Edema & Hyperemia Flashcards
Inflammatory edema is localized damage involving a role of…
chemical mediators
Non-inflammatory edema involves a role of…
hemodynamic forces across a capillary wall
What are four causes of non-inflammatory edema?
- Increased hydrostatic pressure
- Decreased plasma colloid osmotic pressure
- Impaired lymph flow
- Renal retention of salt and water
Which vein is affected by deep vein thrombosis?
Popliteal vein (seen inferiorly)
How does impaired lymph flow lead to edema?
Compressed lymphatics can cause edema in another area
Describe local increases in hydrostatic pressure leading to edema
Impaired venous outflow (lower extremities) due to thrombosis/stasis
A blood clot in a vein
Describe generalized increases in hydrostatic pressure leading to edema
High blood pressure leads to edema fluid everywhere ie. left or right heart failure or renal failure
What is the most important plasma protein balancing osmolarity?
Albumin
Decreased plasma colloid osmotic pressure is due to…
loss of serum albumin
What are three causes of loss of serum albumin?
- Nephrotic syndrome
- Cirrhosis (or liver disease causing failure)
- Malnutrition
How does nephrotic syndrome lead to edema?
Kidney disease with massive protein urea leads to decreased serum albumin (decreased plasma colloid osmotic pressure)
Ascites is an example of what type of edema?
Peritoneal edema; nephrotic syndrome causing decreased plasma colloid osmotic pressure
Kwashiorkor is an example of what type of edema?
Malnutrition: normal calories and decreased protein causing decreased plasma colloid osmotic pressure
What are some causes of lymphatic obstruction leading to edema?
- Inflammation
- Neoplasia (specifically breast cancer)
- Parasitic infection
What is an example of parasitic infection that obstructs lymphatics and may cause edema?
Filariasis; filarial worms hatch and live in lymphatics
If a patient has unilateral edema in their whole lower extremity, what is the likely cause?
Lymphatic obstruction
What are some causes of salt and water retention leading to edema?
- Primary/reduced renal function
- Secondary/heart disease
How does left-sided heart failure cause salt and water retention leading to edema?
Lowers blood pressure to kidney –> activates RAAS –> increases blood pressure –> left-sided heart failure worsens
What is a common cause of bilateral renal stenosis?
Atherosclerosis with high blood pressure
If the kidney is affected, the ___ is affected, and vice versa
heart
How will stenosis affect kidneys?
Lowers blood pressure to kidneys –> activates RAAS –> blood pressure increases
What is malignant hypertension (numerically)?
180/100
What are some clinical presentations of subcutaneous tissue edema?
- Dependent edema
- Ascites
- Generalized edema/anasarca
What is dependent edema?
Subcutaneous tissue edema
Most often due to right-sided heart failure
Lower extremities are involved, influenced by gravity
Ascites is a peritoneal edema commonly associated with ___ pathology
liver
With ascites, ___ may also be present
caput medusae
Caput medusae may be present with which edema?
Ascites, subcutaneous tissue edema
Generalized edema/anasarca is most often due to…
renal failure
Periorbital and pitting edema are examples of…
generalized edema/anasarca, subcutaneous tissue edema
How does generalized edema/anasarca compare to dependent edema?
Generalized edema/anasarca is more severe and occurs everywhere
How is a pitting edema measured?
How deep is the pit? How long does it take to return?
What are common causes of pulmonary edema?
- Pneumonia
- Left-sided heart failure or macrovascular (microbial) damage
What is the appearance of alveoli with pulmonary edema?
Edematous, proteinaceous (frothy) fluid within alveoli
What are the symptoms of pulmonary edema?
Dyspnea, chest pain, decreased oxygen saturation
Bacterial pneumonia leads to what type of exudate?
Purulent exudate
With bacterial pneumonia, which immune cells will be increased?
Neutrophils
What are some causes of brain edema?
Traumatic brain injury, climbing a mountain, or other causes
Brain edema can be ___ or ___
localized or diffuse
Brain edema is a cause of increase…
ICP
What occurs with a brain edema?
Cranial cavity leaves nowhere to go, so the brain under pressure will shut down and herniate
What is active hyperemia?
How is it mediated?
Increased blood flow to a tissue
Sympathetic or chemically mediated
What is passive hyperemia?
Congestion: decreased blood flow away from a tissue
Thrombus is an example of which type of hyperemia?
Passive/congestion
Congestion can be ___ or ___
localized or systemic
Systemic passive hyperemia is caused by which side of the heart failing?
Right-sided heart failure
Hypoxia/ischemia of an affected tissue (cyanosis) leads to which type of hyperemia?
Passive/congestion
Congestion usually results in…
edema
What are some example sites of chronic passive congestion?
Lungs and liver
Which chronic passive congestion is caused by left-sided heart failure?
Chronic passive congestion of lungs
Which chronic passive congestion is caused by right-sided heart failure?
Chronic passive congestion of liver (nutmeg liver)
When the liver is engorged with blood by chronic passive congestion, what is the result?
Bilateral lower extremity pitted edema
Chronic passive congestion of the lungs is caused by…
left-side heart failure
Chronic passive congestion of the liver is caused by…
right-sided heart failure
