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Dr- AHMED ABD EL-HAMIED
the effect of MLD
1-Analgesic : gate control- drainage of nociceptive substances
2- soothing.
BASIC STROKES
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1- carotid sinus syndrome
2- hyperthyroidism.
3- age: >60
1-pregnancy.
7-Inflammatory conditions.
2-dysmenrrhea
3-Illus
8- Radiation fibrosis
4- Diverticulosis.
9- unexplaind pain
5- Aortic aneurysm.
6-DVT.
LYMPH - COLLECTORRS- PRECPLLECTORS - TRUNK>>ETC
1- manipulation of the axillary lymph nodes (bimanual stationary ccircles between latissmus dorsi and pectoralis-toward the apex of axilla )
2- efflurage (to the axillary) and do not touch nipple.
3- ةساتسmanipulation of the lymph vesseles in health mammary gland( rotatory and pump in the mammary fold- glandular tissue- below the nipple)
4- ةشىهحعمشفهخmanipulation of lateral thorax (from lower horizantal watershed toward axillary lymph nodes follow the IA anastomoses)
5- manipulation of anterior and lateral thorax( anterior sagittal watershed to the thoracic portion of IA anastomosis) followed by step 4.
6- manipulation of anterior axillo-axillary anastomosis (stationary circles toward the axillary lymph nodes) .
7- manipulation of parasternal lymph nodes and vessels.
ثمم
8- manipulation of intercostal lymph vesseles (stationary circles from lateral to medial and deep )
9- efflurage
1- efflurage from the back of the head following the descending trapizus to the accromion.
3- manipulation of the occipital and parital regions( stationary circles from the posterior head toward the paritak area and direction toward ocipital and ear)
4-manipulation of the parotid and retroauricular lymph nodes (in front and behind the ear stationary circles ) and repeat step 2
2- manipulation of the deep lateral cervical lymph nodes(stationary circles from the angle of the jaw to supraclavicular fossa) bi hand use.
5- manipulation of shoulder collectors (pump technique- from acromion to upper tapizius in direction of supraclavicular fossa)
6-manipulation of the inferior cervical lymph nodes(stationary circles on supraclavicular fossa)
7- manipulation of paravertebral lymph nodes and vesseles
8-efflurage
1-efflurage 2-3 times (from posterior sagittal watershed to inguinal lymph nodes)
2-manipulation of lumbar area(alterating rotatory from sagital watershed to the ASIS ) the upper hand is parellal to lower horizantal watershed, the lower hand follow posterior inguinal anastomosis. (pii anastomosis)
3- manipulation of PII anastomosis (bimanual stationary circles from pii anastomosis toward inguinal lymph nodes)
4- manipulation of paravertebral lymph nodes and vesseles(stationary circles paravertebrally)
5-efflurage
1- manipulation of the axillary lymph nodes(stationary circles bimanually toward the apex of axilla)
2- efflurage ( from sagittal wtershed to axillary nodes)
3- manipulation of the lat. thorax(stationary circles from horizantal watershed to axillary lymph nodes(thoracic portion of the IA anastomosis))
4- manipulation of the posterior thorax (rotatory teqnique from sagittal watershed to lymph nodes)
5- manipulation of the posterior and lateral thorax (alternating rotatoary technique from the sagittal watershed to thoracic portion of IA anastomosis (followed by step 3))
6. manipulation of the post. axillo-axillary anastomosis( bimanual stationary circles psrallel with sagittal watershed )
7- manipulation of the paravertebral lymph nodes (stationary circles )
8-manipulation of the intercostal lymph vesseles( stationary circles -finger pad )
9- efflurage
1-efflurage (from sternum to accromion)
2- manipulation of inferior cervical lymph nodes(stationary circles- supraclavicular fossa)
3- manipulation of the deep lateral cervical lymph nodes( stationary circle- from earlobe to supraclvicular fossa)
4- manipulation of the parotid and retroauricular lymphnodes( fan finger- followed by step 3)
5- manipulation of sub mandibular lymph nodes ( stationary-repeaat step 3)
1- manipulation of axillary lymph nodes.
2-efflurage (2-3 times covering the arm).
3-manipulation of the medial aspect of upper arm(stationary circle from medial epicondyle to axillary lymph nodes).
4-manipulation of the tissue covering the ant. and post. portion of deltoid muscle(stationary circles - may bimanual- toeard axillary lymph nodes)
5- manipulation of lateral aspect of the upper arm( pump technique from lat. epicondyle to acromion- may use alternating pump and stationary).
6- manipulation of antecubital fossa (thumb circles -stationary - from distal to proximal -5 cm above and below).
7- manipulation of the forearm (scoop technique- anterior and posterior aspect of the forearm).
8- manipulation of the dorsom of the hand(stationary thumb circles- from MP to styloid process)
9-manipulation of the palmar aspect of the hand and ant. wrist(stationary- thumb-from center of the palm to radial and ulnar edge).
11- rework.
10- fingers from proximal to distal.
12- efflurage.
1-manipulation of the inguinal lymph nodes(stationary circles -working phase directed toward inguinal ligament).
2- efflurage.
3- manipulation of ant. thigh (alternating pump following rectus femoris between the base of patella to ASIS).
4-manipulation of ant. and lat. thigh (pump and stationary -ant pathway take the rectus femoris- lat. pathway take illiotibial band.
5- manipulation of the medial thigh (stationary from medial knee to the groin).
7- manipulation of the lower leg (scoop from calf to knee) .
8 - manipulation of the foot(stationary circle by the thumb).
9- rework.
10- final efflurage.
1- efflurage
2- manipulation of the posterior thigh(pump from popleteal fossa to horizantal gluteal fold).
3-manipulation of the medial thigh(stationary circles from medial knee to groin)
4-manipulation of the posterior and lat. thigh (pump and stationary )
5- manipulation of the knee (stationary covering popleteal fossa.
6- lower leg.
7-rework.
8-efflurage.