Murphy&;s sign is seen in?
**Core Concept**
Murphy's sign is a clinical indicator used to assess for gallbladder disease, specifically cholecystitis or gallstones. It is a palpable tenderness or discomfort in the right upper quadrant of the abdomen when the patient takes a deep breath in and the examiner applies pressure to the gallbladder area.
**Why the Correct Answer is Right**
During a physical examination, the examiner applies gentle pressure to the gallbladder area, which is located just below the liver and right of the midline. When the patient inhales deeply, the gallbladder contracts, and if it is inflamed or contains gallstones, the patient will experience pain or tenderness. This is because the inflamed or obstructed gallbladder becomes irritated and sensitive to pressure and movement. The contraction of the diaphragm during deep breathing exacerbates this irritation, causing the patient to experience pain or discomfort.
**Why Each Wrong Option is Incorrect**
**Option A:** Murphy's sign is not typically associated with liver disease, although liver disease can cause similar symptoms. The sign is specific to gallbladder pathology.
**Option B:** While a palpable mass in the right upper quadrant could be related to gallbladder disease, Murphy's sign is a specific clinical indicator that involves the patient's response to pressure and deep breathing.
**Option C:** This option is not relevant to the clinical indicator of gallbladder disease known as Murphy's sign.
**Clinical Pearl / High-Yield Fact**
To elicit Murphy's sign, the examiner should apply gentle pressure to the gallbladder area, and then ask the patient to take a deep breath in. A positive sign is indicated by the patient experiencing pain or tenderness in the right upper quadrant.
**Correct Answer: C. Gallbladder disease.