<prompt> In a patient of acute cholecystitis, referred pain to the shoulder is kaMurphys signGray Turner signBoas signCullens sign  <response>: Boas sign is the area of hyperaesthesia between 9th and 11th ribs posteriorly on the right side,i.e.,below the right scapula,sign of acute cholecystitis. Murphys sign is right upper quadrant tenderness that is exacerbated during inspiration by the examiners right subcostal palpation.Its also a sign of acute cholecystitis. Grey turner sign is the skin discolouration in the left flank in cases of acute hemorrhagic pancreatitis. Cullens sign is the discolouration of umbilicus and surrounding skinumbilical black eye.Its due to hemoperitoneum seen in conditions like ruptured ectopic pregnancy,acute hemorrhagic pancreatitis. Reference:SRBs manual of surgery,5th edition,page no:644;Bailey Loves manual of surgery,25th edition,page no:1121. 