Palpate for Inguinal Hernias

To palpate for inguinal hernias, the examiner places his or her right index finger in the patient's scrotum above the left testis and invaginates the scrotal skin. There should be

Figure 18-27 Varicocele. Figure 18-28 Hydrocele.

Figure 18-29 Transilluminated hydrocele.

Hydrocele

Figure 18-30 Cross section of a hydrocele, illustrating its anatomy.

Hydrocele

Figure 18-30 Cross section of a hydrocele, illustrating its anatomy.

sufficient scrotal skin to reach the external inguinal ring. The finger should be placed with the nail facing outward and the pad of the finger inward. This is demonstrated in Figure 18-31. The examiner's left hand may be placed on the patient's right hip for better support.

The examiner's right index finger should follow the spermatic cord laterally through the external inguinal ring, into the inguinal canal parallel to the inguinal ligament, and upward toward the internal inguinal ring, which is superior and lateral to the pubic tubercle. The external ring may be dilated and allow the finger to enter easily. The correct position of the right hand is shown in Figure 18-32 and is illustrated in Figure 18-33.

With your index finger placed either against the external ring or in the inguinal canal, ask the patient to turn his head to the side and to cough or strain down. If a hernia is present, a sudden impulse against either the tip or the pad of the examining finger is felt. If a hernia is detected, have the patient lie down, and observe whether the hernia can be reduced by gentle, sustained pressure on the mass. If the hernia examination is performed with adequate scrotal skin and is done slowly, it is painless. The characteristics of hernias are discussed in the next section.

After the left side is evaluated, repeat the procedure by using your right index finger to examine the patient's right side. Some examiners prefer to use the right index finger to

Figure 18-31 Technique for examination for inguinal hernias.

Figure 18-32 Technique for palpation of inguinal hernias.

Internal inguinal ring Inguinal canal External inguinal ring

Figure 18-32 Technique for palpation of inguinal hernias.

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Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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