Dr. Matt and Dr. Mike delve into the causes of tissue swelling, exploring edema and its impact on body tissues. They discuss the role of sodium potassium ATPase pump, differences between intracellular and extracellular edema, fluid accumulation's influence on pressure in the body, capillary exchange dynamics, and regulatory mechanisms to prevent edema. The episode concludes with health tips and listener engagement for upcoming topics.
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Quick takeaways
Hydrostatic pressure changes, such as in hypertension or heart failure, can lead to interstitial edema formation.
Oncotic pressure disruptions and capillary integrity affect fluid leakage into tissues, contributing to edema development.
Pre-capillary sphincters help regulate blood flow into capillary beds, maintaining consistent pressures despite variations.
Deep dives
Capillary Exchange: The Battle of Forces
At the arterial end of the capillary bed, there is a hydrostatic force of 35 millimeters of mercury pushing fluid out, carrying oxygen and nutrients to the tissues. Simultaneously, the inward pulling force in the form of the oncotic pressure remains at 25 millimeters of mercury, effectively pushing out fluid. However, at the venous end, the hydrostatic pressure drops to 15 millimeters of mercury, while the oncotic pressure remains at 25. This results in a net inward pulling force of 10 millimeters of mercury, reclaiming water, carbon dioxide, and waste back into the capillary bed.
Lymphatic System: The Fluid Reclaimer
Any residual fluid not reclaimed by the capillary system stays in the interstitium, where it is eventually collected by the lymphatic system. The lymphatics gather lost fluid and proteins, returning them back to the venous supply to prevent excessive fluid buildup in the tissues. This essential function ensures that the fluid balance is maintained and prevents the loss of vital plasma proteins into the interstitial space.
Pre-Capillary Sphincters: Regulating Blood Flow
Pre-capillary sphincters play a crucial role in controlling blood flow into the capillary bed. These smooth muscle structures regulate the diameter of the arterials before entering the capillary bed. They respond to factors like blood pressure variations and nervous system signals to adjust the diameter, maintaining a consistent hydrostatic pressure in the capillary beds despite fluctuations in overall blood pressure levels.
Alterations in Hydrostatic Pressure Leading to Interstitial Edema
The first key point discussed in the podcast revolves around alterations in hydrostatic pressure as a cause of interstitial edema. Various factors such as prolonged hypertension and heart failure can contribute to increased hydrostatic pressure, leading to fluid accumulation in the interstitial space. Prolonged hypertension affects arterial function, changing pressures in the capillary bed, resulting in fluid accumulation. Similarly, right side heart failure impedes the right ventricle's ability to pump blood effectively, causing fluid build-up in the venous system. On the other hand, left side heart failure leads to increased hydrostatic pressure in the pulmonary veins, resulting in pulmonary edema.
Oncotic Pressure Changes and Capillary Integrity Impacting Edema Formation
The second main idea focuses on oncotic pressure changes and capillary integrity as factors influencing edema development. Disruptions in oncotic pressure, often linked to liver dysfunction in conditions like cirrhosis, can reduce the inward pulling force in capillaries, leading to fluid leakage into the interstitial space. Additionally, issues with capillary integrity, such as vascular injury or inflammation, can increase capillary permeability, allowing proteins and fluid to escape into the interstitium. The lymphatic system plays a crucial role in draining excess fluid and proteins, with lymphatic obstructions or surgical removal contributing to edema, highlighting the complex interplay between various physiological mechanisms in edema pathogenesis.
What causes tissues to swell? In this episode, Dr Matt and Dr Mike explore the biology behind why in certain conditions fluid can accumulate in various parts of the body.
If you want to watch Dr Mike discuss the various causes of Oedema, visit their YouTube channel!