Edema

Localized
Systemic
Local disturbance of fluid exchange
Increased retention of body sodium
mechanism
and water
Causes inflammation, allergic
Causes congestive heart failure,
reaction, venous obstruction,
renal disease, hypoproteinemia
lymphatic obstruction
protein loss in urine-kidney disease,
decreased protein synthesis-liver
disease, decreased protein intakemalnutrition
Edema deposits in ankles in upright and sacral region in bedridden
Whole body edema is anasarca

Hyperemia
Active process
Increased blood blow (inflammation,
exercise)
Erythematous and warmer (rubor,
calor)
Crazy workoutmaybe
transudateno edema unless
lymphatics are blocked

Congestion
Passive process
Decreased venous outflow
(obstructed vein-local, CHF-general)
Cyanotic (bluer), increase in
deoxygenated blood,
chronicityhypoxianecrosis
Increased hydrostatic
pressuretransudatecapillary
rupture

Congestion
Acute Edema
Acute
Sudden left ventricular
Pulmonar failure, increase hydrostatic
y Edema pressure, engorgement of
capillary beds (transudate
formation) capillaries
rupture, frothy pink edema
Acute
Secondary to shock or
Liver
hepatic vein thrombosis,
Congesti central vein and sinusoids
on
distended with blood,
centrilobular hepatocytes
more vulnerable to injury

Chronic
Pulmona
ry
Edema
Chronic
Liver
Congesti
on

Chronic Edema
Persistent, less severe
hydrostatic pressure,
alveolar wallsthicken
and fibrotic, macrophges
heart failure cells
(hemosiderin from RBC)
Right ventricular failure,
hepatic lobule zonal
changes, chronic hypoxia
appears as fatty change,
centrilobular
hepatocyteshypoxicne
crosis small foci of
hemorrhage, hemosiderin
filled macrophages, red

areas-congestion and
hemorrhage, yellow areasviable parenchyma
(nutmeg liver), advanced
cases-fibrosis-cardiac
cirrhosis, but no actual
cirrhosis, since no
regeneration nodules, only
fibrosis

Bleeding to Death
Trauma, major surgery, hemophilia

Clotting to Death
Stroke, MI, thrombosis

Thrombus
Coagulation cascade and platelet
activation
Develops in heart and vascular
system

Blood Clot
Coagulation cascade only

Often attached to underlying

endothelium
Displays orderly layering of platelets
and fibrin

Result of activation/inactivation of
coagulation cascade and platelet
activation (major role)

Develops in extravascular areas

(hematoma), in vitro (test tube),
vessels after death (post mortem
clot)
Not attached to underlying
endothelium
Displays randomly oriented fibrin
with passively entrapped platelets
and RBCs
Post-mortem clot shows
sedimentation effect, fibrin,
entrapped RBCs settle out, leaving
WBCs, plasma to form upper clot
layer
Result of activation of coagulation
cascade platelet activating (minor
role)