Pain and Oedema

Question 1

Define oedema 2

Answer 1

1. Commonly known as swelling
2. accumulation of fluid: cells/ interstitial spaces

Question 2

How is oedema classified? 4

Answer 2

1. Pathophysiological mechanism
2. Location
3. Clinical finding
4. Organ specific

Question 3

Describe the location classification of oedema 2

Answer 3

Oedema can either be:

1. Generalized: cardiac, hepatic, renal or endocrine
2. localized: venous, lymphatic, angioedma or allergy/inflammation

Question 4

Describe the clinical finding classification of oedema 2

Answer 4

Oedema can either present with:

1. Pitting (liver, kidney or heart)
2. Non-pitting (lymphatic system or thyroid)

Question 5

Describe the organ specific classification 1

Answer 5

When oedema is organ specific we term it ascites (brain, lung, peritoneum)

Question 6

Describe how hydrostatic pressure results in oedema

Answer 6

Fluid within the blood vessels causes water to filter out into the tissue

Question 7

Describe how oncotic pressure results in oedema

Answer 7

Proteins draw water back into the blood vessels

Question 8

What does oedema result from? 5

Answer 8

1. Decreased cappillary/plasma oncotic pressure/ colloid osmotic pressure
2. Increased capillary hydrostatic pressure
3. Increased tissue/interstitial oncotic pressure
4. Increased capillary permiabiliity
5. Inadequate lymphatic drainage

Question 9

In the pathophysiology of oedema, describe increased hydrostatic pressure 3

Answer 9

1. Hydrostatic pressure > oncotic pressure
2. No fluid reabsorption
3. Oedema

Question 10

In the pathophysiology of oedema, describe decreased oncotic pressure 4

Answer 10

1. Reduced albumin synthesis in liver or malnutrition
2. decreased plasma oncotic pressure
3. increased movement into tissue (osmosis)
4. Oedema

Question 11

In the pathophysiology of oedema, describe lymph obstruction 6

Answer 11

Impaired lympatic drainage because of:

1. Radical mastectomy
2. pressure on lymph ducts
3. inflammation of lymphatics
4. occlusion of lymphatics
5. malignancy
6. Milroy’s disease

Lymph oedema

Question 12

In the pathophysiology of oedema, describe sodium and water retention 4

Answer 12

1. Hypovolaemia
2. Renal vasoconstriction: renin-aldosterone/ ADH
3. Renal retention of sodium and water
4. Oedema

Question 13

In the pathophysiology of oedema, describe inflammation 4

Answer 13

1. Injury/ tissue damage
2. increased tissue permeability to proteins
3. decreased oncotic pressure
4. oedema

Question 14

List the pathophysiological mechanisms that cause oedema 5

Answer 14

1. increased hydrostatic pressure
2. decreased oncotic pressure
3. lymph obstruction
4. sodium and water retention
5. inflammation

Question 15

List the types of oedema 10

Answer 15

1. peripheral
2. pedal
3. pulmonary
4. cerebral
5. angioedema/ allergic reaction
6. heriditary angioedema
7. papilledma
8. macular edema
9. dependant edema
10. scrotal edema

Question 16

What are the causes of edema? 10

Answer 16

1. medication
2. excessive salt intake
3. menopause and pregnancy
4. malnutrition
5. burn
6. heat
7. diseases: kidney, heart, lungs, liver and brain
8. diabetes
9. allergies
10. obstructive sleep apnea

Question 17

What is done to diagnose oedema? 7

Answer 17

1. Blood tests
2. liver function tests
3. heart function tests
4. venous ultrasonography
5. lymphoscintigraphy
6. urine tests
7. chest xrays

Question 18

Fill out the oedema assesment table 8

Answer 18

Question 19

List the treatments of oedema 7

Answer 19

1. Diuretics
2. decrease salt intake
3. anticoagulant therapy
4. oxygen
5. compression stocking
6. body position: elevation
7. exercise/ massage/ electrotherapy