Term
| Main organs of lymphatic system |
|
Definition
lymph nodes
lymph vessels
(thymus glands, spleen, tonsils, peyer's patches) |
|
|
Term
| Function of lymphatic system |
|
Definition
fluid regulation
immunological |
|
|
Term
|
Definition
milky white lymph fluid (esp p fatty meal)
fatty acid absorption from intestines |
|
|
Term
| Lymph system: intrinsic or extrinsic pump? |
|
Definition
|
|
Term
| Types of lymph vessels (in increasing order of size) |
|
Definition
capillary
pre-collector
collector
trunks & ducts |
|
|
Term
| Location of "swinging flaps" in lymph system |
|
Definition
|
|
Term
| Capillaries: one-way valves |
|
Definition
|
|
Term
| Functions of pre-collector lymph vessels |
|
Definition
absorption
transport
(has some smooth mm & valves) |
|
|
Term
| Function of collector lymph vessels |
|
Definition
| transportation (no absorption) |
|
|
Term
| function unit of lymphatic system |
|
Definition
|
|
Term
|
Definition
| section of collector btwn distal valve & proximal valve (in collector) |
|
|
Term
|
Definition
superficial
deep
perforating |
|
|
Term
| Lymphatic ducts empty into... |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Location of thoracic duct |
|
Definition
| parallel to spine, L2 to left venous angle |
|
|
Term
| Quadrant drained by thoracic duct |
|
Definition
|
|
Term
|
Definition
abdominal portion of thoracic duct
sac-like enlargement |
|
|
Term
| Quadrant drained by R lymphatic duct |
|
Definition
|
|
Term
|
Definition
jxn btwn
internal jugular v
& subclavian v |
|
|
Term
|
Definition
|
|
Term
|
Definition
filter bacteria, toxins, dead cells
produce lymphocytes
regulate protein concentration |
|
|
Term
| Avg # of lymph nodes in body |
|
Definition
|
|
Term
| Swollen lymph node signifies... |
|
Definition
| body is working hard to filter lymph (esp in illness) |
|
|
Term
| Lymph node distributions are usually... |
|
Definition
|
|
Term
|
Definition
interstitial fluid
capillaries
pre-collectors
collectors
nodes
collectors
trunks/ducts
venous angle
vascular circulation |
|
|
Term
|
Definition
median-sagittal
transverse
clavicle
spine of scapulae
chaps (gluteal) |
|
|
Term
one way
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
circular flow
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
1-2 L/day
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
L/min
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
intrinsic vessel contraction
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
central pump
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
peripheral pressure unaffected by limb dependency
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
limb dependency incr peripheral pressure
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
obstruction >> high protein fluid accumulation
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
obstruction >> low protein fluid accumulation
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
long latency period btwn injury & clinical appearance
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
short latency period btwn injury & clinical appearance
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
fluid filtered by nodes
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
fluid filtered by kidneys
(lymph flow OR blood flow?) |
|
Definition
|
|
Term
| Diffusion is dependent on... (4) |
|
Definition
molecule size
concentration
distance
temperature |
|
|
Term
|
Definition
| avg blood capillary pressure = avg colloid osmotic pressure |
|
|
Term
| blood capillary pressure > colloid osmotic pressure |
|
Definition
|
|
Term
| blood capillary pressure < colloid osmotic pressure |
|
Definition
|
|
Term
|
Definition
active (hand in hot water)
passive (DVT) |
|
|
Term
|
Definition
amt of substances that have to be removed from interstitium by lymphatic system
(net ultrafiltrate) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| amt of lymph transported (similar to HRmax) |
|
|
Term
|
Definition
| amt of transport capacity not being utilized |
