Lymphology Association of North America (LANA) Practice Exam

During manual lymphatic drainage, which pathway should be used for secondary left upper-extremity lymphedema?

1. Bilateral axillo-inguinal

2. Right axillo-inguinal and inter-axillary

3. Inter-axillary only

4. Left axillo-inguinal and inter-axillary

The correct answer is: Left axillo-inguinal and inter-axillary

For secondary left upper-extremity lymphedema, the optimal pathway to use during manual lymphatic drainage is the left axillo-inguinal and inter-axillary. This is because the drainage process aims to facilitate lymphatic flow from the affected area to appropriate drainage sites, allowing for effective management of the lymphedema. Using the left axillo-inguinal pathway allows for a direct connection to the left inguinal nodes, which can help drain excess lymphatic fluid from the left upper extremity. The inter-axillary pathway also plays a crucial role by providing an additional route for drainage toward the axillary nodes, which can become congested in the case of lymphedema. This comprehensive approach ensures that lymphatic fluid is redirected appropriately, minimizing swelling and promoting lymphatic health. In contrast, utilizing pathways that focus on the right side or are unilateral without adequately addressing the left drainage needs would not effectively manage the lymphedema. Therefore, the choice of the left axillo-inguinal and inter-axillary pathway is essential for comprehensive lymphatic management in cases of left upper-extremity lymphedema.