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Tissue fluid formation & Edema slideshare
Tissue fluid is formed from blood capillaries and tissue metabolism and occupies the spaces between cells. It is formed primarily through the filtration of fluid out of capillaries due to hydrostatic pressure gradients, and reabsorbed based on oncotic pressure gradients, as described by Starling's forces. Edema occurs when there is excessive accumulation of fluid in the interstitial spaces, which can be caused by increased capillary filtration, inadequate drainage, or decreased plasma oncotic pressure due to conditions like heart or liver disease.
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Tissue fluid formation & Edema slideshare
- 1. Tissue fluid formation& Edema Dr Anu Priya J
- 2. Introduction • Tissue fluid/ Interstitial fluid is the fluid which occupies the intercellular spaces. • A medium for the exchange of substances such as nutrients, O2, CO2, metabolic wastes, etc., between the cells and blood.
- 3. Role of capillaries •Fluid exchange between intravascular and interstitial compartments occurs only at the level of capillaries. The other parts of the vascular system are impermeable. • The capillaries are permeable because they are lined by a single layer of flattened endothelium.
- 4. Formation of tissuefluid • Tissue fluid is derived from two sources: 1. From blood capillaries 2. From metabolism in tissues
- 5. Formation of tissuefluid • Factors affecting the formation of tissue fluid: a. Permeability of capillaries b. Diffusion c. Filtration and reabsorption d. Metabolic activity of tissues
- 6. Filtration & Reabsorption •Most important mechanism by which tissue fluid is formed. • Fluid is filtered out at the arterial end of the capillary & is reabsorbed at its venous end. • Starling’s forces regulate the movement of fluid into and out of the capillaries. Formation of tissue fluid
- 7. Drainage of tissuefluid • 85% reabsorbed in the venular end of capillary • 15% drained via lymph
- 8. Starling’s forces • Hydrostaticpressure in capillary (Pc) • Hydrostatic pressure in interstitium (Pi) • Colloidal osmotic pressure/ Oncotic pressure in capillary (πc) • Colloidal osmotic pressure/ Oncotic pressure in interstitium(πi) Formation of tissue fluid
- 9. Formation of tissuefluid
- 10. Starling’s forces • Filtrativeforce = Hydrostatic pressure gradient (Pc – Pi) • Absorptive force = Oncotic pressure gradient (πc-πi) Formation of tissue fluid
- 11. Starling’s forces • Nf= Kf [(Pc – Pi) - (πc-πi) • Kf = Permeability x Surface area • Nf - Net filtration force • Kf - Permeability coefficient Formation of tissue fluid
- 12. Formation of tissuefluid Pc 37 mmHg Pc 17 mmHgπc 25 mmHg πi 0 mmHgPi 1 mmHg Hydrostatic pressure Hydrostatic pressure Arteriolar end of capillary Venular end of capillary
- 13. Arteriolar end: • Netfiltration force = +11mmHg • Hydrostatic pressure gradient > Oncotic pressure gradient • Filtration of fluid Venular end: • Net filtration force = (-9mmHg) • Hydrostatic pressure gradient < Oncotic pressure gradient • Absorption of fluid Formation of tissue fluid
- 14. Edema • Accumulation ofabnormally large amount of fluid in the interstitial spaces Pathophysiology of edema i. Increased filtration of fluid ii. Inadequate drainage of fluid
- 15. Etiology / Causes Basedon etiology: • Cardiac edema • Renal edema • Inflammatory edema • Noninflammatory-Giant/angioneurotic edema • Heat edema • Lymphedema • Edema due to malnutrition • Edema due to liver disease • Edema due to venous obstruction
- 16. Types of edema •Based on location • Based on response to pressure
- 17. Types of edema Basedon location • Localised edema • Generalised edema
- 18. Types of edema Basedon response to pressure Pitting edema • pit/intendation seen after 30s pressure – due to displacement of fluid from the area of pressure • Inflammation, Congestive cardiac failure(CCF), Renal diseases etc., Nonpitting edema • Conditions where the swelling is not chiefly due to fluid collection • Myxedema, Lymphedema in filariasis, etc.,
- 19. Edema in liverdisease • Hypoproteinemia due to decreased synthesis of proteins - decreased oncotic pressure in the capillaries – reabsorptive force lesser than the filtration force – accumulation of fluid in the interstitial spaces - edema
- 20. Edema in renalfailure • Hypoproteinemia due to proteinuria –decreased oncotic pressure in the capillaries – reabsorptive force lesser than the filtration force– accumulation of fluid in the interstitial spaces - edema
- 21.
Editor's Notes
- #4 There is constant exchange of fluid between the different fluid compartments of the body. But, fluid exchange between intravascular and interstitial compartments occurs only at the level of capillaries.
- #7 Mvt of fluid into n out of capil first desc by Ernest Henry Starling. Hence, forces that govern the mvt.. Starling’s forces.