Signs in Surgery

·         Chvostek's sign (spasm resulting from tapping over the facial nerve) and Trousseau's sign (spasm resulting from pressure applied to the nerves and vessels of the upper extremity, as when obtaining a blood pressure). seen in hypocalcemia.

·         Battle's sign (ecchymosis behind the ear) can be seen with basilar skull fractures.

·         pigmentation in the proximal or lateral nail folds (Hutchinson's sign) is diagnostic of subungual melanoma.

·         Rovsing's sign: pain in the right lower quadrant when palpatory pressure is exerted in the left lower quadrant also indicates the site of peritoneal irritation

·         A Murphy's sign, an inspiratory arrest with deep palpation in the right subcostal area, is characteristic of acute cholecystitis.

Focal tenderness over the gallbladder when compressed by the sonographic probe (sonographic Murphy's sign) also is suggestive of acute cholecystitis.

·         blood from necrotizing pancreatitis may dissect through the soft tissues and manifest as a blueish discoloration around the umbilicus (Cullen's sign) or in the flanks (Grey Turner sign).

·         Fothergill's sign is a palpable abdominal mass that remains unchanged with contraction of the rectus muscles and is classically associated with rectus hematoma.

·         Physical examination may reveal a mass lesion that is mobile only from the patient's right to left or left to right :Tillaux's sign.

·         Obstruction of venous return at the thoracic inlet from a substernal goiter results in a positive Pemberton's sign: acial flushing and dilatation of cervical veins upon raising the arms above the head

·         On physical examination, an elongated mass is detected in the right upper quadrant or epigastrium, with an absence of bowel in the right lower quadrant (Dance's sign), seen in intussusceptions.

·         If severe, weakness and atrophy of the ulnar-innervated intrinsic muscles of the hand may occur causing Froment's, Wartenberg's, or Jeanneau's signs, seen in ulnar nerve compression (cubital tunnel syndrome).

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·         Abdominal Examination Signs

SIGN	DESCRIPTION	DIAGNOSIS/CONDITION
Aaron sign	Pain or pressure in epigastrium or anterior chest with persistent firm pressure applied to McBurney's point	Acute appendicitis
Bassler sign	Sharp pain created by compressing appendix between abdominal wall and iliacus	Chronic appendicitis
Blumberg's sign	Transient abdominal wall rebound tenderness	Peritoneal inflammation
Carnett's sign	Loss of abdominal tenderness when abdominal wall muscles are contracted	Intra-abdominal source of abdominal pain
Chandelier sign	Extreme lower abdominal and pelvic pain with movement of cervix	Pelvic inflammatory disease
Charcot's sign	Intermittent right upper abdominal pain, jaundice, and fever	Choledocholithiasis
Claybrook sign	Accentuation of breath and cardiac sounds through abdominal wall	Ruptured abdominal viscus
Courvoisier's sign	Palpable gallbladder in presence of painless jaundice	Periampullary tumor
Cruveilhier sign	Varicose veins at umbilicus (caput medusae)	Portal hypertension
Cullen's sign	Periumbilical bruising	Hemoperitoneum
Danforth sign	Shoulder pain on inspiration	Hemoperitoneum
Fothergill's sign	Abdominal wall mass that does not cross midline and remains palpable when rectus contracted	Rectus muscle hematomas
Grey Turner's sign	Local areas of discoloration around umbilicus and flanks	Acute hemorrhagic pancreatitis
Iliopsoas sign	Elevation and extension of leg against resistance creates pain	Appendicitis with retrocecal abscess
Kehr's sign	Left shoulder pain when supine and pressure placed on left upper abdomen	Hemoperitoneum (especially from splenic origin)
Mannkopf's sign	Increased pulse when painful abdomen palpated	Absent if malingering
Murphy's sign	Pain caused by inspiration while applying pressure to right upper abdomen	Acute cholecystitis
Obturator sign	Flexion and external rotation of right thigh while supine creates hypogastric pain	Pelvic abscess or inflammatory mass in pelvis
Ransohoff sign	Yellow discoloration of umbilical region	Ruptured common bile duct
Rovsing's sign	Pain at McBurney's point when compressing the left lower abdomen	Acute appendicitis
Ten Horn sign	Pain caused by gentle traction of right testicle	Acute appendicitis