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Murphy's triad was named after John Benjamin Murphy, an American physician and abdominal surgeons and one of the earliest advocates for the intervention of the removal of the appendix in all cases of appendicitis.
The patient lies on a couch. The examiner gently stretches the right spermatic cord using the thumb and index finger right about the testis in the right scrotum. For a patient with appendicitis, this causes pain in the right iliac fossa. [2]
Markle's sign, or jar tenderness, is a clinical sign in which pain in the right lower quadrant of the abdomen is elicited by the heel-drop test (dropping to the heels, from standing on the toes, with a jarring landing).
Murphy's sign has a high sensitivity and negative predictive value, although the specificity is not high. [2] However, in the elderly the sensitivity is markedly lower; a negative Murphy's sign in an elderly person is not useful for ruling out cholecystitis if other tests and the clinical history suggest the diagnosis.
The sign indicates aggravation of the parietal peritoneum by stretching or moving. Positive Blumberg's sign is indicative of peritonitis, [3] which can occur in diseases like appendicitis, and may occur in ulcerative colitis with rebound tenderness in the right lower quadrant.
Appendicitis is inflammation of the appendix. [2] Symptoms commonly include right lower abdominal pain, nausea, vomiting, fever and decreased appetite. [2] However, approximately 40% of people do not have these typical symptoms. [2]
The hamburger sign is used in the diagnosis of appendicitis. [1] The sign is used to rule out that disease, with the physician inquiring if the patient would like to consume their favourite food. [2]
Rovsing's sign, named after the Danish surgeon Niels Thorkild Rovsing (1862–1927), [1] 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.