EDEMA & MEKANISME

Edema (also oedema, dropsy, andhydropsy) (/dim/; Greek odma, "swelling")[1] is an

abnormal accumulation of fluid in the interstitium, located beneath the skin and in the cavities of the
body. Clinically, edema is manifest as swelling; the amount ofinterstitial fluid is determined by the
balance of fluid homeostasis, and the increased secretion of fluid into the interstitium, or the impaired
removal of the fluid can cause edema.

Mechanism[edit]
Six factors can contribute to the formation of edema:

1. increased hydrostatic pressure;

2. reduced oncotic pressure within blood vessels;

3. increased tissue oncotic pressure;

4. increased blood vessel wall permeability e.g. inflammation;

5. obstruction of fluid clearance in the lymphatic system;

6. changes in the water retaining properties of the tissues themselves.

Raised hydrostatic pressure often reflects retention of water and sodium

by the kidney.[7]

Generation of interstitial fluid is regulated by the forces of the Starling

equation.[8]Hydrostatic pressure within blood vessels tends to cause

water to filter out into the tissue. This leads to a difference in protein

concentration between blood plasma and tissue. As a result the oncotic

pressure of the higher level of protein in the plasma tends to draw water

back into the blood vessels from the tissue. Starling's equation states

that the rate of leakage of fluid is determined by the difference between

the two forces and also by the permeability of the vessel wall to water,

which determines the rate of flow for a given force imbalance. Most

water leakage occurs in capillaries or post capillary venules, which have

a semi-permeable membrane wall that allows water to pass more freely

than protein. (The protein is said to be reflected and the efficiency of

reflection is given by a reflection constant of up to 1.) If the gaps

between the cells of the vessel wall open up then permeability to water

is increased first, but as the gaps increase in size permeability to protein

also increases with a fall in reflection coefficient.

Changes in the variables in Starling's equation can contribute to the

formation of edemas either by an increase in hydrostatic pressure within

the blood vessel, a decrease in the oncotic pressure within the blood

vessel or an increase in vessel wall permeability. The latter has two

effects. It allows water to flow more freely and it reduces the oncotic

pressure difference by allowing protein to leave the vessel more easily.

transudate
/transudate/ (transu-dt) a fluid substance that has passed through a membrane or has been
extruded from a tissue; in contrast to an exudate, it is of high fluidity and has a low content of protein,
cells, or solid materials derived from cells.
Transudate is extravascular fluid with low protein content and a low specific gravity (< 1.012). It
has low nucleated cell counts (less than 500 to 1000 /microlit) and the primary cell types
are mononuclear cells: macrophages, lymphocytes and mesothelial cells. For instance,
an ultrafiltrate of blood plasma is transudate. It results from increased fluid pressures or
diminished colloid oncotic forces in the plasma.

exudate

/exudate/ (eksu-dt) a fluid with a high content of protein and cellular debris which has escaped
from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of
inflammation.

Transudate vs. exudate

Transudate Exudate
Main causes Increased hydrostatic Inflammation-Increased Vascular Permeability
pressure,
Decreased colloid
osmotic pressure
Appearance Clear[1] Cloudy[1]
Specific gravity < 1.012 > 1.020
Protein content < 2.5 g/dL > 2.9 g/dL[2]
fluid protein/ < 0.5 > 0.5[3]
serum protein
Difference of > 1.2 g/dL < 1.2 g/dL[4]
albumin content
with blood albumin
fluid LDH < 0.6 or < 23 > 0.6[2] or > 23[3]
upper limit for serum
Cholesterol content < 45 mg/dL > 45 mg/dL[2]

HYPERTENSION AND NAUSEA

While high blood pressure is often called the "silent killer" and many times comes with no
symptoms, some people with prolonged high blood pressure may develop symptoms like
nausea. High blood pressure and nausea may be closely related because the abnormal pressure
causes a lack of oxygen to the brain. The heart of a person with high blood pressure has to work
much harder to circulate oxygenated blood throughout the body. After a prolonged period of time,
this basic task may become too much for the heart and parts of the body, such as the outer limbs
and brain, begin to lose their oxygen supply.