Diagram of location of lymph nodes in body. Lymphatic System: Structure, Function, and Self-Examination Guide

05.07.202214.07.2023 by alexxlab

What is the lymphatic system and how does it work. How to perform a self-examination of lymph nodes. Why is checking lymph nodes important for skin cancer patients. What are the key areas to check for enlarged lymph nodes. How often should you check your lymph nodes. What should you do if you find an enlarged lymph node.

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Understanding the Lymphatic System: A Vital Component of Your Body’s Defense

The lymphatic system plays a crucial role in our body’s immune defense and fluid balance. It consists of a network of vessels and tissues that work together to filter out harmful substances and maintain health. But what exactly makes up this complex system?

Key Components of the Lymphatic System

Lymphatic vessels
Lymph nodes
Lymphatic tissue
Lymph fluid

Lymphatic vessels can be likened to a river system that starts as small streams weaving between cells and blood vessels. These vessels collect excess fluid, proteins, and waste materials from tissues, forming lymph. This fluid then travels through larger vessels before eventually emptying into the bloodstream via ducts in the neck.

Lymph nodes, small oval-shaped structures found along lymphatic vessels, act as filtration stations. They trap harmful organisms and abnormal cells, preventing their spread throughout the body. Typically, these nodes are not noticeable unless they become enlarged due to infection or other health issues.

The Importance of Lymph Node Self-Examination for Skin Cancer Patients

For individuals diagnosed with skin cancer, regular lymph node self-examinations become an essential part of ongoing care. Why is this so crucial? Skin cancer has the potential to spread through the lymphatic system, making early detection of any changes in lymph nodes vital for timely intervention.

Healthcare providers typically examine relevant lymph nodes during follow-up appointments, focusing on areas near the original skin cancer site. For instance, if the cancer was on your leg, the inguinal (groin) lymph nodes would be checked. However, being proactive in self-examination between appointments can lead to earlier detection of potential issues.

Frequency of Self-Examination

How often should you check your lymph nodes? A monthly self-examination is generally sufficient. Coinciding this check with your regular skin examination for changing moles can help establish a routine. It’s important to note that checking more frequently may make it challenging to notice gradual changes.

Step-by-Step Guide to Lymph Node Self-Examination

Understanding how to properly examine your lymph nodes is crucial for effective self-monitoring. Here’s a comprehensive guide to checking different lymph node regions:

Examining Head and Neck Lymph Nodes

Use your fingertips to gently feel the areas shown in the diagram, using a circular motion.
Start with the nodes in front of the ear (1) and follow the numbered sequence, ending just above the collarbone (10).
Always check in this order and examine both sides for comparison.
When checking neck nodes (8), tilt your head towards the side being examined to relax the muscle.
For nodes above the collarbone (10), hunch your shoulders and bring elbows forward to relax the skin.

Checking Armpit (Axillary) Lymph Nodes

Remove upper body clothing for easy access.
Sit comfortably and check each armpit separately.
For the left armpit, lift your arm slightly, place right hand fingers high in the armpit, then lower your arm.
Feel the central armpit area.
Move fingers firmly against the chest wall along the front, back, and inner arm borders of the armpit.
Repeat for the right armpit.

Examining Groin (Inguinal) Lymph Nodes

Locate the horizontal chain of nodes just below the groin ligament.
Feel along the vertical chain on the upper thigh.
Check both groins for comparison.

Recognizing Enlarged Lymph Nodes: What to Look For

During your self-examination, you’re primarily searching for any unusual enlargement or changes in the lymph nodes. But what exactly should you be feeling for?

An enlarged lymph node typically feels like a small, firm swelling, often described as being similar in size to a pea. However, they can sometimes be larger. It’s important to remember that lymph nodes can enlarge due to various reasons, not just cancer. Infections, for instance, can cause temporary swelling.

Key Characteristics of Concerning Lymph Nodes

Firmness or hardness
Lack of tenderness (unlike typically painful infected nodes)
Persistent enlargement (lasting more than a week)
Continued growth over time

If you notice any of these characteristics, it’s crucial to consult your healthcare provider for a proper evaluation.

