Lump examination Flashcards
Things to consider when assessing lumps
Size Shape Colour Surroundings Surface Temperature/transluminacy/tethering/tenderness (pain) Fluctuatance Pulsatility Auscultation
Position of patient/angle of couch
Lying down - 45 degrees
What are you inspecting during general inspection?
Hyperactivity Agitation Anxiety Fidgeting Tremors
(hyperthryoid/fever/infection symptoms)
What are you inspecting in the hands?
Thyroid related symptoms: Thyroid acropachy Palmar erythema Dry skin Increased sweating
Peripheral tremor (check using paper on back of outstretched hands) Radial pulse - rate and rhythm
Face inspection
Inspection:
Dry skin
Sweating
Loss of outer 1/3 eyebrows
Eye inspection
Exopthalmus
Lid retraction (sclera visible or not above pupil)
Lid lag (ask patient to follow your finger up and down)
Redness/inflammation of conjunctiva
H test (ask if pt experiences diplopia or pain)
Neck inspection
Scars Erythema/skin changes Trachea deviation Ask pt to swallow water Ask pt to protrude tongue
Neck palpation - steps
Start from under the chin Palpate laryngeal prominence of thyroid cartilage Palpate cricoid cartilage below Isthmus Two lobes of thyroid Ask pt to drink water Ask pt to protrude tongue Palpate lymph nodes (follow SCM)
Percussion
Three taps on sternum (praecordium) to check for retrosternal goitre
Last things you do
Auscultate for bruit Reflexes (thyroid) Inspect legs for pretibial myxedema Ask pt to cross arms and squat (proximal myopathy) Thank patient
Things to consider when assessing lumps
Size
Shape
Colour
Surroundings
Surface (smooth/rough)
Temperature
Transluminacy
Tethering
Tenderness (pain)
Fluctuance
Pulsatility
Auscultation
