Editing Inguinal lymph nodes

{{Short description|Lymph nodes in the human groin}}
{{Infobox lymph
| Name        = Inguinal lymph nodes
| Latin       = nodi lymphoidei inguinales superficiales
| Image       = Illu lymph chain12.jpg
| Caption     = {{ordered list |style=text-align: left; |Superomedial superficial inguinal |Superolateral superficial inguinal |Inferior superficial inguinal |Deep inguinal lymph nodes}}
| Image2      = Gray610.png
| Caption2    = The lymph glands and lymphatic vessels of the lower extremity in males.
| Width       = 120
| DrainsFrom  = Most of perineal region
| DrainsTo    =Abdominal region of lymph nodes 
}}

'''Inguinal lymph nodes''' are [[lymph node]]s in the [[groin]]. They are situated in the [[femoral triangle]] of the inguinal region. They are subdivided into two groups: the superficial inguinal lymph nodes and deep inguinal lymph nodes.

==Superficial inguinal lymph nodes==
The '''superficial inguinal lymph nodes''' are the inguinal lymph nodes that form a chain immediately inferior to the [[inguinal ligament]]. They lie deep to the [[fascia of Camper]] that overlies the [[femoral vessel]]s at the medial aspect of the [[thigh]]. They are bounded superiorly by the inguinal ligament in the femoral triangle, laterally by the border of the [[sartorius muscle]], and medially by the [[adductor longus muscle]].

There are approximately 10 superficial lymph nodes. They normally measure up to 2&nbsp;cm in diameter.<ref name="Assessment of lymphadenopathy">{{cite web |title=Assessment of lymphadenopathy |url=http://bestpractice.bmj.com/best-practice/monograph/838/diagnosis/step-by-step.html |access-date=2017-03-04 |website=[[BMJ Best Practice]]}} Last updated: Last updated: Feb 16, 2017</ref>

They are divided into three groups:
* inferior – inferior of the [[saphenous opening]] of the leg, receive drainage from lower legs 
* superolateral – on the side of the saphenous opening, receive drainage from the side buttocks and the lower abdominal wall. 
* superomedial – located at the middle of the saphenous opening, take drainage from the [[perineum]] and [[sex organ|genitals]].<ref>{{Cite web|url=http://www.medilexicon.com/medicaldictionary.php?t=51862|title=Superficial Inguinal Lymph Nodes -- Medical Definition|website=www.medilexicon.com|access-date=2016-05-09|archive-date=2016-05-12|archive-url=https://web.archive.org/web/20160512223255/http://www.medilexicon.com/medicaldictionary.php?t=51862|url-status=dead}}</ref>

=== Afferents ===
They may receive [[lymphatic vessel#Afferent vessels|lymphatic afferents]] from the following as applicable:
* [[integument]] of the [[Human penis|penis]]
* [[scrotum]]
* [[perineum]]
* [[buttock]]
* [[abdominal wall]] below the level of the [[Navel|umbilicus]]
* [[back]] below the level of the [[iliac crest]]
* [[vulva]]
* [[Human anus|anus]] (below the [[pectinate line]])
* the thigh and the medial side of the leg (the lateral leg drains to the popliteal lymph nodes first).

=== Efferents ===
They drain to the deep inguinal lymph nodes.<ref name="Assessment of lymphadenopathy" />

==Deep inguinal lymph nodes==
The '''deep inguinal lymph nodes''' are 3-5 in number. They lie medial to the [[femoral vein]] deep to the [[cribriform fascia]].<ref name=":0">{{WhoNamedIt|synd|2657}}</ref><ref name="Loukas">{{cite journal |vauthors=Loukas M, El-Sedfy A, Tubbs RS, Wartman C |date=November 2007 |title=Jules Germain Cloquet (1790-1883)--drawing master and anatomist |journal=Am Surg |volume=73 |issue=11 |pages=1169–72 |pmid=18092657}}</ref>

