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Anatomy
Lower Limb
A 54 year old woman presents with unilateral swelling of the left leg. Her d-dimer is normal and ultrasound has shown no demonstrable deep vein thrombosis. Your consultant has arranged for a CT of the leg and pelvis which shows lymphadenopathy of the deep inguinal lymph nodes. Which of the following best describes the location of the deep inguinal lymph nodes:
Answer:
The deep inguinal lymph nodes (about 1 - 3 in number) lie medial to the femoral vein within the femoral canal.Deep and Superficial Inguinal Lymph Nodes
Anatomy / Lower Limb / Anterior Thigh
Last Updated: 10th April 2019
The inguinal nodes are found in the upper aspect of the femoral triangle.
Superficial Inguinal Nodes
The superficial inguinal lymph nodes (about 10 in number) are located in the superficial fascia, forming a line below the inguinal ligament, and medially extending inferiorly along the terminal part of the great saphenous vein. They receive lymph from the gluteal region, lower abdominal wall, perineum and superficial regions of the lower limb.
Deep Inguinal Nodes
The deep inguinal lymph nodes (about 1 - 3 in number) lie medial to the femoral vein within the femoral canal. They receive lymph from deep lymphatics associated with the femoral vessels and from the glans penis or clitoris in the perineum.
The inguinal lymph nodes drain to the external iliac lymph nodes associated with the external iliac artery in the abdomen.
![By Henry Vandyke Carter [Public domain], via Wikimedia Commons](https://mrcemsuccess.com/wp-content/uploads/2017/01/Superficial-Inguinal-Nodes.png)
Lymphatic Drainage of Lower Limb. (Image by Henry Vandyke Carter [Public domain], via Wikimedia Commons)
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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