Examination of superficial lymph nodes in dogs and cat
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Transcript of Examination of superficial lymph nodes in dogs and cat
My Topic is about ………..?
Exactly Lymph-nodes
Submandibular
Prescapular
Axillary
Inguinal
Popliteal
5 major lymph
nodes on each side of
a dog
1- Basic Knowledge
2- Clinical Examination of lymph nodes
What is la lymph node
I am a gland
Part of lymph-System
Important part of immune system
Filters lymph fluid
Trapping bacteria, viruses, foreign stuff
Basic Knowledge
Can we palpate all lymph nodes?Question to Anastasia:
A: No, Lymph nodes are palpable in the loose subcutaneous tissues.
Basic Knowledge
Are they all the same size?
Question to Omri:
Basic Knowledge
A: No, their size will vary with location and species
Basic Knowledge
What shape do they have?
Question to Kyriakos:
Basic Knowledge
A: Lymph nodes are bean shaped and have a smooth contour.
Basic Knowledge
Are they difficult to locate?
Question to Bella:
Basic Knowledge
A: Yes and No. A number of superficial lymph nodes are easily
identified in domestic animals others are more difficult to locate.
Basic Knowledge
Clinical Examination of Lymph nodes
inspection palpation and if possible the course of lymphatics
Needle aspirate/biopsy
Physical examination of the lymph nodes
Physical examination of palpable lymph nodes involves:
palpation
Inspection reveals changes in normal contours caused by enlargement.
Palpation provides more critical evaluation of any changes.
inspection
Lymph nodes that are normally palpable in small animals include:
mandibular
Prescapular
Inguinal
Popliteal
- Mandibular- Prescapular- Superficial inguinal- Popliteal
Occasionally the superficial cervical, superficial inguinal and facial lymph nodes are palpable.
Lymph nodes that are not normally palpable in small animals include:
- Cervical- Retropharyngeal- Axillary- accessory
axillary- femoral
Retropharyngeal
Accessory-axillary
femoral
are palpable, disease is likely.
Cervical
Normally palpableNot normally palpable
A fine needle aspire or biopsy may also be taken.
During Examination
When examine lymph nodes we do not just look on the size of the node
There are several physical characteristics we need to check before making any diagnosis
Physical characteristics to assess include:
Size
Response to palpationTemperature of the overlying
skin
Adhesion between the lymph node and the skin or surrounding tissues
Lobulation
Consistency
Abscess formation, maturation and discharge
Physical characteristics to assess include also:
And here we still do not make any early diagnosis
Do not just look at the lymph node the owners are worrying about.
Always remember, the animal is an organism and everything is connected
Examine the whole organism
Number of palpable
lymph nodes involved is
notedLymph nodes are normally flaccid
or tensely elastic, easily
displaces and in one piece
Whether the involvement is unilateral or bilateral
Size
Lymph node enlargement can have several reasons
Let´s check them out
Lymph node size
Consider age and condition of an animal with lymphadenopathy
(Lymphadenopathy or adenopathy is disease of the lymph nodes, in which they are abnormal in size, number, or consistency)
In cachectic patient loss of fat surrounding the nodes makes them seem more
prominent
Size
Young animals are exposed to a variety of new antigenic stimuli, increased lymph node
size is a normal immunological response
As an animal ages lymph node size often decreases and the nodes
become difficult to palpate
Why?
Animal-Age + Condition
Infiltration of
inflammatory cells
response to antigenic
stimulation
Also lymph node enlargement may be due to:
Proliferation of lymphocytes + macrophages in response to antigenic stimulation
Infiltration with inflammatory cells Proliferation of hematopoietic neoplasia Infiltration by metastatic neoplastic cells
Neoplasia cellsAbundant
cytoplasm
Small, raund nucleus
Clumped and irregular
chromatin
Increased nuclear size
5. Part of a generalized neoplasia of lymphatic
tissue (myeloid leukemia)
1. Acute local inflammatory
reaction which may either
resolve completely or
lead to suppuration (equine and
puppy strangles)
2. Part of systemic
reaction to a major specific
disease (malignant
catarrhal fever)
3. Chronic inflammatory
reaction (chronic suppuration of
the sinuses)
4. Neoplasia, which may be
primary (lymphosarcoma) or metastasis as the result of
spread from neighboring
tissues (caricinoma)
When assessing lymph node, remember enlargement could be due to:
Get confidence in your touchHow?
A very important part in the differentiation of
lymphadenopathy is to interpret your palpation
Your palpation may aid in differentiation between
Reactive lympha denopathy “it react to virus, bacteria…”
neoplastic lymphadenopat
hy
Reactive lymph nodes tend to be painful
Tend to be less firm
Marked inflammatory reactions Fungal disease
Enlarged individuals are firm, freely moveable + NON PAINFUL lymphoma
If lymph nodes are extremely firm metastaic neoplasia are likely (or fibrosis)
Metastatic neoplasia or extracapsular lymphoma
Fixation of nodes to surrounding tissues
suggests:
Etiology of lymph node enlargement unknown?
Distribution of lymphadenopathy may provide you important clues to the
etiology of lymph node enlargement
If one or localized set of lymph nodes is involved these lymphatic sites
are carefully examined for
infection, inflammation or
neoplasia
Book-Page 293-294