Physical Exam

How to Palpate Lymph Nodes

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Video coming September 2026

How to Perform

With the patient seated and the muscles overlying each region relaxed, use the pads of the fingers and gentle circular pressure to palpate the node groups systematically, comparing the two sides — the head and neck chains (preauricular, posterior auricular, occipital, tonsillar, submandibular, submental, the anterior and posterior cervical chains, and the supraclavicular fossae), then the axillary, epitrochlear, and inguinal regions. Support the limb and keep the overlying muscles slack when examining the axilla and the epitrochlear groove above the medial epicondyle. For any node felt, note its location, size, consistency, tenderness, mobility, and whether it is discrete or matted.

How to Interpret

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References

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Vassilakopoulos TP, Pangalis GA. Application of a prediction rule to select which patients presenting with lymphadenopathy should undergo a lymph node biopsy. Medicine (Baltimore). 2000;79(5):338-347. PMID: 11039082.
Cervin JR, Silverman JF, Loggie BW, Geisinger KR. Virchow's node revisited. Analysis with clinicopathologic correlation of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes. Arch Pathol Lab Med. 1995;119(8):727-730. PMID: 7646330.
Libman H. Generalized lymphadenopathy. J Gen Intern Med. 1987;2(1):48-58. PMID: 3543267.
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.