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NPTE > Lymph & Integ > Flashcards

Lymph & Integ Flashcards

1
Q

what are two different main causes of lymphedema? what’s an example of each?

A

(1) when lymphatic load exceeds transport capacity of the lymphatic system (ex. venous insufficiency)
(2) decreased transport capacity without increased lymphatic load (ex. lymph node removal)

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2
Q

what is the difference between primary and secondary lymphedema?

A

(1) primary: congenital or hereditary causes

(2) secondary: injury to one or more components of the lymphatic system

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3
Q

what is the difference between pitting, brawny, and weeping edema?

A

(1) pitting: soft feeling; leaves pits
(2) brawny: hard feeling; no indentation
(3) weeping: fluid leaks from cuts and sores

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4
Q

what is a stemmer sign? what does it indicate?

A

(1) on the dorsal side of the 2nd or 3rd digit, the skin is unable to be lifted or is difficult to do so
(2) indicates stage 2 or 3 lymphedema

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5
Q

what are the hallmarks of each stage of lymphedema?

A
  • Stage 0: ocassional reports of heaviness; no edema and skin appears normal
  • Stage 1: pitting edema; edema increases in standing and reduces with elevation
  • Stage 2: hard swelling (brawny); fibrosclerotic tissues, possible (+) stemmer sign in later stage 2
  • Stage 3: (+) stemmer sign, severe brawny edema, infections are common
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6
Q

which stage of lymphedema is the only reversible stage?

A

stage 1 (stage 0 is basically pre-lymphedema)

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7
Q

what is the pitting edema scale for both depth and time?

A

1+ - 0 seconds; <0.25 inches (mild)
2+ - <15 seconds; 0.25-0.5 inches (mod)
3+ - 15-30 seconds; 0.5-1 inches (severe)
4+ - >30 seconds; >1 inch (very severe)

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8
Q

what is the difference between lymphangitis, lymphadenitis, and lymphadenopathy?

A

(1) lymphaNGITIS: inflammation of lymph vessels
(2) lymphaDENITIS: inflammation of lymph nodes
(3) lymphaDENOPATHY: enlargement of lymph nodes

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9
Q

what is lipedema? what areas of the body does it typically affect?

A

(1) lipid accumulation within certain areas of the body

2) PROXIMAL areas, such as buttocks and thighs (but won’t affect feet

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10
Q

what is a huge difference between lipedema and lymphedema?

A

lipedema has NO swelling in feet, no stemmer sign, and is BILATERAL

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11
Q

how large would a lymph node need to be to refer a patient out?

A

> 1cm

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12
Q

what type of bandages are recommended for treatment of lymphedema?

A

low, short stretch bandages (NOT HIGH STRETCH)

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13
Q

what is the order in which manual lymphatic drainage is performed?

A

(1) decongest trunk FIRST
(2) decongest from PROXIMAL extremity to distal
(3) direction of flow is always towards the trunk

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14
Q

when performing exercises for lymphedema, what order should the exercises be performed?

A

proximal to distal (ex: cervical before shoulder and shoulder before elbow)

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15
Q

what sensation are krause end bulbs responsible for transmitting in the skin?

A

cold sensation (Krause = KOLD)

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16
Q

what sensation are meissner corpuscles responsible for transmitting in the skin?

A

light touch (Meissner’s LIGHT Beer)

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17
Q

what sensation are pacinian corpuscles responsible for transmitting in the skin?

A

pressure and vibration (P for pressure)

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18
Q

what sensation are ruffini endings responsible for transmitting in the skin?

A

hot sensation

19
Q

what sensation are free nerve endings responsible for transmitting in the skin?

A

pain

20
Q

what is the location, appearance, and symptoms of venous insufficiency wounds?

A

(1) location: proximal to medial malleolus
(2) appearance: irregular, shallow, hemosiderin staining
(3) sx: mild to moderate pain (relieved by elevation)

21
Q

what is the location, appearance, and symptoms of arterial insufficiency wounds?

