Edema Flashcards
1
Q
Escape of Fluid
A
Edema
2
Q
Escape of cellular elements of blood
A
Hemorrhage
3
Q
Undesired clotting of blood
A
Thrombosis
4
Q
Detached intravascular mass
A
Embolism
5
Q
Ischemic necrosis
A
Ischemia
6
Q
Tissue injury secondary to systemic hypotension
A
Shock
7
Q
Water accounts for ____ % of the lean body weight
A
60 %
8
Q
Is most water of the body in extracellular or intracellular spaces?
A
Intracellular
9
Q
Residual fluid left in the interstitium is drained by _______
A
Lymphatic vessels
10
Q
How much fluid (ml/min) is moved out from arteries to tissues?
A
14 ml/min
11
Q
How much fluid (ml/min) is moved in from tissues to veins?
A
12 ml/min
12
Q
How much fluid is drained via the lymphatic system (ml/min)?
A
2 ml/min
13
Q
Accumulation of interstitial fluid within the tissues
A
–Edema
14
Q
= pleural effusion
A
Hydrothorax
15
Q
= pericardial effusion
A
Hydropericardium
16
Q
=ascites (alcoholic cirrhosis)
A
Hydroperitoneum
17
Q
–High specific gravity
–Protein rich
–Inflammatory edema
A
•Exudate
18
Q
–Low specific gravity
–Protein poor
–Volume or pressure overload
–Reduced plasma protein
A
Transudate
19
Q
- Lymphatic spread of bacterial infection
* Painful red streaks and regional lymphadenopathy
A
Lymphangitis
20
Q
–Increase in fluid in the interstitial space caused by an abnormality in the lymphatic system
–Lymphatic fluid collects in tissues causing edema
–May be congenital or acquired
•Acquired
•Congenital
A
Lymphedema
21
Q
- Parasitic tropical disease
- Mosquito vector
- Nematode (roundworm) -Wuchereriabancrofti
- Lymph node fibrosis, lymph stasis and chronic lymphedema
- Elephantiasis
A
Lymphatic Filariasis
22
Q
- Angiosarcoma arising from chronic lymphedema
* Long-standing lymphedema secondary to surgical lymph node dissection and/or radiation therapy
A
Stewart-Treves Syndrome
23
Q
Severe, generalized edema
A
Ansarca
24
Q
- Congestion in systemic and portal venous circulations •Congestive hepatomegaly -chronic passive congestion -“nutmeg” liver
- Congestive splenomegaly
- Pleural effusion
- Peripheral edema -pitting edema
A
Right-sided edema
25
* Increased intra-cranial pressure may result in herniation of cerebellar tonsils through the foramen magnum
* Compression of the medulla depression of the centers for respiration and cardiac rhythm control
Cerebral Edema
26
_____ edema is usually caused by –Increased vascular permeability (injury-inflammation)–Obstruction of venous or lymphatic outflow
Localized
27
_______ edema is generally caused by decreased plasma osmotic pressure
Generalized
28
Generalized edema is generally caused by decreased ________
plasma osmotic pressure
29
```
Severe swelling and edema of the entire body is called:
A.Ascites
B.Transudate
C.Effusion
D.Anasarca
```
Ansarca
30
What are the 5 pathophysiologic categories of edema?
```
Increased hydrostatic pressure
Decreased plasma osmotic pressure
Lymphatic obstruction
Sodium retention
Inflammation
```
31
Arteriolar dilation leads to increased blood flow
–Active process
–Sites of inflammation
–Skeletal muscle during exercise
•Affected tissues turn red (erythema) because of engorgement of vessels with oxygenated blood
Hyperemia
32
* Reduced outflow of blood from a tissue (stasis)–Passive process–Impaired venous drainage dilation of venules and capillaries
* Congested tissues take on a dusky, reddish-blue color (cyanosis) due to red cell stasis and accumulation of deoxygenated hemoglobin
Deep venous thrombosis
33
Compression of superior vena cava by neoplasm obstructing venous return
Superior Vena Cava syndrome
34
= extravasation of blood into the extravascular space
Hemorrhage
35
____ hemorrhage =rupture of a large vessel secondary to injury –Trauma, atherosclerosis, erosion of a vessel wall (inflammation or neoplasia)
Severe hemorrhage
36
___________ =increased tendency to hemorrhage –occurs in a variety of clinical disorders
Hemorrhagic diathesis
37
: pinpoint hemorrhages
Petechiae
38
: petechiae become confluent> 0.3 cm
Purpura
39
:purpurae become confluent> 1.0 cm
Ecchymosis
40
: a physiologic process that maintains blood in a fluid state in normal vessels, yet also permits the rapid formation of a hemostatic clot at the site of a vascular injury
Hemostasis
41
: pathologic counterpart of hemostasis that involves blood clot (thrombus) formation within intact vessels
Thrombosis
42
____ hemostasis is associated with platelet plug
Primary hemostasis
43
______ hemostasis is associated with fibrin clot
Secondary hemostasis
44
_____ hemostasis: formation of hemostatic plug–Highly thrombogenic sub-endothelial matrix exposed–Platelet adherence and activation–Shape change from small, round disks to flat plates with markedly increased surface area–Release of secretory granules–Recruitment of additional platelets (aggregation)
Primary hemostasis
45
* Most common hereditary bleeding disorder•Group of bleeding disorders
* Quantitative or qualitative abnormality of the von Willebrand factor (vWF)
* vWF is a platelet adhesion molecule required for normal platelet adhesion
* vWF is the carrier protein for factor VIIIsite of injury
Von Willebrand Disease
46
•Compound defect involving both platelet function and coagulation pathway
von Willebrand Disease
47
* Balance between antithrombotic and prothrombotic properties of endothelium determines whether thrombus formation, propagation or dissolution occurs
* Normally exhibit antiplatelet, anticoagulant and antifibrinolytic properties
* May be activated by trauma, infectious agents, hemodynamic forces, plasma mediators and cytokines
* After activation, endothelial cells acquire procoagulant activities
Endothelial Cells
48
What are the 3 factors leading to thrombosis (Virchow's triad)?
