Appendicitis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Physical examination will mostly be focused on abdominal findings. The patient may | Physical examination will mostly be focused on abdominal findings. The patient may appear in pain with a fever and mild [[tachycardia]]. Even minimal pressure on the [[abdomen]] can elicit a marked response from the patient due to pain. | ||
==Physical Examination== | ==Physical Examination== | ||
===Vitals=== | ===Vitals=== | ||
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*A [[fever]] is often present | *A [[fever]] is often present | ||
====Pulse==== | ====Pulse==== | ||
=====Rate===== | =====Rate===== | ||
*[[Tachycardia]] may be present | *[[Tachycardia]] may be present | ||
=====Rhythm===== | =====Rhythm===== | ||
*The pulse is regular | *The pulse is regular |
Revision as of 20:36, 18 November 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination will mostly be focused on abdominal findings. The patient may appear in pain with a fever and mild tachycardia. Even minimal pressure on the abdomen can elicit a marked response from the patient due to pain.
Physical Examination
Vitals
Temperature
- A fever is often present
Pulse
Rate
- Tachycardia may be present
Rhythm
- The pulse is regular
Symmetry
- The pulses may be asymmetric
Blood Pressure
- Hypotension may be present
Respiratory Rate
- Tachypnea may be present, or breathing patterns may be altered by patient to compensate for abdominal pain
Skin
- Diaphoresis may be present
- Pallor may be present
Abdomen
- The abdominal wall is very sensitive to mild palpation.
- Rebound tenderness
- Abdominal guarding
- Rovsing's sign
- Deep palpation of the left iliac fossa may cause pain in the right iliac fossa
- Psoas sign
- Occasionally, an inflamed appendix lies on the psoas muscle and the patient will lie with the right hip flexed for pain relief.
- Obturator sign
- If an inflamed appendix is in contact with the obturator internus, spasm of the muscle can be demonstrated by flexing and internally rotating the hip.
- This maneuver will cause pain in the hypogastrium
- A digital rectal examination elicits tenderness in the rectovesical pouch in special cases of appendicitis
- In case of a retrocaecal appendix even deep pressure in the right lower quadrant may fail to elicit tenderness
- If the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity