# Inguinal lymph nodes

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{{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](/source/lymph_node)s in the [groin](/source/groin). They are situated in the [femoral triangle](/source/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](/source/inguinal_ligament). They lie deep to the [fascia of Camper](/source/fascia_of_Camper) that overlies the [femoral vessel](/source/femoral_vessel)s at the medial aspect of the [thigh](/source/thigh). They are bounded superiorly by the inguinal ligament in the femoral triangle, laterally by the border of the [sartorius muscle](/source/sartorius_muscle), and medially by the [adductor longus muscle](/source/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](/source/BMJ_Best_Practice)}} Last updated: Last updated: Feb 16, 2017</ref>

They are divided into three groups:
* inferior – inferior of the [saphenous opening](/source/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](/source/perineum) and [genitals](/source/sex_organ).<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 afferents](/source/lymphatic_vessel) from the following as applicable:
* [integument](/source/integument) of the [penis](/source/Human_penis)
* [scrotum](/source/scrotum)
* [perineum](/source/perineum)
* [buttock](/source/buttock)
* [abdominal wall](/source/abdominal_wall) below the level of the [umbilicus](/source/Navel)
* [back](/source/back) below the level of the [iliac crest](/source/iliac_crest)
* [vulva](/source/vulva)
* [anus](/source/Human_anus) (below the [pectinate line](/source/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](/source/femoral_vein) deep to the [cribriform fascia](/source/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](/source/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 [cut-off value](/source/Reference_range) 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=https://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](/source/groin), deep to the [inguinal ligament](/source/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](/source/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> Cloquet's node is also considered as a potential [sentinel lymph node](/source/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](/source/Jules_Germain_Cloquet),<ref name=":0" /><ref name="Loukas" /> or for German anatomist [Johann Christian Rosenmüller](/source/Johann_Christian_Rosenm%C3%BCller).<ref>{{cite web |title=Whonamedit - dictionary of medical eponyms |url=http://www.whonamedit.com/synd.cfm/2657.html |website=www.whonamedit.com |language=en |url-status=dead }}</ref><ref>{{Cite news |title=node of Cloquet |work=TheFreeDictionary.com |url=https://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](/source/paraaortic_lymph_nodes).<ref>{{Cite web |title=lymph nodes and nerves |url=https://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](/source/lymphadenopathy) (swelling) may indicate an infection, or spread as a [metastasis](/source/metastasis) from [cancer](/source/cancer)s, such as [anal cancer](/source/anal_cancer) and [vulvar cancer](/source/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](/source/Murine) inguinal lymph node beneath the bifurcation of [superior epigastric vein](/source/superior_epigastric_vein). Bright structure visualised by [MHC II](/source/MHC_II)-[GFP](/source/Green_fluorescent_protein) 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

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Adapted from the Wikipedia article [Inguinal lymph nodes](https://en.wikipedia.org/wiki/Inguinal_lymph_nodes) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Inguinal_lymph_nodes?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.