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Body fluids and edema by Dr. Irum

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The physiology of edema. By Dr Irum Junaid
Body Fluid Distrbution ,[object Object],TBW intracellular 2/3 extracellular 1/3 Interstitial 3/4 intravascular 1/4 starling force
Body Fluid Compartments Copyright 2009, John Wiley & Sons, Inc.
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Edema ,[object Object],[object Object],[object Object],[object Object]
Intracellular Edema ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],Extracellular Edema
Determinants of Capillary Filtration Capillary Pressure (P c ) Plasma Colloid Osmotic Pressure ( π c ) Interstitial Fluid Pressure ( P if ) Interstitial Colloid Osmotic Pressure ( π if ) K f FILT = K f (P c - P if - π c + π if )
Causes of Increased Capillary Filtration FILT = K f (P c - P if - π c + π if ) Increased K f : Toxins, ischemic damage, infections, etc. Increased Pc: ,[object Object],[object Object],[object Object],Decreased π c : ,[object Object],[object Object],[object Object],[object Object]
 
“ PRINCIPALES OF EQUILIBRIUM OF FORCES ACROSS CAPILLARIES ” ,[object Object],[object Object],[object Object],[object Object],[object Object]
“ PRINCIPALES OF EQUILIBRIUM OF FORCES ACROSS CAPILLARIES ” ,[object Object],[object Object],[object Object]
“ PRINCIPALES OF EQUILIBRIUM OF FORCES ACROSS CAPILLARIES ” ,[object Object],[object Object],[object Object],[object Object]
Normal Filtration FILT = K f x Net Filt Pressure = 6.6 x ( 17.3 - (-3) - 28 +8) = 6.6 x ( + 0.3) = 1.89 ml/min FILT = 2722 ml/day Where does all of this fluid (and protein in it) go? FILT = K f (P c - P if - π c + π if )
 
 
 
 
Figure 25-1; Guyton and Hall ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Lymphatic Failure and Edema X
Conditions Causing Edema ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Conditions Causing Edema
Safety Factors Against Edema ,[object Object],[object Object],[object Object],[object Object],[object Object],Total Safety factor = 17 mmHg
I. Low Tissue Compliance and Negative Interstitial Fluid Hydrostatic Pressure Interstitial Volume Interstitial Fluid Hydrostatic Pressure Capillary Filtration
Interstitial Fluid Volume (liters) Interstitial Fluid Pressure (mmHg) Free Fluid Gel Fluid Low compliance High Compliance Copyright © 2006 by Elsevier, Inc. - 8 - 4 0 + 4 12 24 36 48 60 0
Importance of Interstitial Gel in Preventing Fluid Accumulation in the Interstitium. ,[object Object],[object Object],[object Object]
Interstitial Fluid Volume (liters) Interstitial Fluid Pressure (mmHg) Free Fluid Gel Fluid Low compliance High Compliance Copyright © 2006 by Elsevier, Inc. - 8 - 4 0 + 4 12 24 36 48 60 0
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
II. Increased Lymph Flow Interstitial Volume Interstitial Fluid Hydrostatic Pressure Lymph Flow
Lymph Flow ( x normal) 20 10 1 - 6 - 4 - 2 0 2 4 Interstitial Fluid Pressure ( mmHg) Effect of Interstitial Fluid Pressure on Lymph Flow
III. “Wash-down” of Interstitial Fluid Proteins Interstitial Volume Interstitial Fluid Oncotic Pressure Capillary Filtration Interstitial Fluid Hydrostatic Pressure Lymph Flow Protein Removal From Tissues
2 4 6 8 0 Plasma Protein Concentration Rate of Non-Visceral Lymph Flow (ml/hr) Interstitial Fluid Protein concentration (gm/100 ml) Wash-down of Interstitial Proteins 0 20 40 60 80 100 120 140 160 180
Safety Factors Against Edema ,[object Object],[object Object],[object Object],[object Object],[object Object],Total Safety factor = 17 mmHg
Hydrostatic pressure: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organ specific: ,[object Object],[object Object],[object Object],[object Object]
 

