Michael Lockwood, DO, FCA Jessica Alm , Undergraduate Teaching Fellow

1. MEDICAL MICROBIOLOGYSomatotopic and lymphatic relationships for integrated Patient Encounters Michael Lockwood, DO, FCA Jessica Alm, Undergraduate Teaching Fellow Kirksville College of Osteopathic Medicine A T Still University

2. Somatotopic Relationships to Autonomic Function T1-4 Head and Neck T1-6 Heart, Lungs T2-8 Upper Extremity T2-8 Esophagus T5-9 Upper GI System T10-11 Mid GI System T10-Kidney T 10-11-Ovaries, Testes T11-L1 Upper Ureter T12-L2 Bladder T12-L2 Lower GI System T12-L2 Uterus, Prostate T11-L2 Lower Extremity Sympathetic Nervous System

3. Somatotopic Relationships to Autonomic Function CN 111,VII,IX Head and Neck Vagus OA/AA Heart, Lungs Esophagus Upper GI System Mid GI System ? Kidney Ovaries, Testes Ureter Lower GI System Bladder Uterus, Prostate Upper Extremity None Sacrum-S2-4 Lower Extremity Parasympathetic Nervous System

4. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Head, Eyes, Ears, Nose or Throat Parasympathetic Component T1-4 HEAD and NECK CN III, VII, IX VAGUS OA/AA Sympathetic Component Examples: Cephalgia, Orbital Cellulitis, Otitis, Sinusitis, Rhinitis, Pharyngitis

5. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Heart Parasympathetic Component T1-6 HEART VAGUS OA/AA Sympathetic Component Examples: Angina Pectoris, Congestive Heart Failure, Myocarditis, Pericarditis

6. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Lungs and Bronchial Tree Parasympathetic Component T1-6 LUNGS, BRONCHI Note- Pleura, T1-12 VAGUS OA/AA Sympathetic Component Examples: Bronchitis, Lung Abscess, Pneumonia, Pleurisy, Lung Cancer, Histoplasmosis

7. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Upper Extremity Parasympathetic Component T2-8 UPPER EXTREMITY NONE Sympathetic Component Examples: Cellulitis, Osteomylitis, Lymphadenitis, Myositis, Osseous Tumors

8. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Esophagus Parasympathetic Component T1-5 ESOPHAGUS VAGUS OA/AA Sympathetic Component Examples: Gastric Acid Reflux (GERD), Esophageal Spasm, Varicosities, Carcinoma

9. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Stomach, Small Intestines, Gall Bladder, UGI Parasympathetic Component T5-9 UPPER GI (Greater Splanchnic Nerve) CN III, VII, IX VAGUS OA/AA Sympathetic Component Examples: Intestinal Parasites, H.pylori, Hepatic Abscess, Vomiting, Pancreatitis

10. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Ovaries, Testes, Kidney Parasympathetic Component T10-11 Ovaries Testes Kidney VAGUS OA/AA Sympathetic Component Examples: Orchitis, Ovarian Cysts, Pyelonephritis, Nephroliathisis, Nephritis

11. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Lower GI System, Colon and Rectum Parasympathetic Component T12-L2 Distal Colon Rectum SACRAL SPLANCNIC S2,3,4 Sympathetic Component Examples: Colitis, Irritable Bowel Syndrome, Rectal Abscess, Diarrhea, Parasites

12. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Unirary Bladder, Uterus, Adenexa, Prostate Parasympathetic Component T12-L2 Bladder Adenexa Uterus SACRAL SPLANCNIC S2,3,4 Sympathetic Component Examples: Chlamidia, Endometritis, Cystitis, Vaginitis, Urethritis, STD’s, Prostititis

13. Somatotopic Relationships to Autonomic Function for Patient Presentations Involving the Lower Extremity Parasympathetic Component T11-L2 Lower Extremity NONE Sympathetic Component Examples: Cellulitis, Osteomylitis, Myositis, Lymphadenitis, Osseous Tumors

14. Lymphatic Relationships for Patients Presentations Involving the Head, Eyes, Ears, Nose and Throat Location: Anterior and posterior to the Sternocleidomastoid Muscle Examples: Cephalgia, Orbital Cellulitis, Otitis, Sinusitis, Rhinitis, Pharyngitis

15. Lymphatic Relationships and Palpatory Areas for Patients Presentations Involving the Sinuses Above picture only 1,2,3=Frontal 4=Sphenoid 5=Ethmoid 6,7,8=Maxillary Examples: Maxillary, Ethmoidal, Sphenoidal Sinusitis. also Rhinitis

16. Lymphatic Relationships for Patients Presentations Involving the Thoracic Inlet Location: Thoracic Inlet (T1-4, Clavicles, Neck) Examples: Lymphatic Congestion, Asymmetry of Thoracic Inlet, Supraclavicular Lymphadenitis

17. Lymphatic Relationships for Patients Presentations Involving the Lungs and Bronchi Location: Supraclavicular Space Examples: Bronchitis, Lung Abscess, Pneumonia, Pleurisy, Histoplasmosis, COPD

18. Lymphatic Relationships for Patients Presentations Involving the Upper Extremity Location: In the axilla, including the posterior axillary fold Examples: Cellulitis, Osteomylitis, Lymphadenitis, Myositis, Osseous Tumors

19. Lymphatic Relationships for Patients Presentations Involving the Uterus, Adenexa, Urinary Bladder, Genitalia Location: Inguinal Fold Examples: Urethritis, Vaginitis, Gonorrhea, Endometritis, Prostititis, Cystitis

20. Lymphatic Relationships for Patients Presentations Involving the Lower Extremity Location: Inguinal fold, Popliteal space Examples: Cellulitis, Osteomeylitis, Myositis, Lymphadenitis, Osseous Tumors

21. Lymphatic Relationships for Patients Presentations Involving the Spleen Location: Upper left quadrant of the abdomen Examples: Infectious mononucleosis, Myelogenous leukemia, Leishmaniasis, Gaucher’s Disease

22. Lymphatic Relationships and Pain Patterns for Patient Presentations Involving the Abdomen Location: Occasionally the Supraclavicular space (Virchow’s node) Examples: Parietal Pleuritis, Sub-diaphragmatic Abscesses, Peritonitis

23. Lymphatic Pumps enhance Leukocyte Counts and Lymphatic Flow Click on Article to Open

24. Picture Creditsthanks to