The cough impulse is a clinical sign that is elicited when examining a hernia.
If the swelling expands upon coughing, it is said to have a 'cough' impulse.
Movement of the swelling without expansion or an increase in tension is not a cough impulse.
The presence of an expansile cough impulse is almost diagnostic of a hernia. However a hernia may not have a cough impulse - neck of the sac may be blocked by adhesions which prevent the movement of additional viscera into the sac during coughing.
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