Difference between revisions of "Local Oedema"
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Latest revision as of 16:52, 15 October 2013
- Local oedema is the local accumulation of excess interstitial fluid.
- Caused by disturbance of the balance betwen fluid extravasation and resorption at the level of the capillaries.
- Outwards Forces - arteriolar
- Vasuclar hydrostatic pressure - 35 mmHg
- Interstitial osmotic pressure - 3 mmHg
- Inwards forces - venular
- Plasma protein osmotic pressure - 25 mmHg
- Interstitial hydrostatic pressure - 4 mmHg
- Outwards Forces - arteriolar
- May be of inflammatory or non-inflammatory origin.
Types of Local Oedema
Inflammatory oedema
- Generated by one or more of the following:
- Increased vascular permeability
- Increased arteriolar blood pressure
- Breakdown of tissue protein or transfer of plasma proteins into ECF.
- Results in raised osmotic pressure of tissue fluid.
- Obstruction to lymphatic drainage.
- Usually by fibrin.
Lymphatic oedema
- Results in accumulation of high protein fluid.
- May provoke a granulation or fibrous tissue response.
- Due to:
- Lymphangitis/ lymphadenitis
- Acute inflammation of lymphatics/ lymph nodes. R
- Caused by stasis in lymphatics and/or bacterial infection.
- E.g. “Monday Morning leg” in horses.
- Chronic inflammation caused by persistent or granuloma-producing bacterial infection.
- E.g. Johne's disease, actinobacillosis.
- Tumour spread.
- Metastasis of tumour cell plugs lymphatics and nodes
- e.g. mammary carcinoma.
- Parasitic migration
- Larvae may be following their normal pathway (e.g. Schistosomiasis), or may be aberrant.
- Lymphangitis/ lymphadenitis
Local venous obstruction
- Obstruction to venous drainage may be mechanical or inflammatory-mediated.
- Causes raised hydrostatic pressure.
- Endothelial permeability increases due to hypoxia.
- There may be inflammatory damage.
- Mechanical obstruction, e.g.
- Torsions of bowel
- Misplaced organs.
- Pressure from outside vein from adjacent structures.
- Venous inflammation (phlebitis)
- May be associated with thrombosis (thrombophlebitis).
"Allergic" oedema
- Results from immediate (Type I ) or delayed (Type IV) hypersensitivity.
- Vasular permeability is increased due to release of histamine and vaso-dilating substances.
- E.g.
- Insect stings (immmediate).
- Vaccination (delayed).
- Food reaction (delayed).