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Edema: Prof. Dr. Yesari Karter
Edema: Prof. Dr. Yesari Karter
EDEMA
Increasing of fluid volume in tissues.
-It is usually used to define the increasing of
extracellular and extravascular fluid volume
Intraperitoneal - Ascites
Intrapleural - Hydrothorax
PATHOGENESIS OF EDEMA
1) Capillary permeability
2) Hydrostatic pressure of intracapillary fluid
3) Oncotic pressure of intracapillary fluid
4) Oncotic pressure of interstitial fluid
5) Tissue resistance
6) Lymphatic drainnage
7) Renal hormonal factors
8) Atrial natriretic peptide
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Capillary permeability
Water, electrolytes,gases Diffusion
Proteins - Filtration
Hydrostatic pressure:
It forces the blood fluid pass into the tissues
through the capillary wall.
It is 32 mmHg at the arteriolar end of the
capillary, and 12 mmHg at the venule hand.
Oncotic pressure:
Formed by plasma proteins (especially albumin)
It tries to keep the fluid in the capillary
The oncotic pressure of the capillary is 24 mmHg.
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Lymph drainege:
Some of the fluid in the interstitium and a few
amount of protein diffused into interstitium is carried
by lymph vessels. Obstruction of the vessels causes
edema.
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Increasing of ADH
Reabsorbtion of water
in tubules of kidneys
aparatus
Secretion of renin
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Renin
Angiotensinogen
Angiotensin I
Converting enzyme
Angiotensin II
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Angiotensin II:
1) Causes vasoconstriction
2) Increases the secretion of aldosteron from adrenal
gland ( seconder hyperaldosteronism) ncreases
sodium reabsorbtion in distal tubules
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EDEMA
-Dsseminated edema
-Local edema
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Disseminated Edema
Local edema
- Traumatic
- Inflammatory edema
- Obstriction of venous circulation
- Thrombophlebitis
- Compression of veins
-Lymphatic edema
-Angioneurotic edema
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Cardiac Insufficiency
- Blood volume per minute decreases Water is
conserved by renal and hormonal mechanisms
- Hydrostatic pressure increases
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Nephritic Edema
Mild and hard edema is seen in acute glomerulonephritis
Glomerular filtration decreases, but tubular reabsorbtion is
not disturbed. (glomerulotubular inbalance)
Capillaritis (generalized capillary disorder)
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Nephrotic Edema
-It is very soft and in anasarca type
-Low oncotic pressure due to protein loss
-Secondary hyperaldosteronism
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Cirrhotic Edema
It is usually seen with ascites
Albumin synthesis in liver decreases
Some blood proteins are excreted in feces
due to portal hypertension
Aldosteron breakdown in liver decreases ;
secretion by adrenal gland increases
(secondary hyperaldosteronism)
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Nutritional edema
Kwashiworker
Malabsobtion Syndromes
Gastrectomy
Cancer
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Iatrogenic Edema
Mineralocorticoid
Corticosteroid
Androgen
ADH
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Inflammatory Edema
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Venous Edema
Thrombophlebitis: Local inflamations cause
thrombus venous obstriction
-Large and hard edema
- Erythema, hotness,pain
Compression of veins
-Ganglion, tumor,ascites
Edema related to varices
High hydrostatic pressure in veins
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Lymphatic Edema
Due to obstruction of lymph vessels,plasma
proteins cannot be taken from the
interstitium
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Angioneurotic Edema
(Quinckes edema)
Vessels insubcutaneous tissue enlarge due to local
histamine discharge and extravasation from
capillaries occurs
-Food allergy
-Drug allergy
-Infections
-Emotional
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References
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