Abluminal Side

Outside a lymphatic vessel.

Acute

A sudden onset of symptoms or disease.

Adenoma

A benign tumour formed from glandular tissue.

Aetiology

The study of cause(s) of an illness or disorder

Afferent Lymphatics

Pre-nodal (that is the ones that enter the lymph node) collecting vessels having smooth muscle in their walls and capable of pumping lymph.

Alopecia

The loss of hair which may include all body hair as well as scalp hair.

Ameliorated

Improvement in condition.

Anaemia

A condition which causes a decrease in the number of red blood cells. Symptoms may include feeling tired, weak and shortness of breath.

Anaesthetic

Can be local or general. Local anaesthetic is a medical term used to describe how a cream or injection can be used to cause temporary numbness in a specific area of the body during certain tests or procedures. General anaesthetic is a medical term used to describe how a specialist doctor (anaesthetist) uses drugs to put patients to sleep during an operation.

Analgesic

Any drug that relieves pain.

Analysis of Variance

A statistical technique which is used to compare differences between groups.

Anorexia

Loss of appetite.

Antibody

A substance formed by the body to help it fight infection.

Antigen

A substance (usually a protein) identified as foreign by the body's immune system, triggering the release of antibodies as part of the body's immune response.

Anti–emetic

Something that can help or prevent sickness.

Atrophy

Wasting of the muscles

Autoimmune

An immune response by the body against one of its own tissues, cells, or molecules.

Axon

Part of the neuron which carries signals to specific cells such as muscle cells.

Axuilla

The armpit.

Bariatric

Severe obesity.

Barium enema

Procedure for examining the lower intestine. The patient lies on an X-ray table. An enema of barium and water is squirted into the back passage (rectum) through a small plastic tube. The barium spreads through the lower bowel and shows up any lumps or swellings, which can be seen on the X-ray screen.

Barium swallow

This test looks at the foodpipe (gullet or oesophagus) and stomach. It is carried out in the X-ray room. The patient is given a drink of white barium liquid. The doctor may want to take X-rays while the liquid is being swallowed as well as when it is in the patient's stomach.

Barium x-ray

This investigates the outline of any part of the digestive system. A barium swallow is usually used to investigate the gullet or stomach, while a barium enema is used to investigate the lower bowel or colon. Barium is a white liquid that shows up clearly on an x-ray. It coats the inside of the gullet, stomach or bowel, so that tumours show up as irregular outlines extending from the wall of the affected organ.

Benign

Non-cancerous lump or tumour which grows slowly in one specific area and when removed by surgery rarely returns.

Bicuspid Valve

Valve with two flaps or 'cusps'.

Bioimpedance

A newer approach to evaluating tissue changes related to lymphoedema is based on measuring impedance instead of limb volume.  Impedance is an electrical property that is similar to resistance but measured using signals of different frequencies.

Within our bodies, fluid can be found within the cells (intracellular fluid) or outside the cells (extracellular fluid).  Lymph is a form of extracellular fluid and lymphoedema is an excess of extracellular fluid.  Low frequency electrical current travels through the extracellular fluid in the spaces between the cells without penetrating the cell membrane.  Higher frequency signals penetrate the cell walls and pass through both intracellular and extracellular fluid.  Impedance can be calculated based on current flows at different signal frequencies and used to estimate how much extracellular fluid is present.

Bioimpedance can be measured using a hand-held device and electrodes attached to one foot, each hand and wrist (for upper extremity).  The process is fast and painless.

Biopsy

Carried out if cancer is suspected in an area of the body, by examining a sample of tissue removed from that area.

Bone Marrow Test

This investigates whether there are cancer cells in the bone marrow. A small sample of marrow is taken (aspirated) using a syringe, usually from the hip. It can be used for any type of cancer if it is suspected that the bone marrow could contain cancer cells, but is most often done for cancers that affect the bone marrow, such as: Lymphomas (non-Hodgkin’s lymphoma or Hodgkin’s disease). Leukaemias. Multiple myeloma.

