Abdominal Exam

Question 1

Grey Turner’s Sign

Answer 1

Ecchymosis of the flanks

• Hemoperitoneum;
(pancreatitis)

Question 2

Cullen’s Sign

Answer 2

Ecchymosis
around the umbilicus
• Hemoperitoneum
(pancreatitis; ectopic
pregnancy)

Question 3

Normal span of the liver

Answer 3

Normal span = 6‐12cm

Question 4

Rovsing’s Sign

Answer 4

Pain in the RLQ during Left‐sided pressure‐
referred rebound tenderness seen in appendicitis

Question 5

McBurney’s Point

Answer 5

rebound tenderness or pain 1/3 of the
distance from the ASIS to the umbilicus‐ may suggest appendicitis/peritoneal irritation.

Question 6

Murphy Sign

Answer 6

tests for acute cholecystitis or
cholelithiasis. Palplate deeply during inspiration and
observe for pain.

Question 7

Courvoisier’s Sign

Answer 7

Enlarged non‐tender gallbladder
secondary to pancreatic disease or cancer

Question 8

Iliopsoas Muscle Test

Answer 8

Have the patient flex their hip against your resistance
‐ Increased abdominal pain is a
positive test. This suggests irritation of the psoas muscle from an inflamed appendix.

Question 9

Obturator muscle test

Answer 9

Flex the patients right thigh at the hip, with the knee bent, and rotate the leg internally at the hip. Right hypogastric pain is a positive test. This suggests
irritation of the obturator muscle from an inflamed appendix.

Question 10

Lloyd punch/Kidney punch/Costovertebral Angle(CVA) Tenderness

Answer 10

gently tapping the area of the back overlying the kidney produces pain in people with an infection around the kidney (perinephric abscess) or pyelonephritis or renal
stone.

Question 11

Heel Strike

Answer 11

Patient supine. Doc strikes patient’s heel. Pain
upon striking could indicate appendicitis.