Lecture | Part 1 Hemodynamic Disorder Flashcards
1
Q
governed by several forces in the blood vessel wall intravascular volume.
A
Fluid dynamics
2
Q
Fluid exits through
A
arterial vascular compartment/end
3
Q
Fluid returns through
A
venous vascular compartment/end
4
Q
pushing force
A
hydrostatic pressure
5
Q
pulling forces
A
oncotic or osmotic pressure
6
Q
what happens in hydrostatic pressure
A
Fluid exits through arterial vascular compartment
7
Q
what happens in oncotic (osmotic) pressure
A
Fluid returns to venous vascular compartment
8
Q
level where pushing forces are about equal to the pulling forces.
A
At the capillary level
9
Q
pulling forces so water from the interstitial space are pulled into the intravascular volume
A
oncotic or osmotic pressure
10
Q
pushing pressure that promote water out of the blood vessel and into the interstitial space
A
hydrostatic pressure
11
Q
behavior of water across compartments and to a certain extent blood. eg, Congestion hyperemia
A
Hemodynamic Disorders
12
Q
in blood vessel there is hemostasis and if there is disturbances it may lead to clotting of the blood
A
Thromboembolic Disease
13
Q
circulatory collapse
A
shock
14
Q
increased fluid in the ECF
A
Edema
15
Q
increase in blood blood flow in the arteriolar end
A
Hyperemia
16
Q
increase in the backflow at the venus end
A
Congestion
17
Q
extravasation of blood
A
Hemorrhage
18
Q
blood is within the intravascular compartment if it goes out of the intravascular compartment it is now called
A
Hemorrhage
19
Q
keeping keep the blood flowing in the intravascular space
A
Hemostasis
20
Q
conditions that can cause clotting of blood
A
Thrombosis/thrombus formation.
21
Q
From the adhered blood vessel, clotted blood is detached from the thrombus and travel across the blood vessels it will essentially be called
A
embolus
22
Q
death of tissues due to lack of blood
A
Infarction
23
Q
death of tissues due to decreased delivery of oxygen and this will cause cellular hypoxia
A
Infarction
24
Q
circulatory failure/collapse
A
Shock
25
lack of perfusion to the different organs of the body
shock
26
4 possibilities of EDEMA
1. Increased Hydrostatic Pressure
2. Reduced Oncotic Pressure
3. Lymphatic Obstruction
4. Sodium/Water Retention
27
composes 60% of body
water
28
2/3 of body water is
intracellular
29
1/3 of body water is
interstitial
30
Only 5% water is
Intravascular
31
shift of water to the interstitial space
edema
32
water filling in the thoracic cavity
Hydrothorax.
33
water inside the pericardial space or pericardial cavity
hydropericardium
34
general term of fluid accumulating in the body cavities
Effusion
35
accumulation of water that involves the peritoneum
ascites
36
presence of water in the peritoneal cavity
ascites
37
generalized edema
anasarca
38
accumulation of fluid in the soft tissues in the body cavities
anasarca
39
total body water volume
40 liters, 60% body weight
40
25 liters, 40% body weight
Intracellular fluid volume
41
15 liters, 20% body weight
extracellular fluid volume
42
12 L, 80% of ECF
interstitial fluid volume
43
3 L, 20% of ECF
plasma volume
44
15% of water is in the
interstitium
45
least amount of water is found in
blood
46
- Impaired venous return
- Congestive heart failure
- Constrictive pericarditis
- Venous obstruction or compression
- Thrombosis
- External pressure (e.g., mass)
- Lower extremity inactivity with prolonged dependency
- Arteriolar dilation
- Heat
- Neurohumoral dysregulation
INCREASED HYDROSTATIC PRESSURE
47
- Protein-losing glomerulopathies (nephrotic syndrome)
- Liver cirrhosis (ascites)
- Malnutrition
- Protein-losing gastroenteropathy
REDUCED PLASMA ONCOTIC PRESSURE (HYPOPROTEINEMIA)
48
REDUCED PLASMA ONCOTIC PRESSURE is also referred as
HYPOPROTEINEMIA
49
one that exert this oncotic pressure and will attract water to go inside the blood vessel
plasma proteins
50
Most important and abundant plasma protein
albumin
51
Protein-losing in kidney
Protein-losing glomerulopathies
52
Protein-losing in intestines
Protein-losing gastroenteropathy
53
where the arteriolar end the pushing forces will tend to predominate so it will try to push water out of the blood vessel
REDUCED PLASMA ONCOTIC PRESSURE
54
- Inflammatory
- Neoplastic
- Post-surgical
- Post-irradiation
LYMPHATIC OBSTRUCTION (LYMPHEDEMA)
55
mechanism of edema that can block the flow of lymph tissue or lymphatic tissue fluid, flow of tissue fluid inside the lymphatic vessels
lymphatic obstruction
56
conditions that will promote this lymphatic obstruction will tend to cause edema such as
1. Inflammation
2. presence of tumors
3. the lymphatic vessels are destroyed during surgical operation
4. or during radiation therapy
57
any mass tumor, that can block the vessel you know will cause an decrease or increase in the pushing force?