The Role of Lymph Nodes in Cancer Detection and Staging

Lymph node examination plays a pivotal role in cancer detection and staging, particularly for skin cancers. But how exactly do healthcare providers use this information?

When skin cancer spreads, it often travels first to nearby lymph nodes. By examining these nodes, doctors can gain valuable insights into the extent of the disease. This process, known as lymph node staging, helps determine the most appropriate treatment plan.

Lymph Node Staging Methods

Physical examination
Imaging studies (e.g., ultrasound, CT scan)
Sentinel lymph node biopsy
Complete lymph node dissection (in advanced cases)

The sentinel lymph node biopsy is a particularly important procedure for many skin cancer patients. It involves identifying and removing the first lymph node(s) where cancer is likely to spread. This minimally invasive technique can provide crucial information about the cancer’s stage while minimizing potential complications associated with more extensive lymph node removal.

Lymphatic System Health: Beyond Cancer Detection

While our focus has been on lymph node examination for skin cancer patients, it’s important to recognize the broader significance of the lymphatic system in overall health. This intricate network plays vital roles beyond cancer detection.

Key Functions of the Lymphatic System

Fluid balance: Helps maintain proper fluid levels in body tissues
Immune defense: Filters out pathogens and abnormal cells
Fat absorption: Assists in the absorption of dietary fats in the digestive system
Waste removal: Helps clear cellular debris and toxins from tissues

Given these crucial functions, maintaining a healthy lymphatic system is beneficial for everyone, not just those with a history of skin cancer. But how can you support your lymphatic health?

Tips for Promoting Lymphatic System Health

Stay hydrated: Adequate fluid intake helps maintain lymph flow
Exercise regularly: Physical activity stimulates lymph circulation
Practice deep breathing: Diaphragmatic movement can enhance lymph flow
Maintain a healthy diet: Proper nutrition supports overall immune function
Consider lymphatic massage: Professional lymphatic drainage can be beneficial for some individuals

By incorporating these habits into your lifestyle, you can support your lymphatic system’s function and overall health.

When to Seek Medical Attention: Red Flags in Lymph Node Self-Examination

While regular self-examination is crucial, it’s equally important to know when to seek professional medical advice. Certain findings during your self-checks should prompt a consultation with your healthcare provider.

Signs That Warrant Medical Attention

A persistently enlarged lymph node (lasting more than a week)
Rapid increase in the size of a lymph node
Hardening of a previously soft lymph node
Multiple enlarged lymph nodes in the same region
Lymph node enlargement accompanied by unexplained weight loss, fever, or night sweats
Any changes that cause concern or anxiety

Remember, early detection and prompt medical evaluation are key to addressing potential health issues effectively. Don’t hesitate to reach out to your healthcare team if you notice any of these red flags.

What to Expect During a Medical Evaluation

If you do need to see a healthcare provider for a lymph node concern, what can you expect? The evaluation typically involves:

A thorough medical history review
Physical examination of the affected area and possibly other lymph node regions
Possibly imaging studies such as ultrasound or CT scan
In some cases, a biopsy may be recommended for definitive diagnosis

Your healthcare provider will use this information to determine the cause of the lymph node changes and recommend appropriate next steps or treatment if necessary.

Empowering Yourself Through Knowledge and Self-Care

Understanding your lymphatic system and knowing how to perform self-examinations are powerful tools in maintaining your health, especially for those with a history of skin cancer. By incorporating regular self-checks into your routine and staying attuned to your body, you become an active participant in your ongoing care.

Key Takeaways for Effective Self-Monitoring

Familiarize yourself with the normal feel of your lymph nodes
Establish a consistent monthly self-examination routine
Use proper technique when checking different lymph node regions
Be aware of what constitutes a concerning change
Don’t hesitate to seek medical advice when needed

Remember, self-examination is not a substitute for regular medical check-ups but rather a complementary practice that can help detect potential issues between appointments. By combining professional care with informed self-monitoring, you create a comprehensive approach to your health management.

As you continue on your health journey, whether managing a skin cancer diagnosis or simply prioritizing overall wellness, let this knowledge empower you. Your active participation in self-care, including lymph node awareness, is a valuable component of a proactive health strategy.

