Manual Lymphatic Therapy: The Godoy & Godoy Concept by José Maria Pereira de Godoy & Ana Carolina Pereira de Godoy & Godoy Maria de Fátima Guerreiro

Author:José Maria Pereira de Godoy & Ana Carolina Pereira de Godoy & Godoy, Maria de Fátima Guerreiro
Language: eng
Format: epub
Publisher: THS Editora
Published: 2013-04-15T16:00:00+00:00

Figure 31: The use of silicone rubber rollers to drain the chest follows the same rules as manual drainage using the hands

Figure 33: The use of silicone rubber rollers to drain the chest follows the same rules as manual drainage using the hands

Figure 35: The use of silicone rubber rollers to drain the chest follows the same rules as manual drainage using the hands

Figure 37: The use of silicone rubber rollers to drain the chest follows the same rules as manual drainage using the hands

Chapter V Manual Lymphatic Therapy of the arms

The lymphatic system of the arms is well defined; it mainly drains into the axillary lymph nodes. However, the cephalic and posterior lymph nodes normally do not. The cephalic lymph node chain is formed by a single vessel that flows through the external bicipital canal and follows the deltopectoral groove; it may then pass through the infraclavicular region or over the clavicle into the supraclavicular region. The posterior chain runs along the posteroexternal face of the arm, follows the tricipital groove and drains into the scapular circumflex lymph node.

In practical terms for Manual Lymphatic Therapy, it is essential to start with the positioning of the arm in order to allow good access to the main lymphatic chains (Figure 1). Figures 2 to 7 illustrate the sequence of movements and maneuvers during lymph drainage of the arm. The procedure begins by draining the proximal region (in the distal to proximal direction) and then gradually addresses the more distal regions as shown in the figures.

This sequence of maneuvers can be repeated as many times as necessary, but two or three times is normally enough. Be careful with the pressure and speed during drainage. This is the main approach to drain the arm of healthy subjects.

After this, the cephalic and posterior chains must be drained. They are of extreme importance in patients submitted to axillary lymph node dissection. In some cases, these may be the only two chains that can be drained.

Figure 1: the positioning of the arm for good access to the main lymphatic chains

Figure 2: The region in which drainage is begun; the finger shows the direction of flow Figure 3: The next step; the finger indicates to where the lymph must be drained

Manual Lymphatic Therapy of the cephalic chain

In regards to the cephalic chain, the positioning of the arm should allow good access. Figure 7 illustrates the change in the position to expose the region of the cephalic chain and to make drainage possible. You should start by gentle compression in the infaclavicular and supraclavicular regions, to where the lymph flows. This lymphatic vessel may pass over the clavicle into the supraclavicular region.

This maneuver is intended to drain the terminal portion of the lymphatic chain. In this region there are many collecting trunks that are afferents of the axillary lymph nodes and it is not advisable to direct the flow towards the cephalic chain. Compression enables more physiological drainage. Subsequently, it is necessary to start the drainage in the proximal region of the arm, always following the direction of lymph flow from distal to proximal.

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