Disturbances Of Fluid Balance Flashcards
Approx ____% of the normal male body weight is water, that of the female is about ___% because of their _______.
60
50
higher fat content
A 70 kg man has ______ of water in his body.
_______ percent of the water is intracellular and remainder is found in the extracellular compartment, mostly as ______ fluid.
42 liters
Seventy five
interstitial
There are approximately__-___ liters of lymph in the body, compared to __-___ liters of blood
6 to 10
3.5 to 5
Oedema is the term used to describe ______ caused by _____ in the _____ space.
swelling of tissue
excess fluid
interstitial
Oedema may be localised or generalised.
T/F
T
In generalised oedema, fluid may also accumulate in the body cavities [ _______ ], variously called
_______ or ________ (peritoneal cavity),
_______ or ________ (pleural cavity),_________ or ________ (pericardial sac).
effusions
ascites or hydroperitoneum
hydrothorax or pleural effusion
hydropericardium or pericardial effusion
Anasarca is a (mild or severe?) and (localized or generalised?) oedema with profound __________________ swelling.
Severe
generalised
subcutaneous tissue
The capillary endothelium is highly permeable to water
T/F
T
The capillary endothelium is highly permeable to almost all solutes in plasma with the exception of _________.
proteins
The passage of water across the walls of small vessels is determined by the balance between the _____ pressure and _________ pressures.
hydrostatic
plasma oncotic
In normal circulation fluid is expelled from the _____ end of the microcirculation and re-enters at the ____ end.
arterial
venous
Fluid is constantly removed from the interstitium by the _______.
lymphatics
The primary force driving fluid transport between the capillaries and tissues is _______ pressure
hydrostatic
hydrostatic pressure can be defined as the pressure of ________________
Blood hydrostatic pressure is the force exerted by the ______ confined within ______________
any fluid enclosed in a space.
blood
blood vessels or heart chambers.
Specifically, the pressure exerted by blood against the wall of a capillary is called _______________ (CHP), and is the same as ______________.
capillary hydrostatic pressure
capillary blood pressure
_____ is the force that drives fluid out of capillaries and into the tissues.
This process is called ______
CHP
filtration
The net pressure that drives reabsorption—the movement of fluid from the interstitial fluid back into the capillaries is called _____ pressure (______ pressure)
osmotic
oncotic
Whereas _____ pressure forces fluid out of the capillary, ______ pressure draws fluid back in.
hydrostatic
osmotic
Blood oncotic pressure is determined by __________
plasma proteins
The plasma proteins can move across the semipermeable capillary cell membrane
T/F
F
cannot and so they remain in the plasma.
Arterial end
net filteration pressure =
HP=
COP=
10mmHg
35mmHg
25mmHg
Mid capillary
net filteration pressure =
HP=
COP=
0mmHg
25mmHg
25mmHg
Venous end
net filteration pressure =
HP=
COP=
-7mmHg
18mmHg
25mmHg
Since overall capillary hydrostatic pressure is higher than blood colloidal oncotic pressure (BCOP), net fluid will exit the capillary through _____ at the ______ end than enters through ______ at the ______ end.
Not all fluid is reabsobed, approximately ___ liters per day are filtered, whereas ______ liters are reabsorbed.
This excess fluid is picked up by capillaries of the _____ system drain into the ____ veins in the ____.
filtration; arterial; reabsorption; venous
24 ; 20.4
lymphatic; subclavian; neck
An important function of the lymphatic system is to ________________.
return the fluid (lymph) to the blood
Lymph may be thought of as recycled ________
blood plasma.
Edema fluids and effusions may be
Inflammatory[ ______ ] or Noninflammatory[______]
exudate
transudate
Inflammatory fluid [exudate] is a _____-rich fluid that accumulates due to increases in ____ caused by ________
protein
vascular permeability
inflammatory mediators.
Noninflammatory fluid oedema and effusions are _______-poor fluids called ______.
protein
transudates
Specific gravity of exudate
Specific gravity of transudate
Greater than 1.020
Less then 1.012
The fluid is an exudate if one of the following Light’s criteria is present
Effusion protein/serum protein ratio is greater than ____
Effusion Lactate dehydrogenase [LDH]/serum LDH ratio is greater than ____
Effusion LDH level greater than _____ the ____ limit of the laboratory’s reference range of serum LDH
0.5
0.6
two thirds; upper
An increase in the _____ pressure or a fall in ______ pressure will increase the net flow of fluid into the interstitial space.
