Pain Referral/quadrants

Question 1

What refers pain to the right shoulder?

Answer 1

Liver, right kidney, gallbladder, peptic ulcer, pancreatic cancer, head of the pancreas

Question 2

What refers pain to the left shoulder?

Answer 2

cardiac, left kidney, tail of the pancreas, spleen

Question 3

What refers pain to the mid-back/scapula

Answer 3

Pancreas, esophagus, gallbladder, stomach

Question 4

What refers pain to the pelvis/ low back/ sacrum?

Answer 4

Colon, appendix, pelvic viscera

Question 5

What is in the RUQ?

Answer 5

Gall bladder
Right lobe of liver
Small intestine
Transverse/ascending colon
Right kidney

Question 6

What is in the LUQ?

Answer 6

Left lobe of liver
Stomach
Spleen
Pancreas
Small intestine
Transverse/ descending colon
Left kidney

Question 7

What is in the RLQ?

Answer 7

Appendix
Lower ascending colon/small intestine
Right ureter
Right ovary
Right spermatic cord

Question 8

What is in the LLQ?

Answer 8

Large portion of small intestine
Descending colon
Left ureter
Left ovary
Left spermatic cord

Question 9

What causes a positive Kehr’s sign?

Answer 9

-Ruptured spleen
-Ectopic pregnancy
-Laproscopy
-Blood bleeding spleen, liver, stomach

Question 10

How to perform Kehr’s sign?

Answer 10

-Left shoulder pain when PT applies pressure over the abdomen

Question 11

What causes a positive Danforth sign?

Answer 11

-ruptured spleen
-ectopic pregnancy
-laproscopy
-blood bleeding spleen, liver, stomach

Question 12

How do you perform the Danforth sign?

Answer 12

The pt will experience pain with inspiration

Question 13

What are the appendix special tests?

Answer 13

-Blumberg’s sign
-McBurney’s point
-Rovsing Sign
-Psoas sign
-Obturator sign
-Markle sign

Question 14

How do you perform the Blumberg’s sign test?

Answer 14

Also called rebound tenderness
Start on opposite side
Ex: left- start on left abdominal wall and depress, compress slowly and rapidly release
“Ding dong” ??>

Question 15

How do you perform the McBurney’s point special test?

Answer 15

Point tenderness
Line right ASIS, belly button 1.5-2 inches above ASIS, there has to be pain

Question 16

Rovsing Sign special test?

Answer 16

Press on LLQ and pain will be elicited in RLQ

“Wrong side”

Question 17

How do you perform Psoas sign special test?

Answer 17

When pt is sidelying on the L and perform hip extension- pain willl be elicited on the RLQ

Question 18

How do you perform the Obturator sign special test?

Answer 18

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

Question 19

How do you perform the Markle Sign special test?

Answer 19

Pain elicited in RLQ when patient drops from standing on toes to the heels with jarring landing

“Meghan Markle wears heels”

Question 20

What tests for gallbladder and how do you perform it?

Answer 20

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

Question 21

What is stress incontinence and how do we treat it?

Answer 21

-involuntary leakage of using during cough, sneeze exert pregnant/post partum

Trx: strengthen pelvic floor muscles

Question 22

What is overflow incontinence and how do we treat it?

Answer 22

-Impaired sensation of bladder fullness
-LMN, diabetes type 1, detrusor muscle not contracting, damage to autonomic aferente nerves

Trx: meds, catheter

Question 23

What is functional incontinence and how do we treat it?

Answer 23

-Can’t get to the bathroom, mobility issues, dexterity
-OA, TBI, Alzheimer’s

Trx: clear room, clutter, rugs, prompted voiding

Question 24

What is urge incontinence and how do we treat it?

Answer 24

-Increased frequency and decreased amount of using
-infection, UTI

Trx: treat infection/medication