Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Fundamentals of PT > Lymphedema > Flashcards

Lymphedema Flashcards

1
Q

What is lymph?

A

Interstitial fluid once it enters the lymph vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the only organs that do not secrete lymph?

A

THe brain and spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does lymph contain?

A

protein, water, fatty acids and cellular components of bacteria, viruses and debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the function of lymph?

A

Keeps connective tissue in a healthy state
Removes fluid, foreign particles from tissues and fats from intestines and returns to bloodstream
Protects body from infection and disease via immune response (lymphocytes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the components of the lymphatic system?

A 
Lymph vessels 
Lymph nodes
Spleen
Thymus gland
Tonsils
Peyers patches
Lymphocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the two segments of a lymph vessel?

A 
The superficial portion (contains Capillaries and pre-collectors-NO VALVES)
Deep portion (contains collectors and Trunks. HAVE VALVES)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are lymphangions?

A

Valves that separate collectors into functional segments. Resemble veins but have thinner walls and valves in shorter intervals. FROM ONE VALVE TO ONE VALVE.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does lymphatic fluid flow rely on?

A

Intrinsic muscle contractions from the smooth muscle within walls of the vessels (lyphangions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How often do Lymphangions contract at rest? During exercise, heat or inflammation?

A

6-10x/min. Increases 10 x with exercise, heat or inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a lymphotome/watershed?

A

Distinct, anatomic areas of lymph drainage that drain to regional lymph nodes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is lymph drained through to get across a watershed?

A

Through anastomoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are lymph nodes?

A

Small kidney shaped vessels arranged in chains.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How many lymph node are there in the body? How big are they?

A

600-700 lymph nodes. About 2-25mm in diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Lymphatics vs. Circulation: direction

A

lymphatics-one way

circulation-circular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lymphatics vs. Circulation: Amount

A

lymphatics-1/2 litres/day

circulation-4-8 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Lymphatics vs. Circulation: Contraction

A

Lymphatic- intrinsic contractions (can also be aided by skeletal muscle contractions)
Circulation-seperate pump (heart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Lymphatics vs. Circulation: Obstruction

A

Lymphatics-Obstruction leads to accumulation of high protein fluid (>1.5 gm/dl) doesn’t move well with gravity changes
Circulation-Obstruction leads to collection of low protein fluid (<1gm/dl) moves better with gravity changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Lymphatics vs. Circulation: Filtering

A

lymphatics-fluid filtered by lymph nodes

Circulation-no filtering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is microcirculation?

A

The 10% of fluid that leaves the arterial end of a capillary that is not reabsorbed by the venous end is reabsorbed by the lymphatic system and returns to circulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some clinical implications of microcirculation?

A
  • Accumulation of proteins in interstitum w/ impaierd lymphatic system. Will pull water across cell membrane to maintain osmotic equilibrium.
  • Loss of elasticity of skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is dynamic insufficiency?

A

Healthy lymphatic system but LL exceeds TC

Happens during sprained ankle, DVT, cardiac edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is mechanical insufficiency?

A

Diseased lymphatic system, normal LL exceeds impaired TC

Lymph node removal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is lymphedema?

A

Abnormal accumulation of protein-rich fluid in the interstitial that occurs when the lymph load exceeds the lymph transport capacity (general but heavily debated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the signs and symptoms of lymphedema?

A

slow, progressive onset
pt feels limb is heavy, not painful
usually starts distally and is asymmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Primary lymphedema?

A

Hereditary or congenetial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is secondary lymphedema?

A

Acquired
Result of damage to soft tissue, lymph vessels or nodes
secondary to radiation, surgery, tumor infection
mosquito bite (Filariasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 4 stages of lymphedema?

A

Sub-clinical stage 0-feeling of heaviness in limb w/o any visible swelling
Stage 1- pits on pressure, high water content, reduces with elevation, reversible
Stage 2-Non-pitting, not reduced by elevation, moderate to severe clinical fibrosis
Stage 3-Elephantiasis-skin changes, lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Who experiences primary lymphedema most?

A

females 87%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is lymphadema praecox?

A

primary lymphedema that occurs before 35 (83% of cases)

30
Q

What is lymphedema tardum?

A

primary lymphedema that occurs after age 35

31
Q

Where is primary lymphedema most common? What can trigger it?

A

Lower extremities. Triggered or exacerbated by infection, trauma or pregnancy

32
Q

What is aplasia?

A

Lack of lymphatics incompatible with life

33
Q

What is hypoplasia?

A

most common type of lymphatic dysfunction, decrease collectors and capillaries

34
Q

What is hyperplasia?

A

Increase in width of lymphatic collectors, insufficient valves

35
Q

What is inguinal node fibrosis?

A

Kinmonth syndrome, nodes cannot drain properly

36
Q

What is inguinal node fibrosis?

