lymphedema Flashcards
what is the lymphatic system?
part of your immune system, which protects you against infection and disease
what is included in the body’s lymphatic system?
your spleen, thymus, lymph nodes and lymph channels, as well as your tonsils and adenoids.
what is lymphedema?
an abnormal accumulation of protein rich lymph fluid in the fatty tissues just under your skin. This build-up might also be called an obstruction and cause swelling and discomfort.
how do the circulatory system and lymphatic system work together?
The lymphatic system, a complex network of vessels, is essentially a drainage system within the body which transports excess fluid and metabolic waste products from interstitial spaces into the blood circulatory system. Lymph flow is governed by extrinsic forces due to the movements of organs and skeletal muscles which exert external pressure on the lymphatic walls, and by the intrinsic forces due to rhythmic contractions of smooth muscle in the walls of the lymphatic vessels which play a major role in lymph circulation.
what is primary lymphedema?
A rare, inherited condition caused by problems with the development of lymph vessels in your body. This disorder often begins in infancy or at puberty and causes lymph nodes to form abnormally.
what is secondary lymphedema?
Occurs as a result of something else that affects the lymphatic system such as:
Lymph node removal
Radiation
Infection
Tumors
Trauma
Chronic venous insufficiency
Filariasis
how many stages of lymphedema are there?
4 (0-3)
describe stage 0 (latency/subclinical) stage of lymphedema
A subclinical state where swelling is not evident despite impaired lymph transport. This stage may exist for months or years before edema becomes evident. The patient has reduced transport capacity of their lymphatic system but has no swelling. Most patients are asymptomatic. The patient may have subjective complaints such as heaviness in the limb or mild aching or tightness. There is no swelling or pitting present on exam. The patient is at risk to develop lymphedema.
describe stage 1 (mild stage) of lymphedema
arly accumulation of protein-rich fluid that subsides with limb elevation. Pitting may occur. The skin is typically soft with no dermal fibrosis. There may be edema present which pits. This is often called the reversible stage since the edema can reverse and go away with elevation or compression.
describe stage 2 (moderate stage) of lymphedema
Accumulation of protein-rich fluid with limb swelling that does NOT resolve with limb elevation. There is early dermal fibrosis starting to develop. The limb may no longer pit on exam. This is sometimes called spontaneously irreversible stage since it does not reverse with compression. With prolonged treatment and compliance dermal fibrosis can improve and reverse.
describe stage 3 (severe stage) of lymphedema
On exam there is swelling. Pitting can be absent. Trophic skin changes such as fat deposits, papillomatosis, and hyperkeratosis develop. The patient can develop lobules with deep skin creases, which can be problematic hygienically. Skin crevices become prone to fungal infection, skin breakdown, and secondary bacterial infections.
what are symptoms of lymphedema?
Observable swelling
Sensation of heaviness, tightness, fullness, or aching sensation in the affected area
Tight fit of clothing or jewelry
what are some important past medical history or differential diagnosis for lymphedema?
Lipedema (Bilateral)
Congestive Heart Failure (Bilateral)
Vascular Insufficiency (Bilateral)
Renal/Hepatic Dysfunction (Bilateral)
Acute DVT (Unilateral)
Post Thrombotic Syndrome (Unilateral)
Osteoarthritis (Unilateral)
Baker’s Cyst (Unilateral)
what is lymphorrhea?
leakage of lymph from the skin surface
what is papillomatosis?
development of warty growths on the skin that contain dilated lymph vessel and fibrous tissue
