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22 Cards in this Set

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  • Back
What are the two main causes of cancer related lymphedema?
Secondary to cancer therapy (lymph node dissection and vessel irradiation) or secondary to cancerous spread (malignant invasion of the lymphatics or tumor compression of the collectors/ducts).
Name the three stages of lymphedema.
Stage 1- Reversible lymphedema
(accumulation of high protein fluid)

Stage 2- Spontaneously Irreversible Lymphedema (accumulation of high protein fluid and scar tissue formation)

Stage 3- Lymphostatic elephantiasis (accumulation of protein rich fluid, scar formation, hardening of dermal tissues, and skin papillomas)
What is the difference between primary lymphedema and secondary lymphedema?
Primary lymphedema arises due to developmental abnormalities within the lymphatic tissues that result in a a mechanical insufficiency of the vessels and nodes leading to a decreased transport capacity.
Secondary lymphedema can be caused by surgery, radiation, trauma, filariasis, cancer, infection, and C.V.I.
How can lymphedema be diagnosed?
-Physical Exam and Hx (Stemmer Sign, palpation, interview)
-Indirect Lymphography
-Doppler/Duplex Ultrasound
-CT Scan
What are contraindications to treating lymphedema?
-Acute infection
-Untreated malignancy
-Kidney malfunction
-Uncontrolled CHF
What are the componenets of a lymphedema management program?
Applied pressure softens fibrous tissue, excess proteins needs to be removed, provide support to lax tissues through the use of compression bandages, and facilitation of better oxygenation to the tissues.
What is the top treatment mechanism for lymphedema?
Exercise (remedial, resistive, and aerobic components). Lymphatic fluid will move with movement.
When should a compression garment be utilized?
This should be fitted upon to discharge to maintain the limb. It can be used once the arm size has stabilized and it helps support the compromised skin elasticity.
Is a compression garment interchangeable with compression bandaging?
Do compression pumps work on the lymphatic system?
No- pneumatic compression pumps work on the venous system. They should only be used as an adunct to a complete lymphedema management program.
What is manual lymph therapy?
A technique that allows for shunting of the accumulated fluid and faciliates its movement to an area that is still draining effectively. Should be done proximally to distally. Utilizes alternating pressures to direct lymph flow.
Is elevation an effective treatment for lymphedema?
What is the rationale for compression therapy?
Supports the elasticity of the skin and its underlying vessels, directly affects the underlying lymphatic vessels, veins, and tissues, and gradient pressure is necessary.
What is the law of LaPlace?
Applied pressure is inversely proportional to the circumference of the limb. The smaller the circumference the more pressure when wrapping. Normal people have built in LaPlace (skinny/small distally and larger proximally).
What is resting pressure?
The pressure from the outside in the resting position of the muscle.
What is working pressure?
Pressure that is generated inside the body when the muscles are active.
What are the two types of compression bandages?
Elastic high stretch bandaging (high resting pressure and low working pressure) and Low-stretch bandages (low resting pressure and high working pressure)
Define a lymphotome.
An area of the body that drains to the same place.
What are the three different strokes used during manual lymphatic drainage?
1. Flat finger circles (used to prime the area and transport fluid from one lymphotome to another across watersheds)

2. Scoop/Pump (primarily a transport technique that is the "workhorse")

3. Thumb circles (used to break up fibrous tissue and to sculpt)
What is included in Phase 1 of complete decongestive therapy?
Meticulous skin care, manual lymphatic drainage, bandaging, and remedial exercises.
What is included in phase two of complete decongestive therapy?
Compression garments, home exercises, self skin care, self manual lymphatic drainage.
What are some of the benefits of MLD?
-Improved lymph circulation
-Break down of fibrous tissue
-Maximize lymph production
-Redirect flow away from impaired areas