Physical examination maneuver
Physical Exam
Head and Neck Lymph Node Palpation
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With the patient seated and the neck muscles relaxed, use the pads of the fingers and gentle circular pressure to palpate the cervical node groups systematically — preauricular, posterior auricular, occipital, tonsillar, submandibular, submental, the anterior and posterior cervical chains, and the supraclavicular fossae — comparing the two sides. Note the size, consistency, tenderness, and mobility of any node.
How to Interpret
Showing 12 of 24 findings
Conjunctivitis
Preauricular adenopathy
Rule in
Not helpful
Rule out
InconclusiveWide CI
Evidence:Moderate
Infectious Mononucleosis
Posterior auricular adenopathy
Rule in
Very helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Posterior cervical lymphadenopathy in an adolescent or young adult
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Moderate
Malignant Lymphadenopathy
Fixed lymph node, detecting a malignant or granulomatous cause of lymphadenopathy
Rule in
HelpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Hard texture, detecting a malignant or granulomatous cause of lymphadenopathy
Rule in
Somewhat helpfulDerived CI
Rule out
Somewhat helpfulDerived CI
Evidence:Moderate
Generalized lymphadenopathy, detecting a malignant or granulomatous cause
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Supraclavicular nodes
Rule in
Somewhat helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Head and neck nodes (not supraclavicular)
Rule in
Minimally helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Lymph node tenderness, detecting a malignant or granulomatous cause of lymphadenopathy
Rule in
Not helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Thyroid Carcinoma
Cervical (neck) lymphadenopathy in a patient with a goiter / thyroid nodule
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:ModerateResearch in progress
Goiter, cervical adenopathy
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:ModerateResearch in progress
Thyroid nodule, cervical adenopathy
Rule in
Somewhat helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:ModerateResearch in progress
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Rule in:VHSplenomegaly, HMalaria, SHCirrhosis +13 more
Rule out:SHMyelofibrosis, MHInfectious Mononucleosis, MHSplenomegaly +13 more
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Axillary Lymph Node Palpation
Rule in:SHBreast Cancer, SHHIV Infection, SHInfectious Mononucleosis +4 more
Rule out:MHInfectious Mononucleosis, NHBreast Cancer, NHHIV Infection +4 more
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Inguinal Lymph Node Palpation
Rule in:SHInfectious Mononucleosis, ICMalignant Lymphadenopathy, IELymphoma +2 more
Rule out:MHInfectious Mononucleosis, NHMalignant Lymphadenopathy, IELymphoma +2 more
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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
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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
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Abdomen Palpation
Rule in:VHExtrahepatic Biliary Obstruction, VHIntussusception, VHPyloric Stenosis +32 more
Rule out:VHHepatocellular Jaundice, HAppendicitis, SHDiverticulitis +32 more