Lymphedema

Question 1

lymph vessels rely on _________ to pump fluid

Answer 1

external forces

Question 2

substances not drained or reabsorbed by the blood stream. Lymph content

Answer 2

lymphatic loads LL

Question 3

Lymphatic loads LL is made mostly of… (4)

Answer 3

protein, water, fat, cell fragments

Question 4

the average person is born w/ ______ lymph nodes

Answer 4

600-700

Question 5

first line of defense for the body

Answer 5

regional nodes

Question 6

3 regional nodes areas

Answer 6

1. axillary
2. inguinal
3. cervical

Question 7

the abnormal accumulation of protein and water in the interstitial spaces, causing swelling of soft tissues

Answer 7

lymphedema

Question 8

TF lymphedema is not a disease and has no cure

Answer 8

true

Question 9

2 ways lymphedema develops through inadequate transport

Answer 9

1. mechanical insufficiency

2. dynamic insufficiency

Question 10

impairment of the lymph transport system; limb is “at risk”

Answer 10

mechanical insufficiency

Question 11

lymph load exceeds transportation capacity TC

Answer 11

dynamic insufficiency

Question 12

hypertrophied mm walls in lymphatic system decreases effectiveness of pumping ability

Answer 12

chronic lymphedema

Question 13

LL < transport capacity TC =

Answer 13

fluid balance, no edema

Question 14

difference between edema and lymphedema

Answer 14

edema= water. can go away
lymphedema= protein and water. lifelong

Question 15

movement of lymph and activation of vessels

Answer 15

lymphangiomotoricity

Question 16

transportation vessels adjacent to each other. Drains area toward same REGIONAL LYMPH NODES

Answer 16

territories

Question 17

linear areas separating territories. Upper/lower horizontal, sagittal/median, gluteal

Answer 17

watersheds

Question 18

connections that re-route LL from impaired quadrants towards healthy quadrants

Answer 18

anastomoses

Question 19

anastomoses btwn lymph collectors in same territory

Answer 19

intra-territorial (w/in)

Question 20

anastomoses connections btwn 2 adjacent territories

Answer 20

inter-territorial (btwn)

Question 21

anastomoses (5)

Answer 21

1. AAA
2. PAA
3. AI/IA
4. AII
5. PII

Question 22

“hidden” lymphedema. Does not develop visible symptoms

Answer 22

stage 0

Question 23

spontaneously reversible. Pitting edema present

Answer 23

stage 1

Question 24

spontaneously irreversible. Not reversible w/ elevation. Non pitting edema

Answer 24

stage 2

Question 25

lymphostatic elephantiasis.

Answer 25

stage 3

Question 26

lymphedema developed due to malformation of lymphatic system. Idiopathic. Typically LE

Answer 26

primary

Question 27

lymphedema present following a known insult to lymphatic system. Surgery, radiation, infection, trauma. Typically UE

Answer 27

secondary

Question 28

Lymphedema s/s (2)

Answer 28

1. pitting in early stages | 2. not relieved by elevation

Question 29

shows lymph flow, lymph node uptake, and backflow

Answer 29

lymphangiography

Question 30

size of indention and the time it takes to go back to normal

Answer 30

1t-4t pitting assessment

Question 31

effective treatment only if edema is due to sodium retention

Answer 31

diuretics

Question 32

4 components of Complete Decongestive Therapy CDT. Gold standard

Answer 32

1. skin care 2. manual lymph drainage MLD 3. Compression garments/bandage 4. decongestive exercise

Question 33

PT goal for lymphedema

Answer 33

reduce swelling and maintain reduction

Question 34

absolute contraindications for CDT (4)

Answer 34

1. acute infection 2. cardiac edema 3. acute DVT 4. acute bronchitis

Question 35

precautions for CDT (3)

Answer 35

1. malignancies 2. bronchial asthma 3. hypertension

Question 36

CDT goal to decongest involved extremity. Ends when measurements plateau or pt is I w/ self management

Answer 36

phase 1- intensive

Question 37

CDT goal to improve and/or maintain phase 1 accomplishments

Answer 37

phase 2- improvement

Question 38

TF you do not need to be certified to perform manual lymph drainage MLD

Answer 38

false

Question 39

w/ MLD strokes are...

Answer 39

dist-prox strokes moving prox-dist (clear the traffic jam)

Question 40

MLD 4 stroke techniques

Answer 40

1. stationary circle 2. pump 3. rotary 4. scoop

Question 41

MLD parameters

Answer 41

1 sec during working phase, 5-7 reps in one area

Question 42

TF you do not have to be certified for compression and bandaging

Answer 42

true

Question 43

first goal w/ bandaging

Answer 43

get pt I w/ bandaging in first week

Question 44

compression phase w/ stockinette and short-stretch bandages

Answer 44

phase 1

Question 45

compression phase w/ compression garments during the day and bandages as needed at night

Answer 45

phase 2

Question 46

long stretch bandages that has low working pressure and does not counteract mm pump

Answer 46

ACE bandages

Question 47

decongestive ex must be performed w/ compression to counter....

Answer 47

pressure mm pump

Question 48

decongestive ex schedule

Answer 48

20-30min, 2x/day. Elevate limb x30 min post-ex

Question 49

Pt education (4)

Answer 49

1. avoid skin injury 2. avoid mosquito bites 3. avoid heat 4. know s/s

Question 50

lymphedema measurements should be made...

Answer 50

at least 1x/week