Neck Lump Examination

OSCE Checklist

A- General 1- Introduce yourself

2- Explain

3- Take consent

4- Ensure privacy

5- Position: Sitting
6- Exposure: waist up

7- Wash hands +- Gloves

B- Inspection General look: E.g. sign of abnormal temperature regulation: shivering or
sweating

Hands Fingers: Thyroid acropachy , Onycholysis

Palms: erythema

Fine tremor: hands outstretched with palms facing downwards

and place a piece of paper on top of the hands.

Radial pulse
Temperature
Head Alopecia, hair thinning
Eyebrows Lateral one third hair loss
Eyes and Behind the Look for proptosis
periorbital area patient:
Front of the Lid retraction, pale conjunctiva, periorbital oedem
patient Extra-ocular muscle function: H shape
Convergence: Move your finger in towards the
patients nose: looking for pain or diplopia.

Face Flushing

Neck -Scars or skin changes

-Lumps if yes : assess : site, size, shape, surface, consistency,
fluctuance, mobility, transillumination, pulsility.
Ask the patient to swallow sip of water and inspect the lump
movement; if lump rises it is likely to be thyroid mass or a goitre
Ask the patient to protrude his/her tongue: if lump rises it is likely
to be a thyroglossal cyst
C. Palpation -Behind the patient palpate the whole neck
-Again ask the patient to drink sip of water and palpate the lump
- Palpate the lymph nodes
- Feel for tracheal deviation
D. Percuss For retrosternal dullness

E. Auscultate For bruit

F. Peripheral -Inspect the leg for pretibial myxedema
- Patellar reflex
-Sit-to-stand test: stand from their chair without using their arms

Rawan Alsulami