Term
| Name the three types of primary lymphedema and how they are defined |
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Definition
Congenital < 2years of age Praecox 2-35 Tarda >35 |
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Term
| What are the two types of lymphedema classification and give examples of both |
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Definition
Primary- is congenital Secondary- infectious (filariasis) malignancy, XRT, iatrogenic( vein harvest) traumatic |
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Term
| Name 4 diagnostic signs of lymphedema |
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Definition
Stimmers sign-inability to squeeze base of toe Dorsal hump squaring of digits Pitting |
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Term
| What are the ultrasound characteristics of lymphedema? |
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Definition
Minimal increase in thickness of dermis Increase in the subq layer Hyperechogenic dermis and hypoechogenic subcutaneous layer |
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Term
| Define lymphedema location and the stages of development |
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Definition
Like venous edema it is a swelling of the compartment above the deep fascia of the muscle. The swelling is a protein rich fluid which attracts further fluid through osmotic action. This is followed by an increase in blood vessels. Eventually an increase in macrophages and fibroblasts leading to a fibrotic induration. Because of the higher protein levels there is also a chronic sub-clinical inflammatory process |
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Term
| What % of lymphedema is primary? |
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Definition
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Term
What type of dietary substance can affect lymphedema and how does this occur?
What is the term to describe it? |
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Definition
| Long chain fatty acids may result in large flow from the mesenteric area that flow from the legs is impeded or retrograde flow occurs into the limbs (chylous reflux) |
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Term
| What are the average lymphatic pressures? |
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Definition
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Term
| Name some risk factors for lymphedema that are under the patients control |
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Definition
| Body mass, skin integrity, activity levels (inactivity the worst) constrictive clothing |
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Term
| Name the elements of proper lymphatic massage |
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Definition
Always proximal first Light, gentle |
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Term
| Name some rx options in lymphedema |
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Definition
Antibiotics when infection is present Benzopyrones (Flavinoids) assist in removal of accumulated protein Compression bandaging Compression garments,pumps Diet-decrease long chain fatty acids Diuretics Elevation Exercise programs Hydrotherapy Low level laser Massage Electrical stimulation of lymphatic and smooth muscle Skin care |
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Term
| Name and define the 3 stages of lymphedema |
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Definition
Stage 1-- No fibrosis. Edema pits. Skin normal Stage 2 -- substantial fibrosis. Persistent, doe not pit Skin thickening Stage 3 -- elephantine changes pigmentation |
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