Lab- lymphatics Flashcards
What is the common compensated pattern?
L/R/L/R
what is the uncommon compensated pattern?
R/L/R/L
What are the 4 different junctions you assess lymph?
craniocervical, cervicothoracic, thoracolumbar, and lumbopelvic
how should you introduce rotation of the lumbopelvic junction?
by placing the pads of your hands on the posterolateral aspects of the innominates
which junction should you treat first?
the thoracic inlet
what is the technique of the thoracic inlet MFR and any other junction?
you assess motion: flexion/extension, rotation, sidebending; then apply the principals of direct or indirect myofascial release
what is the main principle of diagnosis of the lymphatics?
you evaluate the central myofascial pathways
how you you evaluate the fluid pumps?
you observe and palpate for restriction of motion at the thoracic inlet, thoracic diaphragm, and pelvic diaphragm
What is the technique of doming the diaphragm?
you instruct the patient to take a deep breath and exhale; on exhalation you press your thumbs posteriorly and superiorly; push further on exhalation and resist on inhalation
where do you place your hands when doming the pelvic diaphragm?
place thumbs medial to the ischial tuberosities
what are two ways we can maximize the diaphragmatic functions?
doming the thoracic diaphragm and doming the pelvic diaphragm
what are three ways we can increase pressure differentials or transmit motion?
pectoral traction, rib raising (supine), tapotement
what is the technique of pectoral traction?
you grasp inferior to the pt’s clavicles at the anterior axillary fold; extend arms and lean back to apply cephalad traction bilaterally; pull when pt inhales and resist on exhalation
what are the 3 rhythmic forces that can be used during tapotement?
hacking, cupping/clopping, and slapping
what is the technique of the thoracic pump: repetitive/oscillatory?
place your thenar eminence of each hand inferior to the clavicles; have the patient take a deep breath and exhale fully; at the end of the exhalation apply a rhythmic posterior inferior pumping
what should the rate of the thoracic pump be?
120x per minute; continue for 2 minutes
what is the technique of the thoracic pump: vacuum/ atelectasis modification?
place thenar eminence of each hand inferior to clavicles; have the patient take a deep breath and exhale fully; as patient exhales, apply a compressive force downward and resist during inhalation; continue for 4-5 breaths; at beginning of last inhalation, briskly remove hands to allow for rapid, deep inhalation
what is the technique of the abdominal pump?
place palms on abdomen with fingers toward pt’s head; pump posteriorly in a rhythmic manner
what should the rate of the abdominal pump be?
20-30 times per minute; continue for 2 minutes
what is the technique of the pedal pump?
dorsiflex the pt’s feet; apply an on and off rhythmic cephalad force
what should the rate of the pedal pump be?
120x per minute; continue for 2 minutes
what is a concerning area to find enlarged lymph nodes and what should you be suspicious of?
the supraclavicular area- you have to be very suspicious of cancer
what is effleurage?
the doc induces a stroking force distally to proximally
what is petrissage?
the doc induces a kneading/twisting force distally to proximally
where should all lymph below the diaphragm be directed?
to the cisterna chyli
