Lymphatic Venous System Flashcards
Frontal Sinus-LV
TP: over the supra-orbital foramen of the frontal bone
Tx: translation of the nasal bone inferiorly towards the opp side, while pulling the ipsilateral side of the frontal bone superiorly towards the opp side
Maxillary Sinus-LV
TP: located over the infraorbital sinus
Tx: translation of the ipsilateral maxillary bone in an anterior/inferior direction, while providing counter pressure in the opposite direction on the contralateral maxilla
Submandibular Lymphatics-LV
TP: post/inf aspect of the descending ramus
Tx: c/s rotation away from the TP and glide the submandibular/submental lymphatics (b/w the mandible and digastric muscle in an ant/slightly medial direction)
Facial Vein-LV
TP#1: ant/inf aspect of the masseter muscle
TP#2: middle of the zygomaxillary suture
Tx: glide facial vein TP#1 towards the top of the nasal bone in an ant/sup direction
PTER-LV
TP#1: inf/lat aspect of the lambdoidal suture (2 fw sup/med from the asterion
TP#2: found in large depression on the temporal bone (post to the upper ear and lateral to the lambdoid suture
Tx: glide mandible and masseter muscle in an ant and slightly inferior direction
UJUG-LV
TP: slightly below and 1 fw lateral to the post occipital protuberance on the inf nuchal line (pull in a sup/lat direction)
Tx: cervical rotation away, glide the parotid gland and upper jugular vein in an ant and sup direction (add traction of the head during)
Jugulodiagstric/retromandibular vein
TP: located over the post aspect of the C2 transverse process in the paravertebral mass
Tx: c/s rotation away from the tender point, glide of lymphatics & retromandibular vein, posterior to mandible in superior direction.
EJUG-LV
TP#1: located in a small depression on the post occiput, 3cm sup and slightly lat to the lat aspect of the semispinalis capitus insertion
TP#2: over paravertebral mass of C4
Tx: glide external jugular vein (post to mid SCM) in a sup and slightly ant direction
Anterior Jugular-LV
TP: C5 paraspinal mass
Tx: glide lower aspect of the ant jugular vein (grasp lateral to the SCM at the level of the C5) in medial direction
EPI C1-LV
TP: b/w the occiput and the medial arch of the atlas (post to ant)
Tx: c/s flexion (to level), side bend away and rotate toward with traction
EPI C2-C7-LV
TP: over lateral humerus (centrally) from below the deltoid tuberosity to the supracondylar ridge
C7 is located on the medial end of the clavicle
Tx: flexion to the level, side bend away and rotate towards with traction
EPI T1-6-LV
TP: centrally over the manubrium and sternum
Tx: patient seated, thoracic flexion, side away and rotate towards and exaggerate the segmental curve seen
EPI T7-T11-LV
TP: under the corresponding inferior rib margins
Tx: thoracolumbar flexion, side bend away and rotation towards (use the ipsilateral axilla or ilium depending on the level of dysfunction)
EPI T12-L1-LV
TP: T12: inner rim of the mid iliac crest
L1: 1 cm medial to upper ASIS
Tx: thoracolumbar flexion, side bend away and rotation towards (use the axilla or ilium depending on the level of dysfunction)
EPIL2-L5-LV
TP: in a row over the lateral mid femur (middle 1/3)
Tx: LTR away from the involved side with mild to mod traction
EPI S1-S2-LV
TP: in sacral foramen 1 and 2 (med to lat)
Tx: glide sciatic nerve in the sciatic notch in an inf/lat direction
EPIS3-S4-LV
TP: in sacral foramen 3 and 4 (med to lat)
Tx: glide pudendal (inf to sacrotuberous ligament)
in an inf/med direction towards the pelvic floow
PEPI C1-LV
TP: lateral aspect of the nasal aperture of maxilla, slightly inf to level of the inferior orbit. approach lat to med
Tx: OA ext, side bend away and rotate toward the tender point side (traction the neck)
PEPI C2-C6-LV
TP: located over medial humerus from below the level of the deltoid mass to the lower 1/4 of the medial humeral shaft
Tx: cervical side bend away and rotation toward the tender point side, shoulder flexion (marked) and adduction (mild)
PEPIC7-T4-LV
TP: located over the superior aspect of the spinous processes C7-T4 (sup to inf)
Tx: supine, cervicothoracic side bed away and rotate toward, shoulder abduction and traction of the humerus (long axis)
PEPI T5-T9-LV
TP: superior surface of the spinous processes of T5 through T9
Tx: prone, thoracolumbar extension, side bending away and rotation toward tender point side (utilize the axilla to localize to the level of dysfunction)
PEPI T10-L5-LV
TP: superior surface of the spinous processes of T10 through L5
Tx: prone, thoracolumbar extension, lumbar side bending away and rotation away from the tender point side (use ipsilateral ileum to localize to the involved segment) (changes due to draining into lumbar vein below T9 vs azygos above)
SMED C1-C2-LV
TP: located on the medial surface of the upper 1/2 of the mandible (med to lat)
Tx: c/s sidebend and rotation away from tender point side and translate involved cervical segment in an ant and lat direction toward TP side
SMED C3-C7-LV
TP over the lateral margin of the first rib in the thoracic inlet (lat to med)
Tx: c/s sidebend and rotation away from tender point side and translate involved cervical segment in an ant and lat direction toward TP side
SMED T2-T10-LV
TP: superior margin of the corresponding rib at the mid axillary line (lat to md and sup to inf)
Tx: pt seated with involved axilla resting on the PTs thigh, thoracic translation toward the involved side and rotation away
SMED T11-L5-LV
TP: on vertical line on the ant/lat tibia from below the tibial tuberosity to the lower 1/4 of the tibia (lat to med on the lateral tibia)
