1. Skill Lab Dr. Ghassan A Barayan, MBBS Urology Demonstrator, UQU

2. Hx of Lump Hx of ulcer Ex of Lump Ex of ulcer

3. HPI Analysis of chief complation ▫SDN OPERA  Site – Severity  Duration  Nature  Onset  Progression – Precipitating Factor  End  Radiation – reffered – Relifing Factor  Aggrevating Factor – Associated Symptoms ▫Previous Similar Attack ▫Risk Factors ▫Associated Symptoms

4. Hx of lump & ulcer Wher? Site How? S/He notice When? Onset: Acute vs Chronic Progression? size Other lump? Previous similar Risk factors Associated feature ▫Pain ▫Discharge ▫Constitutional symptoms  Malignancy  Inflammation ▫Hx of trauma What do you think is the cause?

5. Ex of Lump Inspection 4Ss ▫Size ▫Site ▫Shape ▫Overlaying Skin  Color  Ulcers  Scars

6. Palpation: STC >> easy life ▫2Ts  Temperature  Tenderness ▫2 C  compressibility  consistency ▫2 S  Surface  Relation to surrounding  Overlying skin  Underlying structure

7. Palpation “cont’ “ ▫Edge ▫Reducibility ▫Cough impulse ▫Fluctuation ▫Fluid thrill ▫Tran illumination ▫Pulsetile

8. Percussion ▫Resonant vs Dull Auscultation ▫Abdominal sound ▫bruit

9. Ex of ulcer Inspection ▫4 Ss  Size  Site  Shape  Surrounding  Color  Scar  Induration or edema ▫F E  Floor  Edge ▫Depth

10. Palptaion ▫2Ts  Tenderness  Temprature ▫Base ▫Status of blood supply??