Surgery Signs and Triads Flashcards
What is Allen’s test?
How is Allen’s test performed?
Test for patency of ulnar artery prior to placing a radial arterial line or performing an ABG
1. Examiner occludes both ulnar and radial arteries with fingers as patient makes fist
2. patient opens fist while examiner releases ulnar
artery occlusion to assess blood flow to hand
Note: 28% of pop. have complete radial
artery dominance
Balance’s sign?
Constant dullness to percussion in the left flank/LUQ and resonance to percussion in the right flank seen with splenic rupture/hematoma
Battle’s sign?
Ecchymosis over the mastoid process in patients with basilar skull fractures
Beck’s triad?
Seen in patients with cardiac tamponade:
1. Increased JVD
2. Decreased or muffled heart sounds
3. Decreased blood pressure
Blumer’s shelf?
Metastatic disease to the rectouterine (pouch of Douglas) or rectovesical pouch creating a “shelf” that is palpable on rectal examination
Carcinoid triad?
Seen with carcinoid syndrome
1. Flushing
2. Diarrhea
3. Right-sided heart failure
Think: “FDR”
Charcot’s triad?
Seen with cholangitis:
1. Fever (chills)
2. Jaundice
3. Right upper quadrant pain
Cullen’s sign?
Bluish discoloration of the periumbilical area due to retroperitoneal hemorrhage tracking around to the anterior abdominal wall through fascial
planes
Condition seen in: acute hemorrhagic pancreatitis
Cushing’s triad?
Signs of increased intracranial pressure:
1. Hypertension
2. Bradycardia
3. Irregular respirations
Goodsall’s rule?
Anal fistulae course in a straight path anteriorly and a curved path posteriorly from midline
Note: Think of a dog with a straight anterior nose and a curved posterior tail
Hamman’s sign/crunch?
Crunching sound on auscultation of the heart resulting from emphysematous mediastinum
Condition seen in: Boerhaave’s syndrome, pneumomediastinum, etc.
Howship-Romberg sign?
Pain along the inner aspect of the thigh
Condition seen in: seen with an obturator hernia as the result of nerve compression
McBurney’s point?
One third the distance from the anterior iliac spine to the umbilicus on a line connecting the two
Meckel’s diverticulum rule of 2s?
2% of the population have a Meckel’s diverticulum
2% of those are symptomatic
they occur within ≈2 feet of the ileocecal valve
Murphy’s sign?
Cessation of inspiration while palpating under the right costal margin; the patient cannot continue to inspire deeply because it brings an inflamed
gallbladder under pressure
Condition seen in: acute cholecystitis
Chvostek’s sign?
Twitching of facial muscles upon tapping the facial nerve in patients with hypocalcemia
Think: CHvostek’s = CHeek = hypoCalcemia
Courvoisier’s law?
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
Obturator sign?
Pain upon internal rotation of the leg with the hip and knee flexed
Condition seen in: patients with appendicitis/pelvic abscess
Pheochromocytoma SYMPTOMS triad?
- Palpitations
- Headache
- Episodic diaphoresis (excessive sweating)
Think of the first three letters in the word pheochromocytoma—“P-H-E”
Psoas sign?
Pain elicited by extending the hip with the knee in full extension
Conditions seen in: appendicitis and psoas inflammation
Racoon eyes?
Bilateral black eyes as a result of basilar skull fracture
Reynolds’ pentad?
- Fever
- Jaundice
- Right upper quadrant pain
- Mental status changes
- Shock/sepsis
Thus, Charcot’s triad plus #4 and #5
Conditions seen in: patients with suppurative
cholangitis
Rovsing’s sign?
Palpation of the left lower quadrant resulting in pain in the right lower quadrant
Condition seen in: appendicitis
Virchow’s node?
Metastatic tumor to left supraclavicular node Condition classically due to: gastric cancer
