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EDEMA

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Water distribution

  • Water makes up two-thirds (2/3) of the total body weight.
  • Of this two-thirds (2/3), about
    • eight twelfths (8/12) is intracellular,
    • three twelfths (3/12) is interstitial, and
  • one twelfth (1/12) is intravascular.

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Pathophysiology of Edema ( Heart Failure)

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Forces Regulating Body Water

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Gross Appearance:

  • Swollen, usually soft and doughy, distended
  • Pits on pressure and the indentations remain after the pressure is removed
  • Edematous tissue is cool

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Increased Intravascular Hydrostatic Pressure

    • Venous Obstruction
    • Increased hydrostatic Pressure
    • Leakage of crystalloids ( salts and fluid)

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Increased Intravascular Hydrostatic Pressure: Examples

Cirrhotic liver

Ascitis

Portanl venous flow obstructed due to Cirrohosis

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    • Decreased Colloids
    • Hypoproteinemia
    • Fail to reabsorb

Pathophysiological Mechanism: Decrease Intravascular colloidal Pressure

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Neoplastic Liver

Low Albumin Production

Edema

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Normally, small quantities of fluid (blue), crystalloids (black dots), and colloids (protein-white circles) escape from the capillary and are drained from the interstitium by lymphatics.

Edema: Decreased Lymphatic Drainage

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Endothelial Damage

Increased Permeability

Increase in colloids

Reduced Reabsorption

Increased Permeability

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