Physical examination maneuver

Physical Exam

Axillary Lymph Node Palpation

★ Free sample
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How to Perform

With the patient seated, slightly abduct and support the arm of the axilla being examined so the muscles remain relaxed. Use the finger pads of your other hand to reach as high as possible into the apex of the axilla. Press the finger pads against the tissues and palpate with small circular motions while gradually drawing the hand downward through the central axilla. Then repeat the maneuver with the finger pads directed toward the anterior wall for the pectoral nodes, the posterior wall for the subscapular nodes, and the lateral wall along the upper humerus for the lateral nodes. Lower the arm to the patient's side and, with the finger pads, palpate for the infraclavicular nodes just below the clavicle and along the deltopectoral groove between the pectoralis major and the deltoid. Repeat on the opposite side. Then, with the patient relaxed and the shoulders dropped, hook the finger pads behind each clavicle and palpate deeply into the supraclavicular fossa, comparing the two sides and asking the patient to take a deep breath if no node is felt. Note the size, consistency, tenderness, and mobility of any palpable node.

How to Interpret

Showing 4 of 7 findings

Breast Cancer

Palpable axillary lymphadenopathy in a patient with known or suspected breast cancer
Rule in
Somewhat helpfulNo CI
Rule out
Not helpfulNo CI
Evidence:ModerateResearch in progress

HIV Infection

Axillary adenopathy (in a patient with tuberculosis)
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate

Infectious Mononucleosis

Axillary or inguinal lymphadenopathy in an adolescent or young adult
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Moderate

Malignant Lymphadenopathy

Unexplained lymphadenopathy located in the axilla (rather than another node region)
Rule in
Not helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate

Related Bedside Tests

Head and Neck Lymph Node PalpationMembers
Sign in
Head and Neck Lymph Node Palpation
Rule in:VHInfectious Mononucleosis, HMalignant Lymphadenopathy, SHThyroid Carcinoma +9 more
Rule out:SHMalignant Lymphadenopathy, MHInfectious Mononucleosis, ICConjunctivitis +9 more
🎬Video coming soon
Inguinal Lymph Node Palpation
Rule in:SHInfectious Mononucleosis, ICMalignant Lymphadenopathy, IELymphoma +2 more
Rule out:MHInfectious Mononucleosis, NHMalignant Lymphadenopathy, IELymphoma +2 more
🎬Video coming soon
Spleen Palpation
Rule in:VHSplenomegaly, HMalaria, SHCirrhosis +13 more
Rule out:SHMyelofibrosis, MHInfectious Mononucleosis, MHSplenomegaly +13 more
How to Palpate Lymph NodesMembers
Sign in
How to Palpate Lymph Nodes
Rule in:IEIntra-abdominal Malignancy, IELymphoma, IELymphoproliferative Disease +4 more
Rule out:IEIntra-abdominal Malignancy, IELymphoma, IELymphoproliferative Disease +4 more
Breast PalpationMembers
Sign in
Breast Palpation
aka Clinical breast examination
Rule in:VHBreast Cancer, IEIntraductal Papilloma
Rule out:VHBreast Cancer, IEIntraductal Papilloma
C-spine and Neck PalpationMembers
Sign in
C-spine and Neck Palpation
Rule in:SHCervical Spine Injury, IECervical Spondylolisthesis, IEEsophageal Rupture +6 more
Rule out:SHCervical Spine Injury, IECervical Spondylolisthesis, IEEsophageal Rupture +6 more

Related Systems / Regions

HematologicImmunologicReproductiveUpper Extremities

Related Diagnoses

Breast CancerGranulomatous LymphadenitisHIV InfectionInfectious MononucleosisLymphomaMalignant LymphadenopathyMetastatic CarcinomaReactive Lymphadenitis

Related Chief Complaints

Abdominal PainChillsFatigueFeverHeadacheNight SweatsRashSore ThroatSwollen GlandsSwollen Lymph NodesWeakness

References

Research in progress on one or more findings above; ratings may change.

  • Cai X, Ebell MH, Haines L. Accuracy of Signs, Symptoms, and Hematologic Parameters for the Diagnosis of Infectious Mononucleosis: A Systematic Review and Meta-Analysis. J Am Board Fam Med. 2021 Nov-Dec;34(6):1141-1156. doi:10.3122/jabfm.2021.06.210217. PMID 34772769.
  • Sharma SK, Kadhiravan T, Banga A. A clinical prediction rule to identify patients with tuberculosis at high risk for HIV co-infection. Indian J Med Res. 2009;130(1):51-57. PMID: 19700801.
  • Majid S, Tengrup I, Manjer J. Clinical assessment of axillary lymph nodes and tumor size in breast cancer compared with histopathological examination: a population-based analysis of 2537 women. World J Surg. 2013;37(1):67-71. PMID: 22976793.
  • Chau I, Kelleher MT, Cunningham D, et al. Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients. Br J Cancer. 2003;88(3):354-361. PMID: 12569376.
  • Specht MC, Fey JV, Borgen PI, Cody HS 3rd. Is the clinically positive axilla in breast cancer really a contraindication to sentinel lymph node biopsy? J Am Coll Surg. 2005;200(1):10-14. PMID: 15631914.
  • Fijten GH, Blijham GH. Unexplained lymphadenopathy in family practice. An evaluation of the probability of malignant causes and the effectiveness of physicians' workup. J Fam Pract. 1988;27(4):373-376. PMID: 3049914.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.