LYMPHATICS Flashcards
(14 cards)
LYMPHATICS - THYROID EXAM
Palpate cricoid cartilage, down and slightly out
Should feel like butterfly
Shouldn’t be inflamed
One side at a time
Rotate head slightly to relax SCM
LYMPHATICS - EXAMINATION OF LYMPH NODES - CHARACTERISTICS
Size- no bigger than pea
Consistency- soft, characteristically rubber- metastatic cancer- hard but not painful
Tenderness- infection may cause swelling/tenderness
Fixation- fixation= malignancy
LYMPHATICS - EXAM SEQUENCE
Inspect for enlarged nodes
Palpate one side at a time using flat fingers
Compare to contralateral side
Site, size, consistency, tenderness
LYMPHATICS - CERVICAL NODES
Start under chin
Along to masseter area for parotid
Up to maxillary
Move towards front of ear- pre-auricular
Behind ears- retro-auricular
Follow round occiput and down neck for poster cervical chain
Back to mastoid process, palpate down SCM for superficial and deep anterior chain
Palpate supra/infraclavicular areas (stomach/breast cancer)
LYMPHATICS - AXILLARY AND EPITROCHLEAR NODES
1st sign of malignancy in breasts
Ant and central- flat hand
Lats/teres grab underneath and push
Hands on hips, push elbow slightly forward
Epitrochlear- look for signs of skin cancer on forearm, slightly up from normal PROM
Assess axillary, cervical and epitrochlear if problem is suggested
LYMPHATICS - INGUINAL NODES
ASIS- follow inguinal ligament –> fem pulse, bring contact down slightly
Follow horizontal group then vertical group
LYMPHATICS - POPLITEAL NODES
Behind knee
Some may have lumps- Bakers cyst
Synovial cyst in capsule, arthritis causes inc of synovial fluid–> inflammation
Should be able to reduce it but likely to come back
Extreme arthritis stays, lymph node would be moveable and stays
LYMPHATICS - THORACIC INLET
Removing barrier
Fingers fix off 1st rib
SB head towards hand, rhythmically compress when head is closest to hand
Rot head away from hand- warn Pt it may be slightly uncomfortable as inc stretch
Support head with stomach, aim for full range of rotation whilst fixing 1st rib
LYMPHATICS - THORACIC INLET VIA CLAVICLE
Ask Pt to place hands on chest
Fix ribs 2-3 (relatively medial/close to sternum)
Ask Pt to hold your side, grip arm between your arm and your side
Rhythmically pull arm out laterally
LYMPHATICS - DIAPHRAGM
Assess movement from each side- move side to side
Find xiphoid cartilage, move a couple of cm inferiorly, place thumbs here
Ask Pt to breathe in deeply, and out, apply pressure down/lean in into diaphragm
If restriction is found, hold
Bend knees to relax rectus abdominals
Variation
o If Pt is too big/cant apply pressure through thumbs
o Stand above head
o Grip fingers underneath ribs
o Be mindful of palms in relation to chest
o Pull/grip underneath as Pt breathes out
LYMPHATICS - ISCHIAL TUBEROSA/DIAPHRAGM
Supine, bend knee, locate ischial tuberosity (medial)- explain where you are going, “ischial tuberosity is sitting bone, lmk if you feel uncomfortable”
Rest leg against your shoulder
Place hand over diaphragm (fingers point towards couch)
Inhibition- should feel like they move together
LYMPHATICS - PECTORAL TRACTION
Practitioner sitting
Grip underneath pec major
Lean back and pull
Useful for people with shoulder protraction/problems
Keep pulling until release is felt
LYMPHATICS - THORACIC PUMP
Cross hands- more important to do so on a female, can have arms uncrossed
Pump 2x1s- caution= osteoporosis
Push down (CPR like movement)
Promotes blood and lymph movement (redness on skin is blood flow)
LYMPHATICS - ABDOMINAL PUMP
Bend knees
Applying pressure to thoracic duct
Push in under ribs
