Where does pain from the liver and gallbladder commonly refer?
Right upper abdomen, right shoulder, right scapular region
Where does pain from the lung and diaphragm commonly refer?
Left neck and shoulder
Where does pain from the heart commonly refer?
Left chest, left shoulder, medial left arm, sometimes jaw
Where does pain from the stomach commonly refer?
Mid-epigastric region and middle back.
Where does pain from the pancreas commonly refer?
Midline upper abdomen, radiating to mid-back
Where does pain from the colon commonly refer?
Lower abdomen, across lower back
Where does pain from the ovary commonly refer?
Lower abdomen, pelvic region
Where does pain from the kidney commonly refer?
Side of lower back and radiating to groin
Where does pain from the urinary bladder commonly refer?
Lower abdomen, suprapubic area
Where does pain from the ureter commonly refer?
Groin/inner thigh
Where does pain from the small intestine commonly refer?
Mid-abdominal region (above umbilicus)
Where does pain from the appendix commonly refer?
Right lower abdomen (McBurney’s point)
What is Murphy’s sign used for?
Exam technique used to differentiate pain in RUQ
What are the common pain referral patterns for angina/MI?
Pain can radiate to the mid-chest, upper chest, neck, jaw, inside of arms (left > right), upper abdomen (can mimic indigestion), and between the shoulder blades
How is Murphy’s sign performed?
Palpation of R subcostal region with deep inhalation
What indicates a positive Murphy’s sign?
If pt experiences pain and stops deep inhalation, test is (+)
A positive Murphy’s sign is indicative of what problem?
Inflammation of gallbladder or cholecystitis
What is tympany?
Medical percussion over an area filled with air
What may accompany tympany?
Abdominal tightness or distension
When is tympany considered abnormal?
When there is air in an abnormal place, like the abdominal cavity
What is Blumberg’s test/sign?
Rebound tenderness when slow pressure is removed quickly
What does Blumberg’s sign indicate?
Peritonitis, appendicitis, colitis, bowel obstruction/perforation
What is McBurney’s point?
Specific area of RLQ that is compressed to assess for acute appendicitis via Blumberg’s test
Where is McBurney’s point located?
Between umbilicus and ASIS
