Inguinal lymph nodes are

lymph node A lymph node, or lymph gland, is a kidney-shaped organ of the lymphatic system and the adaptive immune system. A large number of lymph nodes are linked throughout the body by the lymphatic vessels. They are major sites of lymphocytes that inclu ...

s in the human

groin In human anatomy, the groin (the adjective is ''inguinal'', as in inguinal canal) is the junctional area (also known as the inguinal region) between the abdomen and the thigh on either side of the pubic bone. This is also known as the medial comp ...

. Located in the

femoral triangle The femoral triangle (or Scarpa's triangle) is an anatomical region of the upper third of the thigh. It is a subfascial space which appears as a triangular depression below the inguinal ligament when the thigh is flexed, abducted and laterally rot ...

of the inguinal region, they are grouped into superficial and deep lymph nodes. The superficial have three divisions: the superomedial, superolateral, and inferior superficial.

Superficial inguinal lymph nodes

* The superficial inguinal lymph nodes are the inguinal lymph nodes that form a chain immediately below the

inguinal ligament The inguinal ligament (), also known as Poupart's ligament or groin ligament, is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may dev ...

. They lie deep to the

fascia of Camper The fascia of Camper is a thick superficial layer of the anterior abdominal wall. It is areolar in texture, and contains in its meshes a varying quantity of adipose tissue. It is found ''superficial'' to the fascia of Scarpa. Structure Superfici ...

that overlies the

femoral vessel The femoral vessels are those blood vessels passing through the femoral ring into the femoral canal thereby passing down the length of the thigh until behind the knee. These large vessel are the: * Femoral artery (also known in this location as ...

s at the medial aspect of the

thigh In human anatomy, the thigh is the area between the hip (pelvis) and the knee. Anatomically, it is part of the lower limb. The single bone in the thigh is called the femur. This bone is very thick and strong (due to the high proportion of bone ...

. They are bounded superiorly by the inguinal ligament in the femoral triangle; laterally by the border of the

sartorius muscle The sartorius muscle () is the longest muscle in the human body. It is a long, thin, superficial muscle that runs down the length of the thigh in the Anterior compartment of thigh, anterior compartment. Structure The sartorius muscle originates f ...

, and medially by the

adductor longus muscle In the human body, the adductor longus is a skeletal muscle located in the thigh. One of the adductor muscles of the hip, its main function is to adduct the thigh and it is innervated by the obturator nerve. It forms the medial wall of the fem ...

. They are divided into three groups: * inferior – inferior of the

saphenous opening In anatomy, the saphenous opening (saphenous hiatus, also fossa ovalis) is an oval opening in the upper mid part of the fascia lata of the thigh. It lies 3–4 cm below and lateral to the pubic tubercle and is about 3 cm long and 1.5&nb ...

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 The perineum in humans is the space between the anus and scrotum in the male, or between the anus and the vulva in the female. The perineum is the region of the body between the pubic symphysis (pubic arch) and the coccyx (tail bone), includi ...

and

genitals A sex organ (or reproductive organ) is any part of an animal or plant that is involved in sexual reproduction. The reproductive organs together constitute the reproductive system. In animals, the testis in the male, and the ovary in the female, a ...

. There are approximately ten superficial lymph nodes, and they drain to the deep inguinal lymph nodes. Inguinal lymph nodes may normally be up to 2 cm in size. Last updated: Last updated: Feb 16, 2017 They receive lymphatic afferents from the following: *

integument In biology, an integument is the tissue surrounding an organism's body or an organ within, such as skin, a husk, shell, germ or rind. Etymology The term is derived from ''integumentum'', which is Latin for "a covering". In a transferred, or ...

of the

penis A penis (plural ''penises'' or ''penes'' () is the primary sexual organ that male animals use to inseminate females (or hermaphrodites) during copulation. Such organs occur in many animals, both vertebrate and invertebrate, but males do n ...

scrotum The scrotum or scrotal sac is an anatomical male reproductive structure located at the base of the penis that consists of a suspended dual-chambered sac of skin and smooth muscle. It is present in most terrestrial male mammals. The scrotum cont ...

buttock The buttocks (singular: buttock) are two rounded portions of the exterior anatomy of most mammals, located on the posterior of the pelvic region. In humans, the buttocks are located between the lower back and the perineum. They are composed ...

abdominal wall In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls. There is a common set of layers covering and forming all the walls: the deepest being the v ...

below the level of the umbilicus *

back The human back, also called the dorsum, is the large posterior area of the human body, rising from the top of the buttocks to the back of the neck. It is the surface of the body opposite from the chest and the abdomen. The vertebral column run ...

below the level of the

iliac crest The crest of the ilium (or iliac crest) is the superior border of the wing of ilium and the superiolateral margin of the greater pelvis. Structure The iliac crest stretches posteriorly from the anterior superior iliac spine (ASIS) to the posterior ...

vulva The vulva (plural: vulvas or vulvae; derived from Latin for wrapper or covering) consists of the external sex organ, female sex organs. The vulva includes the mons pubis (or mons veneris), labia majora, labia minora, clitoris, bulb of vestibu ...

anus The anus (Latin, 'ring' or 'circle') is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, the residual semi-solid waste that remains after food digestion, which, d ...

