Book 4 - Self Instructional Manual for Cancer Registrars - SEER ...

Lymph Nodes of Upper and Lower ExtremitiesLocated deep within the underarm and upper chest, the axillary nodes receive lymphatic drainagefrom the breast, skin, and other tissues of the arm, hand, shoulder, chest wall, and upper back. Thelymphatics of the hand and forearm first drain through a few epitrochlear nodes situated just abovethe bend of the elbow, dorsally.Analogous to the epitrochlear nodes are the popliteal nodes located behind the knee. Thesenodes drain the skin of the heel and posterior leg. The other lower extremity nodes are the femoral(superficial inguinal) nodes located in the groin (the area between the abdomen and upper thigh).The nodes associated with the upper and lower extremities and the sites which drain into these nodesare:• Axillary lymph nodes: Arm, hand, shoulder, chest wall, upper back, breast• Epitrochlear lymph nodes: Forearm, hand• Femoral (superficial inguinal) lymph nodes: Vulva, penis, anus, scrotum, perineum, I anteriorabdominal wall, lumbar region, lower back, lower extremities (excluding heel)• Popliteal lymph nodes: Posterior leg, heelSee Figures 8A and 8B, for a diagram of lymph nodes of the upper and lower extremities.lperineum--The skin-covered muscular region between the vagina and the anus in the female andbetween the scrotum and the anus in the male.85