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Pathology Unit II
Edema
28
Pathology
Graduate
01/27/2013

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Term
Edema
Definition
accumulation of excess fluid in the intercellular (interstitial) tissue spaces or body cavities.
Term
Anasarca
Definition
severe and generalized edema causing diffuse swelling of all tissues and organs in the body.
Term
Effusion
Definition
collection of edema fluid in one of the body cavities
Term
Ascites/peritoneal effusion
Definition
collection of edema fluid in the peritoneal cavity.
Term
Hydrothorax/pleural effusion
Definition
collection of edema fluid in the pleural cavity
Term
Hydropericardium/pericardial effusion
Definition
collection of edema fluid in the pericardial sac.
Term
Transudate
Definition
a fluid with low protein content and a specific gravity less than 1.012. Is an ultrafiltrate of blood plasma and results from hydrostatic imbalance across intact vascular endothelium.
Term
Exudate
Definition
an inflammatory extravascular fluid that has a high protein concentration, cellular debris, and specific gravity above 1.020. Implies significant alteration in the normal permeability of small blood vessels in the area of injury.
Term
Mechanism for maintaining the normal distribution of total body water
Definition
in the microcirculation a small amount of fluid leaks out of capillaries into the extracellular spaces as a result of the relatively high hydrostatic pressure at the arteriole end of the capillaries. Much of this fluid is returned to venules due to the relatively high osmotic pressure associated with the presence of proteins, such as albumin, remaining in the capillary.

The excess extracellular fluid is absorbed by blind ending lymphatic capillaries. Alteration in the system at any point results in edema.
Term
The Primary causes of Edema (5)
Definition
increased hydrostatic pressure, reduced oncotic pressure, lymphatic obstruction, increased osmotic tension of interstitial fluid, increased endothelial permeability
Term
Increased hydrostatic pressure
Definition
Local increased hydrostatic pressure results from impaired venous return

Generalized increased hydrostatic pressure leads to systematic edema (in congestive heart failure) due to reduced cardiac output, the angiotension-renin axis and inducing sodium and water retention
Term
Reduced oncotic pressure
Definition
conditions in which albumin is lost from circulation or synthesis causes reduced plasma osmotic pressure.
Term
Lymphatic obstruction
Definition
localized obstruction caused by inflammatory or neoplastic condition, can also occur as a complication of therapy
Term
Increased osmotic tension of interstitial fluid related to sodium retention
Definition
excessive retention of salt can lead to edema by increasing hydrostatic pressure (expansion of intravascular volume) and reducing plasma osmotic pressure
Term
Increased endothelial permeability
Definition
inflammation, burns, trauma, allergic or immunologic reactions
Term
Causes of Systemic Edema
Definition
Congestive heart failure, renal diseases, cirrhosis of the liver, and other reasons
Term
Congestive heart failure
Definition
reduced cardiac output leads to hypoperfusion of the kidneys, triggering the renin-angiotensin-aldosterone axis and inducing sodium and water retention. Failing heart cannot increase its cardiac output in response to the compensatory increases in blood volume.
Term
Renal diseases
Definition
Nephrotic syndrome- damaged glomerular capillaries become leaky, leading to the loss of albumin in the urine and the development of generalized edema
Term
Cirrhosis of the liver
Definition
low albumin levels lead to edema, reduced intravascular volume, renal hypoperfusion, and secondary hyperaldosteronism. Increased salt and water retention fails to restore the plasma volume deficit, and exacerbates the edema because low serum protein still exists.
Term
Lymphatic blockages
Definition
Filariasis- parasitic infection causes massive edema of lower extremities and genitalia by engendering inguinal lymphatic and lymph node fibrosis.
Breast cancer- infiltration and obstruction of superficial lymphatics can cause edema of the overlying skin; the characteristic finely pitted appearance of the skin of the affected breast called peau d'orange. Complications of therapy after axillary lymph node resection and/or irradiation, can disrupt and obstruct lymphatic drainage, resulting in severe lymphedema
Term
3 Causes of localized edema
Definition
impaired venous drainage, increase in vascular permeability, lymphatic blockage
Term
Impaired venous drainage
Definition
DVT in the lower extremity can cause edema restricted to the distal portion of the affected leg
Term
increase in vascular permeability
Definition
excessive retention of salt leads to edema by increasing hydrostatic pressure
Term
Clinical significance of edema
Definition
minor or major significance depending on underlying cause
Term
Fluid moves from the bloodstream into surrounding tissues when there is a/an
Definition
increase in tissue hydrostatic pressure and a decrease in tissue oncotic pressure
Term
What is the difference between an effusion and localized edema?
Definition
an effusion is a collection of excess fluid in a body cavity; localized edema is the accumulation of excess fluid in interstitial tissues
Term
Edema occurs very early in an acute inflammatory response. The mediator MOST responsible for triggering the events leading to this early edema is
Definition
Histamine
Term
[image]
Definition
Congestive Heart Failure
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