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
SUBM-LV Submandibular Lymphatics
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
AINT1-LV
TP: ant/lat end of the clavicle (in the AC joint) ant to post
Tx: glide anterior intercostal vein in the corresponding rib inerspace (below named rib) in a lateral direction
AINT2-6-LV
TP: lateral/post scapula (2-3fw medial to the lateral border)
Tx: glide anterior intercostal vein in the corresponding rib inerspace (below named rib) in a lateral direction
AINT7-10-LV
TP: distal 2/3 of the medial hamstring mass
Tx: glide anterior intercostal vein in the corresponding rib interspace (below named rib) in a lateral direction
PINT1-LV
TP: posterior aspect of the mid clavicle (just medial to the attachment of the upper trap
Tx: glide post aspect of the first rib (supreme intercostal vein) in a lateral and inferior direction
PINT 2-6-LV
TP: lateral border of the scapula
Tx: paraspinal mass and medial aspect of the corresponding rib in an ant and lat direction with added inf/sup glide
PINT 7-11-LV
TP: lateral most aspect of the post surface of the ribs 7-11
Tx: glide paraspinal mass and medial aspect of the corresponding rib in an ant and lat direction with added inf/sup glide
IVC-LV
TP: inf aspect of the umbilicus (Sup to inf)
Tx: glide IVC (starting 4fw sup to the umbilicus and slightly right of the umbilicus) in an inferior direction
CIL-LV (R vs L)
TP: R: sup/lat aspect of the umbilicus (med to lat) (10:00)
L: sup/lat aspect of the umbilicus (inf/med to sup/lat) (11:00)
Tx: gilde corresponding common iliac vein in an inf and ipsilateral direction towards femoral triangle
EIL-LV
TP#1: L3 paravertebral mass (med to lat)
TP#2: over right lat border of the umbilicus, (med to lat)
Tx: glide external ilic veins and lymphatics in an inf and lat direction
IIL-LV
TP#1: small depression between PSIS and PIIS
TP#2: right inferior or inf/lat aspect of the umbilicus
Tx: patient sidelying with ipsilateral hip flexed and glide the IIL vein (med to the ASIS (1/2 between ASIS and umbilicus) in an inf, med and post direction (aim towards pelvic floor)
LUM-LV
TP: L1 paravertebral mass, medial to lateral snapping
Tx: ascending lumbar vein and lymphatics (sup and lat to the umbilicus) in an inf and lat direction
SBA-LV
TP: located over the superior aspect of the humeral head 2cm anterior and lateral to the anterior tip of the acromion
Tx: shoulder abduction to 45, intrenal rotation marked and extension to 20-30, translation of the humerus in a sup/lat/ant direction
SBP-LV
TP: superior aspect of the humeral head 2cm ant and lat to the posterior tip of the acromion
Tx: shoulder abduction 30-45, internal rotation and flexion to 30, translation of the humerus in a post/sup/lat direction
SUBS-LV
TP#1: over the subscapularis bursa (high in the medial axilla)
TP#2: lateral aspect of the 3rd rib in the posterior axillary line
Tx: shoulder abduction 45* in mod to max external rotation and glide the post scapula in a lateral then ant/inf direction grasp the scapula
BRA-LV
TP: post latr aspect of the radial head (just distal to the radial head
Tx: glide the brachial vein (post to mid bi ceps) in an inf/lat direction toward TP)
CUB-LV
TP: ant/med aspect of the distal humerus (med articular surface)
Tx: glide median antebrachial vein in a distal direction {(in middle of forearm)
MPALM-LV
TP: palmar aspect of the triquetrum (just lat/post to the pisiform bone)
Tx: glide medial aspect of the palmar venous arch (lat to the base of the 5th metacarpal in a distal and lat direction
LPALM-LV
TP: palmar aspect of the trapezium
