Lymphnode
Protocols
Lymph node (LN) examination:
Points to note ~
- 1.Site of lymph node enlargement
- 2. Number: Single or multiple
- 3. Size of the largest one
- 4. Local temperature: Normal or raised - Pyogenic infection ,TB,Lyphoma
- 5. Tenderness: Present or absent
- 6. Nature: Matted- TB Infection or discrete - Lyphoma, Leukaemia
7. Consistency:
- Soft-pyogenic infection
- Rubbery-Hodgkins lymphoma
- Firm- Lyphocytic leukaemia
- Hard - Secondary deosit
9. Overlying skin colour: Normal or reddish
10. Discharging sinus: Present- TB or not
11.Adjacent structures: Free or adherent
112. Pressure symptoms e.g. Respiratory distress, dysphagia
facial puffiness etc.: Present or not
A) Generalised
- 1. Viral-- Epstein-Barr virus, cytomegalovirus and HIV
- 2.Bacterial-Brucellosis, syphilis.
- 3. Protozoal- Toxoplasmosis
- 4. Neoplastic--Lymphoma, acyte or chronic lymphocytic leukaemia.
- 5. Others --- Rheumatoid arthritis, systemic lupus ,erythematosus, Sarcoidosis etc
B) localised :
- 1.Infective --Acute or chronic, including viral, bacterial and other
- 2.Neoplasti- Secondary metastatic
Primary haematological, including Hodgkin's and non-Hodgkin’s lymphoma
Name of Cervical Lyphnode :
- 1. Sunmental
- 2.Sunmendibular
- 3. Pre-auricular
- 4.post-auricular
- 5.Anterior cervical
- 6.Subraclavicular
- 7. posterior cervical chain
- 8. Occipital
Palpation of cervical lymphnode Procedure:
- 1. Patient's position - on sitting
- 2. Examiner's position-on standing, from behind the patient.
- 3. Palpate the cervical group of lymphnodes by the fingers of both hands (middle fingers) in following order .
Axillary group lyphnode:
- 1. Anterior
- 2. posterior
- 3. lateral
- 4.medial
- 5.central
- 6. Apical
Palpation of axillary l_ymphnode :
Procedure :
- 1. Patient's position - sitting
- 2. Stand infront of the patient, supporting the hand on the side under examination. | .
- 3. Palpate the axilla by opposite hand
- 4 it is better to examine the posterior group of lymphnode from back of the patient