Term
|
Definition
| smooth muscles contraction of each lymph vessel, skeletal muscle pump, massage of thoracic duct by diaphragm, aorta contractions along thoracic duct |
|
|
Term
|
Definition
| unidirectional ("safety valve"); lymph flows to lymph node located in its watershed area under normal conditions; lymph can flow via anastomoses to lymph nodes of neighboring watershed areas under stress |
|
|
Term
| lymphedema pt characteristics |
|
Definition
| firm lymphedema limb, secondary pains/aches due to carry extra wt., wt. fluctuates often, loss of ROM, dec. mobility, emotional/psychological effects, moisture drainage from skin/ulcerations, disfiguring/tight clothes, pain in limb, inc. risk of infections/wounds from bacteria, poor circulation |
|
|
Term
|
Definition
| an abnormal accumulation of protein-rich fluid due to a mechanical insufficiency of the lymphatic system; this protein inc. the activity of fibroblasts that produce more collagen resulting in tissue fibrosis |
|
|
Term
| Causes/characteristics of PRIMARY lymphedema |
|
Definition
| congenital, born w/ poor lymphatic system, hypoplasia/hyperplasia of vessels, aplasia of vessles (absence of lymph capillaries); lymph nodes present, more common in females, occur more in lower extremities, easier to treat than secondary lymphedema |
|
|
Term
| Causes/characteristics of SECONDARY lymphedema |
|
Definition
| nodes and/or vessels are damaged or removed; surgery, radiation, trauma, cancer, filariasis (worm that lives in lymph vessels and clogs it up), DVT, pregnancy, obesity; equal men/women ratio |
|
|
Term
| Diagnostic characteristics of lymphedema |
|
Definition
| non-symmetric, fluctuates, medical hx (i.e. cancer, abdominal surgery) |
|
|
Term
|
Definition
| limited fxn, painful extremity or back pain, tissue fibrosis, skin breakdown, chronic infections, emotional stresses, cosmesis; can develop into lymphangiosarcoma |
|
|
Term
| Traditional treatments (no cure) |
|
Definition
| debulking surgery, vascular surgery (lympho-venous anastomoses), diuretics, compression pumps and elevation, compression stockings, Benzopyrones (medicine that breaks down good and bad protein) |
|
|
Term
| Treatment phase (daily for about 2-3 wks) |
|
Definition
1. manual lymph drainage (MLD): stimulates inc. absorption of lymph and the flow of lymph to intact lymph nodes via anastomoses; inc. activity at lymph nodes of adjacent root areas and trunk (esp. thoracic duct), and flow of lymph b/t root areas.
2. meticulous skin care
3. wear compression bandaging w/ short stretch bandages 24 hrs/day to enhance muscle pump action on lymphatics, maintain dec. in edema, break down fibrotic tissue, inc. tissue pressure to dec. ultrafiltration of fluids to interstitial space.
4. remedial exercises w/ bandages on |
|
|
Term
| Maintenance phase (lifetime) |
|
Definition
1. compression garment during the day
2. bandaging at night
3. remedial exercises
4. skin care: cuts can cause inflamm/infection which can inc. fluid flow to extremity |
|
|
Term
| precautionary considerations prior to lymphedema treatment |
|
Definition
| cardiac edema/CHF, airplane trips, asthma, acute infection, malignant disease, arterial disease |
|
|
Term
| Pt education during therapy |
|
Definition
1. deep breathing to massage thoracic duct
2. massage area where lymph nodes are still intact: proximal to distal in direction of lymph flow, stretch skin w/o moving hand up arm to stretch vessels and cause contractions, do each part of skin 10x per med/lat side
3. wrap w/ low stretch bandages: distal to proximal w/ multiple layers to provide compression
4. AROM exercises to get muscles moving |
|
|
