EDEMAEDEMA Fluid extravasation and accumulation in the interstitial spaces.
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Transcript of EDEMAEDEMA Fluid extravasation and accumulation in the interstitial spaces.
EDEMAEDEMAEDEMAEDEMA
Fluid extravasation and Fluid extravasation and
accumulation in the interstitial accumulation in the interstitial
spaces spaces
EDEMA• Localized Localized ( a limb) or ( a limb) or systemicsystemic
• InflammatoryInflammatory or or non inflammatorynon inflammatory
• Massive edema is called AnasarcaAnasarca
• Fluid may also accumulate in body body
cavities:cavities:
HydrothoraxHydrothorax
Hydro pericardiumHydro pericardium
Hydro peritoneum is also called Hydro peritoneum is also called AscitesAscites
Edema Fluid
• A TRANSUDATETRANSUDATE is protein-poor (specific
gravity <1.012)(non inflammatory)
• An EXUDATEEXUDATE is protein-rich (specific
gravity >1.020) (inflammatory edema)(inflammatory edema)
Pathophysiologic Categories of Edema
I.Increased Hydrostatic PressureII.Reduced Plasma Oncotic PressureIII.Sodium retentionIV.Lymphatic obstruction
•EDEMA - Summary
•INCREASED•HYDROSTATIC•PRESSURE• Congestive Heart Failure• Ascites• Venous Obstruction
•DECREASED •ONCOTIC•PRESSURE• Nephrotic Syndrome• Cirrhosis• Protein Malnutrition
•LYMPHATIC•OBSTRUCTION• Inflammatory• Neoplastic
• HEART• LIVER• KIDNEY
EdemaMorphology
•Edema of the subcutaneous tissue is most
easily detected GrosslyGrossly (not microscopically)
•Push your finger into it
•and a depression remains
Compare between:Hyperemia & Congestion
HYPEREMIA:HYPEREMIA:
• is an active process
• resulting from increase
blood inflow into tissue
• due to arteriolar dilation
• (e.g. acute inflammation)
Congestion Congestion
• is a passive process
• resulting from
impaired outflows
from a tissue
• Impaired venous
return
• (e.g. cardiac failure or
venous obstruction)
HemorrhageHemorrhageHemorrhageHemorrhage
Extravasation of bloodExtravasation of blood
due to rupture of blood vesselsdue to rupture of blood vessels
Hemorrhage
Causes:Causes:– Rupture of a large vessel:
– Trauma
– Atherosclerosis
– Inflammatory
– Neoplastic Erosion
– Rupture of small vessels:
» hemorrhagic
diathesis
Forms:Forms:
May be:
– external
– into a body cavity
– into a tissue
Hemorrhage: into tissue
1) Haematoma: 1) Haematoma:
accumulation of blood accumulation of blood ENCLOSED OR CONFINED WITHIN ENCLOSED OR CONFINED WITHIN
TISSUETISSUE
e.g.
- Bruise (insignificant)
- retroperitoneal haematomaretroperitoneal haematoma
due to ruptured aortic aneurysm
fatal
Hemorrhage
2) Petechiae:2) Petechiae:
minute hemorrhages into
skin, mucous membranes, or
serosal surfaces (1-2 MM) • Associated with:Associated with:
– Local increase hydrostatic
pressure– Thrombocytopenia
Hemorrhage
3) Purpura:3) Purpura:
– Slightly larger hemorrhages than Petechiae (3-5
MM)– Causes:Causes:
• Causes as Petechiae• Trauma• Vasculitis• Increased vascular fragility
Hemorrhage4) Ecchymoses:4) Ecchymoses:
– Subcutaneous haematoma ‘bruise’ OVER 1-2
CM
Q: Why do bruisesbruises changechange colorcolor as they Resolve?
• The RBC’s in a hemorrhage are broken down:
– hemoglobin (red) – bilirubin (blue-green) – hemosiderin (golden-brown)
Hemorrhage: Accumulation of blood Accumulation of blood in a body cavityin a body cavity::
– Hemothorax
– Hemopericardium
– Hemoperitoneum
– Hemarthrosis