Exam III Flashcards
Peptic ulcer referral pattern
right shoulder, lateral border, right scapula
Myocardial ischemia referral pattern
left or right shoulder and down arm (L>R)
Thoracic aorta aneurysm referral pattern
left shoulder or between shoulder blades
Hepatic /biliary: Acute cholecystitis referral pattern
right shoulder, in between scapula, right subscapular area
Gallbladder referral pattern
right upper trap, right shoulder
liver disease (hepatitis, cirrhosis, metastatic tumor, abscess) referral pattern
right shoulder, right subscapular
Pulmonary (pleurisy, pneumothorax, Pancoast tumor, pneumonia) referral pattern
Ipsilateral shoulder, upper trap
Kidney referral pattern
Ipsilateral shoulder
Gynecologic: Endometriosis referral pattern
Reported in right shoulder, possible in either shoulder depending on location of cysts
Internal bleeding: spleen rupture or trauma, post-op laparoscopy referral pattern
Left shoulder (Kehr’s sign)
Pancreas referral pattern
Left shoulder
infectious mononucleosis (hepatomegaly, splenomegaly) referral pattern
left shoulder/left upper trap
Gynecologic: Ectopic pregnancy
ipsilateral shoulder
Diaphragmatic Irritation
Irritation of the peritoneal (outside) or pleural (inside) surface of the diaphragm refers sharp pain
Central portion—upper trapezius, neck, supraclavicular fossa
Peripheral portion—costal margins and lumbar region
Pain is ipsilateral to area of irritation
Septic arthritis
Sudden/severe, warm with swelling and limited ROM, constitutional signs and symptoms
