Method Of Exam
Author: A. Chandrasekhar, MD
Consultant: J. Pickleman, MD
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.
Examine over the femoral canal. Have the patient strain.
Do not ask patient to 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.