Chapter 8 Soft Tissue Management Techniques: Compression and Edema Management

Flashcards covering key concepts from the PTA 112 lecture on Soft Tissue Management Techniques focusing on compression and edema management.

What is edema?

An abnormal accumulation of fluid in the interstitial space.

Where does edema occur?

In interstitial spaces, the fluid-filled areas that surround cells.

What are the two types of edema presentations?

Acute localized edema (e.g., sports injury) and sustained swelling of a limb (lymphedema).

What three pathways does fluid travel through the body?

Circulatory system, lymphatic system, and interstitial spaces.

What is the role of the circulatory system?

It pumps fluid through veins and arteries; capillary bed exchanges nutrients and reabsorbs ~90% of blood.

What is the role of the lymphatic system in fluid balance?

It removes ~10% of fluid and all protein, returning them to circulation at the jugular angles.

Why is protein removal from interstitial spaces important?

Without it, death would occur within ~24 hours due to uncontrolled fluid accumulation.

What are the three functions of the lymphatic system?

Regulation of fluid balance, defense against infection/cancer, and transport of digestive fat from the gut.

What mechanisms assist lymph transport?

Musculoskeletal pump, respiratory pressure changes, intrinsic pulsation of deep lymphatic vessels, and gravity.

How much fluid and protein does the lymphatic system transport daily?

2–2.5 L/day and 80–200 g of protein.

What are the main types of edema?

Acute, venous, lymphatic, systemic (heart/kidney, generally pitting), and toxic edema.

What are primary lymphedema types?

Milroy’s disease, lymphedema praecox, and lymphedema tarda.

What are causes of secondary lymphedema?

Damage from trauma, surgery, infection, tumor obstruction, radiation, parasites, paralysis, or chronic venous insufficiency.

What is Stage I lymphedema?

Reversible: edema reduces with elevation; pitting edema present.

What is Stage II lymphedema?

Irreversible: edema remains despite elevation; fibrosis forms; minimal pitting.

What is Stage III lymphedema?

Elephantiasis: extensive tissue hardening, papillomas, massive limb size.

What is 1+ pitting edema?

Barely detectable.

What is 2+ pitting edema?

Slight indentation visible when skin is depressed.

What is 3+ pitting edema?

Deeper fingerprint, resolves in 5–30 seconds.

What is 4+ pitting edema?

Limb swollen 1.5–2 times normal size.

What should be included in edema patient examination?

Timing of symptoms, medical/surgical history, pain, self-treatment, medications/tests, functional limitations.

What should be documented in edema evaluation?

ROM, strength, joint stability, posture, sensation, skin integrity, edema measurement, vitals (BP, HR, pulses), wound description, function, Stemmer sign.

What are the goals of edema management?

Increase ROM, decrease pain and edema, improve skin integrity, normalize tissue temp, promote independent management.

What additional goals support long-term management?

Reduce recurrence risk via education, ensure proper device use, promote caregiver independence.

What interventions are used for edema?

RICE, exercise, aquatic PT, electrical stimulation, massage, complete decongestive therapy (CDT), intermittent compression devices.

What are contraindications for compression?

Circulatory obstruction, recent thrombophlebitis/DVT, CHF, infection in treated area, malignancy, unstable fracture, pulmonary edema/embolism.

What are indications for compression?

Chronic edema, lymphedema, hypertrophic scarring, new residual limb, DVT risk, stasis ulcers, venous insufficiency.

What are types of compression bandages?

Long stretch, medium stretch, and short stretch bandages.

What are intermittent compression devices?

Air-inflated sleeves placed over limbs with adjustable inflation pressure, cycles, and treatment times.

What is the inflation pressure range for intermittent compression?

30–100 mmHg (UE: 30–60 mmHg; LE: 40–80 mmHg).

What pressure limit should not be exceeded?

Do not exceed the patient’s diastolic pressure.

What is the on-off time range?

30s on/30s off to 4–5 min on/1–5 min off, based on comfort.

What is the treatment time range?

30 min up to 6–8 hours.

What measurements should be taken before and after treatment?

Circumferential limb measurements.

How does exercise help edema management?

Enhances venous and lymphatic flow through musculoskeletal pump.

Why combine compression with exercise?

Compression + isometric exercise maximizes pumping action.

What is the role of aquatic PT in edema?

Water immersion provides gradient compression, assisting fluid return.

How does electrical stimulation reduce edema?

Induces rhythmic contractions to enhance musculoskeletal pump.

What polarity principle applies in edema reduction?

Proteins/plasma have negative polarity; applying negative polarity repels them, moving fluid away.

How does massage help edema?

Reduces swelling by enhancing lymphatic and venous flow.

What technique is often used in massage for edema?

Deep effleurage, starting proximal to distal with elevation.

What should be documented in edema management?

Measurements pre/post, consistent timing, comparison with opposite limb, patient response, patient education/self-management.