Appendix cancer physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
* | * | ||
* Patients with appendix cancer may appear normal, pale or diaphoretic. | |||
* | |||
* | * | ||
*Physical examination of patients with appendix cancer is usually normal. | *Physical examination of patients with appendix cancer is usually normal. | ||
| Line 70: | Line 40: | ||
===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with | * HEENT examination of patients with appendix cancer is usually normal. | ||
===Neck=== | ===Neck=== | ||
* Neck examination of patients with | * Neck examination of patients with appendiceal cancer is usually normal. | ||
* [[Lymphadenopathy|Cervical lymphadenopathy]] might be present. | |||
*[[ | |||
===Lungs=== | ===Lungs=== | ||
* Pulmonary examination of patients with | * Pulmonary examination of patients with appendix cancer is usually normal. | ||
* [[Wheezing]] : if the patient develop carcinoid syndrome | |||
* | |||
===Heart=== | ===Heart=== | ||
* Cardiovascular examination of patients with | * Cardiovascular examination of patients with appendix cancer is usually normal. | ||
but | |||
*if the patient develop carcinoid syndrome [[Murmur|systolic or diastolic murmur]] might be present | |||
*Right heart murmurs specially TR is prevalent. | |||
* | |||
===Abdomen=== | ===Abdomen=== | ||
| Line 136: | Line 63: | ||
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | *[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]] | ||
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test | *Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test | ||
* Abdominal examination may be remarkable for: | |||
'''Palpation''' | |||
* The abdominal wall is very sensitive to mild palpation | |||
* [[Rebound tenderness]] | |||
* [[Abdominal guarding]] | |||
* [[Rovsing's sign]] | |||
* [[Psoas sign]] | |||
'''Rectal examination''' | |||
* Tenderness in the [[rectovesical pouch]] | |||
===Back=== | ===Back=== | ||
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===Extremities=== | ===Extremities=== | ||
* Extremities examination of patients with | * Extremities examination of patients with appendix cancer is usually normal. | ||
*[[ | *rarely patients with carcionid syndrome might present with [[Edema|lower limb edema]] | ||
==References== | ==References== | ||
Revision as of 19:12, 24 January 2019
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Appendix cancer Microchapters |
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Diagnosis |
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Treatment |
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Appendix cancer physical examination On the Web |
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American Roentgen Ray Society Images of Appendix cancer physical examination |
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Risk calculators and risk factors for Appendix cancer physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Patients with appendix cancer usually appear normal, pale or diaphoretic. If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present. Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome. Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common. In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.
Physical Examination
- Patients with appendix cancer may appear normal, pale or diaphoretic.
- Physical examination of patients with appendix cancer is usually normal.
- If the patient with appendix cancer present with acute appendicitis which is quit common, abdominal tenderness, Rebound tenderness, abdominal guarding, Rovsing's sign, as well as Psoas sign might be present.
- Around 5% of the patients with appendiceal carcinoid tumors might develop carcinoid syndrome.
- Common physical examination findings of carcinoid syndrome include dehydration due to diarrhea, tachycardia as well as facial flushing, right heart murmurs like TR murmur is quit common.
- In patients with carcinoid syndrome, the presence of dermatitis, diarrhea, and dementia on physical examination is highly suggestive of of Pellagra disease.
Appearance of the Patient
- Patients with appendix cancer usually appear normal but might be pale or diaphoretic, or even present with a facial flushing.
Vital Signs
- Fever might be present in patients presenting with appendicitis.
- Tachycardia is prevalent in patients with carcinoid syndrome as well as patients with appendicitis.
- Tachypnea
- Hypertension
Skin
- Skin examination of patients with appendix cancer is usually normal.
in the presence of carcinoid syndrome the following might be present:
HEENT
- HEENT examination of patients with appendix cancer is usually normal.
Neck
- Neck examination of patients with appendiceal cancer is usually normal.
- Cervical lymphadenopathy might be present.
Lungs
- Pulmonary examination of patients with appendix cancer is usually normal.
- Wheezing : if the patient develop carcinoid syndrome
Heart
- Cardiovascular examination of patients with appendix cancer is usually normal.
but
- if the patient develop carcinoid syndrome systolic or diastolic murmur might be present
- Right heart murmurs specially TR is prevalent.
Abdomen
- Abdominal examination of patients with [disease name] is usually normal.
OR
- Abdominal distension
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right/left upper/lower abdominal quadrant
- Guarding may be present
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
- Abdominal examination may be remarkable for:
Palpation
- The abdominal wall is very sensitive to mild palpation
- Rebound tenderness
- Abdominal guarding
- Rovsing's sign
- Psoas sign
Rectal examination
- Tenderness in the rectovesical pouch
Back
- Back examination of patients with [disease name] is usually normal.
OR
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Genitourinary
- Genitourinary examination of patients with [disease name] is usually normal.
OR
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
- Clear/(color), foul-smelling/odorless penile/vaginal discharge
Neuromuscular
- Neuromuscular examination of patients with [disease name] is usually normal.
OR
- Patient is usually oriented to persons, place, and time
- Altered mental status
- Glasgow coma scale is ___ / 15
- Clonus may be present
- Hyperreflexia / hyporeflexia / areflexia
- Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
- Muscle rigidity
- Proximal/distal muscle weakness unilaterally/bilaterally
- ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
- Unilateral/bilateral upper/lower extremity weakness
- Unilateral/bilateral sensory loss in the upper/lower extremity
- Positive straight leg raise test
- Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
- Positive/negative Trendelenburg sign
- Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
- Normal finger-to-nose test / Dysmetria
- Absent/present dysdiadochokinesia (palm tapping test)
Extremities
- Extremities examination of patients with appendix cancer is usually normal.
- rarely patients with carcionid syndrome might present with lower limb edema