Tx: lateral aspect of the palmar venous arch (inf/med to the base of the 1st metacarpal) in a distal and lat direction
PALM 2-4-LV
TP: in soft tissue 2nd through 4th (pinch the fingers)
Tx: traction of the adjacent digits and corresponding volar veins in a distal and med direction
MCAR-LV
TP: dorsally b/w the proximal aspect of the shafts of the metacarpals 1-5
Tx: glide the digital veins (b/w the shafts of the metacarpals) in a distal direction
BRS-LV
TP: lateral aspect of the 4th rib on the posterior axillary line
Tx: glide bronchial lymphatics (on the sternum ribs 2-4) in a lat and inf direction
BRI-LV
TP: lateral aspect of the 5th rib in the posterior axillary line
Tx: glide T10-11 paravertebrals in an ant/lat and inf direction
UGI-LV
TP: lateral aspect of the 6th rib on the post axillary line
Tx: glide upper abdominal viscera (just below the xiphoid process) in a lateral and inf direction
LIV/ST-LV
lateral aspect of the 7th rib on the posterior axillary line
Tx: glide the liver (R) or stomach (L) in an inf and lat direction
MGI-V
TP: Lateral aspect of the 8th rib in the posterior axillary line
Tx: glide the abdominal viscera (above belly button level) in an inf and lat direction
LGI-LV
TP: lateral aspect of the 9th rib in the post axillary line
Tx: glide the lower abdominal viscera (below umbilicus) in an inf and lat direction
BL-LV
TP: lateral aspect of the 10th rib on the post axilllary line
Tx: glide the bladder in an inf and lat direction
ADR-LV
TP: T11 paravertebral mass (approach med to lat with a snapping)
Tx: glide paravertebrals of T12/L1 in an sup and lat direction
REN-LV
TP: T12 paravertebral mass (appoach med to lat in a snapping direction
Tx: glide T12-L2 in an inf and lat direction
SIG1/SIG2-LV
TP: proximal 1/4 of add longus muscle at 3-4cm from the pubic ramus (3fw below the pubis bone). Cross-fiber snapping motion
Tx: glide sigmoid/rectal vessels (above left pubic ramus ) in an inf and post direction with deviation towards the TP side (left side Sigmoid 1, right side Sigmoid 2)
PULV-LV
TP: 4-5cm post to the ASIS (just behind the TFL)
Tx: hip flexion, abduction (mild), and traction of the proximal hip in an inf/lat direction
TLFC-LV
TP: trochanteric bursea (post/lat aspect of the greater trochanter, multiple locations)
Tx: hip flexion to 30* with slight hip abduction, glide the LFC vein in an inf and lat direction (towards the TP)
DLFC-LV
TP: just post to the distal attachment of the ITB
Tx: glide DLFC vein (med to sartorius muscle) in an inf and lat direction
PFEM-LV
TP: located over the inf aspect of the medial 1/3 of the inguinal ligament (inf to sup)
Tx: glide proximal aspect of the femoral vein (middle femoral triangle) in an inf/post and slightly med direction
PSOAS-LV
TP: proximal iliopsoas bursa (med to the upper sartorius fibers and below inguinal ligament)
Tx: glide iliolumbar vein (above and med to the ipsilateral iliac crest ) in an inf and slightly med direction
this gives you L5 paravertebral tenderness
SGL-LV
TP: sup fibers of glut med/min (2cm below iliac crest in multiple locations
Tx: start in sciatic foramen and glide SGL in a sup and lateral towards the TP
IGL-LV
TP: upper 1/4 of the post/med thigh in the proximal adductor magnus muscle (lat and post to the gracilis) (3-4 fw below ischial tuberosity)
Tx: glide inf gluteal vein (sup to the ischial tuberosity) in an inf and slightly lat direction
PUD-LV
TP: proximal 1/4 of the gracilis muscle (in post aspect of the adductor mass (post to adductor longus)
Tx: glide pudendal vein (inf to the sacrotuberous ligament) in a med, inf and ant direction (affects pes anserine bursa)
LPERF-LV
TP: post aspect of the lateral thigh (1/2 way down femur)
