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Cardiovascular 2018 > Fluid shift across capillary wall > Flashcards

Fluid shift across capillary wall Flashcards

1
Q

What % of weight is body water?

A

60% of body weight

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2
Q

What proportion of body water is extracellular?

A

1/3rd

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3
Q

What percentage of body water is interstitial?

A

75%

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4
Q

What is the function of interstitial fluid?

A

acts as the go-between blood and body cells

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5
Q

What is the roll of capillaries in terms of metabolites?

A

remove metabolites from cells

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6
Q

What does blood flow in the capillaries depends upon?

A

the contractile state of the arterioles

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7
Q

In which tissue are precapillary sphincters present?

A

mesentery

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8
Q

What is the rate of blood flow through the capillary bed?

A

slow (like a lake)

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9
Q

What do capillaries unite to form?

A

Venule

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10
Q

How do water soluble substances pass through capillaries?

A

through water filled capillary pores

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11
Q

How do lipid soluble substances pass through capillaries?

A

gasses can pass through endothelial cells

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12
Q

How are exchangeable proteins moved across the capillary walls?

A

vesicular transport

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13
Q

How do plasma proteins pass across capillary walls?

A

They can’t

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14
Q

What gradient does fluid follow?

A

Pressure gradient

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15
Q

What gradient do gasses and solutes follow?

A

Fick’s law of diffusion

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16
Q

What is transcapillary flow driven by?

A

Pressure gradients

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17
Q

What is ultra-filtration?

A

exchange of protein-free plasma across capillary walls

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18
Q

What are the forces favouring filtration?

A

capillary hydrostatic pressure (Pc) interstitial fluid osmotic pressure (πi)

19
Q

What are the forces opposing filtration?

A

capillary osmotic pressure (πc)

Interstitial fluid hydrostatic pressure (Pi)

20
Q

What is the normal value for Pc?

A

35mmHg at arteriolar end

17mmHg at venular end

21
Q

What is the normal value for πi?

A

1mmHg

22
Q

What is the normal value for πc?

A

25mmHg

23
Q

What is the normal value for Pi?

A

1mmHg

24
Q

Where to starling forces favour absorption and filtration?

A

Favour filtration at the arteriolar end

Absorption at the venular end

25
Q

How is excess fluid returned to the circulation?

A

Via the lymphatics as lymph

26
Q

What is pulmonary resistance in comparison to systemic resistance?

A

10%

27
Q

What is pulmonary capillary hydrostatic pressure?

A

Low (8-11mmHg)

28
Q

What is capillary osmotic pressure?

A

25mmHg

29
Q

Why is lymphatic drainage so important?

A

Prevents accumulation of interstitial fluid

30
Q

What is oedema?

A

Accumulation of fluid in the interstitial space

31
Q

What factors are affected by pulmonary oedema?

A

Diffusion distance increases so gas exchange is compromised

Compliance is affected

32
Q

What are the causes of oedema?

A

Raised capillary pressure

Reduced plasma oncotic pressure

Lymphatic insufficiency

Changes in capillary permeability

LVF

33
Q

What are the causes of raised venous pressure?

A

Left ventricular failure (pulmonary oedema)

Right ventricular failure (peripheral oedema, sacral)

Prolonged standing (swollen ankles- damage the valves in the lower limb veins)

34
Q

What will heart failure do to the frank starling curve? and why?

A

Shift it right

you will have less stroke volume per pre-load, causing pooling of blood in the heart and creating back-pressure

35
Q

What is the normal plasma protein pressure?

A

65-80g/l

36
Q

What are the causes of raised capillary pressure?

A

arteriolar dilatation

raised venous pressure

37
Q

When does reduced plasma protein cause oedema?

A

When it is <30g/l

38
Q

What are the causes of reduced plasma oncotic pressure?

A

Malnutrition

Protein malabsorption

Excessive renal excretion of protein (proteinuria)

Hepatic failure (liver is not manufacturing proteins in the first place)

39
Q

What are the causes of lymphatic insufficiency?

A

Lymph node damage

Filariasis-elephantiasis

40
Q

What kind of oedema will lymphatic deficiency cause?

A

Non-pitting oedema

41
Q

What are the causes of change in capillary permeability?

A

Inflammation

(histamine increases leakage of proteins)

42
Q

What is the pathogenesis of LVF in oedema?

A

accumulation of fluid in the interstisital and intra-alveolar lung spaces, manifested by varying degrees of SOB.

43
Q

What are the clinical manifestations of LVF?

A

Clinically there may be crepitation’s in auscultation of lung bases.

chest x ray shows haziness in perihilar region

Cardiovascular 2018 (39 decks)

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