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CHAPTER FIVE. Lymphedema

Lymphatic flow in the lower extremity is

a. Deep to superficial.

b. Superficial to deep.

c. Anterior to posterior.

d. Posterior to anterior.

Which of the following mechanisms is not effective in assisting lymphatic flow?

a. Diaphragmatic breathing

b. Positive pressure gradient within the lymphatic system

c. Muscle contractions

d. Smooth muscle in the walls of the collecting vessels

Which of the following characteristics are associated with Stage III lymphedema?

a. Hard non-pitting edema and presence of skin folds

b. Mild fibrosis and pitting edema

c. Normal joint range of motion and strength

d. Negative Stemmer test and loss of skin mobility

JB, a 62-year-old retired postal worker, presents with the following symptoms: heaviness and aching in both lower extremities, hemosiderin stains on the lower 1/3 of the legs, bilateral edema from the dorsum of the foot to below the knee, positive Stemmer sign bilaterally, mild to moderate fibrosis in the lower leg, and 3+ distal pulses. Medical history is negative for diabetes. What is the most likely diagnosis for this patient?

a. Kidney insufficiency

b. Cardiac insufficiency

c. Primary lymphedema

d. CVI with secondary lymphedema

The most effective intervention for Stage II lymphedema is

a. Education, garments, and MLD.

b. Diuretics, garment, and exercise.

c. MLD, compression therapy, and exercise.

d. Education, compression pump, and diuretics.

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