lymphatics lect/lab Flashcards

1
Q

5 models of osteopathic patient care

A
  1. biomechanical-structural
  2. respiratory-circulatory
  3. metabolic-nutritional
  4. neurologic ANS-CNS-PNS
  5. behavioral-psychosocial
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2
Q

biomechanical-structural

A

assess patient for a structural impediment

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3
Q

respiratory-circulatory

A

respiratory & circulatory components of the homeostatic response

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4
Q

neurological

A

abberancies or impairments of neural function

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5
Q

metabolic-nutritional

A

balance between energy production, distribution, and expenditure

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6
Q

behavioral-biopsychosocial

A

assess mental, emotional, & spiritual state of being as well as personal lifestyle choices

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7
Q

role of lymphatic system

A
  • to remove fluid, particulates, extravasated proteins from the interstitium
    -maintain osmotic balance b/n extracellular, intracellular & intravascular fluids
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8
Q

tissues without a blood supply

A

cartilage
lens & cornea of the eye
epidermis
inner portion of walls of large BVs

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9
Q

terminal lymphatic vessels

A

-endothelial lined cul de sacs anchored into surrounding ECM by small anchoring filaments
-lack smooth muscle walls

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10
Q

path of lymph flow

A
  1. afferent/prenodal vessels
  2. efferent / postnodal vessels
  3. lymphatic trunks
  4. L thoracic duct or R lymphatic duct
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11
Q

what is not a factor that contributes to lymph flow?

A

a hydrostatic gradient from capillary bed to terminal lymphatics

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12
Q

LE drainage

A

LEs & abdominopelvic cavity –> cisterna chyli –> thoracic duct

  • superficial = to proximal nodes at inguinal area
  • deep = into popliteal space & exits b/n heads of hamstrings
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13
Q

UE drainage

A
  • superficial = follows subQ routes to proximal nodes at the axilla
    -deep = follows major neurovascular structures
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14
Q

deep cervical nodes

A

terminal pathway for all drainage of the head & neck

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15
Q

classic model of brain lymph drainage

A

from brain CSF acts as lymphatic fluid, is formed in choroid plexus & drained through arachnoid granulations

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16
Q

glymphatic system

A

clearance of waste products from the brain
-combined activity of water channels at glial cells

  1. CSF into brain via periarterial spaces, exchanges with ISF, through extracellular space to collect within perivenous spaces
17
Q

heart drainage

A

endo to myo to epicardial
-heart drainae enters R thoracic duct
-pericardium drains into thoracic duct

18
Q

pulmonary lymph

A

drains out of the lungs at the hilum into the tracheobronchial nodes & into both the R lymphatic trunk & thoracic duct

19
Q

gut lymphatics

A
  • have lacteals to absorb fat (chyle)
  • join iliac & preaortic nodes en route to cisterna chyli & thoracic duct
  • celiac drainage uses this route
20
Q

anterior & superior bladder drainage

A

hypogastric nodes

21
Q

middle bladder drainage

A

external iliac trunks

22
Q

posterior & inferior bladder drainage

A

common iliac trunks

23
Q

major functions of lymphatic system

A
  1. maintain fluid balance
  2. purification/cleansing of tissue
  3. immune system defense
  4. nutrition
24
Q

OA zone has ___ junction & ___ transverse diaphragm

A

junction = craniocervical
diaphragm = tentorium cerebelli

25
Q

cervico-thoracic zone has ___ junction & ___ transverse diaphragm

A

cervicothoracic junction
thoracic inlets/outlets = diaphragm

26
Q

thoraco lumbar zone has ___?

A

thoracolumbar junction
respiratory diaphragm

27
Q

lumbo sacral zone has ___?

A

lumbosacral junction
pelvic diaphragm

28
Q

3 classifications of fascial patterning

A
  1. ideal = no apparent preferences, but is rarely seen clinically
  2. compensated = rotational bias in one transition zone accompanied by an opposite fascial rotation in next zone
  3. uncompensated = rotational pattern didn’t alternate & is thought to be less healthy
29
Q

sites of terminal lymphatic drainage dysfunction

A
  1. supraclavicular space
  2. posterior axillary fold “arm”
  3. epigastric area “abd & chest”
  4. inguinal area “LE”
  5. popliteal space “leg”
  6. achilles tendon “ankle & foot”
30
Q

direction of lymphatic tx

A

treat segmentally from proximal to distal while augmenting flow in distal to proximal direction within each segment

31
Q

diaphragm doming

A
  1. wrap hands around diaphragm, thumbs along lateral costal margin
  2. apply superior & medial compression force
  3. take several slow & full breaths
  4. as they exhale induced firm compression
  5. hold compression as they inhale again
  6. repeat 2-3 breaths then reassess
32
Q

thoracic inlet MFR “steering wheel”

A
  1. contact across sternoclavicular junction & ribs 1-2 while posterior contacting T1-2 with thumbs (choke them)
  2. slight compression to engage Sibson’s fascia
  3. induce motion in ant-post, med-lat, rotational planes until position achieved
  4. hold 20-60 seconds until creep indicates release of tension then reassess
33
Q

UE lymphatic sequence

A
  1. ant & post axillary fold release - pincer grasp
  2. antecubital fossa release - grasp with bilat thumbs & spread laterally
  3. carpal tunnel release - same as above
34
Q

LE lymphatic sequence

A
  1. inguinal ligament - palpate perpendicularly & apply compression
  2. popliteal fossa - fingers of bilat hands engage & spread
  3. achilles tendon - compression force with fingers & thumb just anteiror to achilles tendon and hold
35
Q

pedal pump / dalrymple pump

A
  1. palms over plantar aspect of toes
  2. DF feet
  3. induce rhythmic motion toward pt head, 2 compressions/sec (see motion throughout body)
  4. continue for 30 secs - 2 mins
  5. go back to neutral & reassess
36
Q

thoracic / miller pump

A
  1. palms inf to clavicles
  2. inhale & exhale deeply - while you introduce rhythmic post/inf motion at 2 compressions/sec
  3. induce for 30 secs - 2 mins