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Integument Test 2 > Lymphedema > Flashcards

Lymphedema Flashcards

1
Q

What is lymphedema?

A

Chronic disease with no cure

Cause by pooling of fluid in the interstitial space

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2
Q

What is a characteristics of lymphedema?

A

Swelling

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3
Q

T/F Swelling occurs due to impaired flow of lymph?

A

TRUE

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4
Q

What layer of the skin do we see lymphedema?

A

subcutaneous fatty tissue

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5
Q

Prevalence of lymphedema?

A

Pts with cancer living longer
Obesity rates are rising
population is aging

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6
Q

How many cases of lymphedema globally?

A

140-250 million cases estimated to exsist

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7
Q

The lymphatic system is regarded as the ____ component of the vascular system (or forgotten step child)

A

3rd

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8
Q

What does the lymphatic system consist of?

A

Lymph vessels, capillaries, pre collectors, collectors(similar to veins)
Lymphatic tissue: nodes and trunks

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9
Q

What is the purpose of the lymphatic system?

A

return fluid and protein from interstitial spaces to the vascular system (thick, more viscous)

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10
Q

Lymphatic systems two main functions?

A
  1. Maintain the pressure and volume of the interstitial fluid and blood by returning excess water and dissolved substances from the interstitial fluid to the circulation.
  2. Assist the immune system at the lymph nodes and other lymphatic tissue with lymphocytes and macrophages
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11
Q

What does lymph fluid consist of?

A

-Protein
-Water
-Fatty acids
-Salts
-WBCs
-Microogranisms
-Debris
(this is why the fluid is so thick)

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12
Q

How is normal plasma volume maintained?

A
  • Capillaries pick up interstitial proteins/etc
  • Return fluid to vascular system
  • Prevents interstitial edema
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13
Q

Two systems are content by _______ vessels?

A

perforating

just like veins

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14
Q

T/F capillaries –>pre collectors–>collector nodes–>trunks–>ducts

A

TRUE

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15
Q

T/F lymph capillaries are smaller than blood vessels?

A

FALSE

-Larger because they have to absorb larger volume of fluid

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16
Q

Which direction does fluid flow?

A

in the direction of low pressure

17
Q

Collectors have ______ prevent back flow

A

valves

18
Q

What happens in an overloaded lymphatic system?

A
  • fluid/proteins accumulate in the interstitial space
  • high-protein edema builds up in the tissue
  • triggers inflammatory response with deposition of collagen
19
Q

What is acute lymphedema and how long does it last?

A

Lasts less than 6 months (reversible)
Pitting edema with pressure
lack of brawny skin changes

20
Q

What are some risk factors for acute lymphedema?

A
  • surgical drains with leakage of drainage back into surgical site
  • Acute injury to a limb compromising lymph system
  • radiation therapy
  • infections
  • phelblitis
21
Q

What is chronic lymphedema?

A

Not reversible

skin changes likely

22
Q

What are the two types of chronic lymphedema?

A

Primary (idiopathic) lymphedema
–generally involves a LE, congenital absence or abnormalities in lymph system
Secondary (acquired) lymphedema
–most commonly associated with malignancy and treatment

23
Q

What are three classification of primary lymphedema?

A

-Congenital= detected at 35 years old

24
Q

In secondary lymphedema occurs at lymph node from?

A 
Surgery
Radiation
Trauma
Infection
Malignancy
Scar Tissue
25
Q

Stage 0 of lymphedema includes..?

A

Reversible
Swelling is not evident
Damage to lymphatic function has occurred (tumors or cancer)
May occur for months or years before swelling is detectable

26
Q

What occurs in stage 1 of lymphedema?

A 
Reversible
Lymph fluid with high protein content
Fluid dissipates after the involved limb is elevated
  ---gravity helps 
Pitting edema begins distally
No palpable fibrosis
Negative or borderline stemmer sign
27
Q

What occurs in stage 2 of lymphedema?

A 
Irreversible
Pitting edema is present
Non-pitting edema develops
   ---cant depress down into the skin
Limb evolution does not reduce edema
Tissue fibrosis starts
Positive stemmer sign
Skin thickens
Skin has rough cobblestone appearance and texture
28
Q

What occurs in stage 3 lymphedema?

A

Irreversible
Knows as elephantiasis
Pitting edema not present
Increased skin changes

29
Q

What is pitting edema?

A

Present when indentation in the skin remains longer than 5 seconds after pressure is removed
(hold for 30 seconds, depth you can go in and how long does it stay there)

30
Q

What is Stemmer’s sign/Test?

A

Indication of lymphedema

Inability to pinch a skin fold on the dorsal aspect of the 2nd toe

31
Q

Do false positives occur with the Stemmers test?

A

No

-negative tests don’t necessarily rule out lymphedema could be at stages 0 to 1

32
Q

What is lipedema?

A

Fat deposition in irregular patterns/amounts

Predominantly found in the legs (bilaterally)

33
Q

T/F lipedema can lead to lymphedema?

A

TRUE

due to tissue congestion

34
Q

Cause not know for lipedema but suspect _______?

A

Female hormones

  • puberty
  • Pregnancy
  • Around time of menopause
  • Respond poorly to compression therapy

Integument Test 2 (2 decks)

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