Bone Scan

This involves injecting a radioactive substance into the bloodstream. This collects in the bones and is detected by a 'gamma camera'. More of the radioactive substance tends to collect in areas where there is a lot of activity in the bone, meaning it is breaking down or repairing itself. These 'hot spots' can be seen by the camera. They may be caused by other conditions, such as arthritis.

Cancer

A general name for more than 200 diseases in which abnormal cells grow out of control.

Carcinogen

A substance which causes or helps to cause cancer

Cardiac

Relating to the heart.

Carrier

A carrier of a genetic disorder will carry a gene for a recessive disorder, while usually remaining unaffected. The carrier, however, may pass the faulty gene onto their children.

Carrier testing

A person can be genetically tested to find out if they have a 'copy' of a faulty gene which they could potentially pass on to their children.

Cells

The basic unit of life.

Cellulitis

An infection of the skin and subcutaneous tissues.

Cervical Smear

This involves a few cells being removed from a woman’s cervix using a spatulum. These are sent off to a laboratory to be examined under a microscope.

Chemotherapy

The use of special cell – killing drugs to treat cancer.

Chromosomes

These are the housing for genes.

Complex decongestive therapy (CDT)

The recognised conservative two phased approach to the management of lymphoedema.

Compression garments

are required for life-long containment of oedematous limbs:

Flat-knit garments: knitted as a flat (made to measure) piece and joined with a seam.  Material is firmer and thicker than a circular knit garment.

Circular knit garments: knitted on a cylinder with no seam.  Garments are shaped by varying stitch height and yarn tension.

Compression garments

are required for life-long containment of oedematous limbs:

Flat-knit garments: knitted as a flat (made to measure) piece and joined with a seam.  Material is firmer and thicker than a circular knit garment.

Circular knit garments: knitted on a cylinder with no seam.  Garments are shaped by varying stitch height and yarn tension.

Compression garments

are required for life-long containment of oedematous limbs:

Flat-knit garments: knitted as a flat (made to measure) piece and joined with a seam.  Material is firmer and thicker than a circular knit garment.

Circular knit garments: knitted on a cylinder with no seam.  Garments are shaped by varying stitch height and yarn tension.

Consent

Before certain investigations or procedures, you will be asked to give written or verbal agreement for them to be carried out.

Contracture

Shortening of the muscle or tendon preventing the joint from moving freely.

Creatine Kinase

A type of protein found in muscle. Some forms of Muscular Dystrophy are associated with high levels of this.

CT (Computerised Tomography) Scan

Computerised tomography uses x-rays to generate an image of parts of the body. While traditional x-rays use a single x-ray beam, CT scans provide more detailed information by sending multiple beams from different angles, and using a computer to interpret them. It is used for both diagnosis and staging of cancers - staging of cancer being a measure of how much it has grown and spread.

Cystoscopy

A cystoscope is a thin tube containing optic fibres with a light and an eyepiece attached. A cystoscopy is an inspection of the bladder, carried out by passing the cystoscope through the urethre. It is the most important test for diagnosing primary cancer of the bladder or to investigate whether other cancers have spread to the bladder. It is also used to investigate:

Cytology

Refers to the microscopic examination of abnormal cells. This examination allows the cancer specialist to identify the type and extent of the cancer.

Deletion mutation

This is where genetic material is lost from a chromosome or gene.

Desmin

A protein that forms the intermediate filaments of muscle cells.

Diagnosis

The medical term given to any illness that has been identified following a full medical investigation of symptoms and/or specific test results.

DNA (Deoxyribonucleic Acid)

An acid present in the chromosomes of all plants and animal cells by which all hereditary characteristics are passed from parent to offspring

Dominant inheritance

A case where the person displaying symptoms of a condition has only one pair of affected chromosomes.

Duchenne Muscular Dystrophy

Caused by an error in a gene called dystrophin and usually affects only boys, although there are rare cases in girls. A lack of dystrophin protein results in muscle cells breaking down, causing progressive muscle weakness. It affects the muscles of the pelvis and thighs first, causing difficulty in walking between the ages of one and three.

