Confirm, Tenderness, Temp, Size, attachment, mobility, Consistency, edges, surface, pulsation, Transillumination, compressibility

  • Confirm the inspection (site –use the bone prominence as landmark, shape)

  • Tenderness (the swelling and surroundings) (and look to the patient face

  • Temperature (mass and the surrounding tissue) (by the dorsum of the hand, and compare up/down, Rt/Lt)

  • Size: measure by ruler in 2 dimensions 

  • Attachment (superficial-skin or deep-muscle, how to defrentiate? ask patient to use muscle, to determine attachment, by asking to contract muscle, by flexing; if mass disappeared, then its attached to the muscles); if not attached could be subcutanous, skin, or otherwise.

  • Mobility (up/down) 

  • Consistency (Vary from soft to stony), Fluctuation; usually when mass has fluids

  • Edges (regular/irregular, sharp/rounded)

  • Surface (ex; smooth, rough, cobblestone)

  • Pulsation (CC) (artery lesion) expansile pulsation; if hands moves or (Related to artery) transmit pulsation; if lump moves.

  • Transillumination (should be in dark room) filled with fluid; with no internal tissue structure

  • Compressibility / Reducibility (compressible: lump disappear on pressure ; Hemingioma and reappear on release , Reducible: Lump reappears only after application of another force ex, inguinal hernia)