003 Swellings - Introduction to Clinical Surgery Lectures

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Information about 003 Swellings - Introduction to Clinical Surgery Lectures

Published on July 1, 2008

Author: memorablemedicine

Source: slideshare.net

Description

Lecture on swellings from a series of lectures on an introduction to clinical surgery. It has been devised with medical students in mind.

Swellings Nick Harvey

History of a Swelling Onset, Course, Duration? Painful or Painless? Other Lumps? Effect on General Condition? Cause? Does the lump disappear?

Onset, Course, Duration?

Painful or Painless?

Other Lumps?

Effect on General Condition?

Cause?

Does the lump disappear?

Examination of a swelling: Inspection Site Size Shape Symmetry Surface Skin overlying Scars Special signs Pulsations, cough impulse, movement on swallowing, etc.

Site

Size

Shape

Symmetry

Surface

Skin overlying

Scars

Special signs

Pulsations, cough impulse, movement on swallowing, etc.

Examination of a swelling: Palpation Tenderness Skin temperature Size Surface Smooth, irregular Edge Well-defined, ill-defined Consistency Cystic/solid, soft/firm/hard Relation to surrounding structures Skin, muscles, arteries, nerves… Draining lymph nodes Special signs

Tenderness

Skin temperature

Size

Surface

Smooth, irregular

Edge

Well-defined, ill-defined

Consistency

Cystic/solid, soft/firm/hard

Relation to surrounding structures

Skin, muscles, arteries, nerves…

Draining lymph nodes

Special signs

Examination of a swelling: Consistency Cystic Fluctuation Paget’s Test Solid Soft Firm (Indurated) Hard

Cystic

Fluctuation

Paget’s Test

Solid

Soft

Firm

(Indurated)

Hard

Examination of a swelling: Relation to Skin Is the lump separate from the surrounding skin? Pinch the skin over the lump Is the lump tethered or fixed to the skin? Move the lump and see what happens to the skin

Is the lump separate from the surrounding skin?

Pinch the skin over the lump

Is the lump tethered or fixed to the skin?

Move the lump and see what happens to the skin

Examination of a swelling: Relation to Muscle Feel the swelling before and after muscle contraction Is the swelling: Superficial Within Deep to the muscles?

Feel the swelling before and after muscle contraction

Is the swelling:

Superficial

Within

Deep to the muscles?

Examination of a swelling: Pulsations Expansile Transmitted

Expansile

Transmitted

Examination of a swelling: Transillumination Hydrocoele Cystic hygroma …

Hydrocoele

Cystic hygroma



Examination of a swelling: Neck Lumps Thyroid Thyroglossal Cyst

Thyroid

Thyroglossal Cyst

Examination of a swelling: Hernias Cough impulse Reduction

Cough impulse

Reduction

Examination of a swelling: Percussion & Auscultation Percussion Retrosternal goitre Ausultation Esp over arteries/pulsating masses

Percussion

Retrosternal goitre

Ausultation

Esp over arteries/pulsating masses

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