Lymphatic Drainage Term 4 Exam

name the structures that make up the lymphatic system

• lymph vessels

• lymph nodes

• aggregated lymph nodules

• tonsils

• lymph tissue

• lymphocytes

• lymph

• sleep

• thymus

what are the fibers that anchor the flaps in the initial capillaries called

anchoring filaments

what causes these flaps to open

• the anchoring fibers stretch and relax which opens and closes the flaps

• an increase in fluid volume and pressure in the interstitial spaces causes the anchoring filaments, which are attached to the neighbouring tissue to stretch and open the flaps of the initial lymphatics

what percentage of precollectors is located just under the skin

70%

what is lymphangion

A segment of a lymphatic vessel that is bounded by two valves and is the functional unit of the lymphatic system

what divides each lymphangion

• the one-way valves divide each section into lymphangions

• this gives vessels and prollectors their bead shape

approximately how many lymph nodes are in the body

600-700

how many lymph nodes are in the neck

160

where are most of the lymph nodes located

in the intestines

what are the principle lymphatic trunks

• lumbar trunks

• intestinal trunk

• intercostal trunks

• bronchiomedistinal trunk

• subclavian trunk

• jugular trunks

what are the lymphatic ducts

there are two lymphatic ducts: 1. the right lymphatic duct and 2. the thoracic duct, which are the largest lymph vessels in the body and drains lymph into the subclavian veins

what areas of the body do the lymphatic ducts drain

the lymph vessels from the right half of the head, neck, and chest concierge in the right lymphatic duct, which empties into the right subclavian vein via the right venous angle (aka terminus). all other areas are drained by the thoracic duct, which is formed by the cisterna chyli

how does lymph move

• the lymph pump

• the lymph pump is the rhythmic wave-like contraction of lymphangitis

what are watersheds

lines are drawn on the basis of different directions of superficial lymph flow.

where are the watersheds in the body

• the body is divided into superior and inferior halves by a watershed that is located at the navel around the iliac crest to the L2 area. Lymph below this watershed is drained to the inguinal lymph nodes and lymph above this watershed is drained, for the most part, to the axillary lymph nodes

• in the lower limb there is a watershed down the posterior aspect of the leg

• there is a watershed that runs from the jugular notch to the pubic symphysis dividing the body into right and left

• there is another watershed that follows the clavicle and spine of the scapula

what is lymphedema

chronic edema caused by pathology or obstruction of the lymphatics. edema from inflammatory responses can become chronic lymphedema if scar tissue obstructs the lymph vessels or if lymphatic tissue is destroyed

what are the contraindications to performing LDM

• a person with edema in which the cause is unknown

• acute inflammation caused by bacteria, allergies or toxic substances

• acute illness contagious conditions

• active cancer or seriously ill get physician approval

• open wounds rashes inflamed skin conditions

• fevers

• thrombosis and phlebitis local CI

• Major heart problems congestive heart failure heart attack or heart surgery in the past year

• kidney failure or undergoing dialysis

• undergoing organ transplant

what are some precautions to LDM

• kidney problems and liver problems - get physician approval

• severe uncontrolled asthma

• untreated thyroid hyperactivity

• treated tuberculosis

• mastectomy with edema in the arms

• people at risk for thrombosis

• pregnancy with a history of miscarriage

• varicose and spider veins that are hot, red, painful

• low blood pressure

name some conditions that LDM can help

• edema know the cause before treating

• acute injuries/inflammation decreases fibrin and metabolic wastes therefore decreasing scar tissue formation

• chronic injuries and soft tissue injury

• LDM can reduce chronic sinus infections

• scar/scar tissue

• before and after surgery- speed healing and reduce edema

• traveller’s or positional; edema - beware of deep vein thrombosis

• sluggish immune system - frequent colds or allergies. LDM stimulates the circulation of immune cells

• maintaining a healthy immune system

• reduce stress and muscle tension - triggers PNS

• enhancing the skin’s health - unhealthy skin caused by poor circulation. LDM can help with acne and eczema

what is the direction of the techniques used in LDM

the direction of lymphatic flow

what are the 4 main techniques used in LDM

1. stationary circles

2. scoop technique

3. pump technique

4. rotary technique

what are some basic principles of LDM

• moving the skin

• apply gentle pressure

• slow movements

• move in the proper direction

• rhythm and repetition

what are some indication for performing LDM on the face and neck

• reduces bruising and swelling following injury or surgery, do not massage open wounds

• facial edema, hormones, medication fatigue, illness, injury, weeping

• stimulating a sluggish immune system to become more active may be helpful with clients who have frequent colds and flu

• improve skin’s complexion

• whiplash ( careful not to reduce protective spasm)

• chronically swollen lymph nodes from repeated infections (after the infection has healed)

where are the lymph nodes in the face located

lymph nodes are located in the front of the ears, at the angle of the jaw anterior to the masseter, and sometimes near the eyes, nose, and mouth

where are the lymph nodes in the neck located

there are two triangles on the neck. the anterior triangle is bordered by the SCM muscles. borders if the posterior triangle is the SCM clavicle and the border of the upper trapezius muscle. the apex of this triangle is below the ear lobe. lymph nodes are also located behind the mandible from the angle of the mandible to the chin back behind the ears and along the base of the skull

what makes up the triangles of the neck

the anterior triangle is bordered by the SCM muscles. borders of the posterior (lateral) triangle are the SCM, clavicle and border of the upper trapezius muscle. the apex is below the ear lobe

describe stationary circles

15-30 circles in one spot

moving the skin

stretch skin lengthwise and clockwise, this stretches the initial capillaries and stimulates lymph vessels to contract. it also pulls on the anchoring filaments, causing the flaps of the initial capillaries to open. stretching the lymphangion increases the pulsation rate, and this increases the flow of lymph

apply gentle pressure

the softer the tissues or more severe the edema, the lighter the pressure. stokes must be adjusted to each region of the body. some text say that the pressure should be 30-40 mmHg less than .5 to 8 ounces per inch or the weight of a nickel. too much pressure can damage the thin anchoring filaments, too little pressure will have noeffect

slow movements

the greater the amount of edema the slower the movements should be. movements can be as slow as 6 circles per minutes or sped up depending on the tissue response

move in the proper direction

move towards the lymph nodes in the neck, axilla and inguinal area keeping in mind where the watersheds of the body are. drain the lymph nodes first then proceed to the related quadrant working proximal to distal and then back to proximal finishing by draining the lymph nodes. massaging the lymoh nodes first will make room for the incoming fluid from the related region

never perform LDM distal to the edema this will cause a bottle neck effec t and further congest the affected area

rhythm and repetition

smooth rhythmic movements are essential to lymph drainage massage success. slow rhythmic repetition of massage movements stimulates a wave in the fluid similar to intestinal peristalsis. remain in contact with the same area for at least one minute, repeating the stoke with the same pressure, direction, and speed until there is a palpable change in the tissue. begin with 6 to 10 repetitions of the massage stroke in one minute, increasing the minutes in an area if the tissue does not respond