Lymphatics & Abdominal Omm Techniques

Front 1

What are the indications for Doming the Diaphragm?

Back 1

Lymphatic congestion distal to the diaphragm and/or respiration that does not (myofascially) extend fully to the pubic symphysis.

Front 2

What are the countraindications for Doming the Diaphragm?

Back 2

This procedure should not be used if the patient has drainage tubes, intravenous lines, thoracic or abdominal incision, or moderate to severe hiatal hernia or GERD symptoms.

Front 3

What is the Physiological Goal of Doming the Diaphragm?

Back 3

The goal is to improve lymphatic and venous return; it may improve immune function

Front 4

When is Marian Clark Drainage indicated?

Back 4

Menstrual cramps and pregnancy.
Restricted venous & lymphatic drainage.

Front 5

Why perform Marian Clark Drainage?

Back 5

This technique improves passive venous and lymphatic drainage from the lower abdomen and pelvis.

Front 6

What are the indications for the Prone Ishiorectal Fossa Release?

Back 6

Impaired pelvic diaphragm motion, and impaired venous and lymphatic drainage.

Front 7

What are the indications for the Supine Pedal Pump AKA the Dalrymple Technique?

Back 7

Lymphatic congestion
Fever
Infection
& Inability to use the thoracic pump.

Front 8

What are the contraindications for the Supine Pedal Pump AKA the Dalrymple Technique?

Back 8

Venous thrombosis;
Acute Ankle Sprain;
Achilles Sprain;
Gastrocenemious strain,
or other acute process and/or painful lower extremity conditions. It should also be avoided in the acute postoperative period in some abdominal surgery patients.

Front 9

What are the indications for the Miller Thoracic (Lymphatic) Pump?

Back 9

Infection;
Fever;
Lymphatic Congestion;
Rales;
Chronic Productive Cough;
Also Preventive, it may increase titers post vaccination.

Front 10

What are the contraindications for the Miller Thoracic (Lymphatic) Pump?

Back 10

Fractures;
Osteoporosis;
Moderate to Severe Dyspnea;
Regional Incisions;
Subclavian Lines;
Metastatic Cancer & So On.

Front 11

What is the physiologic goal of the Miller Thoracic (Lymphatic) Pump?

Back 11

Accentuate intrathoracic pressure, increase lymphatic return, loosen mucus plugs via the vibratory component, and potentially stimulate the autoimmune system.

Front 12

What are the indications for the Miller Thoracic (Lymphatic) Pump, Exaggerated Respiration?

Back 12

Infection;
Fever;
Lymphatic Congestion;
Rales;
Chronic Productive Cough;
Also Preventive.

Front 13

What are the contraindications for the Miller Thoracic (Lymphatic) Pump, Exaggerated Respiration?

Back 13

Fractures;
Osteoporosis;
Moderate to Severe Dyspnea;
Regional Incisions;
Subclavian Lines;
Metastatic Cancer or similiar condition.

Front 14

What is the physiologic goal of the Miller Thoracic (Lymphatic) Pump, Exaggerated Respiration?

Back 14

Accentuate Negative Intrathoracic pressure and increase lymphatic return.

Front 15

What is the indications for the Thoracic (Lymphatic) Pump, Atelectasis Modification>

Back 15

This technique is indicated for atelectasis

Front 16

What are the contraindications of the Thoracic (Lymphatic) Pump, Atelectasis Modification?

Back 16

Fracture;
osteoporosis;
severe congestion;
incision;
subclavian line;
Metastatic Cancer or similiar condition.

Front 17

What is the physiologic goal of thoracic (Lymphatic) Pump, Atelectasis Modification.

Back 17

The goal is to accentuate the negative phase of respiration and clear mucus plugs.

Front 18

What are the indications for Pectoral Traction: Pectoralis Major, Pectoralis Minor, and Anterior Deltoid.

Back 18

lymphatic congestion; upper extremity edema, mild to moderate dyspnea or wheeze, and/or reactive airway or asthma; it facilitates the thoracic pump.

