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  • Positioning: patient lying supine with one pillow

The Patient

  • General Features

    Age, gender, general comfort

  • Body Habitus

    Weight (change), BMI, waist-hip ratio

Male Breast Exam

  • If appropriate

  • Inspect

    Enlargement, deformity, nipples

  • Palpate For Masses

    Flat hand, spiral motion outward from nipple

    Location, size, shape, consistency, mobility

  • Axillary Lymph Nodes

    Size, tenderness, consistency, mobility

The Groin

  • Patient lying supine

  • Hernia

    Inguinal / femoral

    Palpate and ask patient to cough

  • Lymph Nodes

    With or without tenderness

Testicular Examination

  • Patient standing, exposed from the waist down

  • Prepare

    Consent, undress, position

  • Inspection

    Lower abdomen, penis and scrotum

  • Testicular Palpation

    Between the thumb and index finger

    For masses

  • Epididymis

    Tenderness, enlargement

  • Spermatic Cord

    Tenderness, masses

  • Cremasteric Reflex

    Stroke inner thigh, look for retraction of testes

Digital Rectal Examination

  • Prepare

    Consent, chaperone, undress, position

  • Perianal Inspection

    Fissure, fistula / sinus, rash, mass, blood

  • Rectal Wall Palpation

    Haemorrhoids, fissures, look for blood on glove

  • Prostate Palpation

    Size, consistency, mobility, tenderness