Abdomen PE

Question 1

McBurney’s Point

Answer 1

⅓ between ASIS to umbilicus

RLQ

deep tenderness = appendicitis

• Also where you test for rebound tenderness
  
  • release the pressure quickly!!

Question 2

Rovsing’s Sign

Answer 2

Palpate on the LLQ and the pt will feel pain on the RLQ

suggests appendicitis

Question 3

Psoas Sign

Answer 3

Have pt lie supine and lift one, straight leg against resistance of your hand

• stretches the psoas muscle which puts pressure on the appendix
  
  • sign is Positive if pt feels more abd pain when lifting leg

Question 4

Obturator Sign

Answer 4

When the pt lies supine and you bend the pts leg moving the knee laterally

• this stretches the obturator muscle = puts more pressure on appendix
  
  • this sign is positive if abd pain increases

Question 5

Murphy’s Sign

Answer 5

Press firmly upward on the RUQ and ask pt to take a deep breath

• if gall bladder is enlarged it will push down on the hand and elicit pain.
  
  • sign is positive if pt stops breathing due to pain

Question 6

Fluid Thrill

Answer 6

Tests for Ascites

• requires 3 hands:
  
  • have one person place hand on abdomen and push down
    
    • I will have one hand on each side of abdomen and tap
      
      • if fluid is present I will be able to feel the fluid wave on the opposite side

Question 7

Castell’s Spot

Answer 7

feeling for splenomegaly

• percuss at castell’s spot and have pt inhale and exhale
  
  • if you hear dullness on percussion during this inhale/exhale = positive indication for splenomegaly