Abdomen

1. Rebound tenderness (Blumberg’s sign)

Rebound tenderness is elicited by palpating slowly and deeply over a viscus and then suddenly releasing
the palpating hand. If rebound tenderness is positive then the patient experiences pain.
2. Rovsing’s sign
Is a sign of appendicitis. If palpation of the left lower quadrant of a person's abdomen increases the pain
felt in the right lower quadrant, the patient is said to have a positive Rovsing's sign and may have
appendicitis.
3. Referred rebound tenderness
Rebound tenderness is a clinical sign that a doctor or other health care provider may detect in physical
examination of a patient's abdomen. It refers to pain upon removal of pressure rather than application
of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.)

It represents aggravation of the parietal layer of peritoneum by stretching or moving.

Rebound tenderness can be associated with peritonitis,[1] which can occur in diseases like
appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower
quadrant. The others are tenderness and abdominal guarding.

Clinical sign of PERITONITIS

4. Psoas sign
The psoas sign is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the
abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the
iliopsoas muscle is retroperitoneal). It is elicited by performing the psoas test by passively extending the
thigh of a patient lying on his side with knees extended, or asking the patient to actively flex his thigh at
the hip.[1] If abdominal pain results, it is a "positive psoas sign".
5. Obturator sign

The obturator sign, also known as the Cope sign,[citation needed] is an indicator of irritation to the
obturator internus muscle.[1]

The technique for detecting the obturator sign, called the obturator test, is carried out on each leg
in succession. The patient lies on his back with the hip and knee both flexed at ninety degrees.
The examiner holds the patient's ankle with one hand and knee with the other hand. The
examiner rotates the hip by moving the patient's ankle away from the patient's body while
allowing the knee to move only inward. This is flexion and internal rotation of the hip.

6. Murphy’s sign
Classically Murphy's sign is tested for during an abdominal examination; it is performed by asking the
patient to breathe out and then gently placing the hand below the costal margin on the right side at the
mid-clavicular line (the approximate location of the gallbladder). The patient is then instructed to inspire
(breathe in). Normally, during inspiration, the abdominal contents are pushed downward as the
diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is
tender and, in moving downward, comes in contact with the examiner's fingers) and winces with a
'catch' in breath, the test is considered positive. In order for the test to be considered positive, the same
maneuver must not elicit pain when performed on the left side.
7. Mcburney’s sign
A reaction of the patient indicating severe pain and extreme tenderness when McBurney's point is palpated.
Such a reaction indicates appendicitis. Located at the RLQ, between umbilicus and iliac crest. Test for rebound
pain by pressing firmly and slowly, then release quickly. Test for appendicitis.