(below the

pectinate line The pectinate line (dentate line) is a line which divides the upper two-thirds and lower third of the anal canal. Developmentally, this line represents the hindgut-proctodeum A proctodeum is the back ectodermal part of an alimentary canal. It ...

) * the thigh and the medial side of the leg (the lateral leg drains to the popliteal lymph nodes first).

Deep inguinal lymph nodes

There can be three, four or five deep inguinal lymph nodes. They lie medial to the

femoral vein In the human body, the femoral vein is a blood vessel that accompanies the femoral artery in the femoral sheath. It begins at the adductor hiatus (an opening in the adductor magnus muscle) as the continuation of the popliteal vein. It ends at th ...

under the

cribriform fascia The cribriform fascia, fascia cribrosa also Hesselbach's fascia is the portion of fascia covering the saphenous opening in the thigh. It is perforated by the great saphenous vein and by numerous blood and lymphatic vessels. (A structure in anatomy ...

. The uppermost node is in the

, under the inguinal ligament, and is called Cloquet's node (also Rosenmuller's node). This node is named for French surgeon

Jules Germain Cloquet Jules Germain Cloquet (18 December 1790 – 23 February 1883) was a French physician and surgeon who was born and practiced medicine in Paris. His older brother, Hippolyte Cloquet (1787-1840) and his younger nephew Ernest Cloquet (1818-1855) w ...

, or for German anatomist

Johann Christian Rosenmüller Johann Christian Rosenmüller (May 25, 1771 – February 28, 1820) was a German anatomist born near Hildburghausen, Thuringia. He was the son of theologian Johann Georg Rosenmüller (1736-1815). He received his education at the Universitie ...

. It can also be considered as the lowest of the

external iliac lymph nodes The external iliac lymph nodes are lymph nodes, from eight to ten in number, that lie along the external iliac vessels. They are arranged in three groups, one on the lateral, another on the medial, and a third on the anterior aspect of the vessel ...

. Cloquet's node is also considered as a potential

sentinel lymph node The sentinel lymph node is the hypothetical first lymph node or group of nodes draining a cancer. In case of established cancerous dissemination it is postulated that the sentinel lymph nodes are the target organs primarily reached by metastasiz ...

. 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 The periaortic lymph nodes (also known as lumbar) are a group of lymph nodes that lie in front of the lumbar vertebrae near the aorta. These lymph nodes receive drainage from the gastrointestinal tract and the abdominal organs. The periaortic lymp ...

Lymph node size

The mean size of an inguinal lymph node, as measured over the short-axis, is approximately 5.4 mm (range 2.1-13.6 mm), with two

standard deviation In statistics, the standard deviation is a measure of the amount of variation or dispersion of a set of values. A low standard deviation indicates that the values tend to be close to the mean (also called the expected value) of the set, while ...

s above the mean being 8.8 mm. A size of up to 10 mm is generally regarded as a cut-off value for normal vs abnormal inguinal lymph node size.

Clinical significance

The presence of swollen inguinal lymph nodes is an important clinical sign because

lymphadenopathy Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In cli ...

(swelling) may indicate an infection, or spread as a

metastasis Metastasis is a pathogenic agent's spread from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, then, ...

from

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

s, such as

anal cancer Anal cancer is a cancer which arises from the anus, the distal opening of the gastrointestinal tract. Symptoms may include bleeding from the anus or a lump near the anus. Other symptoms may include pain, itchiness, or discharge from the anus. ...

and

vulvar cancer Vulvar cancer is a cancer of the vulva, the outer portion of the female genitals. It most commonly affects the labia majora. Less often, the labia minora, clitoris, or vaginal glands are affected. Symptoms include a lump, itchiness, changes in t ...

. Inguinal lymph nodes may normally be up to 2 cm. The cut-off value for normal sized inguinal nodes is up to 10 mm.

Additional images

File:Inguinal_Lymph_nodes.png, A view of the different inguinal lymph nodes File:Inguinal lymph node MHCII-GFP mouse.jpg,

Murine The Old World rats and mice, part of the subfamily Murinae in the family Muridae, comprise at least 519 species. Members of this subfamily are called murines. In terms of species richness, this subfamily is larger than all mammal families excep ...

inguinal lymph node beneath the bifurcation of

superior epigastric vein In human anatomy, superior epigastric veins are two or more venae comitantes which accompany either superior epigastric artery before emptying into the internal thoracic vein. They participate in the drainage of the superior surface of the di ...

. Bright structure visualised by

MHC II MHC Class II molecules are a class of major histocompatibility complex (MHC) molecules normally found only on professional antigen-presenting cells such as dendritic cells, mononuclear phagocytes, some endothelial cells, thymic epithelial cells, ...

GFP GFP may refer to: Organisations * Gaelic Football Provence, a French Gaelic Athletic Association club * Geheime Feldpolizei, the German secret military police during the Second World War * French Group for the Study of Polymers and their Applicat ...

construct, is the lymph node File:Lymph node regions.svg , Lymph node regions

References

{{Authority control Lymphatic organ anatomy