Obturator sign - Wikipedia Obturator sign The obturator internus and nearby muscles A coronal section of the pelvis illustrating the proximity of the obturator internus to the abdominopelvic viscera. The obturator sign or Cope 's obturator test is an indicator of irritation to the obturator internus muscle. 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 internally 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. Evidence shows that the obturator test does not adequately diagnose appendicitis. It was introduced by Zachary Cope ( 1881 -- 1974 ), an English surgeon. See also Abdominal exam McBurney 's point Markle sign Psoas sign Rovsing 's sign References Jump up ^ Allan B Wolfson ( 1 September 2009 ). Harwood - Nuss ' Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins. pp. 1222 --. ISBN 978 - 0 - 7817 - 8943 - 1. Retrieved 30 May 2011. Jump up ^ McGee, S. ( 2007 ). Evidence based physical diagnosis ( 2nd ed. ). Philadelphia : Saunders. Jump up ^ Huang, Ih - Ping ; Smith, C Daniel ( August 2006 ). `` Cope 's Early Diagnosis of the Acute Abdomen, 21st Edition ''. Annals of Surgery. 244 ( 2 ) : 322. doi : 10.1097 / 01. sla. 0000230276.84612. b4. PMC 1602170. Jump up ^ Silen, William ( revised by ) ( 2005 ). Cope 's early diagnosis of the acute abdomen ( 21st ed. ). Oxford : Oxford University Press. ISBN 0 - 19 - 517545 - X. External links Acute appendicitis review in American Family Physician Symptoms and signs : digestive system and abdomen ( R10 -- R19, 787,789 ) Upper Nausea Vomiting Heartburn Aerophagia Dysphagia oropharyngeal esophageal Odynophagia Halitosis Xerostomia Hypersalivation Burping Wet burp Defaecation Flatulence Fecal incontinence Encopresis Blood : Fecal occult blood Rectal tenesmus Constipation Obstructed defecation Diarrhea Rectal discharge Psoas sign Obturator sign Rovsing 's sign Hamburger sign Heel tap sign Aure - Rozanova 's sign Dunphy sign Alder 's sign Lockwood 's sign Rosenstein 's sign Abdomen Abdominal pain Acute abdomen Colic Baby colic Abdominal guarding Rebound tenderness Abdominal distension Bloating Ascites Tympanites Shifting dullness Bulging flanks Fluid wave test Abdominal mass Hepatosplenomegaly Hepatomegaly Splenomegaly Jaundice Mallet - Guy sign Puddle sign Eponymous medical signs for digestive system and abdomen Digestive system Gastrointestinal tract Goodsall 's rule Chilaiditi syndrome intussusception : Dance 's sign Lockwood 's sign appendicitis : Aaron 's sign Arapov 's sign ( contracture ) Dunphy sign Markle sign McBurney 's point Rosenstein 's sign Rovsing 's sign Sherren 's triangle Aure - Rozanova 's sign Alder 's sign pancreatitis Mallet - Guy sign Radiologic signs : Hampton 's line Klemm 's sign Accessory liver : Councilman body Mallory body biliary : Boas ' sign Courvoisier 's law Charcot 's cholangitis triad / Reynolds ' pentad cholecystitis ( Murphy 's sign Lépine 's sign ) Nardi test Abdominopelvic Peritoneum Blumberg sign Rigler 's sign Cupola sign Hernia Howship -- Romberg sign Hannington - Kiff sign Other Fothergill 's sign Carnett 's sign Abdominal general spleen / LUQ : Ballance 's sign Traube 's sign Castell 's sign hemorrhage : Cullen 's sign Grey Turner 's sign This medical sign article is a stub. You can help Wikipedia by expanding it. Retrieved from `` https://en.wikipedia.org/w/index.php?title=Obturator_sign&oldid=766267895 '' Categories : Medical signs Medical sign stubs Hidden categories : Use dmy dates from May 2011 All stub articles Talk About Wikipedia Polski Português Edit links This page was last edited on 19 February 2017, at 06 : 37. Text is available under the Creative Commons Attribution - ShareAlike License ; additional terms may apply. By using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia ® is a registered trademark of the Wikimedia Foundation, Inc., a non-profit organization. About Wikipedia

Question: a positive obturator sign would elicit pain in the
Answer: the retrocecal or pelvic region