Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin Med: Final Material > Lymphedema and Swelling Disorders > Flashcards

Lymphedema and Swelling Disorders Flashcards

(72 cards)

Start Studying
1
Q

Overview of the Lymphatic System

A

Lymph vessels absorb interstitial fluid from the skin and subcutaneous tissue = transport it to the circulatory system

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

Nutritional fatty acids are absorbed via intestinal lymph called ___

A

chyle

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

Lymphocytes are manufactured in bone marrow:

A

B Cells mature in bone marrow

T Cells mature in thymus

WBC circulate between vascular and lymphatic tissue

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

Primary Lymphoid Organs

A

Thymus
Bone marrow
Fetal liver

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

Thymus:

A

a lymphoid organ located in the anterior superior mediastinum = matures T cells for the immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bone Marrow:

A

All blood cells are produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fetal Liver:

A

12 weeks gestation thru delivery; production and storage of blood stem cells prior to bone marrow development

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

Secondary lymph organs:

A

lymph nodes
spleen
peyer’s patches

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

Lymph Nodes:

A

small gland located in lymphatic system; high concentration of immune cells (B cells)

function as filters

cervical, abdominal, inguinal node beds

Part of the immune system

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

Structure of lymph nodes:

A

Generally located in the adipose tissue

Palpable sensitive nodes signify infection

Vary in size from 2-30 mm long, oval, round, kidney shape

600-700 lymph nodes in the body, majority found in the abdomen

Afferent vessels to Efferent vessels

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

Spleen:

A

located under the rib cage and above the stomach in the left upper quadrant of the abdomen

produces lymphocytes as needed

largest organ in the lymphatic system

acts primarily as a blood filter

RBCs are recycled in the spleen, WBC and platelets are stored in the spleen

acts as a blood reservoir (shock or hemorrhage)

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

Peyer’s Patches:

A

groupings of lymphoid follicles in the mucus membrane that lines your small intestine

similar to lymph nodes

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

Thoracic Duct:

A

the largest lymphatic vessel in the human body

1-5 mm diameter, 40 cm long

Located left and anterior to the spine

Drains into the venous Angle -> Junction of the internal Jugular and subclavian veins -> Superior Vena Cava

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

Cisterna Chyli:

A

a dilated sac at the lower end of the thoracic duct, functions as a temporary reservoir

collects mid to long chain fatty acids as chyle

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

Lymph Vessels:

A

thin-walled system for transporting lymph throughout the body

From distal to proximal

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

Lymph Node Function:

A

Filtering station for noxious matter such as mutated cells, bacteria, toxins and dead cells

Regulate the concentration of protein in the lymph = hydrostatic and osmotic pressure controls the balance of water between the lymph nodes and blood vessels

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

Lymph Nodes arrangement

A

Arranged in chains

~600 total = 100-200 are mesenteric

Size ranges from 2 – 30 mm

Outside: fibrous capsule

Afferent Vessels: entering node

Efferent Vessels: exiting node

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

Lymph Vessel types:

A

capillaries
pre-collectors
collectors
trunks
ducts

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

Lymph Vessels

A

Different from veins and arteries = NO central pump

Localized pump action via movement and muscle contraction

moves fluid distal to proximal to the subclavian and into the circulatory system

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

Lymphatic capillaries

A

collect interstitial fluid and dissolved particles including proteins, cell debris, and pathogens

Structurally adapted to promote absorption of large molecules from the interstitial spaces

surround blood capillaries in loose connective tissue

blind-ended (have a true start)

mini-valves ensure fluid only goes in one direction - towards the heart

Most often located near blood capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

lymph capillaries vs blood capillaries

A

lymph ones are much more permeable

lymph ones are much larger

large particles like pathogens and cancer cells cannot directly get into blood capillaries but they can lymphatic capillaries

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

lymph capillary walls

A

Walls are made of one layer of overlapping flat endothelial cells

Surrounded by fibrous network

Fixed in the connective tissue by anchoring filaments which prevent the collapse of the initial lymph vessel network

