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Inguinal Canal ExamAka: Inguinal Canal, Internal Inguinal Ring, External Inguinal Ring

Indications
1. Male Genital Exam
2. Inguinal Hernia evaluation in men
Anatomy
1. See also Hasselbach's Triangle
2. Inguinal Canal components
  1. Internal inguinal ring
    1. Lateral to inferior epigastrics
    2. Landmark: Middle of inguinal ligament
  2. Canal
    1. Follows spermatic cord course in men
    2. Follows round ligament in women
  3. External inguinal ring
    1. Located at pubic tubercle
    2. Occurs just above inguinal ligament
    3. Medial and inferior to internal inguinal ring
Technique for inguinal canal palpation in men
1. Place fingertip at most dependent portion of scrotum
2. Invaginate scrotal wall to external inguinal ring
3. Gently insert finger into canal along spermatic cord
  1. Move finger laterally and cephalad
  2. Patient coughs, strains or performs valsalva maneuver
Findings
1. Inguinal Hernia
  1. Small Indirect Hernia may slightly tap end of finger
  2. Large Indirect Hernia may be palpable as mass
  3. Direct Inguinal Hernia may be felt on pad of finger
2. Spermatic cord tenderness (Funiculitis)
3. Spermatic cord Lipoma
4. Hydrocele

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.