Hernia Differentiation

 

Indirect Inguinal Hernia: most common, originates above inguinal ligament, progresses into scrotum. With the examinating finger in the inguinal canal during straining or cough, the hernia comes down the inguinal canal and touches the fingertip.

Direct Inguinal Hernia: less common, above inguinal ligament, close to the pubic tubercle, near the external inguinal ring, rarely progresses into scrotum. With the examining finger in the inguinal canal during straining or cough, the hernia bulges anteriorly and pushes the side of the finger forward.

Femoral Hernia: More common in women than men, Originates below the inguinal ligament, appears more lateral than an inguinal hernia and may be hard to differentiate from lymph nodes. Never Progresses into scrotum. With the examining finger in the inguinal canal during straining or cough, the inguinal canal is empty.

Locations of different hernia types:

Bates, Barbara. 1974. A Guide to Physical Examination. J.B. Lippincott Company, Toronto.

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