to b Qb

Examination of mass swelling lump tumor g

site the anatomical region

in chest in which intercostal space anatomical line
example in 2nd intercostal space in the midclavicular line

in Abdomen Left iliacfossa left lumbar lefthypochondrium epigastric

Rt hypochondrium Rt lumbar Rt iliacfossa suprapubic umbilical
regions
in face in forehead nose cheeks jaw

in heck in midline or laterally in anterior posteriortriangle

or over the sternodeidomastoid muscle

in leg Anterior posterior lateral

in hands on which bone carpals metacarpals phalanges
on dorsum or plantar at hand

size Xm I FIL
length wealth height of mass
if mass is spherical in shape measure i diameter height
It I
shape of mass spherical elliptical lenticel oval satellite
irrigularshape
Surface Examine using palmar of fingers smooth surface
rough nodular surface

Edge of mass well defined Sharpeedge like nevi

ill defined like abscess
color distant surroundings I mass Ji od 5

hypopigmented hyperpigmented pale erythemato us

Composition Solid fluid or gas
1 Consistency 2 fluctuation 3 Transillumination

4 Transmission of thrill 5 percussion

1 Consistancy Very soft like jelly fluid or gas

soft like relaxed muscle
firm like contracted muscle
hard like contracted muscle of boxers
like contracted biceps

Stony or bony hard like bone

rubbery like rubber

spongy like sponge

2 fluctuation fluctuate but still on its site fluid content

Slippery away from its site like lipoma
moves

3 Transillumination should performed in a dim environment local

with a torch in direct contact with the mass if the mass light up
bright gas fluid
4 Transmitted thrill if means fluid content
in large mass

5 percussion o Resonance gas dull fluid or solid

Springs I
compressibility press on the mass mass decrease in size

when pressured is removed mass returns back to its

b first size reform spontaneously

di reducibility
after pressing

Temperature of mass away from mass

cold hot or same as surroundings

bfood inflammation
no supply

Tenderness tender or not

mobility
Examine related nearest pulse lymph nodes
Examination of ulcer
ulcer Any breakdown of continuity of skin epithelium or mucous

membrane
ulcer Is Wound Jt
site same as mass

size length depth wealth

Shape
floor bis
See i discharge blood pus bone tendon dead black material
granulation tissue newly growing healthy tissue
base 6 41 thick or not Indurated or not indurated

palpable thick
fatal mistake gloves if 8 D8

I IF
Edge cut edge sloping everted inverted undermine

Temperature
tenderness
Nearest pulse lymph nodes

Causes of ulcer o Vascular traumatic neuropathic inflammation

infectious neoplastic idiopathic
1 Vascular arterial atherosclerosis
venous DVT no drainage no bloodsupply gaffaenrgeoesus

coagulopathy

neuropathy DM

3 neoplastic basal cell carcinoma

4 traumatic wound pressure ulcer bedsore
5 infection TB
6 inflammation burn chemicals
color pulse temp pain ukerdqjs j.ws
ulcer color temp Pain pulse

vascular arterial paleto white cold topofpaintischemic pulseless

Vascular venous congested very hot graduallyincrease weak pulse
ue 1sweating
neuropathy normal normal painless normal
inflammation red hot painful normal
infection red hot painful normal
traumatic red hot painful normal