Deck 21: The Lymphatic System

Question 1

Which of the following lymphedema prevention strategies is MOST related to the integumentary system?

A)Avoid having blood pressure taken if possible on the "limb at risk."
B)Avoid sudden heavy lifting.
C)Avoid punctures such as injections or blood draws.
D)Avoid exposure to extreme cold.

Answer 1

C
Lymphedema prevention strategies specific to the integumentary system would be to avoid anything that may cause trauma or injury to the skin in order to reduce infection risk.

Question 2

Besides cancer,which of the following conditions is the MOST significant risk factor for the development of lymphedema?

A)Smoking
B)Type 2 diabetes
C)Obesity
D)Increasing age

Answer 2

C
Although increasing age (grouped by decade)was found to have a positive and significant association with the incidence of lymphedema,body mass index (BMI)was found to have an even stronger positive association.

Question 3

Which of the following conditions related to poor functioning of the lymphatic system MOST likely contributes to the risk for atherosclerosis?

A)Filtration of lipoproteins is increased.
B)Risk of oxidative damage is greater.
C)Risk of lipoprotein entrapment is decreased.
D)Diminished time arterial intima is exposed lipoproteins.

Answer 3

B
If the lymphatic system is not working properly,then filtration of lipoproteins will take longer,thus raising the risk of oxidative damage and entrapment within the vessel wall.

Question 4

Which of the following values represents the amount of fluid normally taken up by the lymphatic system and ultimately returned to the venous system per day?

A)2 to 4 L/day
B)6 to 8 L/day
C)10 to 12 L/day
D)18 to 20 L/day

Question 5

Which of the following structural components of the lymphatic system functions to filter harmful material such as bacteria,viruses,and cancer cells?

A)Precollectors
B)Collectors
C)Lymph nodes
D)Lymphangion

Question 6

A patient with soft and pitting edema that is reversible with elevation has a negative Stemmer sign and has skin tissue that appears normal is determined to be in which of the following lymphedema stages?

A)Stage 0
B)Stage I
C)Stage II
D)Stage III

Question 7

Which of the following lymphedema stages is also termed lymphostatic elephantiasis?

A)Stage 0
B)Stage I
C)Stage II
D)Stage III

Question 8

Which of the following factors contribute the MOST to reduced lymphatic function in the cardiovascular system leading to the formation of atherosclerosis?

A)Sedentary lifestyle
B)Decreased vital capacity
C)Obesity
D)All of the above

Question 9

Which of the following reasons BEST explains how external compression provided by compression bandages or garments is effective in reducing lymphedema?

A)Reduces an elevated blood capillary filtration rate.
B)Prevents an increase in a low blood capillary reabsorption rate.
C)Results in a negative interstitial fluid hydrostatic pressure.
D)Increases interstitial colloidal osmotic pressure.

Question 10

Which of the following tissues and organs are considered a part of the lymphatic system?

A)Thymus
B)Bone marrow
C)Spleen
D)All of the above

Question 11

Which of the following statements is the BEST reason for why a physical therapist should understand the anatomy and physiology of lymphotomes?

A)Knowledge of lymphotomes and the physiology assists a physical therapist with strategies that facilitate the reduction in lymphedema.
B)Knowledge of lymphotomes assists the physical therapist with the provision of patient education.
C)Knowledge of lymphotomes assists the patient with an understanding of the location of specific lymph nodes to be used for manual lymph drainage.
D)Knowledge of lymphotomes assists the physical therapist with strategies to move lymph to watersheds.

Question 12

If a patient has lymphedema in the right upper extremity and plans to fly on an airplane,which of the following prevention strategies should be implemented to reduce the risk for increased lymphedema?

A)Wear a well-fitting pressure garment.
B)Get up from the seat frequently to walk in the aisle.
C)Wrap extra bandages over an existing compression garment.
D)Avoid prolonged sitting.

Question 13

Which of the following pathological conditions results in primary lymphedema?

A)Infection
B)Radiation therapy
C)Hypoplasia of the lymphatic system
D)Chronic venous insufficiency

Question 14

The lymphatic system is similar to the venous system in which of the following ways?

A)The presence of one-way valves
B)The ability of a vessel to contract via the autonomic nervous system
C)Immune defense
D)Key function is waste removal

Question 15

Which of the following imaging methods of the lymphatic system has the capability to measure both superficial and deep lymph fluid movement,lymph node uptake speeds,while a patient exercises on a treadmill?

