EDEMA Fluid extravasation and accumulation in the interstitial

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EDEMA Fluid extravasation and accumulation in the interstitial spaces

EDEMA Fluid extravasation and accumulation in the interstitial spaces

EDEMA • Localized ( a limb) or systemic • Inflammatory or non inflammatory •

EDEMA • Localized ( a limb) or systemic • Inflammatory or non inflammatory • Massive edema is called Anasarca • Fluid may also accumulate in body cavities: l Hydrothorax l Hydro pericardium l Hydro peritoneum is also called Ascites

Edema Fluid • A TRANSUDATE is protein-poor (specific gravity <1. 012)(non inflammatory) • An

Edema Fluid • A TRANSUDATE is protein-poor (specific gravity <1. 012)(non inflammatory) • An EXUDATE is protein-rich (specific gravity >1. 020) (inflammatory edema)

Pathophysiologic Categories of Edema I. Increased Hydrostatic Pressure II. Reduced Plasma Oncotic Pressure III.

Pathophysiologic Categories of Edema I. Increased Hydrostatic Pressure II. Reduced Plasma Oncotic Pressure III. Sodium retention IV. Lymphatic obstruction

 • EDEMA - Summary • INCREASED • HYDROSTATIC • HEART • PRESSURE •

• EDEMA - Summary • INCREASED • HYDROSTATIC • HEART • PRESSURE • LIVER • Congestive Heart Failure • Ascites • KIDNEY • Venous Obstruction • LYMPHATIC • OBSTRUCTION • Inflammatory • Neoplastic • DECREASED • ONCOTIC • PRESSURE • Nephrotic Syndrome • • Cirrhosis Protein Malnutrition

Edema Morphology Edema of the subcutaneous tissue is most • easily detected Grossly (not

Edema Morphology Edema of the subcutaneous tissue is most • easily detected Grossly (not microscopically) Push your finger into it • and a depression remains •

Compare between: Hyperemia & Congestion HYPEREMIA: • is an active process • resulting from

Compare between: Hyperemia & Congestion HYPEREMIA: • is an active process • resulting from increase blood inflow into tissue Congestion • is a passive process • resulting from • due to arteriolar dilation impaired outflows • (e. g. acute inflammation) from a tissue • Impaired venous return • (e. g. cardiac failure or venous obstruction)

Liver - Chronic Passive Congestion “Nutmeg” Liver Cross Section of a Nutmeg

Liver - Chronic Passive Congestion “Nutmeg” Liver Cross Section of a Nutmeg

Hemorrhage Extravasation of blood due to rupture of blood vessels

Hemorrhage Extravasation of blood due to rupture of blood vessels

Hemorrhage Forms: Causes: – Rupture of a large vessel: – Trauma – Atherosclerosis –

Hemorrhage Forms: Causes: – Rupture of a large vessel: – Trauma – Atherosclerosis – Inflammatory – Neoplastic Erosion – Rupture of small vessels: » hemorrhagic diathesis May be: – external – into a body cavity – into a tissue

Hemorrhage: into tissue 1) Haematoma: accumulation of blood ENCLOSED OR CONFINED WITHIN TISSUE e.

Hemorrhage: into tissue 1) Haematoma: accumulation of blood ENCLOSED OR CONFINED WITHIN TISSUE e. g. - Bruise (insignificant) - retroperitoneal haematoma due to ruptured aortic aneurysm fatal

Hemorrhage 2) Petechiae: minute hemorrhages into skin, mucous membranes, or serosal • surfaces (1

Hemorrhage 2) Petechiae: minute hemorrhages into skin, mucous membranes, or serosal • surfaces (1 -2 MM) Associated with: – Local increase hydrostatic – pressure Thrombocytopenia

Hemorrhage 3) Purpura: – Slightly larger hemorrhages than Petechiae (3 -5 MM) – Causes:

Hemorrhage 3) Purpura: – Slightly larger hemorrhages than Petechiae (3 -5 MM) – Causes: • Causes as Petechiae • Trauma • Vasculitis • Increased vascular fragility

Hemorrhage 4) Ecchymoses: – Subcutaneous haematoma ‘bruise’ OVER 1 -2 CM Q: Why do

Hemorrhage 4) Ecchymoses: – Subcutaneous haematoma ‘bruise’ OVER 1 -2 CM Q: Why do bruises change color as they Resolve? • The RBC’s in a hemorrhage are broken down: – hemoglobin (red) – bilirubin (blue-green) – hemosiderin (golden-brown)

Hemorrhage: Accumulation of blood in a body cavity: – Hemothorax – Hemopericardium – Hemoperitoneum

Hemorrhage: Accumulation of blood in a body cavity: – Hemothorax – Hemopericardium – Hemoperitoneum – Hemarthrosis

Hemorrhage Cerebral hemorrhage

Hemorrhage Cerebral hemorrhage