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Youtube internet of things explained order write for me capstone turbine generators police blotter report format philippines postal code let's talk about hemorrhage we've already defined it let's describe a little bit better sometimes the word hemorrhagic diathesis is used and really I kind of object to the word diathesis because it's a big confusing word that never means anything but sometimes it's used to describe hemorrhage if the hemorrhage has a pressure or mass effect and surrounding structures is often called hematoma hence the word alma if the blood process dice X through the wall of its vessel and this is particularly true with arteries and larger arteries such as an aorta they'll often use the word dissecting hemorrhage hemorrhage can also be described on the surface of organs or skin especially in terms of its size if the size of the reddish purplish discoloration is about a millimeter that's called petechiae if it's up to a centimeter it's called purpura if its larger than a centimeter is called an ecchymosis and basically these are just sighs descriptions so the more extensive the larger the size with one millimeter less than one centimeter and more than centimeter being the boundaries however clinically a really smart person once told me that if the hemorrhage is petechial then the cause of the bleeding is almost always a platelet problem in other words either platelets that aren't enough in numbers or ones that aren't working perhaps another name for these larger hemorrhages can be called bruises as well just like with water we said there's such a thing as hydro thorax hydro pericardium hydro perineum hydro hydra hydra throws this way if you sup the word heem for hydro the same process in which no we have blood in these cavities rather than edema or fluid or water and of course we said that acute hemorrhage will manifest itself as blood cells and blood products whereas chronic hemorrhage will be breakdown of these products histologically this would be manifested as hemosiderin a golden pigment which stains intensely with depression blue stain and you would guess it stains if you guess that same blue you're correct let's talk about evolution of hemorrhage because you all know when you get a bruise it changes colors and in the very acute stage is kind of a purplish red which is you know what you'd expect Oh perhaps after a few days maybe a week it kind of gets greenish and then eventually it gets brown and basically that's due to the chemical changes that go on in hemorrhage in the earliest stages it's hemoglobin which is purplish red at least to the I grossly bilirubin becomes a main product after some amount of time and of course chronic hemorrhage now hemosiderin is the main product so that's the reason why purple green and brown generally are seen as hemoglobin bilirubin and hemosiderin respectively let's look at some hemorrhage for X hemorrhage along a mucosal surface like hair nikkolon perhaps hemorrhage in the form of a hematoma causing some compression of brain ask in bruges and of course you know if that's over a centimeter what you call it sub uncle hemorrhage or a general a purplish discoloration of the skin if you think that's purple you know it's recent if you think it's a green or brown then you know it's more evolved with time there's some hemorrhage in the brain it could be subdural it could be epidural it could be a subarachnoid depending on causes and different things let's not try to find this but you would guess if this is below the dura it would be subdural if it was above the dura and almost almost always involving probably some skull fracture would it be epidural if it was bleeding from a very large beth vessel rupture which runs in the subarachnoid space then you call that subarachnoid hemorrhage here's some hemorrhage in the abdomen you can see there's a gelatinous blood clots and remember blood cots can form after a patient dies as well so there's a little trick we use to differentiate what call pre-mortem from post-mortem blood clots and of course in the pulmonary artery this is crucially important to figure out whether this clot formed in the lung after the person died or not only before but it's what caused them to died here's some hemorrhage along a serosal surface here's some free hemorrhage within the abdominal cavity here's hemorrhage as might be seen on a CT scan you know it's CT because the bones are the densest structures it might look perhaps like a tumor within the spleen perhaps you could see it as some disruption of the kidney and the principle is if the hemorrhage is denser than the surrounding tissue that it's in it will show up as an increased density x-ray wise as well an MRI on the other hand is much better for hemorrhage because as these chemicals change from bilirubin I'm sorry from hemoglobin to bilirubin to hemosiderin they give off different signals under a variety of tweaking of the coils and the magnet so you can actually look tell chemically whether the hemorrhages in one of these three chemicals by being a slick MRI doctor and of course usually an MRI the bone is one of the least intense things so you know this is MRI what's a difference between the hematoma in a clot well not much they're both about the same but remember if a blood clot whether it's especially a pre-mortem blood clot has kind of a mass effect it is generally called a hematoma okay so let's go into another start solidly into another topic called hemostasis and hemostasis can be defined at Best Buy talking about what it is the opposite of it is the opposite of thrombosis so if you took all of the forces in the body that coagulate blood that's called thrombosis if you look at all of the forces that prevent coagulation that's called hemostasis so hemostasis are the forces which preserve the liquidity of the blood and hemostasis is also a mechanism for plugging sites of vascular injury hemostasis has three main components and we're going to get into that in the next ten minute clip but let's mention them now there are vascular wall components and that's chiefly due to the action of endothelial cells and the underlying extracellular matrix that's also be thought of as being the earlier component or earliest then there is the component of platelets doing all the things that platelets do which we'll talk about and then finally the classical coagulation cascade the changing of pro factors into factors with the ultimate of formation of the fibrin clot all of the factors that lead up to it and some of the factors after it after it which either stabilize that clot or dissolve the clot which is called fibrinolysis so let's talk about the sequence of events following vascular injury at least the beginning the very first thing that happens is that's a reflex neurogenic vasoconstriction it has nothin to it chemicals it's strictly neurogenic the endothelial cells however then release a compound called endothelium which is a very powerful vasoconstrictor why because it wants to close off that vessel that's leaking that's why the extracellular matrix when exposed to the blood x is a very very very powerful substance to adhere and activate platelets and the ultimate secondary process then is the formation of a platelet plug or platelet aggregation and that's called primary hemostasis if tissue factor or when tissue factor is released by the endothelium or you get that whole coke a coagulation cascade we're then talking about the final formation of fibrin the fibrin plug or secondary hemostasis and of course if you think that's into the story it's not because then there's called TPA tissue plasminogen activator which limits that plug and there are other processes which dissolve it called fibrinolysis let's continue in another movie do my excel 2018 capstone project ex 3 simnet Hebrew Union College.