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Exam (elaborations)

CLT-LANA Questions Answered 100% correct, Scored A+

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CLT-LANA Questions Answered 100% correct, Scored A+ Stage 0 CVI No symptoms, norm protein Stage I cvi Mild edema, normal protein, norm lymph vessels, phlebolymphodynamic insufficiency Stage 2 cvi Mod symptoms ( pigmentation, viscosity, pain), high protein, vessels morphologically changed, TC reduced, phlebolymphostatic insufficiency Stage 3 cvi Severe symptoms( hypoxia, necrosis, pain), very high protein load, lymph vessels morphologically change, TC reduced, severe phlebolymphostatic insufficiency Treatment stage 0 cvi Compression therapy, elevation, exercise Treatment stage 1 cvi Compression therapy, elevation, exercise Treatment stage 2 cvi CDT Treatment stage 3 cvi CDT and wound care Ambulatory venous hypertension Failure of venous valves such that blood flow bidirectional resulting in increased pressure to the capillaries What happens with low flow states in blood capillaries to leukocytes They become trapped and release proteolytic enzymes and oxygen free radicals which damage capillary basement membranes What happens to plasma proteins with low flow states in blood capillaries Plasma proteins leak into leak into the surrounding tissue creating a fibrin cuff, edema, and hypoxia What causes reddish brown skin associated with edema/ lymphedema High intracApillary pressure stretches endothelial cells away from each other and eurythrocytes leave the blood capillaries staining skin with hemosiderin deposits Does ambulatory venous hypertension cause an increase or decrease in net filtration Increase What causes mechanical insufficiency in cvi Fibrin leakage into the tissue as well as an inflammatory reaction overall increase in protein and water load What is not considered with staging lymphedema Limb volume Mild lymphedema severity volume increase <20% Moderate lymphedema severity volume increase 20-40% Severe lymphedema severity increase >40% Where do DVT form Sub fascial veins What is the most common ulceration and where do they form Venous stasis and they form in the distal 1/3 of the leg usually around the malleoli vascular venous wounds Shallow, irregular, on anterior/ medial leg with peri wound with hemosiderin staining,scaly, weepy, warm skin Arterial wound Round, deep, necrotic, or pale base found on lateral leg/ foot and tips of toes. The peri wound may include tissue pallor, dry, scaly skin, cool to the touch Mixed inflammatory vasculitis Small, dark base found anywhere, raised, palpable purpuri Pyoderma Irregular, jagged necrotic base found mostly on leg/ trunk skin with violaceous wound border, erythema Fungating Raised, necrotic, bleeds easily, extremely malodorous found anywhere with a lip of tissue around the wound margin Chemotherapy infiltration Painful erythema toys with necrosis, Escher/ slough, at the site of the catheter, skin is edema with erythema Radiation Exposed dermis, superficial, found in skin field, skin may have erythema with dark black coloration Minor trauma excoriation Linear, shallow, found anywhere with local or advancing erythema Minor trauma skin tears Shallow, linear flaps found on arms, hands legs common with ecchymosis Failed surgical site Partial or full thickness, necrotic base found at site of incision with erythema and edema Fistulae Pathological opening between organs cavities and the skin found at site of abcess with opening in wound beds presenting with drainage organs and tissue cavities Stewart-Treves syndrome/angiosarcoma Malignant neoplasm originating from blood vessels found with chronic lymphedema but rarely Skin metastasis Present as hardened or rubbery, light pink nodules with surrounding by a lighter area accompanied by patchy erythema, pimple like, may or may not be painful Partial thickness wound Down to but not through the dermis Is hemosiderin staining common with lymphedema Not unless the venous system is also compromised What is the significance of wet Escher with arterial wounds Indicates the onset of wet gangrene and requires immediate medical attention General Contraindications for MLD Cardiac edema, renal failure, acute infection, acute bronchitis, acute DVT, malignancy, bronchial asthma, hypertension Local contradictions to the neck Carotid sinus syndrome, hyperthyroidism, age (>60 arthrosclerosis) Local contradictions to the abdomen Pregnancy, dysmenorrhea, illustrated, diverticulitis, aortic aneurysm, recent abdominal surgery, DVT, inflammatory conditions, radiation fibrosis, unexplained pain What is net filtration as it relates to compression Blood capillary pressure- net filtration With respect to net filtration what is inward forces Interstitial pressure With respect to net filtration what are outward pressures Blood capillary pressure Which gestational week of embryonic development does the lymphatic system begin? End of the fifth Which layer of the three primary germ cells does the lymphatic vessels, spleen, and nodes arise from (mesoderm, endoderm, or ectoderm)? Mesoderm What other structures arise from the same germ level as the lymphatic system Connective tissue, muscle,bone, urogenital and circulatory system True or false: the lymphatic system is an offshoot of the venous system True: via lymph sacs that connect to embryonic veins. Lymph vessels are lined by endothelial cells At which stage in embryonic development is the primitive lymphatic system developed 2 months How do the deep and superficial lymphatic systems connect Perforating vessles What does the superficial system drain Skin and supra facial layers What does the deep system drain Muscle, tendons, nervous tissue, the periosteum, and joint structures Where are the transport vessles of the superficial system located In the fatty tissue What plays a vital role in colloid osmotic balance Proteins How long does it take for half the proteins circulating in the blood to leave the capillaries and travel to the interstitial spaces 24 hours

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