Appendicitis physical examination: Difference between revisions
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*[[Hypotension]] | *[[Hypotension]] | ||
*[[Tachypnea]] | *[[Tachypnea]] | ||
**Breathing patterns may be altered by patient to compensate for abdominal pain | **Breathing patterns may be altered by patient to compensate for abdominal pain<ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034</ref> | ||
===Skin=== | ===Skin=== |
Revision as of 19:30, 29 January 2016
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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
- Fever
- Tachycardia
- Hypotension
- Tachypnea
- Breathing patterns may be altered by patient to compensate for abdominal pain[1]
Skin
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
References
- ↑ Hardin, M. Acute Appendicitis: Review and Update. Am Fam Physician".1999, Nov 1;60(7):2027-2034