A

(1) location: lower 1/3 of leg, toe, lateral malleolus
(2) appearance: smooth, well defined, deep, hair loss, yellow nails
(3) sx: severe pain (made worse with elevation)

22
Q

what are the stages for pressure ulcers?

A

Stage 1 - non-blanchable erythema
Stage 2 - superficial (first 2 layers gone)
Stage 3 - subcutaneous fat may be visible
Stage 4 - full-thickness; bone, tendon, etc exposed
Unstageable - excessive necrotic tissue

23
Q

where are diabetic ulcers typically located?

A

weight bearing surfaces of the feet

24
Q

what is the difference between vesicles and bullae?

A

vesicles are small blisters and bullae are large blisters

25
Q

what is the difference between normal, hypertrophic, and keloid scars?

A

(1) normal: pink and flat; similar to skin color
(2) hypertrophic: thick fibrous, WITHIN original wound margins
(3) keloid: grows OUTSIDE of original wound margins

26
Q

how do superficial burns present? how long does it take to heal?

A

(1) only involves epidermis; area may be red with slight edema (think sunburn)
(2) healing: 2-5 days

27
Q

how do superficial partial thickness burns present? how long does it take to heal?

A

(1) involves epidermis and top layer of dermis; extremely painful and exhibit blisters (minimal to no scarring)
(2) healing: 5-21 days

28
Q

how do deep partial thickness burns present? how long does it take to heal?

A

(1) complete loss of epidermis and most of dermis; hypertrophic / keloid scarring
(2) healing 21-35 days (if no infection)

29
Q

how do full thickness burns present? how long does it take to heal?

A

(1) destruction of epidermis, dermis, and part of subcutaneous fat layer
(2) healing: weeks to months with or without graft

30
Q

how do subdermal burns present? how long does it take to heal?

A

(1) complete destruction of epidermis, dermis, and subcutaneous tissue (may involve muscle and bone)
(2) healing: extensive; often require surgery

31
Q

what is the rule of 9s for burns?

A 
determine how much of the body was burned
FRONT ONLY:
head: 4.5%
arms: 4.5 each
torso: 18%
leg: 9% each
dick and balls: 1%
(Back is the same)
32
Q

what can generally be said about the inside and outside of wounds?

A

keep the inside of wounds WET

keep the outside of wounds DRY

33
Q

what type of dressing should be used for very mild and minimal exudate wounds?

A

(1) very mild: transparent films

(2) minimal: hydrogel and hydrocolloid

34
Q

what type of dressing should be used for moderate and heavy exudate wounds?

A

(1) moderate: foams

(2) heavy: alginates

35
Q

what types of dressing should be used for infected wounds? (3)

A

(1) hydrogel
(2) alginates
(3) gauze

36
Q

what is wet to dry gauze used for?

A

to remove necrotic tissue

37
Q

what is the difference between selective and non-selective debridement?

A

(1) selective: removal of only necrotic tissue

(2) removal of both viable and necrotic tissue

38
Q

what is the purpose of zinc oxide for wounds?

A

it increases wound healing

39
Q

when is silver sulfate used for wounds?

A

for infected wounds

40
Q

when is iodine used for wounds?

A

to clean a surgical sites

41
Q

when is nitrofurazone used in wounds?

A

used for burns or skin infections due to grafts

42
Q

what are the stage of lipedema?

A

Stage 1: skin surface smooth, subcutaneous fat thickened, fine knots
Stage 2: skin surface uneven, coarse knots
Stage 3: tissue coarse and hard, large deforming fat lobes
Stage 4: additional severe lipolymphedema

43
Q

what are the 4 classes of garment compression? what are the pressure for each? when are they indicated?

A 
Class 1: 20-30 mmHg pressure
-mild lymphedema; frail skin
Class 2: 30-40 mmHg
-Stage II UE lymphedema
Class 3: 40-50 mmHg
-Stage II LE lymphedema
Class 4: 50-60 mmHg (rarely used)
-ONLY used for LE lymphedema

NPTE (10 decks)

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