Examination: Lumps and Bumps


  • Wash hands
  • Introduce yourself
  • Ask permission to examine lump and offer a chaperone
  • Expose abdomen, groin and legs
  • Reposition - standing

Inspection:
  • The lump itself (size/colour/shape)
  • The surrounding tissue - any erythema?
  • Scars

Palpate:
  • Feel the lump. Is it...
    • Hard? Soft?
    • Fluctuant?
    • Painful?
    • Warm?
    • Mobile?
    • Tethered? If so, to what?
    • Smooth?
    • Can you get above the lump?
    • Ask patient to cough while you have two fingers on the lump – see if there is a cough reflex
    • Where exactly is it positioned? This can help you decipher between different types of hernia:
      • Try to push the lump inwards (reduce the lump) – warn the patient first
      • Once it is reduced, find the pubic tubercle and place finger over it
      • Ask patient to cough and observe where lump appears in relation to your finger
        • Inguinal hernia – above and medial
        • Femoral hernia – below and lateral

Auscultate:
  • Listen over the lump for bowel sounds - is there herniation of bowel in the lump?

To conclude the examination:
  • Thank the patient and offer to help them get dressed
  • Offer to examine the patient's abdomen and groin
  • Consider requesting an ultrasound of the lump

written by: celine_lakra, first posted on: 05/01/13, 12:04

Downloads / Links

download pdf here
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Comments:

sana says...
plz keep the histry taking also. like example how to ask the question related to this problems
POSTED ON: 31/08/13, 17:20

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