Lump General:

Body built Cushing/tumor or steroid origin Cachexia, hypothyroid,

hyperthyroid
Height: Average, Giant, Swarf Hypogonadism infantilism
Nutrition status Over, normal or under by Malnutrition, marasmus
BMI/midarm circumference kwashiorkor, generalized
anasarca
BMI
Color Yellow, Pale, Cyanosis, Obstructive upper sclera on
daylight, Acute or chronic
malignancy, acute air
respiration obstruction
Decubitus Chest pain, orthopnea, knee Fallot tetralogy, Heart disease,
elbow position, renal colic kidney disease
Vitals Shock, thyrotoxicosis unequal
pulse AF
Cervical rib Thoracic outlet syndrome Atherosclerosis, luen? block
outside,
AF: acute ischemia limb +
stroke, mesenteric vessel
occlusion
Irregular irregularity, Cant
measure 4 beats
Bruits BP: Shock, hypovolemia, secondary
HTN __> pheochromocytoma,
renal stone, renal artery
stenosis
Temperature: Fever, inflamed infection
hyperthermia septic and death
RR: Tachypnea, Kussmaul Pneumothorax,
breathing
Parotic enlarge: Tumor, hepatic failure Alcohol consume, bilharzia
Xanthelasma Fat deposits Hyper cholesterol level
Neck + chest Lymph node + thyroid, Virchow nodes under
diaphragm carcinoma, umbilical
malignancy, malignant stomach
late diagnosis
Gynecomastia Liver cell disease Loss of inhibitory secretion of
estrogen
Splenectomy
Esophageal varices
Spider angioma Liver cell failure Shunts portosystemic varies
Detoxification Vaso active Palmar erythema
amine
Superior vena cava distribution
neck to upper chest
Exchange transfusion anti
coagulant plaharsia, parasite in
vessel, US detection
Murphy sign: 9th costal cartilage Acute cholecystitis
margin
Edema Lower limb swelling Subcutis
Bilateral Systemic cardiac, liver, renal or
nutrition
Unilateral DVT
Bruney lymphatic obstruction
filariasis protein denature,

Bed ridden presacral edema,

Varicose dilated elongated Ulcer, DVT, valve vein disease 2nd varicose,
torture veins and faulty deep vein
Trousseau syndrome Pancreatic cancer migrating Paraneoplastic
Bronchus cancer: bronchiectasis Liver disease,
Lymphadenopathy
Generalized: cervical or axilla Comment and chose larger 1
and inguinal, liver and spleen consistency group
Swelling examination
Inspect
Site, size, shape surface, skin
overlying, others
Testis paraaortic Finger axilla Toe melanoma inguinal
Surrounding structure special
characters
Midline of neck hypo, inguinal region Triangles of neck

Mass inguinal region Hernia lymph node

4 midlines swelling Thyroglossal cyst connected Thyroid cancer, lymph node,

anatomically cystic hygroma,
Shape Lemon, pear Orange irregular
Length: width Height
Skin overlaying Ulcer, Red, pigment, scar, Operation (incision hernia),
biopsy sinus, neurofibromatosis (café
late),
Dimpling, Varicosity, tethering, Malignancy
recurrence, Pea D orange
Blind ended tract drain skin, Pilonidal sinus: hair collection,
incavitate skin abscess formed, swelling, drainage,
Obstructed venous drainage Dilated veins of breast

Color Hemangioma, melanoma

Palpation: 8s CETT
Consistent Cyst: Firm, hard rubbery
Edge, Well defined Ill defined
Temperature
Tender
Paget fluctuation, modified, Hydrocele, Tunica vaginalis,
hold base, Bipolar for testis,
Drain lymph node
Transillumination: Epidermal cyst, cystic hygroma,
meningocele, back congenital
anomaly,
Movement with deglutition Thyroid disease
Movement with tongue
protrude
Thrill/ machinery murmur: AV
malformation
Pulsation test Expansile Transmitted
Surrounding structure Breast: pinch gliding try 2 ways, Nerve: foot drop

Fusion line: dermoid cyst angle
of eye
Expanded pressure effect
malignancy invasion post
auricular
house-made bursa is cyst.
Multiple lipoma
Teratoma
Hernia types
Drain of lymph node
Muscle contracted waist move
along fibers and against it
Lipoma lobulated slippery edge Liposarcoma dilated veins and
neck limb edema
Ganglion: herniated synovial Dermoid implantation sewer
fluid collection of tendons job, similar to epidermoid cyst
Tx: excision. Move across
contracted muscle.
Anterior SCM
Thyroglossal sinus/ Puctus: cystic hygroma posterior SCM
discharge
Sacral region cancer of many Before delivery US
tissues bone, cartilage, muscle,
epithelia
Cough test Umbilical
Pressure test, Ventral
Site Scrotal
Epigastric
Paraumbilical
Femoral
Testis para aortic IVC, Squamous scrotum: LN inguinal
Ulcer Discontinue epithelium Trauma cell death wound type
Edge area b/w margin and floor, Margin junction to normal,
biopsy site
Floor visible surface, Base something felt that ulcer
rest over
Slope
Punched Syphilis trophic,
Flask shape DM trophic foot
Undermine TB
Rolled over Basal cell cancer
Everted Squamous cell cancer
Granuloma: red Healing process
Pale: margin healing infected
Yellow: necrosis
Black mass: melanoma
Discharge Serous: healing process Purulent spread: infected
Bloody: malignant Bony spicules: osteomyelitis Green: pseudomonas
Cause Trauma vascular Malignant
Nonspecific: specific pathos TB, Syphilis, actinomycotic
Malignant ulcer
Callous: trophic DM foot no heal Indurated base
Surrounding Eczema pigment venous ulcer Scar wrinkle TB
Limb: Varicose venous ulcer Insufficient artery supply
Tender: Infect Non tender Malignancy
Base: depth DM foot Bleeding Malignant Relation structures fixed
Drain: lymph node: TB matted slight tender Malignant fixed stony hard
Inflamed Soft Abscess redundant
Tip of toe: arterial Medial malleolus Venous Pressure: metatarsal
neuropathic
Attached bone Attached muscle Clinical notes