Lymphatics Flashcards
How much fluid does the lymphatic system collect?
10-20% of interstitial fluid
What percentage of interstitial fluid collection indicates that the Lymphatic system isn’t working properly?
> 20%
What are all the components of the lymphatic system?
Lymphatic vessels
Lymphatic fluid
Organs
Lymph Nodes
When are lymph nodes normal?
<1 cm
nontender, nonpalpable
Where can lymph nodes be found?
- supramandibular
- submaxillary
- cervical
- UE (axilla, subscap, pec, humeral, cubital)
- LE (inguinal, iliac, popliteal, parasternal, mesenteric)
What parts of the body does the R Lymphatic duct collect?
Right UE
Right head/R neck/R upper trunk
*the L gets everything else
Lymphatic Load
what needs to be transported
Lymphatic capacity
what CAN be transported
Causes of Primary Lymphedema?
Hypoplasia
Hyperplasia
Aplasia
Dysplasia
Causes of Secondary Lymphedema
- surgery
- radiation
- tumors
- trauma (anything that is a trauma to the lymph ndoes)
- infection
- CRPS
- disuse
*mosquitos (outside of the U.S.)
Stage 0 Lymphedema
Latent stage or preclinical stage
- swelling is NOT evident but the extremity will feel heavy
Educate pt to avoid running barefoot to protect skin
not considered reversible
Stage 1 Lymphedema
Pitting Edema that SUBSIDES with limb elevation
Reversible lymphedema
worse with activity, head, and humidity
worse at night, better in the morning
Stage 2 Lymphedema
Elevation does NOT reduce swelling
pitting may or may not occur
tissue fibrosis develops
spontaneously irreversible
(+) Stemmer’s Sign
Stage 3 Lymphedema
Pitting is absent
“brawn”
tropic skin changes such as ascanthosis, fat deposits, warty fibrotic overgrowths
aka lymphastatic elephantiasis
(+) Stemmer Sign
What is Lipidema?
an estrogen related pathology that occurs with hormonal changes and that results in excessive subcutaneous fat deposit
- will affect both limbs
What can cause unilateral edema?
DVT
lymphedema
post-thrombotic syndrome
arthritis
baker’s cyst
What can cause bilateral edema?
CHF
CVI
lipidema
renal and hepatic dysfunction
What is Lipidema?
- excessive subcutaneous fat deposit
- normal function of lymphatic system
- estrogen-related; occurs with hormonal change
Signs and Sx of Lipidema
- b/l and symmetrical
- mainly LE but can occur in UE (uncommon)
- swelling STOPS at ankles and wrists
- pain and bruising are prominent
- Mainly females
- Stemmer’s (-)
- cellulitis is rare (but common with lymphedema)
Lymphadenopathy
Enlarged lymph nodes due to infection
- localized (enlarged lymph node in one body region)
- generalized (enlarged lymph nodes in 2 or more body regions)
Lymphadenitis
inflammation of the lymph nodes, accompanied by signs of infection such as redness and tenderness
Lymphangitis
inflammation of lymph VESSELS
acute bacterial (strep) or viral infection that spreads throughout the lymphatic system
- RED S
