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58 Cards in this Set
- Front
- Back
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Lymphatic system is NOT a _________ like the circulatory system.
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closed system
Accessory route by which lymph fluid can flow from the tissues into the bloodstream |
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Manual lymph drainage was introduced by massage therapist and philosopher___________
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Vodder
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Complete decongestive therapy consist of:
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Skin care
Manual Lymph Drainage (MLD) Compression Exercise |
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Abnormal accumulation of protein-rich fluid in the interstitial space is also known as?
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lymphedema
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T or F, the most common cuase of lyphedema in the US is surgical intervention that involves the lymphatic system?
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true
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The main purpose of the lymphatic system is to?
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Pick up and transport substances that cannot be reabsorbed by the venous system
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What the lymph system carries is also known as?
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lymphatic load (LL)
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One of the biggest differences b/t edema and lymphedema is that edema is NOT?
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a protein base fluid
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The lymphatic system is a _________system that starts blindly in the interstitium and empties into the _____________.
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one way
subclavian vein |
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Blood capillaries separate the arterial and venous systems, they manage the transfer of nutrients and pick up waste products for the entire body, what BCs don't pick up becomes___________.
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lymphatic load (LL)
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Lymphatic load consist of what 4 substances?
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Water
Protein Cells Fat |
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Once interstitial fluid enters the initial lymph capillaries, it is known as?
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lymph
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______liters of water are returned to the venous system via the thoracic duct every 24 hrs.
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2-3
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Because proteins are macromolecules, they can't be reabsorbed at the venous end of blood capillaries, as a result these proteins become part of the ________ and all are returned to the venous system via the ______________.
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lymph load
lymphatic system |
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Lymph is normally clear/colorless/transparent except in the digestive system where it is?
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milky
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T or F, cell fragments of cancer cells, bacteria, tattoo ink, spores we inhale, tar, and dirt all can become part of lymph load?
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true
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Purpose is to drain the lymphatic load of the skin
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superficial lymphatic system
99% of the lymphedema we see involves the superficial LS |
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The deep lymphatic system is _________ and drains everything but skin:________,________,________, and __________
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subfascial
muscles tendons joints inner organs |
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T or F, lymphedema of the deep lymphatic system is common?
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false
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Some signs of lyphedema of the deep lymphatic system are?
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pain
loss of power pale paresthesia |
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__________ are imaginary lines where lymph lines do not cross, an example being the mid chest.
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watershed areas
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___________ are made up of several collectors that run adjacent to each other and are responsible for draining the same body area.
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lymphatic territories
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Each lymphatic territory is separated by __________, which are areas where lymphatic vessels usually do not cross.
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watersheds
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At some points of watershed areas, collectors' origins directly align and create__________, which are usually dormant.
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anastomoses
Knowing the locations help us to re-route the lymph around impaired or absent nodes and vessels, toward healthy uninvolved quadrants |
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This type of lymphedema is caused by a malformation or dysplasia of the lymphatic system;
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Primary lymphedema (not very common)
its most commonly hypoplasia and is more common in women |
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_________is caused by a known insult to the lymphatic system as surgery, radiation, infection, cancer, or self-induced.
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Secondary lymphedema
most common cause in US is surgery, however worldwide the most common cause is an infection known as filariasis |
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This is considered the _______ stage or stage____ where anyone who goes through surgery involving the lymph sys. or trauma and DOES NOT develop visible lymphedema.
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latency stage or stage 0
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T or F, stage 1 lymphedema is reversible?
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true
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Lymphedema that involves no fibrotic tissue, no secondary skin changes, no papillomas, and could possibly recede overnight is known as?
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Stage 1 lymphedema
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Stage I lymphedema is often soft and pitting but if left untreated, it may progress to _______.
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stage II, due to increasing fibrotic tissue
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This stage of lyphedema is known as chronic irreverisible and is defined by the degree of lypmphostatic fibrosis.
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stage II
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Stage II lyphedema is also characterized by the inability to pinch the skin on the hands or feet, AKA ____________.
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stemmer's sign
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During stage II lymphedema, natural skin folds deepen and local immune defense weakens leading to frequent ____________.
