Definition: Palpation of superficial lymph nodes’ The axillary lymph nodes
Test procedure: Ask the patient to abduct their arms. Place cupped fingers high up in the axilla against the chest wall. Ask the patient to lower their arms. Then gently drag your fingers down against the chest wall and you should feel them rolling under your fingers. The pectoral nodes are situated over the pectoralis major. These are of particular clinical significance in females.
Test findings: The axillary lymph nodes drain external features of the thorax, the breasts, the thoracic wall and the upper arm. Therefore pathologies such as infections, inflammation and malignancy may activate these lymph nodes. When palpating assess whether nodes are normal, tender, enlarged, hard or rubbery. Compare both sides sequentially. Be aware of areas drained by various lymph node groups. General causes of lymphadenopathy include infection (local or systemic, viral (Epstein-Barr, HIV) or bacterial (Brucellosis)), carcinoma (leukaemia, lymphoma, metastases) and autoimmune disease (inflammatory diseases such as SLE, RA, sarcoidosis).
Special considerations: Some normal patients will have easily palpable lymph nodes whist in others you will find it more difficult to access them. However when enlarged they much more easy to identify them in of these both groups.