Lymph nodes
examination
Wail Alamoudi
Classification
•
•
•
•
Head & neck and clavicle
UL
(axillary , epitrochlear)
LL
(inguinal , femoral and popliteal)
Abdomen
( paraaortic , liver and spleen )
Head & neck and
clavicle
• There are approximately 300
lymph nodes in the neck
Head & neck and clavicle
Inspection :
Open mouth and see the
1. Tonsils
2. Adenoids (pharyngeal tonsils)
Palpation
• Perauricular
• Posterior auricular
• Occipital
• Submandibular
• Submental
• Tonsillar
•
•
•
•
Anterior cervical
Posterior cervical
Deep cervical
Supraclavicular
Examination of the Neck
• Perauricular: in front of the tragus of ear
• Posterior auricular: behind ear
• Occipital: at base of skull
Examination of the Neck
• Submandibular
• Submental
• Tonsillar: at angle of mandible
• Anterior cervical: superficial to the sternocleidomastoid
• Posterior cervical: along anterior edge of the trapezius
• Deep cervical :
lies below the sternomastoid and cannot be palpated
without getting underneath the muscle
• Supraclavicular
• The deep cervical chain of lymph nodes
– Inform the patient that this procedure will cause some
discomfort.
– Hook your fingers under the anterior edge of the
sternomastoid muscle.
– Ask the patient to bend their neck toward the side
you are examining.
– Move the muscle backward and palpate for the deep
nodes underneath
Axillary LN
1. central lymph nodes
2. pectoral axillary lymph nodes (or "anterior")
3. subscapular axillary lymph nodes (or "posterior")
4. apical lymph nodes (or "medial" or "subclavicular")
5. brachial lymph nodes (or "lateral")
Epitrochlear LN
Inguinal LN
Inguinal LN
1. horizontal group (Along inguinal ligament)
2. vertical group (Along femoral vessels)
1. Superomedial superficial inguinal
2. Superolateral superficial inguinal
3. Inferior superficial inguinal
4. Deep inguinal lymph nodes
Wail Alamoudi
0504649662
Examination of Lymph Nodes
• Small, mobile, discrete, nontender nodes are
common and termed shotty
• Nodes are abnormal if greater than 1 cm
and/or present greater than one month
• Hard nodes suggest malignancy
• Tender nodes suggest infection
• Rubbery nodes suggest lymphoma
• in abnormal nodes, describe in terms of
– location
– size
– delimination (discrete or matted together)
– mobile or fixed
– consistency (soft, hard, firm)
– tenderness
• scalene lymph nodes are located deep in the
neck near the cervical vertebra.