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Cerebral circulation by DR.ARSHAD
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Cerebrum internal features by DR.ARSHAD
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Sensory systems by DR.ARSHAD
Sensory systems by DR.ARSHADSensory systems by DR.ARSHAD
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Thalamus by DR.ARSHAD
Thalamus by DR.ARSHADThalamus by DR.ARSHAD
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Speech disorders by DR,ARSHAD
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Speech and language by DR.ARSHAD
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autonomic nervous system by DR.IFRA
autonomic nervous system by DR.IFRA autonomic nervous system by DR.IFRA
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Upper and lower motor neuron lesions by DR.IFRA
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Cerebellum by DR.ARSHAD
Cerebellum by DR.ARSHADCerebellum by DR.ARSHAD
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Autonomic nervous system by DR.ARSHAD
Autonomic nervous system by DR.ARSHADAutonomic nervous system by DR.ARSHAD
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Mid brain by DR.TATHEER
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Cranial nerves by DR.ARSHAD
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Body fluids and edema by Dr. Irum

  • 1.  
  • 2. The physiology of edema. By Dr Irum Junaid
  • 3.
  • 4. Body Fluid Compartments Copyright 2009, John Wiley & Sons, Inc.
  • 5.  
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  • 9.
  • 10. Determinants of Capillary Filtration Capillary Pressure (P c ) Plasma Colloid Osmotic Pressure ( π c ) Interstitial Fluid Pressure ( P if ) Interstitial Colloid Osmotic Pressure ( π if ) K f FILT = K f (P c - P if - π c + π if )
  • 11.
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  • 16. Normal Filtration FILT = K f x Net Filt Pressure = 6.6 x ( 17.3 - (-3) - 28 +8) = 6.6 x ( + 0.3) = 1.89 ml/min FILT = 2722 ml/day Where does all of this fluid (and protein in it) go? FILT = K f (P c - P if - π c + π if )
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  • 19.  
  • 20.  
  • 21.
  • 22.
  • 23.
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  • 28. I. Low Tissue Compliance and Negative Interstitial Fluid Hydrostatic Pressure Interstitial Volume Interstitial Fluid Hydrostatic Pressure Capillary Filtration
  • 29. Interstitial Fluid Volume (liters) Interstitial Fluid Pressure (mmHg) Free Fluid Gel Fluid Low compliance High Compliance Copyright © 2006 by Elsevier, Inc. - 8 - 4 0 + 4 12 24 36 48 60 0
  • 30.
  • 31. Interstitial Fluid Volume (liters) Interstitial Fluid Pressure (mmHg) Free Fluid Gel Fluid Low compliance High Compliance Copyright © 2006 by Elsevier, Inc. - 8 - 4 0 + 4 12 24 36 48 60 0
  • 32.
  • 33.
  • 34. II. Increased Lymph Flow Interstitial Volume Interstitial Fluid Hydrostatic Pressure Lymph Flow
  • 35. Lymph Flow ( x normal) 20 10 1 - 6 - 4 - 2 0 2 4 Interstitial Fluid Pressure ( mmHg) Effect of Interstitial Fluid Pressure on Lymph Flow
  • 36. III. “Wash-down” of Interstitial Fluid Proteins Interstitial Volume Interstitial Fluid Oncotic Pressure Capillary Filtration Interstitial Fluid Hydrostatic Pressure Lymph Flow Protein Removal From Tissues
  • 37. 2 4 6 8 0 Plasma Protein Concentration Rate of Non-Visceral Lymph Flow (ml/hr) Interstitial Fluid Protein concentration (gm/100 ml) Wash-down of Interstitial Proteins 0 20 40 60 80 100 120 140 160 180
  • 38.
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  • 41.