Sxs and Complications - Lymphedema

Question 1

onset of lymphedema

Answer 1

slow

progressive

pitting in early stages

Question 2

edema is

Answer 2

not detectable clinically until interstitial volume reaches 30% above normal

Question 3

stages of pitting

Answer 3

1+-4+

Question 4

1+

Answer 4

barley detectable

tissue returns to normal almost immediately

Question 5

2+

Answer 5

slight indentation is visible when skin is depressed

returns after 15-30 s

Question 6

3+

Answer 6

deeper indentation

returns after 60-90s

Question 7

4+

Answer 7

returns after 2-3 min

Question 8

general sxs start

Answer 8

distally

Question 9

general sxs

Answer 9

squaring of the toes

dorsum of foot

loss of ankle contour

asymmetric (if bilateral)

full sensation in the limb w/ tightness of the skin

rarely painful

skin changes

increase risk of infection

Question 10

squaring of the toes

Answer 10

stemmers sign positive

Question 11

dorsum of foot

Answer 11

buffalo hemp

Question 12

rarely painful

Answer 12

c/o of discomfort and heaviness

Question 13

skin changes

Answer 13

hyperkeratosis

papillomas

Question 14

connective tissue changes

Answer 14

fibroblasts proliferate

Question 15

collagen fibers

Answer 15

are produced

Question 16

fatty tisse

Answer 16

increases

Question 17

tissue changes

Answer 17

fibrotic changes and induration

Question 18

stages

Answer 18

0-3

Question 19

stage 0

Answer 19

latent stage

no visible/palpable edema

only subjective c/o’s

Question 20

stage 1

Answer 20

reversible lymphedema

pitting edema

reduced with elevation (no fibrosis)

Question 21

stage 2

Answer 21

spontaneously irreversible lymphedema

pitting becomes progressively more difficult

fibrosis sets in

Question 22

stage 3

Answer 22

lymphostatis elephantiasis

non-pitting

significant skin changes

severe fibrosis/induration

Question 23

significant skin changes –> 4

Answer 23

papillomas

hyperkeratosis

Question 24

complications

Answer 24

progressive

no cure

increased risk of infection

increased risk of open wound

Question 25

no cure --> complications

Answer 25

appropriate tx can contral sxs

Question 26

increased risk of infection --> complications

Answer 26

cellulitis bacterial fungal etc.

Question 27

increased risk of open wounds --> complications

Answer 27

ability for body to heal wounds

Question 28

possible complications

Answer 28

hyperkeratosis fungal infections lymph fistulas lymph cysts lymph varicosity radiation fibrosis

Question 29

hyperkeratosis

Answer 29

overabundant skin thickening callus formation wart like papillomas (toe creases)

Question 30

fungal infections

Answer 30

itchy grayish white film moisture and maceration b/w the toes peeling off of the skin

Question 31

lymph fistulas

Answer 31

abnormal connections b/w the lymph vessels and the skin

Question 32

lymph cysts

Answer 32

abnormally wide lymph vessels that cause tiny visible vesicles or blisters that have the danger of rupturing and causing infection

Question 33

lymph varicosity

Answer 33

superficial dilated lymph vessels

Question 34

radiation fibrosis

Answer 34

appears as a reddish-brown discoloration in the irradiated area