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Oedema, image, image, image …

- - - - Describe the Pathology of RV Failure
        Liver: Hepatomegaly
        Due to Nutmeg Congestion.
        Resulting in Centrilobular necrosis +/- fibrosis.
        Spleen: Splenomegaly
        If splenomegaly occurs of a period of time, then fibrosis of Sinusoidal Walls will occur.
        Kidneys: Congestion
        Due to activation of RAAS resulting in NA+ retention in the Kidneys.
        Dependent Areas: Ankle/Sacral pitting oedema.
        Peritoneum: Ascites due to an accumulation of fluid in peritoneal cavity.
        Brain: Congestion/Hypoxia due to accumulation of deoxygenated blood in the brain = oxygen starvation.
        
        Pathology of LV Failure
        List the organs Affected by LV Failure
        Lungs
        Systemic Organs
        
        Describe the Pathology of Liver Failure
        Lungs: Chronic Passive Venous Congestion
        Resulting in Pulmonary oedema and Pleural Effusions, due to the accumulation of fluid (Blood).
        Systemic Organs: Hypo perfusion
        Resulting in infarcts and Changes in shock.
  - - - Renal Failure
        What are the 2 conditions which give rise to oedema ?
        Nephrotic Syndrome gives rise to generalised oedema.
        Acute Renal Failure/Glomerulonephritis
        
        Describe the Mechanisms of Oedema Formation in Renal Failure
        
        Nephrotic Syndrome
        
        Increase in Protein loss in the urine, resulting in a decrease in the osmotic pressure of the blood.
        RAAS system is activated, resulting in increase in osmotic pressure of interstitial fluid and Na+ retention.
        +/- Superimposed renal vein Thrombosis.
        
        Acute renal failure/Glomerulonephritis
        
        No renal Perfusion
        Therefore no Na+ and Water can be lost in urine.
        
        Describe the Pathology of Nephrotic Syndrome
        Preorbital Oedema
        Ascites, Pleural Effusion
        Dependent Areas: Pitting Oedema
- - - - Cerebral Oedema
        The Classification of Cerebral Oedema
        List The Types of Cerebral Oedema
        
        Cytotoxic Oedema
        
        Vasogenic Oedema
        
        Hydrocephalic/ Interstitial Oedema
        
        Other
        
        NOTE: If Cerebral oedema occurs and becomes excessive, Brain herniation will occur.
        
        Cytotoxic Oedema
        What is Cytotoxic Oedema ?
        Cytotoxic Oedema is caused by Hypoxia in the brain, and endothelial cells.
        So the Na+ and Water will enter the endothelial cells, and pass into the Neurons and Glial Cells.
        Resulting in intracellular oedema (maximal in the cortex of the brain)
        The Blood-Brain barrier is intact so there is no ring enhancement on CT Scan
        
        Vasogenic Oedema
        What is Vasogenic Oedema ?
        Vasogenic Oedema is caused by a brain infarct.
        The blood-brain barrier is breeched. Resulting in extracellular fluid accumulation (Maximal in White Matter)
        CT Scan: shows a ring of contrast enhancement with surrounding oedema)
        
        Hydrocephalic/Interstitial Oedema
        What is Hydrocephalic Interstitial Oedema ?
        It is caused by the obstruction of Cerebral Spinal Fluid outflow.
        The fluid accumulates adjacent to ventricles in extracellular space.
        Blood-Brain Barrier is intact.
        
        Other types of Oedema
        Are:
        Poisoning,
        Congestive,
        Hypo-Osmolar