Term
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Definition
Balance volume & composition of interstitial fluid (IF)
Transport excess fluid, protein, and waste from IF
Distribute immune cells & substances from lymphoid tissues to systemic circulation
Filtration and removal of foreign material (e.g. bacteria) from IF
Absorb nutrients (especially fats) from the GI tract |
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Term
| lymphatic system and immune system both begin developing at... |
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Definition
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Term
| at birth lymph tissue is still immature and increases till approximately... |
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Definition
| 6-9 yrs of age then starts to regress until age 15/16 whre it reaches adult levels |
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Term
| lymph channels begin in... |
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Definition
| the soft tissue as closed endothelial-lined capillaries |
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Term
| lymph channel structure/attachment |
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Definition
single layered squamous cells supported by anchoring filaments attached to the interstitial matrix
**these join to form larger lymphatic channels. larger lymphatic levssels communicate w/the blood system in nodes and through lymph ducts |
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Term
| lymph vessels extend into all tissues of the body EXCEPT (5) |
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Definition
- CNS (brain and spinal cord)
- Epidermis (including hair and nails)
- Bone marrow
- Endomysium of muscles and cartilage
- Portions of peripheral nerves |
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Term
| lymph channels of abdomen, pelvis, and lower limbs drain into... |
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Definition
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Term
| lymphatic drainage of the body |
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Definition
all of the body drains via the LEFT thoracic duct EXCEPT right side of head/neck and right chest (inclusive of heart and portions of lungs), which drain into RIGHT lymphatic duct
**ex. since right foot drains to lymphatics on left, treat left inlet/outlet to ensure proper drainage |
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Term
| right lymphatic drains... |
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Definition
| into the circ system at right sublavian vein |
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Term
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Definition
| into circ system at left subclavian vein but FIRST PIERCES THE FASCIA covering thoracic outlet |
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Term
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Definition
| excess interstitial fluid (IF) and return it ot blood (about 3 liters/day) |
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Term
| How many grams of protein can escape the blood capillaries? |
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Definition
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Term
| hydrostatic pressure vs oncotic pressure |
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Definition
| hydrostatic pressure favors movement out of capillaries, while oncotic pressure favors movement into capillaries |
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Term
| describe lymph pressure gradients |
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Definition
Any increase in interstitial fluid pressure increases the absorption of lymph into lymph capillaries up to a certain pressure
-Interstitial Fluid Pressure: -6.3 mm Hg
-Increasing IF to 0 mm Hg increases lymphatic flow 20 times
-Greater that 0 mm Hg interstitial fluid pressure becomes greater than the pressure inside the lymph channels they collapse and obstruct the pathways. |
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Term
| if interstitial fluid pressure increased enough so that outside is greater than inside... |
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Definition
| then channels will collapse on themselves and there'll be no flow |
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Term
| if interstitial fluid pressure just increased a little and inside is still higher... |
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Definition
| it will open up cells and allow for molecules/fluid to flow into lymph vessel |
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Term
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Definition
lymph formation > lymph return
**so from increased lymph formation or decreased lymph return |
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Term
| factors causing increased lymph formation (3) + examples |
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Definition
1. Increased Venous Pressure
-Congestive Heart Failure
2. Increased Capillary Permeability
-Cytokine and Histamine release (allergic reaction, infection)
-Toxins (rattlesnake poison)
3. Decreased Oncotic Pressure
-Decreased Protein Synthesis (Liver Cirrhosis) |
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Term
| factors causing decreased lymph return (2) + examples |
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Definition
1. Mechanical Obstruction/Blockage
1. Posttraumatic/Postsurgical scarring
2. Filariasis
3. Intraluminal Carcinoma
2. Collapsed vessels secondary to increased pressure from overproduction of Interstitial Fluid. |
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Term
| 2 of important complications of edema |
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Definition
compression of nearby vascular and neurological structure, compromising function
Tissue congestion and stasis causing pH changes and inflammation which further propagates edema. |
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Term
| indications of lymphatic drainage (5) |
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Definition
pulmonary disease (bronchitis, pneumonia)
COPD
lymphedema
acute musculoskeletal injuries (enhance drainage of soft tissue swelling)
liver disease (supportive care) |
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Term
|
Definition
1. remove (restrictive impediments to lymphatic flow)
2. promote
3. augment |
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Term
| primary force behind lymph movement |
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Definition
respiration
**always get the respiratory and circulatory systems working well before lymphatic treatments |
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Term
| hypersympathetic tone will cause... |
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Definition
| constriction of the larger lymph vessels |
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Term
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Definition
help remove restriction and facilitate sympathetic NS via thoracic sympathetic chain ganglia
improve thoracic cage's respiratory excursion |
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Term
| tissue obstruction of lymph |
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Definition
| lymph runs in longitudinal plane, so any horizontal tissues can impede flow |
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Term
| Anything that runs horizontally is usually a _____. List them. |
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Definition
diaphragm:
diaphgram sellae, tentorium cerebelli
thoracic inlet, abdominal diaphragm, pelvic diaphragm
popliteal fossa, plantar fascia |
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Term
| cisterna chyli passes through... |
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Definition
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Term
| left thoracic duct passes through... |
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Definition
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Term
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Definition
Grasp the patient’s toes and ball of foot
Guide ankle into dorsiflexion (to barrier)
Apply superiorly directed oscillatory motion to the foot/ankle furthering dorsiflexion up to the anatomic barrier (gentle and careful).
Repeat 3 to 6 times |
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Term
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Definition
Place both hands over pre-pectoral region
a) Heel of hand just distal to the clavicle
b) Thumbs at appr. 45 degrees to sternum
Instruct patient to deeply inhale and exhale
During exhalation apply oscillatory forces and compression on chest cage
At end of exhalation, hold chest while patient starts again inhalation effort
Next, rapidly release compression during initial phase of inhalation
Repeat above 2 to 6 times |
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Term
| contraindications to lymph pump techniques (4) |
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Definition
osseous frature
bacterial infection w/temp over 102 F
certain stages of carcinoma
thromotic events |
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Term
| increased risk factors for thrombosis (7) |
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Definition
immobility
faluty blood clotting
contraceptive pill/hormon replacement therapy (HRT)
damage to inside lining of vein
older people, preganancy, obesity incrase risk of DVT
***practice questions (not in slide show) starting at 46:00 |
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