(WGU D443) NURS 3116 Health Assessment Objective
Assessment Review Q & S 2024.
Lymphadenopathy (adenopathy) - ANSWER enlarged lymph node(s)
Lymphadenitis - ANSWER inflamed and enlarged lymph node(s)
Lymphangitis - ANSWER inflammation of the lymphatics that drain an area of
infection; tender erythematous streaks extend proximally from the infected area;
regional nodes may also be tender; may appear as red streaks on overlying skin.
Lymphedema - ANSWER edematous swelling due to excess accumulation of lymph
fluid in tissues caused by inadequate lymph drainage
Lymphangioma - ANSWER congenital malformation of dilated lymphatics
Shotty - ANSWER small non-tender nodes that feel like BBs or buckshot under the
skin; generally of no clinical consequence & usually represent enlargement of the
lymph nodes following viral infection. However, nodes in the epitrochlear or
supraclavicular regions require additional evaluation.
Fluctuant - ANSWER wavelike motion that is felt when the node is palpated; feel like
they contain fluid--suggest suppuration from infection.
Matted - ANSWER group of nodes that feel connected and seem to move as a unit;
lymph nodes that are enlarged & juxtaposed so that they feel like a large mass rather
than discrete nodes.
Reminders about nodes..... - ANSWER A hard, fixed, painless node suggests a
malignant process.
• The more tender a node, the more likely it is an inflammatory process.
• Nodes do not pulsate; arteries do.
• A palpable supraclavicular node on the left (Virchow node) is a significant clue to
thoracic or abdominal malignancy.
• Slow nodal enlargement over weeks and months suggests a benign process; rapid
enlargement without signs of inflammation suggests malignancy.
Transilluminate a mass that is found..... - ANSWER nodes do not, and fluid-filled
cysts do.
With bacterial infection, nodes may become..... - ANSWER ...warm or tender to the
touch, matted, and much less discrete, particularly if the infection persists.
The supraclavicular node that warns of malignancy - ANSWER lies anterior to the
sternocleidomastoid muscle.
, In tuberculosis, the lymph nodes are... - ANSWER often felt in the cervical chains,
are usually body temp, soft, matted, and not tender or painful.
Lymphadenopathy that is widespread, involving several lymph node regions,
indicates - ANSWER systemic disease or disorder.
Lymph nodes to which malignancy has spread... - ANSWER vary greatly in size,
from tiny to many centimeters in diameter, sometimes discrete, sometimes matted
and firmly fixed to underlying tissue, tend to be harder than expected. Involvement is
often asymmetric; contralateral nodes in similar locations may not be palpable.
Fixation of the nodes to underlying tissue is most common in - ANSWER metastatic
cancer but can also occur with chronic inflammation.
DIFFERENTIAL DIAGNOSIS Conditions Simulating Lymph Node Enlargement -
ANSWER Lymphangioma (transilluminates; hemangiomas do not)
• Cystic hygroma (thin-walled, contains clear lymph fluid)
• Hemangioma (tends to feel spongy; appears reddish blue, with color depending on
size and extent of blood vessel involvement; Valsalva maneuver may enlarge the
mass)
• Branchial cleft cyst (sometimes accompanied by a tiny orifice in the neck along the
lower third of the anteromedial border of the sternocleidomastoid muscle between
the muscle and the overlying skin; may fluctuate in size when inflamed)
• Thyroglossal duct cyst (midline in the neck; may retract when tongue is protruded)
• Granular cell tumor
• Laryngocele
• Esophageal diverticulum
• Thyroid goiter
• Graves disease
• Hashimoto thyroiditis
• Parotid swelling (e.g., from parotitis or tumor)
• Femoral hernia (below inguinal ligament; protrudes with cough; reducible)
Nodes that are detected should be described according to - ANSWER location, size,
shape, consistency, tenderness, fixation, and delineation of borders.
Sentinel nodes - ANSWER are indicators for invasion of the lymphatics by cancer.
Supraclavicular nodes are only palpable in the presence of disease - ANSWER
An abnormal finding that warrants further investigation - ANSWER is a node that is
tender, hard, fixed, or enlarged (regardless if it is tender or not).
Tender nodes __________________________________________, whereas hard or
fixed nodes ________________________. - ANSWER are usually a result of
inflammation ; suggest malignancy
Patients demonstrate immediate recall - ANSWER by repeating a series of numbers
(e.g. 7, 4, 1) in the order they are presented or in reverse order.
