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Fluid and Hemodynamic Disorders

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Presentation on theme: "Fluid and Hemodynamic Disorders"— Presentation transcript:


2 Fluid and Hemodynamic Disorders

3 Where’s my water? Intracellular Ions
Ion specific gates in cell membrane Cellular proteins Extracellular Interstitial (between the cells) Lymph Intravascular Blood Lymphatic fluid

4 Movement of water in the vascular system
Hydrostatic, the pumping pressure Heart Skeletal muscle action Oncotic or osmotic, holds fluid in. Proteins such as albumin Cellular elements such as RBCs

5 Intracellular & Extracellular Water


7 Things can go wrong Heart failure Kidney failure Myocardial infarction
Pulmonary emobolus Tissue congestion Edema

8 Edema Too much extracellular fluid. Swelling Localized or Generalized
tumor Localized or Generalized Dependent action of gravity

9 Tansudate or Exudate? Exudate Inflammatory water
Part of the inflammatory reaction Rubor, dolor, calor, tumor Purposeful and intentional Localized

10 Tansudate or Exudate? Transudate Leakage, not part of healing
Increased hydrostatic pressure Heart failure Lymphatic obstruction Decreased oncotic pressure Decreased albumin

11 Congestive Heart Failure

12 Congestive Heart Failure

13 Passive Congestion

14 Chronic Passive Congestion, Nutmeg Liver

15 Chronic Passive Congestion

16 Pulmonary Edema

17 Pulmonary Edema

18 Pulmonary Edema

19 Pitting Edema

20 Lymphedema

21 Papilledema

22 Water in Hollow Spaces Hydrothorax Hydropericardium Hydroperitoneum


24 Healthy Blood Clotting
Platelets Vessels Clotting Proteins

25 Healthy Clotting

26 Clotting Factors

27 Factor Activation


29 Hematoma

30 Petechiae

31 Thrombosis A pathological clot
A clot forming in the fixed vascular system.

32 Thrombosis Endothelial damage Stasis and clotting factor activation
Clotting factor abnormalities Too many clotting proteins Pregnancy Cancers Too little inhibition Abnormal factors Leiden Factor (abnormal V)

33 Thrombosis

34 Thrombosis Arterial Side Thrombi Venous Side Thrombi
Platelet activation Endothelial cell injury Venous Side Thrombi Stasis Clotting factor activation

35 Coronary Artery Thombosis

36 Acute Myocardial Infarction

37 Mural Thrombus

38 Aneurysm with Thrombus

39 Deep Leg Vein Thrombosis

40 Airplane Travel Gunner turret

41 Outcomes of a DVT

42 Embolus Space occupying mass moving in the fixed vascular system
Blood clot Bone Fragments Amniotic Fluid Air

43 Pulmonary Embolus

44 Pulmonary Embolus


46 Infarction Anemic Hemorrhagic End artery supply No blood White
Venous occlusion Loose tissues Dual blood supply Red

47 Anemic Infarct

48 Anemic Infarct

49 Cerebral Infarction

50 Hemorrhagic Infarct

51 Shock Poor perfusion Tissue hypoxia Tissue acidosis Many causes
Poor pumping by heart Low blood volume Loss of fluid Overwhelming infections

52 Types of Shock Cardiogenic Hypovolemic Anaphylaxis Septic
Decreased output Hypovolemic Blood loss Fluid loss Anaphylaxis IgE and histamine Septic Gram negative rods Toxins

53 What Happens Next? Compensated Decompensated Irreversible Fluid shifts
Progression possible Irreversible No recovery

54 The Shock Spiral

55 Summary Fluid shifts Excessive tissue water Clot formation Thrombosis
Oncotic & Hydrostatic Pressures Excessive tissue water Exudate vs. Transudate Clot formation Vessels, platelets & proteins Thrombosis Pathological clot Arterial = endothelial damage & platelet activation. Venous = stasis and factor activation

56 Summary Infarction Ischemic = end artery organ
Hemorrhagic = venous or dual blood supply Tissue vulnerability Brain Kidney muscle


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