Surgery Signs, Triads, Etc.

Front 1

ABCs of melanoma

Back 1

Asymmetry, Border irregularity, Color variation/dark, Diameter >0.6cm, Evolution

Front 2

Allen's test

Back 2

test for patency of ulnar artery prior to placing a radial ABG

Front 3

ballance's sign

Back 3

constant dullness to percussion in the L flank/LUQ and resonance to percussion in the R flank (seen w/splenic rupture/hematoma)

Front 4

barrett's esophagus

Back 4

columnar metaplasia of the distal esophagus (GERD related)

Front 5

battle's sign

Back 5

ecchymosis over the mastoid process in patients w/basilar skull fractures

Front 6

beck's triad

Back 6

seen in patients w/cardiac tamponade: 1. JVD, 2. decreased/muffled heart sounds, 3. decreased BP

Front 7

bergman's triad

Back 7

seen w/fat emboli syndrome: 1. mental status changes, 2. petechiae (often in axilla/thorax), 3. dyspnea

Front 8

blumer's shelf

Back 8

metastatic disease to the rectouterine (pouch of Douglas) or rectovesical pouch, creating a shelf that is palpable on rectal exam

Front 9

boas' sign

Back 9

R subscapular pain resulting from cholelithiasis

Front 10

borchardt's triad

Back 10

seen w/gastric volvulus: 1. emesis followed by retching, 2. epigastric distention, 3. failure to pass an NGT

Front 11

carcinoid triad

Back 11

flushing, diarrhea, R-sided heart failure

Front 12

charcot's triad

Back 12

seen w/cholangitis: 1. fever (chills), 2. jaundice, 3. RUQ pain

Front 13

chvostek's sign

Back 13

twitching of facial muscles upon tapping facial nerve in patients w/hypocalcemia

Front 14

courvoisier's law

Back 14

enlarged nontender gallbladder seen w/obstruction of the common bile duct, most commonly w/pancreatic cancer (NOT seen w/gallstone obstruction --> gallbladder is scarred 2ary to cholelithiasis)

Front 15

cullen's sign

Back 15

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)

Front 16

cushing's triad

Back 16

signs of increased ICP: 1. hypertension, 2. bradycardia, 3. irregular respirations

Front 17

dance's sign

Back 17

empty RLQ in children w/ileocecal intussusception

Front 18

fothergill's sign

Back 18

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 1/2-way upright)

Front 19

fox's sign

Back 19

ecchymosis of inguinal ligament seen w/retroperitoneal bleeding

Front 20

goodsall's rule

Back 20

anal fistulae course in a straight path anteriorly and a curved path posteriorly from midline

Front 21

grey turner's sign

Back 21

ecchymosis or discoloration of the flank in patients w/retroperitoneal hemorrhage as a result of dissecting blood from the retroperitoneum

Front 22

hamman's sign/crunch

Back 22

crunching sound on auscultation of the heart resulting from emphysematous mediastinum; seen w/boerhaave's syndrome, pneumomediastinum, etc.

Front 23

homans' sign

Back 23

calf pain on forced dorsiflexion of the foot in patients w/DVT

Front 24

howship-romberg sign

Back 24

pain along the inner aspect of the thigh; seen w/obturator hernia as the result of nerve compression

Front 25

kehr's sign

Back 25

severe L shoulder pain in patients w/splenic rupture (referred pain from diaphragmatic irritation)

Front 26

kelly's sign

Back 26

visible peristalsis of the ureter in response to squeezing or retraction; used to ID the ureter during surgery

Front 27

krukenberg tumor

Back 27

metastatic tumor to the ovary (classically from gastric cancer)

Front 28

laplace's law

Back 28

wall tension = pressure x radius (--> the colon perforates preferentially at the cecum b/c of the increased radius and resultant increased wall tension)

Front 29

sister mary joseph's sign

Back 29

metastatic tumor to umbilical lymph node(s)

Front 30

virchow's node

Back 30

metastatic tumor to L supraclavicular node (classically due to gastric cancer)

Front 31

virchow's triad

Back 31

risk factors for thrombosis: 1. stasis, 2. abnormal endothelium, 3. hypercoagulability

Front 32

trousseau's sign

Back 32

carpal spasm after occlusion of blood to the forearm w/ a BP cuff in patients w/hypocalcemia

Front 33

valentino's sign

Back 33

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

Front 34

westermark's sign

Back 34

decreased pulm vascular markings on CXR in a patient w/pulmonary embolism

Front 35

whipple's triad

Back 35

evidence for insulinoma: 1. hypoglycemia (<50), 2. CNS and vasomotor symptoms (e.g., syncope, diaphoresis), 3. relief of sx w/administration of glucose