Lab- lymphatics

Question 1

What is the common compensated pattern?

Answer 1

L/R/L/R

Question 2

what is the uncommon compensated pattern?

Answer 2

R/L/R/L

Question 3

What are the 4 different junctions you assess lymph?

Answer 3

craniocervical, cervicothoracic, thoracolumbar, and lumbopelvic

Question 4

how should you introduce rotation of the lumbopelvic junction?

Answer 4

by placing the pads of your hands on the posterolateral aspects of the innominates

Question 5

which junction should you treat first?

Answer 5

the thoracic inlet

Question 6

what is the technique of the thoracic inlet MFR and any other junction?

Answer 6

you assess motion: flexion/extension, rotation, sidebending; then apply the principals of direct or indirect myofascial release

Question 7

what is the main principle of diagnosis of the lymphatics?

Answer 7

you evaluate the central myofascial pathways

Question 8

how you you evaluate the fluid pumps?

Answer 8

you observe and palpate for restriction of motion at the thoracic inlet, thoracic diaphragm, and pelvic diaphragm

Question 9

What is the technique of doming the diaphragm?

Answer 9

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

Question 10

where do you place your hands when doming the pelvic diaphragm?

Answer 10

place thumbs medial to the ischial tuberosities

Question 11

what are two ways we can maximize the diaphragmatic functions?

Answer 11

doming the thoracic diaphragm and doming the pelvic diaphragm

Question 12

what are three ways we can increase pressure differentials or transmit motion?

Answer 12

pectoral traction, rib raising (supine), tapotement

Question 13

what is the technique of pectoral traction?

Answer 13

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

Question 14

what are the 3 rhythmic forces that can be used during tapotement?

Answer 14

hacking, cupping/clopping, and slapping

Question 15

what is the technique of the thoracic pump: repetitive/oscillatory?

Answer 15

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

Question 16

what should the rate of the thoracic pump be?

Answer 16

120x per minute; continue for 2 minutes

Question 17

what is the technique of the thoracic pump: vacuum/ atelectasis modification?

Answer 17

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

Question 18

what is the technique of the abdominal pump?

Answer 18

place palms on abdomen with fingers toward pt’s head; pump posteriorly in a rhythmic manner

Question 19

what should the rate of the abdominal pump be?

Answer 19

20-30 times per minute; continue for 2 minutes

Question 20

what is the technique of the pedal pump?

Answer 20

dorsiflex the pt’s feet; apply an on and off rhythmic cephalad force

Question 21

what should the rate of the pedal pump be?

Answer 21

120x per minute; continue for 2 minutes

Question 22

what is a concerning area to find enlarged lymph nodes and what should you be suspicious of?

Answer 22

the supraclavicular area- you have to be very suspicious of cancer

Question 23

what is effleurage?

Answer 23

the doc induces a stroking force distally to proximally

Question 24

what is petrissage?

Answer 24

the doc induces a kneading/twisting force distally to proximally

Question 25

where should all lymph below the diaphragm be directed?

Answer 25

to the cisterna chyli