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2. EDEMAEDEMA : presence of: presence of
excess fluid in theexcess fluid in the
body tissuesbody tissues

3. A.A. Intracellular EdemaIntracellular Edema
aa.. depression of the metabolicdepression of the metabolic
systemssystems of the tissuesof the tissues
b.b. lack of adequate nutrition to thelack of adequate nutrition to the
cellscells

4. A. Extracellular Edema
a. abnormal leakage of fluid from the plasma to the
interstitial spaces across the capillaries
failure of the lymphatics to return fluid from the
interstitium back into the blood
The most common clinical cause of interstitial fluid
accumulation is excessive capillary fluid filtration

5. Factors That Can Increase Capillary Filtration
1. Filtration Coefficient – product of permeability and surface
area of the capillaries (Kf)
2. Capillary Hydrostatic Pressure (Pc)
3. Interstitial Fluid hydrostatic Pressure (Pif)
4. Capillary Plasma colloid Osmotic Pressure (iic)
5. Interstitial Fluid Colloid Osmotic Pressure (iiif)
Filtration = Kf x ( Pc – Pif – iic + iiif )

6. Major Factors that cause Increased
Capillary Filtration of Fluid and Protein into
the Interstitium:
1. Increased capillary Hydrostatic Pressure
2. Decreased Plasma Colloid Osmotic Pressure
3. Increased Capillary Permeability

7. Summary of Causes of Extracellular Edema
Increased capillary pressure
A. Excessive kidney retention of salt and water
1. Acute and chronic kidney failure
2. Mineralocorticoid excess

8. B. High venous pressure
1. Heart failure
2. Venous obstruction
3. Failure of venous pump
a) paralysis of muscles
b) immobilized parts of body
c) Failure of venous valves

9. C. Decreased arteriolar resistance
1. Excessive body heat
2. Insufficiency of sympathetic nervous system
3. Vasodilator drugs

10. II. Decreased plasma protein
A. Loss of proteins in urine (nephrotic syndrome)
B. Loss of protein from denuded skin areas
1. Burns
2. Wounds
C.Failure to produce proteins
1. Liver disease
2. Serious protein or caloric malnutrition

11. III. Increased capillary permeability
A. Immune reactions that cause release of histamine
B. Toxins
C. Bacterial infections
D. Vitamin deficiency, especially vitamin C
E. Prolonged ischemia
F. Burns

12. IV. Blockage of lymph return
A. Cancer
B. Infections (filarial nematodes)
C. Surgery
D. Congenital absence or abnormality of lymphatic
vessels

13. Safety Factors That Prevent Edema
1. The safety factors caused by low tissue compliance
( -3mmHg )
2. The safety factor caused by increased lymph flow ( 7 mmHg )
3. The safety factor caused by washdown of proteins from the
interstitial spaces ( 7 mmHg )

14. DAILY INTAKE AND OUTPUT OF WATER (in ml/day)________
Normal Prolonged
Heavy Exercise
Intake
Fluids ingested 2100 ?
From metabolism 200 200
Total intake ?
Output
Insensible – Skin 350 350
Insensible - Lungs 350 650
Sweat 100 5000
Feces 100 100
Urine 1400 500
Total output 2300 6600

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