Fluid and Hemodynamic Disorders Flashcards
describe normal capillary filtration
describe the flow of lymphatics
describe edema
- edema is an abnormal excess accumulation of fluid in the intercellular space
- body cavities = effusion
- occurs most commonly in: subcutaneous tissues, lungs and the brain
edema in the pleural space = _____ (_____)
edema in the pleural space = pleural effusion (hydrothorax)
edema in the pericardium = ______ (____)
edema in the pericardium = pericardial effusion (hydropericardium)
edema in the peritoneum = ____ (____)
edema in the peritoneum = ascites (hydroperitoneum)
____ = severe generalized edema
anasarca = severe generalized edema
describe fluid collection in a patient with heart failure (CHF)
describe fluid accumulation seen in hypoproteinemia
describe fluid accumulation as seen in lymphatic obstruction
describe fluid accumulation seen in infections
describe congestive heart failure (causes of RHF and LHF) and management
- right heart failure
- increased hydrostatic pressure - edema
- dependent edema (legs, sacrum)
- signs = HEAD (hepatomegaly, peripheral edema, ascites, distended jugular vein)
- left heart failure
- reduced GFR, renin-angiotensin-aldosterone axis = sodium retention
- pulmonary edema
- management
- salt restriction, diuretics
- aldosterone antagonists
describe renal disease (what it affects)
-
damages basement membrane
- excess albumin loss → hypoalbuminemia (Nephrotic Syndrome)
- decreased plasma oncotic pressure - edema
-
glomerulonephritis
- inflammatory damage with clogging of glomerular capillaries → reduced GFR
- secondary hyperaldosteronism → sodium and water retention
- generalized edema: initially periorbital edema
describe how liver disease can lead to edema
- cirrhosis of liver
- portal hypertension → increased hydrostatic pressure in splanchnic circulation → ascites
- decreased albumin synthesis → reduced plasma oncotic pressure
describe how malnutrition can lead to edema
contrast transudate and exudate
describe the morphology of skin edema and 3 associated problems
- skin
- cell swelling, clearing and separation of the extracellular matrix
- pitting or non-pitting edema (myxedema)
- cell swelling, clearing and separation of the extracellular matrix
- 3 problems:
- impaired wound healing
- thickening
- susceptible to infxn
describe the morphology of pulmonary edema
- interstitial: early phase
- alveolar: frothy fluid in alveolar lumen
- severely congested alveolar capillaries and alveoli filled with homogenous pink-staining fluid
- clinical features:
- cough, dyspnea
- severe cases: frothy sputum, cyanosis
describe what is seen in the image
describe cerebral edema
- 2 categories
- vasogenic edema
- disruption of BBB: interstitial edema
- infxns, trauma, neoplasms
- cytotoxic edema (gray matter)
- intracellular edema: due to cell injury
- hypoxic-ischemic insult
- vasogenic edema
- headache, papilledema
- motor/sensory abnormalities
- treat by intravenous mannitol and steroids
describe a transtentorial (uncal) herniation
-
displacement of the temporal lobe
- presses on cranial nerve III and PS fibers → impaired ocular movements, pupillary dilation
- duret hemorrhages in midbrain and pons
describe a tonsillar herniation
- tonsillar herniation through the foramen magnum
- brain stem compression → respiratory centers in medulla oblongata
- death due to cardio-resp. arrest
describe a subfalcine herniation
displacement of cingulate gyrus under the falx cerebri
- compression of branches of ant. cerebral artery
- ischemic injury of primary motor and/or sensory cortex
- weakness and/or sensory abnormalities in leg
