Flashcards in Edema Deck (34):
What percent of lean body mass if water?
What percent of body water is blood plasma?
How much of body water is intracellular?
Hydrostatic (blood) Pressure
forces fluid OUT of blood vessel
Osmotic (oncotic) pressure
due to plasma proteins (ALBUMIN) -- holds fluids IN
increased fluid in interstitial tissue spaces, body cavities, and cells
due to increased vascular permeability; PROTEIN RICH exudate
PROTEIN POOR transudate
What causes non inflammatory edema? (4)
1. Inc Hydrostatic Pressure
2. Reduced Osmotic Pressure
3. Lymphatic Obstruction
4. Sodium Retention
What causes local increase in hydrostatic pressure?
Impaired venous outflow -- local edema
What causes generalized increase in hydrostatic pressure?
Leads to systemic edema -- could be because of congestive heart failure
What does cardiac edema (and other generalized edema's) respond to (treatment)?
What causes reduced plasma oncotic pressure?
excessive loss or reduced synthesis of albumin
What can cause loss of albumin?
1. Nephrotic syndrome (leaky)
2. Reduced synthesis (liver failure, protein malnutrition)
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
Lymphatic obstruction results in...
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
What is the result of salt retention?
1. Increases hydrostatic pressure
2. Dec Vascular osmotic pressure
EDEMA (occurs in acute renal dysfunction)
Diffuse - all parts of body
Dependent - legs or sacrum (depends on body position)
* can impair wound healing and clearance of infection
Left sided heart failure
Lungs = 2-3x normal weight -- frothy blood tinged fluid
* can be fatal if interferes with ventilation; predispose to infection (pneumonia)
Due to infection, neoplasm, hypertensive crisis, venous obstruction
* rapidly fatal -- herniation
Large accumulation of fluid in body cavities (pleural, pericardial, peritoneal -- ascites)
Local increased intravascular volume of blood within a tissue
Inflow of blood due to arteriolar dilation
RED tissue -- INC O2 blood
Impaird outflow on venous side
BLUE-red tissue -- accumulated deoxy hemoglobin
Gross morphology of hyperemic/congested tissues
Hemorrhagic and Wet
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
extravasation of blood due to vessel rupture most often from trauma, atherosclerosis, or erosion from inflammation or neoplasm
Types of hemorrhage
Hematoma -- in tissue
Petechiae -- in skin, mucous membranes
Purpura -- > 3 mm subcutateous
Ecchymoses -- bruise
Formation of ecchymoses
1. Erythrocyte eaten by macrophage
2. Hemoglobin(red-blue) changed to bilirubin (blue green) then to hemosiderin (gold-brown)
Large accumulations of blood in body cavities
How much of a blood loss can an adult withstand?
up to 20% of blood volume
>20% loss of blood may result in what
hemorrhagic (hypovolemic) shock