Edema-水肿英语技术总结.ppt

Edema Zhou Yun The Affiliated Hospital of Medical College of Ningbo University Emergency Department Objective Definition Classification Etiology and pathogenesis Differential diagnosis Definition The excessive accumulation of intestitial fluid A pathologic process caused by diseases Not accompanied with cellular edema Classification According to the range that edema fluid spreads to: Generalized edema Localized edema According to the cause of edema: Renal edema Hepatic edema Cardiac edema Malnutritional edema lymphedema Classification Generalized edema: Puffiness of the face Indentation of the skin “pitting edema” Ascites Hydrothorax Localized edeme Edema Pitting edema Ascites Etiology and pathogenesis Imbalance of fluid exchange between plasma and interstitial compartment Imbalance of fluid exchange between extra- and intra-body Imbalance of fluid exchange between plasma and interstitial compartment Capillaries Figure 7-7 Total Pressure Differences Inside and Outside Capillary ↑ ↑ permeability ↓ obstruction 1. Increased capillary blood pressure Causes: Elevated plasma volume Increased venous pressure General venous pressure, i.e. congestive heart failure Local venous pressure, i.e. venous thrombosis Arteriolar dilation i.e. acute imflammation ↑Capillary blood pressure ↑Force driving fluid into interstitium ↑Formation of interstitial fluid Edema When greater than lymphatic compensatory return 2. Decreased plasma colloid osmotic pressure Causes: Plasma albumin content decrease Decrease of protein production i.e. hepatic cirrhosis, malnutrition Excessive loss of protein i.e. nephrosis Elevated catabolism of protein i.e. chronic debilitating diseases, such as malignant tumor ↓ Plasma colloid osmotic pressure ↓Force drawing water back into capillary from interstitium ↑Formation of interstitial fluid Edema When greater than lymphatic compensatory return 3. Obstruction of lymphtic Causes: Blockage by cancer Blockage by infection, especially with fil