Deck 8: Soft Tissue Management Techniques: Compression and Edema Management

Question 1

Why is the application of ice to an edematous area the treatment of choice in some situations?

A)The patient may have a history of Raynaud's phenomenon.
B)It may cause a reflex vasodilation if applied longer than 10 to 20 minutes.
C)It often does not permit elevation of the part during the application.
D)It can minimize accumulation of fluid when used appropriately.

Answer 1

D

Question 2

The lymphatic system normally transports approximately 2 to 2.5 liters of fluid per day and 80 to 200 grams of protein back to the circulatory system. What structures filter the lymphatic fluid, and why?

A)The lymphocytes; they reduce the pressure in the lymphatic system to maintain homeostasis.
B)The macrophages; they remove foreign substances and reduce hydrostatic pressure.
C)The lymph nodes; they remove foreign substances and fight infection.
D)The lymph nodes; they remove foreign substances and reduce blood pressure.

Answer 2

C

Question 3

Which of the following statements is most accurate regarding edema assessment techniques?

A)The use of a tape measure for girth measurements is not reproducible.
B)Water displacement is preferable to girth measurements.
C)Both water displacement and calculated volume for the upper extremity are acceptable, but they are not interchangeable.
D)Water displacement and calculated volume for the upper extremity are both acceptable and interchangeable.

Answer 3

C

Question 4

When would elevation of a body part be contraindicated and inappropriate as a potential remedy to assist in edema reduction?

A)If the limb is elevated above the heart
B)If the limb is acutely edematous
C)If the limb is ischemic
D)If the limb is comfortable in an elevated position

Question 5

Localized acute tissue trauma will cause edema that is characterized by which of the following?

A)Hematoma formation
B)Pain
C)High protein content
D)Low protein content

Question 6

In a normal state, how much of the fluid that is filtered out of the capillary bed on the arterial side is reabsorbed on the venous side?

A)100%
B)90%
C)80%
D)50%

Question 7

Which of the following is NOT a major pathway for fluid to travel through the body?

A)Circulatory system
B)Edema
C)Lymphatic system
D)Interstitial spaces between cells

Question 8

Which of the following statements is true regarding the lymphatic system?

A)The gaps in the lymph vessels are equal in size to the gaps in blood vessels.
B)The lymphatic system is a one-way system.
C)Deeper lymphatic vessels do not have valves that prevent backflow.
D)It is one of two systems that remove protein from the interstitial spaces.

Question 9

Which of the following is NOT a function of the lymphatic system?

A)Regulation of fluid balance through the transport of fluid and proteins
B)Regulation of fluid balance through the transport of blood
C)Defense against infection as a part of the immune system
D)Transport of digested fat from the gut

Question 10

RICE therapy has been the intervention of choice since the 1950s in the first 24 to 72 hours after injury. This acronym stands for Rest, Ice, Compression, and Elevation of the affected body part. How long should the rest component last and why?

A)There should not be a period of rest; this form of treatment is incorrect based upon more current data.
B)The rest component should be very brief to maintain mobility of the part and make the reabsorption of fluids easier.
C)The rest component should last for weeks to allow for the area to heal before being stressed.
D)The rest component should last indefinitely to ensure that the area does not become edematous.

Question 11

Which of the following metabolic disease states can cause increased capillary pressure due to a venous obstruction from pooling of blood in the veins?

A)Malnutrition
B)Congestive heart failure
C)Liver disease
D)Hypothyroidism

Question 12

The heart is responsible for pumping fluid through an extensive network of vessels divided into an arterial side and a venous side. If the arterial side were impaired, which of the following structures/systems would not be working efficiently?

A)Capillary beds
B)Interstitial spaces where fluid and nutrients leave the capillary beds
C)Reabsorption of by-products of metabolism and fluids
D)The lungs

Question 13

Compression increases the hydrostatic pressure in the tissues, decreasing the ultra-filtration out of the damaged capillaries and increasing the absorption of fluid by the veins and fluid and proteins by the lymphatic vessels. What is the recommended pressure range for intermittent compression devices, and why?

A)30 to 60 mm Hg for the upper extremity and higher for the lower extremity, due to the girth difference between the upper and lower extremities
B)Below 30 to 40 mm Hg, due to inaccurate control of the actual pressure created by the devices or the potential damage to the superficial lymphatic vessels
C)40 to 80 mm Hg for the lower extremity and lower for the upper extremity, due to the girth difference between the upper and lower extremities
D)20 mm Hg less than the patient's diastolic pressure to decrease the risk of closure of the lymphatic vessels

Question 14

Which of the following acts as an extrinsic pump in the lymphatic system, similar to the function that the heart fulfills in the circulatory system?

A)Patient positioning and gravity
B)Gravity, musculoskeletal contraction, and respiratory pressure changes
C)The arterioles and venules within the circulatory system
D)The heart

Question 15

Which of the following signs would be consistent with venous edema but not with acute edema?

A)Loss of the normal contours of the leg
B)Redness
C)Localized
D)Painful to palpation

Question 16

Of what potential benefit would an aquatic exercise program be for individuals with leg swelling of non-metabolic origin and who have a stable cardiovascular system, and why?

A)Water exerts compression on the immersed body part, which would make it too difficult for the patient to move in the aquatic environment.
B)Water exerts compression on the immersed body part, with the distal portion of the limb receiving the greatest pressure.
C)Water exercise would be inappropriate because of the placement of the part in a dependent position; otherwise, exercise would be beneficial.
D)Water exerts too much compression on the immersed body part; with the distal portion of the limb receiving the greatest pressure there is a risk of blocking the lymphatic vessels.

Question 17

What is the only physiological mechanism to remove proteins from the tissues?

A)Circulating blood
B)Lymphatic system
C)Immobilization
D)Respiration

Question 18

What is the significance of the removal of proteins along with the excess fluid from the interstitial spaces by the lymphatic system?

A)Removal of the proteins permits cell walls to collapse.
B)The lymphatic system acts as a "sewer system" to remove debris.
C)The removal of proteins along with excess fluid is an essential function, without which we would die within about 24 hours.
D)The removal of proteins encourages the rapid spread of bacteria through the tissues.

Question 19

The composition of the lymphatic system's "gel matrix" enables what to occur?

A)Absorption of less fluid than in the normal state
B)Absorption of more fluid than in the normal state
C)The capacity to increase its flow rate by tenfold
D)The capacity to decrease its flow rate by 90%

Question 20

What effect does therapeutic exercise have on lymphatic flow?

A)It is contraindicated.
B)It decreases venous and lymphatic flow.
C)It has no effect on venous and lymphatic flow.
D)It enhances venous and lymphatic flow.