Edema/Lymphedema/Vascular Disorders

Question 1

what is edema?

Answer 1

excess fluid in the body tissues, primarily in the extracellular compartment (interstitial)
results from either abnormal leakage of fluid across the capillaries from the plasma into interstitial spaces (increased filtration) or from failure of the lymphatic system to adequately return fluids from the interstitium to the blood. Can be local or generalized. It is a “dynamic insufficiency”
the lymphatic loaid is higher than the transport capacity

Question 2

what is lymphedma?

Answer 2

protein rich fluid which develops from low output failure due to a damaged or malformed lymphatic system. It is caused by an abnormal accumulation of protein-rich fluid in the extracellular space of skin and subcutaneous tissue. It is a mechanical insufficiency.
The transport capacity is lower than the lymphatic load

Question 3

what provides the major blood supply to the hand?

Answer 3

the superficial palmar arch, which is a continuation of the ulnar artery, and then deep palmar arch, which is a continuation of the radial artery

Question 4

what is Laplace’s law?

Answer 4

explains the importance of graded compression using elastic materials. It states: the radius of a cylinder (extremity) is increased, the tension needs to be increased to achieve the same pressure.” THis means that if compression is applied on a cylinder using equal tension, the pressure is greatest whre the radius of the cylinder is smallest. Therefore, more padding is used at the dorsal hand, wrist, distal forearm, and cubital fossa to obtain the cylindrical effect

Question 5

Above what pressure level to lymph vessels collapse?

Answer 5

above 45 mm/Hg

Question 6

why is use of intermittent pneumatic compression pumps not indicated for lymphedema?

Answer 6

THey may collapse lymph vessels. Movement and decongestive exercise are more beneficial. Pumps remove water content from the extremity, but DO NOT remove protein molecules, which is the main component of lymph fluid. THis leaves the tissues thicker and more prone to the development of fibrotic lymphedema, which is more difficult to decongest.

Question 7

why is diaphragmatic breathing effective for MEM?

Answer 7

1. respiration changes tissue pressure and stimulates lymphatic absorption
   2.it changes pressure in the thoracic duct, which helps propel lymph centrally towards the subclavian veins
2. pressure changes create a vacuum, pulling the lymph fluid from the peripheral structures centrally

Question 8

what is hypothenar hammer syndrome?

Answer 8

ulnar artery thrombosis due to repetitive trauma against the hook of the hamate. Most often seen in males doing manual labor who use their palm as a hammer or expose it to repetitive trauma. 80-90% of ppl diagnosed are smokers

Question 9

how many compartments are in the forearm and hand?

Answer 9

3 in the forearm and 10 in the hand

Question 10

what is normal tissue pressure in a compartment?

Answer 10

8-10 mm Hg

Question 11

what is the most common cause of inflammation of the lymphatic system and lymphedema?

Answer 11

Parasitic infection
lymphatic filariasis caused by threadlike, parasitic filarial worms – Wucharia Bancroft – that live almost exclusively in humans and is endemic in the tropics/subtropics. Transmitted when an infected mosquito bites a person

Question 12

what type of e-stim is hypothesized to be good for lymphedema?

Answer 12

high voltage pulsed direct current

Question 13

what is interstitium?

Answer 13

composed of fluid, proteoglycan filaments, and collagen fiber bundles which make it gelatinous in density. THis gelatinous substance holds our cells together

Question 14

how much of the human body is made up of interstitium?

Answer 14

1/6