I don't suppose whoever told you this told you why this works and that it cannot be distinguished from peritonitis which could have several different causes.
Ruling out appendicitis?
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I don't suppose whoever told you this told you why this works and that it cannot be distinguished from peritonitis which could have several different causes.
WiFi_Cowgirl
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No..
If you are going to perform a test like this, just have the pt flex their hip while sitting, all you have to do is take the pressure off of psoas major, forget jumping up and down or coughing. At the begining of the cough it will increase intra abd pressure and pain so will the landing of a jump, right before they fall to the ground. (do no harm)
But all the test tells you really is that there is pain from peritoneal stretch receptors. It may not work depending on the normal anatomical variances of the cecum and appendix so when it works it really just narrows down where the inflamation is. In females there is so much in the area it is practically worthless.
BossyCow
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That's because we're SPECIAL
OP..Other s/sx for appendisitis include..
Rovsing's sign is present when tenderness is referred to the right lower quadrant when the left lower quadrant is palpated.
Psoas sign is the increase of pain when the psoas muscle is stretched as the patient is asked to extend the hip.
Obturator sign is the elicitation of pain as the hip is flexed and externally rotated.
Rebound tenderness is a late sign and w/o a prior exam would be relatively useless in regards to assessing for an appy.
I dont believe it's in our scope as pre hospital providers to rule anything out.
In response to other post... blood will not necessarly decrease bowel sounds, a leaking aneurysm may not present as urgently as some may believe. While they need to be seen they will not look horrible.
Rovsing's sign is present when tenderness is referred to the right lower quadrant when the left lower quadrant is palpated.
Psoas sign is the increase of pain when the psoas muscle is stretched as the patient is asked to extend the hip.
Obturator sign is the elicitation of pain as the hip is flexed and externally rotated.
Rebound tenderness is a late sign and w/o a prior exam would be relatively useless in regards to assessing for an appy.
I dont believe it's in our scope as pre hospital providers to rule anything out.
In response to other post... blood will not necessarly decrease bowel sounds, a leaking aneurysm may not present as urgently as some may believe. While they need to be seen they will not look horrible.
NebraskanPrincess
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Question: Someone mentioned abd distension on AAA - are we talking post- or pre-rupture? They thought my mom had it but her only symptom was pain and tenderness - no distension and you could feel pulsation but she's itty bitty. Probably another reason I should re-consider dieting for the new year, so someone could better palpate my abdominal aortic artery Tee hee hee...
Remember, you can still detect a pulse in those who are little and especially peds patients, so palpating one doesn't always mean a AAA.
Was the heel-drop test recommended to find rebound tenderness? I thought that test was only positive for peritonitis - help!
Tee hee hee...Remember, you can still detect a pulse in those who are little and especially peds patients, so palpating one doesn't always mean a AAA.
Was the heel-drop test recommended to find rebound tenderness? I thought that test was only positive for peritonitis - help!
Princess, You're right sometimes pulsations are normal for people. The heel drop is intended to assess for peritonitis. Rebound tenderness is assessed by slowly pushing in and holding it for 5 or 10sec and then quickly take your hands off. If pain is reported when you quickly let go it's rebound tenderness. In appy's this is a late sign and generally indicates that it could have ruptured or extremely inflamed.
JPINFV
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