hernia question

[coreytayloris]

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lads,
I do't understand the answer to this question.
surely the answer could be either medial or lateral, there's nothing indicating whether it's indirect or direct from the examination...?

the answer is A is it not?

 

[xpert787]

Since the mass is felt at the superficial ring, but not the deep, this indicates its a direct, since indirect should traverse the inguinal canal, and be felt at both the superficial and deep rings. With that said, this question is ridiculous, because the diagnosis of direct vs indirect is made at the time of surgery, the most you can usually say with confidence is the patient has a hernia.

 

[Transposony]

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lads,
I do't understand the answer to this question.
surely the answer could be either medial or lateral, there's nothing indicating whether it's indirect or direct from the examination...?

the answer is A is it not?

You are right. the answer should be A.
There is so much wrong about this question and the explanation.

In olden times Inguinal hernia was diagnosed clinically and basically you have to demonstrate that if it protrudes after occlusion of deep ring by pressure and coughing. Both indirect and direct will protrude since both are coming lateral to the superficial ring. However, only direct will protrude on occlusion of the deep ring. The fact that it does not protrudes after occlusion of the deep ring rules out a direct hernia and therefore it has to lie lateral to the inferior epigastric artery (since the deep ring is lateral to it).
Hope this helps.