Random Review LYMPHATICS Flashcards
Will lymphedema usually present unilaterally or bilaterally?
Unilaterally, on the distal portion of the extremity
What makes Stemmer’s sign positive?
- if the skin on the dorsum of the toes and fingers cannot be lifted, or is difficult to lift, compared to the opposite side
- accurately diagnoses the presence of lymphedema
When is compression therapy contraindicated for management of edema?
in the presence of peripheral arterial disease
Why is manual lymph drainage contraindicated with patients who have congestive heart failure?
the heart will not be able to handle the additional fluid and the heart failure will worsen
Primary lymphedema
Occurs due to an abnormal development of the lymphatic system
Secondary lymphedema
Occurs as a result of some other disease or injury that causes damage to the lymphatic system
Types of insufficiencies that lead to lymphedema
- Dynamic
- Mechanical
- Combined
Dynamic lymphatic insufficiency
- Most common
- Excess lymph in circulation, exceeds transport capacity of the system
What does dynamic lymphatic insufficiency lead to?
Pitting edema
Mechanical lymphatic insufficiency
Transport capacity of the system is reduced due to damage of the lymph system
What does mechanical lymphatic insufficiency lead to?
Protein-rich lymphedema
Combined lymphatic insufficiency
Both increase in lymph fluid and decrease in transport capacity
Primary sign of lymphedema
Swelling in the extremities
Classification for lymphedema
- Mild
- Moderate
- Severe
Mild lymphedema
<3 cm difference b/t affected and unaffected limbs
Moderate lymphedema
3-5 cm difference b/t the affected and unaffected limbs
Severe lymphedema
> 5 cm difference b/t the affected and unaffected limbs
Stages of lymphedema
0-3
Stage 0 lymphedema
- AKA latent (preclinical) stage
- No visible edema
- Transport of the lymph system has been affected
Stage 1 lymphedema
- AKA reversible lymphedema stage
- Pitting edema is present, increases w/ activity or heat
- Edema diminishes w/ elevation and rest
Stage 2 lymphedema
- AKA spontaneously irreversible lymphedema stage
- Edema is non-pitting, no change w/ elevation or rest
- Skin has fibrotic changes, risk of infection increases
- Positive stemmer’s sign
Stage 3 lymphedema
- AKA lymphostatic elephantiasis stage
- Extensive non-pitting edema
- Significant fibrotic changes to the skin, papillomas, deep skinfolds, and hyperkeratosis
- Infection is common at this stage
- Positive Stemmer’s sign
What is regarded as the most sensitive and accurate standard for volume measurement with lymphedema?
Water displacement
What is CDT with lymphedema treatment?
Complete decongestive therapy
