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NPTE > Lymphatic System > Flashcards

Lymphatic System Flashcards

1
Q

Lymphatic organs

A

nodes, tonsils, thymus, spleen, thoracic duct, bone marrow

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2
Q

Major lymph nodes

A

submaxillary, cervical, axillary, iliac, mesenteric, inguinal, popliteal, cubital, supraclavicular, parasternal

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3
Q

Flow of lymph

A

CV-NTD

Lymphatic capillaries > lymphatic vessels > lymph nodes filter > lymphatic trunks > lymphatic ducts > subclavian veins

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4
Q

Right lymphatic duct drains which area of body

A

RUE, R face, R trunk

Into subclavian veins

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5
Q

Thoracic duct drains which area of body

A

LUE, L face, L trunk, and rest of body

Into subclavian veins

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6
Q

Lymphatic load

A

Amount of lymphatic fluid transported

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7
Q

Transport capacity

A

maximum amount of fluid that lymphatic system can transport

can decrease with lymph node removal and lead to lymphedema

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8
Q

Primary lymphedema

A

Congenital or genetic/hereditary abnormalities in the lymphatic system

Milroy’s disease (0-2 y/o)
Lymphedema praecox/meige disease (10-20 y/o)
Lymphedema tarda (>35 y/o)

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9
Q

Secondary lymphedema

A

Injury to one or more components of the lymphatic system

lymph node removal
infection
tumor
trauma
chronic venous insufficiency
fibrosis
filariasis (elephantiasis)

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10
Q

Severity of lymphedema

A

Pitting
Brawny
Weeping

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11
Q

Pitting edema

A

rebounding
short duration
little to no fibrotic changes in skin or subQ tissue

least severe

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12
Q

Brawny edema

A

pressure on area feels hard with palpation
progressive, fibrotic changes in subcutaneous tissue

severe

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13
Q

Weeping edema

A

Fluid leaks from cuts or sores
Impaired wound healing
Only occurs in LEE
Uncommon

Most severe

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14
Q

Stemmer sign

A

Positive = indication of stage 2 or 3 lymphedema

Positive if skin on dorsal surface of fingers or toes cannot be pinched/lifted compared to uninvolved limb

Indicative of worsening condition

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15
Q

Stage 0 of Lymphedema

A

Latency stage

No clinical edema, occasional reports of heaviness
Negative stemmer
Tissue/skin normal appearance

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16
Q

Stage 1 Lymphedema

A

Reversible stage

Soft, pitting edema
Negative stemmer
Edema increases w/ activity/standing, reduces with elevation

17
Q

Stage 2 lymphedema

A

Spontaneously irreversible stage

Hard swelling, progresses to brawny edema
Positive stemmer (can be neg in early stage 2)
Fibrosclerotic tissue

18
Q

Stage 3 lymphedema

A

Lymphostatic elephantiasis stage

Severe brawny edema
Positive stemmer
skin changes (papillomas, deep skinfolds, warty protrusions, hyperkeratosis, mycotic infections)
Repeated bacterial/viral infections common

19
Q

Pitting edema 1+

A

Mild
barely perceptible
<1/4 in pitting

20
Q

Pitting edema 2+

A

Moderate
Easily identified depression
Rebound w/in 15 sec
1/4-1/2 in pitting

21
Q

Pitting edema 3+

A

Severe
15-30 sec rebound
1/2-1 in pitting

22
Q

Pitting edema 4+

A

Very severe
>30 sec rebound
>1 in pitting

23
Q

Lipedema

A

Bilateral LE
Affects proximal extremities but not hands/feet
Affects skin elasticity
Skin sensitive to pressure/touch (easy bruising and painful)

24
Q

Lymphedema vs lipedema

A
25
Q

Limb measurements

A
26
Q

Bioimpedance

A

Low level currents to measure resistance of flow through extracellular fluid in UE

Higher resistance to flow = more fluid present

27
Q

Palpation of lymph

A

Normal: soft, non-tender, non-palpable

Abnormal: tender, hard, immobile > physician referral required

Persistent enlargement is of concern

28
Q

Lymphadenopathy

A

Enlarged lymph nodes

29
Q

Lymphangitis

A

inflammation of lymph vessels

30
Q

lymphadenitis

A

inflammation of lymph nodes

31
Q

Phases of lymphedema management

A

Phase 1: intensive phase
- MLD
- multiple layer compression bandage
- skin/nail care
- exercise

Phase 2: maintenance phase
- Self-MLD
- compression garment during day
- multiple layer bandage at night
- skin/nail care
- exercise

32
Q

Manual lymphatic drainage (MLD)

A

Proximal areas cleared before distal
Circular mvmts or stroking
Stroke distal to proximal towards specific lymph nodes

33
Q

Compression therapy

A

Low stretch bandages (low resting pressure, high working pressure)
Distal to proximal application
Used day and night

34
Q

Exercise for lymphedema management

A

Active ROM, stretching, low intensity resistance exercises - perform with compression on

Swimming

Proximal to distal series of exercise

35
Q
A

NPTE (40 decks)

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