surgery med terms

Question 1

ballances sign

Answer 1

Constant dullness to percussion in the left fank/LUQ and resonance to percussion
in the right flank seen with splenic rupture/hematoma

Question 2

Beck’s triad

Answer 2

Cardiac tamponade:

1) JVD
2) Muffled heart sounds
3) Decreased bp

Question 3

Bergman’s triad

Answer 3

Fat emboli syndrome:

1) Mental status change
2) Petechiae (axilla or thorax often)
3) dyspnea

Question 4

Blummer’s shelf

Answer 4

Mets to rectouterine/vesicle pouch. Creates shelf on rectal exam

Question 5

Boas sign

Answer 5

R subscapular pain from cholelithiasis

Question 6

Borchardt’s triad

Answer 6

gastric volvulus:

1) Emesis followed by retching
2) Epigastric distension
3) Failure to pass NGT

Question 7

Carcinoid triad

Answer 7

Seen with carcinoid syndrome (Think: “FDR”):

1. Flushing
2. Diarrhea
3. Right-sided heart failure

Question 8

Charcot’s triad

Answer 8

Seen with cholangitis:

1. Fever (chills)
2. Jaundice
3. Right upper quadrant pain

Question 9

Courvoisier’s law

Answer 9

Enlarged nontender gallbladder seen with obstruction of the common bile duct, most commonly with pancreatic cancer
Note: not seen with gallstone obstruction because the gallbladder is scarred secondary to chronic cholelithiasis

Question 10

Cullen’s sign

Answer 10

Bluish discoloration of the periumbilical area due to retroperitoneal hemorrhage tracking around to the anterior abdominal wall through fascial planes (e.g., acute hemorrhagic pancreatitis)

Question 11

Cushing’s triad

Answer 11

Signs of increased intracranial pressure: 1. Hypertension

2. Bradycardia
3. Irregular respirations

Question 12

Dance’s sign

Answer 12

Empty right lower quadrant in children with ileocecal intussusception

Question 13

Fothergille’s sign

Answer 13

Used to differentiate an intra-abdominal mass from one in the abdominal wall; if mass is felt while there is tension on the musculature, then it is in the wall (i.e., sitting halfway upright)

Question 14

Fox’s sign

Answer 14

Ecchymosis of inguinal ligament seen with retroperitoneal bleeding

Question 15

Goodsall’s rule

Answer 15

Anal fistulae course in a straight path anteriorly and a curved path posteriorly from midline (Think of a dog with a straight anterior nose and a curved posterior tail)

Question 16

Hamman’s sign/crunch

Answer 16

Crunching sound on auscultation of the heart resulting from emphysematous mediastinum; seen with Boerhaave’s syndrome, pneumomediastinum, etc.

Question 17

Homans’ sign

Answer 17

Calf pain on forced dorsiflexion of the foot in patients with DVT (doesn’t work)

Question 18

Howship-Romberg sign

Answer 18

Pain along the inner aspect of the thigh; seen with an obturator hernia as the result of nerve compression

Question 19

Kehr’s sign

Answer 19

Severe left shoulder pain in patients with splenic rupture (as a result of referred pain from diaphragmatic irritation)

Question 20

Kelly’s sign

Answer 20

Visible peristalsis of the ureter in response to squeezing or retraction; used to identify the ureter during surgery

Question 21

Krukenberg tumor

Answer 21

Metastatic tumor to the ovary (classically from gastric cancer)

Question 22

Laplace’s law

Answer 22

Wall tension = pressure x radius (thus, the colon perforates preferentially at the cecum because of the increased radius and resultant increased wall tension)

Question 23

Meckel’s diverticulum rule of 2s

Answer 23

2% of the population have a Meckel’s diverticulum, 2% of those are symptomatic, and they occur within 2 feet of the ileocecal valve

Question 24

Mittelschmerz

Answer 24

Lower quadrant pain due to ovulation

Question 25

Obturator sign

Answer 25

Pain upon internal rotation of the leg with the hip and knee flexed; seen in patients with appendicitis/pelvic abscess

Question 26

Pheo Sx's triad

Answer 26

1) Palpitations 2) HA 3) Episodic diaphoresis (First 3 letters of pheo)

Question 27

Pheo rule of 10's

Answer 27

10% bilateral, 10% malignant, 10% in children, 10% extra-adrenal, 10% have multiple tumors

Question 28

Psoas sign

Answer 28

Pain elicited by extending the hip with the knee in full extension, seen with appendicitis and psoas inflammation

Question 29

Rovsing’s sign

Answer 29

Palpation of the left lower quadrant resulting in pain in the right lower quadrant; seen in appendicitis

Question 30

Saint’s triad

Answer 30

1. Cholelithiasis 2. Hiatal hernia 3. Diverticular disease

Question 31

Silk glove sign

Answer 31

Indirect hernia sac in the pediatric patient; the sac feels like a finger of a silk glove when rolled under the examining finger

Question 32

Sister Mary Joseph’s node

Answer 32

Metastatic tumor to umbilical lymph node(s)

Question 33

Virchow’s node

Answer 33

Metastatic tumor to left supraclavicular node (classically due to gastric cancer)

Question 34

Virchow's triad

Answer 34

Risk factors for thrombosis 1. Stasis 2. Abnormal endothelium 3. Hypercoagulability

Question 35

Trousseau’s sign

Answer 35

Carpal spasm after occlusion of blood to the forearm with a BP cuff in patients with hypocalcemia

Question 36

Valentino’s sign

Answer 36

Right lower quadrant pain from a perforated peptic ulcer due to succus/ pus draining into the RLQ

Question 37

Westermark’s sign

Answer 37

Decreased pulmonary vascular markings on CXR in a patient with pulmonary embolus

Question 38

Whipple’s triad

Answer 38

``` Evidence for insulinoma: 1. Hypoglycemia ( < 50) 2. CNS and vasomotor symptoms (e.g., syncope, diaphoresis) 3. Relief of symptoms with administration of glucose ```