The axillary lymph nodes are a group of lymph nodes located in the axillary region of the body, commonly known as the armpit. These nodes receive lymphatic drainage from various areas of the upper limb, breast, and upper trunk quadrant. Here are the main groups of axillary lymph nodes and the paths of the relevant collectors:
Anterior Axillary Lymph Nodes:
Located along the lateral edge of the pectoralis minor muscle.
Receive lymphatic drainage from the lateral aspect of the breast, including the lateral quadrants, as well as the lateral part of the arm and forearm.
Lymphatic vessels from the anterior axillary nodes converge to form the subscapular trunk.
Posterior Axillary Lymph Nodes:
Situated along the posterior axillary fold, posterior to the axillary vein.
Receive lymphatic drainage from the posterior aspect of the upper arm, posterior chest wall, and the superficial back.
Lymphatic vessels from the posterior axillary nodes converge to form the subscapular trunk.
Central Axillary Lymph Nodes:
Located in the central axillary space, deep to the pectoralis minor muscle.
Receive lymphatic drainage from the anterior and posterior axillary nodes.
Lymphatic vessels from the central axillary nodes converge to form the subclavian trunk.
Subscapular (Posterior) Lymph Nodes:
Situated along the subscapular vein and artery, deep to the posterior axillary nodes.
Receive lymphatic drainage from the posterior aspect of the thoracic wall, scapular region, and the posterior aspect of the upper limb.
Lymphatic vessels from the subscapular nodes converge to form the subclavian trunk.
Lateral Axillary Lymph Nodes:
Found along the lateral border of the axillary vein.
Receive lymphatic drainage from the upper limb, lateral chest wall, and the lateral aspect of the breast.
Lymphatic vessels from the lateral axillary nodes converge to form the subclavian trunk.
Pectoral (Anterior) Lymph Nodes:
Located along the lateral thoracic vessels, deep to the pectoralis major muscle.
Receive lymphatic drainage from the anterior chest wall, including the medial aspect of the breast.
Lymphatic vessels from the pectoral nodes converge to form the subclavian trunk.
These axillary lymph nodes and their collectors play a crucial role in draining lymphatic fluid from the upper limb, breast, and upper trunk quadrant, contributing to immune function and fluid balance in these areas.
Case Study: Post-Traumatic or Postoperative Swollen Shoulder
Symptoms:
Pronounced swelling and edema in the right shoulder region
Limited range of motion and stiffness in the right shoulder joint
Discomfort and tenderness in the swollen shoulder area
Difficulty performing activities of daily living due to shoulder swelling and stiffness
Treatment Plan: A comprehensive treatment plan was developed for Sarah, focusing on Manual Lymphatic Drainage therapy to address the lymphatic component of her post-traumatic or postoperative swelling and promote tissue healing.
Session Details:
Session Duration: 60 minutes
Frequency: Twice weekly for six weeks
Techniques Used: Gentle, targeted MLD strokes following the Vodder method, focusing on the lymphatic pathways of the shoulder, upper arm, and upper trunk. Additional techniques, such as lymphatic pumping and gentle compression, were utilised to stimulate lymphatic flow and reduce swelling.
Session Progression:
Assessment and Evaluation: Conducted a thorough assessment of the shoulder swelling, range of motion, and tissue texture. Baseline measurements were recorded to track progress over the course of treatment.
Treatment Initiation: MLD therapy began with gentle strokes over the unaffected lymphatic drainage pathways, gradually progressing to the swollen shoulder region. Careful attention was given to avoid exacerbating pain or discomfort during the session.
Focused Attention: Special focus was placed on stimulating lymphatic drainage from the affected shoulder, targeting lymphatic vessels and nodes in the axillary region and upper trunk. Gentle, rhythmic movements were applied to encourage fluid movement away from the swollen area.
Education and Self-Care: Educated on self-care techniques, including proper shoulder positioning, elevation, and gentle exercises to promote circulation and mobility. Provided guidance on managing shoulder swelling and stiffness in daily life.
Follow-Up and Monitoring: Progress was monitored closely throughout the treatment period. Any changes in symptoms or response to therapy were documented, and adjustments were made to the treatment plan as needed.
Outcome: After six weeks of MLD therapy, reported significant improvement in shoulder swelling and discomfort. The swelling had noticeably decreased, and demonstrated improved range of motion and flexibility in right shoulder. Expressed satisfaction with the treatment outcomes and indicated plans to continue with self-care practices to maintain the benefits of MLD.