Endothelial junctions = overlapping endothelial cells can open and close

Do not contain one way valves = lymph can flow in any direction

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

exchange across capillary walls

A

fluid and solutes flows out of capillaries due to blood pressure
> “bulk flow”

interstitial fluid flows back into capillaries due to osmosis
> plasma proteins increase osmotic pressure in capillary

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

____ of fluid returns to capillaries and ___ fluid returns via lymph

A

85%
15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Lymph Capillaries: Important Characteristics
Form a plexus throughout the body Are larger in diameter than blood capillaries Are able to absorb interstitial fluid as necessary = including solids Have no valves inside the capillary vessels = lymph can flow in any direction
26
LYMPH FLOW
blood capillaries -> interstitial tissue -> lymph capillaries -> lymph collectors -> lymph trunks -> lymph ducts
27
Pre-Collectors
Channel the lymph fluid into the larger transporting vessels Able to absorb fluid and molecules = similar to lymph capillaries Connect lymph capillaries to collectors Mostly function to move fluid from capillaries to collectors = few valves Some areas of smooth muscle
28
Collectors
Transporting lymph vessels Contain valves = determine direction of lymph fluid flow = distal to proximal or toward the nearest regional node bed = each valve segment called ‘lymphangion’ Contractions determined by autonomous regulation through the sympathetic nervous system Lymph volume stretches the vessel wall and smooth muscle responds with a localized contraction Exercise increases the frequency of contractions
29
Collectors - Three layer walls
similar to veins, however, thinner than veins Inner layer: endothelial cells and basement membrane Middle layer: smooth muscle Outer layer: connective tissue
30
Lymphangion Activity
Sympathetic nervous system innervation of smooth muscle Rhythmic contractions Also utilizes skeletal muscle contraction, arterial pulsation, and respiration to move fluid
31
Trunks
Larger than collectors Afferent Collectors -> -> Efferent Trunks One way valves Smooth muscle layer = contraction of lymphangions after leaving the lymph nodes, the largest lymphatic collecting vessels converge to form lymph trunks drain large areas of the body
32
Lymphatic Ducts
Lymphatic vessel that empties lymph into either right or left subclavian veins -> superior vena cava -> right atrium Transport 1.5-2.5 L/24 hours
33
Right lymphatic duct
drains lymph from the right upper limb, right side of thorax and right halves of head and neck empties at junction of right internal jugular and right subclavian veins 3 cm long Moves lymph from right upper quadrant to right subclavian vein
34
Thoracic duct
drains lymph from all other areas of the body into the circulatory system at the left brachiocephalic vein between the left subclavian and left internal jugular vein Largest lymph vessel 40 cm long 2-3 cm wide 20 valves Moves lymph from lower body and left arm to left subclavian vein
35
most inferior part of thoracic duct =
cisterna chyli
36
Definition of Lymphedema
Protein-rich edema that occurs when the lymph load or volume exceeds the lymph transport capacity in any body segment Considered a disorder/disease
37
Primary Lymphedema
absent or under-developed
38
Secondary Lymphedema
Obstructed or damaged
39
Pedal edema =
swelling in bilateral feet and LE due to long periods of sitting or standing = causes hypervolemia
40
Cerebral edema =
fluid accumulation on the brain
41
Pulmonary edema =
left sided heart failure leads to accumulation of fluid on the lungs
42
Polymyositis =
inflammatory muscle condition that causes generalized weakness and swelling
43
Musculoskeletal injury =
unresolved acute inflammation and edema leads to chronic inflammation and edema
44
Definition of Edema
Visible and palpable excessive accumulation of interstitial fluid Edema is a symptom and not a disease
45
Definition of Lipedema
Lipedema is a disorder characterized by massive, bilateral accumulation of fat below the waist and in the legs Enlargement of the lower extremities is often accompanied by leg pain and accumulation of fluid Little is known about the functional changes that lead to fat accumulation and pain in patients (women>>>men) with lipedema
46
Definition of Cellulitis
