Compression Flashcards
What is compression?
The inward directed mechanical force that increases pressure on the body or body part
What is the primary clinical application for compression?
To control/reduce peripheral edema associated with vascular or lymphatic dysfunction
What are some secondary applications for compression?
Prevent formation of DVT or to help with ulcers
what is compression used for?
To improve fluid balance and circulation (increases hydrostatic pressure in the interstitial space relative to vessels and lymph system
How can compression be administered?
Constant or intermittent
What is edema?
The presence of abnormal amounts of fluid in the extra cellular tissue spaces in the body
How is fluid equilibrium maintained through homeostasis?
Through a balance of osmotic pressure ad hydrostatic pressure
what is osmotic pressure determined by?
Concentration of proteins inside and outside the blood vessels
What is hydrostatic pressure determined by?
Blood pressure and gravity
What does a high hydrostatic pressure inside the vessel do?
Pushes fluid out of the vessels
What does a high osmotic pressure inside the vessel do?
Keeps fluid in the vessels
What generally happens in healthy tissue?
Hydrostatic pressure is slightly higher than osmotic pressure
-net loss of fluid to interstitial space
-lymphatics pick up interstitial fluid and return to venous system via subclavian veins
What are some causes of edema?
Venous or lymphatic obstruction/insufficiency
Increased plasma a volume from sodium and water retention
Trauma
Surgery
Burns
Infection
What are some diseases we wouldn’t want to compress?
Chronic heart failure, cirrhosis, kidney disease
How do healthy and normal veins prevent edema?
When muscles around a vein contract, they exert a pressure on the outside of veins to push blood proximally through the veins. Normally we get enough skeletal muscle activity to push venous blood proximally. Valves are key structures within venous and lymph vessels that prevent the back flow of fluid ensuring the fluid moves proximally toward the heart rather than pushed towards the extremities
What normal pressure do we get at the gastrocsoleus?
200 mmHg
What happens when there is a lack of physical activity or dysfunction of the valves?
Insufficiency and accumulation of fluid in the peripheral circulation system.
-space occupying lesion
-inflammation
What is the most common cause of venous insufficiency?
Plebitis which is inflammation of the veins
What are some other causes of venous insufficiency?
Varicose veins
Thickening of vessel wall with loss of elasticity- increase in hydrostatic pressure of venous system
Damage of valves- blood flows in both directions
What is lymphedema?
Concentration of proteins in lymph is generally high than interstitial space which causes fluid to flow into the lymph system
What are some major causes of lymphedema?
Low serum albumin- reduction in osmotic pressure
Lymphatic obstruction- resection d/t CA
Reduced activity
What are some consequences of edema?
Can limit ROM, limit function, and cause pain