Dysphagia

Difficulty in swallowing.

Dystrophy

Any disorder arising from defective or faulty taking in and metabolism of nutrients.

Efferent Lymphatics

Post-nodal (ones leaving the lymph node) muscular collecting vessels similar to the afferent lymphatics but larger and also capable of pumping lymph.

Egg freezing

The process by which women can have eggs surgically removed and frozen for future use.

Endoscopy

The endoscope contains a camera and light, enabling the physician to visualise the area in question. It is usually used to investigate the: Oesophagus. Stomach. Duodenum. The endoscopy is usually carried out at outpatients. Most patients have a choice between having the test while they are awake (with a throat spray to numb the throat), or after having a medicine to make them drowsy (a sedative). The endoscope tube is passed down the throat to the area being investigated. The patient will be asked you to swallow as the tube goes down. If there are any abnormalities, the doctor will take pieces of tissue from the abnormal looking area to send to the laboratory for closer inspection under a microscope. These tissue samples are called biopsies.

Endothelial Cells

Thin flattened cells found lining blood vessels and lymphatics.

Enzyme

A protein molecule that causes chemical reactions of other substances, without itself being destroyed or altered on completion of the reactions

Exon

Coding sequence in a gene.

Flap Valve

Overlapping endothelial cells.

Genes

Shorter sections of DNA which act as code for a particular characteristic. If a person inherits particular chromosomes, they also inherit the particular characteristics coded for by the genes on those chromosomes.

Genetic

Characteristics determined by genes

Genetic counselling

Information and support provided by specialists to individuals with genetic conditions in their families.

Genetic disorder

Conditions resulting from abnormality in the genetic makeup of an individual. Genetic disorders can be caused by defects in one or more genes.

Genetic testing

Tests on an individual's DNA to identify any faults which could cause a disorder.

Hospice

An institution specialising in caring for people receiving palliative care.

Human Papilloma Virus (HPV)

A virus responsible for various warts. Some HPV’s cause genital warts; others have been implicated in Cervical Cancer.

Hydrostatic Pressure

The pressure exerted by a fluid at rest. It acts equally in all directions.

Hypotonia

Floppiness.

Initial Lymphatics

Blind-ended sacs with thin walls that consist of a single layer of edothelial cells.  These have no muscle in their walls and are not capable of active pumping.

Initial Lymphatics

Blind ended sacs with thin walls that consist of a single layer of endothelial cells.  These have no muscle in their walls and are not capable of active pumping.

Interstitial Fluid

The fluid within the tissues.

Interstitial pressure

The pressure of the interstitium or tissue spaces. Again, there are two components; interstitial oncotic and interstitial hydrostatic pressure.

Interstitial Spaces

The spaces within the tissues that are outside of the blood vessels are known as interstitial spaces or compartments.  Most of the body's fluids that are found outside of the cells are normally stored in two spaces; the blood vessels (where the fluids are called the blood volume) and the interstitial spaces (where the fluids are called the interstitial fluid).

Intraluminal Pressure

The pressure within the lumen (inside) of a vessel.

Limb Volme Bioimpedance Method

Bioimpedance measures tissue resistance to an electrical current, which estimates extracellular fluid volume.

Limb Volume Perometery Method

This method uses an infrared optoelectronic system to measure limb volume.

Limb Volume Water Displacement Method

This method is considered the Gold Standard for calculating limb volume, particularly for hands and feet.  It is based on the principle that an objext displaces its own volume of water.

Lipoedema

can be described as a bilateral, symmetrical, flabby swelling that arises from the deposition of adipose tissue.  The cause of lipoedema is not fully understood.  Lipolymphoedema is a combination of lipoedema, obesity and lymphoedema.

Lumbar puncture

This is a puncture into the spinal cord to obtain cerebrospinal fluid (CSF) for clinical investigation, to remove excess fluid or to inject medication. It can be used to detect increased CSF pressure, which may indicate brain tumours.

Luminal Side

Inside a lymphatic vessel.

