Class 10.5 Flashcards
What is EDEMA?
Accumulation of excess fluid in tissue interstitial space. Can occur inside an organ or structure, in tissue networks, or close to skin surface. Can be local or generalized condition. Excess fluid accumulation inside serous sacs is also referred to as edema.
What is Interstitium?
“space between” – supporting or connective tissue or material that lies between principal cells of an organ, or between structures in body; network of collagen fibers & fluid-filled spaces that underlies skin & surrounds gut,
muscles, & blood vessels
What is Anasarca?
full body edema
What is Hydrothorax / Pleural Effusion?
edema in pleura (serous sacs around lungs)
What is Hydropericardium / Pericardial Effusion?
edema in pericardium (serous sac around heart)
What is Ascites?
edema in peritoneum (serous sac around abdominal viscera)
What is Myxedema?
fluid collected in skin/subcutaneous space
What is Dependent Edema?
edema that collects in a structure d/t me gravitational pull or prolonged sitting (e.g., in wheelchair)
What is Lymphedema?
edema caused by accumulation of protein rich fluid that is usually drained through lymphatic system, occurs with removal, disease or serious obstruction of lymphatic servicing a body part/area. Most commonly affects arms or legs, can also occur in chest wall, abdomen, neck & genitals.
What’s Joint Effusion?
edema inside a synovial joint
What is Hydronephrosis?
kidney edema
What is Pulmonary edema?
inside the lungs
What is Cerebral edema?
around/in the brain
What is Pitting/Pitted Edema?
When firmly pressed with finger, maintains depression produced by finger. Protein-rich fluid accumulates stagnantly in tissue, it naturally gels. Pitted edema occurs most commonly in legs, ankles & feet.
Can be short-term, e.g., from flying, pregnancy; happens more with obesity. Chronic cases are strongly associated with conditions of circulatory dysfunction or altered lymphatic function.
Conditions more associated with pitting edema are: congestive heart failure, hypertension, diabetes, kidney liver/lung diseases, inflammatory arthritides like psoriatic arthritis, venous obstruction scenarios.
Medications i.e. steroids, NSAIDs, vasodilators, thiazolidinediones (T2 diabetes), high estrogen compounds e.g., oral contraceptives, HRT can promote pitting edema.
Chronic cases lead to declining tissue health, poor healing, altered sensation (especially numbness, paraesthesia), sometimes motor weakness; pitting edema can also become hot & inflamed (needs immediate medical attention).
EDEMA MECHANISMS
- ↑ capillary hydrostatic pressure
Description: Too much fluid is forced out at capillary level due to high pressure
Potential Causes: Hypertension, excessive arteriole dilation, liver/kidney failure, venous obstruction, pregnancy - ↑ capillary permeability
Description: Too much fluid permeates capillary due to some sort of damage at wall
Potential Causes: Inflammatory processes, wall damage - ↑ colloid osmotic/oncotic pressure of interstitium
Description: Greater presence of molecules with high osmotic pressure in interstitium that draw too much fluid from capillary
Potential Causes: Leaked plasma proteins in interstitium, high electrolyte concentration (eg. from ↑’d salt consumption), cellular debris due to impaired lymphatic function - ↓ colloid osmotic/oncotic pressure of blood
Description: Decrease in plasma proteins blood results in ↓’d capacity of capillary to draw fluid back from interstitium
Potential Causes: Typically some form of hypoalbuminemia (eg. plasma proteins leaking into interstitium, some kidney pathologies leading to albumin loss via urine) - obstruction of lymphatic flow
Description: Damaged lymphatic system leads to backup of debris in lymph vessels & interstitium (which then leads to #3)
Potential Causes: Lymph node network damage or removal, proximal obstruction (e.g., scar tissue), vascular
congestion/edema compressing lymphatic vessels
