Lump Examination
Content
Surgical Lump Examination Any lump should be inspected in the same way :A. Inspection: 1. Solitary / Multiple 2. Site 3. Shape ( in 2 dimensions) 4. Size 5. Surface 6. Skin (Edema – color change – Dilated veins) 7. Scars 8. Pulsations 9. Cough impulse - performed only if the lump is suspected to be in communication with peritoneal , plueral, spinal or cranial - increase in size and pressure in the lump
B. Palpation 1. Temperature 2. Tenderness (inflammation) 3. Confirm size 4. Confirm shape (in 3 dimensions ) 5. Confirm surface 6. Edge - Defined and Regular Benign - Defined and Irregular Malignant - Diffuse and ill-defined Inflammation 7. Consistancy - Cystic More soft at the center - Solid More firm at the center - Soft Do the tests 8-12 - Variable 8. Fluctuation : transmission of movement impulse in 2 perpendicular directions and it indicates Fluid in the lump 9. Translumination: indicates presence of clear fluid 10.Cough impulse : increase in size and pressure in the lump 11.Reducibility : on reduction the swelling reappears only if the pressure increased 12.Compressibility : on reduction the swelling reappears even without increased pressure 13.Pulsation : Expansile X Transmitted 14.Fixation : - Skin: Fixed , Unfixed , tethering - Muscle : Superficial , within, deep to - Tendon - Bone
C. Percussion Tympanic notes if bowel is contained D. Auscultation Briut : Vascular origin X Highly vascular tissue Bowel sounds
Finally I have to check 1. L.N. 2. Joint movement 3. Pressure effect -
Artery Vein Nerve
weak pulse Edema + V.V. Wasting
B. Palpation 1. Temperature 2. Tenderness (inflammation) 3. Confirm size 4. Confirm shape (in 3 dimensions ) 5. Confirm surface 6. Edge - Defined and Regular Benign - Defined and Irregular Malignant - Diffuse and ill-defined Inflammation 7. Consistancy - Cystic More soft at the center - Solid More firm at the center - Soft Do the tests 8-12 - Variable 8. Fluctuation : transmission of movement impulse in 2 perpendicular directions and it indicates Fluid in the lump 9. Translumination: indicates presence of clear fluid 10.Cough impulse : increase in size and pressure in the lump 11.Reducibility : on reduction the swelling reappears only if the pressure increased 12.Compressibility : on reduction the swelling reappears even without increased pressure 13.Pulsation : Expansile X Transmitted 14.Fixation : - Skin: Fixed , Unfixed , tethering - Muscle : Superficial , within, deep to - Tendon - Bone
C. Percussion Tympanic notes if bowel is contained D. Auscultation Briut : Vascular origin X Highly vascular tissue Bowel sounds
Finally I have to check 1. L.N. 2. Joint movement 3. Pressure effect -
Artery Vein Nerve
weak pulse Edema + V.V. Wasting
