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Lymph Flashcards

1
Q

primary fxn of lymph system

A

immunity and transport excess fluids

“drainage and sanitation” systems

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2
Q

What 6 products are transported in lymph system

A

protein
H2O
fatty acid
WBC
bacteria
virus

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3
Q

6 structures of the lymph system

A

nodes
spleen
thymus
bone marrow
tonsils
peyer patches in sm intestine

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4
Q

what are the 5 layers (superficial to deep)

A

-initial lymph capillary
-pre collector
-collector
-lymph node
-lymphatic trunk

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5
Q

how much fluid circulates through the body in a day

A

20 L

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6
Q

what does lymph system connect to? where?

A

venous system

venous triangle: jct of internal jug v and subclavian

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7
Q

what is hypoplasia

A

vessels smaller or lower # in region

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8
Q

what is hyperplasia

A

vessels are larger or valves incompent

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9
Q

what is aplasia? where is it common?

A

no lymph vessels in a region

dorsum of ft

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10
Q

what are 3 forms of primary lymphedema

A

congenital hereditary
lymphedema praecox
lymphedema tarda

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11
Q

what is congenital hereditary primary lymphedema

A

Milray’s
-B LE at birth or infancy

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12
Q

what is lymphedema praecox? who’s at highest risk?

A

Meige disease
-most common
-mostly girls and young W

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13
Q

when does lymphedema tarda occur

A

after 35 yo

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14
Q

6 risk factors for secondary lymphedema

A

-radiation therapy
-over wt
-benign/malig tumor
-infect
-chronic v insuff
-trauma

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15
Q

5 causes of secondary lymphedema

A

-breast cancer tx
-filariasis (parasite infect)
-tumor
-UE DVT
-scar tissue

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16
Q

what is the most common cause of secondary lymphedema? worldwide?

A

breast cancer tx

filariasis

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17
Q

What is one major edu

A

Increase fluid uptake

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18
Q

Describe what type of exercise for lymphedema (characteristics)

A

-slow and rhythmic
-low exertion

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19
Q

What is one major priority for skin care

A

Infection prevention

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20
Q

6 skin care/daily skin routine items

A

-hypoallergic soap
-moisturize daily
-inspect daily
-protect w/ insect repellent, sunblock
-specialist trimming toenails
-beware of constricting clothing

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21
Q

What footwear is best for lymphedema

A

Shoes

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22
Q

Clinical presentations (7)

A

-unilateral swelling
-heavy, achy pain
-trophic skin and nail changes
-hyperkeratosis
-lymphangiectasia
-reoccurring infection
-decreased ROM

23
Q

3 things that increase symptoms

A

-warm weather
-menstruation
-limb depended position

24
Q

3 primary intestine s/s

A

Abdom bloating
Diarrhea
Intolerance fatty foods

25
What is stage 0 of lymphedema (name, description)
Pre-stage, latency No edema, negative Stemmer sign
26
What is stage 1 of lymphedema (name and description)
Reversible Soft, pitting edema Edema increases w/ standing or acts **edema reversible with elevation Negative stemmer sign
27
What is stage 2 of lymphedema (name and description)
Spontaneously irreversible -Soft pitting edema -> nonpitting brawny edema -Edema NOT reversible with elevation -Positive stemmer sign -Increased frequency of skin infections
28
What is stage 3 of lymphedema (name and description)
Lymphatic elephantiasis -Severe brawny edema, non-pitting -Positive stemmer sign -permanent integ changes (deep skin folds, change in color and texture, papillomas (non cancerous warts), hyperkeratosis, mycotic infections
29
What is edema severity determined by
Progression of integ system changes
30
What are the 3 types of edema
Pitting, brawny, weeping
31
What is brawny edema
Tissue hard/firm; fibrotic changes occurring in subcutaneous changes
32
What is weeping edema
Fluid leaks from open wounds -wound healing delayed -most severe lymphedema -almost always in LE
33
Describe norm lymph nodes
Not visible or easily palpable
34
Describe abnorm lymph nodes
Tender, may be hard, immobile
35
What 5 regions should be palpated for lymph nodes
-axilla -head -neck -trochlear -inguinal
36
Goal for lymphedema mgt
Decrease progression, retain/restore tissue integrity
37
What are 4 components of complete decongestive therapy (CDT)
-manual lymph drainage -compression therapy -ex -edu
38
What does manual lymph drainage consist of
Slow, light rep stroking circular motions across top layer
39
What level do you clear first during manual lymph drainage
Upper levels to move fluids in proximal direction Clear proximal first to prevent “clogging”
40
What does compression therapy consist of? How long should they be worn?
Low stx and resist bandage All day/night
41
How to differentiate edema and lymphedema
Edema: -increased water in interstitial space -improves with elevation -usually symmet -localized or systematic -dynamic insuff of lymph system -pitting always present Lymphedema: -increased water and protein in interstitial space -not always improved with elevation Negative stemmer -assymetries -localized, never generalized -mechanical insuff of lymph system -pitting in stages 1 and 2
42
What is the gold standard dx imaging? Describe
Lymphoscintigraphy Min invasive -injected dye
43
What are 4 other dx imaging methods
-direct lymphography -indirect lymphography -MRI -CT
44
What is direct lymphography
-invasive, rarely used -repeat radiographs for mapping -limited use d/t pelvic surg or complicating conditions
45
Contraindications for intervention
Any modality producing vasodilation to involved area
46
6 modalities to avoid
-heat packs -cold packs -sauna -contrast bath -paraffin -estim
47
What setting for US is allowed
Pulsed can soften fibrotic tissue
48
4 modalities/interventions
-US -low level laser -massage -pneumatic compress SPECIFIC for lymph
49
What is the range for compression levels
20-60 mmHg LE
50
Describe what circular knit is
Seamless, cheap, more aesthetic
51
Describe flat knit
Seams, customizable, higher compression
52
7 contraindications for mgt
-acute DVT -acute infection -untx CHF -untx cancer -kidney dysfxn -arterial insufficiency -neuropathy
53
What is lipedema
Symmetrical gradual and progressive accumulation of fat in subcutaneous tissue (butt and LE)
54
How to differentiate lipedema and lymphedema
Lipedema: -mostly W -fam hx common -B LE, symmetric involv -cellulitis rare -TTP -hematoma -no ft edema -stemmer negative Lymphedema: -W > M -fam hx rare -unilateral or bilateral (assymetries) -cellulitis common -no TTP -no hematoma -distal edema -stemmer +

546 (9 decks)

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