Temperature • Feel with back of fingers on surfacesurrounds.
Tenderness • Ask to tell when feel pain. • Nerve: can cause pins and needles.
Consistency • Softspongyfirm.
Mobility and attachment • Move lump in two directionsright-angled to each other. Then repeatexam when muscle contracted: • Bone: immobile. • Muscle: contraction reduces lump mobility. • Subcutaneous: skin can move over lump. • Skin: moves with skin.
Pulsatile • Assess with 2 fingers on mass: • Transmitted pulsation: both fingers pushed same direction. • Expansile: fingers diverge (esp for AAA).
Fluctuation [fluid-containing] • Assess by placing 2 fingers in "peace sign" on either edge oflumpthen tapping lump center with index finger of other hand: fluctuantlump will displace peace sign fingers. • Very large masses can be assessed by a fluid thrill. See Ascitesexamination.
Irreducible • Compressible: mass decreases with pressurebut reappears immediatelyupon release. • Reducible: mass reappears only on coughetc.
