In case of appendicitis, if the pain is exacerbated on medial rotation of the thigh, the position of appendix is:

Correct Answer: Pelvic
Description: Dunphy’s sign :Any movement, including coughing, may cause pain. Rovsing’s sign: Pain in the right lower quadrant during palpation of the left lower quadrant. Iliopsoas sign: AKA “Obraztsova’s sign’ pain on extension of hip which relieves on flexing the hip into the “fetal position” (due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves). Theis is typical of retrocecal appendix. Obturator sign: Pain in flexion and internal rotation of the hip (due to irritation of obturator internus). This is typical of pelvic appendix. Blumberg sign: Deep palpation of the viscera over the suspected inflamed appendix followed by sudden release of the pressure causes the severe pain on the site indicating positive Blumberg’s sign and peritonitis. Volkovich –Kocher (Kosher)’s sign : The appearance of pain in the epigastric region or around the stomach at the beginning of disease with a subsequent shift to the right iliac region. Sitkovsky (Rosenstein)’s sign : Increased pain in the right iliac region as patient lies on left side. Bartomier – Michelson’s sign : Increased pain on palpation at the right iliac region as patient lies on leftside compared to when patient was on supine position. Aure – Rozanova’s sign : Increase pain on palpation with finger in right Petit triangle. Typical in retrocecal position of the appendix. Boundaries of Petit triangle areiliac crest, External oblique muscle and Latissimus Dorsi muscle.
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