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D&T 1 Exam 1 > Edema > Flashcards

Flashcards in Edema Deck (34):
1

What percent of lean body mass if water?

60%

2

What percent of body water is blood plasma?

5%

3

How much of body water is intracellular?

2/3

4

Hydrostatic (blood) Pressure

forces fluid OUT of blood vessel

5

Osmotic (oncotic) pressure

due to plasma proteins (ALBUMIN) -- holds fluids IN

6

Edema

increased fluid in interstitial tissue spaces, body cavities, and cells

7

Inflammatory edema

due to increased vascular permeability; PROTEIN RICH exudate

8

Noninflammatory edema

PROTEIN POOR transudate

9

What causes non inflammatory edema? (4)

1. Inc Hydrostatic Pressure
2. Reduced Osmotic Pressure
3. Lymphatic Obstruction
4. Sodium Retention

10

What causes local increase in hydrostatic pressure?

Impaired venous outflow -- local edema

11

What causes generalized increase in hydrostatic pressure?

Leads to systemic edema -- could be because of congestive heart failure

12

What does cardiac edema (and other generalized edema's) respond to (treatment)?

Salt Restriction
Diuretics
Aldosterone Antagonists

13

What causes reduced plasma oncotic pressure?

excessive loss or reduced synthesis of albumin

14

What can cause loss of albumin?

1. Nephrotic syndrome (leaky)
2. Reduced synthesis (liver failure, protein malnutrition)

15

The net loss of fluid from the intravascular space into the interstitial space results in ....

1. Dec Intravascular Volume
2. Dec Renal Perfusion
3. Activation of Renin/Angiotensis/Aldosterone axis --> Na and H2O Retention

16

Lymphatic obstruction results in...

Lymphedema

17

What causes lymphatic obstruction?

1. Filariasis (parasite)
2. Neoplastic obstruction of superficial lymphatics resulting in edema of overlying skin (ORANGE PEEL)
3. Iatrogenic following resection of axillary lymph nodes

18

What is the result of salt retention?

1. Increases hydrostatic pressure
2. Dec Vascular osmotic pressure

EDEMA (occurs in acute renal dysfunction)

19

Subcutaneous edema

Diffuse - all parts of body
Dependent - legs or sacrum (depends on body position)
Pitting edema
* can impair wound healing and clearance of infection

20

Pulmonary Edema

Left sided heart failure
renal failure
Lungs = 2-3x normal weight -- frothy blood tinged fluid
* can be fatal if interferes with ventilation; predispose to infection (pneumonia)

21

Cerebral edema

Due to infection, neoplasm, hypertensive crisis, venous obstruction
* rapidly fatal -- herniation

22

Effusion

Large accumulation of fluid in body cavities (pleural, pericardial, peritoneal -- ascites)

23

Hyperemia/Congestion

Local increased intravascular volume of blood within a tissue

24

Hyperemia

ACTIVE
Inflow of blood due to arteriolar dilation
RED tissue -- INC O2 blood

25

Congestion

PASSIVE
Impaird outflow on venous side
BLUE-red tissue -- accumulated deoxy hemoglobin

26

Gross morphology of hyperemic/congested tissues

Hemorrhagic and Wet

27

Microscopic morph of hyperemic/congested tissues

dilation with blood in small vessels
Heart failure cells -- alveolar spaces contain these hemosiderin-laden macrophages in chronic pulm congestions

28

Hemmorrhage

extravasation of blood due to vessel rupture most often from trauma, atherosclerosis, or erosion from inflammation or neoplasm

29

Types of hemorrhage

Hematoma -- in tissue
Petechiae -- in skin, mucous membranes
Purpura -- > 3 mm subcutateous
Ecchymoses -- bruise

30

Formation of ecchymoses

1. Erythrocyte eaten by macrophage
2. Hemoglobin(red-blue) changed to bilirubin (blue green) then to hemosiderin (gold-brown)

31

Large accumulations of blood in body cavities

Hemothorax, Hemopericardium....

32

How much of a blood loss can an adult withstand?

up to 20% of blood volume

33

>20% loss of blood may result in what

hemorrhagic (hypovolemic) shock

34

Site of hemorrhage is imp

1. Intracranial -- small volume loss can be BAD
2. LOSS of blood -- can lead to iron deficiency