Standing or lying supine
If you wish to palpate on the skin, provide a private room for assessment. The patient is asked if he/she is willing to slightly lower his/her pants a few inches to palpate the superior portion of the inguinal ligament or lower, if needed, for direct palpation on the skin over the pubic tubercles. While the skin can not be viewed with clothes covering the area, the structure usually can be palpated over clothing.
Anterior to the patient.
The upper part of this ligament can be evaluated more accurately if you lower your pants a few inches (and demonstrate the level). Would you feel comfortable doing this? Please place your hands on opposite shoulders or across your chest (or demonstrate). May I touch the front of your hip bone (or point to the demonstrated area of the anterior superior iliac spine or ASIS)? Please place your finger on this area (demonstrated area of the ASIS).
(Proceed and ask the patient if he/she is willing to lower his/her pants, and only if necessary, to the level of the pubic tubercles.) Better assessment of the pelvic bones is possible if you lower your pants (and demonstrate the level, which is to the level of the pubic tubercles). Would you feel comfortable doing this? If not, I can assess some things without moving your clothing and with pressure from my fingers. Please mimic where I place my hands on my own body (demonstrate pressing on the abdomen from your umbilicus down to your pubic tubercles). Your fingers will rest on bony ledges. May I replace your fingers with my thumbs? (You can use a skeleton if available).
(Proceed and ask the patient if he/she is willing to lower his/her pants, and only if necessary, to the level of the pubic tubercles.) Better assessment of the pelvic bones is possible if you lower your pants (and demonstrate the level, which is to the level of the pubic tubercles). Would you feel comfortable doing this? If not, I can assess some things without moving your clothing and with pressure from my fingers. Please mimic where I place my hands on my own body (demonstrate pressing on the abdomen from your umbilicus down to your pubic tubercles). Your fingers will rest on bony ledges. May I replace your fingers with my thumbs? (You can use a skeleton if available).
Guide the patient to drape and then stand or lie supine. Palpate the ASIS as described in this program. Guide the patient
to palpate the pubic tubercles as described in this program. Connect these two landmarks for palpation of the inguinal
ligament.
VH - Inguinal ligament