Principles of Examination of Lumps








  • Number
  • Site
  • Shape (sphere, hemisphere, asymmetrical, pear shaped, kidney shaped or others)
  • Size (in the 3 dimensions)
  • Surface (smooth or irregular)
  • Skin and color (smooth and shiny or thick and rough /scars or sinuses)
  • Special signs
  • Temperature
  • Tenderness
  • As inspection
  • Edge
  • Reducibility
  • Solid, fluid or gas
  • Consistence (Stony hard, firm, rubbery, spongy or soft)
  • Fluctuation by
    • Standard
    • Paget’s
    • Cross fluctuation test
    • Bipolar fluctuation test
  • Fluid thrill
  • Translucence
  • Vascular
  • Pulsation (Expansile or Transmitted)
  • Compressibility
  • Thrill

Relation to surrounding

  • Mobility

Relation to muscles:

Ask the patient to contract the muscle and reset mobility

Superficial to the muscle Swelling bulges more

Within the muscle No significant change in size

Deep to the muscle Swelling diminished in size

  • Mobility

Relation to skin:


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Confirm relation to the muscle

Draining L.N.s
Neuro-Vascular Bundle