Pathophysiology of Lymphedema Flashcards
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Read the first 7 Pathophysiology of Lymphedema flashcards as text
Which of the following best describes 'dynamic insufficiency' of the lymphatic system?
Answer: The lymphatic load exceeds normal transport capacity despite structurally intact lymphatics
Dynamic insufficiency occurs when the lymphatic load is abnormally elevated (e.g., from cardiac or renal edema) and exceeds even normal lymphatic transport capacity, without structural lymphatic damage.
What is 'mechanical insufficiency' of the lymphatic system?
Answer: Reduced lymphatic transport capacity due to structural damage or obstruction
Mechanical insufficiency refers to reduced lymphatic transport capacity caused by structural damage such as node removal, radiation fibrosis, or congenital abnormality, which is the underlying cause of true lymphedema.
Approximately what percentage of the net filtrate from capillaries is normally returned to circulation via the lymphatic system?
Answer: 10–20%
Approximately 10–20% of net capillary filtrate is not reabsorbed directly into capillaries and must be returned to circulation via the lymphatic system, carrying protein and large molecules.
How does chronic protein accumulation in lymphedematous tissue contribute to progressive fibrosis?
Answer: Accumulated protein triggers chronic inflammation and fibroblast activation, leading to collagen deposition
Chronic protein accumulation stimulates an inflammatory response that activates fibroblasts via cytokines like TGF-β, resulting in progressive collagen deposition and irreversible tissue fibrosis.
ISL Stage 0 (or Stage Ia) lymphedema is best described as which of the following?
Answer: Latent or subclinical state where transport is impaired but no visible swelling is present
ISL Stage 0 represents a latent or subclinical phase in which lymphatic transport is impaired and symptoms such as heaviness may occur, but no visible or measurable swelling is present yet.
Which of the following best explains why lymphedema is characterized by a higher protein content in the interstitial fluid compared to other forms of edema?
Answer: Lymphatic failure allows protein, which cannot re-enter blood capillaries, to accumulate in the tissue
Unlike venous or cardiac edema where the lymphatics eventually remove protein, in lymphedema the impaired lymphatics cannot clear the protein that leaks from capillaries, so it accumulates progressively in the interstitium.
Which term describes the end-stage manifestation of severe chronic lymphedema characterized by massive limb enlargement, skin hyperkeratosis, and papillomatous skin changes?
Answer: Lymphostatic elephantiasis
Lymphostatic elephantiasis (ISL Stage III) describes severe chronic lymphedema with massive limb enlargement, non-pitting edema, hyperkeratosis, papillomatosis, and irreversible fibrotic tissue changes.