Body Systems: Lymphatic System Flashcards
lymphodema
abnormal collection of lymph usually in the extremities
lymphoedema ss
- swelling of extremity and gross distension
- no pain
lymphoedema etiology
- inflammatory or mechanical
- if untreated, connective tissues loses elasticity nd edema becomes permanent
- lymphatic circulation may be compromised by infection, neoplasm, thrombosis
- allergic reactions, trauma, surgery may be implicated
- tight clothing tat constrict vessels can cause temporary lymphoedema
- women who had mastectomies my experience lymphedema in the adjacent arm
- stagnant interstitiel fluids are breeding ground for infection and toxins
lymphoedema prognosis
- varies and depends on cause
- surgical intervention usually has positive outcome
- not life threatening but carries danger of uncontrolled infection
lymphoedema diagnosis
- painless swelling suggest lympoedema
-,lymphangiography, radioactive isotope studies
lymphoedema treatment
- remove construction
- reduce swelling via elastic bandages or stockings
- affected limbs elevated above heart to encourage drainage
- diuretics reduce fluid volume
- surgery to relive mechanical obstruction
- antibiotics if infection
lymphoedema prevention
- many cases are not preventable
- avoid tight clothing
lymphangitis
inflammation if lymph vessels
lymphangitis ss
- red streak at site of entry of infective organism that extends to regional lymph node
- swollen and tender lymph node
- cellulitis in surrounding tissue
- general infection involving fever, chills, malaise
lymphangitis etiology
- bacterial invasion into lymph vessels at site of local trauma or ulceration
- occasionally entry side undetectable
- bacteria travel to regional lymph node and stimulate inflammation
lymphangitis prognosis
- varies depending on amount of tissue involved and nature of causative organism
- surgical intervention usually positive outcome
lymphangitis diagnosis
- visual inspection of area
- blood tests indicating leukocytosis
- cultures of infected tissue
lymphangitis treatment
- systemic antibiotics
- elevate unrest affected area
- apply warm and wet dressings
- surgical drainage of purulent material
lymphangitis prevention
- cannot be prevented
- good hand washing prevents infection
lymphoma
- malignant neoplasms arising form uncontrolled proliferation of cellular components of lymph systems
- dysfunctional cells may be B, T cells or both
- neoplastic lymphocytes are migratory and not only found in lymph structure, but also bloodstream, bone marrow, non-lymph organs
- treatment determined by cell type and stage
- 2 categories: Hodgkin’s disease and non-Hodgekin’s lymphoma
- both types of lymphoma are staged using Ann armour Cotswolds staging system considering the neoplastic involvement of lymph structures, extra nodal tumour sites, presences or absence of systemic symptoms
lymphoma staging
stage 1: single lymph structure or region involved
stage 2: two or more lymphs structures involved with involvement being on these same side of the diaphragm
stage 3: lymph region of both sides of the diaphragm are involved
stage 4: widespread involvement of extra nodal tissue above and below the diaphragm
- each stage either an A or a B indicating whet any of the B symptoms are absent (A) or present (B)
- B symptoms: unexplained weight loss of more than 10% of body eight in 6 months, persistent or recurrent fevers above 38C, recurrent drenching night sweats
Hodgkin’s disease
cancer of bodies lymphatic system involving cell proliferation and interference with normal functioning by collecting in masses in various parts of the body
Hodgkin’s disease ss
- painless enlargement of lymph nodes in neck or mediastinum
- fatigue
- alcohol induced pain
- pruritus (itching)
- B symptoms as disease progresses
Hodgkin’s disease etiology
- represents 15% of all lymphomas
- peak incidents: 20s, over 50
- risk factors: previous malignancy, chemotherapy, radiation, family, history, immunosuppression
- tumours arise in tissues of lymph nodes and spread to other lymph nodes, spleen, liver, bone marrow