How to check your Lymph Nodes

Introduction

You have been diagnosed with a skin cancer that on occasions can spread into the lymphatic system. That is why, as part of your examination, your nodes are examined by your doctor or specialist nurse at your follow-up appointments. The lymph nodes examined depend on the location of your skin cancer, eg: if your skin cancer was on your leg then the lymph nodes in your inguinal area (groin) will be felt or if on your face then the nodes in your head and neck would be examined. The aim is to detect any enlargement of the lymph nodes and undertake investigations at an early stage. Some people express a wish to check their own lymph nodes between clinic appointments. This is why you have been given this information. Your doctor or nurse will show you how and which lymph nodes to check.

The Lymphatic System

This system consists of lymphatic vessels and tissue. Lymph is a fluid that contains proteins and waste materials, which is collected from around the cells in the body, eventually draining into larger vessels.

Lymphatic vessels

One way of describing this is to imagine a river that starts as a small stream, which then weaves its way between the cells and small blood vessels of the body’s connective tissue. On its journey more tissue and waste material is collected. The fluid (lymph) that accumulates firstly drains into larger lymph vessels, then into ducts in the neck, before emptying into the blood stream.

Lymphatic tissue

Lymph nodes are small oval clumps of lymphatic tissue found at intervals along the vessels. They are grouped like “beads on a string” both deep in the body and near the surface (see previous diagram). These lymph nodes filter out harmful organisms and cells from the lymphatic fluid before it is returned to the blood stream. Lymph nodes can only be felt in the areas listed:

head and neck
arms
axilla (armpits)
inguinal area (groin)
back of knees

Usually lymph nodes are not enlarged and thus not able to be felt, but if you have previously had an infection (such as tonsillitis) you may have noticed and felt lymph nodes becoming enlarged, painful and tender. Lymph nodes can also become enlarged due to cancer cells lodging in them. Checking your lymph nodes once a month is sufficient and this can be done at the same time as you check your skin for any changing moles. Checking them more often may result indifficulty noticing any change.

Do not panic if you feel a lymph node as it may well be due to an infection, but if it has not gone away in a week contact your doctor or specialist nurse.

How to Check Lymph Nodes in the Head and Neck

With your fingertips, in a gentle circular motion feel the lymph nodes shown.
Start with the nodes in front of the ear (1) then follow in order finishing just above the collar bone (10)
Always check your nodes in this order.
Check both sides for comparison. If you have an enlarged lymph node it may feel like a swelling the size of a pea, sometimes they can be larger.

When feeling the nodes in your neck (marked 8):

Tilt your head towards the side you are examining, this helps to relax the muscle.
Now press your fingers under the muscle.

When checking the lymph nodes above the collar bone:

Hunch your shoulders and bring your elbows forward to relax the skin.
Now feel above the collar bone (marked 10).

How to Check Lymph Nodes in the Armpit

Diagram how to check the lymph nodes in your armpitRemove all clothing down to the waist to get easy access to the armpits.

Sit in a comfortable position.
Check each armpit in turn.

To check the left side, lift your arm slightly then place the fingers of your right hand high into the armpit and then lower your arm.

Feel in the central area of the armpit.

Now move your fingers firmly against the chest wall as follows:

Along the front border of the armpit.
Along the back border of the armpit.
Feel along the inner border of the arm.
Now check the other armpit.

How to Check Lymph Nodes in the Groin

Diagram of the lymph nodes in the groinThere are two areas to look for inguinal (groin) nodes:

Feel the horizontal chain of nodes in the right groin just below the ligament (see above diagram).
Feel the vertical chain along the upper thigh (see above diagram).
Check the lymph nodes in the other groin.

Conclusion

The purpose of this information is to help you understand why you have your nodes checked at your follow-up appointments. It explains which lymph nodes you need to check and how to undertake this procedure yourself. The aim is to ensure that if in the unlikely case there is spread of your skin cancer to the lymph nodes, it is detected and reported to your doctor or nurse straight away rather than waiting until your next clinic appointment.

