Clinical Skills

Question 1

Where does gallbladder pain radiate to?

Answer 1

Tip of the scapula

Question 2

What does Murphy’s sign indicate?

Answer 2

Cholecystitis

Question 3

What is cholecystitis?

Answer 3

Inflammation of the gall bladder potentially due to gallstones

Question 4

Explain Murphy’s sign.

Answer 4

Pressure applied to RUQ during inspiration causes pain and cessation of inspiratory effort.
–suggestive of gallbladder inflammation.

Question 5

Explain Kehr’s sign.

Answer 5

Kehr’s sign
–Left shoulder pain referred from diaphragm
–suggestive of free intaperitoneal blood (splenic injury)

Question 6

Explain McBurney’s point.

Answer 6

McBurney’s point
–Tenderness with palpation of abdomen 2/3 of the way between the umbilicus and right iliac crest.
–Suggestive of appendicitis.

Question 7

Explain Psoas sign.

Answer 7

Psoas sign
– Patient flexes right hip against resistance and experiences RLQ pain
– Suggestive of appendicitis

Question 8

Explain Rovsing’s sign.

Answer 8

Rovsing’s sign
–Palpation into the LLQ causes RLQ pain.
–Suggestive of appendicitis.

Question 9

Explain Grey Turner’s sign.

Answer 9

Grey-Turner’s sign
– Ecchymosis of left flank
– Suggests hemorrhagic pancreatitis

Question 10

Ecchymosis

Answer 10

A discoloration of the skin resulting from bleeding underneath, typically caused by bruising.

Question 11

Explain Cullen’s sign.

Answer 11

Cullen’s sign
– Ecchymosis of periumbilical area
– Suggests hemorrhagic pancreatitis

Question 12

Explain Lloyd’s sign.

Answer 12

Lloyd’s sign
– Percussion of flank elicits pain
– Suggests renal inflammation