Ballottement

Last updated

Ballottement is a medical sign which indicates increased fluid in the suprapatellar pouch over the patella at the knee joint. To test ballottement the examiner would apply downward pressure towards the foot with one hand, while pushing the patella backwards against the femur with one finger of the opposite hand. A "milking" motion is used with the downward pressure. If a bogginess around the joint occurs, then the test is positive for ballottement.

A medical sign is an objective indication of some medical fact or characteristic that may be detected by a patient or anyone, especially a physician, before or during a physical examination of a patient. For example, whereas a tingling paresthesia is a symptom, erythema is a sign. Symptoms and signs are often nonspecific, but often combinations of them are at least suggestive of certain diagnoses, helping to narrow down what may be wrong. In other cases they are specific even to the point of being pathognomonic.

Patella bone of the leg

The patella, also known as the kneecap, is a thick, circular-triangular bone which articulates with the femur and covers and protects the anterior articular surface of the knee joint. The patella is found in many tetrapods, such as mice, cats and birds, but not in whales, or most reptiles.

Knee joint between the thigh and lower leg

In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia, and one between the femur and patella. It is the largest joint in the human body. The knee is a modified hinge joint, which permits flexion and extension as well as slight internal and external rotation. The knee is vulnerable to injury and to the development of osteoarthritis.

Ballottement may also refer to an assessment of an ascitic abdomen. Identifying an organ or a mass in an ascitic abdomen: "Try to ballotte the organ or mass, exemplified here by an enlarged liver. Straighten and stiffen the fingers of one hand together, place them on the abdominal surface, and make a brief jabbing movement directly toward the anticipated structure. This quick movement often displaces the fluid so that your fingertips can briefly touch the surface of the structure through the abdominal wall." [1]

Related Research Articles

Peritoneum serous membrane that forms the lining of the abdominal cavity or the coelom—it covers most of the intra-abdominal (or coelomic) organs—in amniotes and some invertebrates

The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal organs, and is composed of a layer of mesothelium supported by a thin layer of connective tissue. This peritoneal lining of the cavity supports many of the abdominal organs and serves as a conduit for their blood vessels, lymphatic vessels, and nerves.

Abdominal cavity

The abdominal cavity is a large body cavity in humans and many other animals that contains many organs. It is a part of the abdominopelvic cavity. It is located below the thoracic cavity, and above the pelvic cavity. Its dome-shaped roof is the thoracic diaphragm, a thin sheet of muscle under the lungs, and its floor is the pelvic inlet, opening into the pelvis.

Peritonitis inflammation of the peritoneum, the lining of the inner wall of the abdomen

Peritonitis is inflammation of the peritoneum, the lining of the inner wall of the abdomen and cover of the abdominal organs. Symptoms may include severe pain, swelling of the abdomen, fever, or weight loss. One part or the entire abdomen may be tender. Complications may include shock and acute respiratory distress syndrome.

Ascites

Ascites is the abnormal buildup of fluid in the abdomen. Technically, it is more than 25 mL of fluid in the peritoneal cavity. Symptoms may include increased abdominal size, increased weight, abdominal discomfort, and shortness of breath. Complications can include spontaneous bacterial peritonitis.

Thoracic diaphragm sheet of internal skeletal muscle

The thoracic diaphragm, or simply the diaphragm, is a sheet of internal skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity and performs an important function in respiration: as the diaphragm contracts, the volume of the thoracic cavity increases, a negative vacuum is created which draws air into the lungs.

Percussion is a method of tapping on a surface to determine the underlying structure, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the five methods of clinical examination, together with inspection, palpation, auscultation, and inquiry. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The nonstriking finger is placed firmly on the body over tissue. When percussing boney areas such as the clavicle, the pleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of TB.

Paracentesis

Paracentesis is a form of body fluid sampling procedure, generally referring to peritoneocentesis in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid.

