Test 3: Lymphedema Flashcards

1
Q

Lymphatic vessels carry _________

____ with waste products

A

Interstitial fluid

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2
Q

Lymphatic vessels empty into lymph

nodes that act as _____

A

Filters

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3
Q

Once interstitial fluid enters the capillaries it becomes known as ____

A

Lymph

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4
Q

The lymph vessels collect ______
_____, which consists of protein,
water, fats, and wastes from cells.

A

Lymphatic fluid

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5
Q
The lymph vessels transport the
fluid to the lymph nodes, where
waste materials and foreign
materials are filtered out from the
fluid. The fluid is then returned to
the \_\_\_\_\_\_.
A

Blood

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6
Q
When the lymphatic vessels are
\_\_\_\_\_\_ or missing, the lymph
fluid cannot move freely
throughout the system. This
causes an accumulation of fluid
and results in abnormal \_\_\_\_\_\_
A

Impaired

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7
Q

__________ is the result of
this accumulation of lymphatic
fluid in the interstitial tissue

A

Lymphedema

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8
Q

Lymphedema can develop anytime there is an _______ in the lymphatic
system function

A

Impairment

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9
Q

What are the two types of lymphedema?

A

Primary or secondary

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10
Q

Difference in Lymphedema &
Edema:
Lymphedema happens when “Extra fluid builds up in your tissue when your
_________ ________ isn’t working well,
usually because your lymph nodes were
damaged or removed. It’s often a side effect of
cancer treatment and can show up years later.”

A

lymphatic system

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11
Q

Difference in Lymphedema &
Edema:
“Edema happens when your _____ _____
vessels _____ _______ into nearby tissues.
That extra fluid builds up, which makes the
tissue swell. It can happen almost anywhere in
the body.”

A

small blood vessels leak fluid into nearby tissues

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12
Q

Primary lymphedema◦
Due to ________ malformations in
the lymphatic system such as
defective valves or vessels.

A

Congenital

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13
Q

Which type of lymphedema is something “you are born with” or born with a predisposition to have

A

Primary

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14
Q

Secondary lymphedema
AKA “___________ Lymphedema”
It occurs ____birth

A

Acquired

After

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15
Q
Common causes of secondary lymphedema: 
 \_\_\_\_\_\_\_ involving removal of lymph nodes
and vessels (e.g., cancer surgery)
 \_\_\_\_\_\_\_\_ therapy
 \_\_\_\_\_\_\_\_ of lymph vessels and nodes
following infections and trauma
A

Surgery
Radiation
Scarring

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16
Q

If lymph nodes are removed, radiated, or
damaged there is ______ a risk of developing
lymphedema

A

Always

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17
Q

T or F: patients are always at risk to develop lymphedema (even years later) after an insult to lymphatic system.

A

True

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18
Q
Symptoms of Lymphedema:
 A \_\_\_\_\_ sensation in
the limb(s)
 Skin feeling “tight” or
“heaviness” sensation
 \_\_\_\_\_\_\_\_ flexibility
in the hand, wrist, or
ankle
A

Full

Decreased flexibility

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19
Q

Symptoms of Lymphedema:
____ fitting into
clothing in one
specific area

A

Difficulty

20
Q

Symptoms of Lymphedema:

 Bra strap becoming
tight or making deep
\_\_\_\_\_\_\_\_ in the skin
 Persistent swelling
which begins gradually
or suddenly
A

Indentations

21
Q
Symptoms of Lymphedema:
\_\_\_\_\_\_ in the
adjacent shoulder or
hip due to the
increasing weight of
the swelling limb
 Ring/wristwatch/
bracelet tightness.
A

Aching

22
Q
Important to advise “at-risk”
patients…
To seek \_\_\_\_\_\_ medical
advice (and get at least one
second opinion) if they notice any
signs or symptoms of
lymphedema
A

immediate

23
Q

Stages of Lymphedema
Stage 1 -(spontaneously
reversible) “mild”
◦ Tissue is still at the ______ stage, which
means that when pressed by fingertips, the
area indents and holds the indentation. Usually,
upon waking in the morning, the limb(s) or
affected area is normal or almost normal size.

