Reticuloendothelial

Question 1

End of bed

Answer 1

GI - body habitus (obese / cachexic), well / unwell, jaundice

Question 2

Inspection

Answer 2

Larger nodes are often clearly visible

If they are infected the overlying skin may be red

Question 3

Palpation - head and neck

Answer 3

Submental, submandibular, pre-auricular, posterior auricular, anterior cervical chain, supraclavicular, posterior cervical chain, occipital

Virchow’s node: enlarged left supraclavicular node

Question 4

Palpation - axillae

Answer 4

Stand to patient’d right
Place their right hand on your left shoulder and support their right elbow with your right hand
Use your left hand to examine the patient’s right axillae
Repeat for left axillae, examining with right hand

Question 5

Palpation - inguinal

Answer 5

Patient lying supine

Horizontal chain - just below the inguinal ligament
Vertical chain - along the line of the saphenous vein

Question 6

Palpation - hepatosplenomegaly

Answer 6

Palpate and percuss

Question 7

Findings

Answer 7

Site
Number
Size - measure
Consistency - hard and irregular / rubbery (infection)
Tenderness
Fixation
Overlying skin - redness, surface texture changes, oedema

Question 8

Also like to…

Answer 8

Full history
Examine inguinal and popliteal lymph regions
Examine thyroid
Perform an abdo exam for organomegaly (in presence of generalised lymphadenopathy)
Examine the are that drains the palpable lymph nodes (breast, genitals etc)