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Integ Final Review:Lyphedema and Misc Wounds > the end. > Flashcards

the end. Flashcards

1
Q

What are the 3 main functions of the lymphatic system?

A
  1. Drainage of the interstitial fluid from tissues
  2. Absorbs and transports proteins and long chain fatty acids
  3. Immune system response against infection, removes foreign organisms
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2
Q

Lymph Fluid carries 4 Major things

A
  1. Protein macromolecules
  2. Excess water
  3. Long chain fatty acids
  4. Cell load-cell fragments
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3
Q

This type of lymphatic vessel makes up 40% of the lymph system and absorbs fluid from the interstitium.

A

Superificial/initial lymphatics

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4
Q

This type of lympatic vessel is considered the absorber and transporter and has unidirectional valves to direct lymph flow

A

Precollectors

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5
Q

This type of lymphatic vessel is considered the transporting vessel, have one way valves toward the heart. it’s valves divide the lymph system into functional units called lymphangions

A

Collectors

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6
Q

This type of lymphatic vessel is considered filter sites where lymphoctyes identify and destroy foreign material

A

Nodes

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7
Q

Average axillary nodes are____ and aveage inguinal nodes are ____

A

10-24, 8-15

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8
Q

Largest lymphatic trunk in the body, picks up L subclavian trunk and plugs into L subclavian Vein 75% of lymph drains here

A

Thoracic duct

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9
Q

This lymphatic structure is very short and manages fluid of the right arm and torso above the waist, plugs into the R subclavain

A

R lymphatic duct

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10
Q

This lymphatic structure you can find around L2, L lumbar trunk, R lumbar turnk and intestinal trunk collect here and then proceed to the thoracic duct

A

Cisterna Chyli

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11
Q

Which nodes do most of the fluid of the lower body drain into

A

inguinal

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12
Q

Skin of the abdomen, skin of the buttocks and most organs of the lower body with the exception of portions of the liver drain where?

A

right terminus

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13
Q

Whole arm, skin of chest and skin of back drain in what type of node

A

axillary

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14
Q

Intercostals drain to ____

A

thoracic duct and cisterna chyi directly

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15
Q

Occurs when a fluid is forced through a membrane and as a result of the hydrostatic and osmotic pressure differences

A

Filtration

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16
Q

List the 4 factors that lead to increased filtration

A
  1. Heat
  2. Exercise
  3. Venous Congestion
  4. Other (meds, hormones, ANS_
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17
Q

Accumulation of lymphatic fluid that causes swelling in the tissues of an extremity or other body part. Occurs when lymphatic system is damaged causing flow to interrupt

A

Lymphedema

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18
Q

This type of lymphedema is rare and is usually due to congenital malformation or impairment of lymphatics, Le affected most often

A

Primary lymphedema

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19
Q

This type of lymphedma is acquired and more common caused by filiararsis, cancer tx, chronic VIs

A

Secondary Lymphedema

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20
Q

What is the most common reason for lymphedema

A

Filiariasis

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21
Q

This type of lympatic insufficiency occurs when normal lympatic vessels are overwhelmed by lympatic load. Usually due to CHF, Kidney dysfunction, hunger edema, burns, varicose veins.

A

Dynamic

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22
Q

This type of lymphatic insufficiency has a normal lymphatic load but there is some type of impairment to the lymphatic system. Results in low flow, high protein edema.

A

Lyphostatic edema

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23
Q

T/F functional lymphostatic edema is potentially reversivable but organic is not

A

true

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24
Q

T/F organic scondary lymphostatic edema is most common

A

t

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25
Q

____% of patients after breast cancer acquire lymphedema and ____% with prostate

A

23-45 and 70

26
Q

List the chief complaints in lymphedema

A
  1. Limb heaviness
  2. Paresthesia
  3. Achiness
  4. Skin tightness
  5. Altered cosmesis
  6. Decreasaed ADls/ROM
27
Q

Name the condition. Bilateral symmetrical increase in adipose tissue deposition in the abdomen, buttocks and LE, note in Feet. effect mostly women, triggered by puberty, preg, menopause

28
Q

Increase compliance of fat allows interstitial fluid to accumulate and leads to

A

lipolymphedema

29
Q

Stages of Lymphedema

  1. Stage 0
  2. Stage 1
  3. Stage 2
  4. Stage 3
A

Latent: no edema present, commonly due to radiation or surgery
Reversible: edema that pits when digital pressure is applied
Spontaneously Irreversible: does not pit when digital
Lymphostatic elephatiatis: extreme increase in limb volume

30
Q

Unilateral Lyphedema
Mild
Moderate
severe

A

Mild: <3cm
Moderate 3-5
Severe: greater than 5 cm difference

(circumf.)

