Pain Referral/quadrants Flashcards
What refers pain to the right shoulder?
Liver, right kidney, gallbladder, peptic ulcer, pancreatic cancer, head of the pancreas
What refers pain to the left shoulder?
cardiac, left kidney, tail of the pancreas, spleen
What refers pain to the mid-back/scapula
Pancreas, esophagus, gallbladder, stomach
What refers pain to the pelvis/ low back/ sacrum?
Colon, appendix, pelvic viscera
What is in the RUQ?
Gall bladder
Right lobe of liver
Small intestine
Transverse/ascending colon
Right kidney
What is in the LUQ?
Left lobe of liver
Stomach
Spleen
Pancreas
Small intestine
Transverse/ descending colon
Left kidney
What is in the RLQ?
Appendix
Lower ascending colon/small intestine
Right ureter
Right ovary
Right spermatic cord
What is in the LLQ?
Large portion of small intestine
Descending colon
Left ureter
Left ovary
Left spermatic cord
What causes a positive Kehr’s sign?
-Ruptured spleen
-Ectopic pregnancy
-Laproscopy
-Blood bleeding spleen, liver, stomach
How to perform Kehr’s sign?
-Left shoulder pain when PT applies pressure over the abdomen
What causes a positive Danforth sign?
-ruptured spleen
-ectopic pregnancy
-laproscopy
-blood bleeding spleen, liver, stomach
How do you perform the Danforth sign?
The pt will experience pain with inspiration
What are the appendix special tests?
-Blumberg’s sign
-McBurney’s point
-Rovsing Sign
-Psoas sign
-Obturator sign
-Markle sign
How do you perform the Blumberg’s sign test?
Also called rebound tenderness
Start on opposite side
Ex: left- start on left abdominal wall and depress, compress slowly and rapidly release
“Ding dong” ??>
How do you perform the McBurney’s point special test?
Point tenderness
Line right ASIS, belly button 1.5-2 inches above ASIS, there has to be pain
Rovsing Sign special test?
Press on LLQ and pain will be elicited in RLQ
“Wrong side”
How do you perform Psoas sign special test?
When pt is sidelying on the L and perform hip extension- pain willl be elicited on the RLQ
How do you perform the Obturator sign special test?
RLQ pain with ER and flexion to 90 degrees of the R hip with 90 degrees of knee flexion - indicative of inflammation of the sheath of the Obturator nerve
How do you perform the Markle Sign special test?
Pain elicited in RLQ when patient drops from standing on toes to the heels with jarring landing
“Meghan Markle wears heels”
What tests for gallbladder and how do you perform it?
Murphy sign
-Palpate near right subcostal margin as patient takes deep breath in
-It is + if the pt winces, catches breath
-For gallbladder pain will increase with the ingestion of FATTY FOOD
What is stress incontinence and how do we treat it?
-involuntary leakage of using during cough, sneeze exert pregnant/post partum
Trx: strengthen pelvic floor muscles
What is overflow incontinence and how do we treat it?
-Impaired sensation of bladder fullness
-LMN, diabetes type 1, detrusor muscle not contracting, damage to autonomic aferente nerves
Trx: meds, catheter
What is functional incontinence and how do we treat it?
-Can’t get to the bathroom, mobility issues, dexterity
-OA, TBI, Alzheimer’s
Trx: clear room, clutter, rugs, prompted voiding
What is urge incontinence and how do we treat it?
-Increased frequency and decreased amount of using
-infection, UTI
Trx: treat infection/medication
