Lymphatics

Question 1

How much fluid does the lymphatic system collect?

Answer 1

10-20% of interstitial fluid

Question 2

What percentage of interstitial fluid collection indicates that the Lymphatic system isn’t working properly?

Answer 2

> 20%

Question 3

What are all the components of the lymphatic system?

Answer 3

Lymphatic vessels
Lymphatic fluid
Organs
Lymph Nodes

Question 4

When are lymph nodes normal?

Answer 4

<1 cm
nontender, nonpalpable

Question 5

Where can lymph nodes be found?

Answer 5

• supramandibular
• submaxillary
• cervical
• UE (axilla, subscap, pec, humeral, cubital)
• LE (inguinal, iliac, popliteal, parasternal, mesenteric)

Question 6

What parts of the body does the R Lymphatic duct collect?

Answer 6

Right UE
Right head/R neck/R upper trunk

*the L gets everything else

Question 7

Lymphatic Load

Answer 7

what needs to be transported

Question 8

Lymphatic capacity

Answer 8

what CAN be transported

Question 9

Causes of Primary Lymphedema?

Answer 9

Hypoplasia
Hyperplasia
Aplasia
Dysplasia

Question 10

Causes of Secondary Lymphedema

Answer 10

• surgery
• radiation
• tumors
• trauma (anything that is a trauma to the lymph ndoes)
• infection
• CRPS
• disuse

*mosquitos (outside of the U.S.)

Question 11

Stage 0 Lymphedema

Answer 11

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

Question 12

Stage 1 Lymphedema

Answer 12

Pitting Edema that SUBSIDES with limb elevation

Reversible lymphedema
worse with activity, head, and humidity
worse at night, better in the morning

Question 13

Stage 2 Lymphedema

Answer 13

Elevation does NOT reduce swelling
pitting may or may not occur
tissue fibrosis develops
spontaneously irreversible

(+) Stemmer’s Sign

Question 14

Stage 3 Lymphedema

Answer 14

Pitting is absent

“brawn”
tropic skin changes such as ascanthosis, fat deposits, warty fibrotic overgrowths

aka lymphastatic elephantiasis

(+) Stemmer Sign

Question 15

What is Lipidema?

Answer 15

an estrogen related pathology that occurs with hormonal changes and that results in excessive subcutaneous fat deposit
- will affect both limbs

Question 16

What can cause unilateral edema?

Answer 16

DVT
lymphedema
post-thrombotic syndrome
arthritis
baker’s cyst

Question 17

What can cause bilateral edema?

Answer 17

CHF
CVI
lipidema
renal and hepatic dysfunction

Question 18

What is Lipidema?

Answer 18

• excessive subcutaneous fat deposit
• normal function of lymphatic system
• estrogen-related; occurs with hormonal change

Question 19

Signs and Sx of Lipidema

Answer 19

• 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)

Question 21

Lymphadenopathy

Answer 21

Enlarged lymph nodes due to infection
- localized (enlarged lymph node in one body region)
- generalized (enlarged lymph nodes in 2 or more body regions)

Question 22

Lymphadenitis

Answer 22

inflammation of the lymph nodes, accompanied by signs of infection such as redness and tenderness

Question 23

Lymphangitis

Answer 23

inflammation of lymph VESSELS
acute bacterial (strep) or viral infection that spreads throughout the lymphatic system
- RED S