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Lymphedema (ACOLS) > Day 1 > Flashcards

Day 1 Flashcards

1
Q

Global swelling indicates

A

Kidney, heart, and liver problems

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2
Q

What is the main purpose of the lymphatic system?

A

Drain substances that cannot be drained/reabsorbed by the blood system.

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3
Q

What are commonalities between circulatory and lymphatic systems?

A
  • Protect the body from infection and disease
  • Superficial & deep organ systems
  • Leukocytes
  • Blood plasma
  • Serum proteins
  • Common pathway to heart
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4
Q

Circulatory and lymphatic system differences

A
  • No central pump (lymphatic system is innervated by sympathetic part of ANS)
  • Lymph transport is interrupted by lymph nodes
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5
Q

What is edema?

A
  • Accumulation of water in tissues
  • Symptom
  • Caused by dynamic insuffancy of lymphatic system
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6
Q

What is lymphedema?

A
  • Amnormal accumulation of water and protein
  • Disease process
  • Mechanical insuffancy of lymphatic system
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7
Q

What are lymphatic loads made of?

A

Water
Protein
Cells
Long-chain fatty acids (Fat)

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8
Q

How many liters are returned to venous system via the thoracic duct in 24 hours

A

2-4 Liters

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9
Q

It is the responsibility of the lymphatic system to remove what from the tissue spaces?

A

Proteins

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10
Q

What can not be absorbed by the blood vessels of the small intestines?

A

Long-chain fatty acids

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11
Q

Lymphatic loads/cell fragments include

A
  • All cells that become free in the interstitial space
  • Hematoma contents, RBC, WBC, CA cells, bacteria, viruses, and tattoo ink (90-95%)
  • Inhaled spores
  • Cell fragments too large to be reabsorbed by venous capillaries
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12
Q

If mechanical insuffancy is not treated what happens?

A

Lymphedema continues to progress

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13
Q

Initial lymph capillaries are where

A

Plexus

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14
Q

Lymph collectors are located where?

A

Suprafascial fatty tissue

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15
Q

Each lymph capillary endothelial cells is connected to surrounding interstitial tissue via what

A

Anchoring filaments

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16
Q

Locations of perforating precollectors

A

Parasternal
Paravertebral
Intercostal

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17
Q

Purpose of lymphatic collectors

A

Transport lymph to regional lymphatic nodes and lymphatic trunks

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18
Q

Which part of the nervous system innervated the smooth muscles?

A

Sympathetic portion of the autonomic nervous system (ANS)

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19
Q

3 main regional lymph nodes

A

Axillary, inguinal, and cervical

20
Q

What makes up the femoral lymph node borders (femoral triangle)?

A

Inguinal ligament, sartorius muscle, and gracilis muscle

21
Q

How many inguinal lymph nodes are there?

A

6-12

22
Q

What skin areas drain to inguinal lymph nodes?

A

Legs
Lower body quadrants
External genitalia of men and women (penis and scrotum or external labia)

23
Q

Where are axillary lymph nodes located

A

Between pectoralis and latissimus dorsi

24
Q

How many axillary lymph nodes are there?

A

12(10)-24

25
Q

Where is the upper horizontal watershed?

A

Sternal notch - clavicle - acromion - spine of scapula - between c7/t2

26
Q

Where is the lower horizontal watershed?

A

Umbilicus - lower boarder of ribs - to t12

27
Q

Where is the sagittal watershed?

A

Midline dividing body from L to R - vertex to the perineum

28
Q

What are intra-territorial anastomosis

A

Connections between collectors within the same territory

29
Q

What are inter-territorial anastomoses

A

Anastomoses where the collector’s origins directly align with each other at the watersheds

30
Q

How many collectors for every anastomoses?

A

7-10

31
Q

What are the 6 anastomoses?

A 
AAA: Anterior Axillo-axillary
AII: anterior inter inguinal
AI or IA: right or left axillo-inguinal or inguinal-axillary (only on front side)
PAA: posterior Axillo-axillary
PII: posterior inter inguinal
32
Q

Where is the cisterna chyli

A

Anterior to vertebrae T11-L2

33
Q

What makes up the venous angle (R or L)?

A

Internal jugular and subclavian veins

34
Q

The lymph from lumbar trunks feeds into what?

A

Cisterna chyli

35
Q

How much lymph goes through the R lymphatic duct in 24 hours

A

300ml (soda can)

36
Q

What drains into L venous angle?

A

Lower extremities, bil lower quadrants, external genitalia, L upper quadrant, LUE, L side face/head/neck

37
Q

What drains into the R venous angle?

A

R upper quadrant, RUE, R face/head/neck

38
Q

What are the boarders of deep cervical lymph nodes/lateral cervical triangle

A

Anterior boarder: SCM
Posterior boarder: upper trapezius
Inferior boarder: clavicle

39
Q

Where does the upper extremity have a bottle neck?

A

Antecubital fossa

40
Q

What lymph nodes do the upper extremity drain into?

A

Axillary and supraclavicular lymph nodes

41
Q

Ventro-medial bundle is where?

A

15 collectors;
Drains plantar surface of feet, 1/2 medial sole, dorsum of foot, lower leg, bottlenecks behind medial femoral condyle, and increases to run to inguinal lymph nodes

42
Q

Dorsi-lateral bundle is where?

A

1/2 sole of foot, heel, and narrow strip following Achilles to popliteal fossa

43
Q

What options do you have to re-route lymph?

A

Utilize lymph collectors in affected area, plexus, lymphatic vasa-vasorum, anastomoses, deep lymph vessels

44
Q

What are the general effects of MLD?

A 
Increase lymph production
Increase lymphangiomotorocity
Increase in venous return
Reverse of lymph flow
Soothing
Analgesic
45
Q

What are neck contraindications (absolute)?

A 
Carotid endoarterectomy
Hyperthyroidism/thyroid problems
Carotid-sinus syndrome
History of CVA
Cardiac arrhythmia

Lymphedema (ACOLS) (6 decks)

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