A

Pitting

24
Q
Stage 2 (spontaneously
irreversible) “moderate”
◦ The tissue now has a spongy
consistency and is "non-pitting,"
meaning that when pressed by
fingertips, the tissue bounces back
without any indentation forming.
◦ \_\_\_\_\_\_ found in Stage 2
lymphedema marks the beginning of
the hardening of the limbs and
increasing size.
A

Fibrosis

25
Q
Stages of Lymphedema
Stage 3 (lymphostatic
elephantiasis) “severe”
◦At this stage the swelling is
\_\_\_\_\_\_\_\_\_ and usually the
limb(s) is/are very large. A classic
presentation of stage 3
lymphedema is the tissue is very
hard (fibrotic)
A

Irreversible

26
Q

Fibrosis occurs in stage __ lymphedema

A

2

27
Q

In stage 3 lymphedema, tissue
changes and that’s where the name
__________ comes from due to
the appearance of the skin.

A

elephantiasis

28
Q
When lymphedema remains
untreated, protein-rich fluid
continues to accumulate, and in
this state, the swollen limb(s)
becomes a perfect culture medium
for \_\_\_\_\_\_.
Chronic infections and skin/tissue
\_\_\_\_\_\_\_\_\_\_\_ are often the result
A

Bacteria

Breakdown

29
Q
Stemmer’s Sign- an OT
evaluation tool
• \_\_\_\_\_\_\_\_\_\_\_\_ sign - perform test by
attempting to gently pinch and lift a
thickened fold of skin at the base of the
second toe or second finger
A

Stemmer’s

30
Q
Stemmer’s Sign- an OT
evaluation tool
• \_\_\_\_\_\_\_\_ test result- present when the
skin cannot be lifted. This is considered to
be an indication of the presence
 of lymphedema.
A

Positive

31
Q
* important to note that the
absence of Stemmer sign does
not rule out the possibility of
lymphedema. It may be an
\_\_\_\_\_\_\_ \_\_\_\_ of lymphedema .
A

Earlier stage

32
Q

Lymphedema Treatment
GOLD STANDARD- ___________

A
Complete/Complex
Decongestive Therapy (CDT)?
33
Q
What are the 4 components of Complete/Complex
Decongestive Therapy (CDT)?
A
  1. Skin care
  2. Manual Lymphatic Drainage (MLD)
  3. Compression (multi-layer
    bandaging, vaso-pneumatic pump)
  4. Exercise (best results when
    performing exercises with
    compression on)
34
Q

Contraindications for CDT

A
CHF
 Renal Failure
 Acute Infections
 Acute DVT
 Malignancies
 Acute Bronchitis or bronchial asthma
35
Q

Multi-layer bandaging

Low stretch bandage is easier to tolerate over
many hours of wear and can be worn at rest
& during ____

A

exercise

36
Q

Multi-layer bandaging
In Lymphedema use ________ stretch
bandages which have low resting
pressure

A

Low

37
Q

Multi-layer bandaging
In Lymphedema use ________ stretch
bandages which have low resting
pressure

A

Short/low

38
Q
Multi-layer bandaging
 \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ pressure- occurs when
the force of the compression material is the
strongest when the muscle is active and
pushing against the bandage
A

Low resting

39
Q
Multi-layer bandaging
 \_\_\_\_\_\_\_\_\_\_\_\_ pressure- occurs when
force of the compression material is still
strong when muscles are in a relaxed
state.
 Examples: ACE bandages, coban, and
medical compression garments
A

High resting

40
Q

Manual Lymphatic Drainage
(MLD)
A _________________ where the
therapist uses light touch and through
skilled massage the therapist stimulates the
lymphatics and promotes transportation of
lymph in a direction it can be absorbed.

A

Manual therapy technique

41
Q
Manual Lymphatic Drainage
(MLD)
To do this effectively, the therapist must
have a good understanding of patients
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ to know which areas
have lymphatic deficiencies so fluid can be
re-routed in the direction of intact
lymphatic pathways.
A

Medical history

42
Q

Key principles of MLD
Touch is always _____
Skin is stretched, not stroked
The therapist works proximal to distal**

A

Light

43
Q
Key principles of MLD
There should be \_\_\_\_\_\_\_\_\_\_ of the skin
 MLD should never be painful
 The techniques/ hand movements used in
MLD are repeated rhythmically
A

No reddening

44
Q

Compression Garments are
Necessary
To ________ lymphedema occurring
or increasing

A

Prevent

45
Q

Grades of Compression
Garments:
Level 1 – ______ mmHg

A

1-20

46
Q

Grades of Compression
Garments
Level 2 – 30-____ mmHg

A

30-40

47
Q

Grades of Compression
Garments

Level 3 – 40-____ mmHg

A

40-50