Edema Flashcards
what are the causes of non-inflammatory edema?
- increased hydrostatic pressure
- decreased plasma colloid osmotic pressure
- impaired lymph flow
- renal retention of salt and water
what causes local increases in hydrostatic pressure
impaired venous outflow (lower extremities) due to thrombosis/stasis
what are examples in generalized increases in hydrostatic pressure?
heart failure
renal failure
why does renal failure cause an increase in BP? how does this cause edema?
- can’t make urine to decrease the amount of fluid in arteries and veins
- ^BP pushes fluid into ECF
decreased plasma colloid osmotic pressure is due to…
loss of serum (plasma) albumin
name 3 conditions that could result in loss of serum albumin
- nephrotic syndrome
- cirrhosis
- malnutrition
if you have less albumin in your blood what will happen to the water in the capillaries?
the water will rush out of the capillaries
what specific type of edema occurs due to a loss of serum albumin?
ascites (peritoneal edema)
what are causes of LYMPHATIC obstruction?
inflammation
neoplasia
parasitic infection
how does inflammation cause lymphatic obstruction?
if a lymph node gets to large due to inflammation then it can block the lymph flow
how can a neoplasia cause lymphatic obstruction?
tumor compresses lymphatics
eg. breast cancer related lymphedema (axillary nodes)
what kind of edema will right sided heart failure cause?
bilateral ankle edema
what are some causes of salt and water retention?
- primary/ reduced renal function
- secondary/ heart disease
how would left sided heart failure impact salt and water retention?
- decreased BP to kidney
- activates RAAS (^Na retention, H2O follows)
- ^BP -> ^P on heart
- worsens LSHF
how does reduced renal function impact salt and water retention?
- if decreased BP to kidney -> RAAS system activated
- causes ^Na retention (H2O follows)
- ^blood volume = ^BP
what are the 3 different clinical presentations of edema in subcutaneous tissues?
- dependent edema
- ascites
- generalized edema/anasarca
dependent edema is most often due to ____
heart failure (R sided)
where does dependent edema occur and what is it influenced by?
- lower extremities
- gravity
what is ascites?
peritoneal edema (abdomen)
what kind of pathologies most commonly have ascites?
- MC: liver pathologies (cirrhosis)
- also seen in caput medusae
what is generalized edema/anasarca?
severe edema, seen everywhere in the body, including periorbital and pitting edema
generalized edema/Anasarca is most often due to ____
renal failure
what condition is associated with the most severe edema?
renal failure
which is more severe:
dependent edema or generalized edema/anasarca?
generalized edema
what are some spots where generalized edema will go
periorbital edema and pitting edema
but will have edema everywhere
what severity of pitting edema will have a 4mm pit?
2+
how deep will the pit be in 4+ pitting edema?
8mm pit (just multiply it by 2)
what causes pulmonary edema?
due to heart failure or microvascular (microbial) damage (eg. pneumonia)
in a patient with left sided heart failure, what type of fluid is found within the alveoli?
edematous (pulmonary edema), proteinaceous (frothy, white) fluid
what are common symptoms of pulmonary edema?
dyspnea and chest pain
what are the 2 ways that brain edema can present?
localized or diffuse
brain edema causes an increase in ____
ICP (intracranial pressure)
what is hyperemia?
(active) increased blood flow to a tissue
what are the 2 different ways that hyperemia can be mediated?
chemically or sympathetic mediated
what is congestion?
(passive) decreased blood flow away from a tissue
T/F: congestion is only localized
F: it is localized or diffuse
congestion results in ____/____ of the affected tissue
hypoxia/ischemia
(cyanosis)
congestion usually results in ____
edema
(hyperemia will not cause edema)
name 2 examples of chronic passive congestion
- lungs: LSHF
- liver: RSHF
left sided heart failure causes what in the lungs?
heart failure cells (macrophages in the lungs clean up ^RBC)
what is another name for macrophages in the lungs?
hemosiderin-laden macrophages
what does right sided heart failure cause?
nutmeg liver (liver engorged with blood)
what symptom in the lower extremity will you see in a patient with right sided heart failure?
(nutmeg liver)
bilateral ankle edema (usually pitting)
