Super Simplified Pathology by Dr Priyanka Sachdev || Systemic Pathology – Transcript

00:22Is it audible now? Can you respond? Can we go ahead? Yes. Yes. So, Kulp, it is audible. No. Okay. Thank you. Thank you so much. Thank you. Thank you so much. And uh let me start the session. A very good morning to all of you. I welcome you all for today's session. And I am Dr. Dr. Priyanka Sajdev here those who don't know me who are listening the lecture for the first time. So I will start the systemic

00:47pathology today. So in today's session in non-stop marathon of 7 to 8 hours we are going to complete entire systemic pathology in the super simplified manner. Okay. So entire systemic pathology I am going to cover today. So basically in the entire systemic pathology I will cover all these systems one by one. the most important topics from these systems. So I will start with blood vessels followed by CVS followed

01:14by CNS then breast then I guess endocrine then git then renal then respiratory liver male and female genital will be in the end so I will cover all these systems one by one okay so without wasting any further time let's start with the first system I will take all these 12 systems today okay but the important topics not all the topics which are most important ultra important repeatedly asked topics because in the 6 to 8 hours we can cover the important

01:41topics only. Okay. So the high yielding topics let's start with the blood vessel. In the blood vessel I'm going to teach you aneurysm and aotic dissection. So let's start with aneurysm. Okay. What is aneurysm? What is aneurysm? Can you tell me what is aneurysm? So you know the ball of the blood vessel have three layers. Intima media externa. This is the wall of a blood vessel. The arteries or the blood vessels have three walls.

02:06Tuna inima, tuna media and tunika externa. If there is focal weakness at any point in the wall of the blood vessel, there is protrusion. A outpouching or protrusion is produced.

02:18This is out pouching or protrusion. Out pouching or protrusion is produced at focal one point because of weakness of the wall at that particular point. And this is known as aneurysm. So what is aneurysm? Can you tell me what is aneurysm? Anneurism is abnormal dilation of the wall of the blood vessel because of focal weakening. The weakening can be conjural can be acquired. So because of the weakness of the wall focal weakness there is a outpouching and that

02:43outpouching is known as aneurysm. So you all can see here we have drawn aneurysm because of focal weakness of the wall of the blood vessel at one particular point. It can be congenital it can be acquired the weakness right now what are the clinical feature if someone is having this out pouching uh is it bothersome does it produces any symptom?

03:02Now when the blood is flowing through this blood vessel you can imagine the blood will have stasis here. Normally blood keep on flowing keep on flowing keep on flowing but here the blood will have stasis because it is the outpouching. Now stasis yesterday I taught you general pathology in virtual triad stasis was one of the risk factor and it will lead to thrombus formation.

03:21So it will lead to thrombosis. It will lead to thrombosis. Okay. Thrombosis till it is attached to the ball it is thrombus. Once it get detached it is emolism. Yesterday I taught you that also. So thrombosis is the clinical feature. Ambolism is the clinical feature. Okay. You can see here the blood is showing the stasis. That's why it is showing thrombus formation.

03:41Once the thrombus get detached. It is ambolism. Right? Sometime it can get rupture. It is a medical emergency. The aneurysm can rupture at any of the blood vessel. The major blood vessel start bleeding internal bleeding. It's a very uh emergency condition and sometime it can cause compression of the surrounding neighboring structure. Can you see there is a aneurysm here? See the aneurysm and can you appreciate this is a nerve. So if you can appreciate the aneurysm is

04:07compressing the nerve. So the patient will have neuropathological symptoms. So these can be the clinical features. Yes, the PDF will be available after the session. Yesterday also I put the PDF on the Prom Telegram channel. Today also Dr. Bhanu Prakash Prom Telegram channel.

04:22I will put the PDF just after the session. So please concentrate on the session and if you don't write it's okay. Okay, I will provide the PDF, the exact PDF. Can we go ahead now? Can we go ahead? So, this is the clinical feature. You understood what is aneurysm. You understood the four clinical feature. Number one, thrombus formation. Number two, amolism. Number three, rupture. Number four, compression of the surrounding structure. These are the four clinical features of the uh aneurysm. Now, let me tell you three

04:49type of classification of aneurysm. How to classify it? The first classification based on the composition of the wall. It is of two types. What are the two types? True aneurysm and false. False aneurysm also known as pseudo aneurysm. The false one also known as pseudo anurism. What do you mean by true and false? Okay, I told you the wall of the blood vessel have three layers. Tunica inima, media and externa. Okay, so med tunica inima

05:15media externa. If all three are protruding out, intima, media and externa. If all three protruding out, so the wall of the blood vessel is made up of all three layers. It is a true anurism. You can see the wall. Please appreciate the wall. Here you can see the wall contain all three layers. Tuna inima, tunika media, tuna externa. It is a true aneurysm. True means real. Real aneurysm. This is the meaning of the true. The true contain all the three layers. Intima media externa. Can you

05:42see a normal blood vessel here? See the tunica inima. This is media. This is externa. Here also inima media externa. See all three are protruding out. Inima media externa. All three are protruding out. This one is a true aneurysm. You all can appreciate I guess. Okay. See the second possibility. There is a defect here. There is a hole or defect or there is a injury in the wall of the blood vessel. So what will happen? The person will start bleeding. This is the bleeding. To concise the bleeding body

06:10have a protective mechanism. The body will form a connective tissue covering. I'm using the word connective tissue covering. A connective tissue covering to concise the bleeding. Now it is looking like aneurysm but it is not aneurysm. Actually it is a hematoma. You can see it's a hematoma. Now the wall is made up of connective tissue. The wall is not made up of the three layers una inima media. No the wall is made up of connective tissue. It is looking like aneurysm but not aneurysm. That's why it is known as pseudo aneurysm or false

06:37aneurysm. Give me a thumbs up now. Please give me a thumbs up. Got it? Got it? So this is the two type of the aneurysm we have learned. The true aneurysm, the false or pseudo aneurysm. You can understand. So based on the composition of the wall if the ball of the aneurysm contain all three layers it's true. If the ball contains fibrous thickening and connective tissue it is a hematoma it is known as false aneurysm.

