T3—> _________
T7–> ________
T3- spine of scapula
T7- bottom of scapula
Steps of Lymphatic Tx
Steps of Lymphatic Tx
- Open pathways to remove restriction to flow
* a. THORACIC INLET MFR!! - Maximize diaphragmatic fx
* a. Doming the diaphragm - Increase pressure differentials or transmit motion
* a. Pectoral Traction, Rib Raising, Thoracic Pump… - Mobilize targeted tissue fluids
- a. Lungs→ Tapotement
- b. Extremities→ Effleurage, Petrissage
- c. Head/Neck→ Cervical Stroking, Submandibular Drainage, Auricular Drainage
Step 1. Thoracic inlet MFR
- Lay pt on back with the doc at the head of the table
- Use both hands to contact around of thoracic inlet
- Compress and turn both hands to L and R and feel for restriction of motion
- Hold in restriction until tissue creeps
Step 2: Doming the diaphram and the pelvic diaphram
- Pt lays down
- Stand to the side and place my thumbs under their last ribs, near the
- Tell pt to breathe in and out
- When patient breathes out, push in
- repeat 3-5 times
___________
- Hve patient lay on stomach
- Place my thumbs on ischial tuberosity
- tell patient to breath in and out
- apply force during exhalation
- Maintain on inhalation
NOW—we increase pressure differentials or transmit motion
Pectoral traction
Stand at head of the table
- Pt is laying on back with knees flexed
- put my hands in armpits
- tell pt to breathe in and out
- pull back when patient INHALES and not when exhale
- repeat 5-7 times
Rib raising (seated)
- Pt seated at edge of table and doc stands in front.
- cross arms on shoulders
- lean on you
- grab T12 on back and pull up and to you
- move up T12-top
Raising ribs (supine)
- Pt is laying down
- Doct is sitting on tx side
- Grab ipsilateral ribs, starting at T12–> lift up–> all the way up ribs
Thoracic Pump: Repetitive/OScillatory
- Pt is laying down with doc at the head of the table
- Put hands in a fist and put thenar eminence below the clavicle
- Provide a rythmic oschillations 110-120xmin (your feet should be moveing rhymically)
Thoracic Pump Vacumm Atelaectasis Mod
Same position as before and contact same manner,
Resist respirations;
resist–>inhalation, exhale–> compress.
do this 4-5 cycles and increase pressure
LET GO IN THE MIDDLE OF INHALATION
abdominal pump
- pt is on back and doc is on side, facing to pt
- put fingers on abdomen, with fingers to head and thumbs side by side
- pump 20-30x-min
Sacral rocking
- pt is laying on stomach
- Push hands on sacrum and push down and rock as they breathe; move toward abdomen when they exhale and then rock back
Pedal pump
pt is layin on back; doc is at the feet
contact the top of their feet and dorsiflex
-rhythmic force 120/min to 1- 2 minue
STEP 4 —-mobilize targeted tissue fluids—-
Tapotement
Pt lies on back
-karote chop their back–> cup the back--> slap
Effleurage and Petrissage
Pt on back
lift up leg–> raise affected leg and rest on shoulder–> stroke from ankle–> up
–> kneed and tesit
MOVES FLUID UP
IT BAND EFFLEURAGE
- pt lays lateral recumbant, lock top foot in the popliteal fossa
- doc locks greater trochanter w one hand and makes a C with the other
- start at mid IT band- push fluid up for a couple of times
- then go to the knee and start to ppush up
Anterior tracheal/Deep cervical ST
Pt lays on back while doc sits on side
-One hand under head, other hand with fingers lateral to trachea
–> Move trachea from side to side for 30 seconds or more
-
Cervical stroking
Slide the paravertebral muscles to move fluid from head–> down
Cervical chain drainage (SCM!!!!))
Put is laying down with doc at the head of the table
- Turn patients head sideways, pinch the SCM from UP–>down until relaxation
- do BILATERALLY
submandibular drainage
Put fingers at the bottom of submanible
push fluid down into the duct
Mandibular drainage (galbreeath technique)
pt laying on back
- find the corner of your mandible, near ear
- apply a slow, downward traction
PRe and post auricular drainage
Suprahyaoid and infrahyoid release
Pt is lying on back
- doc stands on side
-sandwich the hyoid bone
–> move back and forth
