Boas's Sign
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Boas's Sign
Boas' or Boas's sign is hyperaesthesia (increased or altered sensitivity) below the right Hypochondrium or 12th rib region, which can be a symptom in Acute (medical), acute cholecystitis (inflammation of the gallbladder). It is one of many signs a medical provider may look for during an abdominal examination. Originally this sign referred to point tenderness in the region to the right of the 10th to 12th thoracic vertebrae. It is less than 7% sensitive. Its namesake is Ismar Isidor Boas (1858–1938), a German physician and the first licensed GI specialist in his country. Boas' sign can also indicate stomach and duodenal disease. When the transverse processes of thoracic vertebrae T10-T12 are pressed or effleuraged with the bottom of the hand, pain can appear at the left of spinous processes (in stomach's lesser curvature ulcer) or at the right (in pyloric or duodenal ulcer). References

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Psoas Sign
The psoas sign, also known as Cope's sign (or Cope's psoas test) or Obraztsova's sign, is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal). The technique for detecting the psoas sign is carried out on the patient's right leg. The patient lies on his/her left side with the knees extended. The examiner holds the patient's right thigh and passively extends the hip. Alternatively, the patient lies on their back, and the examiner asks the patient to actively flex the right hip against the examiner's hand. If abdominal pain results, it is a "positive psoas sign". The pain results because the psoas borders the peritoneal cavity, so stretching (by hyperextension at the hip) or contraction (by flexion of the hip) of the muscles causes friction against nearby inflamed tissues. In particular, the right iliopsoas muscl ...
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Hyperaesthesia
Hyperesthesia is a condition that involves an abnormal increase in sensitivity to stimuli of the sense. Stimuli of the senses can include sound that one hears, foods that one tastes, textures that one feels, and so forth. Increased touch sensitivity is referred to as "tactile hyperesthesia", and increased sound sensitivity is called "auditory hyperesthesia". In the context of pain hyperaesthesia can refer to an increase in sensitivity where there is both allodynia and hyperalgesia. In psychology, Jeanne Siaud-Facchin uses the term by defining it as an "exacerbation des sens" that characterizes gifted individuals: for them, the sensory information reaches the brain much faster than the average, and the information is processed in a significantly shorter time. Other animals Feline hyperesthesia syndrome is an uncommon but recognized condition in cats, particularly Siamese, Burmese, Himalayan, and Abyssinian cats. It can affect cats of all ages, though it is most prevalent duri ...
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Hypochondrium
In anatomy, the division of the abdomen into regions can employ a nine-region scheme. The hypochondrium refers to the two hypochondriac regions in the upper third of the abdomen; the left hypochondrium and right hypochondrium. They are located on the lateral sides of the abdominal wall respectively, inferior to (below) the thoracic cage, being separated by the epigastrium. The liver is in the right hypochondrium, extending through the epigastrium and reaching the left hypochondrium. The spleen and some of the stomach are in the left hypochondrium. Definitions, etymology, and modern controversies The word derives from the Greek word υποχόνδριο ("hypochondrio"). This Greek word means literally "below the cartilage" which refers to the costal cartilages. In other words, the word refers to the area of the ventral trunk that is located below the costal cartilages. The word once referred only to the soft portion of the abdomen between the rib cage and the navel (the region ...
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Acute (medical)
In medicine, describing a disease as acute denotes that it is of short duration and, as a corollary of that, of recent onset. The quantification of how much time constitutes "short" and "recent" varies by disease and by context, but the core denotation of "acute" is always qualitatively in contrast with " chronic", which denotes long-lasting disease (for example, in acute leukaemia and chronic leukaemia). In addition, "acute" also often connotes two other meanings: sudden onset and severity, such as in acute myocardial infarction (AMI), where suddenness and severity are both established aspects of the meaning. It thus often connotes that the condition is fulminant (as in the AMI example), but not always (as in acute rhinitis, which is usually synonymous with the common cold). The one thing that acute MI and acute rhinitis have in common is that they are not chronic. They can happen again (as in recurrent pneumonia, that is, multiple acute pneumonia episodes), but they are not t ...
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Cholecystitis
Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, pain in the right shoulder, nausea, vomiting, and occasionally fever. Often gallbladder attacks (biliary colic) precede acute cholecystitis. The pain lasts longer in cholecystitis than in a typical gallbladder attack. Without appropriate treatment, recurrent episodes of cholecystitis are common. Complications of acute cholecystitis include gallstone pancreatitis, common bile duct stones, or inflammation of the common bile duct. More than 90% of the time acute cholecystitis is caused from blockage of the cystic duct by a gallstone. Risk factors for gallstones include birth control pills, pregnancy, a family history of gallstones, obesity, diabetes, liver disease, or rapid weight loss. Occasionally, acute cholecystitis occurs as a result of vasculitis or chemotherapy, or during recovery from major trauma or burns. Cholecystitis is suspected based on symptoms and laboratory testing. Abdom ...