Conclusion: Manual Lymphatic Drainage therapy proved to be an effective intervention for post-traumatic or postoperative swollen shoulder. By addressing the lymphatic component of the condition and incorporating tailored techniques for unique needs, MLD facilitated fluid drainage, reduced swelling, and improved overall function and comfort in the affected shoulder. This case highlights the potential benefits of MLD in managing swelling and promoting recovery following traumatic or surgical injuries to the shoulder, emphasising the importance of a patient-centred approach to treatment.
In the case of post-traumatic or postoperative swollen shoulder, there are specific regions that should be avoided during Manual Lymphatic Drainage (MLD) therapy. These regions include:
Areas with Open Wounds or Incisions: Any areas with open wounds, surgical incisions, or sutures should be avoided to prevent the risk of infection and potential disruption of wound healing. It's essential to allow these areas to heal properly without manipulation.
Acutely Inflamed or Irritated Tissue: Regions with acute inflammation, redness, heat, or tenderness should be avoided during MLD therapy. Manipulating inflamed tissue can exacerbate inflammation and discomfort, delaying the healing process.
Regions with Compromised Circulation: Areas with compromised circulation, such as those affected by deep vein thrombosis (DVT) or vascular compromise, should be treated with caution or avoided altogether. MLD may interfere with circulation and exacerbate underlying vascular issues.
Lymph Nodes Affected by Cancer or Lymphedema: If the patient has a history of cancer or lymphedema, it's essential to avoid stimulating lymph nodes in the affected area to prevent the risk of exacerbating lymphedema or spreading cancer cells through the lymphatic system.
Painful or Tender Areas: Any regions that are particularly painful or tender to the touch should be treated with caution or avoided during MLD therapy. It's important to prioritise the patient's comfort and avoid causing undue discomfort during treatment.
By avoiding these regions during MLD therapy, therapists can ensure the safety and effectiveness of the treatment while minimising the risk of complications or adverse reactions. Additionally, a thorough assessment of the patient's condition and medical history should be conducted to tailor the treatment plan accordingly and determine any specific contraindications or precautions.
Case Study: Sympathetic Reflex Dystrophy (Sudeck's Syndrome) of the Hand
Symptoms:
Severe burning pain and sensitivity in the right hand
Pronounced swelling and edema in the affected hand and fingers
Stiffness and limited range of motion in the right hand joints
Skin changes, including redness and increased temperature in the affected area
Treatment Plan: A customised treatment plan was developed, focusing on Manual Lymphatic Drainage therapy to address the lymphatic component of the sympathetic reflex dystrophy and promote tissue healing.
Session Details:
Session Duration: 60 minutes
Frequency: Three times weekly for eight weeks
Techniques Used: Gentle, targeted MLD strokes following the Vodder method, focusing on the lymphatic pathways of the hand, wrist, forearm, and upper arm. Additional techniques, such as lymphatic pumping and gentle compression, were utilised to stimulate lymphatic flow and reduce swelling.
Session Progression:
Assessment and Evaluation: Conducted a thorough assessment of the hand swelling, pain levels, and tissue texture. Baseline measurements were recorded to track progress over the course of treatment.
Treatment Initiation: MLD therapy began with gentle strokes over the unaffected lymphatic drainage pathways, gradually progressing to the swollen hand and fingers. Careful attention was given to avoid exacerbating pain or discomfort during the session.
Focused Attention: Special focus was placed on stimulating lymphatic drainage from the affected hand, targeting lymphatic vessels and nodes in the hand, wrist, and forearm. Gentle, rhythmic movements were applied to encourage fluid movement away from the swollen area.
Education and Self-Care: Educated on self-care techniques, including proper hand positioning, elevation, and gentle exercises to promote circulation and mobility. Provided guidance on managing hand pain and stiffness in daily life.
Follow-Up and Monitoring: Progress was monitored closely throughout the treatment period. Any changes in symptoms or response to therapy were documented, and adjustments were made to the treatment plan as needed.
Outcome: After eight weeks of MLD therapy, reported significant improvement in hand pain, swelling, and stiffness. The burning sensation had diminished, and demonstrated improved range of motion and flexibility in the right hand. Expressed satisfaction with the treatment outcomes and indicated plans to continue with self-care practices to maintain the benefits of MLD.