Abdominal examination

An abdominal examination is a portion of the physical examination which a physician or nurse uses in order to interrogate 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 stages different stages: first, inspection of the patient and the visible characteristics of their abdomen. Auscultation of the abdomen with a stethoscope. percussion of the patient's abdomen and abdominal organs. Finally, palpation of the patient's abdomen. 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, or simply as a part of a complete physical examination for other conditions. In a complete physical examination, the abdominal exam classically follows the respiratory examination and cardiovascular examination.

Abdominal external oblique muscle

The external oblique muscle is the largest and the outermost of the three flat muscles of the lateral anterior abdomen.

Abdomen frontal part of the body between the thorax (chest) and pelvis

The abdomen constitutes the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the frontal part of the abdominal segment of the trunk, the dorsal part of this segment being the back of the abdomen. The region occupied by the abdomen is termed the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax. The abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear.

In medicine, shifting dullness refers to a sign elicited on physical examination for ascites.

The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.

Visceroptosis

Visceroptosis is a prolapse or a sinking of the abdominal viscera below their natural position. Any or all of the organs may be displaced downward. When the intestines are involved, the condition is known as enteroptosis; when the stomach is found below its normal position, the term gastroptosis is used. The disease exists in all degrees of severity and may give rise to no symptoms whatsoever. Generally, however, there is loss of appetite, heartburn, nervous indigestion, constipation, or diarrhea, abdominal distention, headache, vertigo, emaciation, and loss of sleep. Any or all of these symptoms may be present. The condition is brought about by loss of muscular tone, particularly of the abdominal muscles, with relaxation of the ligaments which hold the viscera in place. In women, tightlacing has been held to be a frequent cause. The symptoms may be alleviated by supporting the organs with a properly applied bandage, or other similar device. Rest in bed, attention to diet, hygiene, exercise, and general muscular upbuilding will cure the majority of cases. In others operation may become necessary. Visceroptosis is a known risk factor for the development of Superior mesenteric artery syndrome.

In medicine, the fluid wave test or fluid thrill test is a test for ascites. It is performed by having the patient push their hands down on the midline of the abdomen. The examiner then taps one flank, while feeling on the other flank for the tap. The pressure on the midline prevents vibrations through the abdominal wall while the fluid allows the tap to be felt on the other side. The result is considered positive if tap can be felt on the other side. However, even with the midline pressure, transmission through the skin must be excluded. A positive fluid wave test indicates that there is a free fluid (ascites) in the abdomen. When one side of the abdomen is pressed, the other side may also be painful due to the transfer of the fluid in it.

Abdominal guarding is the tensing of the abdominal wall muscles to guard inflamed organs within the abdomen from the pain of pressure upon them. The tensing is detected when the abdominal wall is pressed. Abdominal guarding is also known as 'défense musculaire'.

Pelvic examination physical examination of the external and internal female pelvic organs

A pelvic examination is the physical examination of the external and internal female pelvic organs. It is called "bimanual exam" when two hands are used and "manual uterine palpation". It is frequently used in gynecology. It can also be done under general anesthesia.

Peritoneal fluid is a liquid made in the abdominal cavity which lubricates the surface of tissue that lines the abdominal wall and pelvic cavity. It covers most of the organs in the abdomen. An increased volume of peritoneal fluid is called ascites.

Abdominal compartment syndrome is a syndrome and not a disease, and as such it occurs in conjunction with many disease processes, either due to the primary illness or in association with treatment interventions. Abdominal compartment syndrome occurs when the abdomen becomes subject to increased pressure. Specific cause of abdominal compartment syndrome is not known, although some causes can be sepsis and severe abdominal trauma. Increasing pressure reduces blood flow to abdominal organs and impairs pulmonary, cardiovascular, renal, and gastro-intestinal (GI) function, causing multiple organ dysfunction syndrome and death.

Anatomical terminology

Anatomical terminology is a form of scientific terminology used by anatomists, zoologists, and health professionals such as doctors.

References

  1. Bickley, Lynn S. (2003). Bates' Guide to Physical Examination and History Taking. Philadelphia: Lippincott. p. 347. ISBN   978-0-7817-3511-7.