Lymphatics Flashcards
Normal Lymph Node Characteristics
Pea sized Round Spongy Non-tender Mobile Baseline
Thoracic Inlet MFR
Position:
-patient supine, doctor seated at head of the table OR patient seated with physician standing behind patient
Hand Placement:
-hands palms down over shoulder, at cervicothoracic junction
-thumbs over posterior first rib, index fingers superior to clavicles at SC joints, middle fingers inferior to clavicles at SC joints
Technique:
-press toward patient’s feet and twist hands to feel for restriction of motion
-assess for motion: flexion/extension, rotation, sidebending
-apply principles of direct or indirect myofascial release
-release enhancing mechanisms
Doming the Diaphragm
Position:
-patient with hips and knees flexed, physician at patients side facing cephalad
Hand Placement:
-place thumbs inferior to xiphoid process with thumbs pointing cephalad
Technique:
-instruct patient to take a deep breath and exhale
-on exhalation, press thumbs posteriorly and superiorly
-push further on exhalation, resist on inhalation
-repeat 3-5 times
Ischiorectal Fossa Release
Position:
-patient prone, physician at side of table facing cephalad
Hand Placement:
-place thumbs medial to ischial tuberosities bilaterally
Technique:
-apply cephalad and lateral force
-increase force during exhalation, maintain on inhalation
Pectoral Traction
Position:
-patient supine with hips and knees flexed, physician standing at head of table
Hand Placement:
-grasp inferior to patient’s clavicle at anterior axillary fold
Technique:
-extend arms and lean back to apply cephalad traction bilaterally
-pull when patient inhales and resist on exhale
-repeat 5-7 times
Rib Raising (Supine)
Position:
-patient supine, physician sitting on side to treat
Hand Placement:
-grasp ipsilateral posterior/inferior rib angles (lateral TPs) by flexing fingers
Technique:
-starting eith T12, apply anterolateral traction by rocking backward/leaning elbows on table
-continue up ribs
Rib Raising (Seated)
Position:
-patient seated with arms crossed, physician standing facing patient
-patient crosses arms and leans forward toward physician
Hand Placement:
-grasp bilateral posterior/inferior rib angles lateral to TPs
Technique:
-starting with T12, pull superiorly and toward the physician
-continue up ribs
Tapotement
Position:
-patient prone, physician at patients side
Technique:
-apply rhythmic forces to thoracic region
-hacking = karate chop
-cupping = hands in c shape
-slapping = palmar surface of hand
Thoracic Pump: Repetitive/Oscillatory
Position:
-patient supine with hips and knees flexed
Hand Placement:
-place thenar eminence of each hand inferior to clavicles with fingers spread over upper rib cage OR over the sternum
Technique:
-have the patient take a deep breath and exhale fully
-at the end of exhalation, apply rhythmic posterior inferior pumping (120x/min)
-continue for several minutes
Thoracic Pump: Vacuum/Atelectasis Modification
Position:
-patient supine with hips and knees flexed, physician at head of table
Hand Placement:
-place thenar eminence of each hand inferior to clavicles with fingers spread over upper rib cage OR over sternum
Technique:
-have patient take a deep breath and fully exhale
-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
Abdominal Pump
Position:
-patient supine, physician at patients side facing cephalad
Hand Placement:
-place palms on abdomen with fingers towards patient’s head, thumbs side by side
Technique:
-pump posteriorly in a rhythmic manner (20-30x/minute)
Sacral Rocking
Position:
-patient prone, physician at patient side
Hand Placement:
-place heal of cephalad hand on sacral base with fingers pointing towards the coccyx
-caudal hand on top, pointing in cephalad direction
Technique:
-exert a gentle pressure downwards to gap SI joint
-alternate directions following respiration
-inhalation = sacral apex anterior (extension)
-exhalation = sacral base anterior (flexion)
-repeat 10 times until no further RB
Pedal Pump
Position: -patient supine, physician at foot of table Hand Placement: -contact plantar portion of feet Technique: -dorsiflex patients feet -apply on/off rhythmic cephalad force (120x/min) -continue 1-2 minutes
Effleurage and Petrissage
Position:
-patient supine, physician on side to treat
Technique:
-raise patient’s arm or leg to treat
Effleurage: induce stroking forced distally to proximally
Petrissage: induce kneading/twisting force distally to proximally
IT Band Effleuarge
Position:
-patient lateral recumbent with affect side up, physician facing patient
Hand Placement:
-place cephalad hand on patient’s greater trochanter for stabilization
-with caudal hand, make C shape and contact patient’s IT band
Technique:
-start halfway between greater trochanter and knee, stroking distal to proximal with gentle pressure
-after some congestion frees, start just superior to knee and continue stroking in a distal to proximal fashion
-continue 1-2 minutes
GLIDES OVER SKIN
