CLT-LANA Detailed Content Outline

All exams will be based on the new 2022 CLT-LANA Detailed Content Outline beginning August 1, 2022. The following are detailed outlines of the content and sub-content areas covered in the examination, along with their respective weightings showing what percentage of the examination questions are covered by each main content area. Please make sure that you are using the correct outline based on your exam date.

Detailed Content Outline for Examinations through July 31, 2022:

The examination contains 120-questions and candidates will be allowed two hours to complete the examination.

1. ANATOMY AND PHYSIOLOGY 25%

  1. Comprehension of anatomy
    1. Circulatory system (i.e., venous and arterial)
    2. Lymphatic system
      1. Embryology
      2. Lymphangiogenesis
      3. Prelymphatic channels
      4. Lymphatic vessels
      5. Lymph nodes
      6. Lympho-venous anastomoses
      7. Watersheds and collateral anastomoses
      8. Superficial drainage pathways
        1. Head and neck
        2. Upper extremities
        3. Lower extremities
        4. Trunk
        5. Genital
      9. Deep drainage pathways (e.g., abdominal, pelvic, thoracic organs,limbs)
    3. Integumentary system
    4. Interstitium
  2. Comprehension of physiology
    1. Function of the circulatory system including the lymphatic system
    2. Microcirculation
      1. Starling's hypothesis and equilibrium (including updates)
      2. Safety factors that prevent edema
    3. Lymph formation and transport

2. LYMPH VASCULAR DISORDERS (i.e., primary and secondary lymphedema) 15%

  1. Differentiate etiology
  2. Identify pathology and pathophysiology
  3. Classify and stage lymph vascular disorders
  4. Recognize sign and symptoms

3. OTHER DISORDERS (e.g., lipedema, lipolymphedema, phlebolymphedema, chronic venous insuffciency, myxedema) 10%

  1. Differentiate etiology
  2. Identify pathology and pathophysiology
  3. Recognize signs and symptoms

4. PATIENT EVALUATION 20%

  1. Identify relevant elements of patient history
    1. Edema and prior edema treatment
    2. Family history
    3. Other medical history
    4. Medications/supplements/diet
    5. Infections
    6. Symptoms
    7. Functional status (e.g., Activities of Daily Living (ADL))
    8. Psycho-social
  2. Assess implications of patient history
  3. Recognize potential complications associated with lymphedema
    1. Medical conditions associated with lymphedema (e.g., angiosarcoma, cellulitis, anasarca, lymphoceles, cancer recurrence)
    2. Medical conditions that exclude treatment (e.g., acute congestive heart failure, untreated cellulitis, acute deep venous thrombosis)
    3. Medical conditions that may limit treatment approach (e.g., compensated congestive heart failure, peripheral neuropathy, cognitive impairment)
    4. Medical conditions that can affect lymphedema treatment outcomes (e.g., arthritis, hypertension, impaired mobility)
  4. Conduct physical examination
    1. Weight and height
    2. Appearance of involved limb(s) and adjacent areas (e.g., deepened skin folds, lobules, discoloration)
    3. Clinical signs (e.g., tissue texture, Stemmer's sign)
    4. Peripheral pulses
    5. Range of Motion (ROM), muscle strength, posture, and gait
    6. Sensation
    7. Measurements (e.g., circumferential, volumetric, perometry)
    8. Skin integrity (e.g., lymphorrhea, fungal infection)
  5. Comprehension of diagnostic tests (e.g., lymphscintigraphy, computerized tomography (CT), magnetic resonance imagining (MRI), venous Doppler examination, and ankle brachial index (ABI))
    1. Purpose
    2. Testing procedures
  6. Incorporate results of diagnostic tests in treatment planning

5. LYMPHEDEMA MANAGEMENT 30%

  1. Apply principles of complete decongestive therapy (CDT)
    1. Manual lymphatic drainage (MLD)
      1. Effects
      2. Technique concepts (e.g., pressure, direction, sequence)
      3. Contraindications
    2. Compression bandaging
      1. Effects
      2. Concepts (e.g., materials, gradient pressure, procedure)
      3. Contraindications
    3. Compression garments
      1. Effects
      2. Concepts (e.g., types and styles, fitting principles, grades of compression)
      3. Contraindications
    4. Decongestive exercises
      1. Effects
      2. Concepts (e.g., variations, approaches)
      3. Contraindications
    5. Skin care
    6. Education
      1. Activities of Daily Living (ADL) modifications
      2. Compression bandaging
      3. Compression garments (i.e., wear and care)
      4. Exercise
      5. Lymphatic drainage
      6. Nutrition
      7. Precautions and risk reduction
      8. Self-assessment
      9. Skin care
      10. Signs and symptoms of infection
      11. Weight management
      12. Follow-up
    7. Recognize principles of adjunct treatments
      1. Intermittent pneumatic compression (IPC)
      2. Additional compression devices
      3. Additional treatment options (e.g., laser, elastic taping, deep oscillation)
    8. Adapt treatment plan to specific populations and needs (e.g., pediatric, palliative care, wound care)
    9. Recognize factors that affect quality of life (e.g., psycho-social, adherence issues)
    10. Identify best practices (e.g., International Lymphoedema Framework (ILF) International Society of Lymphology (ISL), National Lymphedema Network (NLN) Updated October, 2013

