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Fluid and Hemodynamic Disorders

Fluid and Hemodynamic Disorders. Where’s my water?. Intracellular Ions Ion specific gates in cell membrane Cellular proteins Extracellular Interstitial (between the cells) Lymph Intravascular Blood Lymphatic fluid. Movement of water in the vascular system.

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Fluid and Hemodynamic Disorders

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  1. Fluid and Hemodynamic Disorders

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

  3. 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

  4. Intracellular & Extracellular Water

  5. Things can go wrong • Heart failure • Kidney failure • Myocardial infarction • Pulmonary emobolus • Tissue congestion • Edema

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

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

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

  9. Congestive Heart Failure

  10. Congestive Heart Failure

  11. Passive Congestion

  12. Chronic Passive Congestion, Nutmeg Liver

  13. Chronic Passive Congestion

  14. Pulmonary Edema

  15. Pulmonary Edema

  16. Pulmonary Edema

  17. Pitting Edema

  18. Lymphedema

  19. Papilledema

  20. Water in Hollow Spaces • Hydrothorax • Hydropericardium • Hydroperitoneum • Ascites

  21. Healthy Blood Clotting • Platelets • Vessels • Clotting Proteins

  22. Healthy Clotting

  23. Clotting Factors

  24. Factor Activation

  25. Hematoma

  26. Petechiae

  27. Thrombosis • A pathological clot • A clot forming in the fixed vascular system.

  28. 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)

  29. Thrombosis

  30. Thrombosis • Arterial Side Thrombi • Platelet activation • Endothelial cell injury • Venous Side Thrombi • Stasis • Clotting factor activation • Endothelial cell injury

  31. Coronary Artery Thombosis • Angiogram

  32. Acute Myocardial Infarction

  33. Mural Thrombus

  34. Aneurysm with Thrombus

  35. Deep Leg Vein Thrombosis

  36. Airplane Travel • Gunner turret

  37. Outcomes of a DVT

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

  39. Pulmonary Embolus

  40. Pulmonary Embolus

  41. Infarction • Anemic • End artery supply • No blood • White • Hemorrhagic • Venous occlusion • Loose tissues • Dual blood supply • Red

  42. Anemic Infarct

  43. Anemic Infarct

  44. Cerebral Infarction

  45. Hemorrhagic Infarct

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