Answer
Mrs Taylor is in liver failure; this means that her liver is unable to make the normal amounts of proteins--which is one of its functions. There will therefore be a deficit in the amount of albumin in Mrs Taylor's blood. Plasma proteins, primarily albumins, are responsible for the plasma oncotic pressure ( colloidal osmotic pressure) of the blood fluid. In Mrs Taylor's case, the blood hydrostatic pressure (BHP) may be normal at the arteriolar ends of capillary beds, but the plasm colloidal pressure acting to keep fluid in the blood vessels will be reduced. This means the net filtration pressure will be increased, and more fluid will leave the capillaries for the interstitial spaces.
Work Step by Step
At the venous end of any capillary bed in the patient, the hydrostatic pressures in the ISF may be slightly increased; however, the increase in this "push" force is much less than the decrease in the "pull " force due to the lower amount of albumins in the plasma. Consequently, the percentage of ISF reabsorbed is lower than usual. The residual ISF left after venous reabsorption is usually efficiently returned to the blood stream by the lymphatic vessels. In this case, however, the lymphatics system would not be able to return the total amount of residual ISF in a timely manner. A a result a residues of the normal cyclic residual amounts accumulate. Over time, this accumulation causes tissue swelling or edema, and as pressure increases, pain is experienced by the subject/patient.
