Discuss the principles of manual lymphatic mobilization, as well as the indications and contraindications

FIGURE 56 Caritas Bianchi College of Careers

Access Provided by: Lymphatic watersheds The body is divided into lymph territories that allow drainage of the lymph flow from specific body regions to specific regional lymph nodes. The deep vessels do not cross between watersheds (areas of collection); however, there are some superficial vessels that cross the watershed boundaries and thereby divert lymph fluid from one quadrant to another when there are conditions of overload. The superficial pathways that cross between watersheds can be encouraged with manual lymphatic mobilization to direct more flow to open areas; however, it is usually inadequate to remove the majority of the fluid in the affected quadrant.

The lymph nodes (estimated to be about 700) are located in clusters throughout the body (FIGURE 57). The lymph node is beanshaped and surrounded by a dense fibrous capsule (FIGURE 58). The collectors converge at the convex side of the lymph nodes where they are termed afferent lymph vessels. The fluid moves through the cortex of the node, into the medulla, and exits on the concave side via efferent vessels that then become trunks. The number of efferent vessels is less than the number of afferent vessels, resulting in a decreased transportation rate through the lymph nodes, and thus allowing the immune system cells time to phagocytose the pathogens that are in the lymphatic fluid.