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ACOLS CLT Certification > Final > Flashcards

Final Flashcards

1
Q

Who discovered cisterna chyli and it’s continuum with thoracic duct?

A

Jean Pecquet

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2
Q

Which vertebrae do cisterna chyli exist

A

T11 - L2

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3
Q

Who used mercury injections to depict lymphatics?

A

Marie Sappey

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4
Q

Who created the term complete decongestive therapy (CDT)?

A

Földi

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5
Q

What are the components of CDT?

A 
MLD
Compression
Skin care
Decongestive exercises
Patient education
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6
Q

Vodder said MLD should not be labeled massage. Why?

A

massages deep. MLD is superficial and ABOVE the fascia

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7
Q

Edema versus lymphedema

A

Edema is an accumulation of water in the tissue. Edema is a symptom. Dynamic insufficiency of the lymphatic system

Lymphedema is abnormal accumulation of water and protein. It is a disease process. Mechanical insufficiency of the lymphatic system

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8
Q

What does ALND stand for?

A

Auxiliary lymph node dissection

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9
Q

The most common cause for lymphedema in the United States is what?

A

ALND and breast cancer surgery

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10
Q

What is the most common cause of secondary llymphedema globally?

A

filariasis

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11
Q

Although not reported, we are discovering that ___ is also a frequent cause of lymphedema seen in practice today in the United States

A

obesity

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12
Q

The Lymphatic load of water is called what?

A

Net filtrate

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13
Q

How much water is returned to the Venous system via the thoracic duct in 24 hours?

A

2-4 liters

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14
Q

What is the pathway of FAT to the venous angle?

A 
small intestines
Gastrointestinal trunk
cisterna chyli
Thoracic duct
Venous angle
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15
Q

What is the pathway for initial lymph capillaries?

A

initial lymph capillaries
Pre-collectors
Collectors
Lymph nodes

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16
Q

What is the responsibility of the perforating pre-collectors?

A

Transfers lymph from superficial to deep lymphatic system

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17
Q

What is the unorganized pathway towards lymph capillaries where interstitial fluid flows? It covers the entire body surface

A

initial lymph vessel plexus

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18
Q

Where do the lymphatic collectors reside?

A

located in the superficial fatty tissue above the fascia

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19
Q

How does a smooth muscle react to a smooth slow stretch?

A

Contraction

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20
Q

What is the pathway for the inguinal lymph nodes of the lymphatic system?

A 
LR pelvic Inn
LR lumbar inn
LR lumbar trunk
Cisterna chyli 
Thoracic duct
Venous angle
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21
Q

auxiliary lymph nodes converge to form the ___?

A

subclavian trunk

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22
Q

Where are the bulk of auxiliary lymph nodes located?

A

located between the pectoralis and the latissimus dorsi muscles

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23
Q

Where do the auxiliary lymph nodes drain?

A

drains into both the supraclavicular lnn and auxiliary lnn

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24
Q

Where does the upper quadrant of the lymphatic system drain into?

A

auxiliary Lnn

25
Q

Where does the lower quadrants of the lymphatic system drain into?

A

inguinal lnn

26
Q

Where does the lymph above upper horizontal watershed drain into?

A

cervical lnn

27
Q

name the five anastomoses

A 
AAA: anterior axillo-axillary
AII: anterior inter-inguinal
AI or IA: axillo-inguinal or inguinal-axillary
PAA: posterior axillo-axillary
PII: posterior inter-inguinal
28
Q

What is the pathway of lymph fluid to the left Venus angle?

A 
L/R lumbar trunks
Gastrointestinal trunk
Cisterna chyli
Thoracic duct
Left venous angle
29
Q

What’s another word for Venous angles?

A

Terminus

30
Q

What is the junction of the Venus angle?

A

internal jugular and subclavian veins

31
Q

Where are the Venous angles located?

A

Venous angles are located 2.5–3 inches deep into the supraclavicular fossa

32
Q

what are the skin areas that drain into the left venous angle?

A 
both lower quadrants
Both lower extremities
External genitalia
Left upper quadrant
Left side of head/face/shoulder
Left Upper extremities
33
Q

What are the skin areas that drain into the right Venous angle?

A

right upper quadrant
Right arm
Right head/face/shoulder
300ml (soda can)

34
Q

What are the borders of the lateral cervical triangle for the deep cervical lymph nodes?

A

Anterior: SCM
Posterior: upper trapezius
Inferior: clavicle

35
Q

What are the general effects of MLD?

A

increase in lymph production

Increase in lymphangiomotorcity

reverse of lymph flow

Increase in Venus return

Soothing

Analgesic

36
Q

Describe stationary circles

A
37
Q

Describe pump technique in MLD

A
38
Q

Describe pump – push technique in MLD

A
39
Q

describe “short neck” technique in MLD

A
40
Q

describe neck/face sequence technique in MLD

A
41
Q
A

1) lymph capillary
2) precollector
3) collector 

42
Q
A
43
Q
A
44
Q
A
45
Q
A
46
Q

Is CDT a good plan of care for hypoproteinemia patients?

A

no

47
Q

Dynamic insufficiency

A 
– Healthy LS
- TC is normal
– LL load of water is higher than normal TC
– Protein concentration in tissue is normal
– High volume insufficiency
- MLD/CDT not indicated
- Max LTV equals TC
- Edema
48
Q

Mechanical insufficiency

A 
– Unhealthy LS
– TC is subnormal
– LL could be normal but higher than subnormal TC
– Protein concentration in tissue is higher than normal
– low volume insufficiency
– MLD/CDT indicated
- max LTV = TC subnormal
- lymphedema
49
Q

Combined insufficiency

A

When mechanical insufficiency is present and something happens and causes an increase in lymphatic load causing lymphedema

50
Q

Examples of dynamic insufficiency

A 
Systemic
Acute CHF
Renal and liver failure
System infection
Acute sprain/strain
Post op
Trauma
51
Q

Examples of mechanical insufficiency

A 
surgery Dash a LND
Severe burns
Radiation
Severe trauma
Scars
52
Q

what is the primary lymphedema classification?

A

– Congenital 10–25% (<2 yrs)

  • Lymphedema precox 65 to 80% (ages 2-35)
  • lymphedema tarda 11% (>35)
53
Q

What is the most common cause of primary lymphedema?

A

hypoplasia - fewer collectors

54
Q

List the stages of lymphedema

A

Stages 0-3

55
Q

Define stage 0 Lymphedema

A

Lymphangiopathy, pre-stage, latency

No visible swelling
TC is subnormal
Normal consistency

56
Q

Define stage 1 lymphedema

A

reversible
Edema is soft ( pitting )
Elevation reduces swelling
No secondary skin changes

57
Q

define stage 2 lymphedema

A 
Spontaneously irreversible.
Skin hardens.
Pitting is difficult.
Frequent infections.
Stemmer sign (+)
Fibrosis
58
Q

define stage 3 lymphedema

A 
lymphostatic elephantitis.
Skin breakdown
Deepening of natural skin folds.
Usually increase in limb size.
Frequent infections

59
Q

Constant compression has a ___ effect

A

fibrinolytic

ACOLS CLT Certification (8 decks)

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