Module 2 Test

Question 1

Define diffusion.

Answer 1

migration of particles from higher to lower concentration

Question 2

There is more O2 in blood than in _________, so

02 _________ blood capillaries by process of _______.

Answer 2

tissues
leaves
diffusion

Question 3

Define diffusion distance, as it relates to lymphedema.

Answer 3

distance between blood capillaries and cells in the tissues

Question 4

Swelling ___________ the normal diffusion distance.

Answer 4

increases

Question 5

Name some ways increased diffusion distance negatively impacts tissues?

Answer 5

• local immune response is compromised
• nutritional supply to cells suffer
• frequent infections/increased risk for infections

SKIN CARE IS IMPORTANT TO MANAGE RISK

Question 6

Define COP pl

Answer 6

the force of proteins to hold onto water in the blood plasma (equals 25 mm Hg)

Question 7

In healthy individuals, COP pl is ________ COP ip.

Answer 7

greater than

Question 8

Define COP ip

Answer 8

the force of proteins to pull water into the interstitial spaces

Question 9

In a 24 hour period, approximately what percentage of circulating proteins will leave the blood (at the blood capillary), and move into the interstitial space?

Answer 9

50%

Question 10

Is BP higher or lower than BCP?

Answer 10

higher

Question 11

What is the average BP at the artery?

Answer 11

100 mm Hg

Question 12

What is the average BP at the vein?

Answer 12

3-4 mm Hg

Question 13

Return of blood to the heart depends on…

Answer 13

• muscle pump
• functioning valves
• diaphragmatic breathing
• suction effect of heart at diastole
• pulsation of adjacent arteries

Question 14

How does the precapillary sphincter impact the flow of blood to the capillaries, when in constricts?

Answer 14

contracts = less blood in capillaries - less volume = decreased BCP

Question 15

Filtration occurs at the _______ end of the blood capillary.

Answer 15

arterial

Question 16

Reabsorption occurs at the ______ end of the blood capillary.

Answer 16

venous

Question 17

Define reabsorption.

Answer 17

Process by which water is reabsorbed from tissues back into the venous end of the BC - water picks up waste products and returns them to venous system.

Question 18

What percentage of H2O is reabsorbed by venous system?

Answer 18

80-90%

Question 19

How does H2O remain in the interstitial spaces?

Answer 19

Proteins (hydrophilic macromolecules) exist in the interstitial spaces, and hold back 10-20% of the water. This is referred to as the lymphatic load of water, or net filtrate. Removal of LL is the responsibility of the lymphatic system.

Question 20

Describe the classic view of Starling’s Law.

Answer 20

Arterial blood capillary pressure (29 mm Hg) > colloid osmotic pressure of the plasma, causing protein to be forced out into the interstitial space, at the level of arterial capillaries. On the venous end, blood capillary pressure (14 mm Hg) < colloid osmotic pressure of the plasma, favoring return of fluid into the venous system (80-90%). Proteins are unable to cross the semi-permeable membrane back into the venous system, resulting in protein rich fluid in the interstitial space. This fluid, is managed by the lymphatic system.

Question 21

Name the components of CDT.

Answer 21

• MLD
• skin care
• exercise
• compression

Question 22

How is compression beneficial in lymphedema?

Answer 22

It increases the tissue pressure directed against the capillaries, which hinders filtration and supports reabsorption.

Question 23

Define active hyperemia.

Answer 23

anything that causes vasodilation and increased arterial flow

Question 24

How does active hyperemia influence fluid homeostasis?

Answer 24

increased arterial flow - increased volume - higher arterial BCP - increased filtration - increased net filtrate

Question 25

Name some common causes of active hyperemia.

Answer 25

- deep tissue massage - inflammation/infection - temperature/thermal modalities - sunbathing - vigorous exercise

Question 26

Define passive hyperemia.

Answer 26

increase in BCP caused by an obstruction of venous return or deficiency of venous outflow - blood pools into capillaries

Question 27

How does the body respond to active and/or passive hyperemia?

Answer 27

activation of the lymphatic safety factor, through increase in lymphangiomotoricity and increased lymph time volume

Question 28

Define functional reserve.

Answer 28

The difference between transport capacity (LS working at max amplitude and frequency) and lymphatic load, as the LS will only work as hard as it needs to (lymph time volume), to manage current LL. i.e. the availability for compensation

Question 29

Define dynamic insufficiency.

Answer 29

- healthy LS is overwhelmed - AKA high volume insufficiency, where LL of H2O > TC - LTV is "maxed out" - results in EDEMA (which is a symptom)

Question 30

Describe mechanical insufficiency.

Answer 30

- TC drops below normal amount of LL - AKA low volume insufficiency - due to damage to the LS - results in LYMPHEDEMA (which is a disease)

Question 31

Identify important characteristics of dynamic insufficiency.

Answer 31

- healthy LS - TC is normal - LL > TC - protein concentration in tissue is normal - high volume insufficiency - MLD/CDT not indicated - max LTV = TC - results in edema

Question 32

Identify important characteristics about mechanical insufficiency.

Answer 32

- unhealthy LS - TC is subnormal - LL could be normal, but > subnormal TC - protein concentration in tissue is > than normal - low volume insufficiency - MLD/CDT indicated - max LTV = subnormal TC - results in lymphedema

Question 33

(delete) Identified important characteristics of combined insufficiency. (?)

Answer 33

- unhealthy LS - TC is subnormal - LL is > normal and also than subnormal TC - protein concentration in tissue is elevated - Max LTV = subnormal TC - MLD/CDT indicated - results in lymphedema

Question 34

Define combined insufficiency.

Answer 34

mechanical insufficiency (that was possible under control) with insult resulting in increased LL

Question 35

What is the current gold standard diagnostic tool for lymphedema?

Answer 35

lymphoscintigraphy

Question 36

How does the precapillary sphincter impact the flow of blood to the capillaries, when in dilates?

Answer 36

dilates = more blood in capillaries - greater volume = increased BCP