1.
My Topic is about ………..?

2.
Exactly Lymph-nodes
Submandibular
Prescapular
Axillary
Inguinal
Popliteal
5 major
lymph nodes
on each side
of a dog

3.
 1- Basic Knowledge
 2- Clinical
Examination of
lymph nodes

4.
What is la lymph node
I am a gland
Part of lymph-System

5.
Basic Knowledge
Can we palpate all lymph nodes?
Question to Anastasia:

6.
A: No, Lymph nodes are palpable in the loose
subcutaneous tissues.
Basic Knowledge

7.
Are they all the same size?
Question to Omri:
Basic Knowledge

8.
A: No, their size will vary with location and species
Basic Knowledge

9.
What shape do they have?
Question to Kyriakos:
Basic Knowledge

10.
A: Lymph nodes are bean shaped and have a smooth contour.
Basic Knowledge

11.
Are they difficult to locate?
Question to Bella:
Basic Knowledge

12.
A: Yes and No.
A number of superficial lymph nodes are easily identified in
domestic animals others are more difficult to locate.
Basic Knowledge

13.
Clinical Examination of Lymph nodes
inspection palpation and if possible the course of lymphatics
Needle
aspirate/biopsy

14.
Physical examination of the lymph nodes
Physical examination of palpable lymph nodes involves:
palpation
Inspection reveals changes in normal contours caused
by enlargement.
Palpation provides more critical evaluation of any
changes.
inspection

15.
Lymph nodes that are normally palpable in small animals include:
mandibular
Prescapular
Inguinal
Popliteal
- Mandibular
- Prescapular
- Superficial inguinal
- Popliteal

16.
Occasionally the superficial cervical, superficial inguinal
and facial lymph nodes are palpable.
Lymph nodes that are not normally palpable in small animals include:
- Cervical
- Retropharyngeal
- Axillary
- accessory axillary
- femoral
Retropharyngeal
Accessory-
axillary
femoral
are palpable, disease is likely.
Cervical
Normally palpable
Not normally palpable

17.
A fine needle aspire or biopsy may also be taken.
During Examination

18.
When examine lymph nodes we do
not just look on the size of the node
 There are several physical characteristics we need
to check before making any diagnosis

19.
Physical characteristics to assess include:
Size
Response to palpation
Temperature of
the overlying skin

20.
Adhesion between the lymph node and
the skin or surrounding tissues
Lobulation
Consistency
Abscess formation, maturation and discharge
Physical characteristics to assess include also:

21.
And here we still do not make any
early diagnosis
 Do not just look at the lymph node the
owners are worrying about.
Always remember, the animal is an organism and everything is connected

22.
Examine the whole organism
Number of
palpable lymph
nodes involved
is noted
Lymph nodes are
normally flaccid or
tensely elastic,
easily displaces and
in one piece
Whether the
involvement is
unilateral or
bilateral

23.
Size
Lymph node enlargement can have
several reasons
Let´s check them out

24.
Lymph node size
Consider age and condition of an animal with lymphadenopathy
(Lymphadenopathy or adenopathy is disease of the lymph nodes, in which they are abnormal in size,
number, or consistency)
In cachectic patient loss of fat
surrounding the nodes makes
them seem more prominent
Size
Young animals are exposed
to a variety of new antigenic
stimuli, increased lymph node
size is a normal
immunological response
As an animal ages
lymph node size
often decreases and
the nodes become
difficult to palpate
Why?
Animal-Age + Condition

25.
Infiltration of
inflammatory
cells
response to
antigenic
stimulation
Also lymph node
enlargement may
be due to:
 Proliferation of lymphocytes + macrophages in
response to antigenic stimulation
 Infiltration with inflammatory cells
 Proliferation of hematopoietic neoplasia
 Infiltration by metastatic neoplastic cells
Neoplasia
cells
Abundant
cytoplasm
Small, raund
nucleus
Clumped and
irregular
chromatin
Increased nuclear
size

26.
5. Part of a
generalized
neoplasia of
lymphatic tissue
(myeloid leukemia)
1. Acute local
inflammatory
reaction which may
either resolve
completely or lead to
suppuration (equine
and puppy strangles)
2. Part of systemic
reaction to a major
specific disease
(malignant
catarrhal fever)
3. Chronic
inflammatory reaction
(chronic suppuration
of the sinuses)
4. Neoplasia, which
may be primary
(lymphosarcoma) or
metastasis as the
result of spread from
neighboring tissues
(caricinoma)
When assessing lymph node, remember enlargement could be due to:

27.
Get confidence in your touch
How?
A very important part in the
differentiation of lymphadenopathy is
to interpret your palpation

28.
Your palpation may aid in differentiation between
Reactive lympha denopathy
“it react to virus, bacteria…”
neoplastic
lymphadenopathy
 Reactive lymph nodes tend to be painful
 Tend to be less firm
 Marked inflammatory reactions
 Fungal disease
 Enlarged individuals are firm, freely moveable
+ NON PAINFUL lymphoma
 If lymph nodes are extremely firm metastaic
neoplasia are likely (or fibrosis)
 Metastatic neoplasia or extracapsular
lymphoma
Fixation of nodes to
surrounding tissues suggests:

29.
Etiology of lymph node enlargement unknown?
Distribution of lymphadenopathy may provide you
important clues to the etiology of lymph node
enlargement
If one or localized
set of lymph nodes
is involved these
lymphatic sites are
carefully examined
for infection,
inflammation or
neoplasia