07:00This is the first classification. The second classification based on the shape there are five type of aneurysm. See the first one is the secular. Secular means unilateral protrusion. Unilateral in one of the side unilateral that is secular.

07:13The second is the fusy fusy form. Fusy form is completely circular all around. Protrusion is all around. Not in one direction. It is all around. So this one is fusy form. You can say it's like this. But this one is uh I'm sorry. The first one is the secular and this one is the fusyiform. I hope you can understand the difference between secular and fusify form. The third is the cylindrical in which a long parallel you can see the parallel parallel anurism is formed. The two walls are parallel to each other like cylinder cylindrical.

07:41The next is the serpentine in which multiple small small aneurysms are formed in continuity. It's serpentine. It's serpentine. And last one is the rimmos in which multiple blood vessels are interconnected with each other forming a risimos or a curoite. So these are the five types based on the shape fusififor secular cylindrical serpentine and reimos. Please see. Okay. The third classification based on the pathological mechanism who is causing the weakness. I told you this is the blood vessel. In

08:08the wall of the blood vessel there is a focal weakness at one point. At that point the wall of the blood vessel protrude out. So you should ask me a question ma'am who is causing this weakness? What is the cause of the weakness that is leading to the protrusion? The cause of weakness can be three based on which three type of aneurysm are there. The first reason for the cause of the weakness can be atherosclerosis. Most important 90% cause 90% time the cause is atherosclerosis. So focally there is the

08:35atherosclerosis because of which the wall got weakened and there is focal protrusion of the wall producing the aneurysm. Number one. Number two there can be syphilis. You know syphilis there are three type of syphilis. Primary, secondary, tertiary and tertiary syphilis. The wall of the blood vessels can be involved producing and arthritis in the wall of the blood vessel that is producing this weakness and that is causing the focal protrusion. So such an aneurysm which is caused by syphilis.

09:00The weakness is caused by syphilis it is known as lutic aneurysm. Lutic aneurysm is due to weakness produced by syphilis. It's very important PQ and atherosclerosis. The aneurysm also known as aththerosclerotic aneurysm. Atherosclerotic anorism is due to athosclerosis. Lutic aneurysm is due to syphilis. And third third cause is infection. Imagine if any infection occurs. It can be bacterial, viral, fungal, parasitic, any infection is caused in the wall of the blood vessel

09:26producing vasculitis. Any infection that causes weakness and that is producing the aneurysm. So such an aneurysm which is caused by the infection any infection it is known as micotic aneurysm. So there are three type of aneurysm atherosclerotic aneurysm due to atherosclerosis. Luteic aneurysm due to syphilis and mcotic aneurysm due to infection. So basically who is producing the weakness? There are three type of aneurysm. Give me a thumbs up. Got it?

09:52You can read the three names. The three type of aneurysm atherosclerotic as the name clarify it is due to aosclerosis. 90% is this type. This type only. The second is luteic. Luteic is due to syphilis. It's very important PQ. And third is mcotic. Micotic is due to microbial infection. Now it's a misnomer. Looking at the word mcotic, you may think it's fungus only. It is not only fungus. It can be bacteria, virus, parasite or fungus. Anything. You got it. Can we go ahead? Say yes. So let me describe the atherosclerotic and

10:19syphilis a little bit detailed. Atherosclerotic is the most common as I told you. Okay. As I told you, it is the most common one. Let me tell you. Uh, okay. Let me tell you the location of atherosclerotic and syphilitic aneurysm.

10:35They mostly occur in aortota. Do you know what are the parts of the aota? This is a rough diagram of the heart. This is the right side of the heart. This is the left side of the heart. From the left ventricle, the aot comes out like this. This is the aota. We all know that from the left ventricle, this is the AOTA. So a what parts iota have?

10:52This is ascending a iota. This is arch of iota. And this one is descending iota completely. Right? Now descending a yota is divided into two portion by the diaphragm. By the diaphragm. So above the diaphragm it's thoracic aort. The descending iota is known as thoracic iota and below the diaphragm it is known as abdominal iota. We all know that just revising. Okay. Now the abdominal iota again divided into two portions. Uh above the renal artery. So you can see from the aot the renal arteries are

11:20coming out. These are the two renal arteries supplying the two kidney. So suprarenal and infraal. You can see this portion is supraenal and this portion is infra infrarenal. So tell me the two aneurysm. I told you three important causes of the aneurysm. Atherosclerotic aneurysm, luteic aneurysm is due to syphilis and mcotic. So tell me their most common site in the aorta. Right?

11:42Most important pq. Let me draw arththerosclerotic. The athoscllerotic one is in the infraral portion to be very specific. It is not in ascending. It is not an arch of is in descending. In descending it is not in thoracic, it is in abdominal. In the abdominal, it is not in superal, it is infra. To be specific, this is the most common site of ethosclerotic aneurysm. Please pay attention. Okay. In the lutic, the most common site is the thoracic. The