Lymphatic pump

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The lymphatic pump is a method of manipulation used by physicians who practice manual medicine (primarily osteopathic physicians and chiropractors) to increase the rate of lymph flow in order to help fight infection.

The lymphatic pump can also refer to the flow of lymph from peripheral tissue to central lymph ducts, preventing backflow. The flow of lymph from extracellular fluid (ECF) to peripheral lymph capillaries is mediated by overlapping endothelial cells which slide aside when facing higher interstitial pressure, and contracting when the lymphatic pressure is higher. The flow of lymph from the peripheral, via vasa lymphatica and lymph nodes and then to trunci, finally ending up in ductus thoracicus or ductus lymphaticus dx, is at least partially mediated by contracting muscle fibers.

Unlike the cardiovascular system, the lymphatic system is not closed and has no central pump. Lymph transport, therefore, is slow and sporadic. Despite low pressure, lymph movement occurs due to peristalsis (propulsion of the lymph due to alternate contraction and relaxation of smooth muscle), valves, and compression during contraction of adjacent skeletal muscle and arterial pulsation.^[1]

History

The term lymphatic pump was invented by Earl Miller, D.O. to describe what was formerly known in osteopathic medicine as the thoracic pump technique.^[2]

Techniques

Techniques to achieve this include the thoracic pump and abdominal pump. These methods increase the flow of lymph through the thoracic duct. It is believed that increased lymph flow is beneficial, as the lymphatic system is part of the immune system. Other techniques include Miller Pump (rhythmic, rapid, compression of the superior-anterior wall of the thorax), pedal pump, and diaphragmatic redoming. A modified version of Miller Pump can be used to treat atelectasis (loss of lung volume) by inducing sudden, rapid inflation of the lung. Indications for thoracic lymphatic pump include productive cough, upper respiratory tract infection, and extended bed confinement. Contraindications include osteopenia/osteoporosis, and injury (including surgical) to the thorax.

Relative contraindications

While no firmly established absolute contraindications exist for lymphatic techniques, the following cases are examples of relative contraindications: bone fractures, bacterial infections with fever, abscesses, and cancer.^[3]

References

↑ Shayan, Ramin; Achen, Marc G.; Stacker, Steven A. (2006). "Lymphatic vessels in cancer metastasis: bridging the gaps". Carcinogenesis 27 (9): 1729–38. doi:10.1093/carcin/bgl031. PMID 16597644.
↑ "Glossary of Osteopathic Terminology". American Association of Colleges of Osteopathic Medicine. April 2009. p. 28. Retrieved 4 November 2012.
↑ Savarese, Robert G.; Copabianco, John D.; Cox, James J. (2009). OMT review. p. 126. ISBN 978-0967009018.

v t e Osteopathic Medicine (ICD-10-PCS 7)

General	Osteopathic medicine in the United States Osteopathic medicine in Canada

Treatments	Articulatory technique Balanced ligamentous tension Chapman reflex points Counterstrain Cranial Lymphatic pump Muscle energy technique Myofascial release Paraspinal inhibition Soft tissue technique Somatic dysfunction

Education	List of osteopathic medical schools Doctor of Osteopathic Medicine Accrediting Commission

Licensing	COMLEX NBOME

Organizations	AOA COA AACOM Student Council Specialty Boards Specialty colleges Directors and Medical Educators American Academy of Osteopathy

People	List of osteopathic physicians Andrew Taylor Still S. S. Still

Media	The DO The Journal of the American Osteopathic Association Osteopathic Family Physician

History	History California merger Flexner Report

Osteopathic medicine

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