Inguinal scrotal hernia

Insepction:

• scrotal swelling
• pt not in pain
• emerge superior and medical to pubic tubercle
  
• may have cough impulse
• no overlying skin changes

palpation

• check cough impuse
• reducibility - ask pt to self reduce first
• if reducible - try control at deep ring (mid point of inguinal ligt); then control at superficial ring
• consistency is soft
• separate from testis
• separate from epididymus
• no fluctuance

asculate

• may have bowel sounds

Ending

• non-transilluminable
• examine abdomen - look for raised abd pressure
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