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Medical Conditions II > Lymphatic Anatomy/Physiology > Flashcards

Lymphatic Anatomy/Physiology Flashcards

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USMLE® Step 1 flashcards
1
Q

Components of Lymphatic System

A
  • lymph vessels
  • lymph nodes
  • thymus gland
  • lymphocytes
  • tonsils
  • spleen
  • Peyer’s patches
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2
Q

Lymph Vessels

A
  • capillaries
  • pre-collectors
  • collectors
  • trunks
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3
Q

Right Drainage Area

A
  • RUQ

- (drainage from right UE, right side of head, right upper trunk)

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4
Q

Left drainage area

A

-Everything but RUQ

drainage from LE, lower trunk, Left trunk, left UE, left side of head

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5
Q

70% of lymphatic system is______

A

-superficial

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6
Q

Cistema Chyli

A

-collects emulsified fats

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7
Q

True/False: the lymphatic system is symmetrical

A

-false

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8
Q

Lymphangion

A

-functional unit of muscle tissue around lymphatic valves to push fluid in correct direction

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9
Q

Lymph system relies on_____

A

-voluntary skeletal muscle contractions to move fluid

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10
Q

Lymph system circulates _____ l/day

A

2-2.5 liters/day

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11
Q

Chyle

A

-lymph plus emulsified fats

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12
Q

Lymph Vessels Function

A
  • return protein to cardiovascular system
  • remove excess fluid from interstitium
  • transport chyle (intestinal lymph vessels)
  • transport capacity>lymph load
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13
Q

Insufficiency

A
  • Dynamic (high volume)
  • Mechanical (low volume_
  • Combined
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14
Q

Dynamic Insufficiency

A
  • High volume

- lymph load exceeds transport capacity

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15
Q

Mechanical Insufficiency

A
  • Low volume (normal load)
  • decreased transport capacity due to injury/impairment
  • more common
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16
Q

Forms of LE edema

A
  • venous insufficiency
  • Congestive heart failure
  • lymphedema
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17
Q

Lymphedema

A
  • transport capacity<lymph load
  • abnormal accumulation of protein-rich fluid in interstitium
  • cases inflammation and reactive fibrosis of affected tissue
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18
Q

Skin Characteristics of Lymphadema

A
  • hyperkeratosis
  • lichenification
  • Peau d’orange texture
  • ulcerations unusual
  • elasticity/hydration of skin maintained longer than in venous disease
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19
Q

hyperkeratosis

A

-excess of keratin deposits

20
Q

Peau d’orange texture

A

-skin textured like orange (little dimples, surrounding hair follicles)

21
Q

Lymphadema does NOT cause_____

A

Ulcers, pain

22
Q

Lymphedema Causes

A
  • Primary

- Secondary

23
Q

Primary Lymphadema Causes

A
  • congenital/heredity

- born with it

24
Q

Secondary Lymphadema Causes

A
  • surgery
  • radiation
  • trauma
  • filariasis
  • CVI
  • infection
  • tumor growth
  • artificial (self induced)
25
Q

Lymphadema Staging

A
  • latency
  • stage 1: reversible
  • stage 2: spontaneously irreversible
  • stage 3: lymphostatic edemas
26
Q

Latency Stage

A
  • transport capacity reduced
  • no visible palpable
  • subjective complaints possible
27
Q

Stage 1

A
  • reversible
  • accumulation of protein-rich fluid
  • pitting edema
  • reduces with elevation
  • no fibrosis
28
Q

Stage 2

A
  • Spontaneously Irreversible
  • proteins stimulate fibroblast formation
  • pitting becomes progressively worse
  • connective/scar tissue formation
29
Q

Stage 3

A
  • lymphostatic edema
  • hardening of dermal tissues
  • pitting absent
  • fibrosis/sclerosis
  • skin changes
  • elephantiasis–filariasiss
30
Q

Edema not detected clinically until______

A

-interstitial volume reaches 30% above normal

31
Q

LVF

A
  • location
  • volume
  • fibrosis
32
Q

Primary Differential Diagnosis

A
  • vascular anomaly

- tumor

33
Q

Secondary Differential diagnosis

A
  • DVT, venous insufficiency
  • infection
  • cardiopulmonary failure
  • hepato-renal failure
  • systemic disease (amyloidosis)
  • lipedema
34
Q

Causes of local edema

A
  • lymphedema
  • lipedema
  • acute DVT or thrombophlebitis
  • chronic venous insufficiency
  • congenital vascular malformations
  • arteriovenous fistula
  • trauma
  • infection, cellulitis
  • ruptured synovial cyst (baker’s cyst)
  • hematoma
  • dependency
35
Q

Diagnostic Lab Tests

A
  • CBC
  • Electrolytes
  • Albumin
  • SPE (serum protein electrophoresis)
36
Q

Low Albumin

A

-too much fluid leaves vessels to insterstitium

37
Q

Diagnostic Imaging

A
  • US
  • MRI
  • Venous studies
  • CT
  • Microlymphography
  • x-rays
  • lymphoscintigraphy
38
Q

Gold Standard diagnostic Imaging

A

-Direct Lymphography

39
Q

Diagnosis

A
  • med history
  • physical exam
  • measurements
  • venous evaluation
  • laboratory
40
Q

Pneumatic Compression Pump

A
  • NOT indicated
  • and pressure will collapse superficial lymphatic drainage
  • also fluid won’t be able to get past the blockage
41
Q

Treatment

A
  • surgery
  • pharmocologic
  • CDP-complex decongestive therapy
42
Q

Phases of Complex Decongestive Therapy

A
  • I: intensive daily treatments

- II: supportive

43
Q

Comprehensive Management

A
  • CDT/CDP
  • nutritional counseling
  • education
  • psychosocial intervention
44
Q

Manual Lymph Drainage

A
  • increase lymph vessel contractions
  • increases reabsorption of fluid
  • direct superficial flow
  • improve lymph transport capacity
45
Q

Bandaging

A
  • reduce ultrafiltration rate
  • improve muscle pump efficiency
  • provide support for tissues/joints
  • prevent re-accum of evacuated fluid
  • facilitate softening of fibrotic tissue

Medical Conditions II (34 decks)

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