Lymphatic system | Structure, Function, & Facts

diagram of the human lymphatic system

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Key People:: Florence Rena Sabin
William Hewson
Thomas Bartholin

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Lymphatic circulation

The lymphatic system can be thought of as a drainage system needed because, as blood circulates through the body, blood plasma leaks into tissues through the thin walls of the capillaries. The portion of blood plasma that escapes is called interstitial or extracellular fluid, and it contains oxygen, glucose, amino acids, and other nutrients needed by tissue cells. Although most of this fluid seeps immediately back into the bloodstream, a percentage of it, along with the particulate matter, is left behind. The lymphatic system removes this fluid and these materials from tissues, returning them via the lymphatic vessels to the bloodstream, and thus prevents a fluid imbalance that would result in the organism’s death.

The fluid and proteins within the tissues begin their journey back to the bloodstream by passing into tiny lymphatic capillaries that infuse almost every tissue of the body. Only a few regions, including the epidermis of the skin, the mucous membranes, the bone marrow, and the central nervous system, are free of lymphatic capillaries, whereas regions such as the lungs, gut, genitourinary system, and dermis of the skin are densely packed with these vessels. Once within the lymphatic system, the extracellular fluid, which is now called lymph, drains into larger vessels called the lymphatics. These vessels converge to form one of two large vessels called lymphatic trunks, which are connected to veins at the base of the neck. One of these trunks, the right lymphatic duct, drains the upper right portion of the body, returning lymph to the bloodstream via the right subclavian vein. The other trunk, the thoracic duct, drains the rest of the body into the left subclavian vein. Lymph is transported along the system of vessels by muscle contractions, and valves prevent lymph from flowing backward. The lymphatic vessels are punctuated at intervals by small masses of lymph tissue, called lymph nodes, that remove foreign materials such as infectious microorganisms from the lymph filtering through them.

In addition to serving as a drainage network, the lymphatic system helps protect the body against infection by producing white blood cells called lymphocytes, which help rid the body of disease-causing microorganisms. The organs and tissues of the lymphatic system are the major sites of production, differentiation, and proliferation of two types of lymphocytes—the T lymphocytes and B lymphocytes, also called T cells and B cells. Although lymphocytes are distributed throughout the body, it is within the lymphatic system that they are most likely to encounter foreign microorganisms.

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The Human Body

Lymphoid organs

The lymphatic system is commonly divided into the primary lymphoid organs, which are the sites of B and T cell maturation, and the secondary lymphoid organs, in which further differentiation of lymphocytes occurs. Primary lymphoid organs include the thymus, bone marrow, fetal liver, and, in birds, a structure called the bursa of Fabricius. In humans the thymus and bone marrow are the key players in immune function. All lymphocytes derive from stem cells in the bone marrow. Stem cells destined to become B lymphocytes remain in the bone marrow as they mature, while prospective T cells migrate to the thymus to undergo further growth. Mature B and T lymphocytes exit the primary lymphoid organs and are transported via the bloodstream to the secondary lymphoid organs, where they become activated by contact with foreign materials, such as particulate matter and infectious agents, called antigens in this context.

Thymus

The thymus is located just behind the sternum in the upper part of the chest. It is a bilobed organ that consists of an outer, lymphocyte-rich cortex and an inner medulla. The differentiation of T cells occurs in the cortex of the thymus. In humans the thymus appears early in fetal development and continues to grow until puberty, after which it begins to shrink. The decline of the thymus is thought to be the reason T-cell production decreases with age.

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In the cortex of the thymus, developing T cells, called thymocytes, come to distinguish between the body’s own components, referred to as “self,” and those substances foreign to the body, called “nonself.” This occurs when the thymocytes undergo a process called positive selection, in which they are exposed to self molecules that belong to the major histocompatibility complex (MHC). Those cells capable of recognizing the body’s MHC molecules are preserved, while those that cannot bind these molecules are destroyed. The thymocytes then move to the medulla of the thymus, where further differentiation occurs. There thymocytes that have the ability to attack the body’s own tissues are destroyed in a process called negative selection.

Positive and negative selection destroy a great number of thymocytes; only about 5 to 10 percent survive to exit the thymus. Those that survive leave the thymus through specialized passages called efferent (outgoing) lymphatics, which drain to the blood and secondary lymphoid organs. The thymus has no afferent (incoming) lymphatics, which supports the idea that the thymus is a T-cell factory rather than a rest stop for circulating lymphocytes.

