Fluid and Hemodynamics Disorders

what are 8 clinical forms of edema?

1. cerebral edema (meningitis

2. pulmonary edema (pneumonia, L sided heart failure)

3. periorbital (facia) edema (trauma)

4. hydrothorax (stabbing)

5. hydropericardium (pericarditis/cardiac tamponade)

6. hydroperitoneum (ascites)

7. pitting edema of the lower extremeties

8. anasarca (generalized edema)

*Can People Please Help Harriet Hide Pauls Alcohol?*

what are the symptoms of edema of LT sided heart failure?

-pleural effusion

-chronic congestion of the lungs

-kidney hypoperfusion --> increased renin and Na rentention

what are the symptoms of edema of RT sided heart failure?

-Pulmonary hypertension

-chronic congestion of liver/spleen

-ascities

-venous congestion

-PERIPHERAL EDEMA

What aggravates heart failure and what does it contribute to?

Hypoperfusion of the kidneys leads to increased secretion of renin, which acts on the adrenals, stimulating the release of aldosterone. These hormonal changes contribute to renal retention of sodium and water, which aggravates heart failure and contributes to generalized edema

what is hyperemia?

increased blood flow, TOO MUCH

active hyperemia is? due to? signs?

dilation of arterioles > capillaries ---influx of blood

due to: exercise, inflammation

blushing

passive hyperemia (congestion) involves increased _____ _________?

______ contributes to cyanosis?

increased venous backpressure

venous stagnation contributes to cyanosis

Heart failure is an example of what kind of hyperemia? what are the symptoms? (5)

passiver hyperemia (congestion)

cyanosis, pulmonary edema, heart failure cells, anoxia, pulmonary fibrosis

hematoemesis

throwing up blood

hemoptysis

coughing up blood

what can cause a venous hemorrhage?

IV/phlebotomy

hematochezia

blood in stool - bright red

melena

Black tarry stool (digested blood)

how could an aortic hemorrhage occur? C/O?

-car accident

-"back pain, not abdominal"

how could a cardiac hemorrhage occur?

trauma, stabbing or GSW

how could a intracerebral hemorrhage occur?

stroke, trauma

hematuria

blood in the urine (usually from the bladder)

Menorrhagia is:

Very heavy menstrual bleeding

what are the 3 principal components of intravascular coagulation?

1. endothelial cell injury - switch from anticoagulant to procoagulant

2. injury activates coagulation proteins that form thrombin --> thrombin polymerizes fibrinogen into fibrin- forms clots

3. platelets neutralize heparin and other factors

Virchow's triad promotes _____? whatre the 3 components?

promotes CLOTTING

1. endothelial cell injury

2. hemodynamic changes either cause turbulent flow or decrease blood flow

3. hypercoagulability due to other medical problems

what is the most common site of thrombus formation? what are other locations?

LUNGS --> pulmonary embolism

-heart, artery, venous

what is an embolism?

a freely, moveable mass, can travel to other locations

types of embolism (4)? what kind is the most symptomatic?

thromboembolus - blood clot (MOST common)

- liquid emboli (oil, fat, amniotic fluid)

-gaseous emboli (air injection, caisson disease) --> scuba divers

-solid particle emboli (cholesterol crystals, bone marrow, tumor emboli)

what kind of embolism causes a pulmonary (saddle) embolism? what are the symptoms of PE? what does a PE result in?

Venous embolism

shortness of breath, hemoptysis, pain

lung infarct and sudden death

arterial embolism can occur in?

-brain (infarct)

-ventricular thrombus

-kidney (infarct)

-splenic (infarct)

-intestinal (infarct)

infarction is ? can be ___ or ____ ?

sudden onset of decreased blood supply resulting in ischemic necrosis (infarct)

arterial or venous

white/pale infarcts are due to ? occur in?

arterial occlusion

-heart, kidney, spleen

red/hemorrhagic infarcts are due to? occurs in?

venous infarts

-colon, small intestine, testes, lung and liver

the fate of an infarct depends on?

the anatomical site, status of the circulatory system and the body's ability to repair the infarct

shock is?

state of hypoperfusion of tissues due to bloss loss, resulting in ischemia

what are the 3 possible mechanisms of shock?

1. pump failure of the heart (cardiogenic)

2. loss of fluid from circulation (hypovolemic shock)

3. loss of peripheral vascular tone (hypotonic shock/distributive shock)

what is the 1st clinical stage of shock? Describe

early or compensated shock (treatable)

-tachycardia

-arteriole vasoconstriction

-reduced urine output

what is the 2nd clinical stage of shock?

decompensated but reversible shock

-hypotension

-tachypnea

-SOB

-oliguria

-metabolic acidosis

what is the 3rd/last clinical stage of shock?

irreversible shock

-circulatory collapse

-marked hypoperfusion of vital organs

-loss of vital functions

-DIC is common