Examination of superficial lymph nodes in dogs and cat, Clinical veterinary diagnostic of lymph nodes in small animals, companian animals, Presentation of the palpation of lymph nodes, Lymphadenopathy, Why are lymph nodes enlarged, understand diagnostic of lymph nodes, basic understanding of lymph nodes for veterinary practice.
12. A: Yes and No.
A number of superficial lymph nodes are easily identified in
domestic animals others are more difficult to locate.
Basic Knowledge
13. Clinical Examination of Lymph nodes
inspection palpation and if possible the course of lymphatics
Needle
aspirate/biopsy
14. 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
15. Lymph nodes that are normally palpable in small animals include:
mandibular
Prescapular
Inguinal
Popliteal
- Mandibular
- Prescapular
- Superficial inguinal
- Popliteal
16. 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 palpable
Not normally palpable
17. A fine needle aspire or biopsy may also be taken.
During Examination
18. 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
20. Adhesion between the lymph node and
the skin or surrounding tissues
Lobulation
Consistency
Abscess formation, maturation and discharge
Physical characteristics to assess include also:
21. 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
22. Examine the whole organism
Number of
palpable lymph
nodes involved
is noted
Lymph nodes are
normally flaccid or
tensely elastic,
easily displaces and
in one piece
Whether the
involvement is
unilateral or
bilateral
24. 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
25. 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
cells
Abundant
cytoplasm
Small, raund
nucleus
Clumped and
irregular
chromatin
Increased nuclear
size
26. 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:
27. Get confidence in your touch
How?
A very important part in the
differentiation of lymphadenopathy is
to interpret your palpation
28. Your palpation may aid in differentiation between
Reactive lympha denopathy
“it react to virus, bacteria…”
neoplastic
lymphadenopathy
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:
29. 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