Lymphatic System Anatomy–Lymphosurgery Center

The lymphatic system is an important part of the human cardiovascular system and complements it.

Unlike the circulatory system, the lymphatic system does not have its own pump and is open. The lymph circulating in it moves slowly and under little pressure. Lymph is a fluid that is constantly formed by drainage of interstitial fluid into the lymphatic capillaries.

The structure of the lymphatic system includes:

• lymphatic capillaries
• lymphatic vessels
• lymph nodes
• lymphatic trunks and ducts

subclavian trunks; on the right into the right lymphatic duct, right jugular and right subclavian trunks. The ducts and trunks flow into the large veins of the neck, and then into the superior vena cava. In this way, lymph is transferred from the interstitial spaces back into the blood.

Lymphatic vessels pass through the lymph nodes. They are combined into several groups and are located along the vessels. Many afferent vessels carry lymph to the node, and it flows out from there only through one or two efferent vessels. Lymph nodes are small formations of a round, oval, bean-shaped, less often ribbon-shaped form up to 2 cm long. Here, lymph is filtered, foreign matter is separated and destroyed, and lymphocytes are produced here to fight infection. Lymph nodes that perform a barrier and immune role.

Main functions of the lymphatic system:

• Transport function – carrying lymph, metabolic products from tissues to the venous bed.

• Drainage function – the return of proteins, water, salts, toxins and metabolites from tissues to the blood. Removal of fluid, pus, effusion from the wound, cavities. Stability of the “capillary lymphatic pump”

• Lymphocytopoiesis, hematopoietic function – formation, maturation, differentiation of lymphocytes involved in immune reactions.

• Immune, protective functions – formation of the body’s immune defense, neutralization of foreign particles, bacteria, viruses, fungi, protozoa that enter the body. filtration from impurities, tumor particles and cells.

Any failure or blockage of the lymphatic vessels or nodes entails swelling or swelling of the tissues, lymphadenitis, erysipelas, lymphostasis occur. Experts, not without reason, believe that the lymph could tell about what the blood is “silent about”, because many of the waste products of the cells first enter the lymph, and then into the blood.

If most doctors can help us in the fight against many diseases, then only individual doctors – lymphologists – can diagnose and treat disorders in the lymphatic system.

According to the statistics of doctors themselves, in the CIS there are only a few lymphologists – specialists in the lymphatic system.

Lymphologists say: Your health is the purity of your lymphatic system!

Be healthy and happy!

where they are located, what functions they perform, in which diseases 9 increase0001

Inflammation and enlargement of the lymph nodes usually causes discomfort and pain. As a rule, this indicates that an inflammatory process is underway in the body.

What are lymph nodes

Lymph nodes are the most important organs that perform a barrier-filtration function ¹ . Their main function is the biological filter of lymph – a colorless liquid that washes all the tissues and cells of the body. It consists of plasma and formed elements. Interestingly, lymph plasma has an almost similar chemical structure to blood plasma, but contains fewer proteins ² .

Useful information about lymph nodes

Number in the body	about 600 lymph nodes ³
Functions	barrier-protective, hematopoietic, drainage (promotes the outflow of excess fluid), reserve, exchange
Common causes of increase	infectious processes (especially acute upper respiratory tract infections), autoimmune diseases, tumors
Complications of inflammation	transfer of infection to nearby tissues, vein thrombosis, impaired lymph outflow
What not to do with lymph nodes in case of inflammation , press

Where are the lymph nodes

Lymph nodes are found almost everywhere. They are arranged in such a way as to become an obstacle in the way of various “garbage”: toxins, viruses, bacteria, parasites, fungi, cancer cells.

Most lymph nodes are located deep under the skin and even near internal organs where they cannot be felt. But some lymph nodes – under the jaw, in the armpits, in the groin – can be palpated even in a healthy, non-inflamed state.

Photo: Shutterstock

Functions of the lymph nodes

As mentioned earlier, the main function of the lymph nodes is barrier-protective function. In these organs of the lymphatic system, protective cells of the body are formed, such as lymphocytes, antibodies, phagocytes. Lymph nodes protect against the penetration of infections, and also prevent the reproduction of malignant tumor cells and play a role in the immune response to substances foreign to the body.

