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Anorectal manometry (ARM) is a medical test used to measure pressures in the anus and rectum and to assess their function. [1] [2] The test is performed by inserting a catheter, that contains a probe embedded with pressure sensors, through the anus and into the rectum. [3]
The clinician presses firmly over either the right upper quadrant of the abdomen (i.e., over the liver) or over the center of the abdomen [2] for 10 seconds with a pressure of 20 to 35 mm Hg while observing the swelling of the internal jugular vein in the neck and also observing to be sure the patient does not perform a Valsalva maneuver.
It can contract vigorously for a short time. Contraction of the external sphincter can defer defecation for a time by pushing stool from the anal canal back into the rectum. Once the voluntary signal to defecate is sent back from the brain, the abdominal muscles contract (straining) causing the intra-abdominal pressure to increase.
In medicine, the fluid wave test or fluid thrill test is a test for ascites (free fluid in the peritoneal cavity). It is performed by having the patient (or a colleague) 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.
Blumberg's sign (also referred to as rebound tenderness or Shchetkin–Blumberg's sign) is a clinical sign in which there is pain upon removal of pressure rather than application of pressure to the abdomen. (The latter is referred to simply as abdominal tenderness.) It is indicative of peritonitis.
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The liver scratch test can be used when other exam techniques used to approximate liver size are ineffective or unavailable [2] and is thought to be most useful if the abdomen is distended, too tender for direct palpation, the abdominal muscles are too rigid, or the patient is obese. [3]
In gastroenterology, the puddle sign is a physical examination maneuver that can be used to detect the presence of ascites.It is useful for detecting small amounts of ascites—as small as 120 mL; shifting dullness and bulging flanks typically require 500 mL.