Manual of basic techniques for a health laboratory - libdoc.who.int

184 Manual of basic techniques for a health laboratoryFig. 4.141 Finding a lymph gland infected with trypanosomes●70% Ethanol● Sodium chloride, 0.85% solution (reagent no. 53).MethodFinding a lymph glandLymph nodes are found among the cervical glands of the neck. Feel both the rightand the left sides of the neck, from the base of the neck up to the ears.Affected glands are swollen and form a round lump 2–4cm in diameter (Fig. 4.141).They are elastic and slide under the skin, offering little resistance to pressure. Theydo not become hard (except in chronic cases).Collection of samples1. Ask the patient to sit down. Disinfect the chosen site on the neck with ethanol.2. With the left hand, take the gland between the thumb and the index finger andmake it stand out (Fig. 4.142). Hold your hand steady.3. Holding the needle between your thumb and forefinger, introduce it at rightangles into the centre of the gland (Fig. 4.143). First pierce the skin, then penetratethe centre of the gland. Avoid the jugular vein and the arteries.4. With the left hand, gently knead the gland.With the right hand revolve the needle in both directions (Fig. 4.144).5. The glandular fluid will ooze into the needle. The operation should take about 1minute.Fig. 4.142 Making the lymph gland standoutFig. 4.143 Introducing a needle into the lymphgland