Lymph nodes are small, bean-shaped structures that serve as filters for the lymphatic fluid circulating throughout the body. They are a fundamental component of the immune system, housing specialized white blood cells that trap and destroy foreign particles, such as bacteria and viruses. The axillary nodes, located in the underarm or armpit region, are particularly significant because they drain lymph from the upper limbs, the chest wall, and the breasts. Learning the technique to palpate these nodes provides a tool for self-awareness, enabling a person to notice subtle changes that may warrant a conversation with a healthcare provider.
Understanding the Location of Axillary Lymph Nodes
The axilla contains clusters of approximately 20 to 40 lymph nodes embedded in fatty tissue. To perform an effective self-examination, it is helpful to mentally map the five primary groups of nodes that drain this region. The pectoral (anterior) group lies along the lower border of the chest muscle on the front of the armpit.
The subscapular (posterior) nodes are found along the back wall of the armpit, near the muscle connecting to the shoulder blade. The lateral (brachial) nodes are positioned along the upper arm bone on the inner side of the armpit. These three groups drain into the central nodes, which are located deep within the armpit fat. The apical nodes, situated high up near the collarbone, are the final common pathway before lymph returns to the bloodstream.
Before beginning the physical examination, ensure the muscles are relaxed. Sit or stand with the arm to be examined slightly raised and resting on a surface, such as the opposite shoulder. This relaxed posture allows the examining fingers to reach deeper into the armpit tissue without encountering muscular tension.
Step-by-Step Guide to Palpation
The physical examination requires a systematic approach to assess all five node groups. Use the pads of two or three fingers from the opposite hand, as these are the most sensitive parts for detecting small masses. Ensure fingernails are trimmed short to avoid scratching the skin.
Palpation involves a gentle, overlapping, circular motion. This movement helps roll the soft tissue over underlying structures, making firm nodes easier to feel. Use three distinct levels of pressure: light pressure for superficial tissue, medium pressure for mid-level tissue, and deep pressure against the chest wall.
Start by examining the pectoral group along the anterior armpit fold. Next, check the subscapular nodes along the posterior fold, rolling the tissue against the back wall. Then, palpate the lateral nodes on the inner aspect of the armpit, pressing the tissue against the upper arm bone.
Examine the central nodes, which are located high and deep in the center of the armpit. Press the soft tissue against the ribs and chest wall. Conclude by feeling for the apical nodes in the uppermost part of the armpit, close to the clavicle. Repeat the entire process on the opposite arm for comparison.
Identifying Normal and Abnormal Characteristics
Interpreting the sensation felt during palpation is the purpose of the self-examination. A normal lymph node is typically less than one centimeter in diameter and may be difficult or impossible to feel. If palpable, it usually feels soft, movable, and non-tender, often described as having an oval or bean-like shape.
An abnormal node, medically termed lymphadenopathy, is characterized by changes in size, consistency, and mobility. A node is considered enlarged if it exceeds one centimeter in the axillary region. Temporary swelling is common when the body is fighting an infection. Nodes enlarged due to infection, known as reactive nodes, often feel rubbery, soft, and tender.
Nodes that cause concern exhibit increased firmness or hardness, sometimes described as feeling like a marble. A node that is immobile or “fixed” is also concerning, meaning it does not move freely when pushed. When multiple nodes feel stuck together, this is described as being “matted.” A persistent enlargement lasting longer than a few weeks warrants medical attention.
Next Steps Following Self-Examination
The goal of self-palpation is to identify changes that require professional evaluation, not to diagnose a medical condition. If you find a new lump or enlarged node, monitor it briefly, especially if you have a recent infection, injury, or vaccination in that arm. Swelling from a typical infection usually begins to decrease within one to two weeks as the body recovers.
Contact a healthcare professional if a palpable node persists for more than two to four weeks without an apparent cause, such as a localized infection. Immediate consultation is advised if a node feels hard or fixed, or if the enlargement is accompanied by other systemic symptoms.
These systemic symptoms include unexplained weight loss, persistent fever, or night sweats, which suggest a process beyond a common infection. The physician will perform a comprehensive physical examination and may order additional testing, such as blood work or imaging, to determine the cause of the change. Self-palpation is a screening tool; only a physician can provide an accurate diagnosis.