to digestive

system)system)Athletes (hyperaemia, in muscles)Athletes (hyperaemia, in muscles)Blushing of face (embarrassment, Blushing of face (embarrassment,

excitement or nervousness)---?excitement or nervousness)---?

PathologicalPathologicalDurationDuration

Acute Acute ChronicChronic

ExtentExtentBased on area of tissue Based on area of tissue

involvement, localized or involvement, localized or generalizedgeneralized

Localized hyperaemia Localized hyperaemia confined to an area of confined to an area of limited extentlimited extent

Generalized Generalized hyperaemia, indicative of hyperaemia, indicative of systemic change systemic change involving whole organinvolving whole organ

MechanismMechanismActive (increased arterial flow to an area or Active (increased arterial flow to an area or

tissue) tissue) Passive ( impaired venous drainage)Passive ( impaired venous drainage)

Hyperaemia can beHyperaemia can be

acute local active ( Inflammation)acute local active ( Inflammation)

acute local passive (hyperaemia due to acute local passive (hyperaemia due to intestinal torsion)intestinal torsion)

Chronic local passive ( local Chronic local passive ( local hyperaemia, slowly develops due to hyperaemia, slowly develops due to growing tumors or abscess)growing tumors or abscess)

Chronic general passive (CHF)Chronic general passive (CHF)

Chronic generalized active Chronic generalized active heperaemia??heperaemia??

ACUTE LOCAL ACTIVE ACUTE LOCAL ACTIVE HYPERAEMIAHYPERAEMIA

Local engorgement of blood vessels due Local engorgement of blood vessels due to arterial blood flow (inflammation)to arterial blood flow (inflammation)RednessRednessWarmthWarmth

The increased blood flow due to an The increased blood flow due to an inflammatory process opens the inflammatory process opens the capillary bed present in the area due to capillary bed present in the area due to pressure in the arteriole, pulse can be pressure in the arteriole, pulse can be feltfelt

ACUTE LOCAL PASSIVE ACUTE LOCAL PASSIVE HYPERAEMIAHYPERAEMIA

Acute local congestion ( impairment Acute local congestion ( impairment of venous drainage from some acute of venous drainage from some acute obstruction)obstruction)

Dark red in colour (unlilke bright red Dark red in colour (unlilke bright red in acute local active hyperaemia in acute local active hyperaemia owing to well oxygenated blood)owing to well oxygenated blood)

Pulse (unlikely to be felt)Pulse (unlikely to be felt)ThrombosisThrombosisembolismembolism

Torsion of the uterus or intestine Torsion of the uterus or intestine Veins are thin walled and have low Veins are thin walled and have low

blood pressure in them and due to blood pressure in them and due to torsion can easily be blocked torsion can easily be blocked

CHRONIC LOCAL PASSIVE CHRONIC LOCAL PASSIVE HYPERAEMIAHYPERAEMIA

Chronic local congestionChronic local congestionTime period (only difference from Time period (only difference from

previous one)previous one)Blockage of venous channels Blockage of venous channels

(impairment in drainage process)(impairment in drainage process)Slowly developing blockagesSlowly developing blockages

Tumor (out side the vessel)Tumor (out side the vessel)AbcessAbcess

Chronic inflammatory process Chronic inflammatory process (fibrosis)(fibrosis)Liver cirrhosis (fibrosis) loss of hepatic Liver cirrhosis (fibrosis) loss of hepatic

lobular structure eventually leads to lobular structure eventually leads to portal hypertension, fluid leakage form portal hypertension, fluid leakage form the portal vessel results in its the portal vessel results in its accumulation in the peritoneal cavity ( accumulation in the peritoneal cavity ( ). ).

CHRONIC GENERAL PASSIVE CHRONIC GENERAL PASSIVE HYPERAEMIAHYPERAEMIA

Chronic generalized congestionChronic generalized congestionHeart or lungsHeart or lungs

CHF (congestive heart failure)CHF (congestive heart failure)Pulmonic stenosis, congestion develops with Pulmonic stenosis, congestion develops with

primary target (liver) due to venous primary target (liver) due to venous engorgement of back channels, it occurs engorgement of back channels, it occurs because the right heart not pushing the because the right heart not pushing the blood efficiently to the lung and thus blood blood efficiently to the lung and thus blood stagnates in the back channels.stagnates in the back channels.

Tricuspid inefficiency Tricuspid inefficiency Aortic stenosisAortic stenosis

LungsLungsLung diseases leading to higher Lung diseases leading to higher

resistance for the propulsion of blood resistance for the propulsion of blood and thus cause right sided heart failure and thus cause right sided heart failure and the syndrome is called COR and the syndrome is called COR PULMONALEPULMONALE

APPEARANCE OF APPEARANCE OF HYPERAEMIAHYPERAEMIA

Colour changes in tissueColour changes in tissueBright red or dark red ( depending upon Bright red or dark red ( depending upon

mechanism i.e. active or passivemechanism i.e. active or passiveSwollen or oedematousSwollen or oedematousIn case of chronic passive hyperaemiaIn case of chronic passive hyperaemia

Necrosis may be present ( ? )Necrosis may be present ( ? )

In case of chronic passive hyperaemia In case of chronic passive hyperaemia of lungof lungThe alveolar capillaries get engorged with The alveolar capillaries get engorged with

blood and dilatedblood and dilated

IN CASE OF CHRONIC PASSIVE HYPERAEMIA IN CASE OF CHRONIC PASSIVE HYPERAEMIA OF LIVEROF LIVER

right side heart failure, dilation of right side heart failure, dilation of sinusoids takes place with resultant sinusoids takes place with resultant atrophy of the hepatic cords due to atrophy of the hepatic cords due to pressure of blood.pressure of blood.

Dark red around the central vein with Dark red around the central vein with yellow-brown colour around the yellow-brown colour around the portal triad regionsportal triad regions

Mottled appearance to the liver Mottled appearance to the liver “NUTMEG LIVER”“NUTMEG LIVER”