Neck Lump Exam

Question 1

What is involved in the introduction of a neck lump exam?

Answer 1

1. Wash/gel hands
2. Introduce yourself, confirm pt, explain examination and gain consent
3. Expose patient (entire neck) - unbutton or remove top

Question 2

What would a thin, fidgety, sweaty, flushed, restless patient from end of bed suggest?

Answer 2

hyperthyroidism

Question 3

What would a fat, warmly dressed, hair loss, dry skin, deep voice patient from end of bed suggest?

Answer 3

hypothyroidism

Question 4

What are the stages of inspection for a neck lump?

Answer 4

1. Look from front to sides
2. Define location: midline, anterior / posterior triangle
3. Swallowing
4. Stick out tongue

Question 5

What do you ask about swallowing?

Answer 5

1. Ask pt to sip of water and hold it in mouth
2. Instruct to swallow as you look from front
3. Instruct to swallow as looking from side

Question 6

Why do you ask the patient to stick out their tongue?

Answer 6

thyroglossal cyst moves upwards

Question 7

What do you do in palpitation of neck lump?

Answer 7

1. stand behind patient use both hands to examine
2. palpate from behind whilst patient swallows
3. attempt to transluminate lump

Question 8

What do you look for when palpating lump?

Answer 8

1. Start in centre of lump and move out to edges
2. Size/shape/symmetry
3. Surface
4. Consistency
5. Edge
6. Fluctuance
7. Palpation

Question 9

What do you check specific to thyroid swelling when palpating neck?

Answer 9

1. Diffuse enlargement or single nodule?
2. If diffuse is it smooth or multinodular
3. Lower extent - can you get below the thyroid