31
Q

Describe a postive stemmer sign

A

fold of skin pinched and lifted up at the base of the second toe. Positive when skin fold is THICKER THAN 2 mm

32
Q

What is the gold standard for diagnosing lymphedema

33
Q

What are absolute contras to MLD

A
  1. Acute infection
  2. Untreated cancer
  3. Thrombo
34
Q

Wound caused by friction to skin surface can be superficial or partial thickness

35
Q

With a clean abrasion what type of dressing should be used

A

Moisture-rententive

36
Q

With a contaminated abrasion what type of dressing should be used

A

broad-spectrum antimicrobial and gauze dressing

37
Q

Traumatic wounds resulting from shear or friction forces that separate the epidermis from the dermis, partial thickness wound

A

Skin tears (if there is a skin flap remove it)

38
Q

Payne Martin Classification for Skin Tears

IA
IB
IIA
IIB
III
A 
IA: Linear (Epidermis and dermis pulled apart)
IB: Flap (epidermal flap covers dermis) 
IIA: Scant tissue loss
IIB: Moderate to Large tissue loss
III: Skin tear with complete tissue loss
39
Q

Surgical wounds should be kept clean and dry for _____hours

A

24-48 hours

40
Q

Infection is 4x more likely with ____-

41
Q

Epitheliazation in surgical wounds occur in

42
Q

Factors influencing Dehiscence wounds

A
  1. Malnutrition
  2. Diabetes
  3. Steriods
  4. Smoking
43
Q

80-90% of all bite wounds are caused by

44
Q

Most bite wounds are polymicrobial and you should consider

A

the use of short term antiseptics

45
Q

Only 2 types of spider bites require medical intervention what are they

A
  1. Black widow

2. Brown Recluse

46
Q

Black widow bite how will patient present

A

Patient will be ill within 1-3 hours, will be weak, headache, naseous, hyperreflexia, SOB, diaphoresiss, HTN, tachycardia

47
Q

Treatment for Black widow bite

A

antivenom, NSAID, and muscle relaxer

48
Q

Brown Recluse exist in what parts of the country

A

SW, SE, MDW

49
Q

Majority of brown recluse bites heal without complication in

50
Q

If bitten by a brown recluse patient will present how?

A

Within 24 hours, red inflammed, blue thrombosis, white ischemia with possible necrostic center. Fever, nausea malaise and joint pain.

51
Q

How is Brown recluse bite treated

A

treat with debridement of necrotic tissue, avoid heat, antihistamines, steriods.

52
Q

Damage from radiation depends on what 4 factors

A
  1. Dose
  2. Type
  3. Location
  4. SA
53
Q

What are the patient variables that could contribute to skin damage from radiation

A
  1. Age
  2. Co-morbitideis
  3. Meds
  4. Nurtrition
  5. Immune function
54
Q 
Skin Reaction due to Radiation Treatment
Grade 1
Grade 2
Grade 3
Grade 4
A
  1. Faint erythema, dry desquarrriation, decrease sweating response
  2. Bright erythema, tenderness, moderate edema, moist des.
  3. Moist desqu. with pitting edema
  4. Ulceration or necrosis
55
Q

Intervention for radiation damage

A

silvadine cream, decrease bathing frequency, oatmeal baths

56
Q

What condition is non-infectious progressive necrotizing skin condition, thought to be due to neutrophil dysfunction

A

Pyoderma Gangrenosum

57
Q

Pyoderma Gangrenosum presentation

A

small, painful papule, vesicle or postuel on LE/Trunk may have fever mailaise, myalgia.

58
Q

When should a practioner suspect Pyoderma Gangrenosum

A
  1. Positive wound cultures without response to antibiotics

2. Wound not responding to standard care for presume wound etiology

59
Q

Interventions for Pyoderma Gangrenosum

A
  1. Systemic, topical and locally injjected corticosteriods
60
Q

What is contraindicated when treating pyoderma gangrenosum

A

extensive debridement

61
Q

T/F wound healing is slow and recurrence is common in Pyoderma gangrenosum and PCP will typically rx meds 6-12 months after wound closure

Integ Final Review:Lyphedema and Misc Wounds (1 decks)

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