System: PVS & Lymphatics
Subjective Data
Peripheral Vascular
• Leg pain, cramps?
• Skin changes arms/legs?
• Any swelling?
• Any “swollen glands” noticed?
Breast & Axillary Lymphatics
• Pain?
• Lumps, tenderness or swelling?
• Rash or discharge?
• History of breast disease?
Neck/Regional Lymphatics
• Headaches?
• Head injury, dizziness?
• Neck pain, swelling, lumps?
Objective Data – PVS Objective Data – Regional Lymphatics
Inspect & Palpate Arms Inspect Head & Neck
• Skin color, lesions, arm symmetry • Head midline, erect
• Profile sign of nail beds (normally 1600)
• Accessory muscles symmetrical, no
• Temperature, cap refill 1-2 seconds
limitation of ROM
• Radial & brachial pulses
• Any obvious neck swelling?
o Normal 2+, regular, = bilaterally
• Palpate epitrochlear nodes (normally not Palpate cervical lymph nodes (10 locations)
palpable)
• Gentle circular motion with fingertips
Inspect & Palpate Legs • Follow sequence in text (Jarvis, 2024)
• Skin color & condition, hair distribution, • If palpable, nodes should be discrete,
venous pattern, symmetrical size soft, moveable, and non-tender
• Palpate temperature bilaterally (use dorsa
of hands)
• Popliteal & Pedal pulses bilaterally
• Femoral pulses bilaterally if indicated
• Assess for edema
o Grade from 1+ to 4+
Objective Data – Axillary Lymph Nodes
(normally not palpable)
Palpate 4 locations (think of it like a box)
• Pectoral (anterior)
• Central (high in the axilla)
• Subscapular (posterior)
• Lateral (inner aspect of upper arm)
Patti Manson 2021
Revised February 2024 Melissa Hrebenik