Question
A 32-year-old man comes to the emergency department because of a wound in his foot. Four days ago, he stepped on a nail while barefoot at the beach. Examination of the plantar surface of his right foot shows a purulent puncture wound at the base of his second toe with erythema and tenderness of the surrounding skin. The afferent lymphatic vessels from the site of the lesion drain directly into which of the following groups of regional lymph nodes?
A. |
Deep inguinal
|
B. |
Superficial inguinal
|
C. |
External iliac
|
D. |
Popliteal
|
Show Answer
Correct Answer � B
Explanation
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Answer B) Superficial inguinal
An infection on the anteromedial thigh would also drain into this group of lymph nodes.
Superficial inguinal
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The superficial inguinal lymph nodes directly drain lymph from the skin below the umbilicus, including the lower back, perianal region, and most of the lower extremity with the exception of the posterior calf and the dorsolateral foot, which drain into the popliteal lymph nodes.
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An infection in the medial and plantar region of the foot, as seen in this patient, can result in lymphadenopathy of the superficial inguinal nodes.
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Lymph from the superficial inguinal nodes would drain into the deep inguinal nodes, which, in turn, drain into the external iliac nodes.
Deep inguinal
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The deep inguinal lymph nodes receive lymph directly from the glans penis or clitoris and collect lymph from the superficial inguinal and popliteal lymph nodes.
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Lymph from the plantar aspect of the foot will eventually drain into the deep inguinal nodes but it would not drain directly into these nodes.
External iliac
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The external iliac lymph nodes receive lymph directly from the body of the uterus, the fundus of the bladder, and the deep inguinal nodes.
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Lymph from the plantar aspect of the foot will eventually drain into the external iliac nodes but it would not drain directly into these nodes.
Popliteal
They do not typically receive lymph from the skin over the plantar aspect of the foot.
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