1.

SLIDE: PULMONARY EDEMA

a.) Note the following:
1. Pulmonary capillaries become dilated and congested with erythrocytes.

Figure 1 : The extravasation of red blood cells into the alveoli.

Figure 2 : Dilated capillaries and congested with erythrocytes.

Figure 3: Engorged blood vessels with erythrocytes.

2. Alveolar spaced are filled with plasma fluid (transudate). Any reason for this?
The alveolar spaced are filled with plasma fluid, (transudate) because of the increased
hydrostatic pressure that is resulted from failure of the left ventricle of the heart,
creating a high pressure towards lungs. If someone has a failure in the left side of the
hearts, for examples, the congested heart failure, it will create a high pressure back up
to our lung, creating a high hydrostatic pressure, results in transudate. The fluid is
forced out between the endothelial cell , from the pulmonary artery capillaries into
interstitial tissue and into the alveolar spaces of the lung. Because of the pressure is
very high.

Differentiate between Transudate and Exudate.

TRANSUDATE
CHANGE

DIFFERENCE

HYDROSTATIC CAUSES

AND OSMOTIC PRESSURE

REMAINS

EXUDATE
INFLAMMATION

ENDOTHELIAL CELL AND INTERENDOTHELIAL

WALL OF BLOOD VESSEL

SPACE BECOME LARGER

LEAKAGE OF

VASODILATION OCCUR
FLUID
LEAKAGE
&

LESS

CHOLESTROL

PROTEIN LEAKAGE
MORE

LESS

< 45mg/dl >

GRAVITY

MORE

FLUID LEAKAGE

<1.012>
CLEAR, WATER LIKE OR COLOR

CLOUDY, YELLOW

PALE YELLOW /PLASMA.

ALKALINE

PH

ACID

NONE

BACTERIA

PRESENT

NONE OR FEW

CELL COUNT

MANY

RBC/WBC
LIVER FAILURE

EXAMPLES

RBC/WBC
PNEUMONIA

CONGESTIVE
FAILURE

HEART

TUBERCULOSIS
RHEUMATOID ARTHRITIS

KIDNEY DISEASE

3. a.) Draw the overall structure, and label the above findings.

Figure 4: The blood vessels are distended and "over filled" with blood. They have became
dilated. You may see evidence of pulmonary edema in the alveolar air spaces. The edema fluid
will appear as a faint pink stained material in the background of the air spaces.

b.) Heart failure can lead to pulmonary edema. Discuss.

When the heart cannot function well or have acute left/right ventricular failure, an acute
passive congestion is usually a consequences. With regard to this, pulmonary venous
engorgement leads to pulmonary edema, or accumulation of a plasma fluid (transudate)
within the alveolar space. With acute failure of the right ventricle, the liver can become
severely congested.This is because, when the left ventricle /atrium fails to empty high
pressure in the affected chamber, they will return to pulmonary capillaries. The
pulmonary capillaries then become:
--Congested with erythrocytes
--High Hydrostatic pressure, results in transudation of plasma fluid into alveolar space.
REFRENCES:
A. Bruce, Z. Guiyun, Lippincots illustrated Q&A 7th edition, pg 331.

R. Raphael, B.David, R. Emanuel , Rubins Pathology clinicopathologic Foundation

ofMedicine.pg 229
www. Khansacademy.org.