Lymphatics Flashcards
Fluid Pump locations
Thoracic Inlet
Thoracic Diaphragm
Pelvic Diaphragm
Evaluation of Cranial-Cervical Jxn
Evaluation of Cervical-Thoracic Jxn
Evaluation of Thoracolumbar Jxn
Evaluation of Lumbopelvic Jxn
Lymph Node Palpation sites
Supraclavicular space
Epigastric region
Posterior axillary fold
Inguinal region
Popliteal space
Achilles region
Thoracic Inlet MFR
Doming the Diaphragm
Ischiorectal Fossa Release
Pectoral Traction
Rib Raising, Supine
Rib Raising, Seated
Thoracic Pump (Repetitive/Oscillatory)
Thoracic Pump (Vacuum/Atelectasis Modification)
Abdominal Pump
Sacral Rocking
Pedal Pump
Tapotement
Effleurage and Petrissage
IT Band Effleurage
Anterior Cervical Arches Release
Cervical Stroking
Cervical Chain Drainage
Submandibular Drainage
Mandibular Drainage (Galbreath Technique)
Auricular Drainage
What gives rise to the Thymus and parts of the tonsils?
Endoderm
When does lymphatic development begin? When is it’s prevelance significant?
- Begins during 5th week of gestation
- Significant presence by 20 weeks
What does the mesoderm give rise to in terms of lymphatics?
Lymphatic vessels, lymph
nodes, the spleen, and myeloid tissue
How does age both from infant, to puberty, to elderly influence lympatics?
Lymphoid tissue increases until puberty when the immune system continues to mature, but lymphoid tissue regresses and then levels off.
In elderly, the immune system may decline and they may not mount a fever.
Spleen
What is its location?
Characteriztics and function?
Beneath ribs 9-11 on the left, just below diaphram
Largest mass of lymphoid tissue, pressure sensitive (the movement of diaphragm can function to move lymph)
What is the function of the liver in terms of lymphatics?
Location in the right costal margin
Half of the body’s lymph is formed here
Clears bacteria
“Gate-keeper” of the shared hepato-biliary
-pancreatic venous and lymphatic
drainage
Name the location of the tonsils
Palatine – lateral pharynx (traditional “tonsils”)
Lingual – posterior 1/3 of tongue
Pharyngeal – adenoids at nasopharyngeal border
What organ is significant to the gut associated lymphoid tissue?
What occurs to it with age?
The apendix
Atrophy
Where are peyer’s patches located in the intestine?
The ileum
What is the function of lacteals?
Transport large chylomicrons that cannot cross the intracellular junctions of circulatory capillaries
How much fluid enters the interstitial fluid daily?
30L
What is the importance of the diaphragm in lymphatics?
What innervation effects the diaphragms effects on lympatics?
• 35%-60% of the drainage
through the thoracic duct is
associated with respiration
• “pump” effect of the
diaphragmatic crura on the
cysterna chyli
• Junctures are under sympathetic
control
How do lymphatic collectors move lymph?
Through the lymphagions (valves)
Larger vessels may have smooth muscle with sympathetic innervation
What does the thoracic duct drain?
Where does it originate/terminate?
The entire lower bottom extremities and the upper left
Origin: cisterna chyli as a dilation at L1-2 level
Termination: Pierces Sibson’s fascia at superior inlet, U-turns to empty into L subclav/IJ veins
What is the origin and termination of the right lympatic duct?
Origin: from the junction of R jugular and subclavian trunks (and occasionally the bronchomediastinal trunk)
Termination: Empties at R subclav./IJ venous junction
Indications of OMT for lymph
- Edema, tissue congestion, or lymphatic stasis
- Infection
- Inflammation
Absolute Contraindications for Lymph
Anuria – need kidneys functioning to process the extra
fluid return
Necrotizing fasciitis – in the treatment area
Patient unable to tolerate treatment
Patient refuses treatment
Most common compensitory pattern is ____ at ___%
LRLR, 80%
Steps in Lymphatics
A. Open pathways to remove restriction to flow
a. Thoracic inlet
b. Anterior and posterior axillary fold techniques
c. Popliteal fossa release
B. Maximize diaphramic functions
a. Dome the diaphragm
b. Ischiorectal fossa release
C. Increase pressure differentials or transmit motion
a. Pectoral traction
b. Rib raising (supine or sitting)
c. All other techniques