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Advanced Health Assessment > week 4 module 13 lymph system > Flashcards

week 4 module 13 lymph system Flashcards

1
Q

infants

A

lymph system begins development at 20wks gestation
immature at birth
inc. in childhood especially 6-9y/o

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2
Q

preg.

A

temporary remission of autoimmune/inflammatory disorders

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3
Q

older adults

A

nodes dec. size and number with age

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4
Q

HPI enlarged nodes

A

character: onset, location, duration, number
local s/s: pain, redness, warmth, red streaks
systemic s/s: malaise, fever, wt. loss, night seat, abd. pain
predisposing factors: infection, surgery, trauma
meds: chemo, antibiotics

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5
Q

HPI swelling of extremity

A

uni/bilateral
intermittent or constant
predisposing factors: CV or renal disorder, surgery, infection, trauma, venous insufficiency.
assoc. s/s: warmth, redness/discoloration, ulceration

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6
Q

PMH

A

chest imaging
TB
blood transfusions, use of blood products
Chronic illness: cardiac, renal, malignancy, HIV
surgery: trauma, organ transplant, lymph node biopsy
recurrent infections
autoimmune disorders
allergies

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7
Q

FH

A 
malignancy
anemia
recent infectious disease
TB
immune disorders
hemophilia
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8
Q

personal and social hx

A

travel: asia, africa, wester pacific, india, philippines
recreational drugs
sexual hx

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9
Q

infants and childrens hx

A

recurrent infections

- tonsillitis, adenoiditis, bacterial infections, oral candidiasis, chronic diarrhea, chronic severe ecamea

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10
Q

preg patients

A

weeks of gestation
exposure to infections
pets in household: cat feces
immunization status

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11
Q

older adults

A

autoimmune disease
recent infection or traume to nodes
delayed healing
immunization status

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12
Q

lymphadenopathy

A

enlarged lymph nodes

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13
Q

lymphadenitis

A

inflamed and enlarged lymph nodes

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14
Q

lymphangitis

A

inflammation of the lymphatics that drain an area of infection; tender erythematous streaks extend proximally from the infected area
- regional nodes may also be tender

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15
Q

lymphedema

A

edematous swelling due to excess accumulation of lymph fluid in tissues caused by inadequate lymph drainage

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16
Q

lymphangioma

A

congenital malformation of dilated lymphatics

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17
Q

shotty nodes

A

small non-tender nodes that feel like BB’s or buckshot under the skin

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18
Q

fluctuant nodes

A

wavelike motion that is felt when the node is palpated

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19
Q

matted nodes

A

group of nodes that feel connected and seem to move as a unit

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20
Q

hard, fixed, painless node

A

suggests malignant process

- usually rapid enlargement

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21
Q

tender node

A

more likely an inflammatory process

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22
Q

virchow node

A

palpable supraclavicular node on left

- clue to thoracic or abdominal malignancy

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23
Q

slow nodal enlargement suggests

A

benign process

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24
Q

acute lymphangitis patho

A

inflammation of one or more lymphatic vessels

25
Q

acute lymphangitis subjective

A 
enlarged lymphnode
pain
malaise
possible fever
minor trauma to skin distal to the area of infection
26
Q

acute lymphangitis objective

A

red streaks after the course of the lymphatic collecting duct
tracing of fine lines streaking up the extremity
indurated and palpable to gentle touch sometimes
look distal for sites of infection, esp. between digits

27
Q

acute suppurative lymphadenitis patho

A

infection and inflammation of a lymph node, single or group

28
Q

acute suppurative lymphadenitis subjective

A

enlarged nodes

pain

29
Q

acute suppurative lymphadenitis objective

A

involved node usually firm and tender
overlying tissue edematous, erythematous, within 72hr
abscess formation extensive; nodes fluctuant

30
Q

mycobacterial adenitis characterized by

A

inflammation without warmth that may or may not be tender

31
Q

lymphedema patho

A

edematous swelling due to excess accumulation of lymph fluid in tissues caused by inadequate lymph drainage

32
Q

lymphedema subjective

A 
painless swelling of limb; uni/bilateral
onset usually gradual 
hx of trauma, surgery, or radiation to area
travel where filariasis is common
family hx leg swelling
33
Q

lymphedema objective

A

swelling and often distortion of extremities
may or may not pit
overlying skin thickens and feels tougher than usual

34
Q

primary lymphedema

A

apparent at birth and most often involves the legs
degree varies with the severity and distribution of the abnormality
may not appear till young adulthood

