4. what is the causes of edema ?

Tissue swelling caused by excess fluid is known as interstitial edema. The cause of
edema associated with edema formation mechanism itself which can be grouped into four
general

categories

is

as

follows:

1. Decreasing the concentration of plasma proteins

Decreasing the concentration of plasma proteins cause a decrease in plasma
osmotic pressure. This leads to a decrease in filtration fluid out of the vessel is higher,
while the amount of fluid reabsorbed less than normal; thus there is additional fluid is
left behind interstitial space. Edema caused by a decrease in plasma protein
concentrations can occur in several ways: over-spending plasma protein in the urine
due to kidney disease; a decrease in plasma protein synthesis due to liver disease
(liver synthesize nearly all plasma proteins); Less food containing protein; or expense
of

protein

due

to

extensive

burns.

2. Increased permeability of the capillary

Increased permeability of the capillary walls causing plasma protein out of the
capillaries into surrounding interstitial fluid more. For example, through the capillary
pores dilation triggered by histamine in tissue injury or allergic reactions. A decline in
plasma colloid osmotic pressure which decreases towards the temporary increase in
interstitial fluid colloid osmotic pressure which cause by excess protein in interstitial
pressure increases towards the outside. These imbalances have contributed to a

localized edema associated with injury (eg, blisters) and allergic responses (eg,
urticaria).
Increased capillary permeability may occur in:

Severe infection
Anaphylactic reactions
Poisoning by drugs or chemical substances
Anoxia caused by a variety of poisoning
Increased venous pressure due to heart trouble
Lack of protein in the plasma as a result of albuminuria
Retention of sodium and water in certain kidney

diseases

3. Increased venous pressure

Increased venous pressure, for example unstoppable in venous blood, will be
accompanied by increased capillary blood pressure, capillary because they drain the
contents into a vein. Increasing pressure towards the capillary wall is especially
instrumental in the edema that occurs in congestive heart failure. Regional Edema can
also occur because of local restrictions venous return. One example is is swelling of
the legs and feet are common in pregnancy. Of the enlarged uterus pressing the large
veins that drain blood from the lower extremities when the veins are entered into the
abdominal cavity. Damming of blood in these veins cause leg that drives the regional
lower

limb

edema.

4. Blockage of the lymph vessels

Blockage of the lymph vessels causing edema, due to excess fluid filtered out
stuck in interstitial fluid and can not be returned to the blood via the lymph system.
The accumulation of proteins in the interstitial fluid aggravate the problems through
osmotic effects. Local arms are clogged due to removal of lymph nodes during
surgery for breast cancer. More widespread lymph blockage occurs in filariasis, a
parasitic disease transmitted by mosquitoes which is mainly found in tropical regions.
In this disease, filarial worms infect small thread-like lymph vessels, causing
disruption of lymph flow. Parts of the body are affected, especially the scrotum and
extremities, suffered severe edema. The disorder is often referred to as elephantiasis,
because of swollen extremities such as elephantiasis.

5. Sodium and Water Retention:

Sodium retention occurs when sodium excretion in the urine is smaller than
the (intake), because the concentration of sodium rises will occur hipertoni. Hipertoni
cause water to be detained so that the amount of extracellular water, both the
intravascular

and

the

interstitial

edema

increases

consequently

so.

Edema due to sodium retention is extrarenal (influenced by the nerve) can also be
caused by other hormones. In patients who received treatment with ACTH,
testosterone, progesterone, or estrogen often causes edema more or less.

Source :
Sherwood, lauralee. 2014. Fisiologi manusia dari sel ke sistem 8th edition. Jakarta: EGC
Kumar, Abbas. 2015. Buku Ajar Patologi Robbins 9th edition. : Elsavier Saunders