Lymph Nodes of the Head and Neck. With the patient's neck flexed slightly forward, inspect for noticeably visible node enlargement. For each of the following steps, plan to palpate the head and neck nodes (Figure 2) with both hands, one on each side. In many cases, the nodes are not palpable. Knowledge of grouping and location of cervical lymph nodes is necessary. For palpation of preauricular nodes, roll your finger in front of the ear, against the. 01/21/16 Clinical Skills Resource Centre, University of Liverpool, UK 1 LYMPH NODES OF THE HEAD AND NECK.


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Inform the patient that the exam may feel slightly uncomfortable. Reach your right hand up high in the left axilla, just behind the pectoralis muscle, with fingers pointing toward the mid-clavicle. Press your lymph node examination against the chest wall, and slide them downward to feel the central nodes.


If not done yet, palpate the infraclavicular apical and supraclavicular nodes. While still supporting the patient's left arm, palpate the epitrochlear nodes, which are located medially about 3 cm above the elbow.

Lymph Node Exam (OSCE) - Wikiversity

Lower Extremities Figure 4. Superficial Inguinal Lymph Nodes.

Superficial inguinal lymph nodes Figure 4 lymph node examination located high in the anterior thigh and drain various regions of the legs, abdomen, and perineum. These nodes are often large enough to palpate, even when normal.

Have the patient lay supine with hips lymph node examination extended or slightly flexed. Palpate a horizontal group of nodes along and just inferior to the inguinal ligament. These nodes drain the superficial buttock and lower abdomen, external genitalia excluding the testeslower vagina, anal canal, and perianal area.

Cervical Lymph Nodes

Palpate a vertical group of nodes medial to the horizontal group just inferior to the femoral artery pulse. These nodes lie along the upper lymph node examination vein and drain the same regions of the lower extremities.

The lymph node examination forms an essential part of the evaluation for infectious diseases and cancer.


The lymphatic system is comprised of organs including the spleen, lymphatic channels and lymph nodes. The channels are responsible for returning the lymph formed from extracellular fluid back to the venous circulation.

On its way, lymph node examination lymph encounters multiple lymph nodes. These nodes consist of highly concentrated clusters of lymphocytes, which play a critical role in maintaining immunity. Most lymph channels and nodes reside deep within the body and are too small to be assessed by physical examination.

However, superficial, larger nodes, close to or more than one centimeter in diameter-primarily located in the head and neck region, the axillae and the inguinal areas-can be lymph node examination and assessed.

Lymph nodes in these areas normally present as soft, smooth, movable, non-tender, bean-shaped structures imbedded in the subcutaneous tissue.

Lymphoreticular examination – OSCE guide

This condition is referred to as lymphadenopathy and it lymph node examination indicates an infection or, less commonly, a cancer in the area of lymph lymph node examination.

This video will review the anatomical location of the key lymph nodes as well as demonstrate the procedural steps of this examination. Let's begin by briefly reviewing the lymph nodes in the head and neck area. The list of palpable nodes in this region is extensive including the preauricular and posterior auricular nodes located in front and behind the ear, respectively, the mastoid node positioned superficial to the mastoid process and the occipital nodes found at the base of the skull.

Around the mandible are the tonsillar nodes, the submandibular nodes, and the submental nodes. Another group of nodes surround the sternomastoid muscle.

Lymphoreticular examination - OSCE guide | Geeky Medics

These include the superficial and deep cervical nodes. The last groups of nodes are the clavicular nodes, including the supra- and the infra-clavicular nodes.


The infraclavicular nodes are also known as the apical nodes. Upon entering the examination room, introduce yourself and briefly explain the maneuvers you're lymph node examination to conduct.

Before beginning with the examination, sanitize your hands by using topical disinfectant solution. Start by asking the patient to flex their neck slightly forward and inspect for noticeably lymph node examination nodes.

Following inspection, palpate the preauricular node located in front of the ear.