Surgery: Signs And Triads To Know

Front 1

What are the ABCDs of melanoma?

Back 1

Signs of melanoma:
Asymmetric
Border irregularities
Color variation
Diameter > 0.6 cm and Dark color

Front 2

Ballance's sign

Back 2

Constant dullness to percussion in the L flank/LUQ and resonance to percussion in the R flank seen with splenic rupture/hematoma

Front 3

Barrett's esophagus

Back 3

Columnar metaplasia of the distal esophagus (GERD related)

Front 4

Battle's sign

Back 4

Ecchymosis over hte mastoid process in patients with basilar skull fractures

Front 5

Beck's triad

Back 5

Seen in pts with cardiac tamponade
1. JVD
2. Decreased or muffled heart sounds
3. Decreased blood pressure

Front 6

Bergman's triad

Back 6

Seen with fat emboli syndrome:
1. Mental status changes
2. Petechiae (often in axilla/thorax area)
3. Dyspnea

Front 7

Boas' sign

Back 7

R subscapular pain resulting from cholelithiasis

Front 8

Borchardt's triad

Back 8

Seen with gastric volvulus:
1. Emesis folloewd by retching
2. Epigastric distention
3. Failure to pass an NGT

Front 9

Carcinoid triad

Back 9

Seen with carcinoid syndrome, think FDR:
1. Flushing
2. Diarrhea
3. R-sided Heart Failure

Front 10

Charcot's triad

Back 10

Seen with cholangitis
1. Fevers/chills
2. Jaundice
3. RUQ pain

Front 11

Chvostek's sign

Back 11

Twitching of facial muscles upon tapping the facial nerve in patients with hypocalcemia.

Front 12

Courvoisier's law

Back 12

Enlarged nontender gallbladder seen with obstruction of hte common bile duct, most commonly iwth pancreatic cancer. This is NOT seen with gallstone obstruction because the gllabladder is scarred secodnary to chronic cholelithiasis.

Front 13

Cullen's sign

Back 13

Blusih discoloration of periumbilical area due to retroperitoneal hemorrhage tracking around to the anterior abdominal wall through fascial planes (ex. in acute hemorrhagic pancreatitis).

Front 14

Cushing's triad

Back 14

Seen in increased ICP:
1. Hypertension
2. Bradycardia
3. Irregular respirations

Front 15

Dance's sign

Back 15

Empty RLQ in children with ileocecal intussusception

Front 16

Fothergill's sign

Back 16

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

Front 17

Fox's sign

Back 17

Ecchymosis of inguinal ligmaent seen with retroperiotneal bleeding.

Front 18

Grey Turner's sign

Back 18

Ecchymosis or discoloration of the flank in pts with retroperitoneal hemorrhage as a result fo dissecting blood from retroperitoneum

Front 19

Hamman's sign/crunch

Back 19

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

Front 20

Homan's sign

Back 20

Calf pain on forced dorsiflexion of the foot in pts with DVT

Front 21

Howship=Rhomberg sign

Back 21

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

Front 22

Kehr's sign

Back 22

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

Front 23

Kelly's sign

Back 23

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

Front 24

Krukenberg tumor

Back 24

Metastatic tumor to the ovary (classically from gastric cancer)

Front 25

Laplace's law

Back 25

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

Front 26

McBurney's point

Back 26

1/3 the distance from the anterior iliac spine to the umbilicus on a line connecting the two

Front 27

McBurney's sign

Back 27

Tenderness at McBurney's point in pts with appendicitis

Front 28

Meckel's diverticulum rule of 2s

Back 28

2% of population have a Mechel's diverticulum
2% of those are symptomatic
They occur within ~2 feet of the ileocecal valve

Front 29

Murphy's sign

Back 29

Cessation of inspiration while palpating under the R costal margin; the pt cannot inspire deeply because it brings an inflammed gallbladder under pressure (seen in acute cholecystitis)

Front 30

Obturator sign

Back 30

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

Front 31

Pheochromocytoma triad

Back 31

Palpitations, headaches, episodic diaphoresis

Front 32

Pheochromocytoma rule of 10s

Back 32

10% bilateral
10% malginant
10% in children
10% extra-adrenal
10% have multiple tumors

Front 33

Psoas sign

Back 33

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

Front 34

Raccoon eyes

Back 34

bilateral black eyes as result of basilar skull fracture

Front 35

Reylond's pentad

Back 35

Charcot's triad
1. Fever
2. Jaundice
3. RUQ pain

****PLUS****
4. Mental status changes
5. Shock and sepsis;

seen in pts with SUPPURATIVE cholangitis

Front 36

Rosving's sign

Back 36

Palpation of the LLQ resulting in pain in the RLQ, seen in appendicitis

Front 37

Saint's triad

Back 37

Cholelithiasis
Hiatal hernia
Diverticular dz

Front 38

Virchow's triad

Back 38

Risk factors for thrombosis:
1. Endothelial damage/abnormal endothelium
2. Hypercoagulable states
3. Stasis

Front 39

Trosseau's sign

Back 39

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

Front 40

Valentino's sign

Back 40

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

Front 41

Westermark's sign

Back 41

Decreased pulmonary vascular markings oN CXR in a pt with pulmonary embolus

Front 42

Whipple's triad

Back 42

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