Lymphatic System

Question 1

lymphedema and PT job!

Answer 1

transport is disrupted = accumulation of fluid and proteins in tissue space

PT gets it back to functioning lymphatics and central circulation

Question 2

superficial lymph drainage is ____ while deep lymph drainage is _____

Answer 2

symmetric

asymmetric

Question 3

Right upper extremity and thoracic lymphotome drain into the ______

Answer 3

right lymphatic duct

Question 4

left upper extremity, left thoracic lymphotome, both lower extremities, external genital areas, abdominal lymphotomes drain into the _____

Answer 4

left subclavian vein

Question 5

Three fourths of the total flow draining to the _______

Answer 5

left subclavian vein

Question 6

What enhances flow in the trunks and ducts?

Answer 6

respiratory effort

Question 7

Superficial vs deep vessel lymph flow - what controls each?

Answer 7

superficial vessels rely on MUSCULAR CONTRACTION, hydrostatic pressure, gentle movement of skin

deep vessels have smooth muscle and valves and help prevent back flow

Question 8

T/F deep lymph vessel parallel the venous system

Answer 8

T

Question 9

What are the smallest lymphatic vessels that are only one cell thick?

Answer 9

initial lymphatics (lymph capillaries)

Question 10

Initial lymphatics function as force pumps powered by what?

Answer 10

variations/changes in total tissue pressure and external pressure

Question 11

What causes changes in total tissue pressure that is required for lymph capillaries to work?

Answer 11

MOVEMENT AND MUSCULAR CONTRACTION and variations in external pressure caused by stretch, GRAVITY and change in POSITION

Question 12

Lymphangion

what is their main function?

Answer 12

each segment of collecting lymphatic vessels between valves

prevent backflow and help pump

Question 13

What increases pumping action of lymphatic valves

Answer 13

muscle contraction, autonomic stimulation or manual lymphatic drainage

Question 14

Lymph trunks

Answer 14

gradual increase in diameter size of collecting lymphatics

Question 15

What moves the lymph in the collecting lymphatic walls and what happens if flow is obstructed?

Answer 15

Muscle in the collecting lymph walls is controlled by the ANS at rest and contract 5-10x a minute

If the flow is obstructed, pressure in the vessel rises and can fatigue the muscle wall, causing ineffective contractions and vessel failure = walls dilate and prevent closure of valves = backflow = LYMPHEDEMA

Question 16

Why would unexpected trauma or controlled (surgery) trauma that injuries blood vessels also injure lymph vessels?

Answer 16

deep lymph vessels are embedded in fat and accompany the chains of lymph nodes along the blood vessels

Question 17

What are the main functions of lymph nodes?

Answer 17

filter lymph to clear waste

adjust fluid concentration

produce lymphocytes and macrophages

destroy bacteria and viruses and cancer cells

Question 18

Why are lymph nodes often the sites of obstruction in lymphatic dysfunction?

Answer 18

Lymph nodes offer 100 times the normal resistance to flow of lymph within the lymphatic vessels themselves

(This resistance happens because the lymph has to travel through a network of narrow, tortuous spaces inside the lymph node, which increases the “friction” or resistance to flow. Giving time for immune cells to clean and filter)

Question 19

What do watersheds do

Answer 19

separate territories

Question 20

What are the smaller divisions in each territory called?

Answer 20

lymphotomes

designate areas specific to certain regional nodes

Question 21

What are the 4 trunk quadrants?

Answer 21

right and let axillary territories
right and left inguinal territories

Question 22

Lymphadenitis

Answer 22

inflammation of one or more lymph nodes

Question 23

lymphadenopathy

Answer 23

enlargement of lymph nodes

Question 24

lymphangitis

Answer 24

inflammation of a lymph vessel

Question 25

T/F lymph nodes act as defense barriers and are secondarily involved in systemic infections

Answer 25

T

Question 26

lymphedema

Answer 26

swelling of soft tissues that results from the accumulation of protein-rich fluid in the extracellular spaces

Question 27

What causes lymphedema

Answer 27

decreased lymphatic transport capacity or excessive lymph load

Question 28

Where is lymphedema most common?

Answer 28

upper and lower extremities

Question 29

Individuals who undergo what procedures would have a higher risk of lymphedema?

Answer 29

lumpectomy, axillary lymph node dissection or sentinel lymph node biopsy and radiation therapy, inguinal node dissection, prostate cancer after pelvic node dissection, gynecologic cancers

so getting lymph procedures put you at a higher risk for future lymphedema

Question 30

Etiologic factors of primary lymphedema

Answer 30

IDOPATHIC

• unknown
• hereditary
• developmental
• aplasia
• hypoplasia
  -hyperplasia

Question 31

Most common cause of secondary lymphedema worldwide

Answer 31

Filariasis - parasitic worm via mosquito bite

Question 32

Most common cause of secondary lymphedema in the US

Answer 32

invasive procedures used in the diagnosis and treatment of cancer (radiation)

Question 33

What are other causes of secondary lymphedema?

Answer 33

trauma like surgery
bacterial or viral infection
repeated pregnancies
crush injuries, burns or lacerations or skin injuries can impact lymph flow

Question 34

know general clinical manifestations (kinda common sense)

Question 35

Loss of skin integrity with lymphedema can cause what

Answer 35

open portal for bacteria

Question 36

Edema in the head and neck can cause what

Answer 36

functional impairments in speech, swallowing and respiration

psychologic truama from cosmetic disfigurement

Question 37

Physical impairments of lymphedema may cause psychosocial morbidity, what is this?

Answer 37

social isolation, depression or suicide

Question 38

Infections elsewhere in the body can lead to

Answer 38

lymphadenopathy (enlarged lymph nodes)

can be acute or chronic (fibrosis)

Question 39

Lymphangitis definition and cause

Answer 39

acute inflammation of lymph channels

staph infection entering wound