Fluid Shift & Pulmonary and Systemic Oedems Flashcards

(31 cards)

1
Q

What is the purpose of the interstitial fluid?

A

it acts as a go-between the blood and the body cells

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2
Q

What is the purpose of the capillaries?

A

to allow rapid exchange of gases, water & solutes with interstitial fluid, they deliver nutrients and O2 to the cells and remove the metabolites

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3
Q

What effects the blood flow in the capillaries?

A

The contractile state of the arterioles

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4
Q

What vessels regulate regional blood flow to the capillary bed (CB) in most tissues?

A

Terminal arterioles

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5
Q

What regulates flow in a few tissues such as the mesentery?

A

Precapillary Sphincters

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6
Q

What speed does blood flow through the capillaries and why this speed?

A

It is very slow to allow adequate time of exchange with the interstitial fluid

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7
Q

How doe exchangeable proteins move across the capillary wall?

A

Through vesicular transport

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8
Q

What gradient does fluid movement follow?

A

The pressure gradient (Fick’s Law of Diffusion)

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9
Q

How do lipid soluble substances move through the capillary wall?

A

Through the endothelial cells

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10
Q

How do water soluble substances move through the capillary wall?

A

substances go through the water-filled pores

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11
Q

How is transcapillary fluid flow driven?

A

by the pressure gradient across the capillary wall

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12
Q

What is ultra-filtration?

A

exchange across the capillary wall of essentially protein-free plasma

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13
Q

Net filtration pressure (NFP) is directly proportional to

A

Forces favouring filtration - Forces opposing filtration

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14
Q

What coefficient affects net fluid filtration?

A

Filtration coefficient Kf

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15
Q

What are the 2 forces which favour filtration in transcapillary flow?

A

Pc - capillary hydrostatic pressure

- interstitial fluid osmotic pressure

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16
Q

What are the 2 forces which oppose filtration in transcapillary flow?

A
  • capillary osmotic pressure

Pi - interstitial fluid hydrostatic pressure (-ve in some tissues)

17
Q

What are the names of the forces which determine transcapillary fluid flow?

A

Starling forces

18
Q

What movement of fluid do starling forces favour?

A

They favour filtration at the arteriolar end of the capillary bed and the venular end of the capillary bed

19
Q

What substance in the plasma generally cannot cross the capillary bed?

A

The plasma proteins

20
Q

NFP =

A

(Pc + interstitial fluid osmotic pressure) - (Pi + capillary osmotic pressure)

21
Q

By how much does the filtration of fluid exceed re absorption each day?

A

2-4 L this excess is returned to circulation in the lymphatics

22
Q

What is the definition of oedema (edema)?

A

accumulation of fluid in interstitial space

23
Q

What are the causes of oedema?

A
  • raised capillary pressure
  • reduced plasma osmotic pressure
  • lymphatic insufficiency
  • changes in capillary permeability
24
Q

What raises capillary pressure?

A
  • arteriolar dilation
  • raised venous pressure possibly due to (LV failure - pulmonary oedema, RV failure - peripheral oedema (ankle, sacral) and prolonged standing
25
What is the resistance in the pulmonary capillaries?
The pulmonary capillary hydrostatic pressure is low, the osmotic
26
What causes a reduced osmotic pressure?
- malnutrition - protein malabsorption - excessive renal excretion of protein - hepatic failure (reduced plasma proteins)
27
What causes lymphatic insufficiency?
Lymph node damage | filariasis - elephantiasis
28
What causes changes in capillary permeability?
inflammation | histamine increases leakage of proteins
29
What can left ventricular failure result in?
Pulmonary oedema as there is fluid accumulation in the interstitial and intraalveolar lung spaces
30
How does pulmonary oedema manifest clinically?
varying degrees of shortness of breath | crepitations in the lung bases
31
What is seen through pitting oedema?
Oedema is caused by the increased hydrostatic pressure sign of heart failure rather than lymphatic problem