Fluid and Hemodynamics
Card Set Information
Fluid and Hemodynamics
Fluid and Electrolytes
Transport gases, nutrients, and wastes.
Help generate the electrical activity needed to power body functions.
Take part in the transforming of food into energy.
Composition and Compartmental Distribution of Body Fluids
Body fluids distributed between intracellular and extracellular compartments.
ICF- fluid contained w/in the cells of body.
ECF- fluid contained outside the cells including water in interstitial tissue or spaces and bl. vessel.
Cell membrane- main barrier to the mov't of substances between the ECF & ICF compartments
the mov't of charged or uncharged particles along a concentration  gradient.
all molecules & ions including h2o & dissolved molecules, are in constant random motion.
The mov't of H2O across a semipermeable membrane.
H2O moves from area of higher concentration of H2O to lower like diffusion.
Tension or effect that effective osmotic pressure of a solution w/ impermeable solutes exert on cell size b/c of water mov't across the cell membrane.
isotonic, hypotonic, hypertonic.
Compartmental Distribution of Body Fluids
40% of body weight from ICF
20 % of body weight from ECF
-Plasma compartment 5% of body wt. Interstitial fluid compartment about 14% of body wt. Transcellular compartment about 1 % of body wt.
Palpable swelling produced by an increase in interstitial volume.
Doesn't become evident until interstitial volume has increased by 2.5-3 liters.
Edema from increased capillary filtration pressure
Localized is caused by dialation of precapilary sphincters and aterioles that supply that swollen lesion.
Generalized- reult of increased vascular volume seen in CHF or Rt. sided heart failure.
Edema from decreased capillary osmotic pressure
Plasma proteins exert the osmotic needed to pull fluid back into the capillary from the tissues.
Result in inadequate production or abnormal loss of plasma protein mainly albumin.
Edema from increased capillary permeability
When capillary pores become enlarged or the integrity of the capillary wall is damaged, capillary permeability is increased.
Plasma protein and active particles leak into the interstitial spaces, increasing the tissue collidal osmotic pressure and thereby contributing to the accumulation of interstitial fluid.
Edema from obstruction lymph flow
Plasma proteins and other large particles that can't be reabsorbed throgu the pores in the capillary membrane rely on the lymphatic systems for movement back into the circulatory system.
Lymphedema- edema due to imparied lymph flow often caused by cancer w/ lymph node involvement, infection and lymph trauma.
More about edema
Increases distance for diffusion of O2, nutrients, and wastes.
Increased risk of pressure ulcers and can compress bl. vessels.
Exceeds absortive capacity of tissue gel, tissue H2O is mobile and can be translocated w/ pressure
Non- Pitting edema
reflects on a condition where plasma protein have accumulated in the tissue spaces and coagulated
An unusual amt of bl. in a part increase in quantity of bl. flowing through any part of the body shown by redness of skin
Sudden obstruction of bl. vessel by debris.
Bl. clots, cholesterol containing plaques, masses of bacteria, cancer cells, amniotic fluid, fat from broken bones, and injected substances may lodge in the bl. vessels and ocstruct circulation
Formation or pressure of a bl. clot w/in the vascular system.
Clot can occlude vessels, block bl. flow and O2 supply to part of an organ.
If detaches, can travel and occlude a vessel at a distance from original site.
Episodes of bleeding that last more than a few mintues.
Compromise organ or tissue perfusion.
Clinical syndrome marked by inadequateperfusion and oxygenation of cells, tissues, and organs, usually as a result of marginal or markedly lowered bl. pressure.
4 types of shock
: cardiogenic, hypovolvemic, Obstructive, and Distributive.
Heart fails to pump bl. sufficiently enought to meet the body's demands.
Decrease in cardiac output, hypotension, hyperfusion, and indications of tissue hypoxia despite an adequate intravascular volume.
Dreases bl. volume so that there is inadequate filling of the vascular compartment.
From accute bl. loss of 15-20 % of circulating volume.
s/s- depend on severity, thirst, increased HR, cool, clammy skin, decreased BP, dec. urine output, change in mental status.
Shock from mechanical obstruction of the flow of bl. through the central circulation.
Caused by dissecting aortic aneurysm, cardiac tamponade, pneumothorax, atrial myxoma, and evisceration of abdominal contents into thoracic cavity from ruotured diaphragm, pulmonary embolism.
Vasodialatory shock- loss of bl. vessel tone, enlargement vascular compartment, and displacement of vascular volume away from the heart and central circulation.
2 main causes result in vesssel tone
: Decrease in sympathetic control of vasomotor tone, release of extensive vasodialator substances.
3 Shock states of distributive shock
Neurogenic shock- caused by decreased sympathetic control of bl. vessel tone.
Anaphylactic shock- immunilogically mediates reaction in which vasodialator substance such as histamine are released.
Septic shock- vessel dialates systemic responseto serious problem.
Complications of shock
acute lung injury/ acute respiratory distress syndrome.
acute renal failure
disseminated intravascular coagulation.
multiple organ dysfunction syndrome.
stoppage of bl. flow.
normal process is regulated by complex array of activators and inhobitors that maintain bl. fluidity and prevent bl. from leaving the vascular compartment.
normal when seals bl. vessel toprevent bl. loss and hemorrhage.
abnormal when it causes inappropriate bl. clotting or when clotting is insufficient to stop the flow of bl. from vascular compartments.
Components of Hemostasis
Platelets- platelet production is controlled by thrombopoeitin which are found in liver, kidney, smooth muscle, and bone marrow.
Coagulation- use of plasma proteing that are present as inactive procoagluation factors.
Endothelium- endothelial cells line vessels that modulated several, and frequently opposite, stages of normal hemostasis.
Clot formation and dissolution
Hemostasis 5 stages
vessel spasm, platelet plug formation, bl. coagulation or development of an insoluble fibrin clot, clot retraction, and clot dissolution.
Hemostatic surgical agents/ devices
Thermal hemostatic mechanism- ESU, Laser Unit, and Harmonic scapel.
Chemical Hemostatic agents- Gel foam, avitene, surgicel or oxycel, and epinephrine.
Mechanical hemostatics- clamps, ligatures, clips, spnges, pladgets, bone wax, suction, pressure devices or tourniquets, and drains.