This is the term for a clinically apparent increase in interstitial fluid that can expand by several liters before the abnormality is evident.
Edema
This is the term for edema resulting from hypothyroidism.
Myxedema
This is the term for extreme generalized edema.
Anasarca
This is the term for abnormal accumulation of fluid in the peritoneal cavity.
Ascites
This is the term for the accumulation of serous fluid in one or both pleural cavities or pericardial space.
Hydrothorax/Hydropericardium
____ of water in the body is intracellular, and _____ of all the water in the body is extracellular.
2/3; 1/3
75% of the Extracellular Space is composed of ___________. The remaining 25% of the Extracellular Space is composed of _________.
Interstitial Fluid; Plasma
Define Starling’s Law
The exchange of fluid between the plasma and the interstitium is determined by the hydrostatic and colloid oncotic pressures in each compartment.
Net Filtration = Capillary Wall Porosity x (Hydrostatic Pressure - Oncotic Pressure)
Hydrostatic Pressure is a function of:
- Blood Pressure
- Intravascular Volume
- Venous Outflow
This is the term for the ability of albumin to form covalent bonds with water and retain fluid in a particular compartment.
Oncotic Pressure
Extracellular fluid normally moves from the _________ across ________ into the __________ and is then returned to the circulation via the lymphatic’s
Vascular Space; Capillary Walls; Interstitium
Production of Edema (could be a combination):
- Increased plasma volume
- Elevation in capillary hydrostatic pressure
- Increased Capillary Permeability
- Reduction in the Plasma Oncotic Pressure
- Lymphatic Obstruction
The increase in capillary pressure is generally due to _________. Why?
Increased Venous Pressure; Because the pre-capillary arteriole autoregulates capillary pressure.
What could cause increased capillary pressure?
- Venous Obstruction (Venous Thrombosis)
- Expanded Venous Blood Volume (Heart Failure or Kidney Failure)
Cause of Decreased Plasma Oncotic Pressure
- Hypoalbuminemia (< 2 g/dL)
- Nephrotic Syndrome
- Liver Failure
What causes Increased Capillary Permeability?
Augments transit of proteins into interstitium, therefor decreases oncotic pressure gradients.
Ex:
- Burns
- Angioedema
What can cause lymphatic obstruction?
Secondary to Tumor
*Rare
Clinical conditions Assc with Edema Development Caused by:
Increased Capillary Pressure via:
Increased plasma volume due to renal Na+ Retention
- Heart Failure, including Cor Pulmonale
- . Primary renal sodium retention:
a. Renal disease, including nephrotic syndrome
b. Drugs: minoxidil, NSAIDS, estrogens
c. Early hepatic cirrhosis - Pregnancy and premenstrual edema
Clinical conditions Assc with Edema Development Caused by:
Increased Capillary Pressure via:
Venous Obstruction
- Cirrhosis or Hepatic Venous Obstruction
2. Local Venous Obstruction
Clinical conditions Assc with Edema Development Caused by:
Increased Capillary Pressure via:
Decreased Arteriolar Resistance
- Calcium Channel Blockers
2. Idiopathic Resistance
Clinical conditions Assc with Edema Development Caused by:
Hypoalbuminemia via:
Protein Loss
- Nephrotic Syndrome
2. Protein-Losing Enteropathy
Clinical conditions Assc with Edema Development Caused by:
Hypoalbuminemia via:
Reduced Albumin Synthesis
- Liver Dz
2. Malnutrition
Clinical conditions Assc with Edema Development Caused by:
Increased Capillary Permeability
- Idiopathic Edema
- Burns
- Trauma
- Inflammation or Sepsis
- Allergic Reactions
- DM
- IL2 Therapy
- Malignant Ascites
Clinical conditions Assc with Edema Development Caused by:
Lymphatic Obstruction or Inc. Interstitial Oncotic Pressure
- Post-mastectomy
- Nodal Enlargement Due to Malignancy
- Hypothyroidism
- Malignant Ascites
