Lymphoedema Flashcards
(50 cards)
What is lymphoedema?
A chronic swelling of a body part (usually limbs) caused by the accumulation of fluid and protein in the tissue spaces arising from congenital malformation of the lymphatic system, or damage to lymphatic vessels and/ or lymph nodes.
What occurs when lymphatics are not functioning adequately?
Extra cellular fluid accumulates in the tissues.
What are the roles of the lymphatic system?
- Preserves fluid balance
- Promotes fat absorption via intestinal lymphatics
- Host defence
What functions assist lymph drainage?
- Intrinstic pumping of lymph vessels
- Active muscle contraction
- Passive joint movement
- Pressure changes above and below the diaphragm with respiration
- Pulsation of adjacent blood vessels
What functions assist lymph drainage?
- Intrinstic pumping of lymph vessels
- Active muscle contraction
- Passive joint movement
- Pressure changes above and below the diaphragm with respiration
- Pulsation of adjacent blood vessels
When does primary lymphoedema occur?
Congential abnormality/malformation
When does secondary lymphoedema occur?
- Surgery
- Trauma
- Vascular conditions
- Obesity
- Inflammation
- Medication complication
What cancers are more commonly associated with lymphoedema?
- Breast
- Melanoma
- Gynaecological
- Head and neck
- Prostate
What are the possible risk factors for lymphoedema?
- Infection
- Excess body weight
- Too little exercise
- Heat
- Prolonged tight clothing
- Poor ungraduated bandaging
- Air travel
- High BMI
What effect does exercise have for lymphoedema?
Muscle contraction increases lymph flow and reduces the risk of excess fluid accumulating.
What benefit does strength training have on lymphoedema development?
- Decreased symptoms
- Increased quality of life
What is mastectomy?
Complete removal of all breast tissue
What procedures are included in breast conservation surgery?
- Wide local excision
- Lumpectomy
- Partial mastectomy
When is axillary lymph nodes removal indicated?
When cancer is determined to be invasive
What is involved at each level of axillary lymph node dissection?
Level 1: contents between lat dorsi, axillary vein, lateral border of pec minor
Level 2: + tissue beneath pec minor
Level 3: + resection of pec minor
What is a sentinel node biopsy?
Injection of dye or radioactive substance to locate first affected lymph node, then removed for examination
What are the possible complications of breast cancer surgery?
- Reduced shoulder ROM
- Pain
- Scarring
- Postural changes
- Arm lymphoedema
- Breast lymphoedema
What aspect of surgery most affects morbidity associated with the arm and shoulder?
Surgery involving the axilla
What aspect of surgery most affects morbidity associated with the arm and shoulder?
Surgery involving the axilla
When is axillary web syndrome most prevalent?
4-6 weeks post surgery
What factors affect the severity of lymphoedema?
- Extent of surgical intervention
- Other risk factors i.e. BMI
- Adjuvant treatment
What factors affect the severity of lymphoedema?
- Extent of surgical intervention
- Other risk factors i.e. BMI
- Adjuvant treatment
What factors affect the combination of treatment for breast cancer?
- Histological type of cancer (including oestrogen receptor status)
- Size of tumour
- Stage of cancer
- Grade of tumour
- Multifocality
Why is chemotherapy used and what is its prescription?
Used to eliminate micro metatstases; dose every three weeks for 4-6 cycles