Tx: pt supine, knees flexed with feet slid mildly away from the involved side, translation of the uninvolved side iliac crest in a med/inf and ant direction
SVF C2-T2-LV
TP: corresponding vertebrae at the junction
of the spinous process and the medial laminae (base of the spinous process) approach lat to med
Tx: cervicothoracic flexion (to level), SB away and ROT away and translate involved segment in a post/sup and ipsilateral direction (through the head)
SVF C1-LV
TP 1/2 the distance from the asterion to the lambda on the lambdoidal suture (post to ant)
Tx: cervicothoracic flexion (to level), SB away and ROT away and translate involved segment in a post/sup and ipsilateral direction (through the head)
SVF T3-T9-LV
TP: corresponding vertebrae at the junction
of the spinous process and the medial laminae (base of the spinous process) approach lat to med
Tx: patient seated with hands clasped on their shoulders, thoracic flexion (to level), side bend AWAY and ROT away and translation of the arms/thorax in a post/ipsilateral/superior direction
SVF T10-L5-LV
TP: corresponding vertebrae at the junction
of the spinous process and the medial laminae (base of the spinous process) approach lat to med
Tx: side-lying on affected side, thoracolumbar flexion (to level) and rotation AWAY
*for SVFT10-12 add local glide of the involved segment via rib pressure in a post/inf and med direction
*for SVFL1-5 add additional sidebend by lifting the feet toward the ceiling and translation of femur in a post direction via pressure through the patients knees
SVE C1-LV
TP: superiomedial aspect of the medial pterygoid (med to lat (med to the mandibular angle)
Tx: c/s extension, side bend and rot AWAY and translation of the ipsilateral laminae in a sup/ant/contralateral direction
SVE C2-C7-LV
TP: post/lat aspect of the trachea at the level of the corresponding cervical transverse processes (post/lat to ant/med)
Tx: c/s extension, side bend and rot AWAY and translation of the ipsilateral laminae in a sup/ant/contralateral direction
SVET1-9-LV
TP ant/lat aspect of the sternum or medial rib margin, at the corresponding rib interspace
Tx: thoracic extension, side bend away and translate the proximal rib in an ant and sup direction (P to A glide with a “roll away” of the involved rib
SVE T10-T12-LV
TP: 1 fw inferior and 2 cm post to the corresponding end of each rib (lat to med)
Tx: pt supine with lumbar side bend away (by sliding the leg/feet towards the opp side)
Lumbar rotation away (by lifting the opposite iliac crest in an ant/inf direction
SVE L1-L5-LV
TP: ant aspect of the inguinal ligament (approach ant to post)
Tx: pt supine with lumbar side bend away (by sliding the leg/feet towards the opp side)
Lumbar rotation away (by lifting the opposite iliac crest in an ant/inf direction
DUC-LV
TP: sup/med aspect of the 1st rib at the sternocostal joint (L: thoracic and R: lymphatic duct)
Tx: glide lymphatic vessels (just post to the clavicle and lat to the sternocleidomastoid) in a post/lat direction
IJ-LV
TP: superior aspect of the 2nd rib at the sternocostal joint
Tx: c/s side bend away and glide the internal jugular vein (behind SCM) in a superior direction
MTC-LV
TP#1: super/med aspect of the 3rd rib at the sternocostal joint
TP#2: inf (under) the AC joint (inf to sup)
Tx: medial aspect of the transverse cervical lymphatics (mid clavicle) in a post/slightly lat direction
PEC-LV
TP: located over the superior 4th rib (at the sternocostal joint)
Tx: glide pectoral lymphatics (behind the pectoralis major (at the border of the pec minor) in an ant/med and inf direction
AXL-LV
TP: post/lat arch of the 1st rib
Tx: pt seated with arm resting into internal rotation and glide the axillary vein (high in the axilla) in a lat, ant and inf direction
LTC-LV
TP#1: ant/lat aspect of the spine of the scapula
TP#2: subcoracoid bursa (post/inf aspect of the coracoid process
Tx: glide lateral transverse cervical lymphatics (under upper trap) in a post/lat direction
INOM-LV
TP#1: post/lat aspect of the 2nd rib (ant and deep to the lateral aspect of the upper trapezius muscle)
TP#2: 2cm below the mid scapula spine (in the sup belly of the infraspinatus muscle)
Tx: shoulder abducted to 70-80* with marked ER, glide RIGHT side of the manubrium in a superiolateral direction toward the side of the tender point
SUBC-LV
TP: located mid scapula in the lower belly of the infraspinatus mucle
Tx: arm in internal rotation, cervical side bend towards, glide the subclavian vein (post to medial clavicle and ANT to upper trap), in an inf, lateral and post direction
What organs do the portal vein drain
large intestine
small intestine
spleen
stomach
bottom 1/2 of esophogus
top 1/3 of the rectum
pancreas
gall bladder
Where do the portal and hepatic vein drain in to?
inferior vena cava
HEP-LV
TP: posterior aspect of the 7th paraspinal mass, med to lat snapping motion
Tx: glide over the RIGHT T9 paravertebral mass (glide in an inf direction (toward TP side)
PORT-LV
TP: over the post aspect of the T9 paraspinal mass
Tx: glide the portal vein (in right upper quadrant (slightly inf and med most aspect of the 7th rib) in an inf direction (deviating AWAY from the tender point side
AZY-LV
TP: right T5 paravertebral, med to lat snapping
Tx: glide just lateral to the T6/7 paravertebral mass in an inf and lat direction
HAZY-LV
TP: left T5 paravertebral mass, med to lat snapping
Tx: glide just lateral to the L T8/9 paravertebral mass inf and lat direction