Which sign indicates acute cholecystitis and involves pain on inspiration when the examiner palpates the gallbladder area in the right upper quadrant?

• A. Murphy's sign
• B. Rovsing's sign
• C. Obturator sign
• D. Guarding

Answer: (A)

Murphy's sign is the sign you're looking for. It tests for gallbladder inflammation by palpating the right upper quadrant where the gallbladder sits and asking the patient to take a deep breath. If the inflamed gallbladder irritates the peritoneum and diaphragm, the patient experiences sharp pain and abruptly halts inhalation—that positive response is Murphy's sign and strongly suggests acute cholecystitis. Other signs have different targets: Rovsing's sign relates to appendicitis with pain in the right lower quadrant on palpation of the left lower quadrant, the obturator sign indicates pelvic or intraperitoneal irritation with internal rotation of the flexed hip, and guarding is a general abdominal muscle contraction from peritoneal irritation.