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Cardiology Chest Discomfort (Pericardial Disease) Pericardial Effusion and Tamponade: Pathogenesis and Clinical Findings Pericardial Effusion and Tamponade: Pathogenesis and Clinical Findings

Pericardial Effusion and Tamponade: Pathogenesis and Clinical Findings

Signs (Stigmata) of chronic liver diseaseChronic Liver Disease (cirrhosis, etc)Caput medusae(enlarged, snake-like collateral veins around umbilicus)? hydrostatic pressure in abdominal capillaries Hepatic Encephalopathy:degeneration of neurological functionBlood backs up into the spleen, causing splenic congestionPortal hypertension: ? blood pressure in the hepatic circulationLiver unable to synthesize clotting factorsSclera icterus,JaundiceBlood backs up into the collateral venous system Cruveilhier-Baumgarten sign(auscultated murmur of bloodflow in abdominal collateral veins)Fluid exudes from plasma in the capillaries into peritoneal cavityAscitesLiver not detoxifying toxins like NH3Failure of liver to conjugate bilirubin, or to secrete conjugated bilirubinEasy bruising(Coagulopathy)Blood clotting ability is reducedPositive fluid wave testShifting dullness on percussion of abdomenAsterixis(outstretched hands, with fingers pointed vertically upwards, falls uncontrollably) ? liver function ("liver insufficiency")Bilirubin backs up into circulation and accumulates under the sclera and skin? estrogen in the bloodstream? estrogen removal by the dysfunctional liverPalmar erythema(arteriole dilation under the skin of the palms, but not the palmar surface of the fingers, causing palms to appear more red)Spider Nevi (aka. Telangiectasia)(dilated arterioles on the skin of the upper body, drained by venules circumscribing the arteriole)Effects on reproductive tissue:?Gynecomastia?Testicular atrophy?? pubic hairSplenomegalyDullness to percussion over Traube's space and Castell's PointPalpation of splenic edge in Left Upper QuadrantDupuytren's contracture(common in alcoholics)Terry's NailsClubbing of fingertips(sign of chronic solid organ disease, i.e. liver, lung)Just kidding, mechanism unknownMagicAuthor: Yan YuReviewers:Paul RattiAmy MagheraSam Lee** Indicates faculty member at time of publicationEstrogen relaxes arteriolar smooth muscle, dilating the arteriolesPruritus (itching)