Pediatric emergency medicine trisk 0427 0427

secondary sexual characteristics, hirsutism, or abnormal skin coloring may
indicate the presence of an endocrinopathy. A detailed evaluation of the breasts
and adjacent structures is essential. The chest wall should be inspected for any
gross deformities, asymmetry, or skin changes. The physician should have the
patient lean forward with hands on hips and again observe for any asymmetry or
skin retraction. With the patient supine with arms above the head, the physician
should palpate each breast in a series of concentric circles radiating outward from
the nipple, looking and feeling for nodules, cysts, masses, or inconsistencies in
the breast tissue. Each areola should be gently compressed to assess for masses or
nipple discharge. If present, the color, character, and odor of any discharge should
be noted. The physician should feel for the presence of any masses or
lymphadenopathy in both axillae.