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Medcon Rehab IV > Lymphedema Part 1- Background > Flashcards

Lymphedema Part 1- Background Flashcards

1
Q

Normal fluid lvls:

How maintained?

A

Balance bw hydrostatic and osmotic pressure inside and outside of blood vessels

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2
Q

Hydrostatic pressure:

A

force generated by the pressure of fluid w/in or outside of capillary on the capillary wall

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3
Q

Osmotic pressure:

A

Colloid osmotic pressure or “oncotic pressure”→ pressure exerted by PROs, notably albumin, inside or outside of a vessel that tends to pull water towards the PROs

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4
Q

Hydrostatic Pressure and Osmotic Pressure

A

Work OPPOSITE one another!

When balanced, NORMAL fluid lvls exist and edema does NOT exist

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5
Q

Balance bw hydrostatic and osmotic pressure inside and outside of blood vessels maintained by the blood capillary fluid exchange

via 4 mechanisms:

A
  1. Diffusion
  2. Osmosis
  3. Filtration
  4. Reabsorption
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6
Q

Blood Capillary Fluid Exchange

Diffusion

A

Mvmt of mc’s and particles from areas of HIGH concentration to LOW concentration

Equalizes their distribution*

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7
Q

Blood Capillary Fluid Exchange

Osmosis

A
  • Mvmt or diffusion of water from area of HIGH water concentration to area of LOW water concentration across semipermeable or permeable memb.
    • memb only permeable to H2O
  • Osmotic or oncotic pressure
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8
Q

Blood Capillary Fluid Exchange

Filtration & Reabsorption

A

Passive exchange of water and micromc’s across memb

Pressure gradient caused by blood cap. pressure (BCP)

Mvmt occurs HIGHER to LOWER pressure areas

  • Filtration:
    • water filters thru capillary memb into interstitium
      • carries nutrients TO tissue
  • Reabsorption
    • water reabsorbs thru capillary memb in to circulatory system
      • carries waste products FROM tissue
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9
Q

Blood Capillary Fluid Exchange

Incd Blood Cap pressure vs. Incd Tissue pressure

A
  • Incd blood cap. pressure→ results in an INC in net filtration; more water filtering TO tissue
  • Incd tissue pressure→ results in INC in net reabsorption; more water moves BACK INTO circulatory system
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10
Q

Where does Lymphatic System fit in?

Normally…..

A
  • 10% ECF returned to circ. system thru lymphatic vessels
  • 90% reabsorbed by venous caps.
  • MAJORITY of extracell. PROs transported by lymphatic system
    • PROs and waste prods too lg to be reabsorbed by venous caps.
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11
Q

Lymphatic System:

A
  • Lymphatic vessels, nodes, other tissues
  • CLOSE prox. to the circ vessels and exist in all areas & parts of body
  • Divided into superf and deep; separated by fascia
  • Redundancy + back up systems in order to maint. function in presence of injury or illness
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12
Q

Lymph Fluid

Once its in lymphatic system, call in LYMPH!

A
  • ALL fluid, once in lymph. system==> LYMPH!
  • Components of Lymph Fluid:
    • Water
    • PRO
    • Cellular components & particles
    • Fat and Fatty acids
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13
Q

Lymphatic Vessels

Smallest → Largest

A
  • Lymph caps→ Lymph precollectors→ Lymph collectors→ Lymphatic trunks→ Lymphatic ducts
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14
Q

Lymph Capillaries

A
  • Initial lymph vessels
  • Close prox. w/ venous caps
  • Cover surf of entire body
  • Closed/dead-end tubes
  • Flat endothelial cells
    • “swinging flaps”→ allow lg mc’s to enter from interstitium
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15
Q

Lymph Caps

MORE

A
  • Anchoring filaments
  • absorb macromc’s (PRO, debris)
  • NO one-way valves inside vessels
    • Lymph fluid can move in either direction w/in lymph caps**** KNOW THIS!
  • Flow of lymph fluid thru lymph caps→ negative pressure “suction”
    • External pressure exerted on surrounding tissue:
      • Respiration, MM contraction, massage, mvmt, compression garments/bandaging, gravity
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16
Q

Lymph Caps vs. Blood Caps

A

See chart

17
Q

Lymph Caps vs. Blood Caps.

