Palpable masses Flashcards
Methods for lump examination
Site, Size, Shape
Position
Attachments
Consistency, Colour
Edge
Thrills, Fluctuance
Inflammation and Tenderness
Transillumination
Annular lump
Ring shaped
Arcuate lump
Curved
Nodule
Palpable mass >1cm
Papule
Palpable mass <1cm
Macule
Flat region with a colour change on the surface
Pustule
Small raised lump containing pus
What features help to identify a neural mass?
Neural masses tend to only move left to right
Pressing on a neural mass can cause pain, tingling or sensory loss
How can you start to determine the tissue location of a mass?
Bone masses are immobile
Muscle/tendon masses can be moved, or have their movement limited, by muscle contraction
Neural masses only tend to move left-to-right. Pressing on a neural mass can cause pain/tingling/sensory loss
Lymphadenopathy can present as a palpable non-mobile mass
Sister Mary Joseph nodule
Lymph drainage site to the umbilicus from the bladder via the urachus (remnant of the allantois)
Examination of a varicocele
Doesn’t transilluminate
Feels like a bag of worms
Examination of a hydrocele
Hydrocele is an accumulation of fluid in the scrotal sac due to a patent processus vaginalis
Transilluminates
Possible tp palpate above it
Sits at the level of the testicle
Identification of spermatocele
Spermatocele is a small cystic accumulation of semen in dilated efferent ducts or ducts of the rete testis.
Doesnt transilluminate
Possible to palpate above it
Which three scrotal swellings is it possible to access/palpate above?
Hydrocele
Varicocele
Spermatocele
How can you identify a femoral hernia on inspection
Below and lateral to the pubic tubercle
How would you identify an inguinal hernia n general inspection?
Above and medial to the pubic tubercle
(tend to be in men)
How would you examine an inguinal hernia?
Patient lying down & standing
Observe site and direction
Compare sides
Test cough impulse
Reducible/irreducible
Pressure over alternate inguinal rings
Auscultate
Other regional observations!
Common causes of groin swellings in females
Femoral hernia
Bartolin gland cyst
Methods for lump examination
Size, shape, surface
Position
Attachments
Consistency and colour
Edge
Thrills, pulsation, fluctuance
Inflammation
Transillumination
Thyroglossal duct cyst
Embyrologically the thyroid develops at the base of the tongue and descends to the anterior neck.
Remnants of the tract may persist, producing cysts.
Move on swallowing and tongue protrusion
Branchial cyst
Benign cysts that appear on the upper lateral aspect of the neck along the sternocleidomastoid
Arise from remnants of the second branchial sinus (where pharyngeal arch 2 grows over the lower arches)
Normally contain lymphoid tissue with prominent germinal centres. May have watery, mucinous or granular contents. Enlarge slowly.
Grading of a skin tumour
Asymmetry
Borders
Coloour
Dimensions
Bartholin cyst
Glands lie in the crease between the hymen and labium minora
Caused by infection and acute inflammation of the bartholin gland, results in obstruction of the duct.
