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OPP Lymphatics

WVSOM -- OPP1 -- Lymphatics

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
Created by: tjamrose