Centimeter ruler
Skin-marking pencil
EXAMINATION
The lymphatic system is examined by inspection and palpation, region by region, during the examination of other body systems, as well as with palpation of the spleen.
Lymph Nodes Most Accessible to Inspection and Palpation
The more superficial the node, the more accessible it is to your palpation.
“Necklace” of Nodes
Parotid and retropharyngeal (tonsillar)
Superficial anterior cervical
Superficial posterior cervical
Preauricular and postauricular
Legs
Superficial superior inguinal
Superficial inferior inguinal
TECHNIQUE |
FINDINGS |
---|
HEAD AND NECK |
Inspect visible nodes |
Ask if patient is aware of any lumps. |
UNEXPECTED:Edema, erythema, red streaks, or lesions. |
 |
Palpate superficial nodes; note size, consistency, mobility, tenderness, warmth |
Bend patient’s head slightly forward or to side. Palpate gently with pads of second, third, fourth fingers. |
|
HEAD AND NECK |
Occipital nodes at base of skull
Postauricular nodes over mastoid process
Preauricular nodes in front of ears
Parotid and retropharyngeal nodes at angle of mandible
Submandibular nodes between angle and tip of mandible
Submental nodes behind tip of mandible |
EXPECTED:Nodes accessible to palpation but not large or firm enough to be felt.
UNEXPECTED:Enlarged, tender, red or discolored, fixed, matted, inflamed, or warm nodes; increased vascularity. |
 |
NECK |
Superficial cervical nodes at sternocleidomastoid
Posterior cervical nodes along anterior border of trapezius
Deep cervical nodes along anterior border of trapezius |
EXPECTED:Nodes accessible to palpation but not large or firm enough to be felt.
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