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28 Cards in this Set
- Front
- Back
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lymphatic system as the drainage system in the body (4)
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1. basic purpose of the lymphatic system
2. substances are protein, water, cells and fat (in the digestive system)- lymphatic loads 3. the lymphatic system returns most of the lymphatic loads back into the blood system 4. the lymphatic system works according to the one way principle |
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Anatomy of lymph capillary/system (4)
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1. initial lymph vessels represent the beginning of the lymphatic system
2. open system 3. made of endothelial cells laying adjacent to each other or overlapping each other 4. each cell is connected with the surrounding connective tissue via "anchoring filaments" which enables the lymph capillaries to stay open even under high tissue pressure |
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If interstitial fluid accumulates and the tissue pressure increases, the stretched anchoring filaments...resulting in...allowing for...
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will cause a pull on the endothelial cells resulting in an open junction between cells
through these openings, excess interstitial fluid and other lymphatic loads will then be able to enter the interstitial lymphatic system |
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Lymph fluid absorbed by the initial lymph vessel reaches the lymph collectors via the _____
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precollectors
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The anatomical structure of the bigger lymph collectors is similar to that of _____. Layers? (3)
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blood vessels
1. intima (inner) 2. media 3. adventia (outer) |
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axillary lymph nodes receive lymph from...(2)
-- however |
1. upper extremity
2. skin of the thorax ( anterior and posterior) above the horizontal watershed --however here are anastamoses between quadrants to allow fluid flow out of edemous quadrant |
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the inguinal lymph nodes receive lymph from...(5)
- however... |
1. abdominal region
2. lumbar region 3. gluteal region 4. exterior genitalia 5. lower extremity --however here are anastamoses between quadrants to allow fluid flow out of edemous quadrant |
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Mammary gland drains for the most pat into _____. Other drainage areas are the ...(2)
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1. axillary lymph nodes
2. parasternal 3. supraclavicular lymph nodes |
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metastases in the axillary or supraclavicular lymph nodes or radiation in these areas could affect...(2)
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1. the brachial plexus
2. resulting in paresthesia, pareses or paralysis in the UE |
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The UE drains for the most part into the ______. part of the lateral upper arm may also drain into _______
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1. axillary lymph nodes
2. supraclavicular lymph nodes -- cephalic bundle -- deltoid system |
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Breast Cancer with dissection or radiation, the drainage of lymph from the UE will be _____. This could cause...resulting in...
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1. impaired
2. accumulation of lymph in the arm 3. secondary lymphedema |
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The LE drains into the _____. These lymph nodes are located in the _____ outlined by the _____, _____, and _____. Dissection and/or radiation of these lymph nodes could result in _____.
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1. inguinal lymph nodes
2. femoral triangle 3. inguinal ligament (prox. border) 4. sartorius m. (lateral border) 5. gracilis m. (medial border) 6. secondary lymphedema |
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The more common reason for the onset of lymphedema in the LE are...
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congenital malformations of the lymphatic system resulting in primary lymphedema
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lymph time volume (LTV)
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amount of lymphatic loads transported by the lymphatic system in a unit of time
ex.- LTV of the thoracic duct: approx. 2-3 liters in 24 hrs |
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Transport capacity
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equal to the maximum Lymph Time Volume, i.e. the amt. of Lymph the healthy lymphatic system is able to transport utilizing its maximum frequency and amplitude
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Lymphatic safety factor (reaction to increased lymphatic load (water/protein/water))
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responds by increasing lymph time volume (LTV)...keeps transport capacity the same
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under normal physiological conditions, the Transport Capacity of the lymphatic system is...enabling the system to...
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1. much higher than the actual lymphatic load
2. this enables the lymphatic system to react to an increase in lmphatic load with an increase in lymph time volume (i.e. more lymph enters the lymphatics causing an increase in contraction frequency of lymph angions) |
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An increase in the lymphatic water load or protein and water load results in...
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an increase in lymph time volume (lymphatic safety factor)
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If the lymphatic load exceeds the transport capacity of the lymphatic system...
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fluid will accumulate in the interstitial tissue causing edema (dynamic insufficiency)
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Dynamic insufficiency is often caused by...
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insufficient venous return (CHF, sitting or standing too long, pregnancy , others)
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The appropriate therapeutic approach for dynamic insufficiency is...
what treatments would not be indicated? |
1. elevation
2. exercises 3. compression garment (not warrented in acute CHF) -- manual lymph drainage and complete decongestive therapy is not indicated |
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Mechanical Insufficiency (low volume insufficiency) (3)
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1. lymphatic system is diseased and its reduced
2. Transport Capacity is not able any more to cope with the normal amount of Lymphatic Load 3. Cannot activate its lymphatic safety factor |
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Possible causes of Mechanical insufficiency (6)
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1. trauma
2. surgery 3. radiation 4. infection 5. valvular or mural insufficiencies 6. malformations of the lymphatic system |
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mechanical insufficiency can cause...
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lymphedema
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Safety Valve Insufficiency
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1. the lymphatic water- or protein and water load is increased
2. at the same time the Transport capacity of the lymphatic system is decreased 3. safety valve insufficiency causes serious swellings |
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a pt suffering from lymphedema is susceptible to...resulting in...
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developing an infection (or trauma) in the lymphedematous area
the result would be an increase in the lymphatic load |
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Primary Lymphedema is caused by...
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congenital malformations of the lymphatic system and can be present at birth or develop some time during the course of life
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Secondary Lymphedema is caused by...(6)
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1. the obstruction of lymphatic pathways is caused by a known pathological condition
2. dissection and/or radiation of lymph nodes 3. trauma 4. chronic inflammations of lymph vessels/ lymph nodes (bacterial, viral, fungal, parasites, rheumatoid arthritis, others) 5. malignant tumors can block lymphatic pathways (often combined with blockage of veins and/or nerves) 6. blockage of the lymphatic and venous return mostly with rubber bands or bandages by the pt |
