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Inguinal Canal Exam

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1. Inguinal Canal Exam

Inguinal Canal Exam Inguinal Canal Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Inguinal Canal Exam Inguinal Canal Exam Aka (...) : Inguinal Canal Exam , Inguinal Canal , Internal Inguinal Ring , Deep Inguinal Ring , External Inguinal Ring , Superficial Inguinal Ring II. Indications evaluation (men and women) III. Anatomy See also Inguinal Canal components Internal Inguinal Ring Lateral to inferior epigastrics Landmark: Middle of inguinal ligament Canal Carries spermatic cord in men Carries round ligament in women External Inguinal Ring Located at pubic tubercle Occurs just above inguinal ligament Medial and inferior to Internal

2018 FP Notebook

2. Inguinal hernia in adults

or pelvic contents through a dilated internal inguinal ring or attenuated inguinal floor into the inguinal canal and out of the external inguinal ring, causing a visible or easily palpable bulge. History and exam presence of risk factors groin discomfort or pain with bulge groin mass abdominal discomfort or pain acute abdomen nausea and vomiting constipation male sex old age smoking family history prematurity heavy lifting abdominal aortic aneurysm (AAA) previous right lower quadrant incision defective (...) Inguinal hernia in adults Inguinal hernia in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Inguinal hernia in adults Last reviewed: February 2019 Last updated: December 2018 Summary Protrusion of abdominal or pelvic contents, through a dilated internal ring or attenuated inguinal floor in the inguinal canal. Presents with visible or easily palpable swelling in the groin, often with discomfort during

2018 BMJ Best Practice

3. Inguinal hernia in adults

or pelvic contents through a dilated internal inguinal ring or attenuated inguinal floor into the inguinal canal and out of the external inguinal ring, causing a visible or easily palpable bulge. History and exam presence of risk factors groin discomfort or pain with bulge groin mass abdominal discomfort or pain acute abdomen nausea and vomiting constipation male sex old age smoking family history prematurity heavy lifting abdominal aortic aneurysm (AAA) previous right lower quadrant incision defective (...) Inguinal hernia in adults Inguinal hernia in adults - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Inguinal hernia in adults Last reviewed: February 2019 Last updated: December 2018 Summary Protrusion of abdominal or pelvic contents, through a dilated internal ring or attenuated inguinal floor in the inguinal canal. Presents with visible or easily palpable swelling in the groin, often with discomfort during

2018 BMJ Best Practice

4. Inguinal Canal Exam

Inguinal Canal Exam Inguinal Canal Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Inguinal Canal Exam Inguinal Canal Exam Aka (...) : Inguinal Canal Exam , Inguinal Canal , Internal Inguinal Ring , Deep Inguinal Ring , External Inguinal Ring , Superficial Inguinal Ring II. Indications evaluation (men and women) III. Anatomy See also Inguinal Canal components Internal Inguinal Ring Lateral to inferior epigastrics Landmark: Middle of inguinal ligament Canal Carries spermatic cord in men Carries round ligament in women External Inguinal Ring Located at pubic tubercle Occurs just above inguinal ligament Medial and inferior to Internal

2015 FP Notebook

5. A case report of a groin pseudocyst following inguinal hernia repair and a review of the literature (PubMed)

hernia. Two separate aspiration interventions led to rapid re-accumulation of the fluid. Physical exam demonstrated a large inguinoscrotal mass in the left groin. It was non-tender and there were no overlying skin changes. His testicles were palpable at the bottom of the scrotum. A computed tomography exam demonstrated evidence of a prior left inguinal hernia repair. The left groin/scrotum had a 12 cm fluid collection with incomplete peripheral calcification, consistent with previous history (...) of seroma. An indirect hernial sac could not be excluded from the diagnosis. During groin exploration an inguinal canal pseudocyst was removed in its entirety without violating the capsule. The patient recovered well; there was no recurrence at a six month follow up. Review of the literature revealed that only two other cases had been reported, but in contrast to our case, the previous cases had an anterior repair for the index operation and the pseudocysts were open and partly resected.Post-operative

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2018 International journal of surgery case reports