Assessment Review Q & S 2024.
Lymphadenopathy (adenopathy) - ANSWER enlarged lymph node(s)
Lymphadenitis - ANSWER inflamed and enlarged lymph node(s)
Lymphangitis - ANSWER inflammation of the lymphatics that drain an area of
infection; tender erythematous streaks extend proximally from the infected area;
regional nodes may also be tender; may appear as red streaks on overlying skin.
Lymphedema - ANSWER edematous swelling due to excess accumulation of lymph
fluid in tissues caused by inadequate lymph drainage
Lymphangioma - ANSWER congenital malformation of dilated lymphatics
Shotty - ANSWER small non-tender nodes that feel like BBs or buckshot under the
skin; generally of no clinical consequence & usually represent enlargement of the
lymph nodes following viral infection. However, nodes in the epitrochlear or
supraclavicular regions require additional evaluation.
Fluctuant - ANSWER wavelike motion that is felt when the node is palpated; feel like
they contain fluid--suggest suppuration from infection.
Matted - ANSWER group of nodes that feel connected and seem to move as a unit;
lymph nodes that are enlarged & juxtaposed so that they feel like a large mass rather
than discrete nodes.
Reminders about nodes..... - ANSWER A hard, fixed, painless node suggests a
malignant process.
• The more tender a node, the more likely it is an inflammatory process.
• Nodes do not pulsate; arteries do.
• A palpable supraclavicular node on the left (Virchow node) is a significant clue to
thoracic or abdominal malignancy.
• Slow nodal enlargement over weeks and months suggests a benign process; rapid
enlargement without signs of inflammation suggests malignancy.
Transilluminate a mass that is found..... - ANSWER nodes do not, and fluid-filled
cysts do.
With bacterial infection, nodes may become..... - ANSWER ...warm or tender to the
touch, matted, and much less discrete, particularly if the infection persists.
The supraclavicular node that warns of malignancy - ANSWER lies anterior to the
sternocleidomastoid muscle.
, In tuberculosis, the lymph nodes are... - ANSWER often felt in the cervical chains,
are usually body temp, soft, matted, and not tender or painful.
Lymphadenopathy that is widespread, involving several lymph node regions,
indicates - ANSWER systemic disease or disorder.
Lymph nodes to which malignancy has spread... - ANSWER vary greatly in size,
from tiny to many centimeters in diameter, sometimes discrete, sometimes matted
and firmly fixed to underlying tissue, tend to be harder than expected. Involvement is
often asymmetric; contralateral nodes in similar locations may not be palpable.
Fixation of the nodes to underlying tissue is most common in - ANSWER metastatic
cancer but can also occur with chronic inflammation.
DIFFERENTIAL DIAGNOSIS Conditions Simulating Lymph Node Enlargement -
ANSWER Lymphangioma (transilluminates; hemangiomas do not)
• Cystic hygroma (thin-walled, contains clear lymph fluid)
• Hemangioma (tends to feel spongy; appears reddish blue, with color depending on
size and extent of blood vessel involvement; Valsalva maneuver may enlarge the
mass)
• Branchial cleft cyst (sometimes accompanied by a tiny orifice in the neck along the
lower third of the anteromedial border of the sternocleidomastoid muscle between
the muscle and the overlying skin; may fluctuate in size when inflamed)
• Thyroglossal duct cyst (midline in the neck; may retract when tongue is protruded)
• Granular cell tumor
• Laryngocele
• Esophageal diverticulum
• Thyroid goiter
• Graves disease
• Hashimoto thyroiditis
• Parotid swelling (e.g., from parotitis or tumor)
• Femoral hernia (below inguinal ligament; protrudes with cough; reducible)
Nodes that are detected should be described according to - ANSWER location, size,
shape, consistency, tenderness, fixation, and delineation of borders.
Sentinel nodes - ANSWER are indicators for invasion of the lymphatics by cancer.
Supraclavicular nodes are only palpable in the presence of disease - ANSWER
An abnormal finding that warrants further investigation - ANSWER is a node that is
tender, hard, fixed, or enlarged (regardless if it is tender or not).
Tender nodes __________________________________________, whereas hard or
fixed nodes ________________________. - ANSWER are usually a result of
inflammation ; suggest malignancy
Patients demonstrate immediate recall - ANSWER by repeating a series of numbers
(e.g. 7, 4, 1) in the order they are presented or in reverse order.
