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Pulmonary embolism (mechanism of disease)

This is a mechanism of disease map for pulmonary embolism, covering the risk factors, pathophysiology, and manifestations of the disease. This video was created using Google Slides. ADDITIONAL TAGS: Core concepts Inflammation / cell damage Social determinants of health Respiratory gas regulation Gene expression / regulation Blood pressure physiology Biochemistry Pulmonary embolism Risk factors Risk factor pathophysiology Disease process Manifestation Virchow's triad Venous stasis Endothelial injury Hypercoagulable state Factor V Leiden Prothrombin gene mutation inherited Recent surgery or trauma Immobilization Hormone therapy Active cancer provoking Obesity Cigarette smoking non-provoking Generation of thrombus, typically in lower extremity proximal deep veins Deep vein thrombosis (DVT) travels to lungs DVT occludes pulmonary arteries and/or arterioles Low perfusion in pulmonary vasculature and parenchyma Congestion in pulmonary vascular beds Hypoxia induces increased pulmonary vascular resistance ↓ LV preload + ↑ RV overload: ↓ stroke volume, ↓ cardiac output Hypotension Activates baroreceptors → adrenergic response Tachycardia Lung tissue ischemia and infarction Inflammatory mediators Pulmonary edema Pleuritic irritation Pain receptors in parietal pleura transmit afferent signal via phrenic and intercostal nerves → spinal cord → spinothalamic tract → thalamus → cerebral cortex Pleuritic chest pain Chemo- and mechanosensory receptors lining airway activated Mucus secretion Efferent signals to diaphragm, pharynx, intercostal, and neck muscles Cough Ventilation perfusion mismatch ↓ pH, ↑ pCO2, ↓ PaO2 Hypoxemia Peripheral sensory receptors detect hypoxia → CNS centers drive activation of respiratory system → increased work of breathing Dyspnea Blood flow physiology Nervous system physiology Cellular physiology Signs / symptoms