6. Male Genital Exam

deferens Palpate Epididymis (posterior to ) Palpate for (engorged testicular veins) Patient performs Valsalva while standing V. Exam: Inguinal Canal Exam See Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Male Genital Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care (...) Male Genital Exam Male Genital Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Male Genital Exam Male Genital Exam Aka: Male

2018 FP Notebook

7. Male Genital Exam

deferens Palpate Epididymis (posterior to ) Palpate for (engorged testicular veins) Patient performs Valsalva while standing V. Exam: Inguinal Canal Exam See Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Male Genital Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care (...) Male Genital Exam Male Genital Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Male Genital Exam Male Genital Exam Aka: Male

2015 FP Notebook

8. Cryptorchidism

Cryptorchidism Cryptorchidism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cryptorchidism Last reviewed: February 2019 Last updated: February 2019 Summary Diagnosis is made on physical examination when one or both testes are not present within the dependent portion of the scrotal sac. Approximately 70% of cryptorchid testes are palpable within the upper portion of the scrotum or inguinal canal, whereas the other (...) of testicular cancer and reduced fertility from the affected testis. Immediate specialist consultation should be obtained in any patient with bilateral non-palpable testicles. Patients affected with both cryptorchidism and hypospadias should be screened with karyotype for a disorder of sex development (DSD). Definition Cryptorchidism, or undescended testis, is when one or both testes are not present within the dependent portion of the scrotal sac. History and exam presence of risk factors malpositioned

2019 BMJ Best Practice

9. Hydrocele

Hydrocele Hydrocele - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Hydrocele Last reviewed: February 2019 Last updated: January 2018 Summary A collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck. Common in male infants and the newborn. Most paediatric (...) if the hydrocele is causing problems. Definition Hydrocele is a collection of serous fluid between the layers of the membrane (tunica vaginalis) that surrounds the testis or along the spermatic cord. Rarely, similar fluid collection can occur in females along the canal of Nuck. There are 2 types of hydroceles: communicating and non-communicating (simple). In communicating hydroceles, a patent processus vaginalis connects the peritoneum with the tunica vaginalis, which allows peritoneal fluid to flow freely

2018 BMJ Best Practice

10. Anal cancer

chemoradiation for anal cancer. Int J Radiat Oncol Biol Phys. 2007;68:794-800. http://www.ncbi.nlm.nih.gov/pubmed/17379452?tool=bestpractice.com Adenocarcinomas can arise from anal crypts and should be treated as a rectal cancer. Because of their location and their higher lymphatic flow compared with rectal adenocarcinomas, anal crypt adenocarcinomas have a higher risk of inguinal node spread. Squamous cell and cloacogenic histologies are collectively defined as anal canal cancers. Other rare histological (...) entities can arise, such as small cell neuro-endocrine carcinomas, lymphomas, and melanomas. History and exam presence of risk factors rectal bleeding, pain, or mass inguinal node mass features of distant metastasis HPV HIV men who have sex with men immunosuppression anal trauma anal fistula Crohn's disease Diagnostic investigations anoscopy biopsy of tumour anal ultrasound abdominopelvic CT scan CXR or chest CT scan PET scan inguinal node needle biopsy Treatment algorithm ACUTE Contributors Authors

2018 BMJ Best Practice

11. Groin pain

. History and exam presence of risk factors acute pain related to trauma hx of sports-related or overuse injury positive anterior impingement test (FADIR test) pain on adduction against resistance (neutral hip flexion) pain on palpation of adductor tendons pain on palpation of iliopsoas pain on passive range-of-motion testing of the hip joint snapping/clicking hip positive Trendelenburg's test positive apprehension test positive modified Thomas' test pain on palpation of inguinal canal pain on palpation (...) Groin pain Groin pain - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Groin pain Last reviewed: February 2019 Last updated: March 2018 Summary A very common injury resulting from physical activity, including sport. Most common is adductor-related, iliopsoas-related, inguinal-related, and hip-joint-related groin pain. Most common presentation for intra-articular pathology of the hip joint; however, referred pain from

