ACADEMY OF LYMPHATIC STUDIES (ACOLS)
Professional Certification Programme
MANUAL LYMPHATIC DRAINAGE (MLD)
Training Examination Compendium
Newest Edition |
Complete Questions and Correct Detailed Answers
Verified Answers | Brand New Version
Prepared for Certified Lymphedema Therapist (CLT) Candidates
For Educational and Examination Preparation Purposes Only
,About This Examination Guide
Overview
This compendium has been developed to support candidates preparing for the Academy of
Lymphatic Studies (ACOLS) Manual Lymphatic Drainage (MLD) certification examination. It
presents a comprehensive collection of examination questions alongside their verified correct
answers and detailed explanatory notes, reflecting the most current syllabus for the 2025/2026
assessment cycle.
Scope and Content
The guide covers all core domains assessed in the MLD training examination, including:
• Anatomy and physiology of the lymphatic system — capillaries, pre-collectors, collectors,
lymph nodes, trunks, and the thoracic duct
• Starling's Law, filtration, reabsorption, and the mechanisms that govern fluid
homeostasis
• Lymph formation, lymph time volume, transport capacity, and lymphangiomotoricity
• Classification of oedema and lymphoedema — dynamic insufficiency, mechanical
insufficiency, and combined insufficiency
• Watershed boundaries, lymphatic territories (quadrants and bundles), and drainage
pathways
• Indications, contraindications, and precautions for Manual Lymphatic Drainage and
compression therapy
• Practical effects of MLD techniques on the autonomic nervous system and lymphatic
contractility
How to Use This Guide
Each question is presented exactly as it appears in the examination, followed by the correct
answer clearly indicated. Where multiple-choice options are provided, the verified correct option
is identified. True/False questions are resolved with the confirmed answer and, where
appropriate, a brief clinical rationale. Candidates are encouraged to attempt each question
independently before consulting the supplied answer.
Disclaimer
This document is intended solely for examination preparation and educational purposes. It does
not constitute clinical advice and should not be used as a substitute for formal instruction by a
qualified lymphoedema therapist or ACOLS-certified educator. All clinical decisions must be
made by appropriately trained and licensed healthcare professionals.
, Examination Questions and Verified Answers
Question 1
All these are effects of the use of Manual Lymph Drainage (MLD) except:
a) Increase the local sympathetic response and the general parasympathetic effect
b) Increase in the contraction frequency of lymph collectors
c) Eliminates the risk of re-accumulation after decongestion
d) Re-route lymph flow around blocked areas into more centrally located, healthy areas
Answer:
c) Eliminates the risk of re-accumulation after decongestion
MLD does not eliminate the risk of re-accumulation; it reduces and manages fluid build-up.
Continued compression therapy and skin care are required to maintain results.
Question 2
Lymphoedema is a symptom; oedema is a disease.
True / False
Answer:
False — It is the reverse: oedema is a symptom of an underlying condition, whereas
lymphoedema is itself classified as a chronic disease.
Question 3
Crohn's disease is a contraindication for deep abdominal techniques.
True / False
Answer:
True — Active inflammatory bowel conditions such as Crohn's disease contraindicate deep
abdominal MLD techniques due to the risk of exacerbating inflammation.
Question 4
All of the following are absolute contraindications for compression treatment except:
a) Arterial diseases
b) Spasticity
c) Severe congestive heart failure (CHF)
d) Pregnancy
Answer:
d) Pregnancy
Professional Certification Programme
MANUAL LYMPHATIC DRAINAGE (MLD)
Training Examination Compendium
Newest Edition |
Complete Questions and Correct Detailed Answers
Verified Answers | Brand New Version
Prepared for Certified Lymphedema Therapist (CLT) Candidates
For Educational and Examination Preparation Purposes Only
,About This Examination Guide
Overview
This compendium has been developed to support candidates preparing for the Academy of
Lymphatic Studies (ACOLS) Manual Lymphatic Drainage (MLD) certification examination. It
presents a comprehensive collection of examination questions alongside their verified correct
answers and detailed explanatory notes, reflecting the most current syllabus for the 2025/2026
assessment cycle.
Scope and Content
The guide covers all core domains assessed in the MLD training examination, including:
• Anatomy and physiology of the lymphatic system — capillaries, pre-collectors, collectors,
lymph nodes, trunks, and the thoracic duct
• Starling's Law, filtration, reabsorption, and the mechanisms that govern fluid
homeostasis
• Lymph formation, lymph time volume, transport capacity, and lymphangiomotoricity
• Classification of oedema and lymphoedema — dynamic insufficiency, mechanical
insufficiency, and combined insufficiency
• Watershed boundaries, lymphatic territories (quadrants and bundles), and drainage
pathways
• Indications, contraindications, and precautions for Manual Lymphatic Drainage and
compression therapy
• Practical effects of MLD techniques on the autonomic nervous system and lymphatic
contractility
How to Use This Guide
Each question is presented exactly as it appears in the examination, followed by the correct
answer clearly indicated. Where multiple-choice options are provided, the verified correct option
is identified. True/False questions are resolved with the confirmed answer and, where
appropriate, a brief clinical rationale. Candidates are encouraged to attempt each question
independently before consulting the supplied answer.
Disclaimer
This document is intended solely for examination preparation and educational purposes. It does
not constitute clinical advice and should not be used as a substitute for formal instruction by a
qualified lymphoedema therapist or ACOLS-certified educator. All clinical decisions must be
made by appropriately trained and licensed healthcare professionals.
, Examination Questions and Verified Answers
Question 1
All these are effects of the use of Manual Lymph Drainage (MLD) except:
a) Increase the local sympathetic response and the general parasympathetic effect
b) Increase in the contraction frequency of lymph collectors
c) Eliminates the risk of re-accumulation after decongestion
d) Re-route lymph flow around blocked areas into more centrally located, healthy areas
Answer:
c) Eliminates the risk of re-accumulation after decongestion
MLD does not eliminate the risk of re-accumulation; it reduces and manages fluid build-up.
Continued compression therapy and skin care are required to maintain results.
Question 2
Lymphoedema is a symptom; oedema is a disease.
True / False
Answer:
False — It is the reverse: oedema is a symptom of an underlying condition, whereas
lymphoedema is itself classified as a chronic disease.
Question 3
Crohn's disease is a contraindication for deep abdominal techniques.
True / False
Answer:
True — Active inflammatory bowel conditions such as Crohn's disease contraindicate deep
abdominal MLD techniques due to the risk of exacerbating inflammation.
Question 4
All of the following are absolute contraindications for compression treatment except:
a) Arterial diseases
b) Spasticity
c) Severe congestive heart failure (CHF)
d) Pregnancy
Answer:
d) Pregnancy