A)Direct lymphography
B)Lymphoscintigraphy
C)Magnetic resonance imaging
D)Fluorescent microlymphography

Question 16

The pressure caused by proteins present in the interstitium that results in water being attracted and pulled into the interstitium (filtration)describes BEST which of the four pressures of Starling's law?

A)Plasma hydrostatic pressure
B)Plasma colloidal osmotic pressure
C)Interstitial fluid hydrostatic pressure
D)Interstitial colloidal osmotic pressure

Question 17

The structural component of the lymphatic system that allows fluid and macromolecules such as proteins,cellular debris,and foreign organisms to enter the system is called which of the following?

A)Initial lymphatic vessel or sinus
B)Precollectors
C)Collectors
D)Lymphatic trunk

Question 18

Which of the following pathological conditions is associated with mechanical insufficiency or low-output (volume)insufficiency?

A)Congestive heart failure
B)Hypoproteinemia
C)Lymphedema
D)Chronic venous insufficiency

Question 19

If family heredity is present explaining primary lymphedema,it is referred to as which of the following?

A)Lymphedema praecox
B)Lymphedema trada
C)Milroy disease
D)Lymphatic filariasis

Question 20

The pressure caused by proteins in the capillaries that results in water being attracted and pulled into the capillary (reabsorption)BEST describes which of the four pressures of Starling's law?

A)Plasma hydrostatic pressure
B)Plasma colloidal osmotic pressure
C)Interstitial fluid hydrostatic pressure
D)Interstitial colloidal osmotic pressure

Question 21

To minimize delayed onset muscle soreness in a patient with lymphedema,which of the following exercises should be avoided?

A)Concentric activities with light resistance
B)Eccentric activities with light resistance
C)Low-impact cardiovascular enhancing activities
D)Walking with a walking stick on the affected side

Question 22

Thickened skinfold of the digits on the dorsum of the foot is termed which of the following?

A)Elephantiasis
B)Lipedema
C)Stemmer sign
D)Pitting edema

Question 23

Which of the following physiological changes occurs MOST due to graded compression using bandages or garments?

A)Decreasing filtration of fluid into the interstitium.
B)Reduction of the amount of lymph needing to be transported by the lymphatics.
C)Improves efficiency of the muscle pump during contraction of the distal and compressed muscle.
D)Assists in softening hardened fibrotic tissue found in the more advanced stages.

Question 24

Which of the following statements is true regarding the Laplace law as it pertains to the application of compression dressings?

A)If the tension is the same throughout the extremity,then pressure is greatest where the radius is the smallest.
B)If the tension is the same throughout the extremity,then pressure is greatest where the radius is the largest.
C)Wrapped areas larger in diameter or concave have higher pressures.
D)Wrapped areas smaller in diameter or concave have lower pressures.

Question 25

Which of the following steps of manual lymph drainage should be FIRST?

A)Patient should be lying down and affected extremity elevated.
B)Determine how strokes should be applied.
C)Treat the appropriate central areas and uninvolved lymph nodes.
D)Teach the patient appropriate manual techniques.

Question 26

Which of the following conditions is a contraindication for compression bandaging?

A)Cellulitis
B)Arterial disease of the leg;ankle-brachial index,0.8
C)Malignancy
D)Uncontrolled bronchial asthma

Question 27

Which of the following characteristics BEST distinguishes lipedema from lymphedema?

A)Presence of distal edema in the foot.
B)Absence of pain on pressure.
C)Occurs in bilateral lower extremities.
D)Family history is rare.

Question 28

Which of the following interventions distinguishes phase I complete decongestive therapy from phase II?

A)Compression using bandages first then transitioning to a compression garment
B)Exercise in bandages
C)Meticulous skin care
D)Manual lymph drainage

Question 29

Which of the following physiological properties of the lymphatic system contribute to poor success of surgical procedures to replace lymphatic vessels with synthetic tubes?

A)Lymphangion unit that contracts under control of the autonomic nervous system
B)The extensive blood supply present for lymph node function
C)The presence of one-way valves in the system
D)The presence of a smooth muscle layer in the wall and valves

Question 30

Which of the following conditions are considered complications of intermittent pneumatic compression pumps?

A)The compression pump may move water but not proteins from the interstitial space.
B)Actual pressures applied may be much greater than intended.
C)Movement of edema may cause other areas of edema such as genital edema.
D)All of the above are considered concerns.