Lymph Node Examination
- 1. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 1 LYMPH NODES OF THE HEAD AND NECK
- 2. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 2 Sites of possible palpable lymphadenopathy Lymph nodes are part of the immune system and are involved in tissue fluid circulation They may enlarge for a number of reasons, including infection, malignancy and systemic disease As part of a general examination all groups should be assessed Certain groups are assessed as part of limited local examinations, e.g. axillary in breast examination and cervical in ENT examination Cervical Supraclavicular Axillary Para-aortic (intra-abdominal) Inguinal Epitrochlear (behind the elbow)
- 3. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 3 Some landmarks to become familiar with Upper border clavicle Sternomastoid muscle Trapezius muscle Thyroid cartilage Cricoid cartilage Cricothyroid ligament Suprasternal notch
- 4. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 4 Lateral view of Lymph nodes of the neck Preauricular Postauricular Occipital Posterior cervical Supraclavicular Submental Submandibular Deep cervical Superficial cervical Tonsillar
- 5. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 5 Anterior view of Lymph nodes of head and neck Superfical cervical Deep cervicalPosterior cervical Supraclavicular Infraclavicular
- 6. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 6 Examination of head and neck lymph nodes The nodes of the neck may be examined from in front or behind with the patient seated and the neck exposed Palpate one side at a time Warn the patient that you will be standing behind them if you choose this approach Method for either approach •Use the fingertips •Apply moderate pressure and rotate fingertips in the each of the areas where nodes might be found •Nodes are not normally palpable •Cervical lymph nodes are frequently enlarged in response to upper respiratory tract infections
- 7. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 7 Lymph nodes can be examined from: In front or Behind ↑ one hand at a time
- 8. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 8 Positions in order usually examined 1 Submental in the midline behind the tip of the mandible Submandibular midway and along the inner surface of the inferior margin of the mandible Tonsillar at the angle of the jaw Pre-auricular in front of the ear opposite the tragus Post-auricular over the mastoid process (behind the ear)
- 9. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 9 Positions in order usually examined 2 Occipital back of the head at the base of the skull Posterior cervical run along the anterior border of the trapezius muscle Superficial cervical along the body of the sternomastoid Deep cervical deep to the lateral border of the sternomastoid. They are difficult to feel, press more firmly along the body of the sternomastoid. Supra clavicular lie on top of the clavicle at the lateral border of the sternomastoid medially. Infraclavicular lie along the inferior border of the clavicle
- 10. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 9 Positions in order usually examined 2 Occipital back of the head at the base of the skull Posterior cervical run along the anterior border of the trapezius muscle Superficial cervical along the body of the sternomastoid Deep cervical deep to the lateral border of the sternomastoid. They are difficult to feel, press more firmly along the body of the sternomastoid. Supra clavicular lie on top of the clavicle at the lateral border of the sternomastoid medially. Infraclavicular lie along the inferior border of the clavicle