Hyperaemia, congestion and haemorrhage

HYPERAEMIA,HYPERAEMIA,
and CONGESTIONand CONGESTION

Hyperaemia and CongestionHyperaemia and Congestion
Both terms indicates increase volume ofBoth terms indicates increase volume of
blood inside the vessels, in other wordsblood inside the vessels, in other words
too much blood inside the vesselstoo much blood inside the vessels
HyperaemiaHyperaemia
Active processActive process
Blood is brought to the area due to arteriolarBlood is brought to the area due to arteriolar
dilatationdilatation

CongestionCongestion
Passive processPassive process
Blood is not efficiently drained form the areaBlood is not efficiently drained form the area
and thus accumulates inside the vesselsand thus accumulates inside the vessels

Types of HyperaemiaTypes of Hyperaemia
PhysiologicalPhysiological
After meal (blood is brought to digestiveAfter meal (blood is brought to digestive
system)system)
Athletes (hyperaemia, in muscles)Athletes (hyperaemia, in muscles)
Blushing of face (embarrassment, excitementBlushing of face (embarrassment, excitement
or nervousness)---?or nervousness)---?

 PathologicalPathological
DurationDuration
AcuteAcute
ChronicChronic
ExtentExtent
Based on area of tissueBased on area of tissue
involvement, localized orinvolvement, localized or
generalizedgeneralized
Localized hyperaemiaLocalized hyperaemia
confined to an area ofconfined to an area of
limited extentlimited extent
GeneralizedGeneralized
hyperaemia, indicative ofhyperaemia, indicative of
systemic changesystemic change
involving whole organinvolving whole organ

MechanismMechanism
Active (increased arterial flow to an area orActive (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 intestinalacute local passive (hyperaemia due to intestinal
torsion)torsion)

Chronic local passive ( local hyperaemia,Chronic local passive ( local hyperaemia,
slowly develops due to growing tumors orslowly develops due to growing tumors or
abscess)abscess)
Chronic general passive (CHF)Chronic general passive (CHF)
Chronic generalized active heperaemia??Chronic generalized active heperaemia??

ACUTE LOCAL ACTIVEACUTE LOCAL ACTIVE
HYPERAEMIAHYPERAEMIA
Local engorgement of blood vessels dueLocal engorgement of blood vessels due
to arterial blood flow (inflammation)to arterial blood flow (inflammation)
RednessRedness
WarmthWarmth
The increased blood flow due to anThe increased blood flow due to an
inflammatory process opens the capillaryinflammatory process opens the capillary
bed present in the area due to pressure inbed present in the area due to pressure in
the arteriole, pulse can be feltthe arteriole, pulse can be felt

ACUTE LOCAL PASSIVEACUTE LOCAL PASSIVE
Acute local congestion ( impairment ofAcute local congestion ( impairment of
venous drainage from some acutevenous drainage from some acute
obstruction)obstruction)
Dark red in colour (unlilke bright red inDark red in colour (unlilke bright red in
acute local active hyperaemia owing toacute local active hyperaemia owing to
well oxygenated blood)well oxygenated blood)
Pulse (unlikely to be felt)Pulse (unlikely to be felt)
ThrombosisThrombosis
embolismembolism

Torsion of the uterus or intestineTorsion of the uterus or intestine
Veins are thin walled and have low bloodVeins are thin walled and have low blood
pressure in them and due to torsion can easilypressure in them and due to torsion can easily
be blockedbe blocked

CHRONIC LOCAL PASSIVECHRONIC LOCAL PASSIVE
Chronic local congestionChronic local congestion
Time period (only difference from previousTime period (only difference from previous
one)one)
Blockage of venous channels (impairmentBlockage of venous channels (impairment
in drainage process)in drainage process)
Slowly developing blockagesSlowly developing blockages
Tumor (out side the vessel)Tumor (out side the vessel)
AbcessAbcess

Chronic inflammatory process (fibrosis)Chronic inflammatory process (fibrosis)
Liver cirrhosis (fibrosis) loss of hepatic lobularLiver cirrhosis (fibrosis) loss of hepatic lobular
structure eventually leads to portalstructure eventually leads to portal
hypertension, fluid leakage form the portalhypertension, fluid leakage form the portal
vessel results in its accumulation in thevessel results in its accumulation in the
peritoneal cavity ( ).peritoneal cavity ( ).

CHRONIC GENERAL PASSIVECHRONIC GENERAL PASSIVE
Chronic generalized congestionChronic generalized congestion
Heart or lungsHeart or lungs
CHF (congestive heart failure)CHF (congestive heart failure)
Pulmonic stenosis, congestion develops withPulmonic stenosis, congestion develops with
primary target (liver) due to venous engorgementprimary target (liver) due to venous engorgement
of back channels, it occurs because the right heartof back channels, it occurs because the right heart
not pushing the blood efficiently to the lung andnot pushing the blood efficiently to the lung and
thus blood stagnates in the back channels.thus blood stagnates in the back channels.
Tricuspid inefficiencyTricuspid inefficiency
Aortic stenosisAortic stenosis

LungsLungs
Lung diseases leading to higher resistance forLung diseases leading to higher resistance for
the propulsion of blood and thus cause rightthe propulsion of blood and thus cause right
sided heart failure and the syndrome is calledsided heart failure and the syndrome is called
COR PULMONALECOR PULMONALE

APPEARANCE OFAPPEARANCE OF
Colour changes in tissueColour changes in tissue
Bright red or dark red ( depending uponBright red or dark red ( depending upon
mechanism i.e. active or passivemechanism i.e. active or passive
Swollen or oedematousSwollen or oedematous
In case of chronic passive hyperaemiaIn case of chronic passive hyperaemia
Necrosis may be present ( ? )Necrosis may be present ( ? )

In case of chronic passive hyperaemia ofIn case of chronic passive hyperaemia of
lunglung
The alveolar capillaries get engorged withThe alveolar capillaries get engorged with
blood and dilatedblood and dilated
IN CASE OF CHRONIC PASSIVEIN CASE OF CHRONIC PASSIVE
HYPERAEMIA OF LIVERHYPERAEMIA OF LIVER
right side heart failure, dilation of sinusoidsright side heart failure, dilation of sinusoids
takes place with resultant atrophy of thetakes place with resultant atrophy of the
hepatic cords due to pressure of blood.hepatic cords due to pressure of blood.

Dark red around the central vein withDark red around the central vein with
yellow-brown colour around the portal triadyellow-brown colour around the portal triad
regionsregions
Mottled appearance to the liver “NUTMEGMottled appearance to the liver “NUTMEG
LIVER”LIVER”

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