Method Of Exam

Examine groups of cervical nodes systemically.
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 maxilla.
• Sub occipital lymph nodes are palpable immediately behind the ear.
• Posterior cervical nodes are behind sternomastoid and in front of Trapezius.
• Sub maxillary and Sub mental nodes: Roll your fingers against inner surface of Mandible with patient's head gently tilted towards one side.
• Tonsillar nodes: At the angle of Mandible.
• Deep cervical lymph nodes should be palpated, one side at a time. Gently bend the patient's head forward and roll your fingers over the deeper muscles along the carotid arteries.
• To feel Scalene nodes roll your fingers gently behind the clavicles. Instruct the patient to cough or to bear down like they are having a bowel movement. Occasionally an enlarged lymph node may pop up.

Describe size, location, mobility and character of the skin over the lymph nodes.

Note: The recommended position of the examiner for evaluation of cervical lymph nodes is from behind the patient. However, some find it equally easy to examine from the front.