LYMPHATICS Flashcards
What organs are associated with the lymphatic system?
spleen
tonsils
thymus
bone marrow
Is lymphedema associated with chronic ARTERIAL or chronic VENOUS insufficiency?
venous insufficiency
What is a good test to differentially diagnose lymphedema from lipidemia?
stemmer’s sign: positive in lymphedema, negative in lipidemia
Is involvement typically unilateral or bilateral for lipidemia?
bilateral
What is lymphadenopathy?
enlargement of lymph nodes usually d/t infection
T/F: chemotherapy can result in lymphedema.
false, it’s radiation
T/F: Trauma can damage lymph flow.
true; burns/scars/wounds can damage or impede lymph flow
What is filariasis?
international cause for secondary lymphedema via mosquito-borne disease
In volumetric measurement, how much % difference from one side to the other is considered lymphedema?
10%
What is the blood pressure assessment restriction for those with lymphedema?
it SHOULD NOT be taken on the affected side
You’re assessing your patient and you find hard, immobile lymph nodes. What are your next steps?
refer to physician, as this is likely cancerous issuez
You’re assessing your patient and find soft, tender lymph nodes that move easily. Pt has no known infection. What are your next steps?
refer to doc if no known corresponding illness
Your patient comes into your outpatient clinic with edema in her R leg only. What do you need to rule out first before you think it might be lymphedema?
DVT in RLE
post thrombotic syndrome
arthritis
bakers cyst
What diagnostic test is able to diagnose lymphedema?
lymphoscintigraphy
What is CDT?
complete decongestive therapy: manual lymph drainage, short stretch compression bandages, exercises, functional training, skin care, and lymphedema education
What would be a contraindication to begin CDT?
poorly controlled CP disease (won’t tolerate excess fluid on heart)
- or kidney disease
With Debbie’s lymphedema (just BLEs), where would you have began MLD?
at thoracic duct (clear here first for LUE, BLEs, and torso)
- clear at R lymphatic duct for RUE
What activities are contraindicated for exercise in patients with lymphedema?
strenuous activities, jogging, ballistic movements, rotational movements
- all exacerbate lymphedema
Your patient with RUE lymphedema begins to have aching pain in her armpit with the UE exercise you’re giving her. . What could this indicate, and what should you do?
could indicate lymph overload: discomfort, aching, pain, change in skin color in proximal lymph areas
- stop activity if any of the above are present
What kind of exercise should you give your patients with lymphedema?
walking/cycling/water aerobics
T/F: Nail care and observation is very important with lymphedema
yes, randomly; need regular inspection and cleansing, as well as protection with appropriate footwear
What modalities can you not use on your patient with lymphedema?
anything that causes vasodilation, increasing lymph load
- heat (paraffin, sauna)
- ice
- contrast bath
- hydrotherapy
If using pressure pumps, do you want high pressure or low pressure for phase II management of lymphedema?
low pressure (>45mmHg CONTRAINDIC) - high pressure can damage lymph nodes, may move water instead of proteins, and increase genital lymphedema (if on LEs)
