Kehr's sign
Encyclopedia
Kehr's sign is the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity
when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classical symptom of a ruptured spleen
. May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy.
Kehr's sign is a classical example of referred pain
: irritation of the diaphragm is signalled by the phrenic nerve
as pain in the area above the collarbone. This is because the supraclavicular nerves
have the same cervical nerves
origin as the phrenic nerve, C3 and C4.
The discovery of this is often attributed to a German gall bladder surgeon named Hans Kehr
, but extensive studies into research he conducted during his life shows inconclusive evidence as to whether or not he actually discovered it.
Peritoneal cavity
The peritoneal cavity is a potential space between the parietal peritoneum and visceral peritoneum, that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall...
when a person is lying down and the legs are elevated. Kehr's sign in the left shoulder is considered a classical symptom of a ruptured spleen
Ruptured spleen
Rupture of the capsule of the spleen, an organ in the upper left part of the abdomen, is a situation that requires immediate medical attention. The rupture of a normal spleen can be caused by trauma, such as a car accident.-Function In the Body:...
. May result from diaphragmatic or peridiaphragmatic lesions, renal calculi, splenic injury or ruptured ectopic pregnancy.
Kehr's sign is a classical example of referred pain
Referred pain
Referred pain is pain perceived at a location other than the site of the painful stimulus. An example is the case of ischemia brought on by a myocardial infarction , where pain is often felt in the neck, shoulders, and back rather than in the chest, the site of the injury...
: irritation of the diaphragm is signalled by the phrenic nerve
Phrenic nerve
The phrenic nerve originates mainly from the 4th cervical nerve, but also receives contributions from the 5th and 3rd cervical nerves in humans....
as pain in the area above the collarbone. This is because the supraclavicular nerves
Supraclavicular nerves
The supraclavicular nerves arise from the third and fourth cervical nerves; they emerge beneath the posterior border of the Sternocleidomastoideus, and descend in the posterior triangle of the neck beneath the platysma and deep cervical fascia.-Branches:Near the clavicle they perforate the fascia...
have the same cervical nerves
Cervical nerves
The cervical nerves are the spinal nerves from the cervical vertebrae.Although there are seven cervical vertebrae , there are eight cervical nerves . All nerves except C8 emerge above their corresponding vertebrae, while the C8 nerve emerges below the C7 vertebra...
origin as the phrenic nerve, C3 and C4.
The discovery of this is often attributed to a German gall bladder surgeon named Hans Kehr
Hans Kehr
Johannes Otto Kehr was a German surgeon and professor of surgery born in Waltershausen, Thuringia. He practiced surgery at a private clicic in Halberstädt, and from 1910 worked in Berlin...
, but extensive studies into research he conducted during his life shows inconclusive evidence as to whether or not he actually discovered it.