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13378520-LS - LYMPHATIC SYSTEM ANATOMY AND PHYSIOLOGY...

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L YMPHATIC S YSTEM A NATOMY AND P HYSIOLOGY - essential to system’s role in immunologic and metabolic processes - major factor in maintenance of fluid balance - production of lymphocytes and antibodies - defend against invasion of microorganisms and other particles with filtration and phagocytosis (ingestion and digestion by cells of solid substances) - plays unwanted role in providing at least one pathway for spread of malignancy - drainage point for right upper body empties into right subclavian vein - has no built-in pumping mechanisms and depends on cardiovascular system for this action - usually occur in groups or chains D EVELOPMENTAL V ARIATIONS A. I NFANTS AND C HILDREN - immune system and lymphoid system develop at about 20 weeks gestation - enlargement of tonsils in children is not necessarily an indication of problems - before 2 yrs. old, inguinal, occipital and post-auricular nodes are common - after 2, more likely to have significance - supraclavicular nodes are not usually found - - presence is associated with high incidence of malignancy - - always a cause for concern - lymphatic system reaches adult competency during childhood B. P REGNANT W OMEN - complex changes occur in immune system that are not fully understood - shift from cell-mediated immunity to antibody production/humoral immunity results in increased susceptibility to certain infectious diseases - can lead to remission of autoimmune/inflammatory diseases C. O LDER A DULTS - number of lymph nodes may diminish and size may decrease with advanced age - nodes are more likely to be fibrotic and fatty - - contributing factor in impaired ability to resist infection I. S UBJECTIVE A SSESSMENT A. L YMPHATIC 1. History of Present Illness - bleeding = site, character, associated symptoms - enlarged nodes (bumps, kernels, swollen glands) = character, associated symptoms,
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predisposing factors (infection, surgery, trauma) - swelling of extremity = unilateral, bilateral, intermittent, constant, predisposing factors, associated symptoms, efforts at treatment and their effect 2. Past Medical History - chronic illness, tuberculosis, blood transfusions, surgery, recurrent infections 3. Family History - malignancy, anemia, recent infections, tuberculosis, hemophilia 4. Developmental Variations a. Infants and Children - recurrent infections = tonsillitis, adenoiditis, bacterial infections - poor growth, failure to thrive - immunization history - maternal HIV infection b. Pregnant Women - exposure to rubella and other infections - presence of autoimmune disease c. Older Adults - present or recent infection or trauma - delayed healing II. O BJECTIVE A SSESSMENT A. L YMPH N ODES 1. Inspection and Palpation (can start as soon as you see patient) of Superficial Lymph Nodes
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