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Occipital nodes (Figure 11) – Palpate the occipital nodes about one inch above and below the hairline. Cervical lymph node metastasis is common in patients with nasopharyngeal carcinoma (NPC), but occipital lymph node metastasis in NPC patients has not yet.

Figures 11 through 18 depict the examination techniques for the following lymph nodes. If suspicious nodes are discovered, the patient should be referred to a physician for immediate evaluation. For example, a previous history of cancer should cause the clinician to be more suspicious of newly appearing palpable nodes than if there is no history of cancer. Remember to correlate findings from the medical history and general appraisal of the patient to the observations made during the head and neck examination. When examined, these nodes should be small (less than 1 cm), non-tender and mobile. These nodes are located on the posterior base of the head in the occipital. This is a relatively common occurrence especially within the submandibular group of lymph nodes. The occipital lymph nodes (ok-sip-i-tuhl) are approximately 1 to 3 in number. Occasionally nodes will remain enlarged and palpable after an infection. Groups of tender nodes usually occur in conjunction with some type of acute infection. Lesser occipital nerve, high-resolution ultrasound, sonography.

Single or multiple non-tender, and fixed nodes are very suspicious for malignancy. and three of these showed interference of the LON with lymph nodes or an accessory. Findings which should be noted in the patient record include enlarged palpable nodes, fixed nodes, tender nodes and whether the palpable nodes are single or present in groups. Lymph is a fluid responsible for transporting lymphocytes (a type of white blood cell) all throughout.

The major lymph nodes of the head and neck area should be palpated with the patient in an upright position. Lymph nodes are small, encapsulated units in the lymphatic system.