hydrostatic
plasma oncotic
Increase hydrostatic pressure
••Impaired venous return caused by:
_________ failure
constrictive _____
liver _______
venous obstruction or compression that could be caused by _____ or _________
••Arteriolar dilatation caused by Heat, neurohumoral dysregulation
congestive heart ; pericarditis; cirrhosis
thrombosis; external pressure (eg mass)
Reduced plasma oncotic pressure
Protein losing ________ (_______syndrome)
Protein losing __________
Liver ______
___________
nephropathy; nephrotic
gastroenteropathy
cirrhosis
Malnutrition
Lymphatic obstruction
Causes
Chronic inflammatory lesions of the lymphatics associated with fibrosis ( ______)
_______ lesions can obstruct lymphatic drainage
surgical complication following __________
________ complication
filariasis
Neoplastic
removal of lymph nodes
irradiation
Inappropriate sodium retention
••Excessive ____ intake with decreased renal function.
••Increased ________ of sodium caused by :
renal ______
increased ________ secretion leading to conservation of sodium and subsequent water retention
renal failure
salt
tubular reabsorption
hypoperfusion; renin-angiotensin-aldosterone
Oedema in congestive cardiac failure
Low cardiac output → _____ in effective arterial blood vol. (eabv) →____tension →arterial vol. receptors → ______ nerve stimulation →arteriolar vaso_____ → renal hypoperfusion →__________ secretion - ______ retention by the kidneys →increased plasma vol.
reduction; hypo; sympathetic; constriction
renin-angiotensin-aldosterone
sodium and water
Oedema in congestive cardiac failure
The failing heart can not increase Cardiac Output →increased ____ pressure →_______ →oedema
venous
transudation
Oedema In cirrhosis
Hypoproteinemia
_____ is synthesised in the liver and it is responsible for ______ pressure.There is ________ in cirrhosis
Oedema occurs when serum albumin level falls below ___ g/l. (normal range __-___ g/liter)
Albumin
plasma oncotic
decreased synthesis of albumin
25
35-55
Oedema In cirrhosis
Accumulation of vasodilators
The damaged liver fails to ___________ →____tension, reduced eabv → ______ secretion→ Sodium and water retention →oedema.
degrade the vasodilators
Hypo
raas
Oedema In cirrhosis
Portal hypertension
increases __________
hydrostatic pressure
Renal Oedema
Acute glomerulonephritis
oedema is a symptom of the disease
oedema is attributable to ____ of _____ by the damaged kidney.
retention
salt and water
Renal Oedema
Nephrotic syndrome: glomerular disease which results in massive ______
(urinary protein loss of greater than ___g/day), hypoproteinaemia, oedema, hyperlipidemia.
proteinuria
3.5
Renal oedema
Nephrotic syndrome
Hypoalbuminaemia →decreased _______ →oedema →plasma vol. (contraction or relaxation ?) →renal _____ →secondary _______ secretion → _______ retention →worsening oedema
oncotic presssure
Contraction
hypoperfusion
aldosterone
sodium and water
Oedema is recognised grossly as _______
Finger pressure displaces the interstitial fluid and leaves a depression called _______
swelling
pitting oedema
Microscopically oedema fluid is seen as ______ and ___________________.
cell swelling
separation of the extracellular matrix elements
Subcutaneous oedema
dependent oedema is a feature of ____
generalised body oedema is associated with ____ diseases e.g. _______
Congestive cardiac failure
renal
nephrotic syndrome.
Pulmonary oedema.
Commonly seen in ________ failure.
Can also occur in ____ failure.
The lungs are increased in ____ and cut sections will show ________ fluid, representing ____,______, and _________
left ventricular
renal
Weight
frothy blood tinged
air, fluid and extravasated rbc.
Cerebral oedema .
The brain is swollen, the sulci are _____ and the gyri _______
narrowed
flattened
Brain edema is not life threatening
T/F
F
Brain oedema
if severe, brain substance can ______ through the _______.
A situation that leads to _____.
herniate (extrude)
foramen magnum
death
Pulmonary oedema
The Lungs are typically ____ times normal weight
Cross sectioning causes an outpouring of ____, sometimes ______ fluid
2-3
frothy
blood- tinged
Pulmonary oedema may interfere with pulmonary function
T/F
T
Causes of Brain edema
Trauma, _____, ______, Infection ( _______ due to say… ________), etc
Abscess
Neoplasm
Encephalitis
West Nile Virus
The effect of edema ranges from ______ to _______
merely annoying to rapidly fatal.
Subcutaneous oedema usually points to an underlying disease [_____ or _____ diseases ].
cardiac or renal
Edema can’t impair wound healing or clearance of Infection.
T/F
F
Edema Creates a favorable environment for infection.
T/F
T
Pulmonary oedema may cause death by interfering with ________ and _____
Oxygen and Carbon Dioxide exchange.
