A 30-year-old man has a chronic infected ulcer on the medial aspect of the dorsum of his right little finger. Which group of lymph nodes will enlarge first?

• A Axillary apical nodes
• B Pectoral (anterior) axillary nodes
• C Infraclavicular nodes
• D Supratrochlear (cubital) nodes ✓

Explanation

Lymph from the medial side of the hand and forearm passes through the supratrochlear nodes, which lie just proximal to the medial epicondyle of the humerus, before reaching the lateral axillary nodes. Lateral structures of the hand bypass these nodes and drain directly to the axilla, so an ulcer on the thumb or index finger would not enlarge them. The apical and infraclavicular nodes are second echelon stations, not the first.

Reference: Gray's Anatomy for Students, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.