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FCA > EDEMA & CONTUSIONS > Flashcards

EDEMA & CONTUSIONS Flashcards

1
Q

what is edema?

A

-local/ general accumulation of fluid in the interstitial tissue spaces
EDEMA = result of altered-physiological function in body (*not a disease)
may result from:
->local release of histamine following an injury
->systemic disease: heart failure
->after an obstruction of lymphatic vessels

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2
Q

what is blood largely composed of?
(function & anatomy of the lymphatic system)

A

WBC’s, RBC’s & various proteins suspended in fluid

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3
Q

what happens in circulatory capillaries?
(function & anatomy of the lymphatic system)

A

slightly more fluid is pumped through the arteriole ends into interstitial spaces than absorbed at venous ends

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4
Q

what happens to the excess clear, watery interstitial fluid?
(function & anatomy of the lymphatic system)

A

it is collected, filtered & returned to circulation by the lymphatic system

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5
Q

what is fluid called when it is in the lymphatic system?
(function & anatomy of the lymphatic system)

A

LYMPH

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6
Q

what does lymph contain?
(function & anatomy of the lymphatic system)

A

WBC’s, plasma proteins, fats & debris

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7
Q

EQUILIBRIUM
(function & anatomy of the lymphatic system)

A

equilibrium is maintained as along as fluid entering interstitial vessels via arterioles EQUALS fluid leaving through venules & lymphatics
*EDEMA results if equilibrium is upset

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8
Q

LYMPHATIC VESSELS - contraction & pulse
(function & anatomy of the lymphatic system)

A

minor contractile capability & a pulse of 1-30 beats per minute
-the minor contraction is stimulated by stretching the vessels, either INTERNALLY by the vessels filling/ EXTERNALLY by light massage

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9
Q

how is majority of lymph flow stimulated?
(function & anatomy of the lymphatic system)

A

by movement of skeletal muscles, diaphragm when breathing, peristalsis & contraction of arteries where they are in contact with lymphatic vessels

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10
Q

LYMPHATIC FLOW

A

initial vessels
precollectors
collectors
ducts

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11
Q

INITIAL VESSELS
(lymphatic flow)

A

begin as tiny, delicate lymphatic capillaries
LACK VALVES

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12
Q

PRECOLLECTORS
(lymphatic flow)

A

connect subcutaneously to deeper vessels in limbs & trunk
HAVE VALVES

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13
Q

COLLECTORS
(lymphatic flow)

A

connect to larger vessels
HAVE VALVES

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14
Q

DUCTS
(lymphatic flow)

A

-largest lymph vessels which the collectors connect to
-drain into venous systems at subclavian veins just before vena cava

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15
Q

LYMPH DRAINAGE - DUCTS
(lymphatic flow)

A

-lymphatics of right arm, anterior & posterior right shoulder & right side of head: drain though RIGHT lymphatic duct
-lymphatics of rest of body: drain through THORACIC duct

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16
Q

CATCHMENTS

A

-clustering of several lymph nodes together that form a “bed” or collection
-responsible for collecting lymph from specific region of body
-generally found at “hinge” areas of body
-rate of lymph flow through catchments is SLOWER than through other vessels
-susceptible to blockage

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17
Q

two main catchments in the body

A
  1. AXILLARY (upper limbs)
  2. INGUINAL (lower limbs)
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18
Q

WATERSHEDS

A

-boundary line that gives regional organization to multiple lymphotomes (anatomic connections between groups of specific vessels & collecting capillaries to form a single pathway for lymph flow)
-high concentrations of anastomoses between body regions
-therapist can use watersheds to move lymph to area with less congestion

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19
Q

watersheds of TORSE

A

-one at level of clavicles & scapular spine
-one at umbilicus
-a vertical line at midsagittal line

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20
Q

EDEMA

A

excess amount of fluid in interstitium

21
Q

TYPES OF EDEMA

A

circulatory
lymphedema
traumatic

22
Q

CIRCULATORY EDEMA

A

-caused by dysfunction/ disease in cardiovascular system -> imbalance between dynamic forces of capillary filtration & reabsorption
-common causes: hypertension, venous insufficiency, kidney dysfunction, obesity
-function of lymphatic system is sufficient but temporarily overwhelmed by excess fluid in interstitium

23
Q

LYMPHEDEMA

A

dysfunction / failure in lymphatic system
(opposite of circulatory)
-primary
-secondary

24
Q

PRIMARY LYMPHEDEMA

A

-congenital / genetic defect in lymphatic development results in insufficient fluid return function of system
-usually evident in early childhood -> begins as swelling in legs

25
Q

SECONDARY LYMPHEDEMA

A

-when nodes / vessels of lymphatic system are damaged or destroyed
-scar tissue develops or catchment area is damaged & edema uptake / lymph movement are compromised
-common causes: surgery, radiation, infection, repeated compression

26
Q

TRAUMATIC EDEMA

A

localized & temporary swelling associated with soft tissue injury & exertion of exercise
*with lymphatic facilitation techniques, only traumatic edemas should be treated
-primary
-secondary

27
Q

PRIMARY TRAUMATIC EDEMA

A

amount of fluid actually spilled out of stretched & torn soft tissue

28
Q

SECONDARY TRAUMATIC EDEMA

A

amount of fluid drawn into area of damage due to increased interstitial oncotic pressure of that arm

29
Q

CAUSES OF EDEMA

A

-increased permeability of capillaries
-obstruction of lymphatic flow
-increased capillary pressure
-decrease of plasma protein

30
Q

increased permeability of capillaries
(causes of edema)

A

resulting from inflammation, tissue trauma, immune response or burns

31
Q

obstruction of lymphatic flow
(causes of edema)

A

due to infection, parasites in lymphatic system, lymphatic disease, surgical removal of lymph nodes, radiation treatment, scarring, reduced number of lymph vessels

32
Q

obstruction that leads to retention of plasma proteins which attract more fluid

A

low-flow, high protein edema

33
Q

increased capillary pressure
(causes of edema)

A

from heart failure, thrombophlebitis, pregnancy, generalized allergic reactions

34
Q

decrease of plasma protein
(causes of edema)

A

accompanying liver & kidney disease & starvation, following extensive burns

35
Q

lymphostatic edema

A

high-flow, low protein edema

36
Q

LYMPHEDEMA PT. 2

A

chronic accumulation of interstitial fluid in tissue (primary & secondary)

37
Q

symptom picture - EDEMA

A

-increase in interstitial fluid in affected body part
-lymphedema due to general systemic conditions -> affects entire body (puffy & congested)
-lymphedema due to local lymphatic obstruction -> involves whole limb distal to edema site (taut & firm/ puffy & congested)
-lymphedema from surgery -> returns to normal/ injury may provoke
-pain/ discomfort/ fullness
-decreased ROM, limb feels stiff & heavy
-local edema -> release of histamines
-increase in lymphatic return -> prevents scar tissue formation

38
Q

non-pitted edema

A

firm & discoloured
-coagulation of serum proteins in interstitial spaces -> following trauma / infection

39
Q

pitted edema

A

boggy to touch
-tissue retains indentation after pressure applied
-interstitial fluids exceed there absorption rate

40
Q

observations - EDEMA

A

-trauma: local/ distal to injury, taut & firm
-local lymphatic obstruction: whole limb distal to lesion site, taut & firm / puffy & congested
-general systemic conditions: affects entire body, swollen, puffy & congested
-reddening of skin: infection; bacterial, fungal

41
Q

CONRAINDICATIONS - edema

A

-chronic heart failure
-acute conditions due to bacterial/ viral infection
-low-protein edema due to kidney pathologies
-malignancy
-lymphatic obstruction by parasites

42
Q

what is MLD?

A

-technique developed in 1930’s by Emil Vodder, danish PT
-encourages lymph flow & reduces certain types of edema
-decreases pain & SNS
-reduce scar formation
-useful in treating edema that results from CT restrictions (post-surgical scarring)

43
Q

MLD techniques

A

-pressure of 20-40mmgH
-strokes repeated 5-7x -> toward the heart
-NODAL PUMPING
-STATIONARY CIRCLES
-LOCAL TECHNIQUE

44
Q

what is a contusion?

A

crush injury to a muscle
-damage to muscle fibers, bleeding into subcutaneous tissue & skin
-skin over contusion is intact

45
Q

HEMATOMA

A

-large area of local hemorrhage following trauma
-pooling of blood causes swelling & pain, compresses nearby nerve endings
-swelling more rapid than edema
-pain increases on movement / pressure applied

46
Q

MYOSITIS OSSIFICANS

A

-occasional complications following hematoma, blood within muscle calcifies
-fibroblasts replaced by osteoblasts -> lay down new bone over 6 weeks
-may form within muscle / existing bone
-strength of muscle decreases

47
Q

causes of contusions

A

-contact sports: collision
-MVA
-a fall

48
Q

CONTRAINDICATIONS - contusions

A

-active ROM in acute (prevent tissue damage)
-on site in acute (do not disturb hematoma)
-avoid removing protective muscle splinting (acute)
-frictions: anti-inflammatory medication

FCA (5 decks)

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