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