Edema-水肿英语课件讲述
合集下载
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
↑
permeability
Figure 7-7
1. Increased capillary blood pressure
Causes:
↑Capillary blood pressure
•Elevated plasma volume •Increased venous pressure
↑Force driving fluid into interstitium
3. Obstruction of lymphtic
Causes: •Blockage by cancer •Blockage by infection, especially with filarial
4. Increased capillary permeability
↑Capillary permeability
G-T imbalance
Retention of sodium and water
•↓GFR •↑Reabsorption of proximal tubule •↑Reabsorption of distal tubule and collection tubule
1. Decreased glomerular filtration rate (GFR)
•GFR (glomerular filtration rate) decreases, while tubular reabsorption does not decrease accordingly; •Tubular reabsorption increases, while GRF does not increased.
Ascites
Etiology and pathogenesis
• Imbalance of fluid exchange between plasma and interstitial compartment
• Imbalance of fluid exchange between extra- and intra-body
When greater than lymphatic
compensatory return
Edema
• Excessive loss of protein i.e. nephrosis
• Elevated catabolism of protein i.e. chronic debilitating diseases, such as malignant tumor
glomerular filtration rate (GFR) FF =
renal plasma flow (RPF)
GFR: amount of plasma filtered at glomerulus into Bowman’s capsule FF is the fraction of renal plasma flow that is filtered at the glomerulus In normal condition: FF: 20%
The peritubular capillary oncotic pressure increases
Enhancing fluid reabsorption from the renal interstitial space to the capillary
Decreases renal interstitial pressure
1.↓GFR
Causes
• Extensive glomerular damage
– Acute or chronic glomerulonephritis
• Decrease of effective circulating blood volume
– Congestive heart failure, nephrotic syndrome
------ Renal retention of sodium and water
Glomerular( filtration) and tubular (reabsorption) balance
(G-T balance)
• In normal condition, 9999.5% of total volume of sodium and water filtrated via glomeruli are reabsorbed by tubules.
Factors determining the GFR:
• Filtration area and membrane permeability
• Filtration pressure
• Effective circulating blood volume or renal blood volume
↑Filtration of more protein from capillary to interstitium
↓Plasma colloid osmotic pressure
↑formation of interstitial fluid
When greater than lymphatic
compensatory return
Causes of FF increasing
Congestive heart failure Nephrotic syndrome
Decreased effective circulatory blood volume
Sympathetic-adrenal medullary system exciting
•Arteriolar dilation i.e. acute imflammation
2. Decreased plasma colloid osmotic pressure
↓ Plasma colloid osmotic pressure
↓Force drawing water back into capillary from
favoring reabsorption across the tubular epithelium and minimizing back flux from the renal interstitial
space to the tubule lumen.
↑Reabsorption in proximal tubule
-Increased reabsorption in distal tubule and collecting duct
Congestive heart failure
Nephrotic syndrome
↓Stimulation of volumereceptor in left atrium and
Efferent arteriole constricts stronger than afferent one
↑Efferent arteriole resistance
GFR is increased relative to renal plasma flow
↑FF
3.
Increased ADH (antidiuretic hormone) and ADS (aldosterone) secretion
Increased FF make elevated reabsorption of proximal tubule
Increased FF
The protein concentration in the plasma entering the peritubular capillaries increases
Definition
• The excessive accumulation of intestitial fluid
• A pathologic process caused by diseases
• Not accompanied with cellular edema
Classification
interstitium
Causes:
•Plasma albumin content decrease
• Decrease of protein production i.e. hepatic cirrhosis, malnutrition
↑Formation of interstitial fluid
↑Formation of interstitial fluid
When greater than lymphatic
compensatory return
Edema
• General venous pressure, i.e. congestive heart failure
• Local venous pressure, i.e. venous thrombosis
Edema
Causes: • Inflammation
• Infection • Burn • Allergic response • Trauma • Anoxia • Acidosis
Imbalance of fluid exchange between extraand intra-body
• 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
Edema
Zhou Yun
The Affiliated Hospital of Medical College of Ningbo University
Emergency rtment
Objective
• Definition • Classification • Etiology and pathogenesis • Differential diagnosis
thoracic vessel
↓Effective circulatory blood volume
Sympathetic nerve excitation
↑ADH secretion
Retention of sodium and water
Renin-angiotensinaldosterone system
Imbalance of fluid exchange between plasma and interstitial compartment
Capillaries
Total Pressure Differences Inside and Outside Capillary
↑ ↓
obstruction
• 60-70% of filtrates are actively reabsorbed by proximal convoluted tubule.
• The reabsorptions of sodium and water at distal tubule and collection duct are regulated by hormone.
