Surgery signs, triads, ETC. you should know Flashcards
ABCDEs of melanoma
Signs of melanoma:
Asymmetric Border irregularities Color variation Diameter 0.6 cm and Dark color Evolution (i.e., change in lesion)
Constant dullness to percussion in the le
ank/LUQ and resonance to percussion
in the right ank seen with splenic
rupture/hematoma
Ballance’s sign
Columnar metaplasia of the distal
esophagus (GERD related)
Barrett’s esophagus
Ecchymosis over the mastoid process in patients with basilar skull fractures
Battle’s sign
- JVD
- Decreased or mu ed heart sounds
- Decreased blood pressure
Beck’s triad
Seen in patients with cardiac tamponade
- Mental status changes
- Petechiae (o en in the axilla/thorax)
- Dyspnea
Bergman’s triad
Seen with fat emboli syndrome
Metastatic disease to the rectouterine
(pouch of Douglas) or rectovesical pouch
creating a “shelf” that is palpable on
rectal examination
Blumer’s shelf
Right subscapular pain resulting from cholelithiasis
Boas’ sign
- Emesis followed by retching
- Epigastric distention
- Failure to pass an NG
Borchardt’s triad
Seen with gastric volvulus
- Flushing
- Diarrhea
- Right-sided heart failure
Carcinoid triad
Seen with carcinoid syndrome - Think “FDR”
- Fever (chills)
- Jaundice
- Right upper quadrant pain
Charcot’s triad
Seen with cholangitis
Twitching of facial muscles upon
tapping the facial nerve in patients with
hypocalcemia
Chvostek’s sign
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
Courvoisier’s law
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)
Cullen’s sign
In the context of possible increased ICP:
- Hypertension
- Bradycardia
- Irregular respirations
Cushing’s triad
Empty right lower quadrant in children
with ileocecal intussusception
Dance’s sign
Used to di erentiate 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)
Fothergill’s sign
Ecchymosis of inguinal ligament seen with
retroperitoneal bleeding
Fox’s sign
Anal stulae course in a straight path
anteriorly and a curved path posteriorly
from midline
Goodsall’s rule
(Think of a dog with a
straight anterior nose and a curved
posterior tail)
Ecchymosis or discoloration of the flank in
patients with retroperitoneal hemorrhage
as a result of dissecting blood from the
retroperitoneum
Grey Turner’s sign
(Think: TURNer’s =
TURN side-to-side = flank)
Crunching sound on auscultation of the
heart resulting from emphysematous
mediastinum; seen with Boerhaave’s
syndrome, pneumomediastinum, etc.
Hamman’s sign/crunch
Calf pain on forced dorsiflexion of the foot in patient with DVT
Homan’s sign
Pain along the inner aspect of the thigh;
seen with an obturator hernia as the result
of nerve compression
Howship-Romberg sign
Severe le shoulder pain in patients with
splenic rupture (as a result of referred pain
from diaphragmatic irritation)
Kehr’s sign
Visible peristalsis of the ureter in response
to squeezing or retraction; used to identify
the ureter during surgery
Kelly’s sign
Metastatic tumor to the ovary (classically
from gastric cancer)
Krukenberg tumor
Wall tension pressure radius (thus,
the colon perforates preferentially at the
cecum because of the increased radius and
resultant increased wall tension)
Laplace’s law
One third the distance from the anterior
iliac spine to the umbilicus on a line
connecting the two
McBurney’s point
Tenderness at McBurney’s point in patients with appendicitis
McBurney’s sign
Meckel’s diverticulum rule of 2s
»2% of the population have a Meckel’s diverticulum »2% of those are symptomatic »Occur within ~2 feet of the ileocecal valve
Lower quadrant pain due to ovulation
Mittelschmerz
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
Murphy’s sign
Seen in acute cholecystitis
Pain upon internal rotation of the leg with
the hip and knee flexed; seen in patients
with appendicitis/pelvic abscess
Obturator sign
Palpitations
Headache
Episodic diaphoresis
Pheochromocytoma
SYMPTOMS triad
(Think of the first three letters in the word
pheochromocytoma—“P-H-E”)
Pheochromocytoma rule of
10s
» 10% bilateral » 10% malignant » 10% in children » 10% extra-adrenal » 10% have multiple tumors
Pain elicited by extending the hip with
the knee in full extension, seen with
appendicitis and psoas inflammation
Psoas sign
Bilateral black eyes as a result of basilar
skull fracture
Raccoon eyes
- Fever
- Jaundice
- Right upper quadrant pain
- Mental status changes
- Shock/sepsis
Reynold’s pentad
(Thus, Charcot’s triad plus #4 and #5; seen
in patients with suppurative cholangitis)
Palpation of the left lower quadrant
resulting in pain in the right lower
quadrant
Rovsing’s sign
Seen in appendicitis
- Cholelithiasis
- Hiatal hernia
- Diverticular disease
Saint’s triad
Indirect hernia sac in the pediatric patient;
the sac feels like a finger of a silk glove
when rolled under the examining finger
Silk glove sign
Metastatic tumor to umbilical lymph
node(s)
Sister Mary Joseph’s sign
(a.k.a. Sister Mary Joseph’s
node)
Metastatic tumor to left supraclavicular
node (classically due to gastric cancer)
Virchow’s node
- Stasis
- Abnormal endothelium
- Hypercoagulability
Virchow’s triad
Risk factors for thrombosis
Carpal spasm after occlusion of blood to
the forearm with a BP cuff in patients with
hypocalcemia
Trousseau’s sign
Right lower quadrant pain from a
perforated peptic ulcer due to succus/
pus draining into the RLQ
Valentino’s sign
Decreased pulmonary vascular markings on
CXR in a patient with pulmonary embolus
Westermark’s sign
- Hypoglycemia (
Whipple’s triad
Evidence for insulinoma