Endothelial injury
Stasis or turbulent flow
Hypercoagulability of the blood flow
49
____- thrombi–Heart chambers or aortic lumen
Mural thrombi
50
_______ thrombi–Frequently occlusive–Most common: Coronary, cerebral, femoral arteries–Superimposed on ruptured, ulcerated atherosclerotic plaque
Arterial thrombi
51
______ thrombi –Usually occlusive: thrombus forms a long cast of the lumen–Veins of lower extremities
Venous thrombi
52
_______ thrombi–Begin at sites of turbulence or endothelial injury–Propagate away from the heart
Arterial or cardiac thrombi
53
_______ thrombi–Occur at site of stasis–Propagate toward the heart
Venous thrombi
54
* Thrombi often have grossly and microscopically apparent laminations called_______
* Pale platelet and fibrin deposits alternating with darker red cell-rich layers
* Laminations signify that a thrombus has formed in flowing blood
* Their presence can distinguish antemortem thrombosis from the bland, non-laminated clots that occur postmortem
lines of Zahn
55
Fate of thrombus: fibrinolysis
Dissolution
56
Fate of thrombus: accumulate additional platelets and fibrin
Propagation
57
Fate of thrombus: dislodge and travel to other sites in the vasculature
Embolization
58
_____ thrombi:
| -Embolize to lungs and cause death
Venous thrombi
59
_____ thrombi:
| Embolize and cause downstream infarctions
Arterial thrombi
60
_____ thrombi:
–Cause local congestion, swelling, pain and tenderness
–Rarely embolize
Superficial venous thrombi
61
_____ thrombi:
–Cause local pain and edema –rapidly offset by collateral channels–More often embolize to lungs–Half are asymptomatic, recognized in retrospect after embolization
Deep venous thrombi
62
* Widespread fibrin thrombi in the microcirculation–not grossly visible but can be seen microscopicallyplatelet and coagulation protein consumption (consumptive coagulopathy)
* May cause diffuse circulatory insufficiency–brain, heart, lungs, kidneys
* Fibrinolytic mechanisms are activated
* Initial thrombotic disorder can evolve into a bleeding disorder
* Not a primary disease but a potential complication of any condition associated with widespread activation of thrombin–E.g. advanced malignancy, obstetric complication
Disseminated Intravascular Coagulation
63
* A detached intravascular solid, liquid or gaseous mass that is carried by the blood to a site distant from its point of origin
* Lodge in vessels too small to permit further passage and cause partial or complete occlusion –Major consequence is ischemic necrosis (infarction) of the downstream tissue
Embolus
64
_____ emboli:
| –tend to lodge in one vascular bed (lung)
Venous emboli
65
_____ emboli:
–can travel to a wide variety of sites
–Point of arrest depends on source and relative amount of blood flow
–^ in lower extremities and brain
–Consequences depend on vulnerability of tissue to ischemia, caliber of occluded vessel and collateral blood supply
Arterial emboli
66
An embolus that originates on the right side venous circulation and bypasses lung lodges in the left side systemic arterial circulation
Paradoxical embolus
67
–Restriction in blood supply, usually due to factors in the blood vessels–Lack of oxygen, glucose and other bloodborne materials tissue damage
Ischemia
68
–Complete loss of blood supply, resulting in necrosis
| –Ischemic necrosis
Infarct
69
–More general term denoting a shortage of oxygen
| –Usually a result of lack of oxygen in the air being breathed
Hypoxia
