Examination of superficial lymph nodes in dogs and cat
- 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