oedema

2oed definition
Increased fluid in interstitial spaces
Anasarca -- severe generalized
oedema with profound subcutaneous
tissue swelling
Fluid collection in various cavities is named
Hydrothorax
Hydroperitonium (ascities)
hydropericardium
3oed classification
Increase hydrostatic pressure
Reduced plasma osmotic pressure
(hypoproteinemia)
Lymphatic obstruction
Sodium retention
inflammation
4oed increased hydrostatic pressure
Impaired venous return
Congestive heart failure
Constrictive pricarditis
Ascities (liver cirrhosis)
Venous obstruction
Thrombosis
External pressure (mass)
Inactivity with prolonged dependency
Arteriolar dilation
heart
5oed hyoproteinemia
Reduced plasma osmotic pressure
Protein loosing glomerulopathies
(nephrotic syndrome)
Liver cirrhoses (ascities)
malnutrition
protein loosing gastro-entero pathy
6oed lymphatic obstruction
Inflammatory
Neoplastic
post surgical
Post irradiation
7oed sodium retention
Excessive salt intake ,with renal
insufficiency
Increase tubular reabsorption of sodium
Renal hyoperfusion
Increased renin-angiotensin-aldosteron
secretion
8oed inflammation
Acute inflammation
Chronic inflammation
angiogenesis
9oed variables of pressures
Affecting fluid transit across capillary wall
Capillary hydrostatic & osmatic forces are
balanced
No net loss or gain of fluid across capillary bed
Increase hydrostatic pressure or decreased
plasma osmotic pressure leads to
net accumulation of extra vascular fluid (oedema)
As the interstitial fluid pressure increases
tissue lymphatics remove much of the excess fluid
Eventually returning it to circulation via thoracic duct
pathways leading
To systemic
oedema
Heart failure
Cardiac output
Effective arterial
Blood volume
rennin
aldosteron
Renal sodium
reabsorption
Rena retention
Of Na
+
, H
2
O
Plasma
volume
transudation
oedema
MALNUTRITION
Hepatic SYNTHEIS
NEPHROTIC SYNDROM
PLASMA
Osmotic pressure
Blood volume
Ascities
Other effusions
Renal
vasoconstriction
Tubular reabsorption
Na
+
, H
2
O
GFR
CVP
capillary
pressure
11oed clinical presentation
Ranges from annoying to fatal
Signals the underlying disease
Impairs wound healing & clearance of
infection
Pulmonary oedema interferes with
ventilation & can cause death
Brain oedema is serious and can be fatal
by herniation or pressure ischemia
MORPHOLOGY
SUBCUTANEOUS EDEMA
Dependent, site of higher osmotic pressure
Prominent feature of right heart failure
NEPHROTIC EDEMA
PERIORBITAL EDEMA
PULMONARY EDEMA
Frothy blood tinged fluid, with air
BRAIN EDEMA
Swollen brain,narrow sulci distended gyri

12hyp
Hyperaemia
and congestion
13hyp definition
Both indicate a local increased volume of blood
in particular tissue
Hyperemia is
an active process
augmented tissue inflow
arteriolar dilatation
skeletal muscle in exercise
place of inflammation
Congestion is
passive process
impaired outflow
cardiac failure

14hyp hyperemia versus congestive
In both cases there is
Increased volume
and pressure of blood
in a given tissue with
associated capillary dilatation and
potential for fluid extravasations
15hyp hyperemia versus congestion
hyperemia
Increased inflow leads to
Engorgement with oxygenated blood
Resulting in erythema
Congestion
Diminished out flow leads to
Capillary be swollen
With deoxygenated venous blood
Resulting in cyanosis
MORPHOLOGY
Cut surfacewet and hemorrhagic
Alveolar capillaries engorged with blood
Focal intra alveolar hemorrhage
HEPATIC CONGESTION
Hepatocyte degeneration
Chronic congestion.nutmeg liver
Centrilobular necrosis
Hepatic fibrosisin severe cases