| Question |
Answer |
| What is the Lymphatic System? |
A hollow system of the body that provides slow transit for fluids, nutrients, by-products, toxins and components of the immune system. It is a division of the circulatory system. |
| How does fluid get back to the heart? |
Veins AND lymphatics |
| The lymphatic system is a close partner of what other system? |
immune system |
| How do white blood cells get from the interstitium back into the system? |
Lymphatic vessels |
| What are the two types of fluids that the lymphatic system carries? |
Lymph and chyle |
| What carries long chain triaglycerols? |
lymph vessels via the thoracic duct |
| What are the components of the lymphatic system?(5) |
Tubes, Junctions, nodes, tissues/organs and fluid |
| Are the lymphatic vessels organized? |
NO, they are unorganized |
| What are the characteristics of lymph capillaries? (3) |
Single layer of flat endothelial cells, no valves and fragile |
| How are lymph capillaries connected to surrounding tissue? |
anchoring filaments |
| What are Lymph precollectors? |
larger than capillaries, 1-3 layers of endothelial cells with a few muscle cells. There are some one way valves every 2-3mm |
| What are the lymph collectors? |
The main lymphatic transporting vessels. Have bicuspid valves with muscular units called lymphangions. They carry lymph to the nodes. They look like pearls |
| What are lymphangions? |
muscular units found in the lymph collectors |
| What innervates lymphangions? |
sympathetics |
| What are lymp ducts/trunks? |
biggest lymph collectors. Theyare the final pathways in the venous system. |
| What is the largest lymphatic vessel? |
thoracic duct |
| What does the thoracic duct do? |
joins the lymphatic system with the venous system |
| What happens to the space between valves as diameter increases? |
distance between valves increases |
| What is the cysterna chili? |
RARE! It is an enlargement of the horacic duct |
| What does the right lymphatic duct junction with? |
right jugular v. and right subclavian v. |
| What does the thoracic duct junction with? |
left subclavian and left brachiocephalic v. |
| What is the area drained by the right lymphatic duct? |
heart, right upper body |
| What does the left lymphatic duct drain? |
drains left upper body, all lower body and thoracic viscera |
| How many times does the thoracic duct cross the thoracic inlet? |
twice |
| What vessel goes into the lymph node? |
Afferent lymphatic vessel |
| What vessels leave the lymph node? |
efferent lymphatic vessel |
| How many lymph nodes in the body? |
400-700 |
| What are the primary lymph tissues/organs? |
lymphocyte production and maturation |
| What are secondary lymph tissues? |
lymphocyte storage, antigen destruction |
| What are examples of primary lymph organs? |
bone marrow and thymus |
| What are examples of secondary lymph tissues/organs? |
spleen, tonsils, peyer’s patches, lymph nodes, vermiform appendix and sometimes the liver |
| What percentage of lymph is water? |
96% |
| What happens if lymph doesn’t move? |
we get sick |
| Clear lymphatic fluid is called? |
lymph |
| White lymphatic fluids are called? |
chyle |
| What is chyle? |
triaglycerol rich lymph |
| What is lymph made of? |
water, electrolytes, protein, lipids, cells, toxins, clotting factors and body waste |
| What are the two sections of lymph flow? |
superficial and deep |
| Where is superficial flow? |
just under the skin. NOT directly stimulated by exercise |
| What is deep lymph flow? |
muscles and viscera. STIMULATED by muscle contraction |
| What is lymph flow affected by? |
interstitial fluid pressure, intrinsic lymphatic pump and extrinsic lymphatic pumps |
| What are intrinsic lymphatic pumps? |
lymphangions |
| What are the extrinsic lymphatic pumps?(8) |
arteries, diaphragms, respiration, peristalsis, extremity movements, vigorous excise, external compression and laughter. |
| How is OMT used to help the lymphatic system? |
as an extrinsic measure |
| What are the five diaphragms? |
Tentorium cerebella, occipitoatlantal fascia, cervicothoracic fascia, thoracolumbar fascia and lumbosacral fascia |
| Why are the diaphragms important? |
part of the body’s extrinsic lymphatic pumping mechanism |
| What happens if you don’t have lymphatic drainage? |
severe impairment to death |
| What is the cervicothoracic fascia? |
Thoracic inlet |
| What is the lumbosacral fascia? |
pelvic floor |
| What is the thoracolumbar fascia tied with? |
respiratory diaphragm |
| How do we diagnose impaired lymphatic flow? |
Look for size of difference in limbs, puffiness, stiffness, skin tension, heat, pain, numbness, paresthesia, skin temp, fibrosis and decreased ROM |
| What are the 3 different types of edema? |
Lymphodynamic edma, lymphostatic edema (lymphedema), and safety valve insufficiency |
| What is lymphodynamic edema? |
LYMPHATIC SYSTEM IS NORMAL. A condition of over accumulation of fluid in the body |
| What is lymphostatic edema? |
FAILURE OF LYMPHATICS. A condition of inability to adequately remove lymph. Usually high in protein. |
| What is primary lymphedema? |
ideopathic |
| What is secondary lymphedmea? |
due to known causes |
| What is safety valve insufficiency? |
combination of lymphodynamic edema and lypmhedema. It is usually complicated by gradual deterioration of lymph vessels |
| What are lymphatic vessels like in idiopathic lymphedem? |
aplastic, hypoplastic or hyperplastic |
| Where does primary lymphedema usually occur? |
lower extremity |
| Who usually has primary lymphedema? |
females |
| What causes secondary lymphedema? |
extrinsic factors such as radiation, surgery, post-inflammation and post-paralysis |
| What is most severe cause of secondary lymphedema? |
filarasis. Leads to elephantitis |
| What are the complications of lymphedema? (4) |
Infection, cellulitis, cancer, genital lymphedema and complications due to bandaging or other medical or surgical interventions |
| What are Zink’s Fascial patterns? |
Common compensatory pattern. |
| What is common compensatory pattern for the occipitoatlantal fascia? |
rotated left |
| What is the common compensatory rotation for cervicothoracic facia? |
right |
| What is common compensatory rotation for thoracolumbar fascia? |
left |
| What is the common compensatory rotation of the lumbosacral fascia? |
right |
| How do you treat lymphatic problems with OMT? |
Remove restrictions, move the fluid back into circulation. |
| What is the rule of thumb for lymphatics? |
release central to distal athen pump distal to central |
| How do you remove restrictions? |
treat fascia with myofascial release and normalize autonomics |
| How do you normalize autonomics? |
rib raising, suboccipital inhibition and sacral rocking |
| How do you move fluid with OMT? |
pump techniques and direct pressure techniques |
| What are relative contraindications for lymphatic OMT? |
osseous fracture, acute bacterial infections, certain stages of cancer, severe osteoporosis, DVT and severe CHF |
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