common, potentially serious bacterial skin infection The affected skin appears swollen and red and is typically painful and warm to the touch Cellulitis usually affects the skin on the lower legs, but it can occur in the face, arms and other areas
47
Lymphatic Zones, Watersheds, and Anastamoses
Quadrants or ‘territories’ are only connected to each other through a few anastomotic branches – few vessels connecting the territories The only way lymph can move from one territory or zone to the next is through the initial lymph vessel network = lymph capillaries These cross-over areas are called the ‘lymphatic water shed’ areas via anastamoses
48
Grade 0 lymphedema
Normal sensation Normal appearance Patient at risk to develop lymphedema
49
Grade 1 Lymphedema
Abnormal sensation Pitting Reversible with elevation Early intervention needed
50
Grade II Lymphedema
Intermittent ‘heaviness’ Abnormal tissue texture Irreversible with elevation due to fibrosis
51
Grade III Lymphedema
Elephantitis Persistent ‘heaviness’ Grossly abnormal Irreversibly damaged tissue Treatment will help decrease severity of symptoms
52
1+ Edema
barely detectable <2 mm depression, immediate rebound
53
2+
A slight indentation visible when the skin is depressed 3-4 mm depression, <15 second rebound
54
3+
A deeper fingerprint when the skin is depressed 5-6 mm depression, 10-30 second rebound
55
4+
Large fingerprint when the skin is depressed >7 mm depression, >20 second rebound = the limb may be 1.5-2 times normal size
56
Lymph Fluid Movement
Water, protein and small molecules diffuse through the blood capillary walls into the interstitium = process called filtration = to nourish the tissues Filtration dependent on: > hydrostatic pressure in capillary and interstitial space > Colloid osmotic pressure gradient of plasma proteins
57
In homeostasis, ‘reabsorption’ occurs when
fluid moves from blood capillaries, to interstitial tissue, and then into the lymph vessels due to higher concentration of plasma proteins
58
Lymph Circulation
blood capillary - lymph capillary - initial lymph vessels - precollectors - collectors (pumps) - lymph nodes - lymphatic ducts - subclavian venous system
59
Factors Affecting Tissue Fluid Exchange
> total tissue pressure > gravity > filtration > muscle contraction > diphragmatic breathing > intestinal contractions > skin/tissue movement
60
Lymphedema
High Protein edema Congestion in the interstitium Visible swelling Chronic inflammation of the tissues = proliferation of fibroblasts Proliferation of fibroblasts = fibrosis
61
Primary Lymphedema
Rare inherited condition due to deficient lymph vessels
62
Secondary Lymphedema
Acquired lymphatic system deficits - Surgery - Radiation therapy - Trauma - Filariasis
63
Filariasis
elephantiasis, parasite infection affects 90 million people world-wide primarily in tropical regions
64
Normal healthy lymphatic system =
transport capacity is greater than the lymphatic load
65
Lymphatic system insufficiency =
lymphatic load is greater than the transport capacity
66
Lymph system not able to handle the lymphatic load
Too much fluid in a normal system Normal fluid amount in an abnormal or damaged system
67
Recommended Treatment for Lymphedema
Complete Decongestive Therapy Manual Lymph Drainage Bandaging Garments Remedial Exercise
68
Manual Lymph Drainage = MLD
Cornerstone of effective lymphedema treatment = not effective alone Gentle hand movements that are consistent with the lymphatic anatomy and physiology Systematic approach to tx of lymphedema = superficial or deep Applied through pulsating traction and relaxation superficially to the skin Facilitates absorption and transport of fluid and molecular waste from the interstitium to the lymph system
69
MLD: Clinical Observation Post MLD
Increased urine output Generalized relaxation ‘Heaviness’ or pain reduction Change in tissue tension and pliability = allows for increased movement of fluid
70
Contraindications for Manual Lymph Drainage - Absolute
Congestive Heart Failure (CHF) Renal failure Acute infection Thrombosis, DVT AAA = abdomen Severe Arteriosclerosis Surgery
71
Contraindications for Manual Lymph Drainage - Relative
Malignant or metastatic lymphedema Hyperthyroidism Pregnancy = abdomen
72
Compression Bandaging
Provides increase in tissue pressure Prevents refilling of interstitium Facilitates protein reabsorption Reduces rate of ultrafiltration Improves efficiency of muscle pump during activity

Clin Med: Final Material (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions