MARYVILLE NURS 612 EXAM 3 CORE
MUSCULOSKELETAL, ABDOMINAL, AND
ENDOCRINE ASSESSMENT REVIEW 2026
◉ How to percuss to estimate the liver span.
Answer: o First, determine the lower border of the liver by
percussing up from an area of tympany along the right midclavicular
line. Mark the point where tympany changes to dullness, which
usually occurs at or slightly below the costal margin.
o Second, determine the upper border of the liver by percussing
down from an area of resonance along the right midclavicular line.
Mark the point where resonance changes to dullness, which usually
is in the fifth intercostal space.
o Third, measure the distance between the marks. The vertical liver
span usually ranges from 6 to 12 cm.
◉ Blumberg Sign.
Answer: Rebound tenderness, RLQ, appendicitis, peritoneal
irritation
◉ Cullen sign.
,Answer: ecchymosis around umbilicus
-hemoperitoneum, pancreatitis, ectopic pregnancy
◉ Dance sign.
Answer: Absence of bowel sounds, RLQ, intussusception, bowel
obstruction
◉ Grey Turner's sign.
Answer: Ecchymosis of the flanks. Possible rupture of the spleen.
Hemoperitoneum, pancreatitis, pain may radiate to the left shoulder
◉ Kehr's sign.
Answer: Abdominal pain radiated to the left shoulder, splenic
rupture, renal calculi, ectopic pregnancy
◉ Markle Sign (heel jar).
Answer: Tests for peritoneal irritation, appendicitis, jarring to the
body. Stand with straight legs, then stand on your toes, then relax.
Positive if this causes pain.
◉ McBurney's sign.
Answer: rebound tenderness to the epigastric area associated with
appendicitis
, ◉ Rovsing's sign.
Answer: RLQ pain increases with LLQ pressure.
Appendicitis, peritoneal irritation
◉ Obturator sign.
Answer: pain in the lower abdomen or inside of thigh when the hip
is flexed and internally rotated; a sign of appendicitis or abdominal
abscess
◉ The examiner observes venous return on the abdomen of the
patient that moves upward from the pubis to the chest. This finding
should make the examiner consider.
Answer: inferior vena cava obstruction
◉ Which of the following questions would help an examiner
determine whether a patient has an intrabdominal infection?
A. Where is the pain?
B. Would you like something to eat?
C. What does your urine look like?
D. Is there a history of this problem in your family?.
Answer: B.
MUSCULOSKELETAL, ABDOMINAL, AND
ENDOCRINE ASSESSMENT REVIEW 2026
◉ How to percuss to estimate the liver span.
Answer: o First, determine the lower border of the liver by
percussing up from an area of tympany along the right midclavicular
line. Mark the point where tympany changes to dullness, which
usually occurs at or slightly below the costal margin.
o Second, determine the upper border of the liver by percussing
down from an area of resonance along the right midclavicular line.
Mark the point where resonance changes to dullness, which usually
is in the fifth intercostal space.
o Third, measure the distance between the marks. The vertical liver
span usually ranges from 6 to 12 cm.
◉ Blumberg Sign.
Answer: Rebound tenderness, RLQ, appendicitis, peritoneal
irritation
◉ Cullen sign.
,Answer: ecchymosis around umbilicus
-hemoperitoneum, pancreatitis, ectopic pregnancy
◉ Dance sign.
Answer: Absence of bowel sounds, RLQ, intussusception, bowel
obstruction
◉ Grey Turner's sign.
Answer: Ecchymosis of the flanks. Possible rupture of the spleen.
Hemoperitoneum, pancreatitis, pain may radiate to the left shoulder
◉ Kehr's sign.
Answer: Abdominal pain radiated to the left shoulder, splenic
rupture, renal calculi, ectopic pregnancy
◉ Markle Sign (heel jar).
Answer: Tests for peritoneal irritation, appendicitis, jarring to the
body. Stand with straight legs, then stand on your toes, then relax.
Positive if this causes pain.
◉ McBurney's sign.
Answer: rebound tenderness to the epigastric area associated with
appendicitis
, ◉ Rovsing's sign.
Answer: RLQ pain increases with LLQ pressure.
Appendicitis, peritoneal irritation
◉ Obturator sign.
Answer: pain in the lower abdomen or inside of thigh when the hip
is flexed and internally rotated; a sign of appendicitis or abdominal
abscess
◉ The examiner observes venous return on the abdomen of the
patient that moves upward from the pubis to the chest. This finding
should make the examiner consider.
Answer: inferior vena cava obstruction
◉ Which of the following questions would help an examiner
determine whether a patient has an intrabdominal infection?
A. Where is the pain?
B. Would you like something to eat?
C. What does your urine look like?
D. Is there a history of this problem in your family?.
Answer: B.
