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28 Cards in this Set

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  • Back
Disorders of body fluid include:
Edema
Hemorrhage
Thrombosis
Embolism
Infarction
Shock
What is edema?
Excessive fluid in interstitial space or within body cavities.

Can be localized or generalized and transudate or exudate.
What is the difference between transudate and exudate?
Transudate is primarily plasma with little cells or protein. Exudate is usually seen with inflammation and contains many cells and proteins.
What needs to happen for edema to occur?
Intravascular hydrostatic pressure needs to increase (can be due to inflammation or venous obstruction)

Plasma colloid osmotic pressure must fall (due to either leakage or renal disease)

Lymphatic obstruction must occur (due to inflammation, neosplasia, radiation, or surgery)
Describe normal fluid movement.
At the arteriole end the hydrostatic pressure is greater then the plasma oncotic pressure which causes outward movement of fluid into the interstium. Then at the venous end the plasma oncotic pressure and the hydrostatic pressure cause an inward flow from the interstitial space into the vessel.
What causes edema?
Fluid imbalances caused by inflammation, hypertension, venous congestion, and renal disease.
Define anasarca.
Generalized edema or swelling throughout the body.
Define dependent edema.
Involves swelling of the feet, legs and ankles. Occurs most often at the end of the day or after long periods of traveling while in a seated position.
Define periorbital edema.
Swelling around the eyes commonly seen when first waking up.
Define mechanical edema.
Caused by outside sources (tight socks, undergarments, etc.)
What do the different numbers on the edema scale denote?
1+ (slight pitting, no visible change in the shape of the extremity, depth of indentation less then 6 mm, disappears rapidly)

2+ (no marked changes in the shape of the extremity, depth of the indentation 6-12 mm, disappears in 10-15 sec.)

3+ (noticable deep pitting, swollen extremity, depth of pitting 1-2.5 cm, duration of pitting 1-2 min.)

4+ (very swollen and distorted extremity, depth of pitting greater then 1 in., duration of pitting 3-5 min.)
What is hyperemia?
Hyperemia is an example of hyperperfusion. There is too much blood in a tissue or organ. It happens actively in response to increased metabolic demand and passively in response to congestion.
What is hemorrhage?
Loss of blood from the cardiovascular system. It is an example of hypoperfusion.
What are the two types of hemorrhage?
External (blood leaves body) or internal (blood fills a body cavity)
What are some special types of hemorrhage (7)?
Hematuria (urine)
Hemoptysis (from lungs)
Hematemesis (vomiting)
Hemarthrosis (joint)
Melena (stool)
Hematochezia (anorectal)
Metrorrhagia (uterovaginal)
What is the significance of hemorrhage?
Causes shock, loss of iron and hemglobin with reduced O2 carrying capacity, and damage to internal parts of the body.
What is thrombosis?
Process of stemming blood flow via fibrin meshwork that binds blood cells into a semi solid state. Can be life saving when it stops hemorrhaging or life threatening if it develops pathologically and blocks intact vessels.
What is Virchow's Triad?
Three key factors that can lead to a DVT:
Stasis
Vascular damage
Hypercoagulability
What happens to thrombi in the body?
Small ones are lysed while larger ones undergo organization.
What is an embolus?
A freely moving mass within the vasculature that is able to be carried from one anatomic site to another site by blood. They can occlude vessels and obstruct blood supply.
Where do venous thromboemboli orignate and what happens to them?
Start in the veins and commonly flow through the vena cava into the right heart and lodge in decreasing sized pulmonary arteries. A large thrombus can be fatal causing PE (which is responsible for 15% of all deaths in hospitals).
Where do arterial thromboemboli originate and what happens to them?
Orignate in the left heart chambers, most commonly around the valves. They tend to lodge in medium sized arteries and can lead to stroke.
What is a liquid embolus?
Fat embolus that enters the circulation after fracture.
What is a gas embolus?
Air introduced via IV or injection into veins.
What is shock?
Widespread circulatory disturbance leading to hypoperfusion of tissue.
What are common causes of shock?
Pump failure (cardiac dysfunction)

Loss of effective circulation

Movement of large volumes of fluid into the venous system

Massive systemic insult
Name the different types of shock (3).
Cardiogenic (pump failure leading to cellular hypoxia)

Hypovolumic (loss of blood or fluid)

Hypotonic (loss of vascular tone)
What are the stages of shock and what occurs during them?
Early (compensated) shock causes tachycardia, peripheral vasoconstriction, and reduced urine output.

Decompensated shock occurs when the compensation mechanisms mentioned above fail. Hypotension, tachypnea, SOB, oliguria, acidosis, and decreased cardia output will follow.