Lymphatics Flashcards
Indications for Lymphatic treatment
Acute SD Sprains/strains Edema/Tissue congestion Lymphatic or venous stasis Pregnancy Infection Inflammation
Absolute Contraindications for lymphatic treatment
Anuria
Necrotizing fasciits
Relative Contraindications for lymphatic treatment
Malignancy
Fracture/Dislocation
Certain infections (mono, abscess, chronic osteomyelitis)
Certain circulatory disorders (venous obstructions, embolism, hemorrhage, patients on anticoagulants)
Zink’s Compensated patterns
Alternating may contribute to Lymphatic flow
RLRL or LRLR
(non alternating may contribute to lymphatic congestion)
How to perform Zink “Warmth provocative test” and why
Evaluate thoracic, rib, sternal, cranial, C2, and Sacrum
Warmer areas may be a site of SD
What do you feel for when palpating lymph nodes?
Normal pea size Round/regular shape Spongy consistency Nontender Mobile Overlying skin is baseline
Regional Lymph Node collecting sites
Supraclavicular space Epigastric region Posterior axillary fold Inguinal region Popliteal space Achilles region
What are the 4 principles of Lymphatic treatment?
- Open pathways to remove restriction to flow
- Maximize Diaphragmatic fxns
- Increase pressure differentials or transmit motion
- Mobilize targeted fluid tissue
What lymphatic treatment do you use to open pathways and remove restriction to flow?
Thoracic Inlet MFR
Can also use anterior/posterior axillary fold techniques or popliteal fossa release
What lymphatic treatment do you use to maximize diaphragmatic functions?
Doming the Diaphragm
Ischiorectal Fossa Release/Doming the Pelvic Diaphragm
What lymphatic treatment do you use to increase pressure differentials or transmit motion?
Pectoral traction Rib raising Thoracic pump Abdominal pump Sacral rocking Pedal pump
Where can you perform abdominal pump?
Spleen
Liver
What lymphatic treatment can you use to mobilize targeted tissue fluids?
Tapotement Effleurage and Petrissage Anterior Cervical Arches Release Cervical Stroking Cervical Chain Drainage Submandibular drainage Mandibular drainage/Galbreath Auricular drainage
Lymphatic tissues/Organs
Spleen Liver Thymus Tonsils Appendix Visceral lymphoid tissue Lymph nodes
3 anatomic components of the Lymphatic system
Organized tissues/Organs
Lymph fluid
Lymph vessels
Physiologic fxn of Lymph
Immune
Digestive
Fluid Balance
Waste
Fxn of the spleen
Destroy damaged/deformed RBCs
Synthesize Igs
Clear bacteria
Location of the spleen
Beneath ribs 9-11 on the L
Not palpable
Characteristics of the spleen
Largest single mass of lymphoid tissue
Pressure sensitive - movement of the diaphragm drives splenic fluid movement
Location of the liver
RUQ
Palpable at R costal margin
Characteristics of the Liver
Pressure sensitive - movement of the diaphragm is important for the homeostatic movement of hepatic fluids
Lymphatic fxn of the Liver
Forms half the body’s lymph
Clears bacteria
Gate-keeper of shared hepatobiliary-pancreatic venous and lymphatic drainage
Location of the Thymus
Anterior mediastinum
Characteristics of the Thymus
Development of T cells, important in childhood, replaced by fatty tissue after puberty
Fxn of the Thymus
Maturation site for T cells
Little to no fxn in adults
3 locations of the tonsils
All located in posterior oropharynx
- Palatine - lateral pharynx
- Lingual - Posterior 1/3 of the tongue
- Pharyngeal - Adenoids at nasopharyngeal border
Characteristics of the tonsils
Most not visible until 6-9 months
Remain enlarged through childhood
Fxn of the tonsils
Provide cells to influence and build immunity early in life
Nonessential to adult immune fxn