The deep inguinal lymph nodes are not palpable. However the superficial (palpable) are divided into two groups, the horizontal and the vertical. The horizontal nodes drain portions of the lower abdomen, the buttocks, the anal canal and peri-anal areas. The lower vertical nodes drain the vagina and external genitalia.Â The vertical nodes drain the lower limbs.
Pathologies such as infections, neoplasia may result in lymphadenopathy of the relevant lymph nodes.
Palpation of these lymph nodes should therefore not be overlooked. The inguinal lymph nodes are normally described as firm or rubbery. Using the pads of your fingers apply a gentle rolling motion over the skin attempting to feel within the superficial tissues. Start systematically to ensure you don’t miss any for example start from the lateral end of the inguinal ligament toward symphysis pubis ensuring you feel above and below the inguinal ligament. Note their size, texture, tenderness and whether they are tethered to underlying tissues.