Depending on location, may be Inguinal Hernia, Midline Hernia, or Hernia in Scar

  • Inguinal Hernias:   Direct, Indirect, & Femoral

If not visible/palpable, have pt cough or strain while you look & palpate

  • Before saying “cough,” have pt turn head away from you

Inguinal Hernias — examine pt standing up, you sitting on stool

  • Direct — Above inguinal ligament
  • Indirect — In scrotal sac (men) / Above inguinal ligament (women)
  • Femoral (esp. older women) — Below inguinal ligament, medial to femoral pulse

Midline (Umbilical, Abdominal) Hernias  —  don’t confuse with Diastasis Recti

  • Hernia = Palpable mass
  • Diastasis = separation of muscles on both sides of linea alba (not painful) causing diffuse bulging during a sit-up

Strangulated Hernia: Severe pain & tenderness, nausea/vomiting, ? fever

  • Educate to go straight to ER if this occurs