Edema Flashcards
(42 cards)
<p>Edema</p>
<p>Accumulation of abnormal fluids in the intercellular/interstitial fluid comparment --> swelling of subcutaneous tissues</p>
<p>What mechanisms control edema?</p>
<p>1) Starling's forces
2) lymphatic obstruction
3) vascular permeability
4) cardiovascular function
5) overall fluid balance
6) salt retention</p>
<p>Describe Starling's Law</p>
<p>The movement of fluid between vessels and tissue is governed by 4 forces!</p>
<p class=”large” style=”text-align:center”;>Describe for 4 Starling forces and their net fluid movement relative to the blood vessel:</p>
<p class=”large” style=”text-align:center”;>1) Hydrostatic pressure in vessel (32 arterial to 12 venous) - OUT
2) Oncotic pressure - colloïde osmotic pressure of plasma (reflects the amount of serum protein - albumin) - IN
3) Interstitial fluid pressure (tissue retention) - 3-4 mmHg - IN
4) Interstitial fluid osmotic pressure (very low) - OUT</p>
<p>What are the four main types of edema?</p>
<p>Hydrostatic, Oncotic, Inflammatory/Traumatic, and Lymphedema</p>
<p class=”large” style=”text-align:center”;>What causes hydrostatic edema?</p>
<p class=”large” style=”text-align:center”;>Increase in intravascular hydrostatic pressure (due to increase venous pressure)</p>
<p>What causes pulmonary/oncotic edema?</p>
<p>Decrease in colloid osmotic pressure of plasma due to hypoproteinemia</p>
<p class=”large” style=”text-align:center”;>What causes inflammatory/traumatic edema?</p>
<p class=”large” style=”text-align:center”;>The vascular bed becomes leaky following an injury to the endothelium.</p>
<p>What causes lymphedema?</p>
<p>Lymphatic obstruction (increases interstitial oncotic pressure)</p>
<p class=”large” style=”text-align:center”;>What are the two types of congestive heart failure?</p>
<p class=”large” style=”text-align:center”;>Right side -> peripheral edema
Left side -> lung edema</p>
<p>What diseases are associated with an incrase in intravascular hydrostatic pressure?</p>
<p>Congestive heart failure and deep venous thrombosis of lower legs</p>
<p class=”large” style=”text-align:center”;>What diseases are associated with a fall in colloid osmotic pressure?</p>
<p class=”large” style=”text-align:center”;>Liver disease (cirrhosis); decreased synthesis of albumin
Renal failure due to loss of albumin
Malnutrition</p>
<p>What diseases are associated with lymphatic obstructions?</p>
<p>Cancer, inflammation, post-surgical lyphedema.</p>
<p class=”large” style=”text-align:center”;>What are the diseases associated with sodium retention?</p>
<p class=”large” style=”text-align:center”;>Kidney disease.</p>
<p>What are the causes of local edemas?</p>
<p>(1) increased hydrostatic pressure due to vascular obstruction and (2) lymphatic obstruction via tumour or inflammation.</p>
<p class=”large” style=”text-align:center”;>What are the causes of generalized edems?</p>
<p class=”large” style=”text-align:center”;>(1) increased hydrostatic pressure, (2) decreased colloid osmotic pressure due to loss of albumin, and (3) errors in sodium retention.</p>
<p>What is the difference between a transudate and an exudate?</p>
<p>Transudate results form disturbances in starling forces, while exudates result from damage to capillary walls.</p>
<p class=”large” style=”text-align:center”;>Hyperaemia</p>
<p class=”large” style=”text-align:center”;>Engorgement by blood causes redness (i.e., acute inflammation, exercise)</p>
<p>Congestion</p>
<p>Impaired venous drainage causes accumulation of deoxygenated blood due to increase in venous hydrostatic pressure.</p>
<p class=”large” style=”text-align:center”;>What is thrombosis and what are it’s components?</p>
<p class=”large” style=”text-align:center”;>Formation of mass (clotted blood) in the heart or blood vessels. The mass consists of: RBCs, WBCs, Platelets, Fibrin</p>
<p>What causes thrombosis?</p>
<p>1) Vessel wall damage --> inflammation
2) Changes in blood flow (stasis in lack of activity, or decreased cardiac output, or increase blood viscosity)
3) Changes in blood composition (i.e., increase in [platelets])</p>
<p class=”large” style=”text-align:center”;>What is the prognosis of a thrombosis?</p>
<p class=”large” style=”text-align:center”;>Obstruction –> breakdown into embolli –> dissolve –> may reorganize</p>
<p>Embolism</p>
<p>Occlusion of a blood vessels by an embolus transported through the blood stream.</p>
<p class=”large” style=”text-align:center”;>Types of emboli (5)</p>
<p class=”large” style=”text-align:center”;>Thrombi, gas, fat (in fracture of large bones), tumour, or foreign bodies</p>
Infarction
Area of necrosis produced by ischemia; is irreversible and healing occurs by fibrosis (scarring)
In what cases do you see white infarct?
During aterial occlusion, in solid organs (heart, spleen, kidney, brain), and in leg gangrenes.
In what cases do you see red infarct?
During venous or arterial occlusion, in loose tissues (lung), with dual blood suplies, and in brain/intestines.
Hemorrhage
Bleeding from vessels into surrounding tissues, body cavity, or exterior of the body
Causes of hemorrhages
Trauma to blood vessels, infections, weak artery, invasive tumour, hypertension, hemorrhagic diastheses (spontaneous hemorrhaging affecting capillaries)
Hematoma
Bleeding into soft tissues
Purpura
diffuse, superficial hemorrhage into the skin
Ecchymosis
Larger superficial hemorrhage (i.e., black eye)
Petechia
pinpoint hemorrhage, usually in the skin or mucous/serosal membranes; rupture of capillaries or arterioles
Hemothorax
Bleeding in pleural cavity
Hemopericardium
Bleeding in pericardial cavity
Hemoperitoneum
Bleeding in abdominal cavity
Hemoarthrosis
Bleeding in a joint
Shock
Failure of the circulatory system to maintain appropriate blood supply, especially to vital organs
Causes of shock
Decreased blood volume, decreased cardiac output, redistribution of blood
Types of shock
1) Hypovolemic (hemorrhage, burns, sweating, diarrhea) 2) Cardiogenic shock (inability to pump, or excessive impairment of cardiac output) 3) Septic shock (bacteremia) 4) Anapyhlactic/Neurogenic (allergic, anaesthesia)
Which types of shock cause a decrease in tissue perfusion?
Hypovolemic and cardiogenic.
Which types of shock cause peripheral vasodilation?
Anaphylaxis, neurogenic, and septic shock due to release of factors (cytokines, etc.)
