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Hernias in the Inguinal Region Inguinal hernias: the inguinal ligament stretches from the anterior superior spine of the ilium to the pubic tubercle. The
flattened tube of the inguinal canal lies just above and parallel to it, between the superficial and deep layers of abdominal muscles. The lateral end of the
canal opens posteriorly into the abdominal cavity through the abdominal inguinal ring (internal ring). The internal ring is not palpable, but it is just above the
midpoint of the inguinal ligament. The medial end of the canal opens anteriorly into the subcutaneous tissue through the subcutaneous inguinal ring
(external ring). In the male, this is where the spermatic cord emerges from the abdominal muscles. A hernia is indirect when it enters the canal from the
abdominal cavity through the abdominal inguinal ring; a hernia entering medial to this ring is direct. In small hernias, the relation of the bulge to the
Source: The Abdomen, Perineum, Anus, and Rectosigmoid, DeGowin’s Diagnostic Examination, 10e
midpoint of the inguinal ligament is diagnostic of direct or indirect. If the hernia is large, palpation of the inguinal canal through the scrotum may determine
Citation:
LeBlond
RF, Brown
DD, hernia
SunejaisM,represented
Szot JF. DeGowin’s
Diagnostic
Examination,
10e; 2015
at: http://mhmedical.com/
its site of entrance
into
the canal.
The direct
as an anterior
bulging
of the posterior
wall ofAvailable
the inguinal
canal. Femoral hernia: the
Accessed:
May
10,
2017
femoral artery and vein emerge from the abdomen beneath the midpoint of the inguinal ligament, where the artery is palpable. The impalpable femoral vein
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Education.
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is immediately
medial to
it. The
femoral canal
lies medial
to thereserved
vein, so the canal is approximately 2 cm medial to the pulsating artery. A bulge in the
region of the femoral canal is produced by a femoral hernia, especially on coughing or straining. The diagram shows a femoral hernia protruding upward in