Chapter 4 Tissue Response to Injury Inflammation, Swelling, ：4章组织损伤的炎症反应，肿胀，.pptVIP

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Chapter 4 Tissue Response to Injury Inflammation, Swelling, ：4章组织损伤的炎症反应，肿胀，.ppt

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Chapter 4 Tissue Response to Injury Inflammation, Swelling, ：4章组织损伤的炎症反应，肿胀，

What Causes Edema? Imbalance of fluid filtration caused by an injury Capillary Filtration Pressure Changes after Injury Hematoma (tissue debris and hemorrhage) dumps large amounts of free protein into tissue spaces. Increased tissue oncotic pressure Fluid Filtration in Injured Tissue Injury results in a great increase in the tissue oncotic pressure. TOP Fluid Filtration in Injured Tissue (cont.) Fluid out Fluid in Fluid Filtration in Injured Tissue (cont.) Fluid accumulates in tissue. Fluid Filtration in Injured Tissue (cont.) More fluid accumulates in tissue. Fluid Filtration in Injured Tissue (cont.) Even more fluid accumulates in tissue. What Is Swelling? Hemorrhaging and edema Can do nothing about hemorrhaging Can minimize edema What Causes Swelling? Capillary Tissue spaces Lymphatic How Do You Prevent Swelling? Capillary Tissue spaces Lymphatic How Do You Prevent Swelling? (cont.) Capillary Tissue spaces Lymphatic How Do You Prevent Swelling? (cont.) Capillary Tissue spaces Lymphatic How Does Cold Decrease Swelling? As cold decreases secondary hypoxic injury, the amount of free protein in tissues decreases. This causes less tissue oncotic pressure (the major factor for edema). Cold can prevent edema from occurring only if applied soon after injury. Once edema develops, cold application cannot decrease that edema. Decreased Metabolism Theory, Revisited Secondary hypoxic injury Normal tissue Injured tissue Injured and with cryotherapy O2 needed O2 available Time Course of Swelling Swelling immediately after injury is the result of direct hemorrhaging. Edema begins minutes to hours after injury and continues to develop over many hours. Accounts for the delayed nature of most swelling. Secondary Injury and Edema Secondary injury results in increased edema, and increased edema can contribute to increased secondary injury. Two mechanisms As edema develops, the distance between blood vessel and tissue cells increases. More difficult f