Lymphology Association of North America (LANA) Practice Exam

For a patient with significant edema, which sequence should your MLD include aside from the abdominal sequence?

1. Bilateral axillary nodes only, then bilateral inguinal-axillary anastomoses

2. Bilateral inguinal lymph nodes, but no anastomoses work to the axilla

3. Bilateral axillo-inguinal anastomosis and inter-inguinal anastomoses

4. Bilateral inguinal and axillary nodes and bilateral inguinal-axillary anastomoses

The correct answer is: Bilateral inguinal and axillary nodes and bilateral inguinal-axillary anastomoses

The choice that includes bilateral inguinal and axillary nodes along with bilateral inguinal-axillary anastomoses is the most appropriate sequence to incorporate after the abdominal sequence in managing significant edema. In lymphatic drainage, the inguinal and axillary nodes play crucial roles in the lymphatic pathway. Targeting these lymph node groups helps facilitate proper lymphatic fluid movement and reduces the accumulation of edema. The bilateral approach ensures that both sides of the body are equally treated, maintaining balance and maximizing the effectiveness of manual lymph drainage (MLD). Additionally, focusing on the inguinal-axillary anastomoses is vital because these connections enhance lymphatic flow between remote drainage areas. By addressing the anastomoses, you promote a more comprehensive drainage as lymphatics from the lower body can effectively communicate with the upper body, thereby enhancing overall lymphatic function and reducing the swelling more effectively. This response directly addresses the necessary anatomical considerations when treating significant edema and aligns with best practices for lymphatic health management. Other options may not comprehensively cover the necessary areas of treatment or may omit critical connections that contribute to optimal lymphatic drainage.