Tx: roll the hamstring mass (above the tender point) in a lat and inf direction
MPERF-LV
TP: located in the medial aspect of the post thigh (1/2 way down)
Tx: roll the hamstring mass (above TP) in an inf and med direction
SAPH-LV
TP: distal, medial hamstring 4-5cm above the superior aspect of the medial femoral condyle
Tx: glide the origin of the greater saphenous vein (medial aspect of the femoral triangle) in an inf/med and post direction
MIG-LV
TP: over the medial aspect of the infrapatellar bursa
Tx: glide MIG vein, located in the posterior knee just medial to the popliteal vein at the level of the infrapatellar bursae in a med and ant direction
MSG-LV
TP: over the lateral aspect of the suprapatellar bursa
Tx: glide MSG vein, located in the posterior knee just lateral to the popliteal vein at the level of the suprapatellar bursae in a med and ant direction
LIG-LV
TP: over the lateral aspect of the infrapatellar bursa
Tx: glide LIG vein, located in the posterior knee just lateral to the popliteal vein at the level of the infrapatellar bursae in a lat and ant direction
LSG -LV
TP: over the lateral aspect of the suprapatellar bursa
Tx: glide LSG vein, located in the posterior knee just lateral to the popliteal vein at the level of the suprapatellar bursae in a lat and ant direction
PES-LV
TP: pes anserine bursa (prox ant/med tibia)
Tx: pt supine with knee slightly flexed, glide distal, medial hamstring mass in a med, post, inf direction
there is a connection b/w PES-LV and Pudendal-LV
DFEM-LV
TP: sup/lat aspect of the medial femoral condyle in a popliteal fossa
Tx: distal aspect of the femoral vein(in adductor hiatus), in an inf/post/lat direction
POP-LV
TP: posteriorly over the sup/med aspect of the lat femoral condyle
Tx: glide the popliteal vein located b/w the heads of the gastroc in an inf/lat direction
MSUR-LV
TP: inf/lat aspect of the medial femoral condyle
Tx: glide med gastroc head in an inf/med direction
LSUR-LV
TP: over the inf/med aspect of the lateral femoral condyle
Tx: glide lateral gastroc head in a lat and slightly inf direction
DSAPH-LV
TP: over the lateral, plantar surface of the base of the 1st metatarsal
Tx: eversion of the ankle and 1st metatarsal and glide the greater saphenous vein as it passes anterior to the medial malleolus in a distal direction
SSAPH-LV
TP#1: over the inner shaft of the base of the 5th metatarsal
TP#2: located in the distal soleus muscle, just proximal to the musculo-tendinous junction of the achilles
Tx: glide the proximal aspect of the SSAPH vein (in an inf and slightly lateral direction
FIB-LV
TP: ant/sup aspect of the lateral calcaneus (just post to the inf aspect of the lateral malleolus
Tx: proximal aspect of the fibular vein (post calf at tibial tuberosity level) in an inf and lat direction
PTIB-LV
TP: over ant/sup aspect of the medial calcaneus (post to inf aspect of the medial malleolus)
Tx: sup aspect of the post tibial vein, (tibial tuberosity level) in an inf/med direction
ATIB-LV
TP: located on the talus (in ant joint line) just medial to tibialis anterior tendon
Tx: glide upper aspect of the ATIB vein (medial to upper fibula) in an ant/inf direction
PF-LV
TP: ant/med aspect of the calcaneal fat pad at the attachment of the plantar fascia
Tx: glide the calcaneus and post tibial vein inf
MPL-LV
TP: located over the ant/med aspect of the plantar aspect of the medial cuneiform
Tx: glide the medial aspect of the venous arch, lat to the base of the 1st metatarsal, in an ant and slightly lat direction (towards the center of the foot)
LPL-LV
TP: dorsal lateral aspect of the cuboid bone
