Edema Hyperemia and Congestion Hemorrhage Shock Stages of shock

1. Hemodynamic Disorders
AHMED ABDULWAHAB: 1330095
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2. Edema
 Edema is defined as increased fluid in
interstitial tissue space.
 Hydrothorax is edema in the thoracic
cavity. Hydropericardium is edema in
the pericardial cavity, and
hydroperitoneum is edema in the
peritoneum.
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3. Edema
 Mechanisms and Causes:
Increased hydrostatic pressure
Decreased osmotic pressure
Lymphatic obstruction
Sodium retention
Inflammation
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4. Edema
 Common sites of edema:
 Subcutaneous edema: occurs in heart failure in
the dependent part of the body eg. Legs and
sacral area (dependent edema, or pitting
edema)
 Pulmonary edema: is accumulation of fluid in
the alveolar space. It occurs in heart failure
(Left side failure). It can occur with renal failure
or pulmonary infection.
 Brain edema:
o Localized: in abscess or around tumors
o Generalized: in encephalitis, hypertensive
crisis.
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5. Hyperemia and
Congestion
 It is local increase in the volume of
blood in tissues.
 Hyperemia is an active process
eg. Increase blood to skeletal
muscle during exercise
 Congestion is passive eg. Heart
failure.
 Congestion – Edema - tissue
hypoxia.
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6. Hyperemia and
Congestion
 Common sites of congestion:
 Pulmonary congestion:
o Acute: alveolar capillary congestion with
edema and focal hemorrhage
o Chronic: like acute with fibrosis of alveolar
walls and hemosiderin.
 Liver congestion:
o Acute: congestion of central veins and
sinusoids
o Chronic: like acute with necrosis of the central
region and fibrosis (nutmeg liver, and
Cardiac cirrhosis).
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7. Hemorrhage
 Hemorrhage is extravasation of
blood due to rupture of blood
vessel.
 Causes:
 Trauma
 Atherosclerosis
 Inflammation
 Erosion by tumor
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8. Hemorrhage
 Hemorrhage can be external or internal
(hematoma).
 Hemothorax, themopericardium,
hemoperitoneum, hemarthrosis.
 It can be minimal or fatal.
 Clinical significance: depend on the site,
amount, chronicity.
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9. Hemorrhage
 Petechiae: minute hemorrhage (1-2mm) of skin
and mucosa. Occur due to thrombocytopenia,
clotting factor deficiency, or increased pressure in
capillaries.
 Purpura: small hemorrhage (3-5mm), usually due
to trauma or vasculitis.
 Bruises: is subcutaneous hematoma. Change in
color: red – blue green – yellow brown due to
metabolism of hemoglobin to bilirubin and
hemosiderin.
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10. Shock
 Shock is systemic hypoperfusion
due to reduction in cardiac output
or in effective circulation.
 Features: Hypotension,
hypoperfusion, cellular hypoxia.
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11. Shock
 Types:
1. Cardiogenic shock
2. Hypovolemic Shock
3. Septic shock
4. Neurogenic shock
5. Anaphylactic shock
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12. Stages of shock
1. Initial non-progressive stage
2. Progressive stage
3. Irreversible stage
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13. Thank you
for listening
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