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「闌尾炎 理學檢查的 543」之二 閉孔肌徵象(Obturator sign) Obturator sign：將右大腿屈曲並且內旋(轉)，此時腳踝在外側，這是想辦法讓Obturator muscle (閉孔肌) 動一動 (有些stress感 !)，來誘發下腹痛！ 因為 Obturator muscle(閉孔肌) 在闌尾下面！如果發炎的闌尾剛好碰到了這條肌肉，就會引起疼痛..! 所以Obturator sign要陽性的前提，是你的闌尾屬於pelvic appendix！ | 來講兒科急診的543-吳昌騰醫師
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Nazia Qamar on Instagram: "Appendix (vermiform appendix) ki acute inflammation ko appendicitis kehte hain. Surgical emergency ho sakti hai. 📍 Anatomy Quick Origin: Caecum se, ileocecal valve ke niche Length: ~6–10 cm Position: Most common retrocecal, phir pelvic Blood supply: Appendicular artery (end artery) ⚠️ Etiology / Causes Luminal obstruction: Fecolith (most common) Lymphoid hyperplasia (kids/young) Worms Foreign body Tumor (elderly) 🔬 Pathogenesis (Sequence) Obstruction → mucus secretio
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I used to be cool. Now I describe a stomach ache like I’m at work. Teaching point: Appendicitis usually starts as vague stomach pain and then moves to the lower right side of the belly. Pain that gets worse, becomes sharp, or hurts when you move, cough, or press on it shouldn’t be ignored. What doctors check on exam: -McBurney’s point: Tenderness in a specific spot on the lower right abdomen. -Rebound tenderness: Pain that’s worse when pressure is released, not applied. -Rovsing’s sign: Pressing
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