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infection
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T or F, with stage II it is possibel to reduce fluid with treatment.
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True, the amount of reduction depends on the degree of fibrotic tissue and fluid present.
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One intervention that helps reduce or break up fibrotic tissue is _________.
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compression, it has a fibrinolytic effect
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Stage III lyphedema is characterized by:
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Further progression of fibrosis
Some pitting may be present Positive Stemmer sign Usually, extreme increase in limb volume Secondary skin changes (fungus, Uulcers, cysts) Frequent infections Lymphorrhea – leg weeps fluid |
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List 5 goals of lymphedema treatment:
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-utilize remaining lymph vessels and other lymphatic pathways to decongest swollen body parts
-eliminate fibrotic tissue -avoid reaccumulation of lymph fluid -prevent/eliminate infections -maintain normal or near normal limb size |
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Good skin care reduces the chance of ______and _______ growth.
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bacterial and fungal
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Lymphedema often causes dry skin which can lead to cracking, treatment should consist of frequent?
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cleansing and use of moisturizers
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T or F, it's especially important to treat skin during acute cellulitis?
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false, do not treat skin during acute cellulitis
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When performing manual lymphatic drainage around wounds, it's important to perform MLD___________to the wound.
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proximal
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Elastic fibers of the skin get damaged with swelling, as a result, skin _________may never be completely regained.
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elasticity
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After MLD there is always a risk of re-accumulation of decongestion so?
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Sufficient compression is required to hold back the swelling
Initially compression bandages 24 hours a day Later, garments in the daytime and bandages while sleeping |
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When applying compression, one should?
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use padding to construct a cylinder prior to applying the elastic bandages
A finished bandage will have a pressure gradient against the extremity Higher pressure distally and lower pressure proximally – Short Stretch Bandages (Ace = long stretch, coban + medium) |
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Exercise is important in lymphedema management and MUST be performed with?
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compression (bandages or garments) on
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Benefits of exercise in lymphedema management are?
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Improves the lymph circulation
Improves/increases venous return Optimizes joint and muscle pump |
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The rate of diffusion depends on?
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surface area, temperature, concentration gradient, size of molecules, diffusion distance and movement
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Diffusion distance is defined as the distance between?
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blood capillaries and cells in the tissues
Under normal conditions every tissue cell is within 2-3 cell diameters from the supplying blood capillary |
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Swelling increases__________.
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diffusion distance
Even if you could not see swelling (cm) the normal diffusion distance has increased 100 times |
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Increased diffusion distance leads to?
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compromise of local immune response
decreased nutritional supply increased risk and frequency of infections |
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Effects of compression?
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Reduce filtration
Increase reabsorption Improves efficiency of joint and muscle pump Prevent re-accumulation of lymph fluid Maintains results achieved during MLD Break-down of scar tissue Provides support for tissues that have lost elasticity |
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General guidelines for exercise and lymphedema management?
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Should be kept simple
10-15 minutes; 1-2 times a day 3-4 exercises Pool is great Avoid strenuous, and highly repetitive exercise during decongestive phase |
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Benefits of exercise and lymphedema management:
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Improves lymph circulation
Improve/increase venous return Optimize joint and muscle pump Deep Breathing increases the volume of fluid returned via thoracic duct to the venous angle |
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Examples of trauma that can affect the lymphatic system are?
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Rays: sun burn, radiation burn
Mechanical trauma: blunt trauma, incisions, ant bite, bee sting Acid burns Infections |
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Effects of MLD include:
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Increase in local sympathetic response
Increase in the general parasympathetic effect Increases lymph production Stimulates lymphangiomotoricty Fibrinolytic effect Creates a suction effect on distal collectors Reverses the flow of lymph Increase in venous return Directional stretch of working phase increases superficial venous return Deeper techniquews (abdominal) influence the deep venous systems |
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T or F, MLD also has an analgesic effect?
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true, causes accelerated drainage of nocioeptive substances from the tissues
MLD provides stimulus for “gate-control” |
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With MLD areas closest to venous angles are stimulated_______.
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first, this allows the drainage of more peripheral areas
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In extremities, treatment should begin _________and continue_________according to the direction of the lymph drainage.
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proximal
distally |
