MassesBy : Nermeen Al Othaimeen I tried my best to do this presentation

comprehensible.

I answered the questions in the best way I can , my sources were the net, and doctors.

The pictures in this presentation are not the ones came in the previous exams we just took the questions from the students and we put similar pictures from net.

Please if you find any mistakes or even you find better answers don’t hesitate to tell me or Nojod Al amri

Station 1

Man with a big swelling in the back of his head of few months duration a) List 3 things u can see them by inspection:b) DDx :

c) 2 early or immediate – local – complications of the surgery

1- List 3 things u can see them by inspection:*Round or spherical mass

*well defined*smooth surface

*intact skin

2- Give DDx: Lipoma Sebaceuos cyst Abscess Lymph nodes Heamatomas Sarcoma Osteoma

3- Give 2 early or immediate – local – complications of the surgery :

{ dr. Kurdi gal el so2al maloosh ma3na :D }

1- wound infection2- bleeding3- excessive skin removal.4-heamatoma5- chyle leak6- sutures dehiscence

Station 2

Q.describe?Q.give 3 D.D?

1- Describe what you see Round facial mass In the right cheek Smooth surface Mention the size Mention the skin changes

( redness,discharge…etc)

2- give 3 D.D Salivary glands enlargement ( tumors,

inflammation, stones..) Teeth abscess Mumps Lipoma ??

Station 3

describe? D.D?

1- Describe what you see? Red mass in the head Spherical in shape Mention the size Mention skin changes

2- What is your D.D? Hemangioma Hematoma ???

Station 4

give DDx?Examine ??

DDX :Lipoma ,, AbscessTrauma-induced edema/hematomaInsect bite

Examination:5ps ( present your self , have permission,

proper exposure, privacy, position of the patient)

By inspection : site size shape symmetry skin changes

By palpation : Temperature Tenderness Mobility (assessed in 2 planes) Contour ( defined or nor) Consistency ( firm , hard , soft , rubbery) Tethering and attachment to underlying skin and

subcutaneous tissues Confirm what you see by inspection.By Percussion: resonance and dullnessBy auscultation :Bruits Special tests:Fluctuation ( done in 2 perpendicular planes) Fluid thrill , resonance and dullness , trans-

illumination test ( done in dark room or with cone)

Acronyms 3ashan la Tensoon

S T C PSite Temperature Color PermissionSize Tenderness Consistency Present your self

Shape Tethering Contour PrivacySurface Compressibility Position

Skin changes Always Compare Proper Exposure

Symmetry PulsatileSkin and

subcutaneous attachments to the

Lump ( done by mobility and

contraction of the underlying muscles)

Bruit

Station 5Examination of supra-clavicular region

Ma adri wesh yebi el so2al :DBut I would do a complete neck examination concentrating on lymphadenopathy..

Ensure the 5 p’sBy inspection : Symmetry Skin changes Scars deformity Visible masses Any thing you see abnormal in that area describe it, or even in the neck

By palpation: Stand behind the patient Bend patient’s neck to the left if u want to palpate the left Supra-

clavicular region and vice versa with the right region , the aim is to make the area flexible not tense

Feel any palpable lymph nodes and their composition. Temperature Tenderness

By percussion : Percuss over the supra-clavicular region Clavicle Sternum Lungs

By Auscultation : Auscultate for any possible lung apices cancer with bell and diaphragm of the

stethoscope

Station 6

*give differential diagnosis? Sebaceous cyst Carbuncle Folliculitis Lipoma Sebaceous carcinoma

Pic of Swelling appears in the scalp in between the hair