=== Size ===
The mean size of an inguinal lymph node, as measured over the short-axis, is approximately 5.4&nbsp;mm (range 2.1-13.6&nbsp;mm), with two [[standard deviation]]s above the mean being 8.8&nbsp;mm.<ref name="BontumasiJacobson2014">{{cite journal |last1=Bontumasi |first1=Nicholas |last2=Jacobson |first2=Jon A. |last3=Caoili |first3=Elaine |last4=Brandon |first4=Catherine |last5=Kim |first5=Sung Moon |last6=Jamadar |first6=David |year=2014 |title=Inguinal lymph nodes: size, number, and other characteristics in asymptomatic patients by CT |journal=Surgical and Radiologic Anatomy |volume=36 |issue=10 |pages=1051–1055 |doi=10.1007/s00276-014-1255-0 |issn=0930-1038 |pmid=24435023}}</ref> A size of up to 10&nbsp;mm is generally regarded as a [[Reference range#One-sided cut-off values|cut-off value]] for normal vs abnormal inguinal lymph node size.<ref name="Torabi2004">{{cite journal |author=Maha Torabi, MD |author2=, Suzanne L. Aquino |author3=Mukesh G. Harisinghani |name-list-style=amp |date=2004-09-01 |title=Current Concepts in Lymph Node Imaging |url=http://jnm.snmjournals.org/content/45/9/1509.full |journal=J Nucl Med |volume=45 |issue=9 |pages=1509–1518}}</ref>

=== Cloquet's node ===
The superior-most node is situated in the [[groin]], deep to the [[inguinal ligament]], and is termed the '''Cloquet's node''' (also Rosenmuller's node).<ref name="Zhu">{{cite journal |vauthors=Zhu Y, Zhang SL, Ye DW |display-authors=etal |title=Prospectively packaged ilioinguinal lymphadenectomy for penile cancer: the disseminative pattern of lymph node metastasis |journal=J. Urol. |volume=181 |issue=5 |pages=2103–8 |date=May 2009 |pmid=19286211 |doi=10.1016/j.juro.2009.01.041}}</ref> It can instead be considered as the inferior-most of the [[external iliac lymph nodes]].<ref name="urlClinical Sidelights to Core Concepts in Anatomy">{{cite web |url=http://www.anat.stonybrook.edu/HBA531/ClinicalSidelights.html |title=Clinical Sidelights to Core Concepts in Anatomy |access-date=2010-03-06 |archive-url=https://web.archive.org/web/20100226173408/http://www.anat.stonybrook.edu/HBA531/ClinicalSidelights.html |archive-date=2010-02-26 |url-status=dead }}</ref>{{citation needed |date=September 2017}} Cloquet's node is also considered as a potential [[sentinel lymph node]].<ref name="Zhu" /><ref name="Shen">{{cite journal |vauthors=Shen P, Conforti AM, Essner R, Cochran AJ, Turner RR, Morton DL |title=Is the node of Cloquet the sentinel node for the iliac/obturator node group? |journal=Cancer J |volume=6 |issue=2 |pages=93–7 |year=2000 |pmid=11069226 }}</ref>

This node is named for French surgeon [[Jules Germain Cloquet]],<ref name=":0" /><ref name="Loukas" /> or for German anatomist [[Johann Christian Rosenmüller]].<ref>{{cite web |title=Whonamedit - dictionary of medical eponyms |url=http://www.whonamedit.com/synd.cfm/2657.html |website=www.whonamedit.com |language=en}}</ref><ref>{{Cite news |title=node of Cloquet |work=TheFreeDictionary.com |url=http://medical-dictionary.thefreedictionary.com/node+of+Cloquet |access-date=2017-09-18}}</ref>

=== Efferents ===
The deep inguinal lymph nodes drain superiorly to the external iliac lymph nodes, then to the pelvic lymph nodes and on to the [[paraaortic lymph nodes]].<ref>{{Cite web |title=lymph nodes and nerves |url=http://www.oganatomy.org/projanat/gross/6/2.htm |access-date=2016-05-09 |website=www.oganatomy.org}}</ref>

==Clinical significance==
The presence of swollen inguinal lymph nodes is an important clinical sign because [[lymphadenopathy]] (swelling) may indicate an infection, or spread as a [[metastasis]] from [[cancer]]s, such as [[anal cancer]] and [[vulvar cancer]]. Inguinal lymph nodes may normally be up to 2&nbsp;cm.<ref name="Assessment of lymphadenopathy"/> The cut-off value for normal sized inguinal nodes is up to 10&nbsp;mm.<ref name=Torabi2004/>

==Additional images==
<gallery>
File:Inguinal_Lymph_nodes.png|A view of the different inguinal lymph nodes
 File:Inguinal lymph node MHCII-GFP mouse.jpg|[[Murine]] inguinal lymph node beneath the bifurcation of [[superior epigastric vein]]. Bright structure visualised by [[MHC II]]-[[Green fluorescent protein|GFP]] construct, is the lymph node
File:Lymph node regions.svg |Lymph node regions
</gallery>

==References==
{{Reflist}}

{{Lymphatics of lower limbs}}
{{Authority control}}

[[Category:Lymphatic organ anatomy]]