Sherpath Chapter 21, Peripheral Vascular System and Lymphatic System Assessing the Lymphatic System

Question 1 of 6

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Which is a correct method used when palpating lymph nodes?

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  • Begin with light pressureThe nurse should press lightly at first to avoid displacing the nodes. Once the node is identified, pressure can be increased to adequately assess.
• • Begin with heavy pressureHeavy pressure should not be used when palpating lymph nodes, because pressing too hard may displace the lymph nodes before the nurse has a chance to recognize their presence.
• • Identify all nodes with a marking pencilMarking with a skin pencil at the periphery of an enlarged node can help guide the assessment of change, but this should not be done for palpating all types of lymph nodes.
• • Focus on palpating the superficial nodesIt is common for superficial nodes not to be felt; the nurse should not limit palpation to these nodes.

Question 2 of 6

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List the sequence in which the nurse should palpate the lymph nodes of the neck.

1. Superficial cervical nodes at sternocleidomastoid
2. Posterior cervical nodes along anterior trapezius
3. Cervical nodes deep to sternocleidomastoid
4. Supraclavicular areas in angle of clavicle and sternocleidomastoid

The lymph nodes of the neck should be palpated after those in the head. The superficial cervical nodes at sternocleidomastoid should be palpated first, followed by the posterior cervical nodes along the anterior trapezius. The cervical nodes deep to sternocleidomastoid should be palpated next by probing gently with a thumb and finger around the muscle. Finally, the supraclavicular areas in the angle of clavicle and sternocleidomastoid should be palpated.

Question 3 of 6

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List the sequence in which the nurse should palpate the lymph nodes of the head.

1. Occipital nodes at skull base
2. Postauricular nodes over mastoid
3. Preauricular node in front of ear
4. Parotid/tonsillar nodes at mandible angle
5. Submandibular nodes between angle and tip of mandible
6. Submental nodes behind mandible tip

The lymph nodes of the neck should be palpated first, beginning with the occipital nodes at the skull base, followed by the postauricular nodes over mastoid and the preauricular node in front of the ear. Next, the parotid/tonsillar nodes at mandible angle and the submandibular nodes between the angle and tip of the mandible should be palpated. Finally, the submental nodes behind the mandible tip should be palpated.

Question 4 of 6

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Where are the brachial lymph nodes located?

• • LegsThe brachial lymph nodes are not accessible to inspection and palpation in the legs; the popliteal lymph nodes are located in the legs.
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  • ArmsThe brachial lymph nodes are most accessible to inspection and palpation in the arms.
• • NeckThe brachial lymph nodes are not accessible to inspection and palpation in the neck; the supraclavicular lymph nodes are located in the neck.
• • BreastThe brachial lymph nodes are not accessible to inspection and palpation in the breast area; the subcapsular lymph nodes are located in the breast.

Question 5 of 6

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Which lymph nodes in the lower extremities are accessible to inspection and palpation?

• • Axillary nodesThe axillary nodes are accessible to inspection and palpation in the upper, not the lower, extremities.
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  • Inguinal nodesThe inguinal nodes are accessible to inspection and palpation in the legs.
• Correct
  • Popliteal nodesOccasionally, the popliteal nodes are accessible to inspection and palpation in the legs.
• • Subcapsular nodesThe subcapsular nodes are located in the breast and are not accessible in the lower extremities.
• • Retropharyngeal nodesThe retropharyngeal nodes are adjacent to the ear and are not accessible in the lower extremities.

Question 6 of 6

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Which lymph nodes in the upper extremities are accessible to inspection and palpation?

• • SublingualThe sublingual nodes are accessible to inspection and palpation in the face, not the upper extremities.
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  • EpitrochlearThe epitrochlear nodes are accessible to inspection and palpation in the arms.
• • Anterior pectoral nodesThe anterior pectoral nodes are located in the breast and are not accessible in the upper extremities.
• • Retropharyngeal nodesThe retropharyngeal nodes are adjacent to the ear and are not accessible in the upper extremities.