Flashcards in Drainage Deck (20)
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
Popliteal lymph nodes drain....
- plantar surface of the foot
- posterior calf
Pelvic and sacroiliac lymph nodes drain...
- sciatic pathway
- anus and rectum
- urogenital organs
- lower colon
Alternate pathway of pelvic and sciatic nodes
Sciatic pathway. Not everyone has in bypass inguinal nodes
Abdominal nodes drain...
- liver - concave surface
- gall bladder
Lumbar nodes and trucks drain...
- kidneys and adrenals
- lymph from abdominal nodes
Cysterna chyli collects lymph from...
Right and left lumbar trunks and intestinal truck and legs
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
Axillary nodes drain...
- mammary gland
- skin of thorax
Drainage of the breast...
- internal mammary nodes
Sentinel node biopsy
Most drainage is to the axilla
- central breast - 100%
- lateral quadrants - 95%
- medial quadrants - 88%
- some retrosternal drainage - 10-50%
Parasternal nodes drain...
- mammary gland medial aspect
- intercostal spaces - ribs 1-9 anterior (attached to sternum)
Paraspinal nodes drain....
- posterior intercostal pathways - ribs 1-13
Lateral to medial to spine
Not skin drainage b/w ribs
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
Right lymphatic duct drains...
- right axillary nodes
- right cervical nodes
- lungs - all right lobes and lower left
- liver - convex surface
- right parasternal nodes
Brain and spinal cord drains...
- no lymph vessels in the CNS
- sub arachnoid sheath
- suboccipital LN
- walls of arteries and veins
Brain and spinal cords drain...
- 40% olfactory, optic and auditory nerves
- epidural LV
- virchow- robin spaces
- vasa vasorum
- vasa lympho vasorum
- subarachnoid sheath of spinal nerves
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
No pain. No hyperaemia
What are three absolute contraindications of MLD?
Acute inflammation with infection
Congestive heart failure