Lumps and Bumps - Examination

Question 1

History:

What q’s would you ask? - 7

Answer 1

How long has it been there?
Does it hurt?
Any other symptoms?
Any other lumps?
Is it getting bigger?
Even been abroad?
Otherwise well?

Question 2

Close inspection:

The 6 S’s are used. What are they?

Answer 2

Site
Size
Shape 
Smoothness 
Surface (contour/edge/colour) 
Surroundings

Question 3

Close inspection:

What different shapes can you get? - 4

Surface:
- What could the texture of it feel like?

Answer 3

Round
Oval
Irregular
Well-defined

Thick/rough/smooth/shiny

Question 4

Palpation:

What 6 things are felt for?

Answer 4

Tenderness
Temperature
Consistency 
Tethering 
Pulsatility 
Lymphadenopathy

Question 5

Palpation:

Tenderness:
- How can you check if the patient is in pain?

Temperature:

• How may you check this?
• What does increased temp suggest?

Consistency:
- What does this mean?

Tethering:
- Where may a lump be tethered to?

Pulsatility:
- What does this suggest?

What else needs to be felt in the surrounding areas?

Answer 5

Infection (e.g. abscess)

Check their face

Back of hand

How it feels, it is hard, soft, nodular etc.

Skin or muscle

Vascular aetiology (e.g. aneurysm)

Lymph nodes

Question 6

Auscultation:

What would you hear with vascular involvement?

What would you hear if it is a hernia?

Answer 6

A bruit

Bowel sounds

Question 7

Other tests:

Compressibility and cough impulse done for hernias.

What can be done to see if a lump is cystic (so full of serous fluid)?

Answer 7

Ideally, dim the lights in the room first
Shine a light through the lump and see if it illuminates

Transillumination suggests that the lump is cystic (e.g. hydrocoele)

Question 8

The examination could be split into the 4 S’s 4 T’s and the 3 C’s. What are they?

Answer 8

Site
Size
Symmetry
Shape

Tenderness
Temperature
Tethering
Transillumination

Colour
Consistency
Compressibility