OMM Review — Lymphatics
Original OMM review notes for lymphatic anatomy, flow, and OMT techniques.
Lymphatic Anatomy
Lymphatic vessels carry interstitial fluid to lymph nodes and then to the thoracic duct (left) and the right lymphatic duct (right upper quadrant). The thoracic duct drains the left head/neck, left upper extremity, and both lower extremities/abdomen.
Thoracic Pump
The thoracic pump uses rhythmic compression of the rib cage during exhalation to increase thoracic pressure and promote lymphatic and venous return. It is indicated for pulmonary congestion and postoperative edema.
Contraindications include rib fractures, severe osteoporosis, metastatic cancer, and acute heart failure.
Pedal and Abdominal Pumps
The pedal pump compresses the lower extremity and pelvis to push lymph toward the abdomen. The abdominal pump uses diaphragmatic excursion to draw lymph centrally. Both work with the thoracic pump to enhance total lymphatic flow.
Indications and Precautions
- Edema from venous insufficiency or postoperative stasis.
- Pulmonary congestion without active infection.
- Avoid in active infection, thrombosis, or acute congestive heart failure.
Q: Which duct drains the right upper quadrant and right arm?
A: The right lymphatic duct.
Q: What is the main contraindication to thoracic lymphatic pump?
A: Rib fracture, severe osteoporosis, metastatic cancer, or unstable cardiopulmonary disease.