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Pathophys Edema

What is Edema? increase in interstitial fluid
Examples of systemic or local? local- injury systemic- lymphedema, cancer
What maintains intracellular and extracellular balance? Na, K
What maintains intravascular and interstitial balance? capillary dynamics
What is osmotic pressure? pressure determined by conc. of proteins inside and outside blood vessels; synonymous with oncotic pressure (blood)
What is hydrostatic pressure? pressure exerted by a fluid; Exampe: in blood vessels by heart and gravity, contrib. to movement of fluid into or out of vessels, lymphatics
Relationship of hydrostatic pressure, osmotic pressure and loss of fluid? Usually hydrostatic pressure (pushing out) > osmotic pressure (keeping in)  slight loss of fluid into interstitial space (taken up by lymph system)
What is contained in lymphatic fluid? rich in protein, water and macrophages
osmotic pressure in blood is due to what? proteins (gradient in and out of cell)
What causes hydrostatic pressure? volume of blood present (heart and gravit, standing gravity causes fluid down)
Where is the pressure higher? higher intravascular pressure
Situations that cause edema? Na and H20 retention, increase capillary permeability, obstruction (DVT or CA), decreased muscle action, air travel, left ventricle malfunction, overwhelmed lyymphatic system, exercise or trauma
What happens with edema Increased capillary hydrostatic pressure Increased interstitial osmotic pressure or decreased intravascular osmostic pressure Increased venule permeability Overwhelmed lymphatitc system that can’t accommodate for large fluid shift
WHat forces exist across capillary wall? Hydrostatic Osmotic (oncotic) Capillary wall integrity Lymphatic integrity
what is filtration? Filtration: forces favoring outward movement of fluid
What is reabsorption? Reabsorption: forces favoring inward movement of fluid
Permeability of capillaries to water, protein, other solutes? All capillaries are freely permeable to water Permeability to proteins is low Permeability to other solutes, such as glucose and electrolytes is variable
Clinical manifestation of edema?(edema and effusion) Edema: excess fluid in the interstitial spaces and connective tissues between cells Effusion: excess fluid in potential fluid spaces of the body: pericardial sac, alveoli of lungs, jnt space, intrapleural spaces
Clinical manifestation of edema (ascites and anasarca) Ascites: fluid in the perotineal cavity Anasarca: massive, generalized edema, through entire body
local manifestations of edema increased girth and pitting edema
systemic manifestations of edema increased girth, pitting edema, lung sounds, and weight gain
Lymph manifestations of edema increased girth, pitting edema, and weight gain
What is lymphedema? blocked or removal of lymph nodes; swelling caused by increased lymphatic fluid in interstitial space
What can cause lymphedema? Low albumin Lymphatic obstruction Abnormal vessel distribution Reduced activity
Define lymph fluid consisting of water, white blood cells, cellular debris and protein rich matter
what is a lymphatic plexus groups of small lymphatic cells, located immediately below skin;acts as “sponge” to soak up and gather lymph fluid
define lymphatic vessels known as collectors specialized channels located throughout the body one way valves; smooth muscle directed towards the heart
define lymph nodes filtering bumps located in the lymph channels at 1-2cm intervals purifies lymph fluid of bacteria and viruses
where do nodes congregate? neck, armpits, along trachea, lung near intestines, behind abdominal cavity, groin and pelvis
what is anastamosis? area where left and right lymphatic channels connect
how many lymph trunks are in the body? 6 major trunks, named for the region of the body
What is hypoplasia or aplasia? Born with only a few lymphatic collectors in a particular limb
What is hyperplasia? Collectors are enlarged; one way valves are incompetent
causes of primary lymphedema? hypoplasia, hyperplasia and blockage
What can cause secondary lymphedema? Collectors are enlarged; one way valves are incompetent
stages of lymphedema 0: latent 1: spontaneously reversible 2: spontaneously irreversible 3: lymphatic elephantitis
characteristic stage 0 (latent) Lymphatic vessels sustained damage, which isn’t yet apparent; transport capacity still sufficient
Characteristic of Stage 1 of lymphedema Pitting stage; normal in am but increases size t/o day
Characteristic of Stage 2 lymphedema Spongy consistency & non-pitting, beginning of hardening of the limbs w/ increasing size
Characteristic of stage 3 of lymphedema Irreversible swelling, hard/fibrotic tissue, unresponsive
Grade 1 Lymphedema involves waht parts? distal parts such as forearm and hand or lower leg and foot
Grade 2 lymphedema involves an entire limb or corresponding quadrant of the trunk
Grade 3a edema involves what present in one limb and its associated trunk quadrant
Grade 3b edema involves what same as 3a except two or more extremities are affected
Grade 4 edema involves what elephantitis
Decongestive therapy for lymphedema Lymphatic massage Skin care Compressive garments Exercise
Created by: 696592119