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003 Swellings - Introduction to Clinical Surgery Lectures
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003 Swellings - Introduction to Clinical Surgery Lectures

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

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

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003 Swellings - Introduction to Clinical Surgery Lectures Presentation Transcript

  • 1. Swellings Nick Harvey
  • 2. History of a Swelling
    • Onset, Course, Duration?
    • Painful or Painless?
    • Other Lumps?
    • Effect on General Condition?
    • Cause?
    • Does the lump disappear?
  • 3. Examination of a swelling: Inspection
    • Site
    • Size
    • Shape
    • Symmetry
    • Surface
    • Skin overlying
    • Scars
    • Special signs
      • Pulsations, cough impulse, movement on swallowing, etc.
  • 4. 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
  • 5. Examination of a swelling: Consistency
    • Cystic
      • Fluctuation
      • Paget’s Test
    • Solid
      • Soft
      • Firm
      • (Indurated)
      • Hard
  • 6. 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
  • 7. Examination of a swelling: Relation to Muscle
    • Feel the swelling before and after muscle contraction
    • Is the swelling:
      • Superficial
      • Within
      • Deep to the muscles?
  • 8. Examination of a swelling: Pulsations
    • Expansile
    • Transmitted
  • 9. Examination of a swelling: Transillumination
    • Hydrocoele
    • Cystic hygroma
  • 10. Examination of a swelling: Neck Lumps
    • Thyroid
    • Thyroglossal Cyst
  • 11. Examination of a swelling: Hernias
    • Cough impulse
    • Reduction
  • 12. Examination of a swelling: Percussion & Auscultation
    • Percussion
      • Retrosternal goitre
    • Ausultation
      • Esp over arteries/pulsating masses