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Zieman's Method
A classic clinical technique used to evaluate inguinal and femoral hernias during a physical exam.

Here's how it works:

Technique Overview

1. Patient Position: The patient stands upright, as hernias are more likely to protrude in this position.

2. Examiner's Hand Placement (usually the right hand for the patient's right side):

Middle finger: Placed over the external inguinal ring.

Index finger: Over the internal inguinal ring (just above the midpoint of the inguinal ligament).

Ring finger: Over the femoral canal (just below the inguinal ligament).

3. Valsalva Maneuver: The patient is asked to cough or strain, which increases intra-abdominal pressure.

4. Observation: The examiner feels for any impulse or bulge under the fingers:

A bulge under the Index finger suggests an indirect inguinal hernia.
A bulge under the middle finger suggests a direct inguinal hernia.

A bulge under the ring finger suggests a femoral hernia #Herniadiagnosis #clinicalexamination #Zieman'stest