What is Compression?
The application of a mechanical force that increases the external pressure on the body or body part
Compression is generally used to do what?
- Control peripheral edema caused by vascular or lymphatic dysfunction
- Improve fluid balance and circulation
- Prevent formation of DVTs
- Facilitate residual limb shaping after amputation
- Modify scar formation
How does compression improved fluid balance?
It increases hydrostatic pressure in the interstitial space, which means the fluid in the vessels is circulated rather than pooled
2 Edema classsifications
- Lymphatic edema
- Venous edema
Lymphatic edema vs. Venous edema
Lymphatic edema occurs when plasma proteins in the tissues stagnate owing to mechanical insufficiency of lymphatic drainage
Venous edema results from increased capillary pressure and venous obstruction
How is normal fluid equilibrium in the tissues maintained?
By the balance between hydrostatic and osmotic pressures inside and outside of the blood vessels
Higher hydrostatic pressure inside the vessels acts to push fluid ___ of the vessels
OUT
Higher protein concentration and osmotic pressure inside the vessels act to keep fluid _____ the vessels
INSIDE
Which is higher, hydrostatic or osmotic pressure? What does this result in?
Hydrostatic pressure which results in a slight loss of fluid into the interstitial space
The interstitial fluid is taken up and returned to the venous system via what?
the lymphatic system
3 effects of external compression
- Improve venous and lymphatic circulation
- Limits the shape and size of tissue
- Increases tissue temperature
How does compression improve venous and lymphatic circulation?
- By increasing the hydrostatic pressure in the interstitial space
- By limiting the outflow of fluid from vessels into the interstitial space
- By milking” the fluids from the tissues
8 major causes of edema
- Venous or lymphatic obstruction or insufficiency
- Increased capillary permeability
- Increased plasma volume due to sodium/water retention
- After trauma, surgery or burns
- With infections
- After exercise
- Airplane travel
- Pregnancy
6 other causes of edema
- Congestive heart failure
- Liver failure
- Acute renal disease
- Diabetic glomerulonephritis
- Malnutrition
- Radiation injury
What is the primary factor propelling lymphatic and venous flow?
Muscle contractions
What 3 things cause venous insufficiency?
- Lack of physical activity
- Degenerated valves
- Mechanical obstruction of the veins by a tumor or inflammation
What is phlebitis?
Inflammation of the veins
How does phlebitis increase hydrostatic pressure?
By the thickening and loss of elasticity of vessel walls
What 2 things does phlebitis result in?
- Decreased circulation of deoxygenated blood out of the veins and increased venous pressure
- Dependent position further increases hydrostatic pressure
3 unique characteristics of venous edema
- Generally it is a soft pitting edema
- It has a tendency to pool in the distal extremities
- The skin has a glossy, shiny appearance
What is lymphedema?
It is a condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system
What is the most common cause of venous or lymphatic edema?
Infection
What is the result as plasma proteins are laid down in the tissues over time?
subcutaneous tissue fibrosis and hard induration of the skin
Most effective therapeutic treatment of edema
Low pulse rate electrical stimulation accompanied by elevation
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Intro to Physical Agents24
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Electromagnetic Radiation32
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Inflammation and Tissue Repair57
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Aquatic Therapy34
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Mechanisms of Pain42
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Tone Abnormalities44
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Motion Restrictions6
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Thermal Agents57
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Thermal Agents (part 2)15
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Ultrasound71
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Diathermy39
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Lasers40
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Ultraviolet Radiation22
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Traction42
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Hydrotherapy40
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Compression54
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Massage Therapy41