Lymphangiogram

CT and MRI have largely replaced this specialised x-ray of the lymph nodes, but it is still used to investigate for non-Hodgkin’s lymphoma or Hodgkin’s disease. A dye is injected into the lymph vessels, usually through the skin of the feet. This travels through the lymphatic system and into the lymph nodes and will show up on x-ray. Any lymph nodes that contain cancer will show up as enlarged.

Lymphatic lumen

Inside of a lymphatic vessel.

Lymphocyte

A white blood cell that creates an immune response when activated by a foreign molecule (antigen).

Lymphoedema

is the result of accumulation of fluid containing proteins and other elements in the tissue spaces due to an imbalance between interstitial fluid production and transport (usually low output failure).  It arises from congenital malformation of the lymphatic system or from damage to the lymphatic vessels and/or lymph nodes.

Lymphorrhoea

Leakage of lymph fluid through the skin surface.

Lymphscintigraphy

is radiological imaging of lymphatics using radioactive tracers (nanocolloid).

Malignant

A term used to describe a cancerous tumour. It can invade surrounding tissue and spread into other parts of the body.

Mammogram

A special x-ray of the breast; useful for detecting tumours too small to be felt. Women aged 50 – 64 are routinely invited to have a mammogram every 3 years by the NHS.

Manifesting carrier

A female carrier of an x-linked condition who exhibits symptoms of the condition.

Manual lymphatic drainage (MLD)

A specific form of massage to stimulate the lymphatic system.

Melanoma

Malignant cancers of the skin, spreading from a mole or mole-like area

Membrane

The thin layer between the inside and the outside of a cell or between two compartments of a cell.

Metabolism

Physical and chemical processes occurring within a living cell or organism that are necessary for the maintenance of life.

Metastases

Where the cancer cells break away and spread to other organs within the body which can trigger new cancerous tumours.

Molecule

A very small amount of matter. A chemical combination of two or more atoms.

MRI (Magnetic Resonance Imaging) Scan

Magnetic resonance imaging uses magnetism to build up a picture of the inside of the body instead of X-rays. The information from the scan is translated into a computer image and onto film to be studied by a specialist. It is often used for: Diagnosing tumours of the pituitary gland and brain. Evaluating bone tumours.

Multilayer lymphoedema bandaging (MLLB)

A specialist bandaging technique used to encourage lymph movement and reduce fibrosis.

Muscle

An organ which produces movement by contraction.

Muscle cell

The basic unit of muscle fibre

Muscle fibre

Formed by the fusion of a group of muscle cells.

Muscular Dystrophy

The muscular dystrophies are a group of over 20 hereditary muscle disorders in which slow, progressive muscle wasting occurs, leading to increasing weakness and disability.

Mutation

Alteration of a gene which can be passed down through generations.

Myopathy

Muscle weakness.

Myoprotein

A protein obtained from muscle tissue.

Myositis

Inflammation of a muscle

Myotonia

Muscular condition resulting in muscles contracting and becoming slow to relax.

Nerves

Bundles of axons which transmit signals around the body.

Neuron

Cells that produce signals in the form of electrical impulses.

Nutrition

Taking in and metabolism of nutrients by an organism so that life is maintained and growth can take place.

Oncologist

Doctors who are cancer specialists.

Oncotic Pressure

Because proteins in blood can't easily cross through the walls of the blood capillary they exert a small osmotic pressure across the wall.  This acts to suck fluid back from the tissue spaces into the blood.  The hydrostatic pressure in the capillary normally exceeds this oncotic pressure so that net fluid movement is outward.

Organ

A part of the body made up from tissues e.g. liver, pancreas, heart, and lung.

Orthoses

Devices or aids to prevent or assist movement in the spine or limbs.

Palliative

Treatment or care that gives relief of symptoms but does not cure disease.

Pathology

Study of the changes in tissues and organs of the body which cause disease.

