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Pathology > Exam 1: Edema, Hyperemia, Congestion > Flashcards

Exam 1: Edema, Hyperemia, Congestion Flashcards

(61 cards)

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1
Q

What does the health of cells and organs depend on?

A

Uninterrupted circulation to deliver oxygen and nutrients and to remove waste

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2
Q

What does tissue well-being also require?

A

Normal “fluid balance”

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3
Q

What can abnormalities in vascular permeability or homeostasis result in?

A

Injury, even with an intact blood supply

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4
Q

What does normal fluid homeostasis encompass?

A

Maintenance of vessel wall integrity as well as intravascular pressure and osmolarity within certain physiologic ranges

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5
Q

What affects the net movement of water across the vascular wall?

A

Changes in vascular volume, pressure, or protein content (or alterations in endothelial function)

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6
Q

What percentage of lean body weight is water?

A

Approximately 60%

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7
Q

Describe the distribution of water in the body

A

66% is intracellular

25% is extracellular

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8
Q

What percent of total body water is in blood plasma?

A

8%

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9
Q

What is edema?

A

Increased fluid extravasation into interstitial/extracellular spaces (including body cavities)

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10
Q

How is edema most easily recognized?

A

Grossly

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11
Q

Where does edema generally manifest microscopically?

A

Only as subtle cell swelling, with clearing and separation of the intracellular matrix elements

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12
Q

Where may edema occur and where is it most commonly seen?

A

In any tissues

SQ, brain, and lungs

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13
Q

What can edema occur as?

A

Localized process or may be systemic

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14
Q

How can you indicate edema?

A

Add “hydro” to the anatomic site (hydrothorax, hydropericardium, etc)

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15
Q

What kind of lesion is edema considered to be?

A

A space displacing lesion (exerts pressure in a closed area; brain and lung)

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16
Q

What are general causes of intracellular edema?

A

Depression of metabolic systems of the tissues or lack of adequate nutrition to cells (depressed ionic pumps, Na and water leak in)
Inflammation (increased permeability of cell membranes, Na and water leak in)

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17
Q

What are general causes of extracellular edema?

A

Abnormal leakage of fluid from blood capillaries
Failure of lymphatic system to return fluid from interstitium
Renal retention of salt and water

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18
Q

Describe non-inflammatory edema

A

Transudate
Low protein levels
Fluid accumulation due to hydrostatic imbalances between intravascular and extravascular compartments despite normal vascular permeability
Clear, colorless, or slightly yellow

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19
Q

Describe inflammatory edema

A

Exudate
Related to increased endothelial permeability
High protein levels
Caused by leakage of plasma proteins and leukocytes
Usually opaque

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20
Q

What is the specific gravity of transudate and exudate?

A

T: Less than or equal to 1.015
E: Greater than 1.017

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21
Q

What is the protein content of transudate and exudate?

A

T: Less than 2.5 gm/dL
E: More than 3 gm/dL

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22
Q

How many cells are present in transudate and exudate?

A

T: Less than 1000
E: More than 1000

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23
Q

Are there fibrin clots in transudate and exudate?

A

T: No
E: Yes, fibrin is escaping

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24
Q

What is the clarity of transudate and exudate?

