|Plan for examination of the scrotum|
|Scrotal neck||Junction between corrugated & smooth skin
At root of penis
At the pubic tubercle
|Tunica||Normally not felt except there is fluid||If Minimal fluid it is felt by benching
If large amount of fluid it is felt as swelling
Vas felt like tough structure
|Inguinal region||Inguinal lymph nodes (that drain scrotal skin)|
|Abdomen||Para-aortic lymph nodes
|Neck||Left supraclavicular LNs ( Verchow’s sign)|
Aim of examination in case of scrotal swelling is to answer 4 questions
Can you get above the swelling?
Can you identify the testis and the epididymis?
Is the swelling is translucent?
Is the swelling is tender?
and these are examples for how you can comment on your examination of scrotum.
- “Enlarged right side of the scrotum”
- Look to back of the scrotum and penis
- “No signs of inflammation (scars, sinuses or dilated veins)”
- “No cough impulse and not reducible (بيرجع؟)”
- “I can get above the swelling so it is pure scrotal swelling”
- Feel the swelling (relation to testis and epidydimis)
- Examine in supine position after standing
- Inspection normal
- Feel bag of worms
- May feel cough impulse or thrill
- Separate from testis
- Can get above it
- No transillumination