Hernia Exam

Introduces self	0	1
Confirms name & age of patient	0	1
Explains & gains consent	0	1
Arranges chaperone, closes curtains/sign/locks door	0	1
Washes hands	0	1
Asks if patient is in pain	0	1
Exposes patient from waist down and asks them to stand	0	1
General inspection around bed and patient for scars, swellings, lumps	0	1
Asks patient to cough, observing for impulse in groin and scrotal areas	0	1
For swelling, describes size, shape, surface, consistency, colour, edge, temperature of any masses. Determines if mass is accentuated by coughing	0	1
Place fingers over superficial ring and determine if there is any cough impulse	0	1
Ask patient to reduce the hernia (which might require them to lie down)	0	1
Palpate over deep ring and feel for a cough impulse to determine if hernia is direct or indirect	0	1
Percuss over hernia	0	1
Auscultate the hernia	0	1
Place fingers over superficial ring on the other side and determine if there is any cough impulse	0	1
If hernia present, ask patient to reduce the hernia	0	1
Palpate over deep ring and feel for a cough impulse	0	1
If hernia present, percuss and auscultate the hernia	0	1
Palpate inguinal lymph nodes	0	1
Palpate femoral artery and auscultate for bruits	0	1
Thanks patient and offers help to redress	0	1
Washes hands	0	1
Requests abdominal examination and examination of the external genitalia	0	1
Summarise appropriately with only key findings.	0	1
Offer appropriate differential diagnoses.	0	1
Patient global score	0	1	2

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