Organ Referral Patterns and Special Tests

Question 1

Spleen, special test, location and pain referral

Answer 1

Located all the way to left of abdominals below the chest

Pain refers to Left abdomen and left shoulder, back

Kehrs sign refers pain to L shoulder when palpating w/ patient in supine with legs up

Question 2

Liver pain referral and keywords

Answer 2

R shoulder, r abdomen and interscapular region
Jaundice, hepatitis, ascites, cirrhosis

Avoid Valsalva maneuvers b/c liver takes up space

Question 3

Where does the gallbladder refer pain to and key pathologies

Answer 3

Referred to R upper quadrant front and back, R shoulder, thoracic region
Gallstones/colelithiasis, cholecystitis

Gallstones refers to R scapula and diet related (foods high in fat)

Murphys sign for gallstones Press down (palpate region while pt exhales)

Question 4

Where does the pancreas refer pain to

Answer 4

Refers to upper abdomen and back, L shoulder, epigastric region

Question 5

Summary for GERD

Answer 5

Left side-lying is best

Question 6

Describe the Rebound Tenderness Test

Answer 6

Palpation of abdominal region with broad hand and release, looking for pain. Positive could be peritonitis and should be treated as emergency, immediate action

Question 7

Duodenal Ulcer refers pain to where?

Answer 7

Midthoracic region

Question 8

Diverticulitis refers pain to where

Answer 8

Left quadrant for sigmoid involvement or mid abdominal region

Question 9

UTI referral pattern

Answer 9

Lower back and pelvic region

Question 10

Appendix location and referral and special test

Answer 10

Located in the lower right quadrant. Pain from LRQ to belly button.

Psoas sign is for iliopsoas irritation, and for appendicitis also known as Copes or Obraztsovas sign

Mcburneys sign is also for appendix, apply pressure 1/3 way from ASIS to umbilicus

Rovsing sign is rebound test press on LQ and positive if pain on RQ