Aorta Press deeply in upper abdomen slightly lateral to midline on both sides. Assess width of aorta pulsations. Normal is 2.5cm in width, not including abdominal wall thickness. Prominent pulsations with lateral expansion suggest an abdominal aortic aneurysm. Involuntary resistance, progressive abdominal rigidity.
Patient is unable to relax muscles.
Body's protective function against pain. Localized tenderness - usually in RLQ or right flank pain. Rectal exam reveals right sided rectal tenderness. May indicate inflammatory process other than appendicitis. Place right hand above right knee of the patient.