Front 19

What are the contraindications for Pectoral Traction

Back 19

patient has hypersensitivity to touch at the anterior axillary fold, subclavian line, some pacemakers, metastatic cancer, or similar condition.

Front 20

What is the Physiologic Goal of Pectorial Traction?

Back 20

increase lymphatic return

Front 21

What are the indications for the Abdominal Pump?

Back 21

Congestive Heart Failure;
Infective processes; (may improve immune competence)
Upper Respiratory infection, asthma & COPD;
Restricted Mobility of the lumbar spine and thoracic cage;
Hiatal hernia;
Upper and lower GI dysfunction.

Front 22

What are the contraindications of Abdominal Pump?

Back 22

Thoracic cage mechanical derangements: fracture, dislocation;
Traumatic disruption of liver, spleen or adjacent organs;
Recent surgery to gallbladder or other adjacent organs;
A full stomach (postprandial)

Front 23

What are the indications for Splenic Stimulation

Back 23

Any infectious disease; also preventive

Front 24

What are the contraindications for Splenic Stimulation?

Back 24

Infectious mononucleosis; any splenic enlargement
Neoplasm infiltrating the spleen

Front 25

How to exam a Spleen?

Back 25

Physician stands to the patient’s right.

The left hand is placed over the lateral aspect of the costal margin.

It exerts and even pressure, then draws the skin and subcutaneous tissues caudad.

The right hand is placed below the lateral aspect of the costal margin, finger tips pointing toward the spleen.

Patient is instructed to inhale, just before the zenith of inhalation, compress the hands together slightly and dip a little deeper with the right finger tips.

The spleen, if enlarged, will be felt to bump up against the palpating fingertips. To be palpable a spleen must be enlarged to 1.5x it’s normal size

Front 26

What are the indications for myofascial release/ BLT treatment of the Gallbladder?

Back 26

Cholecystitis
Cholestasis
(Chronic upper abdominal pain)(in Nicholas & Nicholas) but not in Dr. E notes!

Front 27

What are the contraindications for myofascial release/BLT treatment of the Gallbladder?

Back 27

Cholelithiasis
Jaundice
Carcinoma of the Gall Bladder

Front 28

How to palpate the gall bladder

Back 28

The gall bladder lies on the inferior surface of the liver, lateral to the right mid-clavicular line. It is normally not palpable.
Can be palpated posterior to the liver border as a tender sausage like mass.
Hold fingers below the costal margin, instruct the patient to inhale. Positive Murphy sign is inspiratory arrest due to pain.

Front 29

What are the indications for Myofascial Release/BLT Treatment of Kidney Release?

Back 29

Post-Pyelonephritis
Nephrolithiasis
Inflammatory Disorders of the Kidney

Front 30

What are the contraindications of the myofascial release/BLT treatment of the kidney?

Back 30

Renal Carcinoma
Polycystic Kidneys
Congenital Anomalies such as Horseshoe Kidney

Front 31

How to Palpate a Kidney?

Back 31

-Stand at the side of the patient opposite the kidney you wish to palpate.
-Put your non-dominant hand beneath the lower ribs and lift them toward you.
-Use your dominant hand to palpate deep into the abdomen.
-The kidney’s normally feel about the size and firmness of a bar of soap.
-They should ascend and descend with respiration.

Front 32

What are the indications of Releasing the Root of the Mesentery

Back 32

Inflammation and edema of the small intestine
Increased lumbar lordosis

Front 33

What are the contraindications of releasing the root of the mesentery?

Back 33

Recent abdominal incision
Ischemic Bowel Disease
Bowel Obstruction

Front 34

What are the indications for the release of the descending colon mesentery?

Back 34

Diverticulosis
Diverticulitis
Inflammatory Colitis

Front 35

What are the contraindications for the release of the descending colon mesentery?

Back 35

Peritonitis
Diverticular Abscess
Carcinoma of the Colon