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”
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