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13. Disturbances of the peripheral blood circulation

13.1. Name the main forms of the local disturbances of blood circulation:

Arterial hyperemia, venous hyperemia, ischemia, stasis, thrombosis and embolism.

13.2. What is arterial hyperemia?

Arterial hyperemia is an increasing of blood filling of some organ or a tissue due to superfluous receipt of blood on arterial vessels.

13.3. What functional changes and clinical attributes characterize arterial hyperemia?

During arterial hyperemia the expansion of small arteries, arterioles, veins and capillaries are observed; acceleration of the blood flow in them, the pulsation of fine arteries and capillaries, increase in number of vessels seen by an eye, increase in pressure in arterioles, capillaries and veins. As a result of the specified changes there is a diffuse redness, the local temperature raises, the volume of hyperemic site increases, turgor of tissue raises, increases the metabolism and functions of organ.

13.4. What factors can be a cause of arterial hyperemia? What mean the physiological and pathological arterial hyperemia?

The reason of arterial hyperemia can be influence of physical, chemical and biological factors of an environment; increase of loading on organ or the part of tissue; psychogenic influences.

Physiological arterial hyperemia arises as a result of influences of usual physiological matters (such like increasing the load on organ, psychogenic influences). Its main types are working and reactive hyperemia.

The working hyperemia is the increasing of blood flow in the body during amplification of its function (increasing of coronal blood flow in case of amplification of work of heart, hyperemia of salivary glands at reception of food, etc.).

Reactive hyperemia represents increase of blood flow after its short-term restriction. It develops usually in kidneys, brain, skin, intestines and muscles.

Pathological arterial hyperemia arises as a result of action of the unusual (pathological) factors or as a result of increase of sensitivity of vessels to usual influences. It accompanies with development of such pathological processes, as an inflammation, an allergy, burns, a fever. Its clinical examples can be an infectious or allergic spots, reddening of the skin at many infectious diseases (measles, a scarlet fever, a typhus), reddening of half of face at a neuralgia of a trigeminal nerve, etc.

13.5. Name the main mechanisms of the pathological arterial hyperemia development.

Two mechanisms are distinguished: neurogenic and myoparalytic - mechanism which is connected with activity of local chemical (metabolic) factors.

Depending on concrete mechanisms of development neurogenic arterial hyperemia can be of such types: neurotonic and neuroparalytic.

Myoparalytic (metabolic) arterial hyperemia caused by decreasing of contractile properties of smooth muscles of vessels as a result of influence of chemical agents.

13.6. What is the essence of the neurotonic mechanism of development of the arterial hyperemia ?

The neurotonic type of arterial hyperemia develops at increase of pulsation on vasodilating nerves (vasodilators), - such like parasympathetic nerves and sympathetic cholinergic nerves, which mediator is acetylcholine.

In experiment on animals this type of arterial hyperemia is reproduced by irritation of vasodilating nerves. So, irritation of chorda tympani (the branch of n. facialis) causes arterial hyperemia and amplification of submandibular salivary gland secretion (K. Bernara's experiment).

In clinic neurotonic hyperemia arises more often as a reflex at irritation of extra- and intra-receptors, and also at irritation of vasodilating nerves and their centers. In particular it can explain the reddening of the face and neck in case of progress of pathological processes in internal organs (ovaries, heart, and a liver).

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