35
Q

Stage 0 lymphedema

A

latent or subclinical

swelling is not evident despite impaired lymph transport

36
Q

Stage 1 lymphedema

A

pitting may occur
early accumulation of fluid relatively high in protein content
- subsides with elevation

37
Q

Stage 2 lymphedema

A

tissue fibrosis is present
limb elevation alone rarely reduces swelling
pitting may be present, as fibrosis worsens pitting decreases

38
Q

Stage 3 lymphedema

A

pitting is absent

trophic skin changes are present

39
Q

lymphangioma/cystic hygroma patho

A

congenital malformation of dilated lymphatics

40
Q

lymphangioma subjective

A

painless cystic masses
usually manifest during 1st year of life
- often enlarged after an URI
asymptomatic when in posterior triangle of neck
- found anteriorly may cause airway/swallowing issues

41
Q

lymphangioma/ cystic hygroma objective

A

soft, nontender, and easily compressible spongy fluid-containing mass without discrete margins.
most present at birth
- neck, axilla, less common: chest, extremities

42
Q

lymphatic filariasis (elephantiasis) patho

A

massive accumulation of lymphedema throughout the body

- widespread inflammation and obstruction of the lymphatics by the filarial worms transmitted by mosquitos

43
Q

lymphatic filariasis (elephantiasis) subjective

A

swelling of limb or body area
travel: asia, africa, western pacific, india, philippines
many w/out s/s
fever, chronic pulmonary infection

44
Q

non-hodgkin lymphoma patho

A

malignant neoplasm of the lymphatic system and the reticuloendothelial tissues

45
Q

non-hodgkin’s subjective

A 
painless enlarged lymph nodes
fever
wt. loss
night sweats
abd. pain/fullness
family hx
46
Q

non-hodgkin’s objective

A
  • nodes may be localized in the posterior cervical triangle or may become matted, crossing into the anterior triangle
  • nodes well defined and solid
47
Q

Hodgkin’s lymphoma patho

A

malignant lymphoma
starts in single node and spreads to contiguous lymph nodes, spleen, liver, and bone marrow.
neoplastic giant cells release factors that induce accumulation of lymphocytes, macrophages, and granulocytes

48
Q

hodgkin lymphoma subjective

A

painless enlarged lymph nodes
may have abd. pain
sometimes fever
possible hx of mononucleosis

49
Q

hodgkin lymphoma objective

A

most common:
- painless enlargement of cervical lymph nodes
- - generally asymmetric and progressive
Nodes sometimes matted and firm, almost rubbery

50
Q

Epstein-Barr virus Mononucleosis patho

A

infectious mono
oral epithelial cells
incubation period 30-50 days

51
Q

epstein-barr virus mononucleosis subjective

A 
malaise
fatigue
acute or prolonged fever
HA
ST
nausea
abd pain
myalgia
52
Q

epstein-barr virus mononucleosis objective

A
  • generalized lymphadenopathy, most common in cervical nodes and submandibular
  • epitrochlear lymphadenopathy
  • hepatomegaly
  • splenomegaly
  • moderate to severe pharyngitis with tonsillar enlargement, occasional exudates
  • petechiae at the junction of the hard and soft palate
53
Q

toxoplasmosis patho

A

zoonosis, caused by the parasite toxoplasma gondii

  • ingestion of oocysts in soil undercooked meat, raw eggs, cat feces or litter
  • infection persists for life without s/s
  • immunosuppresion: neurologic disease and organ manifestations
  • preg: serous congenital infection, particularly in 1st trimester
54
Q

toxoplasmosis subjective

A

no s/s
hx of eating raw or rare meat, undercooked eggs
hx contact with cat feces

55
Q

toxoplasmosis objective

A

single node, chronically enlarged and nontender

- usually in the posterior cervical chain

56
Q

roseola infantum patho

A

infection by human herpes virus 6

  • common in infancy peak age 2 years
  • present in the saliva of most adults transmitted by oral secretions
57
Q

roseola infantum subjective

A

fever- high grade and persistant over 3-4 days

may have mild resp. illness and lymphadenopathy

58
Q

roseola infantum objective

A
  • adeopathy, discrete and not tender, involves the occipital and postauricular chains, may last for some time.
  • when fever diminishes, morbillifrom fine maculopapular rash occurs, spreads from trunk to extremities, then child begins to feel better

Advanced Health Assessment (57 decks)

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