Examination: Lumps and Bumps
- Wash hands
- Introduce yourself
- Ask permission to examine lump and offer a chaperone
- Expose abdomen, groin and legs
- Reposition - standing
- The lump itself (size/colour/shape)
- The surrounding tissue - any erythema?
- Feel the lump. Is it...
- Hard? Soft?
- Tethered? If so, to what?
- 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
- 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
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