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OS Exam 2 > Lymphatics > Flashcards

Lymphatics Flashcards

1
Q
  • What are some indications for lymphatic treatment?
A
  • Acute somatic dysfunction
  • Sprains/strains
  • Edema
  • Tissue congestion, lymphatic/venous stasis (mild CHF)
  • Pregnancy
  • Infection
  • Inflammation
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2
Q
  • What are the contraindications for lymphatic treatment?
A
  • Anuria and necrotizing fascitis are absolute contraindications
  • Malignancy
  • Fracture/Dislocation
  • Certain infections (mono, abscess, chronic osteomyelitis)
  • Certain circulatory disorders (venous obstruction, embolism, hemorrhage, anticoagulated patient)
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3
Q
  • Where are the fluid pumps located?
A
  • Thoracic inlet
  • Thoracic diaphragm
  • Pelvic diaphragm
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4
Q
  • What is the Zink “Warmth Provacation Test”? What does it indicate?
A
  • Testing for warmer areas (indicating a potential somatic dysfunction in that area)
    *
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5
Q
  • When palpating lymph nodes, what is normal?
A
  • Pea-sized
  • Round
  • Spongy
  • Non-tender
  • Mobile
  • Baseline adjacent areas
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6
Q
  • What is abnormal when palpating lymph nodes?
A
  • Larger
  • Irregular
  • Hard, matted
  • Tender
  • Fixed (low mobility)
  • Red or pale, warm
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7
Q
  • Where should you evaluate lymphatic function?
A
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8
Q
  • What do you need to do before performing any lymphatic treatments?
A
  • Open the thoracic diaphragm
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9
Q
  • How do you perform thoracic inlet MFR?
A
  • Patient is supine with doc seated at head of the table
  • Index fingers above SC joint/angle of rib 1, thumbs over T1 transverse processes bilaterally
  • Press towards pt feet and twist hand to feel for restriction of motion
  • Perform direct MFR
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10
Q
  • How do you perform doming the diaphragm?
A
  • Pt supine
  • Doc places hands in infracostal region below xiphoid process with fingers pointing toward pt head
  • Pt takes a deep breath while pressing posteriorly and superiorly
  • Push further on exhalation and resist on inhalation
  • Repeat 3-4 times
  • Last time, move thumbs under the rib cage
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11
Q
  • How do you perform ischiorectal fossa release (aka doming the pelvic diaphragm)?
A
  • Pt is prone
  • Doc seated at side of table and places thumbs medial to ischial tuberosities bilaterally
  • Apply cephalad and lateral force, increasing force during exhalation and maintaining force on inhalation
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12
Q
  • How do you perform pectoral traction?
A
  • Patient is supine with doc standing at the head of the table
  • Grasp inferior border of pectoral muscles at anterior axilla
  • Extend arms and lean back to apply cephalad traction
  • Pull when patient inhales and resist on exhalation
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13
Q
  • How do you perform seated rib raising?
A
  • Pt crosses arms and leans toward doc
  • Doc grabs posterior/inferior rib angles (lateral to TP)
  • Start with T12 and apply anterolateral traction while pulling towards you
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14
Q
  • How do you perform supine rib raising
A
  • Stand on side to treat
  • Contact rib angles starting at T12
  • Apply anterolateral traction by rocking backwards and continue up the ribs
  • Can use respiration to assist (apply pressure with inhale, release with exhale)
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15
Q
  • How do you perform thoracic pump (repetitive/oscillatory)
A
  • Place thenar eminence of each hand over pectoral muscles, just inferior to clavicles on ribs 2-4
  • Rhythmic pumping at rate of 110-120 bpm
  • Appropriate pace should provide a rebound force at hands
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16
Q
  • How do you perform thoracic pump (vacuum/atelectasis modification)
A
  • Pt supine
  • Doc places thenar eminence of each hand over the pectoral muscles just inferior to clavicles on ribs 2-4
  • As patient exhales, apply compressice force downward and resist during inhalation
  • Continue for 4-5 breaths
  • Midway through last inhalation, briskly remove hands to allow for rapid, deep inhalation (inflates atelectatic lung)
17
Q
  • How do you perform abdominal pump?
A
  • Place palms on abdomen with fingers towards patient’s head, thumbs side by side
  • Push posteriorly at a rate of 20-30 x/min
18
Q
  • How do you perform sacral rocking?
A
  • Patient is prone
  • Heel of cephalad hand on sacral base with fingers pointing down
  • Apply gentle downward pressure to gap SI joint
  • Inhalation: Move sacral apex anterior
  • Exhalation: Move sacral apex posterior
19
Q
  • How do you perform pedal pump?
A
  • Patient is supine, doc at feet
  • Passively dorsiflex feet
  • Apply on and off cephalad force to hyperdorsiflex the feet, watching for nose movement and feeling rebound at feet
  • Pump at 100-120 x/min
20
Q
  • How do you perform lung tapotement?
A
  • Hacking
  • Cupping
  • Slapping
21
Q
  • How do you perform effleurage?
  • How do you perform petrissage?
A
  • Stroking force distally to proximally
  • Kneading/twisting force distally to proximally
22
Q
  • How do you perform IT Band Effleurage?
A
  • Start halfway between greater trochanter and knee
  • Apply pressure and stroke distally to proximally
23
Q
  • How do you perform anterior tracheal/deep cervical soft tissue lymphatic treatment?
A
  • Place fingers lateral to trachea
  • Move trachea from side to side, working cephalad to caudad
24
Q
  • How do you perform suprahyoid and infrahyoid release?
A
  • Pt supine
  • Place fingers lateral to hyoid bone
  • Move hyoid from side to side
  • If there is crepitus, can flex and extend head to decrease friction
  • Can also use swallowing to help release restrictions
25
Q
  • How do you perform cervical stroking?
A
  • Pt supine with doc at head of table
  • Place hands along paravertebral muscles
  • Stroke in caudad to cephalad direction
26
Q
  • How do you perform cervical chain drainage?
A
  • Pt supine with doc at head of table
  • Locate the anterior and posterior border of the SCM’s superior portion
  • Place thumb along anterior margin and other fingers along posterior region
  • Lift and milk anteriorly until you note relaxation, working caudad along the SCM
  • Treat one side at a time
27
Q
  • How do you perform submandibular drainage?
A
  • Patient supine with doc at head of table
  • Apply raking motion under the angle of the manubrium towards the mentum
28
Q
  • How do you perform mandibular drainage (Gallbreath technique)?
A
  • Patient supine with doc at head of table on opposite side to treat
  • Stabilize patient’s head with cephalad hand and place fingers of caudad hand posterior to ramus
  • Slow, repetitive and downward midline traction on the mandible
29
Q
  • How do you perform pre-post auricular drainage?
A
  • Place index and middle finger in front of ear and fourth and fifth finger behind
  • Apply clockwise and counterclockwise rotation to auricular lymph nodes
30
Q
  • What is a normal compensatory pattern?
A
  • R,L,R,L

OS Exam 2 (9 decks)

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