Lymphatics Flashcards
(30 cards)
1
Q
- What are some indications for lymphatic treatment?
A
- Acute somatic dysfunction
- Sprains/strains
- Edema
- Tissue congestion, lymphatic/venous stasis (mild CHF)
- Pregnancy
- Infection
- Inflammation
2
Q
- What are the contraindications for lymphatic treatment?
A
- Anuria and necrotizing fascitis are absolute contraindications
- Malignancy
- Fracture/Dislocation
- Certain infections (mono, abscess, chronic osteomyelitis)
- Certain circulatory disorders (venous obstruction, embolism, hemorrhage, anticoagulated patient)
3
Q
- Where are the fluid pumps located?
A
- Thoracic inlet
- Thoracic diaphragm
- Pelvic diaphragm
4
Q
- What is the Zink “Warmth Provacation Test”? What does it indicate?
A
- Testing for warmer areas (indicating a potential somatic dysfunction in that area)
*
5
Q
- When palpating lymph nodes, what is normal?
A
- Pea-sized
- Round
- Spongy
- Non-tender
- Mobile
- Baseline adjacent areas
6
Q
- What is abnormal when palpating lymph nodes?
A
- Larger
- Irregular
- Hard, matted
- Tender
- Fixed (low mobility)
- Red or pale, warm
7
Q
- Where should you evaluate lymphatic function?
A
8
Q
- What do you need to do before performing any lymphatic treatments?
A
- Open the thoracic diaphragm
9
Q
- How do you perform thoracic inlet MFR?
A
- Patient is supine with doc seated at head of the table
- Index fingers above SC joint/angle of rib 1, thumbs over T1 transverse processes bilaterally
- Press towards pt feet and twist hand to feel for restriction of motion
- Perform direct MFR
10
Q
- How do you perform doming the diaphragm?
A
- Pt supine
- Doc places hands in infracostal region below xiphoid process with fingers pointing toward pt head
- Pt takes a deep breath while pressing posteriorly and superiorly
- Push further on exhalation and resist on inhalation
- Repeat 3-4 times
- Last time, move thumbs under the rib cage
11
Q
- How do you perform ischiorectal fossa release (aka doming the pelvic diaphragm)?
A
- Pt is prone
- Doc seated at side of table and places thumbs medial to ischial tuberosities bilaterally
- Apply cephalad and lateral force, increasing force during exhalation and maintaining force on inhalation
12
Q
- How do you perform pectoral traction?
A
- Patient is supine with doc standing at the head of the table
- Grasp inferior border of pectoral muscles at anterior axilla
- Extend arms and lean back to apply cephalad traction
- Pull when patient inhales and resist on exhalation
13
Q
- How do you perform seated rib raising?
A
- Pt crosses arms and leans toward doc
- Doc grabs posterior/inferior rib angles (lateral to TP)
- Start with T12 and apply anterolateral traction while pulling towards you
14
Q
- How do you perform supine rib raising
A
- Stand on side to treat
- Contact rib angles starting at T12
- Apply anterolateral traction by rocking backwards and continue up the ribs
- Can use respiration to assist (apply pressure with inhale, release with exhale)
15
Q
- How do you perform thoracic pump (repetitive/oscillatory)
A
- Place thenar eminence of each hand over pectoral muscles, just inferior to clavicles on ribs 2-4
- Rhythmic pumping at rate of 110-120 bpm
- Appropriate pace should provide a rebound force at hands
16
Q
- How do you perform thoracic pump (vacuum/atelectasis modification)
A
- Pt supine
- Doc places thenar eminence of each hand over the pectoral muscles just inferior to clavicles on ribs 2-4
- As patient exhales, apply compressice force downward and resist during inhalation
- Continue for 4-5 breaths
- Midway through last inhalation, briskly remove hands to allow for rapid, deep inhalation (inflates atelectatic lung)
17
Q
- How do you perform abdominal pump?
A
- Place palms on abdomen with fingers towards patient’s head, thumbs side by side
- Push posteriorly at a rate of 20-30 x/min
18
Q
- How do you perform sacral rocking?
A
- Patient is prone
- Heel of cephalad hand on sacral base with fingers pointing down
- Apply gentle downward pressure to gap SI joint
- Inhalation: Move sacral apex anterior
- Exhalation: Move sacral apex posterior
19
Q
- How do you perform pedal pump?
A
- Patient is supine, doc at feet
- Passively dorsiflex feet
- Apply on and off cephalad force to hyperdorsiflex the feet, watching for nose movement and feeling rebound at feet
- Pump at 100-120 x/min
20
Q
- How do you perform lung tapotement?
A
- Hacking
- Cupping
- Slapping
21
Q
- How do you perform effleurage?
- How do you perform petrissage?
A
- Stroking force distally to proximally
- Kneading/twisting force distally to proximally
22
Q
- How do you perform IT Band Effleurage?
A
- Start halfway between greater trochanter and knee
- Apply pressure and stroke distally to proximally
23
Q
- How do you perform anterior tracheal/deep cervical soft tissue lymphatic treatment?
A
- Place fingers lateral to trachea
- Move trachea from side to side, working cephalad to caudad
24
Q
- How do you perform suprahyoid and infrahyoid release?
A
- Pt supine
- Place fingers lateral to hyoid bone
- Move hyoid from side to side
- If there is crepitus, can flex and extend head to decrease friction
- Can also use swallowing to help release restrictions
25
* How do you perform cervical stroking?
* Pt supine with doc at head of table
* Place hands along paravertebral muscles
* Stroke in caudad to cephalad direction
26
* How do you perform cervical chain drainage?
* Pt supine with doc at head of table
* **Locate the anterior and posterior border of the SCM's superior portion**
* **Place thumb along anterior margin and other fingers along posterior region**
* **Lift and milk anteriorly until you note relaxation, working caudad along the SCM**
* **Treat one side at a time**
27
* How do you perform submandibular drainage?
* Patient supine with doc at head of table
* **Apply raking motion under the angle of the manubrium towards the mentum**
28
* How do you perform mandibular drainage (Gallbreath technique)?
* Patient supine with doc at head of table on opposite side to treat
* Stabilize patient's head with cephalad hand and place fingers of caudad hand posterior to ramus
* **Slow, repetitive and downward midline traction on the mandible**
29
* How do you perform pre-post auricular drainage?
* Place index and middle finger in front of ear and fourth and fifth finger behind
* Apply clockwise and counterclockwise rotation to auricular lymph nodes
30
* What is a normal compensatory pattern?
* R,L,R,L
