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Slides. So that's up signs to look for in an unwell patient who's got abdominal pain, they might make you think of something like um I'm retired to hemorrhagic pancreatitis. And then the last, last quiz, anyone know these important abdominal um, signs and triads feel free to message in the chat. So there's Murphy sign. Mcburney's point, Charcot's triad. Do you know what they are or what disease there indicate if you see them in a patient? So, Murphy's sign something we mentioned earlier in the abdominal exam is when you palpate with their hand underneath the, and they're kind of right upper quadrant just underneath the costal margin. And when you're pressing, ask the patient to take a deep breath in and if they catch their breath and stop breathing because of the pain that right upper quadrant area, when they're, when you're palpating, then that's Murphy's sign positive. And remember you need to test that on the left hand side as well and make sure there's no pain when you're pressing. Um So, you know, it's just pain on the right rather than the pain being generalized. And so Murphy sign is that stopping breathing and pain when you're pressing on the right upper quadrant and the patient's taking deep breath in. And what is that a sign of? So, it's commonly a sign of curly cystitis, which is inflammation of the gallbladder. Because when you're putting your hand up against the right upper quadrant of the patient, you're kind of pushing their gallbladder against the liver and the rib cage and they take a deep breath in and then the, the diaphragm and the rib cage hits that inflamed gallbladder and they're gonna catch their breath and that's going to cause pain. And so, you know, there's irritation of the, of the gallbladder. So, cholecystitis, um, if there's Murphy sound positive, whereas if they're comfortable and do any press on that, right upper quadrant and they take a deep breath and there's no pain, then you, um, it's less likely that there's an irritation of the gallbladder. So that's a good sign for cholecystitis. Mcburney's point is the area. Um, if you draw a line from the umbilicus down to the anterior superior iliac spine, it's two thirds of the way along from the umbilicus to the anterior spine of the pelvis. And that's the location of the pain where appendicitis usually manifests. So it usually starts off centrally and then migrates down that line across the mcburney's point. And so mcburney's point is often that place in the right, um, side of the lower side of the abdomen where appendicitis pain is felt most commonly uh And then finally, Charcot's triad is try out of three symptoms. So, fever, pain in the right upper quadrant and jaundice and usually indicates something serious like ascending cholangitis, which is an inflammation, infection and inflammation of the common bile duct. Usually because there's a stone that's blocking it. And then obviously, if there's a blockage of that system, then it's not gonna be able to drain and you'll get stagnation of bile, build up of bacteria and infection. Um And so the patient has an infection. So they've got a fever, they've got a blockage of the bile top. So they get jaundice and they've got um usually a stone or in some inflammation going on there. So they're gonna have pain. So, pain in the right upper quadrant fever and jaundiced should make you think of Charcot's triad, which is cholangitis, which is where a um emergency condition that you might see and patient's with, with uh usually with gallstones. All right. Hopefully that was useful. So that is everything for the history examination talk. I think um Paul's helpfully put the feedback link in the chat from correct. Yep. So, hi guys. Thanks. First of all. Thank you very much, Doctor Sharma for that time. They'll probably good know someone who's got Noski coming up this summer that I can tell you that it's very helpful. Indeed. Um Yeah, if you guys could just fill in the feed back, please and just make sure that you can get a certificate and it's also important to Doctor Sharma can get proof that he's been teaching today. Um So please do just fill it in. He'll take literally one or two minutes and then you'll automatically get the, the um uh certificate and the slides should also be available on metal in a few days. Um Once those are uploaded. But um if you guys have any free, any questions for Doctor Sharma, just put them on the chat or on you or if not. Thank you very much for coming and we'll see you in the next lecture in our series. Thank you guys. Thanks. Thanks for coming. Everyone. Hope it was useful. Thanks a lot. I'll just keep the um meeting going for about five minutes and then once everyone's, I'm headed off, I'll close it down. Perfect.