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.<ref>Hardin, M. Acute Appendicitis: Review and Update. ''Am Fam Physician".1999, Nov 1;60(7):2027-2034</ref> | **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=== | ||
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** 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. | ||
** This maneuver will cause pain in the [[hypogastrium]]. | ** This maneuver will cause pain in the [[hypogastrium]]. | ||
* A digital rectal examination elicits tenderness in the [[rectovesical pouch]] in special cases of appendicitis. | * 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. | ** 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. | ** If the appendix lies entirely within the pelvis, there is usually complete absence of abdominal rigidity. |
Revision as of 17:44, 10 January 2018
Appendicitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farwa Haideri [2]
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
- Occasionally, an inflamed appendix lies on the psoas muscle and the patient will lie with the right hip flexed for pain relief.
- Obturator sign[2]
- 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.