HYPEREMIA AND CONGESTION DEFN INCREASED BLOOD FLOW IN

HYPEREMIA AND CONGESTION • DEFN : INCREASED BLOOD FLOW IN ANY ORGAN OR TISSUE. • TYPES : ACTIVE HYPEREMIA PASSSIVE HYPEREMIA (CONGESTION )

MACHANISM OF HYPREMIA AND CONGESTION

ACTIVE HYPERMIA Active dilation of arterioles and capillaries arterial = hyperaemia *Physiological ---- muscular Exercise, Blushing due to exitement *Pathological ------acute inflammation Tissue appears red due to flow of oxygenated blood

PASSIVE HYPERMIA ( CONGESTION ) Passive dilation of veins and capillaries Generalised: *Acute as acute heart failure *Chronic ( gradual) e. g. Rt. sided Heart Failure § Localised : *Acute: sudden complete venous obstruction due to thrombosis *chronic: gradual incomplete venous obstruction Tissue appears dusky reddish-blue due to accumulation of deoxygenated venous blood

CHRONIC VENOUS CONGESTION OF LIVER • CAUSES : CHRONIC RIGHT HEART FAILURE OCCLUCTION OF I. V. C. OCCLUSION OF HEPATIC VEIN GROSS PATHOLOGY : LIVER IS ENLAFGED CAPSULE IS TENSE WITH CONGESTED BLOOD VESSELS

C. V. C. OF LIVER ( CONTD. ) • CUT OF LIVER SURFACE SHOWS : ALTERNATING REDDISH BROWN SLIGHTLY DEPRESSED AREAS ( MORE CONGESTED CENTRE OF HEPATIC LOBULES WITH LOSS OF HEPATOCYTES ) AND LIGHTER PALE YELLOWISH AREAS ( PERIPHERAL LESS CONGESTED AREAS ) HENCE THE NAME NUTMEG LIVER

NUTMEG LIVER

MICROSCOPY OF C. V. C LIVER • DILATED AND CONGESTED CENTRAL VEIN • MORE DILATED AND CONGESTED HEPATIC SINUSOIDS IN THE CENTRILOBULAR AREA CAUSING SSEVERE HYPOXIA AND NECROSIS • LESS CONGESTED PERIPHERAL LOBULAR AREA SHOWING MILD FATTY CHANGE • LATE STAGE FIBROSIS IN THE CENTAL ZONE PRODUCING “ CARDIAC CIRRHOSIS “

C. V. C. OF LUNG • CAUSES FOR C. V. C. OF LUNG : MITRAL STENOSIS CHRONIC LEFT VENTRICULAR FAILURE • GROSS PATHOLOGY : GROSSLY LUNGS ARE HEAVY, FIRM IN CONSISTENCY, CONGESTED • MICROSCOPIC PATHOLOGY : DILATED AND CONGESTED CAPILLARIES IN THE ALVEOLAR SEPTAE

MICROSCOPY OF C. V. C. LUNG (CONTD. ) • INTRASEPTAL HAEMORRHAGE • PRESENCE OF HEART FAILURE CELLS ( HEMOSIDERIN LADEN MACROPHAGES IN THE ALVEOLAR SPACES ) • INTERSTITIAL OEDEMA • FIBROSIS WITH BROWNISH DISCOULORATION OF ALVEOLAR SEPTAE ( BROWN INDURATION)

C. V. C. OF LUNG

C. V. C. OF LUNG (HEART FAILURE CELL )

C. V. C. SPLEEN • CAUSES : PORTAL HYPERTENSION MAINLY IN IN CIRRHOSIS OF LIVER • GROSS PATHOLOGY : ENLARGED DUSKY AND CONGESTED • MICROSCOPY : - DILTAED AND CONGESTED SINUSOIDS IN RED PULP - AREAS OF RECENT AND OLD HAEMORRHAGE - GAMMA-GANDY BODIES ( FIBROTIC NODULES WITH DEPOSITS OF HEMOSIDERIN AND CALCIUM ( SIDEROFIBROTIC NODULES )