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Pathology- fluid Hemodynamics > Fluid and hemodynamics disorders I > Flashcards

Fluid and hemodynamics disorders I Flashcards

(66 cards)

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1
Q

total volume of water in the body

A

36 liters

  • 24 within cells
  • 12 extracellular
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2
Q

intracellular fluid % body weight

A

40%

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3
Q

extracellular fluid % body weight

A

16%

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4
Q

blood serum % body weight

A

4%

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5
Q

approximate blood volume

A

5 liters

  • 3 liters in plasma
  • 2 liters in cells (hematocrit 40%)
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6
Q

what is hematocrit represent?

A

% volume of cells to total volume

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7
Q

what influences water movement between compartments

A

changes in molecular components in the different compartments

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8
Q

what is osmolarity is approximately equal to

A

between the compartments (intracellular a little higher)

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9
Q

what determines water flow from intravascular space to extravascular space?

A

protein concentrations within the vascular space

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10
Q

where is sodium excluded from?

A

intracellular

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11
Q

changes in sodium equilibrates

A

between the vascular and interstitial spaces, but cases net flux of water into or out of cells

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12
Q

osmole gap

A

calculated 172
measured 198
-something in plasma adding to osmolality don’t know: ketones, ethyleneglycol, methyl-alcohol

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13
Q

percent of serum proteins thats albumin

A

60%

-influenced by degree of hydration, synthesis by liver

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14
Q

protein content: IG’s

A

16%

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15
Q

albumin:immunoglobulin ratio

A

A:G is 3:4:1

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16
Q

in serum electrophoresis: albumin peak

A

tallest widest peak

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17
Q

what does decrease in serum protein?

A

influences the shift of water from blood to the interstitium (edema)

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18
Q

main intracellular ion

A

potassium

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19
Q

changes in sodium concentrations act primarily to?

A

change the volume of cells, NOT shift water into or out of the intersitial space (both water and sodium are freely exchanged)
NO EDEMA

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20
Q

in renal failure edema results from?

A

increased hydrostatic pressure NOT changes in sodium concentrations

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21
Q

what does acidosis do to fluid?

A

shift hydrogen ions from outside the cell and replaced potassium which leaves the cell-> resulting in hyperkalemia

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22
Q

edema

A

accumulation of excessive fluid within intercellular tissue spaces or body cavities

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23
Q

two types of edema

A
  1. inflammatory (exudate)

2. non-inflammatory (transudate)

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24
Q

difference between the two types edema

A

increase in vasodilation

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25
anasarca
generalized edema
26
pitting edema
occurs where fluid collects-> usually LE
27
ascites
hydroperitoneum | -peritenium
28
effusions
collection of fluid within potential space | -can be transudate or exudate
29
pleural effusions
congestive heart failure, infections, neoplasms
30
examples of effusions
pleural effusions pericardial effusions hemorrhagic effusion-> bloody fluid within a cavity (TB)
31
edema and effusion
what can cause edema can cause effusion
32
some causes of effusions
hemorrhages tumors infections
33
how is it determined what caused an effusion
aspirated to determine composition
34
edema: two ways to increase in interstitial fluid
1. increased delivery of fluid to interstitial space | 2. decreased efflux of fluid from interstitial space
35
edema mechanism
1. increased vascular permeability 2. increased hydrostatic pressure (decreased venous outflow) 3. decreased protein in the blood 4. decreased lymphatic flow
36
four components hydrostatic pressure
1. hydrostatic pressure 2. Plasmoid colloid: bring fluid into vasculature 3. Lymphatics 4. Venous statsis
37
Hydrostatic pressure change
can mean hypertension
38
plasma colloid changes
scerosis
39
lymphatics changes can mean
surgical obstruction
40
venous stasis can mean
no flow on venous side-> increase pressure-> edema | -pulmonary edema with heart failure, thrombosis, cirrhosis of liver
41
increased hydrostatic pressure
- obstruction of normal blood flow on venous side of capillaries - localized: venous thrombosis in extremities, pulmonary edema - generalized: increased vascular volume due to fluid retention, can effect subcutaneous tissues, visceral tissues (pulmonary edema, pleural effusion, etc)
42
congestive heart failure
can be left sided or right
43
left sided heart failure
results in increased pressures in venous pulmonary system, leading to edema within alveoli -pulmonary
44
right sided heart failure
results from in increased pressures in vena cava, mainly liver, from liver congestion and peripheral edema -peripheral edema is increased in lower limbs
45
thrombosis of hepatic vein
Bud-chiaria syndrome
46
what can cause sodium and water retention
acute reduction of renal function | -inadequate perfusion of kidneys resulting in activation of renin/angiotensin
47
mechanism of water/sodium retention
retained Na + water----> increased intravascular volume----> increased hydrostatic pressure---->edema
48
decreased oncotic pressure can be caused by
1. loss of albumin: nephrotic syndrome, protein-losing enteropathies 2. decreased synthesis of albumin: hepatic cirrhosis, liver failure 3. malnutrition: kwashiokor-> protein caloric undernutrition
49
lymphatic obstruction
normal net flow of fluid from capillaries to lymphatics -obstruction results in collection of fluid in extravascular space-> subcutaneous edema or ascites (obst. of liver lymphatics)
50
causes of obstruction to lymphatics
filariasis neoplasma scarring
51
pathological features of edema
enlarged, swollen tissues - spaces separating cells within tissues - fluid filling spaces
52
clinical syndromes
``` pulmonary edema cerebral edema nephrotic syndrome-> anscarca right sided heart failure-> -peripheral edema "dependent edema" -liver congestion: nutmeg liver ```
53
hyperemia characteristics
arteriole congestion - red in color - active or reactive - inflammatory
54
congestion characteristics
passive involves veins blue in color left heart
55
hyperemia
increased blood flow into capillary beds | -DUE TO arterial or arteriolar dilation
56
causes of hyperemia
1. sympathetic neurogenic mechanisms | 2. release of vasoactive substances-> histamine, serotonin
57
redness associated with
heat dissipation (fever, exercise) blushing inflammation
58
congestions
accumulation of blood within capillaries - DUE TO impaired venous drainage - increased deoxygenated hemoglobin in blood (cyanosis) - chronic congestion can lead to ischemia, necrosis
59
nutmeg liver
right heart failure | -obstruction of vena cava or hepatic vein
60
gross features of nutmeg liver
Alternating areas of light (pale hepatocytes) and dark (distended sinusiods) in a pattern resembling a nutmeg
61
microscopic features nutmeg liver
congestion of central vein with increased blood in sinusoids +/- atrophy or necrosis centrilobular hepatocytes +/- fatty change in perilobular hepatocytes (chronic ischemia)
62
pulmonary edema->CHF
left heart failure
63
gross features pulmonary edema
wet, heavy, boggy lungs
64
microscopic features of pulmonary edema
congestion of pulmonary veins - transudate and red cells within alveoli - "heart failure cells"-> alveolar macrophages containing hemoglobin
65
hemorrhage
``` blood outside of cardiovascular system -vascular disruption -diapedesis petechia, purpura, ecchymosis hematoma hemopericardium, hemothorax, hemoperitoneum, hemarthrosis, hematosalpinx ```
66
consequences of hemorrhage
shock-> severe blood loss -if results in decreased intravascular volume, then tachycardia, pale, cool skin hematoma: benign-> skin bruise, lethal-> brain cardiac tamponade: decreased venous return due to increased fluid volume in pericardium anemia

Pathology- fluid Hemodynamics (4 decks)

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