2018 BMJ Best Practice

12. Oncologic imaging

surgery. 4 Oncologic Imaging Copyright © 2019. AIM Specialty Health. All Rights Reserved. 17 SURVEILLANCE Local recurrence of early stage disease is detectable by exam or anoscopy. For patients at high risk for recurrence (locally advanced [T3/T4], inguinal node positive, or locally persistent/progressive/recurrent anal squamous cell cancer), surveillance may include CT chest, abdomen, and pelvis with contrast annually for a duration of 3 years per the NCCN guidelines. 3 However, due to the lack (...) indications ? MRI foot and MRI ankle for pain indications ? Bilateral exams, particularly comparison studies There are certain clinical scenarios where simultaneous ordering of multiple imaging studies is consistent with current literature and/or standards of medical practice. These include: ? Oncologic imaging – Considerations include the type of malignancy and the point along the care continuum at which imaging is requested ? Conditions which span multiple anatomic regions – Examples include certain

2019 AIM Specialty Health

13. Paediatric Urology

spermatic vessel ligation: an alternative to the Fowler-Stephens technique. J Urol, 1996. 156: 799. 94. Esposito, C., et al. Exploration of inguinal canal is mandatory in cases of non palpable testis if laparoscopy shows elements entering a closed inguinal ring. Eur J Pediatr Surg, 2010. 20: 138. 95. Radmayr, C., et al. Long-term outcome of laparoscopically managed nonpalpable testes. J Urol, 2003. 170: 2409. 96. Baker, L.A., et al. A multi-institutional analysis of laparoscopic orchidopexy. BJU Int (...) ., et al. Histological evidences suggest recommending orchiopexy within the first year of life for children with unilateral inguinal cryptorchid testis. Int J Urol, 2007. 14: 616. 60. Engeler, D.S., et al. Early orchiopexy: prepubertal intratubular germ cell neoplasia and fertility outcome. Urology, 2000. 56: 144. 61. Forest, M.G., et al. Undescended testis: comparison of two protocols of treatment with human chorionic gonadotropin. Effect on testicular descent and hormonal response. Horm Res, 1988

2019 European Association of Urology

14. ACC/AHA/SCAI/SIR/SVM 2018 Appropriate Use Criteria for Peripheral Artery Intervention: a report of the American College of Cardiology Appropriate Use Criteria Task Force, American Heart Association, Society for Cardiovascular Angiography and Interventions

canal to its bifurcation into the anterior tibial artery and tibioperoneal trunk. Rutherford Classi?cation of Chronic Limb Ischemia: Clinical staging system for describing PAD. It includes 7categories:0—Asymptomatic; 1—Mild claudication; 2— Moderateclaudication(Thedistancesthat delineatemild, moderate, and severe claudication are not speci?ed in the Rutherford classi?cation but are mentioned in the Fontaine classi?cation as 200 meters.); 3—Severe claudi- cation;4—Restpain;5 (...) , and covered self-expanding stents. Super?cial femoral artery: Terminal branch of the com- mon femoral artery extending from the origin of the profunda femoris branch to the adductor canal in the distal thigh. Surgical treatment: Artery revascularization procedure that requires skin incision and manipulation of the target artery under direct visualization. Such surgery Bailey et al. JACC VOL. 73, NO. 2, 2019 2018 AUC for Peripheral Artery Intervention JANUARY 22, 2019:214–37 222may involve endarterectomy

2019 Society of Interventional Radiology

15. Cryptorchidism

Cryptorchidism Cryptorchidism - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Cryptorchidism Last reviewed: February 2019 Last updated: February 2019 Summary Diagnosis is made on physical examination when one or both testes are not present within the dependent portion of the scrotal sac. Approximately 70% of cryptorchid testes are palpable within the upper portion of the scrotum or inguinal canal, whereas the other (...) of testicular cancer and reduced fertility from the affected testis. Immediate specialist consultation should be obtained in any patient with bilateral non-palpable testicles. Patients affected with both cryptorchidism and hypospadias should be screened with karyotype for a disorder of sex development (DSD). Definition Cryptorchidism, or undescended testis, is when one or both testes are not present within the dependent portion of the scrotal sac. History and exam presence of risk factors malpositioned

2017 BMJ Best Practice

16. Erectile Dysfunction

Erectile Dysfunction Erectile Dysfunction (ED) Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam (...) , and compassionate inquiry regarding sexual concerns is necessary. Given that many men are uncomfortable broaching the topic of sexual concerns with a physician, it is critical that the physician initiate the inquiry. 46, 47 When the man's presenting concern is ED, a comprehensive evaluation and targeted physical exam should be performed. Detailed assessment of sexual concerns may be difficult in a clinical setting when the presenting complaint is not ED; however, basic inquiry into sexual health should

