FACTS & HINTS

High-Yield Facts

Clinical Points

McBurney's Point and Appendicitis

McBurney's point:Asurface landmark that roughlyindicates the location of the appendix, located approximatelyone third of the wayalong a line from the anterior superior iliac spine to the umbilicus.

Appendicitis:inflammation of the appendix. Pain first presents in the epigastric region, moves to the umbilical region and then localizes in the right lower quadrant. Rupture of the appendixleads to peritonitis (inflammation of the peritoneum). This presents with severe pain, fever, and abdominal rigidity.

Muscle-splitting incision (of McBurney):used to access the appendix. Each muscle layer is split in the direction of the fiber orientation. The incision must not go too far laterallyor the ascending branch of the deep circumflexiliac arterymaybe severed.

Clinical Points

Grey-Turner's sign

Local right flank redness or bruising (ecchymosis)

Indicates a retroperitoneal hemorrhage

Usuallytakes 24 to 48 hours to appear

Can be predictive of severe hemorrhagic pancreatitis, abdominal injury, or metastatic cancer

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Clinical Points

Cullen's sign

Discoloration (ecchymosis) around the umbilicus

Aresult of peritoneal hemorrhage

Mnemonics

Memory Aids

Causes for abdominal expansion (protuberance):

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