Surgery Signs / Triads/ Etc You Should Know

Front 1

ABCDs of Melanoma

Back 1

A= Asymmetry

B = Borders irregular

C = Colour variation

D = Diameter >0.6cm

Dark colour

Front 2

Allen's test: 1) What for

2) When

3) How

Back 2

1) Clinical test to test patency of ulnar artery

2) Before ABG
Before placing a radial arterial line

3) Patient elevates hand and makes a fist

Occlude both radial and ulnar arteries with thumbs x 30 secs

Tell patient to open hand

Hand should appear blanched

Un-occlude ULNAR artery.

Colour should return in 5-15 secs

Front 3

Ballance's sign

Back 3

Constant dullness in the Left flank with resonance in the Right flank

Sign of: Splenic rupture

Haematoma

Front 4

Barrett's oesophagus

What cells usually line oesophagus?

Back 4

Columnar metaplasia, with goblet cells, of the distal oesophagus, assoc with GORD

Normally: Stratified squamous cells

Front 5

Battle's sign

Back 5

Ecchymosis over mastoid processes

Due to basilar skull fracture

Front 6

Beck's triad

Back 6

(Beck becoming muffled as he grabs his chest on stage)

Seen in Cardiac Tamponade

1) JVD

2) Decreased BP

3) Decreased/muffled heart sounds

Front 7

Bergman's triad

Back 7

(iceBERG made of FAT - a FatBerg)

Seen in fat embolus syndrome

1) Mental status changes

2) Petechiae (axilla/thorax espec)

3) Dyspnoea

Front 8

Blumer's shelf

Back 8

Metastatic disease of rectouterine/rectovesical pouch

Creates a 'shelf' palpable on DRE

Front 9

Boa's sign

Back 9

(BOA constricting your CBD)

Right subscapular pain

Seen in cholelithiasis

Front 10

Borchardt's triad

Back 10

(B for belly)

Seen in gastric volvulus

1) Emesis, followed by retching

2) Epigastric distension

3) Failure to pass NG tube

Front 11

Carcinoid triad

Back 11

(FDR in his Car)

1) Flushing

2) Diarrhoea

3) Right heart failure

Front 12

Charcot's triad

Back 12

(CHarcot's for CHolangitis - sCHARCs find bile ducts particularly delicious, especially when cooked in a FLAME)

Sign of cholangitis

1) Fever (chills)

2) Jaundice

3) RUQ pain

Front 13

Chvostek's sign

Back 13

(CHeek for CHvostek)

Twitching of facial muscles

As you tap the cheek

Sign of HyPOcalcaemia

Front 14

Courvoisier's Law

Back 14

GB nontender + enlarged =

NOT chronic cholelithiasis

BUT obstructed CBD,

MC due to pancreatic cancer

Chronic cholelithiasis ==> scarring and tenderness

Front 15

Cullen's sign

Back 15

Blueish discolouration of the periumbilical area due to retroperitoneal haemorrhage

tracking to anterior abdominal wall

through fascial planes.

Common cause = acute haemorrhagic pancreatitis

Front 16

Cushing's triad

Back 16

Signs of increased intracranial pressure

1) Hypertension

2) Bradycardia

3) Irregular respirations

Front 17

Dance's sign

Back 17

Empty RLQ in children with ileocaecal intussusception

Front 18

Fothergill's sign

Back 18

Used to differentiate intra-abdominal masses from masses in abdominal wall

If mass can still be felt with tension on the musculature of the abdominal wall (e.g. half sitting upright position), the mass is in the abdo wall.

Front 19

Fox's sign

Back 19

Ecchymosis of the inguinal ligament

Due to retroperitoneal bleeding tracking

Front 20

Goodsall's rule

Back 20

Anal fistulae

Course in a straight path anteriorly and

A curved path posteriorly

Front 21

Clinical sign?

Back 21

Cullen's sign (see the vampire bites!?)

Blueish discolouration of the periumbilical region due to retroperitoneal haemorrhage tracking through fascial planes to anterior abdo cavity

Common cause = acute haemorrhagic pancreatitis

Front 22

Clinical sign?

Back 22

Fox's sign

Ecchymosis of the inguinal ligament due to retroperitoneal bleeding tracking

Front 23

What is this diagram trying to demonstrate?

Back 23

Goodsall's rule

Anal fistulae

Course a straight path anteriorly and a

Curved path posteriorly

Front 24

Grey Turner's Sign

Back 24

Bluish discolouration of the flank

due to retroperitoneal haemorrhage

with blood dissecting to flanks

Front 25

Hamman's sign

Back 25

(The heart is a piece of ham)

Sign of emphysematous mediastinum

Crunching sound heard on auscultation of the heart

Commonly due to Boerhaav's syndrome, pneumomediastinum etc

Front 26

Howship Romberg's Sign

Back 26

(Ship sailing out of your back passage onto your thigh)

Obturator hernia sign

Pain along the inner aspect of the thigh due to nerve compression by

obturator hernia

Front 27

Kehr's sign

Back 27

(Splenic rupture sign)

Severe Left shoulder pain

Due splenic rupture

Causing blood to irritate diaphragm

==> referred pain to Left shoulder

Front 28

Homan's sign

Back 28

DVT sign

Forced dorsiflexion of the foot ==> Calf pain

Front 29

Clinical sign?

Back 29

Grey Turners

A sign of retroperitoneal haemorrhage

Blueish discolouration of the flank due to dissecting of blood from the retrperitoneum

Front 30

What sign is being tested?

Back 30

Homan's sign

Sign of DVT

Forced dorsiflexion ==> Calf pain

Front 31

Clinical sign?

Back 31

Kehr's sign

Sign of splenic rupture

Left dhoulder pain due to diaphragmatic irritation

Front 32

Parkland formula

Back 32

Formula used for calculating how much IV fluids needed by burn victim in first 24hrs of Rx

4 x weight of patient in kg x % body burned

in mL

First half of fluids is given in first 8hrs.

Next half is given over the next 16hrs

Front 33

Jenkin's rule

Back 33

Amt of suture needs to be 4 times the length of the wound

Front 34

Hilton's Method

Back 34

Abscess exploration method prior to drainage

Incision made over abscess

Wound is explored bluntly using a forceps

Front 35

Sebaceous cyst: How do you clinically diagnose?

Back 35

1) Fluctuation: Test twice. at different right angles, minimum

2) Transillumination

Front 36

Wrist ganglion: How do you clinically diagnose

Back 36

1) Location: At the wrist

2) Can move skin freely over the ganglion

3) Fluctuation in 2 directions

4) Transilluminates brilliantly