FAU Advanced Health Assessment Practice Test

In the assessment of appendicitis, which maneuver evaluates for irritation of the obturator muscle?

1. Cope's test

2. Lempel's test

3. Murphy's sign

4. Rovsing's sign

The correct answer is: Cope's test

The evaluation for irritation of the obturator muscle is conducted using Cope's test. This test involves flexing the hip and knee of the affected side and internally rotating the hip, which can produce pain if the obturator muscle is irritated due to underlying appendicitis or other pelvic conditions. The irritation happens because the obturator nerve runs close to the appendix, and inflammation can cause referred pain in this region during the maneuver. In contrast, other maneuvers evaluate different aspects of appendicitis. For instance, Murphy's sign focuses on gallbladder irritation, specifically detecting inflammation of the gallbladder during inspiration. Rovsing's sign assesses for rebound tenderness in the right lower quadrant when pressure is applied to the left lower quadrant, indicating possible appendicitis rather than irritation of the obturator muscle. Lempel's test, while also diagnostic, relates primarily to detecting peritoneal irritation and does not specifically test the obturator muscle’s integrity. Understanding these distinctions enhances the clinical assessment and helps in accurately diagnosing appendicitis.