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Gallbladder
In vertebrates, the gallbladder, also known as the cholecyst, is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although the structure and position of the gallbladder can vary significantly among animal species. It receives and stores bile, produced by the liver, via the common hepatic duct, and releases it via the common bile duct into the duodenum, where the bile helps in the digestion of fats. The gallbladder can be affected by gallstones, formed by material that cannot be dissolved – usually cholesterol or bilirubin, a product of haemoglobin breakdown. These may cause significant pain, particularly in the upper-right corner of the abdomen, and are often treated with removal of the gallbladder (called a cholecystectomy). Cholecystitis, inflammation of the gallbladder, has a wide range of causes, including result from the impaction of gallstones, inf ...
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Abdominal Examination
An abdominal examination is a portion of the physical examination which a physician or nurse uses to clinically observe the abdomen of a patient for signs of disease. The physical examination typically occurs after a thorough medical history is taken, that is, after the physician asks the patient the course of their symptoms. The abdominal examination is conventionally split into four different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation (listening) of the abdomen with a stethoscope. Palpation of the patient's abdomen. Finally, percussion (tapping) of the patient's abdomen and abdominal organs. Depending on the need to test for specific diseases such as ascites, special tests may be performed as a part of the physical examination. An abdominal examination may be performed because the physician suspects a disease of the organs inside the abdominal cavity (including the liver, spleen, large or small intestines), or simpl ...
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Ismar Isidor Boas
Ismar Isidor Boas (28 March 1858 – 15 March 1938) was a German gastroenterologist born in the town of Exin, then in the Prussian Province of Posen, today in Poland. Boas was born in the family of a small merchant and among several siblings he was the only one who was educated. He went to a high school in Zülichau in Silesia and then studied medicine in Berlin, Halle and Leipzig, and subsequently became an assistant to Carl Anton Ewald (1845-1915) at the Augusta Hospital in Berlin. In 1886, he became a licensed specialist of gastro-intestinal diseases in Berlin. Boas was one of the leading authorities on gastroenterology in Europe. Alone, and with Professor Ewald, he made several contributions regarding the pathology and physiology of digestion. He described ''Lactobacillus acidophilus'', a bacillus found in the gastric juice of individuals with stomach carcinoma. This bacterium is sometimes referred to as the "Boas-Oppler bacillus". In 1895 he founded the ''Archiv für Verdau ...
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Effleurage
Effleurage, a French word meaning "to skim" or "to touch lightly on", is a series of massage strokes used in Swedish massage to warm up the muscle before deep tissue work using petrissage. This is a soothing, stroking movement used at the beginning and the end of the facial and/or body massage. It is also used as a linking move between the different strokes and movements. Effleurage is basically a form of massage involving a circular stroking movement made with the palm of the hand. Effleurage can be firm or light without dragging the skin, and is performed using either the padded parts of the finger tips or the palmar surface of the hands. Lotion may or may not be used. The process works as a mechanical pump on the body to encourage venous and lymphatic return by starting at the bottom of the limb and pushing back towards the heart. This will have more success with this once all the muscles in the area are warmed up and loose. It consists of four sub-categories: # Ethereal or ...
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Spinous Processes
The spinal column, a defining synapomorphy shared by nearly all vertebrates,Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characteristic irregular bone whose complex structure is composed primarily of bone, and secondarily of hyaline cartilage. They show variation in the proportion contributed by these two tissue types; such variations correlate on one hand with the cerebral/caudal rank (i.e., location within the backbone), and on the other with phylogenetic differences among the vertebrate taxa. The basic configuration of a vertebra varies, but the bone is its ''body'', with the central part of the body constituting the ''centrum''. The upper (closer to) and lower (further from), respectively, the cranium and its central nervous system surfaces of the vertebra body support attachment to the intervertebral discs. The posterior part of a vertebra forms a vertebral arch ...
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Stomach
The stomach is a muscular, hollow organ in the gastrointestinal tract of humans and many other animals, including several invertebrates. The stomach has a dilated structure and functions as a vital organ in the digestive system. The stomach is involved in the gastric phase of digestion, following chewing. It performs a chemical breakdown by means of enzymes and hydrochloric acid. In humans and many other animals, the stomach is located between the oesophagus and the small intestine. The stomach secretes digestive enzymes and gastric acid to aid in food digestion. The pyloric sphincter controls the passage of partially digested food ( chyme) from the stomach into the duodenum, where peristalsis takes over to move this through the rest of intestines. Structure In the human digestive system, the stomach lies between the oesophagus and the duodenum (the first part of the small intestine). It is in the left upper quadrant of the abdominal cavity. The top of the stomach lies ag ...
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Lesser Curvature
The curvatures of the stomach refer to the greater and lesser curvatures. The greater curvature of the stomach is four or five times as long as the lesser curvature. Greater curvature The greater curvature of the stomach forms the lower left or lateral border of the stomach. Surface Starting from the cardiac orifice at the incisura cardiaca, it forms an arch backward, upward, and to the left; the highest point of the convexity is on a level with the sixth left costal cartilage. From this level it may be followed downward and forward, with a slight convexity to the left as low as the cartilage of the ninth rib; it then turns to the right, to the end of the pylorus. Directly opposite the incisura angularis of the lesser curvature the greater curvature presents a dilatation, which is the left extremity of the pyloric part; this dilatation is limited on the right by a slight groove, the sulcus intermedius, which is about 2.5 cm, from the duodenopyloric constriction. The ...
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