2018 American Urological Association

17. Erectile Dysfunction

the topic of sexual concerns with a physician, it is critical that the physician initiate the inquiry. 46, 47 When the man’s presenting concern is ED, a comprehensive evaluation and targeted physical exam should be performed. Detailed assessment of sexual American Urological Association (AUA) Erectile Dysfunction Copyright © 2018 American Urological Association Education and Research, Inc.® 9 concerns may be difficult in a clinical setting when the presenting complaint is not ED; however, basic inquiry (...) , the partner’s views on sexuality, and the partner’s personal health/sexual issues, are useful to support a man in the evaluation of ED and to select an appropriate management strategy. Physical exam. Vital signs including pulse and resting blood pressure should be assessed. Obesity is a key indicator of ED risk. 49 Consideration should be given to the assessment of waist circumference. 50 BMI is an alternative but has less specificity for central adiposity, which is a more robust indicator of underlying CVD

2018 American Urological Association

18. Imaging Guidelines

for pneumothorax and hemothorax. 1 Extremity radiographs remain an important secondary adjunct for diagnosis of extremity orthopaedic injury. A best practice is interpretation of all radiographs concurrent with the trauma evaluation to facilitate timely treatment interventions. Computed Tomography Imaging Multi-detector computed tomographic (MDCT) imaging is now well established as the imaging modality of choice in hemodynamically stable patients following the secondary survey exam. Oral contrast (...) require sedation for safety while travelling to the CT scanner. MRI The length of exam, noise, and motion artifact all contribute to a usual requirement for sedation in the pediatric patient, particularly those less than 5-years of age. When feasible consider using the “feed and sleep” technique in infants. When available, use child- life specialists with young children to attempt imaging without sedation. Ensure that qualified personnel remain with the patient throughout the imaging study because

2018 American College of Surgeons

19. Paediatric Urology

spermatic vessel ligation: an alternative to the Fowler-Stephens technique. J Urol, 1996. 156: 799. 94. Esposito, C., et al. Exploration of inguinal canal is mandatory in cases of non palpable testis if laparoscopy shows elements entering a closed inguinal ring. Eur J Pediatr Surg, 2010. 20: 138. 95. Radmayr, C., et al. Long-term outcome of laparoscopically managed nonpalpable testes. J Urol, 2003. 170: 2409. 96. Baker, L.A., et al. A multi-institutional analysis of laparoscopic orchidopexy. BJU Int (...) ., et al. Histological evidences suggest recommending orchiopexy within the first year of life for children with unilateral inguinal cryptorchid testis. Int J Urol, 2007. 14: 616. 60. Engeler, D.S., et al. Early orchiopexy: prepubertal intratubular germ cell neoplasia and fertility outcome. Urology, 2000. 56: 144. 61. Forest, M.G., et al. Undescended testis: comparison of two protocols of treatment with human chorionic gonadotropin. Effect on testicular descent and hormonal response. Horm Res, 1988

2018 European Association of Urology

20. CRACKCast 107 – Peripheral Nerve Disorders

of the ulnar nerve. How can you discern between an ulnar nerve lesion at the elbow or at the wrist? Anatomy: C7 to T1 roots – passes through the brachial plexus to descend medially, without branching, to the ulnar (medial) condylar groove at the elbow. Then goes from cubital canal, it branches to the ulnar wrist flexor and the deep flexors of the fourth and fifth digits. At the wrist it enters Guyon’s Canal between the pisiform and hook of the hamate, after which it bifurcates into the superficial terminal (...) probability heavily favoring the elbow, the presence of sensory abnormalities in an ulnar distribution in the hand and fingers (ie, usually including the fifth digit and “splitting” the fourth digit) strongly suggests that the lesion is at the level of the elbow rather than the wrist. The ulnar cutaneous innervation to the hand branches off from the main trunk proximal to the nerve entering Guyon’s canal. Thus a lesion at the wrist should not produce sensory abnormalities, whereas one at the elbow would

2017 CandiEM

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