A

T: Clear
E: Turbid

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25
What is the gross appearance of edema?
Swollen, distended, tends to gravitate ventrally Tissue pits on pressure and indentations remain after pressure is removed Tissue is cool to touch Tissue is not red or painful
26
Describe SQ edema
Different distributions, depending on the cause | Can be diffuse or may be more conspicuous at sites of highest hydrostatic pressure
27
What is anasarca?
Severe and generalized edema with profound SQ tissue swelling
28
What is the microappearance of edema?
Separation of tissues by spaces that are clear or pink in H and E stained slides Dilation of lymphatic vessels
29
What are the causes/pathogenesis of edema? What kind of edema is produced?
Increased intravascular pressure (transudate) Decreased plasma colloid osmotic pressure (transudate) Increased vascular permeability (exudate) Lymphatic obstruction (transudate) Heart failure/sodium retention (transudate)
30
What happens to fluid when there is increased hydrostatic pressure or diminished plasma osmotc presure?
There is a net accumulation of extravascular fluid (edema)
31
What happens as interstitial fluid pressure increases?
Tissue lymphatic remove much of the excess volume, eventually returning it to the circulation via the thoracic duct
32
What does venous obstruction or impaired venous outflow result in?
Increased hydrostatic pressure as blood backs up in the venous system Leakage of sodium and fluid into the interstitial tissue
33
What are some diseases that can cause increased hydrostatic pressure?
Congestive heart failure Cirrhosis of the liver Obstruction or narrowing of the veins
34
What do the diseases that can cause increased hydrostatic pressure result in?
Impaired venous return and congestion
35
Why does capillary blood contain decreased colloids?
Decreased hepatic synthesis of proteins | Increased protein loss through the kidney or GI tract
36
What happens as a result of hypoproteinemia with decreased plasma colloidal pressure?
Fluid and sodium are not reabsorbed at the venous end of the capillary Fluid is accumulated in the interstitium as edema
37
What are some diseases that cause decreased oncotic pressure of plasma?
``` Kidney disease Cirrhosis of the liver/liver failure Malnutritious/starvation Protein-losing gastroenteropathies Gastrointestinal parasitism ```
38
What does endothelial cell damage result in?
Increased capillary permeability to fluids, salts, and colloids
39
What does an increase in colloids within the interstitium do?
Reduces reabsorption of fluid at the venous end of the capillary
40
What happens with lymphatic obstruction?
Small quantities of fluids, salts, and colloids accumulate
41
What are some diseases that cause lymphatic obstruction?
Inflammation Neoplasia Post-surgical Post-irradiation
42
What is the mechanism of heart failure/sodium retention?
Increased tubular reabsorption of sodium - --Common pathway in congestive heat failure and edema due to hypoproteinemia - --Reduced renal perfusion due to CHF - --Increase renin-angiotensin-aldosterone secretion
43
Describe what occurs with heart failure
Hypoperfusion of the kidneys Renin is released from juxtaglomerular apparatus Angiotensin causes secretion of aldosterone Aldosterone causes increased absorption of Na in the kidneys With Na comes H2O
44
Describe what occurs with kidney disease to cause Na retention
Na is not excreted which results in Na retention
45
What is active hyperemia?
An active process resulting in increased tissue blood flow due to arteriolar dilation Excess blood of arterial origin
46
Why is the affected area red during active hyperemia?
Engorgement with oxygenated blood
47
What are causes of active hyperemia?
Normal physiologic process | Hallmark of inflammatory response
48
What is congestion?
A passive process resulting from impaired outflow from a tissue Interference with venous drainage
49
Why is the tissue have a red-blue color with congestion?
Due to the accumulation of deoxygenated blood
50
What are causes of congestion?
``` Heart failure (generalized slowing of blood everywhere) Venous occlusion (thrombus, pressure, twisting) Hypostasis (hypostatic congestion) ```
51
What is most affected with left heart?
Lung (chronic pulmonary congestion)
52
What is affected with right heart failure?
Liver (chronic passive congestion)
53
What is hypostatic congestion?
Blood pooling in organs and tissues on the lower side of a recumbent animal
54
What is chronic passive congestion caused by?
Any disease that results in right heart failure
55
What is chronic pulmonary congestion caused by?
Any disease that results in left heart failure
56
Describe what happens in active hyperemia
Increased inflow leads to engorgement with oxygenated blood, resulting in erythema
57
Describe what happens in congestion
Diminished outflow leads to a capillary bed swollen with deoxygenated venous blood and resulting in cyanosis
58
What is the tissue like in active hyperemia?
Bright red, warm to touch, and often pulsating
59
What is the tissue like in congestion?
Bluish, slightly swollen, and cool
60
What is the microscopic appearance of hyperemia?
Arterioles and capilaries are dilated and filled with blood If the cause is inflammatory, other morphologic features of inflammation may also be present (inflammatory cells, necrotic cells)
61
What can chronic congestion cause?
Anoxic injury (stasis of blood with no new blood coming in; atrophy and fibrosis) Thrombosis Edema Hemosiderin deposition

Pathology (16 decks)

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