|
|
Term
| Types of lymphatic system insufficiency (3) |
|
Definition
high volume (dynamic)
low volume (mechanical)
safety valve |
|
|
Term
| High volume insufficiency |
|
Definition
TC exceeded by lymph load
(healthy lymphatic system, but overloaded) |
|
|
Term
|
Definition
TC drops below lymph load
(body can't handle even normal lymph load) |
|
|
Term
| Reasons for mechanical insufficiency - mechanical |
|
Definition
valve insufficiency
vessel wall insufficiency
lymphangiospasm
lymphangioparalysis |
|
|
Term
| Reasons for mechanical insufficiency - organic |
|
Definition
filiariasis (parasite)
RA
vv disease of LE
trauma
XRT
surgery |
|
|
Term
| Safety valve insufficiency |
|
Definition
| combo of high volume & low volume insufficiency (decr TC, incr LL) |
|
|
Term
|
Definition
| "abnormal accumulation of a protein-rich fluid in the interstitium, which causes chronic inflammation and reactive fibrosis of the affected tissue" |
|
|
Term
| Classifications of lymphedema |
|
Definition
primary (due to dysplasia)
secondary (due to sx, radiation, infection, trauma, etc) |
|
|
Term
| Types of primary lymphedema |
|
Definition
hypoplasia
hyperplasia
aplasia
inguinal node fibrosis |
|
|
Term
| common site of hypoplasia |
|
Definition
|
|
Term
which is more common:
hypoplasia or hyperplasia? |
|
Definition
|
|
Term
|
Definition
| fewer than normal lymph collectors, insufficient diameter/caliber |
|
|
Term
|
Definition
| lymph vessels dilated >> insufficient valves |
|
|
Term
|
Definition
| Type I congenital hereditary lymphedema |
|
|
Term
Type I congenital hereditary lymphedema:
M v F |
|
Definition
|
|
Term
|
Definition
| Type I non-congenital hereditary lymphedema |
|
|
Term
Type I non-congenital hereditary lymphedema:
M v F |
|
Definition
|
|
Term
| Meige's Syndrome: co-anomalies |
|
Definition
syndactylism (fused toes)
distichiasis (double eyelashes)
myopia (near-sightedness)
yellow nails
vertebral anomalies
cleft palate
port wine stains |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Primary cause of secondary lymphedema |
|
Definition
filariasis
(CA Rx in non-tropical regions) |
|
|
Term
| Other causes of secondary lymphedema |
|
Definition
trauma to nodes/vessels
infections (cellulitis)
sx
malignant tumors
obesity
dependency
CVI (chronic vv insufficiency?)
lymphadenectomy
radiation |
|
|
Term
| Cause of lymphatic cysts, papillomas, fistulas, blisters, etc. |
|
Definition
| lymphedema with reflux (incompetent valves) |
|
|
Term
|
Definition
Latency
Stage I (spontaneous reversible)
Stage II (spontaneously irreversible)
Stage III (lymphostatic elephantiasis) |
|
|
Term
| Stages of lymphedema - latency |
|
Definition
decr TC
no visible edema
subjective complaints (paresthesia) |
|
|
Term
| Stages of lymphedema - Stage I |
|
Definition
accumulation of hi-protein fluid
pitting edema
reduces c elevation (no fibrosis)
lasts 1-2 wks, then resolves (but underlying cause still remains) |
|
|
Term
| Stages of lymphedema - Stage II |
|
Definition
accumulation of hi-protein fluid
progressively more difficule pitting
no change c elevation
CT proliferation (fibrosis) |
|
|
Term
| Stages of lymphedema - Stage III |
|
Definition
accumulation of hi-protein fluid
non-pitting
fibrosis/sclerosis (severe induration)
skin changes (papillomas, hyperkeratosis, wounds, etc) |
|
|
Term
|
Definition
reddish-blue/blackish-blue lumps that rapidly incr in size, bleed easily, ulcerate
very rare
poor Px (>>CA)
can develop p long-standing lymphedema |
|
|
Term
| Subjective info from lymphedema pt - current |
|
Definition
time of onset (slow v fast)
characteristics of onset (dist to prox, areas of involvement)
pain (discomfort)
provoking factors |
|
|
Term
| Subjective info from lymphedema pat - past |
|
Definition
hx of swelling
family hx
infection hx
co-morbidities
wounds |
|
|
Term
| Grading pitting edema: 1+ |
|
Definition
|
|
Term
| Grading pitting edema: 2+ |
|
Definition
| slight indentation when skin depressed |
|
|
Term
