Hemodynamic Disorders Flashcards
(26 cards)
What is Inflammatory Edema?
Have protein rich exudates, accumulated due to increases in vascular permeability caused by inflammatory mediators
What is Non-inflammatory edema?
Have protein poor transudates, common in many diseases
What mainly causes increased hydrostatic pressure?
impaired venous return from DVT of congestive heart failure (systemic)
What causes Reduced Plasma Osmotic Pressure?
Loss of Albumin due to nephrotic syndrome / decreased synthesis due to protein malnutrition or severe liver disease
How is edema exacerbated?
Low Blood pressure
leads to compensation by kidney
leads to increased Na and H2O retention
leads to excacerbation of edema
How does Sodium and Water Retention cause edema?
It increases hydrostatic pressure and diminishes vascular colloid osmotic pressure (due to dilution)
What are the causes of lymphatic obstruction?
Trauma, Fibrosis, Invasive Tumors and infectious agents
What are the microscopic morphology of Edema?
- Clearing and separation of ECM
2. Subtle cell swelling
Renal dysfunction causes edema in what part of the body initially?
Loose Connective Tissue; Eyelids / Periorbital edema
What are the characteristics of Pulmonary edema?
- 2-3x heavier
2. Frothy, blood-tinged fluid upon sectioning
What does Brain edema exhibit?
- Narrowed sulci
2. Distended gyri
What are the characteristics of peritoneal effusions?
Milky effusion due to presence of lipids absorbed from the gut caused by lymphatic blockage
What is the clinical importance of Subcutaneous Edema?
Signals potential Cardiac or Renal Disease. When significant, impairs wound healing and clearance of infections
Where is Pulmonary Edema most commonly seen?
Left Ventricular Failure, also in Renal Failure, ARDS, Pulmonary inflammation and infection
What are the effects of excess fluid in pulmonary edema?
- Fluid collects in alveolar septa around capillaries and impede oxygen diffusion
- Edema fluid in alveolar spaces creates favorable environment for bacterial infection
- Accompanies Pulmonary effusion
Why is Brain Edema life-threatening?
If severe, brain substance can herniate through the foramen magnum, or the brain stem vascular supply can be compressed
What is Hyperemia?
Active process. Arterial Dilation leads to increased blood flow
What are examples of hyperemia?
Sites of Inflammation, Skeletal muscle during exercise
What is Congestion?
Passive process. Resulting from Reduced Outflow of blood from a tissue
What causes congested tissues to appear dusky reddish-blue?
From cyanosis due to red cell stasis and presence of deoxygenated Hgb
What are the microscopic morphology of acute pulmonary congestion?
- Engorged alveolar capillaries
- Alveolar Septal edema
- Focal intraalveolar hemorrhage
What is the microscopic morphology of Chronic Pulmonary congestion?
- Septa are thickened and fibrotic
2. Alveoli contain numerous hemosiderin-laden macrophages/ heart failure cells
What is the microscopic morphology of Acute Hepatic Congestion?
- Central Vein and Sinusoids are distended
- Because centrilobular areas are distal, ischemic necrosis
- Peritoneal hepatocytes that are proximal, underego only fatty change
What is the gross morphology of Chronic Passive Hepatic Congestion?
Centrilobular Regions are red-brown and slightly depressed against the surrounding zones of uncongested tan liver
a.k.a. nutmeg liver
