Landmark

• Deep:
  • superior to midpoint of IL, immediately lateral to IEGA
• Superficial:
  • 1 cm superolateral to the pubic tubercle
• L1, L2 - Genitofemoral
  • premastetric muscle
• L1 - Ilio-inguinal
  • ant. ado wall over pubis
• See in vericocele

Standing

Position

• Expose groin and ASIS
• X ascultation and percussion

Inspection

• Abdominal wall → Focus on
  • Umbilicus
  • Epigastric region
  • Previous scars
• Increase abdominal pressure: Valsalva maneuver

Palpation

<aside>

Reporting

• Pressure at Tip of index finger: indirect
  • Lateral to the Inferior epigastric vessel
  • through deep inguinal ring
  • commonly enter the scrotom
• Pressure at Side of index finger: direct
  • weakened abdominal wall
  • medial to IEV
  • Hard to feel
• Reducible?
• Incarcerated? </aside>

Supine: Scrotal Hernia