Hernias Flashcards
Name some types of hernia
Inguinal
Femoral
Distinguish between inguinal and femoral hernias
The NECK of the swelling is:
Inguinal - superior and medial to pubic tubercle
Femoral - inferior and lateral to pubic tubercle
Name and explain a differential for a femoral hernia
Saphena varix - essentially a varicosity at the saphenofemoral junction, inferolateral to the pubic tubercle
On examination, what would you be looking for?
Site of the lump Which tissue layer the lump lies within Does it extend to the scrotum in males Size Is it tender or warm? Solid or fluctuant? Pulsatile? Cough impulse? Reducible? Percussion and auscultation
If the lump extends into the scrotum, what type of hernia is it?
Indirect inguinal hernia
Hernias which are tender are also?
Reducible
If the lump is red, inflamed and shows signs of toxicity, what would this suggest?
A strangulated hernia with bowel necrosis and obstruction
Give some differentials for groin lumps which are warm, tender and associated with overlying erythema
Groin abscess
Reactive lymph nodes
Infected pseudo-aneurysm
If the groin lump is solid, what does it suggest?
Lymphadenopathy
If the lump is fluctuant, what does it suggest?
Hernia Saphena varix Femoral aneurysm Psoas bursa Hydrocele of the cord
If the groin lump is pulsatile, what does it suggest?
Femoral aneurysm
However, note that you may be detecting a transmitted pulse if the lump over lies the femoral artery
What is a cough impulse?
Whether or not the lump expands (NOT MOVES) during a cough/raised intra abdominal pressure
Which type of hernias do not have a cough impulse?
Incarcerated hernias
How do you detect for cough impulse?
Put hand over kill and ask patient to cough
If the lump is reducible, what could it be?
Saphena varix or hernias