PET (Positron Emission Tomography) Scan

Positron emission tomography is a new scan that can see how body tissues are working. It can be used at the time of diagnosis for staging cancer, or at the end of treatment, to show the difference between scar tissue and active cancer tissue. Sometimes CT scans will show that there are still signs of cancer, but this may be scar tissue left over from the tumour after treatment. A PET scan can show whether it is active cancer tissue or not. In lung cancer, PET scans are sometimes used to look for cancer in the lymph nodes in the centre of the chest, as this can decide whether or not a cancer is operable.

Pneumatic Compression Pump (PCP)

Compartmentalised sequential pressure device used in conjunction with complex decongestive therapy (CDT).

Prenatal

Existing or occurring before birth.

Primary Cancer

The first malignant tumour to develop in a specific part of the body

Proband

The individual in a family through which a genetic condition comes to light.

Prognosis

The medical term used by specialists to describe how your condition is likely to affect you in the future. A forecast as to the probable outcome of a disease.

Protein

Organic compound essential to the make up of all living cells, consisting of amino acids in various combinations.

Protocol

The term given to a cancer treatment plan specific to you.

Pulmonary Circulation

The passage of blood from the right ventricle through the pulmonary artery to the lungs and back through the pulmonary veins to the left atrium.

Radiotherapy

Treatment of cancer using radiation to kill cancerous cells and reduce the tumour size.

Recessive

A recessive condition is not expressed unless the affecting gene is carried by each of the pair of a particular chromosome.

Secondary Growths

New tumours that have formed because cancer cells from the original tumour have been carried to other sites in the body via the blood or lymphatic system.

Sentinel lymph node biopsy

A conservative surgical cancer screening procedure to identify spread of disease to the local primary draining lymph node.

Sperm banking

The process by which human sperm is reserved and frozen for future use.

Stem cells

Cells that have not yet developed into a particular function cell. They have the potential to become any type of cell.

Stemmer's Sign

is positive when a thickened skin fold at the dorsum of the fingers ot toes cannot be lifted or is difficult to lift.  The presence of this sign is an early diagnostic indication of lymphoedema. The absence of a Stemmer sign does not rule out the possibility of lymphoedema.

Stop Codon

A DNA code that stops protein production.

Systemic Circulation

Circulation of blood throughout the body throught he arteries, capillaries, and veins , which carry oxygenated blood from the left ventricle to various tissues and return venous blood to the right atrium.

Talipes

A congenital deformity of the foot, which is twisted out of shape or position.

Telomere

A telomere is a microscopic structure found on the end of our chromosomes controlling the number of times a cell can divide and reinvigorate tissue. The telomeres get shorter each time a human cell duplicates and at a certain length the cell stops duplicating altogether. The telomere also prevents the chromosome joining up with any fragments after it has been broken.

These are the housing for genes.

Chromosomes come in 23 pairs, with one from each parent giving a total of 46. Because chromosomes contain genes, a person will have two copies of every gene. The chromosomes are in the nucleus of the cell.

Tissue

A group of cells in an animal or plant with a similar structure and particular function.

Trial

A trial or study is designed to find answers to specific questions about specific diseases.

Tumour

Abnormal swelling or lump. While it can be benign or malignant, the word tumour is often used to mean cancer.

Ultrasound Scan

Ultrasound uses high-frequency sound waves and their echoes to visualise things that are unseen. It is used for: Providing an early diagnosis of prostate cancer. Some ultrasound machines can provide three-dimensional images that can be used to visualise tiny structures and tumours.

Viruses

Small particles which can only reproduce inside living cells. They can spread between people through air, blood or on occasions through sexual intercourse.

X Chromosome

A chromosome involved in determining an animal's sex. Females have two x chromosomes, whereas males have one x chromosome and one y chromosome.

X Linked

A gene carried on the x chromosome. The corresponding trait or condition, whether dominant or recessive, is always expressed in males. Females with a faulty gene are usually not affected by it as they have a second normal copy of the gene - they will however be a carrier of the trait or condition.

Y Chromosome

A chromosome involved in determining an animal's sex. Y chromosomes occur only in males. Males have one x chromosome and one y chromosome whereas females have two x chromosomes.