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Flashcards in Drainage Deck (20)
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1

Inguinal lymph nodes drain?....

- skin of external genitalia

- skin of buttocks and abdomen

- skin and deeper tissues of the dorsum of foot snd the leg

2

Popliteal lymph nodes drain....

- plantar surface of the foot

- posterior calf

3

Pelvic and sacroiliac lymph nodes drain...

Sacroiliac
- sciatic pathway
- anus and rectum

Pelvic (iliac)
- urogenital organs
- uterus
- vagina
- urethra
- ureters
- bladder
- lower colon

4

Alternate pathway of pelvic and sciatic nodes

Sciatic pathway. Not everyone has in bypass inguinal nodes

5

Abdominal nodes drain...

- stomach

- duodenum

- pancreas

- spleen

- liver - concave surface

- gall bladder

6

Lumbar nodes and trucks drain...

- ovaries

- testes

- kidneys and adrenals

- lymph from abdominal nodes

7

Cysterna chyli collects lymph from...

Right and left lumbar trunks and intestinal truck and legs

8

Thoracic organs are drained by...

Heart - via mediastinal nodes and right bronco-mediastinal trunk

Lung - vessels from lower left lobe follow left bronchus, via hilar lymph nodes crossing at the carina and joining right broncho- mediastinal trunk

9

Axillary nodes drain...

- arm

- mammary gland

- skin of thorax

10

Drainage of the breast...

- supraclavicular

- internal mammary nodes

11

Sentinel node biopsy

Most drainage is to the axilla
- central breast - 100%

- lateral quadrants - 95%

- medial quadrants - 88%

- some retrosternal drainage - 10-50%

12

Parasternal nodes drain...

- mammary gland medial aspect

- intercostal spaces - ribs 1-9 anterior (attached to sternum)

13

Paraspinal nodes drain....

- posterior intercostal pathways - ribs 1-13

Lateral to medial to spine
Not skin drainage b/w ribs

14

Thoracic duct drains...

- left lung
- left cervical nodes
- lungs - upper left
- left parasternal nodes
- para spinal nodes - posterior intercostals
- abdominal and pelvic nodes - inguinal and popliteal nodes

15

Right lymphatic duct drains...

- right axillary nodes
- right cervical nodes
- heart
- lungs - all right lobes and lower left
- liver - convex surface
- right parasternal nodes

16

Brain and spinal cord drains...

- no lymph vessels in the CNS

- sub arachnoid sheath

- suboccipital LN

- perineurim

- walls of arteries and veins

17

Brain and spinal cords drain...

- 40% olfactory, optic and auditory nerves

- 60%
- epidural LV
- virchow- robin spaces
- vasa vasorum
- vasa lympho vasorum
- subarachnoid sheath of spinal nerves

18

What are the principles of applying MLD?

Clear proximal pathways first

Follow drainage pathways

Long duration - at least 20 mins

Move the skin - no gliding

Stretch skin in 2 directions.

Prescribed pressure - up to 30mmHg

Variable pressure phase - zero phase

Slow and relaxing - aids sympathicolytic effects

Repetitive

Rhythmic

No pain. No hyperaemia


19

What are three absolute contraindications of MLD?

Acute inflammation with infection

Untreated thrombus

Untreated cancer

Congestive heart failure

20

What are the relative contraindications of MLD?

Chronic inflammation

Treated thrombus - know high risk groups

Treated cancer - know current status and treatment received

Asthma- omit sternum and short treatment times.

Hyperthyroid - untreated

Pregnancy - no deep abdominal, complications

Menstruation - omit abs if painful

Mole changes

History of tuberculosis

Hypotension - short treatment times