Circulatory Disorders – Disturbance of Blood and Lymph Circulation

Disturbance of Blood and Lymph Circulation,  Depending on the pathogenetic mechanisms, there are three types of circulatory disorders.

The first type is associated with the disturbance in the blood supply of the vessels (hyperemia and anemia, which may be arterial or venous).

The second type develops in disturbance of the theological properties of blood (stasisthrombosis, and embolism).

The third type is due to disruption of the permeability of the vessel wall (bleedinghemorrhageplasmorrhagia).

 

In a healthy organism, normal blood and lymph circulation is closely related to each other and is determined by the activity of the heart as a source of blood flow, vessels – a source of blood distribution and lymph collection; microcirculatory bed – a springboard for trans-capillary metabolism and tissue metabolism.

The function of the circulatory and lymphatic systems is provided by the mechanisms of neurohumoral regulation, which are aimed at maintaining homeostasis – the relative dynamic constancy of the internal environment.

Disorders of blood and lymph circulation and their neurohumoral regulation lead to the disruption of tissue metabolism, which leads to damage to tissue structure (alteration), the development of either type of dystrophy or necrosis.

In case of damage at the level of the heart, there are general, at the level of blood vessels – local disorders of blood and lymph circulation. Local circulatory disorders (eg myocardial infarction) can cause general disorders.

 

DISORDERS OF BLOOD CIRCULATION (Circulatory Disorders)

Circulatory disorders can be divided into 3 groups:

1) violations of blood circulation: plethora (arterial or venous) and anemia;

2) violations of the permeability of the vascular wall: bleeding (hemorrhage) and plasmorrhage;

3) disorders of blood flow and rheological state of blood: stasis, sludge phenomenon, thrombosis, and embolism.

In the fetus, newborn and child of the first 3 years of life, general and local plethora, anemia, hemorrhages, stasis occur faster and more often than in adults, which depends on the immaturity of the regulatory mechanisms of blood circulation. Thrombosis and heart attack are less common in children than in adults. These circulatory disorders occur mainly in connection with malformations of the cardiovascular system, the addition of a secondary septic infection to them, or in some acute infectious diseases (diphtheria, viral myocarditis, etc.).

 

Blood circulation is conventionally divided into central, peripheral, and microcirculatory

Central blood circulation, carried out at the level of the heart and large vessels, provides:

  • maintaining systemic blood pressure;
  • the direction of blood flow from the arterial bed to the venous bed and further to the heart;
  • damping (amortization) of systolic and diastolic fluctuations in arterial pressure during the ejection of blood from the ventricles of the heart to ensure uniform blood flow.

Peripheral (regional) blood circulation is carried out in the vessels of organs and tissues. It includes blood circulation in the vessels of the microvasculature, which includes:

  • arterioles;
  • pre-capillaries;
  • capillaries;
  • postcapillaries;
  • venules:
  • arterio-venular shunts.

Microcirculatory circulation is blood circulation in the smallest vessels. This includes arterioles, precapillaries. capillaries, postcapillaries, venules.

The microcirculatory bed provides blood delivery to tissues, transcapillary exchange of metabolic substrates, oxygen. carbon dioxide, as well as the transport of blood from tissues. Arteriovenous shunts determine the volume of blood flowing to the capillaries. When these shunts are closed, blood from the arterioles enters the capillaries, and when these shunts are opened, it enters the venules, bypassing the capillaries.

 

The lymphatic system is structurally and functionally integrated with the circulatory system and provides lymph-forming, drainage, barrier, detoxification, blood-forming functions and includes:

  • lymphatic organs – lymph nodes, lymph follicles, tonsils, spleen;
  • lymphatic transport pathways – capillaries, microvascular and macrovascular, sinuses, which have adrenergic innervation. common with blood vessels.

All components of the circulatory system are closely related to each other, and a disorder in the activity of one of them, for example, the central one, leads to changes in both peripheral and microcirculatory circulation. On the other hand, disorders of the microcirculation system can cause or aggravate dysfunctions of the heart or large vessels. In this case, the close integration of the circulatory system with the lymphatic system, which essentially also constitutes the microcirculation system, plays an important role in pathology. Lymph is formed in the lymphatic capillaries from tissue fluid and is transported through the lymphatic vessels to the venous system. In this case, 80-90% of the tissue filtrate flows into the venous, and 10-20% – into the lymphatic bed. The outflow of lymph and venous blood is provided by the same mechanisms – the suction action of the heart, chest, diaphragm and muscle work.

 

TYPES OF BLOOD CIRCULATORY DISORDERS

Allocate violations of the central and peripheral circulation.

Pathology of the central circulation is mainly due to dysfunctions of the heart or blood flow in large vessels – the aorta, inferior and superior vena cava, pulmonary trunk, pulmonary veins. In this case, circulatory failure occurs , which is accompanied by changes in peripheral circulation, including microcirculation. As a result, organs and tissues do not receive enough oxygen and other metabolites, and toxic metabolic products are not removed from them. The cause of these disorders can be either a dysfunction of the heart, or a decrease in vascular tone — hypotension.

Pathology of the peripheral (regional) blood circulation, including microcirculation disorders, manifests itself in three main forms:

  1. circulatory disorders (arterial plethora and anemia, venous plethora);
  2. violations of the rheological properties of blood (thrombosis, embolism, stasis, disseminated intravascular coagulation syndrome);
  3. violations of the permeability of the walls of blood vessels (bleeding, hemorrhage, plasmorrhage).

Vascular congestion (hyperemia) can be arterial and venous. Each of them, in turn, can be:

  • downstream – acute and chronic;
  • by prevalence – local and general.

Types of circulatory disorders may differ depending on the pathogenesis and are presented in the table given below.

Classification of circulatory disorders – Disturbance of Blood and Lymph Circulation

Types of circulatory disorders

 

Hyperemia

Anemia (ischemia)

Bleeding, hemorrhage

Plasmorrhagia

Stasis:

  • lymphostasis,
  • hemostasis

Thrombosis

Embolism

Shock

DIC

Necroses:

coagulation (dry),

colliquative (moist)

Infarcts:

anemic or ischemic;

hemorrhagic;

anemic with hemorrhagic rim

 

Gangrene

dry and

wet

Bedsores

Sequestration

Mummification