1. History & Examination of a lump
M K ALAM MS; FRCS
Professor of Surgery

3. History of a lump When did you noticed it? How did you noticed it?
Is the lump symptomatic? Pain, pressure
Any change in size since first noticed?
Does the lump ever disappear or reduce in size? Hernia
Any other lump on the body?
Any cause? Trauma? Heavy wt. lifting?

4. History Remaining history as usual Systemic inquiry
Past medical/ surgical history
Medications
Allergies
Social

5. General examination Patient permission A nurse present Vital signs
Adequate exposure

6. Examination of a lump Inspection: Site Size Shape Surface Colour
Pulsation
Cough impulse
Any other lump in the area or on the body

9. Examination of a lump Palpation: Site Size Shape Surface Colour
Pulsation (true or transmitted)- 2 finger technique
Cough impulse

10. Examination of a lump Temperature Tenderness
Consistency- hard, firm, soft
Edge

11. Examination of a lump Regional lymph nodes
Fluctuation- for fixed & mobile lump, tested in 2 axis
Transillumination
Compressibility: Sustained pressure empties swelling which refills on release of pressure- hemangioma
Reducibility: reduced into another space. Does not return spontaneously
Attachments- overlying skin, underlying muscle/bone
Regional lymph nodes

12. Examination of a lump Percussion: Auscultation: Dull (solid, fluid)
Resonant (gas)
Auscultation:
Bruit (vascular)
Bowel sounds(hernia)

13. Systemic examination
Complete examination of the patient

14. Thank you!