Lymphedema

Question 1

what is normal for lymph nodes?

Answer 1

<1cm, soft, nontender, nonpalpable

Question 2

what is the pathways for lymph circulation?

Answer 2

lymphatic capillaries - lymphatic vessels - large lymphatic ducts (right - thoracic) - left subclavian vein

Question 3

what does the right lymphatic duct drain?

Answer 3

right UE, right head and neck, right upper trunk

thoracic duct does everything else

Question 4

how does lymphatic vessel contraction occur?

Answer 4

autonomic and sensory nerve stimulation
contraction of adjacent muscle
changes in pressure of abdominal and thoracic cavities with breathing
mechanical stimulation of dermal tissue
volume changes within individual lymph vessel

Question 5

what is lymphedema?

Answer 5

chronic disorder characterized by excessive accumulation of lymph fluid in tissues of one or more body organs

Question 6

what is primary lymphedema?

Answer 6

congenital or hereditary disease (Milroy disease)
hypoplasia: fewer lymphatic vessels and smaller than normal
hyperplasia
aplasia

Question 7

what is secondary lymphedema?

Answer 7

acquired
injury to one or more components of the lymph system
caused by surgery, radiation, CVI, tumors, trauma, infection, CRPS

Question 8

what are the stages of lymphedema?

Answer 8

0: latent or subclinical condition where swelling is not evident despite impaired lymph transport, extremity feels heavy
1: pitting edema that subsides with limb elevation (reversible)
2: limb elevation does not reduce swelling, and pitting may or may not occur as tissue fibrosis developed (spontaneous irreversible), + stemmers
3: pitting is absent “brawny” and trophic skin changes such as acanthosis, fat deposits, and warty overgrowths develop (lymphostatic elephantiasis), + stemmers

Question 9

what is lipedema?

Answer 9

bilateral excessive subcutaneous fat deposit

Question 10

what is lymphadenopathy?

Answer 10

enlarged lymph nodes with or without tenderness
typically due to infection

Question 11

what is lymphadenitis?

Answer 11

inflammation of lymph nodes

Question 12

what is lymphagitis?

Answer 12

inflammation of lymph vessels
acute bacterial or viral infection that spreads throughout lymphatic system

Question 13

what are the signs and symptoms of lymphedema?

Answer 13

tightness, heaviness, fullness in extremity, tight-fitting clothing, aching sensation

Question 14

what are the stages of pitting edema?

Answer 14

1+ mild <0.23 in pitting
2+ moderate; returns to normal within 15 seconds 0.25-0.5 in pitting
3+ severe; returns to normal within 15-30 seconds 0.5-1 in pitting
4+ very severe; lasts for >30 seconds >1 in pitting

Question 15

what is brawny edema?

Answer 15

pressure feels hard upon palpation
more severe form of swelling with progressive fibrotic changes

Question 16

what is weeping edema?

Answer 16

most severe and longest in duration
fluid leaks from cuts and sores; wound healing is impaired