The lymph nodes also perform the following functions:

hematopoietic – after the lymph nodes, lymph enriched with lymphocytes gets into the blood;
drainage – promote the outflow of excess fluid;
depository (reserve) – lymph node is a temporary storage of lymphocytes and lymph. The latter lingers in the lymph node in order to ensure the unloading of the bloodstream in “emergency” situations, for example, during venous congestion;
metabolic – lymph nodes are involved in the metabolism of fats, proteins, carbohydrates and other substances.

Causes of swollen lymph nodes

Lymph nodes have their own diseases, and most often their inflammation is a reaction to some other disease or condition. Completely different reasons can lead to an increase in lymph nodes (lymphadenopathy). Consider the most common of them.

Local infections

Infection is one of the most common causes of swollen lymph nodes.

— For example, it can be acute respiratory diseases, leading to an increase in regional lymph nodes associated with the area in which inflammation occurs, says general practitioner Oksana Khamitseva.

As a rule, the focus of the disease is located near enlarged lymph nodes. So, with infections of the upper respiratory tract, the lymph nodes in the neck become inflamed, with a sexual infection – in the groin.

Generalized viral and bacterial infections

If only one category of lymph nodes is affected, then they speak of local inflammation. If the nodes that are not adjacent to each other increase, then we are talking about a generalized inflammation of the lymph nodes.

This widespread inflammation can be caused by infections – bacterial, viral, fungal, which affect the entire body. It can be tuberculosis, some infectious skin diseases, rubella, chickenpox, cytomegalovirus, mononucleosis, HIV and others.

Autoimmune diseases

Autoimmune connective tissue diseases such as arthritis and systemic lupus erythematosus can also lead to swollen lymph nodes. In such diseases, the body begins to attack its own cells. Due to the increasing load on the lymph nodes, their inflammation occurs.

Tumor processes

Swollen lymph nodes can also signal tumor processes in the body. As we wrote above, lymph nodes prevent the reproduction of cancer cells, but in some cases, tumor cells can get stuck in them and multiply. Tumor processes can lead to the development of leukemia, lymphogranulomatosis, lymphoma.

Hypersensitivity of the body

Allergic reactions can also provoke inflammation of the lymph nodes. In addition, their increase may be associated with hypersensitivity to certain drugs.

How lymph nodes are treated

The treatment of lymphadenopathy is varied and always depends on its cause. An increase in lymph nodes is a signal of inflammation, so you need to look for its source.

Most often, inflammation of the lymph nodes occurs as a secondary process, that is, a reaction to another disease:

if this is associated with acute respiratory infections, then it is necessary to treat the respiratory tract infection itself, be it a bacterium or a virus;
if it is associated with a generalized infection (mononucleosis, HIV), then long-term specific therapy is selected here;
cat-scratch disease (felinosis) is treated with special antibiotics;
Sepsis is controlled only in the hospital by intravenous administration of various drugs, including antibiotics, and ionic solutions.
autoimmune diseases (systemic lupus erythematosus, Kawasaki disease, etc.) are treated by a rheumatologist, prescribing hormones or cytostatics for long courses under constant supervision.

Lymphadenopathy can also be caused by cancer. Conventionally, they can be divided into 3 sections:

leukemia, when the primary malignant focus is in the bone marrow;
lymphomas, when the foci are located directly in the lymph nodes;
metastases, when the focus is located in the internal organ, and cancer cells affect the lymph nodes in the path of lymph outflow.

— In the case of leukemia, a bone marrow transplant is possible. With lymphoma, it is useless to do this, you can only use various options for radiation, chemotherapy, genetic engineering methods. And if lymphadenopathy is caused by metastases, then, as a rule, the tumor of the corresponding organ is removed, entering healthy tissues and capturing the “package” of affected lymph nodes, says our expert Oksana Khamitseva.

How to maintain the health of the lymphatic system at home

According to physician Oksana Khamitseva, the health of the lymphatic system primarily depends on two components: good lymphatic drainage and normal functioning of the immune system. This is not difficult to achieve:

regular physical activity;
avoid tight, constricting clothing;
smoking and alcohol cessation;
courses of multivitamins 2 times a year;
food high in protein and fiber in the diet;
adequate fluid intake.