review

Question 1

what is the outcome of diminished lymphatic flow in the resp system

Answer 1

1. Diminished antigen/allergen presentation
2. Tissue congestion
   a. Sinus congestion
   b. Pleural effusion
   c. Pulmonary infiltrates
3. Prolonged recovery from infectious etiologies

Question 2

which adult primary cancers are most likely to metastasize to bone

Answer 2

breast 
prostate
lung 
kidney 
thyroid

Question 3

which adult primary cancers are most likely to have spinal cord metastases

Answer 3

lung
breast
colon
sarcoma

Question 4

which pediatric cancers are most like to have bone metastases

Answer 4

neuroblastoma
wilms
osteosarcoma 
ewing sarcoma
rhabdomyosarcoma

Question 5

patient has pain the iliac crest

flank

sacroiliac joint

where is the bone metasases most likely

Answer 5

T12-L1

Question 6

interscapular bone pain

where are the bone mets

Answer 6

C7-T1

Question 7

posterior headache where are the mets

Answer 7

high cervical spine mets

Question 8

when you are working on doing lymphatic draingae of the whole body, where do you start and what is the order?

Answer 8

First, open the drain, the thoracic inlet *terminal drainage point for all lymph

Treat the baffles of the body:
The respiratory diaphragm, the pelvic floor, popliteal fossa

Treat the lymphatics of the leg
Reduce the tightness of the gastroc and hamstring

Sympathetics to the LE
T11-L2

Question 9

what is the major pump for the lymphatic system

Answer 9

resp diaphragm

Question 10

what are the absolute contraindications to lymph drainage therapy

Answer 10

acute infection

thrombosis

venous obstructions

cardiac event

hemorrhage

cancer

necrotizing fasciitis

anuria

Question 11

what is lymphedema

Answer 11

• Occurs 6 weeks to 20 years after surgery
• Average is 3 years post op
• Usually involves fibrosis as well
• Stays in the external compartments, over the muscle***
• OMT and other modalities should be done ASAP after
the surgery to hopefully prevent lymphedema
• If this cannot occur, then as soon as lymphedema
presents itself so that it can resolve more quickly

Question 12

contraindications for thoracic pump

Answer 12

• Rib fx
• Subclavian line
• Incisions
• COPD (relative)
• Gum in mouth
• Thoracostomy tube (also pectoral traction)

Question 13

where can acute cholecystitis refer pain to >

Answer 13

right shoulder area

or right near the right pectoral muscle

Question 14

what muscles can present as abdominal pain>

Answer 14

rotatores

multifides

Question 15

angina can refer to wear in the abdomen

Answer 15

xiphoid

Question 16

where can a splenic infarct refer pain

Answer 16

left upper quadrant

Question 17

where can appendicitis refer pain

Answer 17

umbilicus

Question 18

Constipation
• Bloating
• Pain
• Contraction of sphincters
• Increased vasomotor tone (may
lead to decreased mucus
production in stomach and
intestines)

Answer 18

sympathetics in GI

Question 19

what can increased sympathetic tone in the GI system lead to

Answer 19

Increased vasomotor (sympathetic)
tone leads to Gastritis, Ulcers (peptic
and duodenal), GERD

Question 20

• Nausea
• Vomiting
• Diarrhea
• Hypermotility
• Relaxation of sphincters
• Increased mucus secretion
• Increased acid production in the
stomach

Answer 20

parasympathetics of GI

Question 21

what is the main OMT technique used on babies with colic

Answer 21

thoracolumbar junction

pelvic diaphragm

lumbar spine

Question 22

what are the relative contraindications to doing visceral manipulation

Answer 22

gallstones

cancer

bowel obstruction

pregnancy

IUD

Question 23

central tendon

Answer 23

“central chain” or “central tendon” which refer to the fascial connection from the base of the sphenobasilar symphysis to the perineal body via the pre-tracheal fascia, mediastinum, the central tendon of the diaphragm, the midline of the abdominal cavity from which all of the organs arose via invagination of the gut cavity during embryology to the pre-sacral fascia.