Edema Lecture Powerpoint Flashcards
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Edema definition
Palpable swelling produced by expansion of insterstitial fluid volume in the tissue itself
Pitting vs nonpitting edema
Pitting edema leaves an indentation when pressed with a finger and indicates less severe fluid buildup, nonpitting edema bounces back from indentation when pressed with a finger and indicates severe fluid buildup
Anasarca definition
Massive and generalized fluid build up, extreme edema
Capillary hydrostatic pressure definition
Pressure pushed on the capillary walls due to blood pressure to release fluid into the tissue bed, increased in cases of inflammation and venous congestion
Capillary osmotic pressure definition
The pressure pulling water back into the capillary vessel due to plasma proteins within the vessel
Lymphatic obstruction and it generally manifests ___laterally
Tumors, parasites, fibrosis, or removal of lymph nodes that cause obstruction of the flow and edema, generally manifests unilaterally
Interstitial osmotic pressure definition
The pressure Inward pulling force of fluid from the capillary into the interstitial space where proteins drive the fluid
Interstitial hydrostatic pressure
The pressure pushing fluid out of the interstitial space and back into the capillaries
___ of total body water is confined to extracellular space, generalized edema requires ___ of excess fluid before even being noticable
1/3, 2.5 to 3 L
Cardiac signs of generalized edema (5)
- dyspnea upon exertion
- paroxysmal nocturnal dyspnea
- JVD
- displaced apical pulse
- cool extremities
Cardiac labs of generalized edema, how is BUN/Cr ratio? How is sodium level? How is BNP level?
Elevated BUN/Cr ratio
- Decreased Na+
- Elevated BNP
Brain natriuretic peptide (BNP) definition
A protein released in the body when the heart is working very hard and failing
Often a patient with paroxysmal nocturnal dispnea will have to do this to sleep
Prop pillows underneath them
Hepatic signs of generalized edema (4)
- history of alcohol abuse
- ascites
- jaundice
- asterixis
Ascites definition
Excessive fluid retention in peritoneal space, often resulting from portal hypertension, has large tortuous veins called caput medusa
Asterixis definition
Flapping fingers when holding hand outright due to nervous system effect
Hepatic Labs of generalized edema, how are liver enzymes?
Elevated
Renal signs of generalized edema (4)
- Uremia
- metalic or fishy taste
- uremic frost
- elevated BP
- periorbital edema
Uremic frost definition
Uremic crystal formation on skin due to renal failure, smells foul
Renal labs of generalized edema, how is albuminuria? RBC count? K+ levels?
- Positive for albuminuria
- Normocytic anemiaRBC count
- Hyperkalemic
Edema can be caused by increased hydrostatic pressure caused by these 2 mechanisms
1) impaired venous return
2) arteriolar dilation
Edema can be caused by reduced plasma osmotic pressure caused by these 3 mechanisms
1) protein losing gastroenteropathy or glomerulopathy
2) liver cirrhosis
3) Malnutrition
Edema can be caused by lymphatic obstruction caused by these 3 mechanims
1) inflammation
2) post surgical
3) post irradiation
Edema can be caused by increased capillary permeability or sodium retention caused by these 2 mechanisms
1) exccess salt intake or reabsorption
2) inflammation/immune rxn
