The examination of a patient reveals a positive Rovsing's sign, which is abdominal pain felt in the right lower quadrant as you pressed deeply and evenly for 5 seconds
a. in her left lower quadrant (LLQ). c. directly over her ileocecal valve.
b. in her right lower quadrant (RLQ). d. in her umbilical area.
A
Rovsing's sign is a differential technique to elicit referred pain, reflective of peritoneal inflammation secondary to appendicitis. Rovsing's sign may be elicited by palpation of the LLQ, causing pain to be felt in the RLQ. This sign is based on the concept that changes in intraluminal pressure will be transmitted through the intestine when the ileocecal valve is competent. Pressing on the LLQ traps air within the large intestine and increases the pressure in the cecum. If the appendix is inflamed, this increase in pressure causes pain.
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