Pathophysiology of Congestion & Oedema

Question 1

what is congestion?

Answer 1

relative excess of blood in vessels of tissue

Question 2

is congestion active or passive

Answer 2

passive

Question 3

is congestion acute or chronic?

Answer 3

can be both

Question 4

what are clinical pathology examples of congestion?

Answer 4

local acute congestion
local chronic congestion
generalised acute congestion

Question 5

whats an example of local acute congestion?

Answer 5

deep vein thrombosis

Question 6

whats an example of chronic congestion

Answer 6

hepatic cirrhosis

Question 7

whats an example of generalised acute congestion?

Answer 7

congestive cardiac failure

Question 8

what is the deep vain blocked by?

Answer 8

localised acute congestion

Question 9

how does blood being backed up in veins/venules/capillaries effect blood, flow and pressure?

Answer 9

decreased outflow of blood

decreased pressure gradient

decreased flow across system

no oxygen therefore ischaemia and infarction

Question 10

what does hepatic cirrhosis result from?

Answer 10

serious liver damage e.g. HBV and alcohol

Question 11

where is the congestion in hepatic cirrhosis?

Answer 11

portal vein and branches

Question 12

what happens to the heart with congestive heart failure?

Answer 12

unable to clear blood, right and left ventricle

Question 13

what effects does congestive heart failure have on the body?

Answer 13

decreased cardiac output

decreased renal glomuler filtration rate

activation of RAAS

increase amount of fluid in the body

fluid overload in the veins

Question 14

with what medication would treat fluid overload in the veins?

Answer 14

diuretics

Question 15

what effects does congestive cardiac failure have on the lungs and in turn how does this effect anything else?

Answer 15

pulmonary oedema in the lungs, this results in -

left heart failure- blood dams back into lungs

crepitations in lungs, tachycardia

Question 16

what effects does congestive cardiac failure have on the liver and in turn how does this effect anything else?

Answer 16

cetral venous congestion, this results in -

right heart failure- blood dams back into systemic circulation

increased JVP, hepatomegaly, peripheral oedema

Question 17

what is the appearence of a hepatic central venous congested liver macroscopically?

Answer 17

“Nutmeg” liver red/brown & pale spotty appearance

Question 18

why are pericentral hepatocytes red?

Answer 18

stasis of poorly oxygenated blood

Question 19

why are periportal hepatocytes pale?

Answer 19

better oxygenated

Question 20

why are periportal hepatocytes better oxygenated?

Answer 20

proximity of hepatic arterioles

Question 21

what are the three components that affect net flux and filtration?

Answer 21

hydrostatic pressure

oncotic pressure

permeability characteristics and area of endotheliem

Question 22

what is an oedema?

Answer 22

accumulation of abnormal amounts of fluid in the extravascular compartment

Question 23

what is peripheral oedema?

Answer 23

iincreased interstitial fluid in tissues

Question 24

what are effusions?

Answer 24

fluid collections in body cavities for eg pleural, pericardial

Question 25

what is transudate?

Answer 25

fluid that has been pushed through the capillary wall due to high pressure

Question 26

what is transudate composed of?

Answer 26

lots of H2O and electrolytes not much protein or albumin

Question 27

what is exudate?

Answer 27

part of inflammatory process due to increased vascular permeability it leaks out the capillaries

Question 28

what is exudate composed of?

Answer 28

higher protein/albumin and H2O and electrolytes

Question 29

what is the pathophysiology of pulmonary oedema in left ventricular failure?

Answer 29

increased atrial pressure increased pulmonary vascular pressure increased pulmomary blood volume increased pulmomary hydrostatic pressure

Question 30

what is the pathophysiology of pulmonary oedema in lungs?

Answer 30

perivascular and interstitial transudate progressive oedematous widening of alveolar septa accumulation of oedema fluid in alveolar spaces

Question 31

what is the pathophysiology of peripheral oedema in right heart failure?

Answer 31

right heart failure- cannot empty RV in systole

Question 32

what is the pathophysiology of peripheral oedema in congestive cardiac failure?

Answer 32

right and left ventricles both fail pulmonary oedea and peripheral oedema at the same time all about the hydrostatic pressure

Question 33

whats the pathophysiology of lymphatic obstruction?

Answer 33

hydrostatic pressure upset!

Question 34

what does lymphatic system blocked lead to?

Answer 34

lymphoedema

Question 35

what does the abnormal renal function result in?

Answer 35

salt and h2o retention

Question 36

decreased renal function os the result of what? (4)

Answer 36

increased salt and h2o increased intravascular fluid volume secondary increased hydrostatic pressure oedema

Question 37

what is low protein oedema?

Answer 37

transudate

Question 38

is oncotic pressure related to transudate?

Answer 38

yes

Question 39

what does hypoalbuminaemia result in ?

Answer 39

decreased oncotic pressure which leads to increased filtration

Question 40

in the arterial side, | which is bigger- capillary hydrostatic pressure or capillary oncotic pressure ?

Answer 40

capillary hydrostatic pressure

Question 41

in the venous side, | which is bigger- capillary hydrostatic pressure or capillary oncotic pressure ?

Answer 41

capillary oncotic pressure

Question 42

why does exudate contrain more protenis that transudate?

Answer 42

damage to endothelial lining produces large pores for proteins and larger molecules t leak out from not just water

Question 43

upsetting the ...... forces can lead to oedema?

Answer 43

starling

Question 44

what is darcy's law?

Answer 44

``` Q = blood flow P = pressure R = resistance ``` Q= change of P/R

Question 45

how are nodules formed in hepatocytes?

Answer 45

liver tries to regenerate around the damage

Question 46

what is the portal blood flow

Answer 46

Circulation of blood to the liver from the small intestine, the right half of the colon, and the spleen through the portal vein; sometimes specified as the hepatic portal circulation.