L9 Lymphedema Flashcards
Lymphedema definition
- chronic and slowly progressive disease that results in swelling in the body
- abnormal or excessive accumulation of protein enriched fluid in the tissue spaces of the body
- Impairment in the reabsorption/transportation of protein molecules within the lymph system
- Leads to fibrosis, abnormal adipose deposition and overgrowth of connective tissue
Purpose of lymphatic system
runs throughout your body
filter toxins and waste
keeps body fluids levels in balance
defends against infection
absorbs fat in digestive system
Lymphatic system is made up of
lymph organs, fluid, vessels, nodes
Lymph nodes
filter bacteria, waste and cellular debris
contain immune cells like lymphoctyes and macrophages
regulate fluid volume
Lymph fluid
derived from interstitial fluid
contains RBCs and WBCs, lymphocytes, fat, water, protein, cellular debris
approx 75-100 g of protein are transported by lymphatic system daily
Lymphatic Vessels
thin-walled tubes that carry lymph fluid
similar to blood vessels, but have valves that prevent backflow of fluid
collect lymph from interstital spaces and transport to lymph nodes
Lymph capillaries
tiny, microscopic vessels that collect excess fluid from interstitium
allow fluid, protein, and cellular debris to enter
drained by vessels and processed by nodes
can be crushed by adiposity
What tissues are lymphatic capillaries not present in?
CNS, bone marrow, avascular tissue
Once fluid enters the lymphatic capillaries it is called
lymphatic fluid
volume = lymphatic load
Lymphatic ducts
lymphatic vessels move into larger ducts that drain the lymph back into the bloodstream
Thoracic duct and right lymphatic duct
Thoracic Duct
largest lymphatic vessel
collects lymph from lower half of body and left side of the body
drains into the left subclavian vein, returns lymph to bloodstream
Right lymphatic duct
collects lymph from the right side of upper body
drains into right subclavian vein, returns lymph to blood stream
Lymphangion
functional unit of lymphatic vessel
segment of lymphatic vessel between two valves that contracts and propels lymph forward during lymphatic pumping mechanism
creates a unidirectional flow of lymph towards nodes
Lymphangion contracts
valves downstream close
prevents backflow of lymph fluid
Lymphangion relaxes
valves upstream open
lymph fluid moves upwards
Transport capacity
the max amount of fluid the lumpahtic system can carry
in healthy intact system, the transport capacity exceeds the lymphatic load almost 10x
When the lymphatic load exceeds the lymphatic transport capacity…
fluid balance is disrupted, protein rich fluid accumulates in the interstitium, and macroscopic swelling or lymphedema occurs
Transport capacity
maximum amount of lymph that can be transported by the body in a given length of time (size of the sink)
Under normal lymphatic circumstances
the lymph system can compensate for increases in lymphatic load (water filling the sink)
things exercising, sunbathing, and hot tubbing can increase load
Lymph time volume
the amount of lymph transported per unit of time
Dynamic Insufficiency
occurs when HEALTHY lymphatic system is overwhelmed
the drain can’t keep up with the faucet, the lymph time volume is maxed out
if dynamic insufficiency is present over time, secondary damage can occur
Mechanical Insufficiency
transport capacity of lymph system is decreased
low volume insufficiency, there is something blocking the drain
caused by surgery, radiation, trauma, infections, chronic venous insufficiencies, congenital malformations
Subjective Exam for Lymphedema
Family history of primary lymphedema
history of cancer treatment like radiation, lymph node dissection
travel to areas with high rates of mosquitos
BMI >50
progressive enlargement of area/limb
infection (increased risk of infection in people with lymphedema)
Edema
accumulation of water in tissues
edema is a SYMPTOM
represents dynamic insufficiency of lymphatic system