Conclusion: Manual Lymphatic Drainage therapy proved to be an effective intervention for sympathetic reflex dystrophy (Sudeck's syndrome) of the hand. By addressing the lymphatic component of the condition and incorporating tailored techniques for unique needs, MLD facilitated fluid drainage, reduced swelling, and improved overall function and comfort in the affected hand. This case highlights the potential benefits of MLD in managing symptoms associated with sympathetic reflex dystrophy, emphasising the importance of a patient-centred approach to treatment.
In the case of sympathetic reflex dystrophy (Sudeck's syndrome) of the hand, there are specific regions that should be avoided during Manual Lymphatic Drainage (MLD) therapy. These regions include:
Areas with Acute Inflammation or Hyperalgesia: Any areas exhibiting signs of acute inflammation, such as redness, heat, or swelling, should be treated with caution or avoided altogether. Manipulating inflamed tissue can exacerbate pain and inflammation, worsening symptoms associated with sympathetic reflex dystrophy.
Painful or Tender Areas: Regions of the hand that are particularly painful or tender to the touch should be treated with care during MLD therapy. Excessive pressure or manipulation of tender areas can increase discomfort and may trigger a pain response.
Areas with Skin Lesions or Abrasions: Any areas of the skin with open wounds, lesions, or abrasions should be avoided during MLD therapy to prevent the risk of infection and potential disruption of the healing process. These areas should be allowed to heal undisturbed.
Regions with Impaired Sensation: If the client exhibits impaired sensation in certain areas of the hand, it's essential to proceed with caution during MLD therapy to avoid causing injury or discomfort. Gentle techniques should be employed, and feedback from the client should be continuously monitored.
Lymph Nodes Affected by Cancer or Lymphedema: If the client has a history of cancer or lymphedema affecting the lymph nodes in the arm or hand, it's crucial to avoid stimulating these lymph nodes during MLD therapy to prevent the risk of exacerbating lymphedema or spreading cancer cells through the lymphatic system.
By avoiding these regions during MLD therapy, therapists can ensure the safety and effectiveness of the treatment while minimising the risk of exacerbating symptoms or causing complications. Additionally, a thorough assessment of the client's condition and medical history should be conducted to tailor the treatment plan accordingly and determine any specific contraindications or precautions.
Case Study: Hand Swelling with Hemiparesis or Other Paralysis
Symptoms:
Swelling and edema in the left hand and fingers
Weakness and limited mobility in the left hand joints
Discomfort and heaviness in the swollen hand area
Impaired sensation or tingling in the affected hand
Treatment Plan: A comprehensive treatment plan was developed, focusing on Manual Lymphatic Drainage therapy to address the lymphatic component of his hand swelling and promote tissue healing.
Session Details:
Session Duration: 60 minutes
Frequency: Three times weekly for eight weeks
Techniques Used: Gentle, targeted MLD strokes following the Vodder method, focusing on the lymphatic pathways of the hand, wrist, forearm, and upper arm. Additional techniques, such as lymphatic pumping and gentle compression, were utilised to stimulate lymphatic flow and reduce swelling.
Session Progression:
Assessment and Evaluation: Conducted a thorough assessment of the hand swelling, mobility, and tissue texture. Baseline measurements were recorded to track progress over the course of treatment.
Treatment Initiation: MLD therapy began with gentle strokes over the unaffected lymphatic drainage pathways, gradually progressing to the swollen left hand and fingers. Careful attention was given to avoid exacerbating pain or discomfort during the session.
Focused Attention: Special focus was placed on stimulating lymphatic drainage from the affected hand, targeting lymphatic vessels and nodes in the hand, wrist, and forearm. Gentle, rhythmic movements were applied to encourage fluid movement away from the swollen area.
Education and Self-Care: Educated on self-care techniques, including proper hand positioning, elevation, and gentle exercises to promote circulation and mobility. Provided guidance on managing hand swelling and weakness in daily life.
Follow-Up and Monitoring: Progress was monitored closely throughout the treatment period. Any changes in symptoms or response to therapy were documented, and adjustments were made to the treatment plan as needed.
Outcome: After eight weeks of MLD therapy, Reported significant improvement in hand swelling and mobility. The swelling had noticeably decreased, and demonstrated improved strength and range of motion in his left hand. Expressed satisfaction with the treatment outcomes and indicated plans to continue with self-care practices to maintain the benefits of MLD.