Hodgekin’s disease prognosis
- one of the most treatable forms of cancer, can be cured
- five year survival rate approaches 90%
- death can result form Hodgkin’s disease or secondary cancers
- B symptoms, low serum albumin and hemoglobin, male, over 45, anemia, leukocytosis indicate poor prognosis
Hodgkin’s disease diagnosis
- node biopsy showing reed-sterner cell in lymphatic tissue, a large cell with 2 or more mirror image nuclei, each with a single nucleolus
- blood studies indicate mild, normochromic normocytic anemia, neutrophilic leukocytosis, lymphopenia, esinophils
- elevated ESR
- bone marrow biopsy
- CT scans of chest, abdomen, pelvis to determine extent
- liver,= and kidney function tests
Hodgkin’s disease treatment
- stage 1,2: radiation therapy or combined chemoradiatherapy
- stage 3, 3B: combined chemoradiotheraoy
- stage 4: chemotherapy alone
- relapses: additional chemotherapy, bone marrow transplantation for multiple relapses
Hodgkin’s disease prevention
none known
non-Hodgkin’s lymphoma
heterogenous neoplasms of lymphoid cells
non-Hodgkin’s lymphoma ss
- painless lymphadenopathy
- slow, indolent growth to rapid fatal progression
- enlargement fo tonsils and adenoids
- fatigue
- pruritus
- bone pain
- GI symptoms
- B symptoms
non Hodgkin’s lymphoma etiology
- peak: preadolescence, increasing age
- risk factors: history malignancy, radiation, immunotherapy, chemotherapy, HIV, HTLV, EBV, hepatitis C, immunosuppression, connective tissue disorders
- 3 categories: depends on how aggressive neoplasm is
- indolent: 35-40% follicular lymphoma most common, small lymphocytic, mantle cell, marginal zone, can arise from B/T/NK
- aggressive: 50% diffues and peripheral T cell most common
- highly aggressive: 5%. burkitt’s adult T cell
non Hodgkin’s lymphoma prognosis
- some can be cured
- five year survival 53%
- indolent: not curable with treatment generally
- aggressive: curable but rapidly fatal if not treated
non Hodgkin’s lymphoma diagnosis
- physical examination
- excision biopsy
- bone marrow aspiration and biopsy
- lab tests, blood tests, renal and liver function
- chest radiography, CT of abdomen and pelvis
- GI endoscopy
- MRI if neurologic signs present
non-Hodgkin’s lymphoma treatment
- indolent: watchful waiting, chemotherapy, radiation though not curable
- aggressive: chemotherapy with or without radiation therapy
- relapses: high dose chemotherapy followed by bone marrow transplantation
- periodic follow up
non Hodgkin’s lymphoma prevention
none known
transfusion incompatibility reaction
blood or blood product transfusion has antibodies to recipients RBCs or recipient has antibodies to donors RBCs
transfusion incompatibility reaction ss
- hypersensitivity can range form mild to fatal
- haemolysis
- agglutination
- bacterial, allergic, circulatory overload transfusion reactions
- chills and fever
- tachycardia
- serve: back pain, vomiting, diarrhea. hives rash, substernal tightness, dyspnea, hypertension, circulatory collapse, bleeding form puncture site, blood in urine, renal failure
- most frequently associated with abcs: febrile and short lived, no hemolysis or allergy
transfusion incompatibility reaction etiology
- ABO and RH incompatible blood as well as antigens the screening does not reveal cause an antigen antibody reaction
- histamine and serotonin related from mast cells and platelets
- disseminated intravascular coagulations usually triggers leading to coagulations problems
transfusion incompatibility reaction prognosis
varies depending on amount of blood infused, cause, speed of intervention
transfusion incompatibility reaction diagnosis
- chills, fever, gives, back pain, dyspnea during transfusion
- analysis of blood and urine
transfusion incompatibility reaction treatment
- stop blood transfusion
- antihistamines
- more aggressive treatment for anaphylaxis
transfusion incompatibility reaction prevention
- prevention is best form of treatment
- careful typing and crossmatching of blood products