{"id":552,"date":"2010-12-02T14:45:46","date_gmt":"2010-12-02T14:45:46","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/palpation-3\/"},"modified":"2023-01-11T22:06:10","modified_gmt":"2023-01-11T22:06:10","slug":"palpation-3","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-gynaecological-examination\/the-examination-of-the-breasts\/palpation-3\/","title":{"rendered":"Palpation"},"content":{"rendered":"<p><strong>Preparation<\/strong><br \/>\nThe patient should lie on the examination couch in the supine position with fully unclothed upper body [Figure 73].<\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-541\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-73.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-73.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-73-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 73<\/span><\/span><\/p>\n<h2>Procedure<\/h2>\n<ul>\n<li>Palpate using the tips of the index finger, middle finger and ring finger. Make circular movements while lightly pressing the breast tissue against the chest wall.<\/li>\n<li>During palpation of the outer quadrants, a woman with large breasts can place the arm on the side of the relevant breast under her head [Figure 74].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-543\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-74.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-74.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-74-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 74<\/span><\/span><\/p>\n<p>In succession, palpate:<\/p>\n<ul>\n<li>the inner upper quadrant [Figure 75]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-544\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-75.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-75.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-75-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 75<\/span><\/span> &nbsp;<\/p>\n<ul>\n<li> the inner lower quadrant [Figure 76]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-545\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-76.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-76.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-76-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 76<\/span><\/span><\/p>\n<ul>\n<li> the outer lower quadrant [Figure 77]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-546\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-77.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-77.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-77-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 77<\/span><\/span><\/p>\n<ul>\n<li> the outer upper quadrant [Figure 78]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-547\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-78.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-78.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-78-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 78<\/span><\/span><\/p>\n<ul>\n<li> the axillary tail of the breast [Figure 79]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-548\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-79.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-79.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-79-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 79<\/span><\/span><\/p>\n<ul>\n<li> the nipple and areola [Figure 80]\n<ul><\/ul>\n<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-549\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-80.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-80.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-80-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 80<\/span><\/span><\/p>\n<ul>\n<li>the area around the breast (parasternal region).\n<ul><\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Note the following:\n<ul>\n<li>pain (inflammation, abscess)<\/li>\n<li>nipple discharge<\/li>\n<li>consistency of the breast tissue.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Tumours<\/strong><\/p>\n<p>Note:<\/p>\n<ul>\n<li>location<\/li>\n<li>size (estimated in centimetres)<\/li>\n<li>shape<\/li>\n<li>consistency (hard, fixed, firm, rubbery, soft, changing)<\/li>\n<li>surface (smooth, irregular, grainy, lobular)<\/li>\n<li>borders relative to surrounding tissue (well-defined or poorly-defined)<\/li>\n<li>mobility relative to the skin and subcutaneous tissue<\/li>\n<li>tenderness<\/li>\n<li>\u2018dimpling\u2019, seen when the skin over the tumour is pinched gently between thumb and index finger [Figure 81].<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-550\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-81.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-81.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-81-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 81<\/span><\/span><\/p>\n<ul>\n<li>Apply circular pressure to the nipple [Figure 82] and observe whether any discharge is released.<\/li>\n<li>Note the following: quantity, colour (blood, milk, pus).<\/li>\n<li>Carry out the same examination on the other breast.<\/li>\n<\/ul>\n<p><span class=\"jce_caption\" style=\"display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-551\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-82.jpg\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-82.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/Gynaecological_gy-fig-82-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\">Figure 82<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Preparation The patient should lie on the examination couch in the supine position with fully unclothed upper body [Figure 73]. Figure 73 Procedure Palpate using the tips of the index finger, middle finger and ring finger. Make circular movements while lightly pressing the breast tissue against the chest wall. During palpation of the outer quadrants, [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[54],"tags":[136],"class_list":["post-552","post","type-post","status-publish","format-standard","hentry","category-the-examination-of-the-breasts","tag-the-gynaecological-examination"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Palpation - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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