Holliman - Week 2 - Fluid Balance

Front 1

What is the definition of Edema

Back 1

refers to the accumulation of excess fluid in cells or tissues.

Front 2

the type of edema that is generally a reflection of cellular injury and altered cell membrane permeability

Back 2

intracellular edema

Front 3

the type of edema that reflects either a disturbance in the normal hemodynamic forces that control fluid transfer between the vascular and extravascular space or it indicates endothelial injury and increased vascular permeability.

Back 3

interstitial edema

Front 4

the normal exchange of fluid between plasma and interstitial tissues occurs where?

Back 4

microcirculation (capillary beds)

Front 5

What causes fluid to leave the vasculature and enter the tissue

Back 5

hydrostatic pressure of intravascular space in combination with the osmotic pressure of the interstitial space.

Front 6

What draws fluid back into the vasculature from the tissues

Back 6

oncotic pressure of the intravascular fluid

Front 7

What is oncotic pressure primarily influenced by?

Back 7

albumin content of the plasma

Front 8

Where does the excess fluid remaining in the interstitial fluid go?

Back 8

it is borne off by the lymphatic channels and ultimately returned to the intravascular space via the right abdominal and thoracic ducts.

Front 9

generalized edema resulting from an increased osmotic pressure of the interstitial fluid is caused by what?

Back 9

an increase in total body sodium.

Front 10

generalized edema resulting from a decrease in oncotic pressure of the plasma protein is caused by what?

Back 10

a decrease in serum albumin.

(failure of albumin synthesis or excessive albumin loss)

Front 11

localized edema resulting in increased hydrostatic pressure of the intravascular fluid is caused by what?

Back 11

obstruction to venous blood flow leads to an increase in hydrostatic pressure on the venous side.

Front 12

localized edema resulting from obstruction of the lymphatic drainage is caused by what?

Back 12

lymphatic obstruction by cancer, scarring, parasitic disease, or lymphadenectomy

Front 13

localized edema resulting from increased capillary permeability is caused by what?

Back 13

endothelial injury, inflammation, immunologic reactions, or other tissue injury

Front 14

What is transudate

Back 14

protein-poor fluid. It develops from imbalances in the normal hemodynamic forces.

Front 15

What is exudate?

Back 15

protein-rich fluid. It is generally the result of endothelial damage and alteration of vascular permeability.

Front 16

Describe Vascular Congestion.

Back 16

refers to decreased blood flow in veins, venules, and capillaries usually due to impaired venous drainage. This leads to increased hystrostatic pressure which is why edema is a common accompaniment.

Front 17

Describe Vascular Hyperemia.

Back 17

refers to increased blood flow through dilated arteries, arterioles, and capillary beds. When associated with inflammation, hyperemia is followed by localized edema resulting from increased vascular permeability.

Front 18

Describe Heart Failure

Back 18

refers to when the heart is no longer able to maintain normal cardiac output.

Hypoxic and congestive effects on other organs and tissues

Front 19

Describe Left-sided heart failure

Back 19

Left-ventricle is unable to maintain adequate cardiac output. the increased hydrostatic pressure in the left ventricle is transmitted backwards into the pulmonary venous circulation.

Pulmonary edema.

Front 20

The clinical manifestations of left heart failure are:

Back 20

primarily pulmonary in origin.

easy fatigability, shortness of breath, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, and cough.

Front 21

Describe Right-sided heart failure

Back 21

occurs when the right side of the heart is unable to maintain adequate ventricular output to the lungs. Due to an inability to overcome an increase in pulmonary arterial pressures. Resulting from vascular obstruction or obliteration, vasoconstriction, or increased flow.

Front 22

What causes Secondary pulmonary hypertension?

Back 22

increased hydrostatic pressure in the right side of heart is transmitted "backward" into the systemic venous return.

Front 23

What does secondary pulmonary hypertension cause?

Back 23

1. engorgement and distention of neck veins. 2. passive congestion of the liver. 3. portal hypertension. 4. dependent pitting edema. 5. increased body weight. 6. liver disease. 7. renal disease. 8. gastrointestinal disease. 9. inflammatory/ immunologic disorders.