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Lymphedema By Christina Hankins PT, CLT, CWS. Objective Identify form and function of circulatory and lymph systems Describe various factors that affect.

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Presentation on theme: "Lymphedema By Christina Hankins PT, CLT, CWS. Objective Identify form and function of circulatory and lymph systems Describe various factors that affect."— Presentation transcript:

1 Lymphedema By Christina Hankins PT, CLT, CWS

2 Objective Identify form and function of circulatory and lymph systems Describe various factors that affect the movement of fluid Describe difference between edema and lymphedema Describe stages of lymphedema Describe types of lymphedema Describe lymphedema treatment Describe Referral process

3 Anatomy of circulatory system 3 structural elements Heart Blood cells- RBC, WBC, platelets Plasma – water, salts, proteins, vitamins, minerals, hormones, dissolved gases, toxins, medications, and fats Blood vessels Arteries, veins, and blood capillaries

4 Anatomy of Lymphatic system 3 structural components Lymph vessels Trunks, collectors, precollectors, and lymph capillaries Lymphatic tissues Lymph nodes ( ), spleen, and thymus Lymph fluid Proteins, WBC, Medications, toxins, fats, water, bacteria

5 Lymph capillaries > Collectors> Nodes>Lymph Vessels>Venous angle Originate close to BC Closed tubes in the interstitial spaces of sub endothelial layers of the skin Larger than BC More permeable Anchoring filaments that connect to skin Flat endothelial cells, arranged in a single layer, overlap

6 Lymph Collectors Are larger vessels than LC Valves that contract Propel lymph into lymph nodes

7 What does the Lymph system Do? Basically a scavenger system that removes proteins, excess fluid, debris, and other matter from the interstitial spaces….

8 Factors affect fluid movement Diffusion Osmosis/osmotic pressure Colloid osmosis/ colloid osmotic pressure Filtration and reabsorption

9 Physiology of lymphatic system Passive edema protection Pressures ^ in BC> pressure ^ in interstitial fluid> ^ reabsorption rate Active edema protection Safety factor: Increase permeability of Lymph Capillaries Increase contraction frequency of Lymph collectors

10 Edema or Lymphedema? Dynamic insufficiency Lymphatic load > Transport capacity of an intact functioning lymph system CHF, CVI (stage I or II), immobility, hypoproteineima, pregnancy Edema is a swelling caused by the accumulation of abnormally large amounts of fluid in the intercellular spaces of the body Treat with Elevation Compression Exercise

11 Lymphedema Mechanical insufficency Reduction of transport capacity due to damage of insufficient lymph system Surgery, radiation, chronic inflammation, paralysis, Primary lymphedema Lymphedema is high protein edema To treat CDT- Complex decongestive therapy

12 Lymphedema or Edema? Combined insufficiency Lymph transport is compromised Compounded with a sx or trauma

13 Stages of Lymphedema Stage 0 Transport capacity is subnormal yet sufficient Stage I Pitting edema that recedes over night, 0 skin changes Stage II Fibrosis, cellulitis, pitting difficult to induce, wounds Stage III Fibrosis, papillomas, cysts, fistuals, hyperkeratosis, recurrent cellulitis, wounds

14 Types of Lymphedema Primary Born with insufficient or compromised lymph system Secondary Due to know insult Cancer, surgery, venolymphedema, obesity induced lymphedema, CHF induced

15 CDT in Home Health 4-6 weeks, although treatment set up upon individual need Ensure pt is a good candidate Education Disease process Bandage Ther Ex MLD Garments Pumps

16 CDT Benefits Individual comprehensive treatment with focus on education to work towards independence with maintenence program Incorporate function Can fit into shoes Ambulates much easier with smaller legs Decreased risk of infection Heal wounds

17 Home Health Benefits Great support staff SN, PT, OT, MSW, Aides In home assessment Readily available to caregivers

18 Refer to Home Health Physical therapy to Eval and treat (Bilateral LE) lymphedema Send prescription to Home Health Phone Fax Demographics


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