Term
| what are the two general requirements healthy tissues need |
|
Definition
intact circulation
normal fluid homeostasis |
|
|
Term
| what are what components of fluid homeostasis |
|
Definition
BV (60% water)
BP
vessels in tact
osmolarity/protein levels
clot formation and prevention |
|
|
Term
| what is the general MOA of fluid balance |
|
Definition
fluid moving out of vessel is nearly balanced by fluid coming in normally (some goes into lymphatics)
vascular hydrostatic pressure pushes fluid out and plasma colloid osmotic pressure pulls fluid in |
|
|
Term
| what are the two types of edema fluid and a aka for each |
|
Definition
transudate - hydrostatic
exudate - inflammatory |
|
|
Term
| what dinstinguishes transudate and exudate |
|
Definition
transudate: protein poor SG <1.012
exudate: potein rich SG >1.020 |
|
|
Term
| what are the types of edema (4) |
|
Definition
hydrothorax
hydroperitoneum (acetes)
hydroperocardium
anasarca |
|
|
Term
|
Definition
| severe edema with subcutaneous swelling |
|
|
Term
| what are the 4 main causes of edema |
|
Definition
increased hydrostatic pressure
reduced plasma oncotic pressure
lymphatic obstruction
water and Na retension |
|
|
Term
| what are 3 causes of increased hydrostatic pressure |
|
Definition
impaired venous return
increased arteriolar dilation
congestive heart failure |
|
|
Term
| what are the two types of edema caused by impaired venous return, what is the cause of each |
|
Definition
local: venous thrombosis in lower extremity
general: congestive heart failure |
|
|
Term
| what causes increased arteriolar dilation (2) |
|
Definition
| heat, neurohumoral dysregulation |
|
|
Term
| congestive heart failure venous effect MOA |
|
Definition
pump fails decreasing CO and blood backs up
blood cannot leave lungs or return from body increasing venous pressure and pulmonary hydrostatic pressure
causes central venous pressure increase and systemic generalized edema |
|
|
Term
| congestive heart failure arterial effect MOA |
|
Definition
pump fails decreasing CO so less blood is pumped into arteries
kidney does not see enough blood
RAAS activated: increases Na and water retension, renal vasoconstriction, ADH
congestive heart failure worsens |
|
|
Term
| what are two causes of reduced plasma oncotic pressure, explain each |
|
Definition
nephritic syndrome: increased permeability of glomerular BM
reduced albumin synthesis: chirrhosis, protein malnutrition |
|
|
Term
| what are the two causes of lymphatic obstruction |
|
Definition
filarias parasite wuchereria bancrofti
neoplastic lymphatic obstruction |
|
|
Term
| how does filarias causes edema |
|
Definition
| causes inguinal lymph and node fibrosis leading to inflammation blockage and elephantitis |
|
|
Term
| what are two types of neoplastic lymphatic obstructions |
|
Definition
arm edema caused by breast cancer or radiation of axilla
peau d' orange: carcinoma of the breast obstructs superificial lymph causing edema |
|
|
Term
| what are the 6 locations of edema |
|
Definition
subcutaneous
pulmonary
brain
dependent
periorbital
generalized |
|
|
Term
| what are 5 signs of subcutaneous edema |
|
Definition
gross detection
dependent
pitting
impair wound healing
impair clearance of infection |
|
|
Term
| what are 5 signs of pulmonary edema |
|
Definition
fluid in alveolar space
lungs 2-3x normal weight
frothy blood tinged fluid
impaired pulmonary function
impaired CO2/O2 exchange inhibits immune system |
|
|
Term
| what is the main cause of subuctaneous edema |
|
Definition
|
|
Term
| what are 6 causes of pulmonary edema |
|
Definition
left sided heart failure
congestive heart failure
adult respiratory distress syndrome
renal failure
pulmonary infection
hypersensitivity |
|
|
Term
| what are two types of brain edema and their causes |
|
Definition
localized; abscess or around tumor
general: encephalitis/infection, hypertension, trauma |
|
|
Term
| what is a major complication of brain edema |
|
Definition
| herniation through foramen magnum causes death |
|
|
Term
| what is dependent edema caused by, how does it present |
|
Definition
congestive heart failure
if standing in legs
if sitting at sacrum |
|
|
Term
| what is the cause of periorbital edema |
|
Definition
initial manifestation of nephrotic syndrome
initial manifestation of general edema |
|
|
Term
| how does general edema present |
|
Definition
effects body equally initially in loose CT (like periorbital)
pitting |
|
|
Term
| what are two causes of generalized edema |
|
Definition
renal dysfunction
nephrotic syndrome |
|
|
Term
|
Definition
| active increased inflow of blood to tisue causing redness |
|
|
Term
|
Definition
| passive decrease outflow of blood and edema in a tissue causing cyanosis |
|
|
Term
| where is hyperemia located |
|
Definition
| internal (hematoma) or external |
|
|
Term
| what is the seriousness of hyperemia dependent on |
|
Definition
location, size, etc
can be minimal or fatal |
|
|
Term
| what are 4 causes of hyperemia |
|
Definition
trauma
athlerosclerosis
inflammation
erosion by tumor |
|
|
Term
| what are 4 clinical challenges with a hyperemia |
|
Definition
<20% blood loss is ok but more can cause hypovolemic shock
trivial subcutaneous bleeding may be hiding massive brain bleed
external blood loss can cause Fe deficiency (internal Fe is salvaged) |
|
|
Term
| what are the 6 types of hyperemia |
|
Definition
hematoma
petechiae
purpura
ecchymoses
hemopericardium
jaundice |
|
|
Term
|
Definition
| accumulation of blood in the tissue |
|
|
Term
| what is an example of a hematoma |
|
Definition
| dissecting aortic aneurysm casuses retropreotineal hematoma |
|
|
Term
|
Definition
| 1-2mm hemorrhage in skin, mucous membrane, or serosa |
|
|
Term
| what is the cause of petechiae (2) |
|
Definition
| increased intravascular pressure, low or defective platelets |
|
|
Term
|
Definition
|
|
Term
| what are the causes of purpura |
|
Definition
|
|
Term
|
Definition
| >1-2cm subcutaneous hematoma |
|
|
Term
| what is the cause of ecchymoses |
|
Definition
|
|
Term
| why does ecchymoses change color |
|
Definition
| RBC are degraded by macrophages (Hb > bilirubin > hemosiderin) |
|
|
Term
|
Definition
| crush injury ruptures myocardium or coronary A and blood traps in pericardium |
|
|
Term
| what is complication of hemopericardium |
|
Definition
|
|
Term
|
Definition
| massive breakdown of RBC releases bilirubin |
|
|
Term
| what are the two sites of congestion |
|
Definition
|
|
Term
| what are two examples of congestion |
|
Definition
| heart failure causing edema and hypoxia |
|
|
Term
| what are the two types of pulmonary congestion, what is the MOA of each |
|
Definition
acute: alveolar capillary congestion causes edema and hemorrhage
chronic: like acute fibrosis |
|
|
Term
| what is the diagnostic sign of chronic pulmonary congestion |
|
Definition
| heart failure cells: hemosiderin laden macrophages |
|
|
Term
| what are the two types of congestion in the liver, what is the MOA of each |
|
Definition
acute: congestion of central vein sinusoids
chronic: like acute with necrosis of central liver and fibrosis |
|
|
Term
| what are three diagnostic signs of liver congestion |
|
Definition
nutmeg liver (necrosis)
cardiac cirrhosis
heart failure cells: hemoserdin laden macrophages |
|
|
