Lymphadenopathy | Respiratory Exam - MedSchool
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Lymphadenopathy refers to enlargement of the lymph nodes, which is often painful. It is important to carefully assess for lymph node enlargement, as this suggests infective, inflammatory or malignant pathology.
The Patient
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Chest Inspection
Chest Palpation
Chest Percussion
Chest Auscultation
 

Lymphadenopathy

 
 
On this page:Cervical Lymph NodesAxillary Lymph Nodes

Overview

  • Lymphadenopathy refers to enlargement of the lymph nodes, which is often painful. It is important to carefully assess for lymph node enlargement, this suggests infective, inflammatory or malignant pathology.

    • How to Elicit

    • Using the pulps of the fingers, gently palpate each of the lymph node groups within the cervical and axillary regions.

    • Feel For

    • Size - normally <10mm
    • Tenderness
    • Consistency - hard (metastasis), rubbery (lymphoma), soft (reactive)
    • Mobility - mobile or tethered to underlying structures

    • Causes of Lymphadenopathy

    • Infection - bacterial, viral, fungal, protozoal
    • Inflammatory disorders - lupus, rheumatoid arthritis
    • Malignancy - leukaemia, lymphoma, solid organ malignancies
    • Medications - allopurinol, atenolol, cephalosporins, penicillin, phenytoin
    • Benign idiopathic

Cervical Lymph Nodes

  • Submental nodes - immediately below chinTeeth, oral mucosa, tongue
  • Submandibular nodes - Along angle of mandibleFloor of mouth
  • Anterior cervical nodes - over sternocleidomastoidPosterior pharynx, tonsils, parotid
  • Posterior cervical nodes - posterior to sternocleidomastoidsScalp, posterior neck
  • Suboccipital nodes - below occiputInferior scalp
  • Preauricular nodes - Anterior to pinnaEyelids, conjunctivae
  • Postauricular nodes - posterior to pinnaExternal auditory meatus, pinna, scalp
  • Right supraclavicular node - in right supraclavicular fossaMediastinum, lungs, oesophagus
  • Left supraclavicular node (Virchow's node) - in left supraclavicular fossaChest, abdomen

Axillary Lymph Nodes

  • Pectoral nodes - anteriorly, behind pectoralis major muscleAnterolateral chest wall, central / lateral breast
  • Subscapular nodes - posteriorly, in front of subscapularis musclePosterior neck and chest wall
  • Lateral nodes - lateral aspect of armpitMedial hand, forearm and arm
  • Central nodes - within centre of axillaDrainage from pectoral, subscapular and lateral nodes
  • Infraclavicular nodes - below distal aspect of clavicleLateral hand, forearm and arm
  • Apical nodes - medially, at lateral border of 1st ribDrainage from all axillary lymph nodes
Last updated on January 24th, 2020
 
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