Lymphedema (first 40ish slides)

Lymphedema is

-excess interstitial fluid

-creates swelling

chronic lymphedema lasts

-> 3 mos

lymphedema sxs

-Swelling

-Pain

-Increased risk of infection and wounds

-No known cure

-Occurs anywhere in body

-Fibrosis

-Functional deficits

What is the tx goal with lymphedema

-reduce and manage sxs

Lymphatic system is

-sewage system

-transports and destroys cell waste

lymph is formed from

-blood and interstitial fluid

What direction does the lymphatic system flow

-distal to proximal

does the lymphatic system have a central pump

no; it is a low pressure system and uses the skeletal muscle pump

what are the functions of the lymphatic system

-transport excess fluid from tissues

-rtn fluid to bloodstream

-immune function:protect body from infection

-malfunction/overload results in swelling

-filter and destroy toxins

what are the components of the lymphatic system

-lymph fluid

-lymph solids

-lymph vessels

-lymph nodes

lymph fluid

-created from blood and interstitial fluid

lymph solids

-bio waste

-bacteria

-cell debris

-cancer

-digestive waste

-viruses

lymph vessels

-transport lymph solids and fluid to lymph nodes

lymph nodes

-filter and process solid waste

-immune system defense

list lymph vessels from distal to proximal

-capillaries

-precollectors

-collectors

-lymph nodes

-lymph trunks

-venous angles (interface w/ bloodstream)

lymph capillary

-collects fluid and waste

-series of flaps that allow lymph fluids and solids to enter from interstitial space

-transfers lymph to vessels

lymph moves through vessels using

-external muscle pump/contraction

lymphangions are

-tiny muscle pumps lining lymph vessels

how many lymph nodes are in the body

600-700

where are most lymph nodes

-abdomen

cervical nodes filter

-head

-neck

-brain

axillary nodes filter

-trunk

-back

-arms

-hands

inguinal nodes filter

-abdomen

-butt

-genitals

-legs

-feet

lymph nodes function

-filter and destroy solid waste

processed lymph is transported to

-venous angles at neck-->bloodstream

excess fluid is excreted as

-urine

dynamic insufficiency is characterized by

-acute fluid overload

-high fluid output

some causes of dynamic insufficiency are

-venous failure

-heart dysfunction

-acute trauma

-infection

-inflammation

mechanical insufficiency is characterized by

-malfunction

-normal output

-damaged lymph system can't keep up-->failure

combined insufficiency is characterized by

-fluid overload

-lymphatic malfunction

-phlebolymphedema

what are the 2 types of lymphedema

-primary and secondary

primary lymphedema is a

-genetic malformation of the lymph system

secondary lymphedema is

-damage to the lymph system

is it possible to have both primary and secondary lymphedema

-yes

lymphedema praecox

-onset before 35

lymphedema tarda

-onset after 35

-triggered by event that overloads lymph system (loss of mobility, obesity, surgery, organ dysfunction)

-platelet factor 4 may be present

what is the #1 type of secondary lymphedema in the western world

-phlebolymphedema due to CVI

what is the #1 cause of UE lymphedema in the western world

-breast cancer tx

What is the #1 contributing factor to lymphedema

-obesity

contributing factors to lymphedema

-obesity

-inflammation

-med side effects

-sedentary lifestyle

-muscle weakness or paralysis

Phlebolymphedema due to CVI

-chronic venous insufficiency

-#1 cause in western world

-swelling BELOW KNEES

-bilateral

-high risk for fibrosis, skin issues, cellulitis, DVT

CVI and phlebolymphedema

-valves in veins fail-->blood reflux-->blood stasis-->LE swelling

-lymph system also fails to move fluid

breast cancer lymphedema

-damaged lymphatic system due to surgery or tx (rad, chemo)

-lifetime risk for lymphedema in arm, hand, torso, breast, axilla

lymphedema secondary to lower body cancer

-same reasons as breast cancer

-has bilateral risk

-may affect legs, groin, genitals, abdomen

-swelling usually worst proximally

Head/neck cancer

-damage lymphatic system

-high rad dose

-thinner tissues

-fibrosis

-affects taste, speech, swallow

lymphedema secondary to obesity

-bilateral legs, trunk, arms

-inflammation

-mechanical failure

-high risk for fibrosis, skin issues, cellulitis, DVT

lymphedema secondary to filariasis

-parasitic infection

-common in legs

-progressive

-lymph system damage

lipedema

-painful, inflamed fat

-primarily women during times of hormonal change

-symmetrical; bilateral: leg/arm

-diseased, specific fat

-disproportionate body size

various locations for lymphedema

-feet and legs

-hands and arms

-breast/chest

-torso

-abdomen

-genitals

-head and neck

-internal organs