DEFINITION OF TERMS

• HEMOSTASIS

  • Three components: blood vessels, coagulation factor, platelets
• PETECHIAE

  
  

  • Purplish red, pinpoint (descriptive size) hemorrhagic spots in the skin caused by loss of capillary ability to withstand normal blood pressure and trauma
  • Caused by capillary fragility (when capillary is exposed to pressure it cannot withstand the force causing breakage/rupture)
  • Genetics
  • Thrombocytopenia (low platelet count): as platelets line the capillary thus contribute to the strength of capillary
  • 1-3mm, non-blanching, and non-palpable
  • Rashes – blanching
• PURPURA

  • Produced/caused by hemorrhage (bleeding) of blood into small areas of skin, mucous membranes, and other tissues
  • First appears red-purple then turns brownish yellow
  • AKA: coalesced petechiae – united petechiae
  • >/= 3mm, non-blanching, but palpable

  
  

  TYPES OF PURPURA:

  • Dry-type: exist in the skin
  • Wet-type: exist from the skin deeper to mucous membrane (more significant as it appears like hemorrhagic blisters and indicates thrombocytopenia)
• ECCHYMOSIS

  • Form of purpura in which blood escapes into large areas of skin (usually subcutaneous) or mucous membranes, but not into deep tissue
  • Appears black/blue then turns greenish brown to yellow
  • Due to the breakdown of hemoglobin (black/blue) → biliverdin (greenish brown) → bilirubin (yellow)
  • >1-2cm and appear as hemorrhagic blisters
  • Caused by on-going process (such as ongoing coagulation) causing discolorations
• HEMATOMA

  • A swelling or tumor in the tissues or a body cavity that contains clotted blood
  • >2-3cm, typically larger
  • Solid clot causing swelling
  • Caused by broken blood vessels and bleeding disorders
• EPISTAXIS

  • Common name: nosebleed
  • Nosebleed is one of the symptoms of vascular fragility (due to genetics or thrombocytopenia)
  • Others: due to infections, allergy, foreign objects
• HEMARTHROSIS

  • Leakage of blood into a joint cavity
  • Main cause: trauma
  • It is attributed to a bleeding disorder stimulated by trauma
  • Hemophilia (bleeding disorder) and any other cases of coagulation factor deficiency
• HEMATEMESIS

  • Vomiting of blood
  • Main cause: bleeding/ulceration in GIT (due to coagulation factor deficiency or thrombocytopenia)
• HEMOPTYSIS

  • Expectoration (spitting) of blood secondary to hemorrhage in the larynx, trachea, bronchi, or lungs
  • Spitting of blood from the respiratory system
• THROMBUS

  • In vivo blood clot causing vascular occlusion and tissue ischemia
  • Three components: platelet, trapped RBC, fibrin
• SEVEN FATES OF THROMBUS

  1. Propagation: spreading of thrombus
  2. Emboli formation: bigger clot together with other components
  3. Foreign body floating in cavities: causing an autoimmune disorder
  4. Abscession: clot gets infected (such as bacteria)
  5. Dissolution (normal thing to happen): clot should be dissolved (fibrinolysis)
  6. Recanalize: stock in canals which can impede blood flow → tissue ischemia (tissue death)
  7. Calcification: because of the Ca2+, clot gets harder which cannot be fibrinolysis
• THROMBOSIS

  Formation, presence of a clot in a blood vessel
• HEMATURIA

  • Presence of intact red cells in the urine
  • Lower part (urethra, bladder), fresh bleeding – Packed/intact RBC = Settle in the bottom with clear supernatant when centrifuged
• HEMOGLOBINURIA

  • Presence of hemoglobin in the urine
  • Upper part (kidney) bleeding = Lysed RBC = Do not settle with no supernatant when centrifuged
• MELENA

  • Passage of dark tarry red stool containing decomposing blood
  • Upper GIT bleeding = dark tarry red
• HEMATOCHEZIA

  • Passage of blood (bright red) in feces
  • Lower GIT bleeding = bright red
• MENORRHAGIA

  • Excessive menstrual bleeding
  • Lasts for >7 days
  • Normal menstrual cycle: 1 week with decreasing portion
  • Causes: hormonal, fibroids (cyst in uterus) → causing anemia
• HYPOCOAGULATION

  • Decreased formation of clot
  • Causing bleeding disorder
• HYPERCOAGULATION

  • Increased/excessive formation of clot
  • Causing thrombotic/clotting disorder