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Appendicitis Signs

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McBurney's Triad Pain at RIF Vomiting Fever (usually <38.5C, if ruptured >40C) Signs Pointing sign McBurney sign Rovsing sign Rebound tenderness (Blumberg sign) Cutaneous hyperesthesia  Guarding Psoas sign - retrocecal Obturator - pelvic Special signs in retrocecal appendix Psoas sign . If severe, can see fixed hip flexion deformity. Also positive in psoas abscess. With absence of usual appendicitis signs Special signs in pelvic appendix Obturator sign Pain in DRE Early diarrhea Special signs in postileal appendix Diarrhea RIF pain Anatomy notes: Psoas m Origin: Lumbar vertebrae Insertion: Lesser trochanter Function: Hip flexion Obturator internus m Origin: Ischipubic ramus Insertion: Medial aspect of greater trochanter Function: Abducts & laterally rotates the extended hip *Pain is elicited when actions opposite to their functions are made??? I guess.

Axilla Pyramid

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Thank you for making this video!

Clinical Breast Examination

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Position of patient: Sitting on inspection of breast and examination of axilla Supine on palpation of breast Thank you  Breast Cancer Resource Centre UMMC  for making this video Examination of breast lump (I think this is very complete)

Nipple Discharge

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Taken from here There are seven basic types of nipple discharge, each of which can be associated with specific clinical conditions. Milky—white discharge; fat globules sometimes observed under microscopy Multicolored gummous—sticky discharge Purulent—pus with WBCs observed under microscopy Watery—colorless discharge Serous—faintly yellow, thin discharge Serosanguinous—thin, clear discharge with pink tint, RBCs observed under microscopy Bloody Green discharge

Types of Dyspepsia

Dyspepsia is a symptom and not a diagnosis Functional dyspepsia was defined as “upper abdominal or retrosternal pain or discomfort, heartburn, nausea or vomiting or other symptoms considered to be referable to the proximal alimentary tract and lasting for more than 4 weeks, unrelated to exercise and for which no focal lesion or systemic disease can be responsible Rome criteria Symptoms of dyspepsia are divided into: reflux-type (retrosternal burning, regurgitation),   ulcer-type (epigastric pain on empty stomach relieved with bland food, antacids or acid suppression drugs),  dysmotility-type (postprandial fullness, distension, early satiety, nausea).  Rome II criteria excluded symptoms of reflux-type, irritable bowel syndrome (pain relieved with defecation, with diarrhoea or constipation) and hepatobiliary diseases (biliary dyskinesia); chronicity of symptoms for 12 weeks at least (not continuous) during 12 months was emphasised. Rome III criteria divided functional d

Couinaud Classification

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It is the preferred anatomy classification system as it divides the liver into eight independent functional units (termed segments) rather than relying on the traditional morphological description based on the external appearance of the liver. The segments are numbered in Roman numerals I to VIII.  (pronounced kwee-NO)