For which lymph nodes would the nurse check while assessing the patient’s neck

What are the aims of this information?

This page has been written to help you to understand more about checking your lymph nodes (‘glands’) yourself. It tells you what lymph nodes are, why you should check them and how often you should do a check. It also explains how to check lymph nodes. At the end of the page there is further information on where you can find out more.

The lymphatic system

Lymph nodes (‘glands’) are part of the lymphatic system, which is a network of tiny tubes that carry a colourless fluid called lymph through the skin and deeper parts of the body. Lymph fluid contains immune cells (lymphocytes), nutrients and waste materials.

Lymphatic vessels

Lymph fluid bathes the cells of the skin and internal organs. It drains into lymphatic vessels then larger lymphatic vessels called ducts in the neck before joining the blood stream near the heart (see Figure 1).

Lymph nodes

Lymph nodes (‘glands’) are small ‘bean-shaped’ nodules that contain millions of infection fighting lymphocyte cells. They are found at intervals along the lymphatic vessels like ‘beads on a string’. The lymph nodes filter out harmful organisms and abnormal cells before the lymph reaches the blood stream.

Lymph nodes can only be felt in certain areas of the body (see Figure 1):

• head and neck
• axilla (armpit)
• inguinal area (groin)
• back of knees

Lymph nodes are usually too small to feel. However, sometimes they can be felt in slim people as smooth pea-sized lumps, usually in the groin. Another time when they can be felt is when you have an infection, (for example, a sore throat or an ear infection which can make the neck lymph nodes enlarged, painful and tender as these are the nearest lymph nodes to the site of infection).

Lymph nodes can also become enlarged if cancer cells lodge in them. In this case, they are usually painless.

Why should you be checking your lymph nodes?

You may have been diagnosed with a skin cancer that can sometimes spread into the lymphatic system, for example, melanoma or squamous cell carcinoma.

At your check-up visits you will usually have the lymph nodes around the location of your skin cancer examined. For example, if the skin cancer was on your face then the nodes around your ears and neck will be examined, or, if the skin cancer was on your leg then the lymph nodes behind your knee and in your groin will be felt. The aim is to detect any enlargement of the lymph nodes at an early stage.

Some people are advised to check their lymph nodes between clinic appointments. If you are worried about enlarged lymph nodes, tell your doctor or nurse specialist straight away, rather than waiting until your next clinic appointment.

If you are unsure about anything in this leaflet please talk to your doctor or clinical nurse specialist, who can show you how and which lymph nodes to check.

How often should I check your lymph nodes?

It is usually advised that you check your lymph nodes once a month. This can be done at the same time as you check your skin for new or changing moles, lumps and bumps.

Non-urgent advice: When lymph nodes appear

Do not be alarmed if you feel a lymph node (especially if it is tender) as it may be due to an infection, but if it has not reduced in size in a week, contact your doctor or clinical nurse specialist.

Where can I get more information about checking lymph nodes?

Lymph Node Examination

A lymph node evaluation should be included in all new patients as part of the oral cancer triage.  Below is a video showing the proper technique and a written explanation of what is expected from dentists when performing a lymph node and thyroid gland examination.

NOTE: Video recorded previous to COVID-19 pandemic.  The PPE does not reflect the actual requirements for patient care.

1. Anterior Cervical Lymph Node Examination

The lymph node examination is performed with circular motion, identifying pain, and swollen ganglia or induration.

For the anterior cervical lymph node exam, palpate the lymph nodes in the neck using circular motion over the underlying tissues in each area.  If a palpable node is located, describe it with detail (painful, hard, indurated).

2. Posterior Cervical Lymph Node Examination

With the tips of the fingers, move the ECM muscle to the front, and follow the posterior line with gentle but firm pressure.  Again, if a palpable node is located, describe it with detail (painful, hard, indurated).

3. Supraclavicular Lymph Node Examination

Palpate the supraclavicular lymph nodes, placing the fingers above the clavicle using firm pressure in small circular movements and feel for gland across the top and slightly behind this bone.

4. Submandibular Lymph Node Examination

Follow the lower border of the mandible with the tips of the finger.

Thyroid Gland Palpation

Inspect the thyroid gland from the front and from the side and then palpate the thyroid gland using both hands from front or behind the patient.  Examine the thyroid gland while having the patient swallow and by pushing the thyroid gland from one side while palpating with the other hand.

Which lymph nodes are located in the neck quizlet?

What is the correct technique to assess the lymph nodes in the neck quizlet?

Which of the following is the best way to palpate the lymph nodes in the neck?

Which assessments would the nurse complete while examining the neck of a patient?