Skip to content
Epomedicine
Epomedicine

Mnemonics, Simplified Concepts & Thoughts

  • Medical Students
  • Bedside Clinics
  • Case Reports
  • Emergency Medicine
  • Blog
  • Surgical Skills
  • Medical Mnemonics
Epomedicine

Mnemonics, Simplified Concepts & Thoughts

Pathophysiology of Acute Compartment syndrome

Epomedicine, Apr 27, 2023Apr 27, 2023

Last updated on April 27, 2023

Definition

Mubarak and Hargens (1981) defined compartment syndrome as an elevation of the interstitial pressure in a closed osseofascial compartment that results in microvascular compromise.

Pathophysiology

Tissue perfusion = Capillary perfusion pressure – Interstitial fluid pressure

  • Normal capillary pressure at rest: 20-33 mmHg (approximately 25 mmHg)
  • Normal interstitial fluid pressure at rest: 10 mmHg

3 major theories for microvascular dysfunction and ischemia:

  1. Critical closing pressure theory:
    • Transmural pressure = Intravascular pressure – Tissue pressure
    • Transmural pressure drops to ‘critical pressure’ → Active closure of small arterioles
  2. Microvascular occlusion theory:
    • Compartment pressure above this level (absolute compartment pressure) → Compartment syndrome
  3. Arteriovenous (AV) gradient theory:
    • Increase in tissue pressure → Decreased AV pressure gradient → Reduction of blood flow

Tissue survival:

  1. Muscle
    • 3-4 hrs: Reversible changes
    • 6 hrs: Variable damage
    • 8 hrs: Irreversible changes
  2. Nerve
    • 2 hrs: Loose nerve conduction
    • 4 hrs: Neuropraxia
    • 8 hrs: Irreversible changes

Vicious cycle of compartment syndrome:

compartment syndrome vicious cycle

Reperfusion injury: Since the tissue pressure does not exceed the systolic blood pressure, there is the potential for some continued perfusion in the affected compartment. This leads to reperfusion injury and includes the release of reactive oxygen metabolites as well as pronounced neutrophil activation.

  • Facebook
  • Twitter
PGMEE, MRCS, USMLE, MBBS, MD/MS Musculoskeletal systemOrthopedics

Post navigation

Previous post
Next post

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Epomedicine. Pathophysiology of Acute Compartment syndrome [Internet]. Epomedicine; 2023 Apr 27 [cited 2025 May 31]. Available from: https://epomedicine.com/medical-students/pathophysiology-acute-compartment-syndrome/.

Pre-clinical (Basic Sciences)

Anatomy

Biochemistry

Community medicine (PSM)

Embryology

Microbiology

Pathology

Pharmacology

Physiology

Clinical Sciences

Anesthesia

Dermatology

Emergency medicine

Forensic

Internal medicine

Gynecology & Obstetrics

Oncology

Ophthalmology

Orthopedics

Otorhinolaryngology (ENT)

Pediatrics

Psychiatry

Radiology

Surgery

RSS Ask Epomedicine

  • What to study for Clinical examination in Orthopedics?
  • What is the mechanism of AVNRT?

Epomedicine weekly

  • About Epomedicine
  • Contact Us
  • Author Guidelines
  • Submit Article
  • Editorial Board
  • USMLE
  • MRCS
  • Thesis
©2025 Epomedicine . All rights reserved.