When examining the lungs, the lymph node stations of the neck, the supraclavicular fossae and the axillae also have to be examined. Swollen glands in the supraclavicular fossae can point, amongst other things, to a bronchial carcinoma metastasised to the lymphatic system, a malignant lymphoma or to sarcoidosis.
Procedure
Stand behind the patient. Palpate the following areas:
- submandibular area on both sides (beneath the mandibula) [Figure 9]
Figure 9: palpation of the lymph node stations; submandibular
- anterior to the sternocleidomastoid muscle on both sides [Figure 10]
Figure 10: palpation of the lymph node stations; anterior to the sternocleidomastoid muscle
- posterior to the sternocleidomastoid muscle on both sides [Figure 11]
Figure 11: palpation of the lymph node stations; posterior to the sternocleidomastoid muscle
- supraclavicular area on both sides (with two finger tips in the supraclavicular cavities) [Figure 12]
Figure 12: palpation of the lymph node stations; subclivicular area on both sides
- both axillary areas (high in both axillae) [Figure 13]
Figure 13: palpation of the lymph node stations; axillary areas