Detailed Content Outline for Examinations beginning August 1, 2022:

Beginning August 1, 2022, the examination consists of 130 multiple choice questions with four options, only one of which is correct. Twenty of these questions are included for research purposes only. The research questions are not identified; therefore, candidates must answer all questions to their best ability.

DOMAIN 1. Anatomy and Physiology 25%

  1. Distinguish among anatomical structures of the human body
    1. Venous and arterial circulatory systems
    2. Lymphatic system
      1. Embryology
      2. Lymphangiogenesis
      3. Prelymphatic channels
      4. Lymphatic vessels
      5. Lymph nodes
      6. Lympho-venous anastomoses
      7. Watersheds and collateral anastomoses
      8. Superficial drainage pathways
      9. Deep drainage pathways
    3. Integumentary system
    4. Interstitium
  2. Demonstrate understanding of physiological functions
    1. Circulatory and lymphatic systems
    2. Microcirculation
      1. Starlings and Revised Starling’s hypotheses and equilibrium
      2. Safety factors that prevent edema
    3. Musculoskeletal system
    4. Interstitium
      1. Adipose tissue
      2. Inflammation

DOMAIN 2. Lymphedema, Vascular, and Related Disorders (e.g., primary and secondary lymphedema, fat disorders, arteriovenous disease) 30%

  1. Differentiate etiologies
  2. Identify pathology and pathophysiology
  3. Distinguish signs and symptoms

DOMAIN 3. Patient Evaluation and Treatment Planning 15%

  1. Obtain a comprehensive patient history
  2. Determine functional status
  3. Conduct a comprehensive patient examination including:
    1. Vital signs and peripheral pulses
    2. Cognition and affect
    3. Neuromusculoskeletal assessment
    4. Integumentary assessment
    5. Measurements
    6. Appearance, clinical signs, and staging
  4. Identify purpose and procedural techniques of diagnostic tests
  5. Review diagnostic and lab tests results
  6. Identify early interventions for at-risk populations
  7. Formulate individualized treatment plan and goals

DOMAIN 4. Management of Lymphedema and Related Disorders 30%

  1. Integrate principles of complete decongestive therapy (CDT) in clinical settings
    1. Manual lymphatic drainage (MLD)
    2. Compression bandaging and garments
    3. Decongestive and functional exercises
    4. Skin and wound care
  2. Integrate core principles of adjunct clinical treatments and modalities
    1. Fibrosis, soft tissue, and scar management
    2. Elastic/kinesiology taping
    3. Intermittent pneumatic compression (IPC)
    4. Emerging therapies
  3. Formulate patient education and transition to self-management
    1. Activities of Daily Living (ADL) modifications
    2. Compression bandaging and garments
    3. Home program and therapeutic and recreational exercise
    4. Lymphatic drainage
    5. Weight management and nutrition
    6. Precautions and risk reduction practice
    7. Skin care
    8. Signs and symptoms of infection
    9. Nonelastic containment systems
    10. Intermittent pneumatic compression (IPC)
  4. Identify adaptations to treatment for special populations and needs
    1. Pediatrics
    2. Palliative care
    3. Bariatric (BMI > 40)
  5. Recognize cognitive, physical, psychological, and socioeconomic factors that affect quality of life and treatment
  6. Analyze potential complications associated with lymphedema and comorbid conditions
    1. Medical conditions associated with lymphedema
    2. Medical conditions that are absolute contraindications to treatment
    3. Medical conditions that are relative contraindications to treatment
    4. Medical conditions that can affect lymphedema treatment outcomes
  7. Identify surgical interventions to manage lymphedema and related disorders
    1. Surgical treatments
    2. Pre-operative management
    3. Post-operative care
  8. Identify the implications of pharmaceutical and/or supplemental treatments
  9. Recognize the impact of cancer and cancer treatment on lymphedema management