The psoas sign, also known as Cope's psoas test[1] or Obraztsova's

sign,[2] 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). It is elicited by performing the psoas test by
passively extending the thigh of a patient lying on his side with knees
extended, or asking the patient to actively flex his thigh at the hip.[3] 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 muscle lies under the appendix when the patient is
supine, so a positive psoas sign on the right may suggest appendicitis.
A positive psoas sign may also be present in a patient with a psoas
abscess.

The obturator sign or Cope's obturator test is an indicator of

irritation to the obturator internus muscle.[1] The technique for
detecting the obturator sign, called the obturator test, is carried out on
each leg in succession. The patient lies on her/his back with the hip
and knee both flexed at ninety degrees. The examiner holds the
patient's ankle with one hand and knee with the other hand. The
examiner rotates the hip by moving the patient's ankle away from the
patient's body while allowing the knee to move only inward. This is
flexion and internal rotation of the hip.

In the clinical context, it is performed when acute appendicitis is

suspected. In this condition, the appendix becomes inflamed and
enlarged. The appendix may come into physical contact with the
obturator internus muscle, which will be stretched when this maneuver
is performed on the right leg. This causes pain and is evidence in
support of an inflamed appendix.

The principles of the obturator sign in the diagnosis of appendicitis are

similar to that of the psoas sign. The appendix is commonly located in
the retrocecal or pelvic region. The oburator sign indicates the
presence of an inflamed pelvic appendix.

Blumberg's sign, also referred to as rebound tenderness, is a clinical

sign that is elicited during physical examination of a patient's abdomen
by a doctor or other health care provider. It is indicative of peritonitis. It
refers to pain upon removal of pressure rather than application of
pressure to the abdomen. (The latter is referred to simply as abdominal
tenderness.)
The abdominal wall is compressed slowly and then rapidly released. A
positive sign is indicated by presence of pain upon removal of pressure
on the abdominal wall. It is very similar to rebound tenderness and
might be regarded by some authors as the same thing, or at least a
particular application of it.

Rovsing's sign, named after the Danish surgeon Niels Thorkild

Rovsing (1862 -1927),[1] is a sign of appendicitis. If palpation of the
left lower quadrant of a person's abdomen increases the pain felt in the
right lower quadrant, the patient is said to have a positive Rovsing's
sign and may have appendicitis.

In acute appendicitis, palpation in the left iliac fossa may produce pain
in the right iliac fossa.

Murphy[1] sign refers to a maneuver during a physical examination

as part of the abdominal examination and a finding elicited in
ultrasonography. It is useful for differentiating pain in the right upper
quadrant. Typically, it is positive in cholecystitis, but negative in
choledocholithiasis, pyelonephritis, and ascending cholangitis.
it is performed by asking the patient to breathe out and then gently
placing the hand below the costal margin on the right side at the mid-
clavicular line (the approximate location of the gallbladder). The
patient is then instructed to inspire (breathe in). Normally, during
inspiration, the abdominal contents are pushed downward as the
diaphragm moves down (and lungs expand). If the patient stops
breathing in (as the gallbladder is tender and, in moving downward,
comes in contact with the examiner's fingers) and winces with a 'catch'
in breath, the test is considered positive. In order for the test to be
considered positive, the same maneuver must not elicit pain when
performed on the left side.

Carnett's sign is a finding on clinical examination in which (acute)

abdominal pain remains unchanged or increases when the muscles of
the abdominal wall are tensed.[1][2] For this part of the abdominal
examination, the patient can be asked to lift the head and shoulders
from the examination table to tense the abdominal muscles. An
alternative is to ask the patient to raise both legs with straight knees.

A positive test increases the likelihood that the abdominal wall and not
the abdominal cavity is the source of the pain (for example, due to
rectus sheath hematoma instead of appendicitis).[3][4] A negative
Carnett's sign is said to occur when the abdominal pain decreases
when the patient is asked to lift the head; this points to an intra-
abdominal cause of the pain.[1]
HowshipRomberg sign is a sign used to identify obturator hernia.[1]
[2] The sign is inner thigh pain on internal rotation of the hip. It can be
caused by an obturator hernia.

Reynolds pentad is a collection of signs and symptoms suggesting

the diagnosis obstructive ascending cholangitis, a serious infection of
the biliary system. It is a combination of Charcot's triad (jaundice,
fever, abdominal pain (usually RUQ)) with shock and an altered mental
status.[1] Or sometimes the two additional signs are listed simply as
low blood pressure and confusion