Lump Examination Component What to do/rationale Expose the relevant body area. Inspect: Size Shape General Inspection Contour -> defined vs poorly defined (i.e.) irregular. Swelling Warmth Erythema Temperature Ask of painful Look for consistency Hard -> malignancy Soft -> cyst or a lipoma Lipomas -> form between the skin and the underlying muscle. Pulsatile -> aneurysm Reducible -> hernia Abscess Palpation Fluctuant Erythema Warmth Edema/swelling Enlarged lymph nodes Mobility Feel more near by lymph nodes and draining lymph nodes. If in skin: Moves when the skin is moved. Examples: Sebaceous cyst Epidermoid cyst Papilloma If in subcutaneous tissue: Skin moves over the lump Examples: Neurofibroma Lipoma Layer If muscle or tendon: Contraction reduces lump mobility. Especially in longitudinal axis. If in bone: Immobile. If in nerve: Pressure induces pins and needles. Mobile in the transverse axis but not in longitudinal axis. If in artery: Pulsatile Test by palpation using the two-forefinger technique. Fluctuance Displace the fingers in both axes when the displacing finger is moved. Place a torch behind the lump Switch the lights down and look for light shinning through the lump. Transillumination Causes: Hydroceles. Cystic hygromas Simple cysts Breast cysts Tells us if lump is solid or cystic. Percussion Cystic -> resonance due to fluid. Solid -> dullness. Others Examine for lumps anywhere on the skin.