increase in the pushing
58
elephantiasis is an example of one of the mechanism of edema
lymphatic obstruction or lymphadema
59
1. Excessive salt intake with renal insufficiency
2. Increased tubular reabsorption of sodium
3. Renal hypoperfusion-Increased renin-angiotensin-aldosterone secretion
Sodium [Na+] retention
60
where sodium goes
water follows
61
in the body the sodium is being managed by
kidney
62
downstream travel of a clot
Embolism
63
INFLAMMATION
1. Acute inflammation
2. Chronic inflammation
3. Angiogenesis
64
inflammation can bring in edema and this is due to the
opening of the gaps in the endothelial lining of the blood vessel wall
65
type of fluid in inflammation
exudate
66
DECREASED RENAL PERFUSION, triggering of RENIN- ANGIOTENSION-ALDOSTERONE complex, resulting ultimately in SODIUM RETENTION
CHF EDEMA
67
INCREASED VENOUS PRESSURE DUE TO FAILURE
CHF EDEMA
68
in congestive heart failure, the heart is not pumping very well and there will be a buildup of
venous pressure
69
in left-sided heart failure, the build-up will occur in the lungs having a
pulmonary edema in congestive heart failure
70
kidneys receive how many percentage of cardiac output
20 percent
71
if kidney receives <20% of the cardiac output it will trigger your
Renin-Angiotensin- Aldosterone Axis (RAAS) (conserve sodium)
72
HEPATIC ASCITES
1. PORTAL HYPERTENSION
2. HYPOALBUMINEMIA
73
another cause of accumulation of water this time in the peritoneal cavity
portal hypertension
74
in Schistosomiasis, there is an increase in --?-- that will cause water to get out of the blood vessel and into the peritoneal cavity
portal hypertension
75
1. SODIUM RETENTION
2. PROTEIN LOSING GLOMERULOPATHIES (NEPHROTIC SYNDROME)
RENAL EDEMA
76
in renal edema, a lot of sodium in the blood will attract water inside the blood vessel so water will pull inside the blood vessel so there's a build up of water in the intravascular space. this typically happens in
hypertension
77
edema manifested in the subcutaneous tissues (dependent area) tend to accumulate in the
lower extremities in the feet
78
most harmful or deadly consequence of edema happens in the
brain
79
enclosed in a bony cranium
brain
80
edema in the brain cannot overcome the hard skull making the soft brain to cause
hernation
81
indentation on the subcutaneous tissue when putting pressure
pitting edema
82
it will cause torsion of the portion of the brain or herniation
edema near the cingulate gyrus in the frontal lobe
83
vulnerable area that will impinge on the midbrain
hippocampus
84
where it will impinge on the lower brain stem.
cerebellum
85
houses the the area for your respiration
lower brainstem
86
3 location vulnerable for hernia
1. Subfalcine herniation
2. transtentorial herniation
3. tonsillar herniation
87
1. results from disturbance of Starling forces
2. specific gravity < 1.012
3. protein content < 3 g/dl
4. LDH low
transudate
88
1. results from damage to the capillary wall
2. specific gravity > 1.012
3. protein content > 3 g/dl
4. LDH high
exudate
89
shift of fluid from one compartment to another
transudate
90
Active Process
HYPEREMIA
91
hyperemia is theincrease in the blood flow at the arteriolar end and manifested as
erythema
92
congestion is the decrease in the outflow at the venous end and manifested as
cyanosis black blue
93
congestion is manifested as cyanosis black blue because
blood is deoxygenized blood
94
1. Passive Process
2. Acute or Chronic
CONGESTION
95
hyperemia is considered an active process due to the
dilatation of arteries
96
congestion is considered a passice process because
only the blood will pull at the venus end there's no dilatation
97
congestion can occur in different organs such as
lung, the liver, and brain
98
in acute passive congestion in the lungs it can be manifested in an x-ray when there is increase in the lines not peripheral lines or what we call
kelsey's lines
99
indicates a characteristic of your pulmonary edema
kelsey's lines
100
In chronic passive congestion in the lungs there is an increased pressure in the pulmonary vessels the small or the thin walls of the blood vessels, making the veins?
rupture and blood can again squeeze through the alveolar spaces
101
blood is taken up by macrophages when a person died with congestive heart failure. At the lungs there are so many hemosiderin macrophages which is known as
heart failure cells
102
in right-sided heart failure, the congestion will occur in the
lungs
103
congestion in the liver occurs in what vein
central veins
104
congestion in the brain will cause --?-- of the gyrus, which is prone to herniation
flattening
