淋巴引流

sorehaeducationsorehaeducationManualLymphDrainage淋巴引流手法sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTContents内容•HistoryofManualLymphDrainage淋巴引流手法概述•Anatomy&PhysiologyoftheLymphSystem淋巴系统解剖学分析•PathologyoftheLymphSystem淋巴系统病理学•ContraindicationsofManualLymphDrainage徒手淋巴引流禁忌症•PrinciplesofManualLymphDrainage淋巴引流手法原则•TechniqueofManualLymphDrainage淋巴引流手法技术•TreatmentofArm&Leg手臂和腿部治疗•ComplexDecongestionTherapy综合性降充血治疗sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTHistoryofManualLymphDrainage手法概述•16thcentury:firstdescriptionsofLymphSystem十六世纪：首先对淋巴系统进行了描述•MLDfoundedanddevelopedin1930s上世纪30年代创立和发展•regularpartofphysiotherapy/physicaltherapysince1970s上世纪70年代运用到临床治疗中•3maindifferenttechniquesofMLD三种不同的技术DrVodder‘sManualLymphDrainageVodder博士淋巴引流手法sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识•vascularsystemincompletiontobloodvesselsystem脉管系的组成部分，最终淋巴流入静脉•„oneway“system单向流动•transportslymphfromperipherybacktoheart回流至心脏•function:evacuationofdebris(proteins,bacteria,...)功能：清除和过滤（蛋白质，细菌，。。。）•balanceoffiltrationandresorption:maintenanceofinterstitialpressure回收和过滤平衡：维持组织间液平衡sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识•initiallymphvessel是淋巴管道的起始段•coverwholebodysurface覆盖全身表面•glove-fingershaped,blindoriginginthetissue膨大的盲端起始•overlappingendothelialcells管壁由单层内皮细胞构成•windows:influxofintersitialfluid&lymph-obligatorysubstances组织液只能进不能出LymphCapillaries毛细淋巴管sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识LymphCapillaries毛细淋巴管•anchorfilaments彼此吻合成网•function:absorptionofinterstitialfluid,generatinglymph功能：收集细胞间隙液（组织液）称为淋巴液，简称淋巴•leadintotheprecollectors汇合形成淋巴管sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识LymphCapillaries毛细淋巴管sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Precollectors淋巴管•fewmusculartissue少量的肌肉组织•valvesavoidreflux内瓣膜防止回流•function:generationandtransportationoflymph功能：产生和运输淋巴液•leadintothecollectors汇合形成淋巴干sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Collectors淋巴干•above&belowmuscularfascia在肌肉筋膜上下•consistoflymphangions由淋巴管构成•builtofmusculartissue&valves肌肉组织和瓣膜结构•internalpressureincreases内压增加lymphangionscontractreflectory淋巴管反射性收缩sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Centralcollectors淋巴导管•Ductusthoracicus胸导管•Ductuslymphaticus左导管/右淋巴导管Venasubclavialeft&right(venousangle)左右静脉角sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Lymphnodes淋巴结•areinterposedintolymphvesselsystem在淋巴管行程的通路上•600lymphnodes600个淋巴结•function:biologicalfilter,specificimmunedefense,regulationofproteinandwaterconcentration功能：过滤淋巴液，免疫反应/免疫防御，调节蛋白质和水的密度/浓度sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Drainagedivides分水线sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Definitions定义•lymph淋巴:contentoflymphaticvessel淋巴管内液体•lymph-obligatorysubstances:allmaterial,thatmustbetransportedbythelymphaticsystem强制性淋巴物质:淋巴循环系统中流动的所有物质•lymphangio-motorfunction:autonomousmotorfunction,passivestretching,auxiliarypumps淋巴流动功能：自主运动功能，被动牵伸，辅助动力sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识TransportationofLymph淋巴流动Diffusion弥散•particlesmovefromplaceswithhigherconcentrationtoplaceswithlowerconcentration(molecularmovement)由高浓度向低浓度渗入（分子运动）•thelongerthetransitdistancethemoretimeisneeded吸收距离越长，所需时间越长Balanceofconcentration间液浓度平衡sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识TransportationofLymph淋巴流动Diffusion弥散sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识TransportationofLymph淋巴流动Osmosis渗透•2fluidswithdifferentconcentrationseperatedbysemipermeablemembrane被半透性的薄膜分离成两种浓度不同的液体solventwandersindirectionofhigherconcentration向高浓度方向溶解sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识TransportationofLymph淋巴流动Osmosis渗透sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识TransportationofLymph淋巴流动Transcytosis胞吞转运作用•activemodeoftransportation自主运输模式•proteins,fattyacidsenter/exitcellsthroughendo-andexocytosis蛋白质，脂肪酸进出内皮细胞，内吞作用，包裂外排/胞外分泌sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Transportationcapacity运送容量•underphysiologicalconditionstheamountoflymph-obligatorysubstancescorrespondstolymph-time-volume正常生理情况下可以使用淋巴-时间-体积表示淋巴的流量sorehaeducationContentsHistoryLymphsystemPathologyMLDTreatmentCDTAnatomy&PhysiologyofLymphSystem淋巴系统解剖学知识Transportationcapacity运输容量Safety-val