Lymphatic

Question 1

Lymphedema definition

Answer 1

chronic and incurable

fluid accumulation in the body 2/2 damage of the lymph structures, affecting normal lymph flow

typically presents in the LEs but can present anywhere in the body

primary and secondary

diagnosed via lymphoscintigraphy, lymphography, MRI and CT (for tumors)

Question 2

Stages of Lymphedema

Answer 2

Stage 0: heaviness, no swelling

Stage 1: pitting edema with activity and heat, diminished with elevation and rest

Stage 2: non-pitting edema, does not change with elevation or rest; fibrotic changes, (+) Stemmer’s sign

Stage 3: elephantiasis, increased fibrotic skin changes, deep skin folds, infection common, (+) Stemmer’s sign

Question 3

Compression Bandages

Answer 3

part of complete decongestive therapy (CDT)

low/short stretch bandages: low resting pressure
-safe for wearing full time, including during exercise
-pressure gradient distal to proximal
-medical grade: 20-30mmHg up to 40-50mmHg

Question 4

Manual Lymphatic Drainage (MLD)

Answer 4

part of complete decongestive therapy (CDT)

move lymph around blockages in the lymphatic system and into desired areas where it can be drained

should first be directed toward uninvolved areas to prepare those areas for new lymph flow
-then directed at involved areas

Question 5

Primary Lymphedema

Answer 5

occurs 2/2 abnormal development of the lymphatic system
-absence in lymph vessels, decreased # or size, and/or increased size
-ie Milroy’s disease (at birth)

Question 6

Secondary Lymphedema

Answer 6

occurs 2/2 some other disease or injury that causes damage to the lymphatic system
-breast cancer surgery and treatment is the most common cause for secondary lymphedema

Question 7

Types of Insufficiency

Answer 7

dynamic: occurs when there is excess lymph circulating in lymphatic system that exceeds transport capacity

mechanical: transport capacity is reduced due to damage of lymphatic system

combined: both an increase in lymph fluid and decrease in transport capacity

Question 8

Circumferences

Answer 8

used to compare limbs; difference of 2-3 centimeters between 4 comparative circumferences on b/l UE is evidence of lymphedema

mild: <3cm difference between affected and unaffected limbs
mod: 3-5 cm
severe: >5 cm

Question 9

Intermittent pneumatic compression

Answer 9

30-35 mmHg for UE
40-45 mmHg for LE