Lymphatic Anatomy/Physiology Flashcards Preview

Medical Conditions II > Lymphatic Anatomy/Physiology > Flashcards

Flashcards in Lymphatic Anatomy/Physiology Deck (45):
1

Components of Lymphatic System

-lymph vessels
-lymph nodes
-thymus gland
-lymphocytes
-tonsils
-spleen
-Peyer's patches

2

Lymph Vessels

-capillaries
-pre-collectors
-collectors
-trunks

3

Right Drainage Area

-RUQ
-(drainage from right UE, right side of head, right upper trunk)

4

Left drainage area

-Everything but RUQ
(drainage from LE, lower trunk, Left trunk, left UE, left side of head)

5

70% of lymphatic system is______

-superficial

6

Cistema Chyli

-collects emulsified fats

7

True/False: the lymphatic system is symmetrical

-false

8

Lymphangion

-functional unit of muscle tissue around lymphatic valves to push fluid in correct direction

9

Lymph system relies on_____

-voluntary skeletal muscle contractions to move fluid

10

Lymph system circulates _____ l/day

2-2.5 liters/day

11

Chyle

-lymph plus emulsified fats

12

Lymph Vessels Function

-return protein to cardiovascular system
-remove excess fluid from interstitium
-transport chyle (intestinal lymph vessels)
-transport capacity>lymph load

13

Insufficiency

-Dynamic (high volume)
-Mechanical (low volume_
-Combined

14

Dynamic Insufficiency

-High volume
-lymph load exceeds transport capacity

15

Mechanical Insufficiency

-Low volume (normal load)
-decreased transport capacity due to injury/impairment
-more common

16

Forms of LE edema

-venous insufficiency
-Congestive heart failure
-lymphedema

17

Lymphedema

-transport capacity-abnormal accumulation of protein-rich fluid in interstitium
-cases inflammation and reactive fibrosis of affected tissue

18

Skin Characteristics of Lymphadema

-hyperkeratosis
-lichenification
-Peau d'orange texture
-ulcerations unusual
-elasticity/hydration of skin maintained longer than in venous disease

19

hyperkeratosis

-excess of keratin deposits

20

Peau d'orange texture

-skin textured like orange (little dimples, surrounding hair follicles)

21

Lymphadema does NOT cause_____

Ulcers, pain

22

Lymphedema Causes

-Primary
-Secondary

23

Primary Lymphadema Causes

-congenital/heredity
-born with it

24

Secondary Lymphadema Causes

-surgery
-radiation
-trauma
-filariasis
-CVI
-infection
-tumor growth
-artificial (self induced)

25

Lymphadema Staging

-latency
-stage 1: reversible
-stage 2: spontaneously irreversible
-stage 3: lymphostatic edemas

26

Latency Stage

-transport capacity reduced
-no visible palpable
-subjective complaints possible

27

Stage 1

-reversible
-accumulation of protein-rich fluid
-pitting edema
-reduces with elevation
-no fibrosis

28

Stage 2

-Spontaneously Irreversible
-proteins stimulate fibroblast formation
-pitting becomes progressively worse
-connective/scar tissue formation

29

Stage 3

-lymphostatic edema
-hardening of dermal tissues
-pitting absent
-fibrosis/sclerosis
-skin changes
-elephantiasis--filariasiss

30

Edema not detected clinically until______

-interstitial volume reaches 30% above normal

31

LVF

-location
-volume
-fibrosis

32

Primary Differential Diagnosis

-vascular anomaly
-tumor

33

Secondary Differential diagnosis

-DVT, venous insufficiency
-infection
-cardiopulmonary failure
-hepato-renal failure
-systemic disease (amyloidosis)
-lipedema

34

Causes of local edema

-lymphedema
-lipedema
-acute DVT or thrombophlebitis
-chronic venous insufficiency
-congenital vascular malformations
-arteriovenous fistula
-trauma
-infection, cellulitis
-ruptured synovial cyst (baker's cyst)
-hematoma
-dependency

35

Diagnostic Lab Tests

-CBC
-Electrolytes
-Albumin
-SPE (serum protein electrophoresis)

36

Low Albumin

-too much fluid leaves vessels to insterstitium

37

Diagnostic Imaging

-US
-MRI
-Venous studies
-CT
-Microlymphography
-x-rays
-lymphoscintigraphy

38

Gold Standard diagnostic Imaging

-Direct Lymphography

39

Diagnosis

-med history
-physical exam
-measurements
-venous evaluation
-laboratory

40

Pneumatic Compression Pump

-NOT indicated
-and pressure will collapse superficial lymphatic drainage
-also fluid won't be able to get past the blockage

41

Treatment

-surgery
-pharmocologic
-CDP-complex decongestive therapy

42

Phases of Complex Decongestive Therapy

-I: intensive daily treatments
-II: supportive

43

Comprehensive Management

-CDT/CDP
-nutritional counseling
-education
-psychosocial intervention

44

Manual Lymph Drainage

-increase lymph vessel contractions
-increases reabsorption of fluid
-direct superficial flow
-improve lymph transport capacity

45

Bandaging

-reduce ultrafiltration rate
-improve muscle pump efficiency
-provide support for tissues/joints
-prevent re-accum of evacuated fluid
-facilitate softening of fibrotic tissue