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# Superficial inguinal nodes

The superficial inguinal nodes are lymph nodes under the skin of the groin; they are the first filters for the vulva, lower [vagina](https://durgical.com/en/anatomy/vagina/), perineum and leg.

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## What it is

Lymph nodes in the groin, just under the skin below the inguinal ligament.

## What it does

The first nodes for the vulva, the lower vagina, the perineum and the leg; checked in vulvar cancer.

## Key points

- Exam exceptions: the [testis](https://durgical.com/en/anatomy/testis/) and [ovary](https://durgical.com/en/anatomy/ovary/) drain to para-aortic nodes (but the [scrotum](https://durgical.com/en/anatomy/scrotum/) to the groin), and the back of the calf and lateral foot drain first to popliteal nodes
- In vulvar cancer they are the first nodes involved; lesions near the midline can spread to both groins, so both sides are assessed
- Small, soft, mobile nodes are often felt in healthy adults; hardness, fixation, tenderness or growth point to infection or malignancy
- Four groups around the saphenofemoral junction: the two inferior groups take the leg; superolateral the buttock and lower lateral abdominal wall; superomedial the genitals, perineum, anal skin and lower abdominal wall

## Key facts

**Where**
Subcutaneous groin, along the inguinal ligament (superomedial, superolateral) and the great saphenous vein (inferior)

**Drains**
Vulva, lower vagina, perineum, [anal canal](https://durgical.com/en/anatomy/anal-canal/) below the pectinate line, lower abdominal wall, [lower limb](https://durgical.com/en/anatomy/region/lower-limb/); a little from the uterine cornu via the round ligament

**Into**
Deep inguinal and [external iliac nodes](https://durgical.com/en/anatomy/external-iliac-nodes/)

## Relations

**Superficial**
[Skin](https://durgical.com/en/anatomy/skin/) and the fatty layer of the superficial fascia of the groin

**Deep**
[Fascia lata](https://durgical.com/en/anatomy/fascia-lata/) and the cribriform fascia over the saphenous opening; beneath them the [femoral vein](https://durgical.com/en/anatomy/femoral-vein/) and the deep inguinal nodes

**Above**
[Inguinal ligament](https://durgical.com/en/anatomy/inguinal-ligament/), along which the horizontal group lies

**Below**
End of the [great saphenous vein](https://durgical.com/en/anatomy/great-saphenous-vein/) and its tributaries, along which the vertical group lies

## How to find it

With the person lying on the back and the hip slightly flexed and turned outwards, the groin is palpated just below and parallel to the inguinal ligament and along the great saphenous vein, noting size, consistency, tenderness and mobility.

## On imaging

Ultrasound shows normal nodes as oval with a bright fatty hilum; a rounded node with a lost hilum or abnormal blood flow is suspicious and can be sampled by needle under ultrasound guidance.

## Clinical notes

- Causes of enlargement: infection of the leg, foot or genitals (cellulitis; sexually transmitted infections such as syphilis, chancroid, genital herpes, lymphogranuloma venereum), lymphoma and metastases (vulvar, anal, penile cancer, melanoma of the leg)
- In lymphogranuloma venereum, nodes enlarged above and below the inguinal ligament can create a groove sign
- Sentinel node biopsy or inguinofemoral lymphadenectomy is part of vulvar cancer staging; a full dissection can cause wound breakdown and leg lymphoedema
- A groin lump can also be a femoral or inguinal hernia or a saphena varix; a cough impulse points to these rather than a node

## Related conditions

- [Syphilis](https://durgical.com/en/conditions/syphilis/)
- [Melanoma](https://durgical.com/en/conditions/melanoma/)
- [Mpox](https://durgical.com/en/conditions/mpox/)
- [Chancroid](https://durgical.com/en/conditions/chancroid/)
- [Plague](https://durgical.com/en/conditions/plague/)
- [Lymphatic filariasis](https://durgical.com/en/conditions/lymphatic-filariasis/)

## Test yourself

Think of the answer, then tap the question to see it.

## Which organs are classic exceptions that do not drain to the superficial inguinal nodes?

The testis and ovary drain to para-aortic nodes (the scrotum does drain to the groin); the back of the calf and lateral foot drain first to popliteal nodes.

## Why are both groins assessed in vulvar cancer?

The superficial inguinal nodes are the first involved, and lesions near the midline can spread to both sides.

## What is the groove sign?

In lymphogranuloma venereum, nodes enlarged above and below the inguinal ligament create a groove.

## Which feature points to a hernia or saphena varix rather than a superficial inguinal node?

A cough impulse.

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Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
nodi inguinales superficiales TA2 5349

**Official Spanish (DeCS)**
Nódulos linfáticos inguinales superficiales DeCS D008198

**English (TA2)**
Superficial inguinal nodes

## Related

- [Labia majora](https://durgical.com/en/anatomy/labium-majus-of-vulva/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=8375); [Anatomy, Abdomen and Pelvis: Inguinal Lymph Node](https://www.ncbi.nlm.nih.gov/books/NBK557639/); Anatomía humana (4.ª ed.), tomo 1, cap. 69: Sistema linfático.

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/superficial-inguinal-nodes/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/superficial-inguinal-nodes/
