GI Special Tests

Question 1

Bowel Sounds

Answer 1

• Hyperactive with diarrhea
• Hypoactive with obstruction or ileus

Question 2

Bruits

Answer 2

Aortic or Renal Stenosis

Aortic bruit may indicate AAA

Question 3

Friction Rub

Answer 3

Liver tumor.

Splenic infarct.

Question 4

Rebound tenderness

Answer 4

Positive if it hurts more when you let go = peritonitis

Question 5

Palpation of aorta

Answer 5

Normal <3 cm

Wider = possible AAA

Question 6

Percussion of kidneys

Answer 6

CVA tenderness = pyelonephritis

Question 7

Shifting dullness

Answer 7

Abnormal: the top is tympanic even after rolling over (d/t shift of gas bubbles).

Indicates ascites.

Question 8

Fluid wave

Answer 8

Positive = easily palpated impulse.

Indicates ascites - common with liver cirrhosis!

Question 9

Ascites findings

Answer 9

Peripheral edema, shifting dullness, fluid wave.

Check for liver cirrhosis.

Question 10

Rovsing’s sign

Answer 10

Positive if deep palpation in LLQ causes pain in the RLG.

Indicates Appendicitis.

Question 11

Psoas sign

Answer 11

Positive = increased pain in RLG with psoas maneuver.

Indicates Appendicitis - Located along the coarse of the psoas muscle.

Question 12

Obturator sign

Answer 12

Positive = increased pain in RLQ.

Indicates Appendicitis - located deep in the R hemipelvis.

Question 13

McBurney’s point tenderness

Answer 13

Positive = pain at this point (1/3 the distance from the ASIS and naval).

Indicates Appendicitis.

Question 14

4 PE special tests for Appendicitis

Answer 14

1. Rovsing’s sign
2. Psoas sign
3. Obturator sign
4. McBurney’s point tenderness

Question 15

Murphy’s sign

Answer 15

Positive = sharp tenderness in the RUQ with a. sudden stop in inspiratory effort.

Indicates cholecystitis.