Conclusion: Manual Lymphatic Drainage therapy proved to be an effective intervention for hand swelling with hemiparesis following a stroke. By addressing the lymphatic component of his condition and incorporating tailored techniques for his unique needs, MLD facilitated fluid drainage, reduced swelling, and improved overall function and comfort in his affected hand. This case highlights the potential benefits of MLD in managing symptoms associated with hand swelling and paralysis, emphasising the importance of a patient-centred approach to treatment.
In the case of hand swelling with hemiparesis or other paralysis, there are specific regions that should be avoided during Manual Lymphatic Drainage (MLD) therapy. These regions include:
Areas with Open Wounds or Skin Lesions: Any areas with open wounds, skin lesions, or abrasions should be avoided during MLD therapy to prevent the risk of infection and potential disruption of the healing process. These areas should be allowed to heal undisturbed.
Painful or Tender Areas: Regions of the hand that are particularly painful or tender to the touch should be treated with care during MLD therapy. Excessive pressure or manipulation of tender areas can increase discomfort and may exacerbate pain.
Regions with Impaired Sensation: If the client exhibits impaired sensation in certain areas of the hand, it's essential to proceed with caution during MLD therapy to avoid causing injury or discomfort. Gentle techniques should be employed, and feedback from the client should be continuously monitored.
Areas with Acute Inflammation or Hyperalgesia: Any areas exhibiting signs of acute inflammation, such as redness, heat, or swelling, should be treated with caution or avoided altogether. Manipulating inflamed tissue can exacerbate pain and inflammation, worsening symptoms associated with hemiparesis or paralysis.
Lymph Nodes Affected by Cancer or Lymphedema: If the client has a history of cancer or lymphedema affecting the lymph nodes in the arm or hand, it's crucial to avoid stimulating these lymph nodes during MLD therapy to prevent the risk of exacerbating lymphedema or spreading cancer cells through the lymphatic system.
By avoiding these regions during MLD therapy, therapists can ensure the safety and effectiveness of the treatment while minimising the risk of exacerbating symptoms or causing complications. Additionally, a thorough assessment of the client's condition and medical history should be conducted to tailor the treatment plan accordingly and determine any specific contraindications or precautions.
Case Study: Pronounced Hematoma on the Back of a Competitive Athlete
Symptoms:
Pronounced hematoma (bruise) on the back, covering a large area
Swelling and edema surrounding the hematoma
Tenderness and pain in the affected area, exacerbated by movement
Limited range of motion and stiffness in the back muscles
Treatment Plan: A comprehensive treatment plan was developed, focusing on Manual Lymphatic Drainage (MLD) therapy to address the lymphatic component of his hematoma and promote tissue healing.
Session Details:
Session Duration: 60 minutes
Frequency: Three times weekly for six weeks
Techniques Used: Gentle, targeted MLD strokes following the Vodder method, focusing on the lymphatic pathways of the back, shoulders, and upper trunk. Additional techniques, such as lymphatic pumping and gentle compression, were utilised to stimulate lymphatic flow and reduce swelling.
Session Progression:
Assessment and Evaluation: Conducted a thorough assessment of the hematoma, bruising pattern, and tissue texture. Baseline measurements were recorded to track progress over the course of treatment.
Treatment Initiation: MLD therapy began with gentle strokes over the unaffected lymphatic drainage pathways, gradually progressing to the swollen area of the back. Careful attention was given to avoid exacerbating pain or discomfort during the session.
Focused Attention: Special focus was placed on stimulating lymphatic drainage from the affected area, targeting lymphatic vessels and nodes in the back, shoulders, and upper trunk. Gentle, rhythmic movements were applied to encourage fluid movement away from the hematoma.
Education and Self-Care: Educated on self-care techniques, including proper posture, rest, and gentle stretching exercises to promote circulation and mobility in the back muscles. Provided guidance on managing pain and swelling in daily life.
Follow-Up and Monitoring: Progress was monitored closely throughout the treatment period. Any changes in symptoms or response to therapy were documented, and adjustments were made to the treatment plan as needed.
Outcome: After six weeks of MLD therapy, reported significant improvement in the hematoma and associated symptoms. The bruising had diminished, and the swelling had noticeably decreased, allowing for improved range of motion and comfort in the back muscles. Expressed satisfaction with the treatment outcomes a