Appendicitis physical examination: Difference between revisions
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** Deep palpation of the [[left iliac fossa]] may cause pain in the [[right iliac fossa]] | ** Deep palpation of the [[left iliac fossa]] may cause pain in the [[right iliac fossa]] | ||
* [[Psoas sign]] | * [[Psoas sign]] | ||
** Occasionally, an inflamed appendix lies on the [[psoas]] muscle and the patient will lie with the right hip flexed for pain relief. | ** Occasionally, an inflamed appendix lies on the [[psoas]] muscle and the patient will lie with the right hip flexed for pain relief.<ref>{{Citation | ||
| last1 = Stockman III | |||
| first1 = James A. | |||
| lastauthoramp = yes | |||
| title = Year Book of Pediatrics 2012 | |||
| publisher = Mosby | |||
| place = Maryland Heights, MO | |||
| edition = 2012 | |||
| year = 2012 | |||
}}</ref> | |||
* [[Obturator sign]] | * [[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. | ** 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. |
Revision as of 20:09, 17 March 2016
Appendicitis Microchapters |
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Appendicitis On the Web |
American Roentgen Ray Society Images of Appendicitis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examinations mostly focus 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
- 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