Right iliac fossa pain Flashcards
What is guarding?
involuntary muscular rigidity in tender areas of the abdomen
How can you demonstrate patietal peritoneum irritation in a kind way to patients
Percussion tenderness, when percussion over an area causes the patient pain, is a
sensitive means of demonstrating parietal peritoneum irritation and is far kinder to
the patient than assessing rebound tenderness.
Why are you looking fetor oris
fetor oris (bad breath), can indicate abdominal sepsis (such as appendicitis).
Why are we looking at cervical lymphadenopathy in those with RIF pain
Mesenteric adenitis (inflammation of the lymph nodes around the mesentery) often follows an upper respiratory tract viral infection, so cervical lymphadenopathy may be present.
MOSTLY IN CHILDREN, AND VERY HARD TO DISTINGUISH FROM APPENDICITIS
Why is it essential to do a rectal exam in a suspected appendicitis
To assess for local tenderness in the rectum. The appendix can lie in a
number of positions relative to the caecum.
An infl amed pelvic appendix
may not result in any abdominal tenderness to palpation, and the only sign
may be right-sided rectal tenderness.
Why is it necessary to examine the external genitalia in a man with RIF pain
you must examine the testicles for signs of torsion – particularly in young men. The window of opportunity for surgical rescue of torted testes is slim.
Why can tescicular torsion pain refer to the abdomen
Torsion can present with referred pain to the abdomen
via T10 sympathetic innervation.
What is a positive rovsings sign?
, palpation in the left iliac fossa results in
greater pain in the RIF than the left (Rovsing’s sign positive)
What can cause slight increases in amylase/lipase levels
What causes very high amylase/lipase levels
Slight increase:
MOST COMMONLY PANCREATITIS
but also
bowel obstruction, mesenteric ischaemia, a posteriorly perforated duodenal ulcer, mumps, pancreatic carcinoma, or opiatemedications.
Very big increase:
ALMOST EXCLUSIVELY PANCREATITIS
What does dilation of sentinel loops mean on radiograph
Dilatation of a few
‘sentinel’ loops refl ects a response to infl ammation of other local structures
such as the pancreas or appendix.
What are renal/ureteric calculi- are they visible on abdo radiograph?
Approximately 80% of renal/ureteric calculi
are radio-opaque and thus visible on a plain abdominal radiograph
What is meckels diverticulum?
Meckel’s diverticulum is an outpouching or bulge in the lower part of the small intestine. The bulge is congenital (present at birth) and is a leftover of the umbilical cord. Meckel’s diverticulum is the most common congenital defect of the gastrointestinal tract.
