This is the microscopic appearance of a pulmonary embolus (PE) in a major pulmonary artery branch. 图示:肺动脉大分支肺血栓栓子 |
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This pulmonary embolus is adherent to the pulmonary arterial wall. If the patient survives, the thromboembolus will organize and, for the most part, be removed. 肺血栓栓子粘附于肺动脉壁上,如果病人幸存的话,血栓将机化,大多数情况下将脱落。 |
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These are "lines of Zahn" which are the alternating pale pink bands of platelets with fibrin and red bands of RBC's forming a true thrombus. 可见Zahn线,是含纤维蛋白的粉红色的血小板带和红色的形成真正血栓的红细胞带的分界线。 |
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Occlusion of main pulmonary arteries can kill the patient suddenly. Occlusion of small pulmonary arteries has no major immediate effect. Occlusion of a medium-sized branch of pulmonary artery can lead to a pulmonary infarction in a person with compromised cardiac or respiratory status. A pulmonary infarct is hemorrhagic because of the dual blood supply from the non-occluded bronchial arteries which continue to supply blood, but do not prevent the infarction. 肺动脉闭塞可引起病人猝死,小肺动脉闭塞不引起严重的影响。对于心肺系统受损的人肺中动脉分支可引起梗死。肺梗死是出血性梗死,由于肺是双重血液供应的,支气管动脉可继续供血,但不能阻止梗死的发生。 |
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Here is another hemorrhagic pumonary infarction in a patient with a pulmonary thromboembolus to a medium sized pulmonary artery. Such infarctions tend to be based on the pleural surface and be roughly wedge-shaped in cross section. 这也是一个由于肺中动脉分支的血栓栓塞所引起的肺出血性梗死。它以胸膜表面为基底,切面大致呈楔形。 |
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Here is an actual electron micrograph of a platelet. Note that this platelet bears a striking resemblance to a chocolate chip cookie. The chocolate chips are the alpha and dense granules that contain a variety of mediators such as ADP. When activated, platelets release their granules to promote coagulation, change shape, and become sticky to aggregate and plug small vascular holes. 这是血小板的电镜图。 注意此血小板与巧克力碎片甜饼有惊人的相似之处。巧克力碎片中有透明和致密颗粒,其中包括不同的介质,例如腺苷二磷酸。当血小板被激活时它会释放颗粒以促进血小板凝固并改变其形状使血小板凝固起来阻塞血管。 |
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Here are petechial hemorrhages seen on the epicardium of the heart. Petechiae (pinpoint hemorrhages) represent bleeding from small vessels and are classically found when a coagulopathy is due to a low platelet count. They can also appear following sudden hypoxia. 这是在心外膜看到的点状出血。是小血管的出血形成的。当患有血小板减少引起的血液病时,在心外膜下会发现瘀点。瘀点也可在突然缺氧的情况下出现。 |
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The blotchy areas of hemorrhage in the skin are called ecchymoses (singular ecchymosis), or also as areas of purpura. Ecchymoses are larger than petechiae. They can appear with coagulation disorders. 皮下的出血斑称为淤斑或称紫癜,淤斑比淤点大。出现于凝血系统功能障碍。 |
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A localized collection of blood outside the vascular system within tissues is known as a hematoma. Here is a small hematoma under the toenail following trauma, which has a bluish appearance from the deoxygenated blood within it. 软组织内的局限性出血被认为是血肿。这是趾甲下面损伤引起的小血肿。由于是静脉血而使其呈现蓝色。 |
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Disseminated intravascular coagulation (DIC) is a consequence of widespread activation of the coagulation system through endothelial injury and/or release of thromboplastic substances into the circulation. DIC can be seen with severe infections, trauma, neoplasia, and obstetric complications, among others. Small fibrin thrombi can form in small arteries of brain, heart, lungs, kidneys, and other organs to produce ischemic tissue damage. 通过内皮损伤和/或释放促凝血物质进入血液循环使凝血系统被广泛激活是DIC产生的原因。严重感染、损伤、肿瘤形成和产科并发症以及其它疾病可以引起DIC。小纤维蛋白血栓可在脑、心脏、肺、肾以及其它器官的小动脉中形成,引起组织缺血。 |