2. ascites Pulmonary edema

3. Edema Definition Pathogenesis Treatment

4. Edema is defined as soft tissue swelling due to expansion of the interstitial volume.

5. Pathogenesis ★ Disturbance of Transcapillary Fluid Exchange ★ Sodium and Water Retention

6. Pc 20mmHg PTPT -10mmHg TT 15mmHg CC 25mmHg +-+ ﹝ ﹞ 〉0〉0

7. ↑Capillary Hydrostatic Pressure eg: thrombophebitis, hepatic obstruction, tight clothing around the extremities, prolonged standing

8. ↓Capillary Plasma Colloid Osmotic Pressure eg: glomerular diseases of the kidney,serous drainage from open wounds,burns,cirrhosis of the liver

9. ↑Tissue Fluid Colloid Osmotic Pressure eg: Severe inflammation ↑Capillary Permeability

10. Obstruction of Lymphatic Return

11. Helminths are worms, that cause filariasis, hookworm, pinworm, schistosomiasis, tapeworm, trichinosis, etc. A typical filariasis infection is a chronic infestation with threadlike filaria nematodes. They congregate in the lymph nodes and surrounding tissue and eventually block the flow of lymph. This results in pain and significant swelling in the area involved Filariasis

12. Four interrelated mechanisms are major cause of edematous states ★ Deceased colloid osmotic pressure in the capillary ★ Increased capillary hydrostatic pressure ★ Increased capillary permeability ★ Lymphatic obstruction or increased interstitial colloid osmotic pressure

13. Pathogenesis ★ Disturbance of Transcapillary Fluid Exchange ★ Sodium and Water Retention

14. Reabsorption of salt Sodium and Water Retention ↓GFR ↑Reabsorption

15. Sodium and Water Retention ↓GFR Glomerulopathy ↓ ↓ Effective circulatory volume

16. Reabsorption of salt Sodium and Water Retention ↓GFR ↑Reabsorption

17. ADH

18. Aldosterone

19. ANP

20. Pathogenesis ★ Disturbance of Transcapillary Fluid Exchange ★ Sodium and Water Retention

21. How does Disturbance of Transcapillary Fluid Exchange effect on Sodium and Water Retention Fluid accumulates the interstitial space Effective circulation Sodium and Water Retention ADH Aldosterone ANP

22. How does Sodium and Water Retention effect on Disturbance of Transcapillary Fluid Exchange Sodium and Water Retention Disturbance of Transcapillary Fluid Exchange Capillary Hydrostatic Pressure

23. Right heart failure Edema ?

24. Sodium and Water Retention Venous return GFR ADH Aldosterone ANP ReabsorptionCapillary Hydrostatic Pressure Colloid Osmotic Pressure in the Capillary Lymphatic obstruction CO

25. Treatment 1. First, treat the underlying disease. 2. Decrease sodium 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 The treatment of edema should neither begin nor end with the administration of diuretics. The basic approaches to treatment are as follows.

26. Pathogenesis ★ Disturbance of Transcapillary Fluid Exchange ★ Sodium and Water Retention

27. Reabsorption of salt Sodium and water retention ↓GFR ↑Reabsorption ANP.ADH. Aldosterone

28. ★ Increased capillary hydrostatic pressure ★ Deceased colloid osmotic pressure in the capillary ★ ★ Lymphatic obstruction