Tx: glide the lateral aspect of the plantar venous arch, in an ant and lat direction
MTAR1-4-LV
TP: dorsally between the proximal aspect of the shafts of the metatarsals
Tx: metatarsal veins (b/w the shafts) in a distal direction
PLAN 1-4-LV
TP: located in the soft tissues b/w each toe (pinch to identify)
Tx: traction adjacent digits and corresponding veins in a distal and lateral direction
DMPERF-LV
TP: post/med surface of the lower 2/3 tibia (multiple locations)
Tx: glide the deep calf muscles (post and sup to the TP) in a medial and anterior and inf direction
DLPERF-LV
TP: located over the post/lat surface of the upper 2/3 fibula (multiple locations)
Tx: glide the deep calf musculature (post and sup to TP) in a lat and ant and inf direction
MCA and LCA-LV
TP: located over the prox, ant aspect of the distal calf (prox to musculotendinous junction)
Tx: glide the calcaneal veins (ant and sup to the tender points) in an inf and post direction
STH-LV
TP: inf aspect of the arch of 1st rib (in the post axillary line) slightly anterior to the upper trapezius muscle (approach inf/lat to sup/med)
Tx: superior/middle thyroid veins (lat to the thyroid cartilage) in an inf/med direction
ITH-LV
TP: lateral aspect of 2nd rib (in post axillary line)
*can also monitor at the scan)
Tx: glide inferior thyroid vein (lat to the inf aspect of the trachea in a superior direction)
PELV-LV
TP: lower aspect of the sciatic notch (lat to med)
Tx: LTR (Away) and glide deeply through bladder (right side) or distal sigmoid colon (left side) in an inferiomedial direction toward the coccyx
OV/TEST-LV
TP: inferiolateral aspect of the AIIS (inf/lat to sup/med)
Tx: l/s side bend away (move feet away), LTR away and glide the ovarian/testicular vein (in mid-abdomen superiomedial to AIIS (inf & med/lat direction toward the TP)
RGAS-LV
TP: posteriorly over the mid-shaft of the RIGHT 7th rib (on vertical line medial to the medial scapular border)
Tx: glide RIGHT gastric vein (located 3 fw inferior to the xiphoid process in a superiolateral direction to the LEFT (stomach side)
LGAS-LV
TP:: posteriorly over the mid-shaft of the LEFT 7th rib (on vertical line medial to the medial scapular border)
Tx: glide the LEFT gastric vein (2fw inf to the xiphoid process in a superior lateral direction toward the stomach (to the left)
SPL-LV
TP: posteriorly over the mid-shaft of the LEFT 8th rib (on a vertical line that is medial to the medial scapular border). Post to ant.
Tx: glide the splenic vein, located 3 fws inf to the xiphoid process, in a lateral direction toward the left (stomach) side.
DUOD-LV
TP: posteriorly over the mid-shaft of the RIGHT 8th rib (on a vertical line that is medial to the medial scapular border). Post to ant.
Tx: glide the duodenal/pancreatic veins, located 4 fws inf to the xiphoid process, in a superolateral direction toward right (head of pancreas) side
SMES-LV
TP: located posteriorly over the RIGHT paravertebral mass of L4. Med to lat snapping motion
Tx: glide the superior mesenteric vein, located 4 fws inf to the xiphoid process, in an inf and slightly right direction toward the cecum
IMES-LV
TP: located posteriorly over the LEFT paravertebral mass of L4. Med to lat snapping motion
Tx: glide the inf mesenteric vein, located 3-4 fws inf to the xiphoid process, in an inf and slightly left direction toward the sigmoid colon.
VERT-LV
TP #1: 3 FWS superior medial from OM suture on the lambdoidal suture.
TP #2: C7 paravertebral mm. Medial to lat snapping motion.
Tx: cervical rotation away. Glide of the vertebral vein (anterior aspect of C6-7 transverse process) in a superior and slightly medial direction.
