today we are going to talk about the
core concepts related with the edema
right now before I really give the
lecture I would love to ask you a few
questions how do you define what is the
Dima yes please
right she is saying that demeyers
accumulation of interstitial fluid
interstitial fluid is normally their
interstitial fluid is normally there but
normally we are not Eddy meters someone
can improve on this definition yes it's
really we can say you are saying that it
is accumulation of abnormal fluid in
interstitial still not good yes is as
you can make it up better
okay he's saying that edema means
accumulation of excessive fluid in
intersession right this is right
definition but it's not the complete
because by this definition doing this a
big part of edema anyone can improve it
further definition of a DM is abnormal
accumulation of fluid in that
interstitial yet not yes okay anyone
else
excellent very good he is saying accept
through it in the body there is a such a
fluid either inside the cells which is
intracellular edema or in the
interstitial and body cavities which is
called extracellular edema so my dear
friend at least you should know what is
edema let me tell you edema is just a
demise excessive fluid excess fluid in
body tissues that's it
what is the demon demise excess fluid
yes n body issues that's it it may be
intercellular or edema may be
extracellular right when you say edema
means fluid in interstitial that is
wrong because normally there is fluid in
interstitial and if you say atomized
excessive fluid in interstitial then you
missed intracellular edema right so what
is adamak atom us simply means excessive
amount of fluid present in the body
tissues but let us refine it further why
because it's excessive fluid not in all
body tissues for example if they are
excessive fluid in the blood if there is
excessive fluid in the blood is it
called edema no if there is excessive
fluid in the blood that is not called
edema it means that when whenever there
is excessive fluid in the vascular
compartment that is not considered edema
so we can further improve our definition
that edema is excessive fluid in body
tissues extravascular lee extra-extra
wasp ler leak right now let me draw a
diagram to make it more clear let's
suppose from your body I remove a piece
of tissue right this is a piece of
tissue a typical tissue from your body
and naturally the stitch is having
arterial supply right let's suppose here
is your left heart
right systemic circulation and this is
hypothetically we make that there is
arterial supply coming to this tissue
right
arterial input in the same way the stew
must have some outflow mechanism that is
Venus right and that will be going to
which side of the heart yes please right
heart very good that was given to the
right heart and of course all of you
know that blood from the right heart yes
blood from the right hearts the
pulmonary what artery is go to lungs and
through the micro vasculature of the
lamps blood is eventually bean brain to
the left side Sao Paulo Manali veins
which have a signature plug right now
what I have what I am showing in this
diagram from the left heart blood is
going to the tissues right and we have
taken a sample tissue here and this is
the arteriolar input and here I've shown
the venous output is that right now
let's see in detail in this tissue right
arterial system of score arteries come
the divided into arterioles
and eventually they divide into capital
R is right there I am going DAW
microcirculation
this is your micro circulation this one
right and there is arterial input here
is Venus output here are your cells
cells in the tissue right parenchymal
cells and let's suppose this is
representing body cavities right body
cavity is these are parenchyma cells in
the body and this area this area
this is interstitial tissue what is this
interstitial tissue so we can say
interstitial tissues between the
parenchymal cells and the vasculature is
that right this is interesting tissue
now let's divide our body wait and see
what are the normal fluid compartment
because when we define a dimah as
excessive fluid we define a demeyers
excess amount of fluid and body tissues
but extravascular lee right when we
define like this we must know what is
the normal amount of fluids in different
body compartments right because then
fluid is expressed then it is edema but
as a good doctor you must know what is
the normal amount of fluid in different
body compartments let's fold here you
are your beautiful picture right yes
let's suppose you are adult and your
weight is 72 kg right if you are 72 kg
how much water will be there in your
body yes 5 liter water I think I will
die immediately
5 liter water is too low water you know
if you are 72 kg and if you have only 5
little border L 5 liter of water in
total body you must be dead already
one one person yes 42 litre how did you
calculate it excellent very good
actually when we say total body weight
total body weight right 72 kg is the
total body weight of this person total
body weight is divided into two total
body water and lean body mass lean body
mass and total body water if we remove
that for example if this diagram is
representing all the body weight right
if it is representing all the body
weight then in this person this whole
should represent 42 kg out of that total
body weight divided into lean body mass
which is about 40% and total body water
is about
stay percent this is very important to
understand whatever overweight
approximately 60% we are just water when
we say if I say I'm falling in love with
a girl actually 60% water of doctor my
GB is and plus 40% of lean body mass is
falling in love with it the girls how
much water 60% of the water and 40% of
real body mass so you need to remember
this then all of us consist us about 60%
of water about 60% of water is the right
children have a little more percentage
anyway so 60% of water
it means if my weight is 72 kg then okay
this whole system as 72 kg weight how
much water is 60%
about 42 liters so if my weight is 72 kg
I will have how much water 42 letters
don't sell 42 kg and if my weight is 100
kg then how much water I have 60 litres
is that clear right and out of this 42
this 42 litre is divided into very
important fluid compartments in the body
right for example out of this 42
one-third is in the intracellular fluid
it means one-third fluid is present
inside the cells these are cells so all
your if my weight is 42 yes
40 is 72 kg total water I have is 42 out
of that intracellular is two-third and
extracellular fluid is one-third x
popular is one-third and total what is
two-third and what is the extracellular
fluid extra fluid in outside yourself
outside the cell mean fluid in the
interstitium including body cavities and
fluid in the blood your understanding so
if
someone to 2 kg weight the 42 little
water in my body out of that 28 litre is
present in Pfizer
cells because 40 to 2/3 is 28 letters
and 1/3 is 14 litter so it means I will
write it here how much I have on yield
28 litres here and how much is left and
fold in so further a little here outside
the cells out of this fold in inside the
plasma is about 3.5 liter 3.5 liters and
outside is about ten point five letters
approximately of course the degree of
hydration changes person to person and
time to time but approximately now we
come back so what we have decided that
extrasolar fluid is divided into
interstitial fluid which is here and
what is this intravascular fluid
normally how much blood you have how
much blood you have five later you are
answering this then you are saying five
zero five liters the amount of blood in
a person but we have fluid outside the
blood secondly you the blood even five
later is not the whole spirit there
ourselves - we are talking about let's
pose this is vascular system these are
red blood cells now which is the fluid
inside the red blood cell that is in
towas color not only intravascular that
is intra cellular - in the blood vessels
you have five liter of the blood but in
the blood there are cells right and
there are red blood cells the white
blood cells and there are let'slet's all
of them have fluid inside but that fluid
is considered part of the intracellular
compartment that is considered part of
the intracellular compartment so plasma
which is left that is considered extra
cellular