Overview

Superficial nodes≈ 8–10

Deep nodes1–3

The superficial inguinal nodes (about 8–10) lie in the subcutaneous fat of the femoral triangle in a "T" arrangement: a horizontal (proximal) group just below and parallel to the inguinal ligament and a vertical (distal) group along the terminal great saphenous vein. They receive all superficial lymph of the lower limb (except the lateral foot and posterolateral calf, which follow the small saphenous vein to the popliteal nodes), the skin and superficial tissues of the anterior abdominal wall and back below the umbilicus/iliac crest, the gluteal region, the perineum, the scrotum and penile skin, the vulva and lower vagina (below the hymen), the anal canal below the pectinate line, and a few vessels from the uterine fundus that travel along the round ligament.

The deep inguinal nodes (1–3) lie beneath the fascia lata on the medial side of the femoral vein. They receive the superficial nodes' efferents, the deep lymphatics accompanying the femoral vessels, the popliteal node efferents and lymph from the glans penis or clitoris. The highest deep node, the node of Cloquet (Rosenmüller), occupies the femoral canal. Deep nodes drain to the external iliac nodes.

Location: Femoral triangle, below the inguinal ligament: superficial nodes in subcutaneous fat; deep nodes deep to the fascia lata medial to the femoral vein.

Parts & subdivisions

Superficial — horizontal group
Parallel to the inguinal ligament; drains the lower abdominal wall, buttock, perineum, external genitalia and lower anal canal.
Superficial — vertical group
Along the terminal great saphenous vein; drains the superficial lower limb.
Deep inguinal nodes
Medial to the femoral vein deep to the cribriform fascia; drain deep limb lymphatics, glans and superficial nodes.
Node of Cloquet
Deep node in the femoral canal; enlargement can mimic an irreducible femoral hernia.

Anatomy

Lymphatic drainage: Superficial → deep inguinal → external iliac → common iliac → lumbar nodes.

Function

Filter lymph from the lower limb, lower trunk wall, buttock, perineum and external genitalia.

Clinical significance

Inguinal lymphadenopathy

Small, mobile nodes (up to ≈ 1.5–2 cm) are common in healthy adults. Pathological causes include lower-limb infection or cellulitis, sexually transmitted infections (genital herpes and chancroid — tender; primary syphilis — painless, rubbery; lymphogranuloma venereum — suppurative buboes and the "groove sign" above and below the inguinal ligament), lymphoma, and metastases from melanoma of the leg, anal (below the pectinate line), vulval and penile squamous-cell carcinoma.

Testicular tumours spare the groin

Testicular cancer spreads to para-aortic nodes, not inguinal nodes, unless the scrotal skin has been breached (e.g. by previous scrotal surgery or a trans-scrotal biopsy, which is therefore avoided).

Compiled from standard anatomy and physiology references — see the Lymphatic & Immune System sources. For education only; not medical advice.