Foundations of Manual Lymph Drainage

Michael Földi, Roman Strossenreuther

• Publisher: Mosby
• Year: 2005
• ISBN:
  9780323070416
• Edition: 3
• Topic: Medicine
• Subtopic: Alternative & Complementary Medicine

This manual lymph drainage guide covers the anatomy, physiology, and pathophysiology of the lymphatic system, providing key background information necessary for effective treatment. Chapters are structured according to anatomic regions, focusing on the lymphatic knots and their tributary regions in the throat, armpit, trunk, and groin. Photographs illustrate the lymphatic knots and lymphatic courses, which are drawn on the human body, and provide a clear picture of the structures to be treated. Designated points are numbered to illustrate the progression of treatment in each region. Also includes coverage of complete decongestive therapy (CDT).

• Explains procedures in a detailed, step-by-step format.
• Features a helpful chart of lymph node groups and their tributary regions that outlines each lymph node as it pertains to a specific anatomical region.
• Key information is summarized in the margins, making it easier for readers to review what they've read and focus on important topics.
• Self-test questions provide an excellent means for readers to assess their comprehension and review key material in the book. These questions are also helpful in preparing for exams.
• Two-color illustrations help the reader visualize and learn theoretical aspects of this therapy.

• The text has been completely updated to reflect the latest techniques in lymph drainage therapy.
• Coverage of individual treatment strokes and stroke sequences have been updated, with more comprehensive descriptions and detailed photos that illustrate proper hand placement, pressure, and movement.
• Expanded coverage of complete decongestive therapy, including a CDT survey — consisting of the case history, examination, and palpation — that can be used to gather valuable information to formulate therapeutic goals and evaluate treatment results.

Chapter 1 Anatomy of the Lymph Vessel System

Important tasks of the lymph vessel system are the drainage and transport of interstitial fluid or lymph.

The lymph vessel system is a component of the lymphatic system, which also includes the lymphatic organs (thymus, spleen, tonsils, etc.). The most important task of the lymph vessels is the drainage and transport of interstitial fluid, along with various substances contained in it, into the venous blood circulation.

The lymph vessels of the small intestine are capable of absorbing and transporting food fats away from the intestine. Furthermore, the lymphatic system is an important component of the immune defense system.

The goal of manual lymph drainage and complete decongestive therapy is to improve or restore lymph drainage that has become impaired. To apply these therapeutic methods successfully, the therapist must master the anatomy, physiology, and pathophysiology of the lymphatic system.

1.1 LYMPH VESSEL SYSTEM

The lymph vessel system is a drainage system. It transports lymph into the venous blood circulation. As in the veins, flap valves in the large lymph vessels ensure directionality of flow.

Unlike the blood vessels, the lymph vessels:

Are not a component of a closed circuit

Do not have a central pump comparable to the heart

Have interposed lymph nodes

Although the lymph vessels run broadly parallel to the blood vessels and have a similar wall construction, the blood and lymph vessels are different in several important ways (Fig. 1.1):

No closed circuit: Contrary to the blood circulation, the lymph vessels form only half a circuit. They begin in the periphery with the so-called initial lymph vessels (lymph capillaries) and end by exiting into the large blood vessels of the venous blood circulation, near the heart.

No “central pump”: In the blood vessel system, the heart functions as a driver for the circulation of blood through the large and small blood vessels. The heart carries the blood through the arteries to the capillary bed and through the venous system back into the right side of the heart. In the capillary bed an exchange of substances and movement of fluids between blood and tissue take place. Unlike blood vessels, lymph vessels transport the lymph primarily through a self-activated pumping motion (see section 3.2); the lymphatic system has no central pump.

No unobstructed motion through the vessels: All along the large lymph vessels, lymph nodes are interposed as “filter stations” (see section 1.2).

Fig. 1.1 Blood circulation and lymphatic system.

[Source: 1.]

NOTE

There are also similarities between the lymph and blood vessel systems. For example, lymph transport is fostered by the same factors that favor venous flow. Respiratory motion, arterial pulse waves, and muscle and joint pumps work both on the veins and on the lymph vessels and might also be positively influenced through physiotherapy.

The lymphatic system can be subdivided into four sections. These ...