1. Lymph nodes examination Wail Alamoudi

2. Head & neck and clavicle UL (axillary, epitrochlear) LL (inguinal, femoral and popliteal) Abdomen ( paraaortic, liver and spleen ) Classification

3. Head & neck and clavicle There are approximately 300 lymph nodes in the neck

4. Head & neck and clavicle Inspection : Open mouth and see the 1.Tonsils 2.Adenoids (pharyngeal tonsils)

5. Perauricular Posterior auricular Occipital Submandibular Submental Tonsillar Anterior cervical Posterior cervical Deep cervical Supraclavicular Palpation

7. Examination of the Neck Perauricular : in front of the tragus of ear Posterior auricular: behind ear Occipital: at base of skull

8. Examination of the Neck Submandibular Submental Tonsillar: at angle of mandible

9. Anterior cervical: superficial to the sternocleidomastoid Posterior cervical : along anterior edge of the trapezius Deep cervical : lies below the sternomastoid and cannot be palpated without getting underneath the muscle Supraclavicular

10. The deep cervical chain of lymph nodes – Inform the patient that this procedure will cause some discomfort. – Hook your fingers under the anterior edge of the sternomastoid muscle. – Ask the patient to bend their neck toward the side you are examining. – Move the muscle backward and palpate for the deep nodes underneath

11. Axillary LN

12. 1.central lymph nodescentral lymph nodes 2.pectoral axillary lymph nodes (or "anterior")pectoral axillary lymph nodes 3.subscapular axillary lymph nodes (or "posterior")subscapular axillary lymph nodes 4.apical lymph nodes (or "medial" or "subclavicular")apical lymph nodes 5.brachial lymph nodes (or "lateral")brachial lymph nodes

15. Epitrochlear LN

17. Inguinal LN

18. 1. horizontal group (Along inguinal ligament) 2. vertical group (Along femoral vessels)

19. 1. Superomedial superficial inguinal 2. Superolateral superficial inguinal 3. Inferior superficial inguinal 4. Deep inguinal lymph nodes

20. Wail Alamoudi 0504649662

21. Examination of Lymph Nodes Small, mobile, discrete, nontender nodes are common and termed shotty Nodes are abnormal if greater than 1 cm and/or present greater than one month Hard nodes suggest malignancy Tender nodes suggest infection Rubbery nodes suggest lymphoma

22. in abnormal nodes, describe in terms of – location – size – delimination (discrete or matted together) – mobile or fixed – consistency (soft, hard, firm) – tenderness

23. scalene lymph nodes are located deep in the neck near the cervical vertebra.