| Grading pitting edema: 3+ |
|
Definition
| deeper finger indentation, returns to normal 5-30 sec |
|
|
Term
| Grading pitting edema: 4+ |
|
Definition
| extremity 1.5x larger than normal |
|
|
Term
| Components of objective observation for lymphedema pts |
|
Definition
skin folds
skin changes
skin integrity
blisters/cysts
skin color
hair distribution (affected by aa/vv ∆s)
scars |
|
|
Term
| Methods of objective msmt in lymphedema pts |
|
Definition
limb volume
perometry (IR light)
bioelectrical impedance spectroscopy
photographs |
|
|
Term
| Lymphedema def'n in literature |
|
Definition
|
|
Term
| DASH questionnaire (fxnl abilities) |
|
Definition
dress self
above-head (reaching height)
shoes, socks
hygiene |
|
|
Term
|
Definition
direct lymphography
indirect lymphography
fluorescence microlymphography
lymphoscintigraphy
vv doppler (r/o blood clot)
CT (r/o CA)
MRI |
|
|
Term
|
Definition
lipedema
vv edema
cardiac edema
DVT
CHF
malignant lymphedema
cirrhosis of liver |
|
|
Term
|
Definition
genetic predisposition to high fatty distrib
pear-shaped
mostly women
bilaterally, symmetrical
(-) Stemmer's sign
no pitting
no cellulitis
painful, tender, easy bruising |
|
|
Term
|
Definition
gaiter distrib
hemosiderin staining
weeping
atrophic skin
subq fibrosis |
|
|
Term
|
Definition
| vv doppler/duplex ultrasound |
|
|
Term
|
Definition
greatest distally
bilateral
significant pitting
ø pain
reduces c elevation |
|
|
Term
|
Definition
significant pitting
orthopnea, DOW, paroxysmal nocturnal dyspnea
jugular v distention |
|
|
Term
|
Definition
pain, paresthesia
edema = central location
rapid development
ulcers
prox to dist |
|
|
Term
| Methods of Rx for lymphedema |
|
Definition
complete decongestive therapy
pneumatic compression
sx
elastic garments
meds |
|
|
Term
| Types of complete decongestive therapy |
|
Definition
manual lymph drainage
compression bandaging
remedial exercise
meticulous skin/nail care
self-care ed |
|
|
Term
| Phases of therapy for lymphedema |
|
Definition
Phase I - Treatment Phase
Phase II - Maintenance Phase |
|
|
Term
| Reasons for failure of complete decongestive therapy |
|
Definition
malignant lymphedema
insufficient treatment (MLD only, improper bandaging)
lack of compliance
improper dx |
|
|
Term
| pneumatic compression = ________ treatment |
|
Definition
|
|
Term
| pneumatic compression: affect on protein |
|
Definition
| none (no skin stretch mechanism) |
|
|
Term
| flat knit elastic garment used for |
|
Definition
|
|
Term
| circular knit elastic garment used for |
|
Definition
|
|
Term
| Basic principles of MLD: stroke intensity |
|
Definition
|
|
Term
| Basic principles of MLD: stroke sequence |
|
Definition
| working phase to resting phase |
|
|
Term
| Basic principles of MLD: stroke duration |
|
Definition
≥1 sec working phase
5-7x in each area |
|
|
Term
| Basic principles of MLD: stroke direction |
|
Definition
|
|
Term
|
Definition
area closest to vv angle
regional lymph nodes
extremity - prox to distal |
|
|
Term
|
Definition
stationary circles (regional nodes, neck, face)
pump (extremities)
scoop (extremities only)
rotary (trunk, large body surfaces) |
|
|
Term
| things to check p applying lymphedema bandaging (3) |
|
Definition
squeeze to check gradient
check finger tips for circulation
check for comfort |
|
|
Term
| Contraindications for lymphedema bandaging |
|
Definition
acute infection (cellulitis)
cardiac edema
arterial disease (relative Øind)
malignant lymphedema (relative Øind) |
|
|
Term
|
Definition
posture
abdominal breathing
head turns
shoulder circles
isometric chest presses, breast stroke
shoulder press, elbow circles, pot stirring
triceps arm elevated
biceps
FA sup/pron
wrist circles
fist, finger dexterity |
|
|
Term
| LE remedial ex (standing) |
|
Definition
posture
breathing
low back stretch
fwd stance
front stance
bkwd stance
gastroc/soleus stretch |
|
|
Term
|
Definition
posture
breathing
sidebending stretch
knee to chest
marching
leg crossing
add squeezes
knee flex/ext
ankle DF/PF |
|
|
