Approach

• If patient is lying in bed, examine supine
• If standing, examine standing

1. Inspect - determine whether problem is "groin" or "scrotum"
   • Inspect groin and scrotum
   • Scrotal incisions may be difficult to see as they are made in the median raphe in between the two hemiscrotums
   • Check in the groins
2. Palpate
   • both testes, one at a time
   • Palpate normal contour, identify epididymis and ductus deferens
   • Surface of testis is firm and regular
   • Lumpbs and irregularity - especially hard masses are abnormal

     ? separate from testis
     ? can you get above it
     ? does it transilluminate

3. Percuss
4. Auscultate

Completion

1. Continue to examine the rest of the abdomen and groin
2. Lymph drainage of tests to para-aortic nodes (retroperitoneal) // inguinal lymphadenopathy is not likely to be a response of testicular problems (but lymph drainage from scrotal skin and penis is)