3 hemorrhage

for Undergraduate medical students (MBBS)

1. HemodynamicsHemodynamics
HEMORRHAGEHEMORRHAGE
Dr.CSBR.Prasad, M.D.

2. HEMORRHAGEHEMORRHAGE
•Hemorrhage - extravasation of blood due to rupture of BV
•Capillary bleeding:
Chronic congestion
Hemorrhagic diatheses
•Rupture of a large artery or vein - due to: Vascular injury
Trauma
Atherosclerosis
Inflammatory
Neoplastic erosion of the vessel wall

3. Manifestations – depends on size, Manifestations – depends on size,
extent, and location of bleeding. extent, and location of bleeding.
•Hematoma (accumulation of blood within tissue )
•Petechiae (1 - 2 mm hemorrhages into skin,
mucous membranes, or serosal surfaces )
•Purpura (≥3 mm)
•Ecchymoses (>1 - 2 cm) subcutaneous
hematomas
•Large accumulations of blood in one or another of
the body cavities - hemothorax, hemopericardium,
hemoperitoneum, or hemarthrosis

4. A - Punctate petechial hemorrhages of the colonic mucosa
B - Intracerebral hemorrhage
Consequences of thrombocytopenia

5. Petechial hemorrhages
(pinpoint hemorrhages)
seen on the epicardium
of the heart

6. Hemopericardium – Hemopericardium –
Cardiac tamponadeCardiac tamponade

7. Aortic tear with hemorrhages

8. Lacerated Liver – [Peritoneal hemorrhages]

9. Ecchymoses

10. Hematoma

11. Adrenal hemorrhageAdrenal hemorrhage

13. Raccoon Raccoon
eyeseyes

14. HematomaHematoma

15. HematomaHematoma

17. Purpura - HSP

18. Subconjunctival hemorrhage

20. Subdural Subdural
hematomahematoma

21. Subdural hematomaSubdural hematoma

22. Subgaleal hemorrhageSubgaleal hemorrhage

23. Subgaleal Subgaleal
hemorrhagehemorrhage

24. Clinical significance of hemorrhage Clinical significance of hemorrhage
Depends on the volume and rate of bleeding & blood loss:

•Rapid loss of up to 20% of the blood volume
or slow losses of even >20%
•Losses >20% may result in hemorrhagic (hypovolemic) shock
•The site of hemorrhage is also important:
Trivial bleeding in the subcutaneous tissues – innocuous
Trivial bleeding in the brain – may cause death
•External loss Vs Internal loss:
Chronic or recurrent external blood loss – Loss of iron and IDA
Hemorrhage into body cavities or tissues – No iron deficiency
No adverse effects

25. E N DE N D
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