Lump

Question 1

What do you look for on inspection?

Answer 1

Location/position - as measured from a landmark
Contour - if visible on inspection, regular/irregular?
Colour of skin - erythematous/pigmented
Abnormalities in overlying skin - ie peau d’orange (lymphatic oedema)
Abnormal vessels - telangiectasia, varicostiy etc

Question 2

What do you look for on palpation?

Answer 2

Surface - smooth/rough/irregular 
Shape
Size - tape measure 
Tenderness 
Temperature 
Cough impulse ie expands with cough 
Consistency - firm/soft/rubbery/uniform etc 
Fluctuant - movable or compressible 
Pulsatile - high blood flow or expansile - aneurysmal, thrill?

Question 3

What do you look for on movement?

Answer 3

Skin tethering - attempt to puck up a fold of skin over the swelling and compare the degree of tethering to the other side
Tethering to deep structures - attempt to move the swelling in different planes relative to surrounding tissue
Tethering to muscles and tendons - palpate the swelling whilst asking patient to use relevant muscle

Question 4

What special tests do you perform?

Answer 4

Transillumination - if you suspect mass to be filled with clear liquid ie hydrocoele, you should attempt to shine a torch through it
Auscultation for bruits or bowel sounds

Question 5

What else do you do?

Answer 5

Examination of local lymph nodes (knowledge of lymphatic drainage is important)