THE LYMPHATIC EXAMINATION LYMPH NODE CHARACTERISTICS SIZE 1

THE LYMPHATIC EXAMINATION

LYMPH NODE CHARACTERISTICS • SIZE – > 1 CM ABNORMAL > 5 CM IS USUALLY MALIGNANT • CONSISTENCY – HARD – MALIGNANT FLUCTUANT – NECROTIC PEA SIZE – “SHOTTY” • MATTING – MALIGNANT, INFECTIOUS • TENDERNESS - INFLAMATION

LYMPH NODE DISTRIBUTION • DIFFUSE METASTATIC MALIGNANCY LYMPHOMA – LEUKEMIA SARCOID MONONUCLEOSIS TB AIDS SYPHILIS COLLAGEN VASCULAR DISEASE • LOCALIZED INFECTION BENIGN MALIGNANT

ALWAYS EXAMINE THE FOLLOWING NODAL GROUPS • • • HEAD AND NECK AXILLARY EPITROCHLEAR INGUINAL FEMORAL PREAURICULAR

LYMPH NODES OF INTEREST • DELPHIAN NODES – LOCATED MIDLINE ON THYROID MEMBRANE. IMPLIES THYROID ABNORMALITY OR CARCINOMA. • SISTER MARY JOSEPH’S NODULE PERIUMBILICAL NODULE OR MASS. IMPLIES PELVIC OR INTRAABDOMINAL MALIGNANCY. • SCROFULA – TUBERCULOUS LYMPHADENITIS OF THE CERVICAL NODES.

HEAD AND NECK CONJUNCTIVITIS SCALP NOSE, LIP, ANTERIOR TONGUE DANDRUFF TEETH NASOPHARYNGEAL TUMOR OTITIS ON THE RIGHT BREAST, LUNG ON THE LEFT (TROISIER’S NODE) BREAST, LUNG, INTRAABDOMINAL, PELVIC VIRCHOW’S NODE IF ENLARGED FROM A GASTRIC CARCINOMA

LYMPHATIC DRAINAGE OF THE BREAST

EPITROCHLEAR AND AXILLARY NODES HANDS FOREARM SARCOID NON – HODGKIN’S LYMPHOMA INFECTIOUS, MALIGNANT

INGUINAL AND FEMORAL NODES MALIGNANT INFECTIOUS INGUINAL FEMORAL FOOT, LEG