negative rebound and negative osculator signs

The palm is in fact placed just below the right costal margin near to the right mid-clavicular line. The examiner stands on the right side of the patient and keeps his/her right palm on the patient’s abdomen. The test is usually down with the patient in a lying position. Remember that abdomen is the area below diaphragm. Picture 3: Note the diaphragm, liver, costal margin and gallbladder, in the picture. It is the junction between the lower margin of the right side of the rib cage (right side of the costal margin) and outer border of rectus abdominis muscle ( 3).This is also the tip of right 9th coastal cartilage ( 3).The junction between the lower margin of the right side of the rib cage (right side of the costal margin) and the line described above is the point under which gallbladder can be palpated.Now, draw an imaginary line downwards (towards abdomen) from the middle of your right collar bone (clavicle) – Right mid-clavicular line ( 2).Identify the lower margin of the rib cage on your abdomen (costal margin).

It is easy to understand where the manoeuvre is done if you can identify a few points on your abdomen. If the person is suffering with pain in the right upper quadrant due to acute cholecystitis, then the palpation of the site elicits a painful reaction from him. On a person, it is actually difficult to palpate a gallbladder by palpating the abdomen. Picture 2: Image showing the four quadrants of the abdomen with the contents of right upper quadrant (RUQ). The green coloured structure shown is gallbladder. Picture 1: Image showing the position of gallbladder under the liver. To see what other organs are situated on the right upper quadrant, click here “ Abdominal Pain”. Gallbladder is situated under the liver on the right side of abdomen, which is on the right upper quadrant. John Benjamin Murphy was the American Surgeon who described the sign first. This test is positive if the patient is having acute cholecystitis (inflammation of the gallbladder) ( 1). It is a finding for differentiating the cause, by physical examination of a patient having pain in the right upper quadrant of the abdomen ( 1). Differential diagnosis of pain in right upper quadrant.

Negative rebound and negative osculator signs