Method Of Exam

Inguinal

• Indirect
  • Examine patient in the upright position.
  • Invaginate the scrotum with the middle finger.
  • Direct the finger towards pubic tubercle.
  • Immediately anterior is the external inguinal ring.
  • The fingertip will rest on the cord as it exits the inguinal ring.
  • Now have the patient bear down like he is moving his bowels.
  • Following bearing down, a hernia sac should be palpable if present.

Femoral

• Examine over the femoral canal. Have the patient strain.

Caution:

Do not have him cough, as this gives a major indistinct pulse. Far more inguinal and femoral hernias can be detected in the upright position than in supine position.