- Since afferent fibres from the appendix are carried in the lesser splanchnic nerve, and impulses enter T10;
pain from the appendix is initially referred to the periumbilical region . Later, the pain may localize in the
right lower quadrant - due to irritation of perietal peritoneum. If the appendix is long and enters the pelvis,
acute appendicitis may resemble raptured ectopic pregnancy.
- Since the appendix crosses the psoas major, the patient flexes the right thigh to relieve pain. If this thigh
ishyperextended (psoas test), there will be pain because it stretches the muscle and its inflamed fascia.
- MC Burney's point -joint between lateral 1/3; and medial 2/3 of a line between anterior superior iliac spine
and umbilicus. This is the point of maximum tenderness in appendicitis. The Gridiron incision is made
perpendicular to the line at this point, in appendicectomy.
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