Edema Zhao Mingyao.ZZU. Dayu Nuo Ya square boat 1.Concept A large amount of body fluid accumulates in the interstitial space (interstitial fluid↑) interstitial.

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Presentation transcript:

Edema Zhao Mingyao.ZZU

Dayu Nuo Ya square boat

1.Concept A large amount of body fluid accumulates in the interstitial space (interstitial fluid↑) interstitial space Cell 60% of body weight) fluid blood vessel

Soft tissue swelling due to expansion of the interstitial volume A large amount of body fluid accumulates in the interstitial space (interstitial fluid↑) Edema

Distinguish concepts Edema Hydrops Cellular edema

Cause, site, type, formation, feature, impact, treatment Edema

Does the body weight certainly increase in all type of edema?

2.Pathogenesis (1) Disturbance of Transcapillary Fluid Exchange (2) Sodium and Water Retention

Formation of interstitial fluid back-flow review

Formation > back-flow (for interstitial fluid ) 1. Capillary blood pressure↑ 2. Plasma colloid osmotic pressure↓ 3. Capillary wall permeability↑ 4. Obstruction of lymphatic flow (1) Disturbance of Transcapillary Fluid Exchange

Filariasis ↑Capillary Hydrostatic Pressure

Reabsorption of salt (2) Sodium and Water Retention ① GFR↓ ② Reabsorption↑ of renal tubule

① Glomerular filtration rate (GFR) ↓ afferent arteriole efferent arteriol e Renal glomerulu proximal tubule Bowman's space Primary ↓: renal failure Second ↓: ECBV ↓

② Reabsorption↑of Na + and H 2 O ⅰ. ADS ↑& ADH ↑ ⅱ. ANF 、 kinin 、 PGE ↓ ⅲ. Redistribution of renal blood flow ⅳ. Filtration fraction↑ Atrial natriuretic factor

Cortical nephrons proximal medullary nephrons Redistribution of renal blood flow Collecting tubules

sympathetic nerve ↑ excitation ↑ ↑ Reabsorption ↑

Filtration fraction↑ FF = GFR/ renal plasma flow efferent arteriole contraction > afferent arteriole contraction afferent arteriole efferent arteriol e Renal glomerulu proximal tubule Bowman's space

3. Treatment of edema ① First, treat the underlying disease ② Decrease Na + intake, either dietary or intravenous ③ Increase excretion of sodium and water a. Diuretics - remember, these are palliative, not curative. b. Bed rest, local pressure neither begin nor end with the administration of diuretics.

Why, sometimes, can`t we get satisfied effects when treat some systemic edema (anasarca) with diuretics, but use albumin to get well result? Question

Thanks

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