Lymphology Association of North America (LANA) Practice Exam

Which anastomoses pathways should be used on a patient with right upper-extremity lymphedema?

1. Left axillo-inguinal and inter-inguinal

2. Bilateral axillo-inguinal and inter-axillary

3. Inter-axillary only

4. Right axillo-inguinal and inter-axillary

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

For a patient suffering from right upper-extremity lymphedema, the most appropriate anastomosis pathways would be those that facilitate drainage from the affected area to regions where the lymphatics are functioning properly. Utilizing the right axillo-inguinal and inter-axillary pathways allows for the re-routing of lymphatic fluid directly from the right upper extremity to the inguinal lymph nodes and the axillary region, optimizing lymphatic drainage. The right axillo-inguinal pathway specifically targets the right side of the body, which is crucial in cases of unilateral lymphedema. The inter-axillary route also provides a network to enhance fluid flow towards accessible lymphatic territories. These anastomoses are designed to provide the most efficient drainage and relief from lymphedema by leveraging the existing functional lymphatic channels. In contrast, the other choices involve left-sided pathways or non-target areas that would not optimally address the condition affecting the right upper extremity. Effective management of lymphedema relies on creating connections that specifically target the affected limb, making the right-sided anastomoses not only logical but necessary for effective treatment.