A
  • Lymph Caps.
    • Larger in diameter, Lumen is irregular, More permeable, NOT connected to venous or arterial vessels, but closed/dead-end tubes
    • Fluid can flow into the lymph cap, but not OUT into interstitial space
    • Purpose is to carry waste OUT of tissue
    • Flow of lymph fluid thru lymph caps:
      • Negative pressure “suction” created when more proximal lymph vessels emptied
      • Ext. pressure from surrounding tissue
18
Q

Lymph Caps. vs. Blood Caps.

A
  • Blood Caps:
    • SMALLER in diameter, Lumen more regular, LESS permeable,
    • ARE connected to arterial vessels in the interstitium ==> continous flow
    • Fluid can flow INTO and OUT of capillary
    • Purpose is to carry nutrients TO tissue and water OUT of tissue
    • Flow of blood thru caps is facilitated by:
      • pumping of the heart as well as mm contraction***
19
Q

Lymph PREcollectors

A

Connect superf lymph caps to deeper lymph collectors*

*may contain valves

20
Q

Lymph Collectors

A
  • Transport fluid to lymph trunks and nodes
  • Innervated by SNS
21
Q

Lymph Collectors

MORE

A
  • Contain valves
    • One-way transport of fluid proximally*
  • Lymphangiomotoricity=> incd rate and quantity of lymph fluid transport from interstitium back into circ. system
    • INCs when:
      • Incd lymph formation
      • Ext manual stretch on lymph wall
      • Manual Lymphatic drainage
      • INCd temp
      • INCd mm activity
      • Diaphragmatic breathing
      • Pulsation of adj. arteries
      • Hormonal inc’s
22
Q

Lymphatic Trunks

A
  • Transport lymph FROM collectors TO lymphatic ducts
  • Lumbar trunks: L and R
    • Drains LEs, lower body quadrants, ext. genitalia
  • Supraclavicular trunk
    • B/L→ drains head, neck, shoulder, part of mammary gland
  • Subclavian Trunk
    • B/L→ Drains lymph from axillary lymph nodess
      • UEs, shoulder, anterio/posterior upper quarter, majority of mammary gland
23
Q

Lymphatic Trunks

2 more

A
  • Parasternal Trunk
    • B/L→ Drains parasternal lymph nodes
      • Part of mammary gland, pleura, diaphragm, liver, pericardium, chests, abdom areas
  • Jugular Trunk
    • B/L→ Drains head/neck regions
24
Q

Lymphatic Ducts

2:

A
  • Thoracic Duct:
    • Cisterna Chyli
    • Ends @ L venous angle
    • L internal jugular and left subclavian arteries
    • Valve @ junction→ prevents blood from entering lymphatic system
    • largest lymph vessel in body
    • ~3L lymph/day
  • Right Lymphatic Duct
    • formed where R jugular, supraclavicular, subclavian, and parasternal trunks meet
    • Empties→ R venous angle
      • ¼ of total lymph/day
25
Q

Lymph Nodes

A
  • Function:
    • Protect body by acting as filter for harmful mats such as pathogens, cx cells, dust, dirt
    • Produce antibodies (antigen stimulated lymphocytes)
    • Thicken lymph fluid by reabsorbing water

Fluid usually passes thru several nodes w/in chain to insure suff. filtration

26
Q

Lymph Nodes

A
  • Lymph fluid flows slowly inside nodes→ lymphocytes/macrophages time to ID pathogens and debris
  • Fluid reabsorbed partly by blood venous caps, remaining lymph transported out of nodes
  • Nodes often first defense in lymphatic transport
    • Sentinel nodes→ first to drain region of body
    • Sentinel Node biopsy→ performed for most Cx’s to detect spread of cx cells*
27
Q

Lymphatic Watersheds

A

Linear areas that separate body regions that are drained by same vessels

*a few lymphatic vessels cross watersheds→ “anastomoses”

28
Q

VIDEOS!!!!

A

SLIDE 28

WATCH CRASH COURSE AGAIN!!!!

Medcon Rehab IV (18 decks)

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