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Cardiovascular System > Pathophysiology of Congestion and Oedema > Flashcards

Pathophysiology of Congestion and Oedema Flashcards

1
Q

The passive movement of water is

A

Down its pressure gradient

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2
Q

Darcy’s law

A

Blood flow = change in pressure/resistance (Q=Δ P/R)

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3
Q

Congestion

A

relative excess blood in vessel soft tissue or organ

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4
Q

Example of local acute congestions

A

Deep vein thrombosis

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5
Q

Example of local chronic congestion

A

Hepatic cirrhosis

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6
Q

Example of generalise acute congestion

A

Congestive cardiac failure

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7
Q

Deep vein thrombosis of leg

A

Vein blocked by thrombosis causing localised acute congestion

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8
Q

Pathophysiology of deep vein thrombosis

A

Blood backs up in veins, venules and capillaries - decreased outflow of blood - local acute congestion - decrease in pressure gradient - decrease flow across systems - no oxygen so ischaemia and infarction

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9
Q

Why does pressure gradient decrease in deep vein thrombosis

A

Due to venous pressure rising to match arterial pressure decreasing the difference in pressure between the 2

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10
Q

Hepatic cirrhosis results from

A

Serious liver damage (eg. alcohol damage)

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11
Q

Regeneration of liver results in

A

Formation of nodules of hepatocytes with intervening fibrosis - loss of normal architecture

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12
Q

Pathophysiology of hepatic cirrhosis

A

Loss of normal liver architecture - altered hepatic blood flow - portal blood flow blocked - congestion in portal vein and branches - increased portal venous pressure - collateral circulation

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13
Q

Collateral circulation

A

Several sites anastomosing with systemic circulation

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14
Q

Local chronic congestion has a risk of

A

High pressure haemorrhage

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15
Q

Consequence of hepatic cirrhosis

A

Portal-systemic shunts

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16
Q

Congestive cardiac failure arrises from

A

The heart being unable to clear blood - ineffective pump

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17
Q

Pathophysiology of congestive heart failure

A

Reduced cardiac output - reduced renal glomerular filtration rate (GFR) - activation of renin-angiotensin-aldosterone system - increase in sodium and water retention - increase amount of fluid in body - increase fluid in veins (overload)

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18
Q

Treatment of congestive heart failure

A

Diuretics

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19
Q

Effects of congestive cardia failure

A

Back pressure, blood dammed back in veins
Lungs: pulmonary oedema - left heart failure - blood dams back into lungs
Liver: central venous congestion - right heart failure - blood dams back to systemic circulation

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20
Q

Signs of central venous congestion

A

Elevated JVP
Hepatomegaly
Peripheral oedema

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21
Q

2 blood supplies of liver

A

Systemic blood supply and portal vein

22
Q

Effect of hepatic central venous congestion on pericentral hepatocytes

A

Stasis of poorly oxygenated blood

23
Q

Effect of hepatic central venous congestion on periportal hepatocytes

A

Relatively better oxygenated due to proximity of hepatic arterioles

24
Q

Microcirculation is driven by

A

Hydrostatic pressure from the heart

25
Q

Microcirculation is balance by

A

Osmotic pressures and endothelial permeability

26
Q

Microcirculation

A

Constant movement of fluid through capillary beds

27
Q

Filtration of microcirculation

A

Capillaries - interstitium - capillaries and lymphatics

28
Q

3 components that affect net flux and filtration of microcirculation

A

Hydrostatic pressure
Oncotic pressure
Permeability characteristics and area of endothelium

29
Q

Oedema

A

Accumulation of abnormal amounts of fluid in the extravascular compartment

30
Q

Peripheral oedema

A

Increased interstitial fluid in tissues

31
Q

Effusions

A

Fluid collections in body cavities

32
Q

Effusion in abdominal cavity

A

Ascites

33
Q

Transudate oedema

A

Alterations in the haemodynamic forces which act across the capillary wall - low protein

34
Q

Exudate oedema

A

Part of inflammatory process due to vascular permeability - high protein

35
Q

Pulmonary oedema is what kind of oedema

A

Transudate

36
Q

Pathophysiology of pulmonary oedema relating to left ventricular failure

A

Increase in left atrial pressure - passive retrograde flow to pulmonary veins, capillaries and arteries - increase in pulmonary vascular pressure - increase in pulmonary blood volume - increase capillary hydrostatic pressure - increase filtration and pulmonary oedema

37
Q

Pathophysiology of pulmonary oedema in the lungs

A

Progressive oedematous widening of alveolar septa - accumulation of oedema fluid in alveolar spaces

38
Q

Peripheral oedema is caused by

A

Right heart failure

39
Q

Pathophysiology of peripheral oedema

A

Right heart failure - can’t empty RV in systole - blood retained in systemic veins - increase capillary hydrostatic pressure - increase filtration - peripheral oedema

40
Q

Pathophysiology of lymphatic blockage

A

Lymphatic obstruction - hydrostatic pressure upset - lymphoedema

41
Q

Abnormal renal function results in

A

Salt and water retention

42
Q

Secondary abnormal renal function

A

Heart failure

43
Q

Primary abnormal renal function

A

Acute tubular damage (eg. hypotension)

44
Q

Pathophysiology of oedema in abnormal renal function

A

Decreased renal function - increase salt and water - increase in intravascular fluid volume - increase in capillary hydrostatic pressure - oedema

45
Q

Pathophysiology of low protein oedema

A

Hypoalbuminaemia - decrease in capillary oncotic pressure - increase in filtration - oedema

46
Q

Capillary oncotic pressure requires

A

Normal protein levels - transudate

47
Q

Examples of low protein oedema

A

Hepatic cirrhosis
Malnutrition
Nephrotic syndrome

48
Q

Permeability oedema is what type of oedema

A

Exudate

49
Q

Low protein oedema is what type of oedema

A

Transudate

50
Q

Pathophysiology of permeability oedema

A

Damage to endothelial lining - increase of pores in membrane - osmotic reflection coefficient of endothelium (permeability) decreases towards 0 - proteins and larger molecules can leak out

51
Q

Permeability oedema can result from

A

Acute inflammation eg pneumonia

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Cardiovascular System (27 decks)

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