Hemodynamic Disorders (4) - Section 1 Flashcards
Edema
Abnormal fluid accumulation in the INTERSTITIAL SPACE
Effusion
Abnormal fluid accumulation in body cavities
Exudate
Fluid high in proteins and cells
Exudate usually implies?
Inflammation due to the increased vascular permeability
Transudate
Fluid low in proteins and cells
What 2 pressure changes can cause Edema (fluid flow out of the blood vessel)?
- INCREASE in Hydrostatic pressure of the vessel
2. DECREASE in Osmotic pressure of the blood vessel
Hyperemia
Too much blood arriving at the arterial side of capillary bed
Congestion
Too little blood leaving the venous side of capillary bed
Hyperemia and Congestion both result in?
INCREASED blood volumes in the tissues
Hyperemia and Congestion - which one is an active controlled process?
Hyperemia due to the pre-capillary sphincter that can open or close to allow more or less blood in respectively
Congestion causes an increase in what pressure?
Hydrostatic pressure - pushes fluid out (edema)
List 4 mechanisms that can cause edema
- Increase in hydrostatic pressure
- Decrease in oncotic pressure
- Increased vascular permeability
- Lymphatic obstruction
What 2 things can increase hydrostatic pressure and thus cause edema?
Congestion
Na+ and Water retention - increases blood volume
Lymphedema
Impaired clearance of interstitial fluid = LOCALIZED edema
In what 2 ways does Heart failure cause edema?
- Increased hydrostatic pressure
2. Decreased renal blood flow
With heart failure, there is decreased renal blood flow as well. Describe the cascade of how this causes edema
Decreased renal blood flow - Activates RAAS - Na+ and Water retention = Increased blood volume == Increased hydrostatic pressure
In what way does Renal failure cause edema?
Na+ and Water retention = Increased blood volume
= Increased hydrostatic pressure
Decreased plasma _____ can lead to decreased oncotic pressure
Albumin
Liver failure, malnutrition and nephrotic syndrome all have decreased ____ that causes?
Protein synthesis which causes decreased oncotic pressure and thus edema!
Kwashoiorkor
Decreased protein in diet
- Causes decreased oncotic pressure
= Edema
What plasma protein is an important regulator of oncotic pressure?
Albumin
- If albumin is low, oncotic pressure in the vessel will be low as well
With heart failure, where does edema occur?
Pulmonary edema (lungs) due to congestion of blood flow
Nephrotic Syndrome
Excess protein in the urine
With Nephrotic syndrome there is excess protein in the urine. This causes?
Decreased oncotic pressure and thus edema
Liver failure causes ascites. Through what mechanisms?
- Decreased Albumin production - decreased oncotic pressure
- Portal Hypertension (congestion)
With Chronic congestion in venous flow, what will eventually leak out of the vessel?
RBCs
With Chronic congestion, RBCs eventually leak out of the vessel. What will this cause to be deposited?
Hemosiderin (iron)
With Chronic congestion, Hemosiderin causes?
Tissue damage
With pulmonary edema due to chronic congestion, _____ is deposited in ______
Hemosiderin is deposited in alveolar spaces
What color does hemosiderin stain?
Blue
With hepatic congestion due to chronic congestion what is obstructed in the liver?
Central vein
If the central vein is obstructed in the liver, DEoxygenated blood is backed up to where?
Center of the lobule
With hepatic congestion, deoxygenated blood backed up at the center of the lobule causes?
Centrilobar necrosis
Centrilobar necrosis is describe as?
Nutmeg liver
Changes in what pressures cause edema?
Increased hydrostatic pressure
ex. Congestion, increased blood volume
Decreased oncotic pressure
ex. Malnutrition, liver failure, nephrotic syndrome, decreased proteins/albumin
What findings will be present in the lungs with heart failure?
Pulmonary Edema AND Pulmonary Effusion
2 common causes of lymphedema?
Lymph node resection
Helminth infection - Filariasis