A

Kinmonth syndrome, leg edema ***

37
Q

What are the 3 watersheds of the body?

A

Transverse, longitudinal, and superclavicular

38
Q

What is LL?

A

Lymphatic load, LL

-Amt of fluid and cells to be removed from the interstitium

39
Q

What is LTV?

A

Lymph Time volume, LTV (lymph transported/time)

-Amount of lymph transported per unit of time

40
Q

What is TC?

A

Transport capacity TC

-Maximum lymph time volume

41
Q

What is secondary lymphedema?

A

Result of an insult to the lymphatic system (often in the treatment of cancer)

42
Q

What factors have a role in secondary lymphedema?

A

surgery, radiation, BMI, and cellulitis

43
Q

When does 2ndary lymphedema usually happen?

A

Within 4 years but can occur over 10 yrs later

44
Q

What are some differential diagnosis for lymphedema?

A 
Chronic Venous insufficency
Acude DVT
CHF
Lipedema
CRPS
Myxedema
Malignant Lymphedema
45
Q

What are some presentations of Acute DVT?

A 
Sudden onset (usually unilateral)
May be painful
Cyanosis or erythema
\+/- Homans's sign
Potential for pulmonary embolus
Venous doppler ultrasound
46
Q

What are some presentations of CHF?

A 
Swelling distally
Sudden weight gain of greater than 2 lbs overnight
Bilateral and symmetrical
Pitting
swelling decreases w/ elevation
painless
jugular venous distention
47
Q

What are some presentations of lipedema?

A 
Usually in women
Bilateral from iliac crest to ankles
dorsum of feet not involved
no pitting 
no cellulitis
pain on palpation w/ bruising
48
Q

What are some presentations of Malignant Lymphedema?

A 
Pain, paraesthesias, paralysis
Proximal swelling
Rapid development, continuous progress
Lymph node enlargement
Ulcers
Heatoma-like discoloration
49
Q

What are the six ways of measuring lymphedema?

A

Circumferential (high intrarater, low interrupter)
Water displacement
Weight
Optoelectrical: perometer
Tonometry
Bioimpedance (ratio of extracellular to intracellular fluid volumes)

50
Q

What are the negatives of measuring lymphedema?

A

none can measure face, hands, feet, breast or trunk
Dont measure differences btwn R and L limbs
do not factor change in noninvolved armo ver time

51
Q

What is a Stemmers sign?

A

Can’t quite pinch the skin on the toes and so you bring extra tissue with it. Presence of lymphedema

52
Q

What is 1+?

A

visible edema

53
Q

What is 2+?

A

5–15 seconds

54
Q

What is 3+?

A

15-30 seconds

55
Q

What is 4+?

A

> 30 seconds

56
Q

What are some interventions for Lymphedema?

A 
Nothing
Pt education
Compression garment, no bandage
Bandage then compression carnet
Complete decongestive therapy (CDT)
compression pump
57
Q

What is phase one of CDT?

A

skin care
MLD
Compression bandage up to 24 hrs a day
exercise in bandage

58
Q

What happens in phase 2 of CDT

A

Skin care self/partner massage

Compression stockings days, bandage nights

59
Q

What are general contraindications for CDT?

A 
Acute infection
Cardiac edema
Malignant disease (relative)
Renal Dysfunction
Acute DVT
60
Q

What are some contraindications for bandaging?

A

Arterial disease

precaution in case of HTN, paralysis, diabetes, bronchial asthma and CHF

61
Q

What are some contraindications for MLD of abdomen?

A

pregnancy
Recent abdominal surgery
intestinal problems
Aortic aneurysm

62
Q

What are some contraindications for MLD of Neck?

A

Cardiac arrhythmia
Hypo/hyper thyroidism
Hypersensitivity or carotid sinus
Over age 60 (relative)

63
Q

Education

A

Fill out

64
Q

What are the effects of MLD?

A

Increased freq. of lymph vessels contractions
increase volume of lymph transported
increased pressure in collectors
redirects lymph flow towards collateral vessels and across watersheds

65
Q

What are the characteristics of MLD techniques?

A 
specific
light
do not cause increased blood flow
superficial (dermis, sub-dermis)
2 phase stretch and release
slow every six to ten seconds
66
Q

What type of bandages are used for lymphedema?

A

Short stretch bandages

67
Q

How much pressure is exerted by a class 1 compression stocking?

A

20-30 mmHg

68
Q

How much pressure is exerted by a class 2 compression stocking?

A

30-40 mmHg

69
Q

How much pressure is exerted by a class 3 compression stocking?

A

40-50 mmHg

70
Q

How much pressure is exerted by a class 4 compression stocking?

A

50-60 mmHg

71
Q

What is exercise thought do do for lymphedema?

A

activate muscle and joint pumps

Fundamentals of PT (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions