Oedema Flashcards
What are some important cardinal features to ask about regarding oedema?
- Site
- Quality
- Onset/Time
- Severity
- Context
- R/A Factors
- Associated features
What are some considerations when looking at oedema for Site?
- where?
- One limb/two?
- moving?
- Changing?
- use a pen to demarkate borders?
What are some considerations when looking at oedema for Quality?
- pitting?
What are some considerations when looking at oedema for Onset?
Fast/slow?
What are some considerations when looking at oedema for Time Course?
- sudden: could be DVT, anaphylaxis
- Slow: could be HF; renal failure
What are some considerations when looking at oedema for Severity?
- how much?
- how bad is it?
What are some considerations when looking at oedema for Relieving/Aggravating factors?
- putting it up? lying down?
- Standing?
What are some considerations when looking at oedema for Context?
- could indicate MI? anaphylaxis? HF? etc.
What are some considerations when looking at oedema for Associated Features?
HF: dyspnoea, fatigue, orthopnoea, paoxysmal nocturnal dyspnoea
DVT: pain (chest pain) - one leg not two
What are some of the mechanisms of oedema?
- increased hydrostatic pressure due to extra fluid/no venous return –> HF
- decreased oncotic pressure because of decreased blood proteins –> cirrhosis
- increased capillary permeability –> allergy, anaphylaxis, septic shock
- obstruction of lypahtics –> lymphoedema (can be caused by lymph removal or parasitic infiltration)
What are some typical locations of oedema?
- lower limbs –> volume overload ie. HF
- unilateral leg –> DVT
- generalised –> increased capillary permeability
Explain the water within the body?
- the body’s water is comaprtmentalised into intracellular water (2/3 total) and extracellular water (1/3)
- extracellular water is then compartmentalised into plasma and interstitial fluid.
- capillary walls allow small amounts of fluid to cross from plasma to interstitium so that oxygen and nutrients can be transported for metabolism.
- the lymphatic system then returns that water.
What elements control the distribution of fluid between the plasma and interstitium?
- permeability of capillary walls
- balance between osmotic and hydrostatic pressure (Starling)
What is oedema?
- accumulation of fluid in the interstitial space between cells.
What is oedema?
- accumulation of fluid in the interstitial space between cells.
