05/02/23 Clinical Skills Resource Centre, University of Liverpool, UK 1
LYMPH NODES OF THE HEAD AND NECK
05/02/23 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)
05/02/23 Clinical Skills Resource Centre, University of Liverpool, UK 3
Some landmarks to become familiar with
Upper border clavicle
Sternomastoidmuscle
Trapeziusmuscle
Thyroid cartilageCricoid cartilage
Cricothyroid ligament
Suprasternal notch
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Lateral view of Lymph nodes of the neck
Preauricular Postauricular
Occipital
Posterior cervical
Supraclavicular
Submental
Submandibular
Deep cervical
Superficial cervical
Tonsillar
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Anterior view of Lymph nodes of head and neck
Superficalcervical
Deep cervicalPosterior
cervical
Supraclavicular Infraclavicular
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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
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Lymph nodes can be examined from:
In front
or
Behind
↑ one hand at a time
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Positions in order usually examined 1Submental in the midline behind the tip of
the mandibleSubmandibular midway and along the inner
surface of the inferior margin of the mandibleTonsillar at the angle of the jawPre-auricular in front of the ear opposite the
tragusPost-auricular over the mastoid process
(behind the ear)
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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
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