Renin- angiotensin system
Sympathetic - adrenal medullary system
↓Renal blood volume
↓GFR
2. Increased filtration fraction (FF) - Increased reabsorption in proximal tubule
Classification
• Generalized edema:
– Puffiness of the face – Indentation of the skin “pitting edema” – Ascites & Hydrothorax
• Localized edeme
Edema
Pitting edema
permeability
Figure 7-7
1. Increased capillary blood pressure
Causes:
↑Capillary blood pressure
•Elevated plasma volume •Increased venous pressure
↑Force driving fluid into interstitium
3. Obstruction of lymphtic
Causes: •Blockage by cancer •Blockage by infection, especially with filarial
4. Increased capillary permeability
↑Capillary permeability
G-T imbalance
Retention of sodium and water
•↓GFR •↑Reabsorption of proximal tubule •↑Reabsorption of distal tubule and collection tubule
1. Decreased glomerular filtration rate (GFR)
•GFR (glomerular filtration rate) decreases, while tubular reabsorption does not decrease accordingly; •Tubular reabsorption increases, while GRF does not increased.
Ascites
Etiology and pathogenesis
• Imbalance of fluid exchange between plasma and interstitial compartment
• Imbalance of fluid exchange between extra- and intra-body
When greater than lymphatic
compensatory return
Edema
• Excessive loss of protein i.e. nephrosis
• Elevated catabolism of protein i.e. chronic debilitating diseases, such as malignant tumor
glomerular filtration rate (GFR) FF =
renal plasma flow (RPF)
GFR: amount of plasma filtered at glomerulus into Bowman’s capsule FF is the fraction of renal plasma flow that is filtered at the glomerulus In normal condition: FF: 20%
The peritubular capillary oncotic pressure increases
Enhancing fluid reabsorption from the renal interstitial space to the capillary
Decreases renal interstitial pressure
1.↓GFR
Causes
• Extensive glomerular damage
– Acute or chronic glomerulonephritis
• Decrease of effective circulating blood volume
– Congestive heart failure, nephrotic syndrome
------ Renal retention of sodium and water
Glomerular( filtration) and tubular (reabsorption) balance
(G-T balance)
• In normal condition, 9999.5% of total volume of sodium and water filtrated via glomeruli are reabsorbed by tubules.
Factors determining the GFR:
• Filtration area and membrane permeability
• Filtration pressure
• Effective circulating blood volume or renal blood volume
↑Filtration of more protein from capillary to interstitium
↓Plasma colloid osmotic pressure
↑formation of interstitial fluid
When greater than lymphatic
compensatory return
Causes of FF increasing
Congestive heart failure Nephrotic syndrome
Decreased effective circulatory blood volume
Sympathetic-adrenal medullary system exciting
•Arteriolar dilation i.e. acute imflammation
2. Decreased plasma colloid osmotic pressure
↓ Plasma colloid osmotic pressure
↓Force drawing water back into capillary from
favoring reabsorption across the tubular epithelium and minimizing back flux from the renal interstitial
space to the tubule lumen.
↑Reabsorption in proximal tubule
-Increased reabsorption in distal tubule and collecting duct
Congestive heart failure
Nephrotic syndrome
↓Stimulation of volumereceptor in left atrium and
Efferent arteriole constricts stronger than afferent one
↑Efferent arteriole resistance
GFR is increased relative to renal plasma flow
↑FF
3.
Increased ADH (antidiuretic hormone) and ADS (aldosterone) secretion
Increased FF make elevated reabsorption of proximal tubule
Increased FF
The protein concentration in the plasma entering the peritubular capillaries increases
Definition
• The excessive accumulation of intestitial fluid
• A pathologic process caused by diseases
• Not accompanied with cellular edema
Classification
interstitium
Causes:
•Plasma albumin content decrease
• Decrease of protein production i.e. hepatic cirrhosis, malnutrition
↑Formation of interstitial fluid
↑Formation of interstitial fluid
When greater than lymphatic
compensatory return
Edema
• General venous pressure, i.e. congestive heart failure
• Local venous pressure, i.e. venous thrombosis
Edema
Causes: • Inflammation
• Infection • Burn • Allergic response • Trauma • Anoxia • Acidosis
Imbalance of fluid exchange between extraand intra-body
• 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
Edema
Zhou Yun
The Affiliated Hospital of Medical College of Ningbo University
Emergency rtment
Objective
• Definition • Classification • Etiology and pathogenesis • Differential diagnosis
thoracic vessel
↓Effective circulatory blood volume
Sympathetic nerve excitation
↑ADH secretion
Retention of sodium and water
Renin-angiotensinaldosterone system
Imbalance of fluid exchange between plasma and interstitial compartment
Capillaries
Total Pressure Differences Inside and Outside Capillary
↑ ↓
obstruction
• 60-70% of filtrates are actively reabsorbed by proximal convoluted tubule.
• The reabsorptions of sodium and water at distal tubule and collection duct are regulated by hormone.
Renin- angiotensin system
Sympathetic - adrenal medullary system
↓Renal blood volume
↓GFR
2. Increased filtration fraction (FF) - Increased reabsorption in proximal tubule
Classification
• Generalized edema:
– Puffiness of the face – Indentation of the skin “pitting edema” – Ascites & Hydrothorax
• Localized edeme
Edema
Pitting edema