Synonyms: Courvoisier’s sign, Courvoisier syndrome, Courvoisier-Terrier sign, Bard-Pic disease Over years, the use of the term Courvoisier’s sign or gallbladder has been suggested instead of law, because of rising number of exceptions. Eponymous to: Ludwig Courvoisier (1843-1918) Definition of Courvoisier’s law Courvoisier’s (koor-vwah-zee-ayz) law states that ‘a palpable non-tender gallbladder…
Tag: General Surgery
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Summary of Clinical Tests and Signs in Orthopedics
Adson’s test: for thoracic outlet syndrome Allen’s test: for testing patency of radial and ulnar arteries Alli’s test: for DDH Anvil test: for testing tenderness of the spine Ape thumb: for median nerve injury Apley’s grinding test: for meniscus injury Apprehension test: for recurrent dislocation of the shoulder Barlow’s test:…
Surgical Skills 
Pterygium Excision
Indications for surgery: 1. Reduced vision secondary to: Threatens visual axis: Pterygium advancing toward or already impinging visual axis Induced astigmatism: Due to flattening of meridian of pterygium by fibrosis in atrophic stage 2. Cosmesis 3. Significant discomfort not relieved by medical therapy 4. Diplopia: Resulting from limited ocular motility…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Thyroidectomy Basics
Synonyms: Thyroid resection surgery, Thyroid removal surge Definition: Thyroidectomy is the surgical removal of all or part of the thyroid gland. A “thyroidectomy” should not be confused with a “thyroidotomy” (“thyrotomy”), which is a cutting into the thyroid, to get access for a median laryngotomy, or to perform a biopsy. Indications: Proven neoplasm…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Applied Anatomy of Submandibular Salivary Gland
Synonyms: Submaxillary gland (SMG), Mandibular gland Definition: Submandibular glands are one of the major salivary glands comprised of mixed serous and mucous acini and located below the lower border of the body of mandible. It is the second largest salivary gland and produces approximately 70% of the saliva. Location: Submandibular triangle…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Triangles and Lymph node levels of Neck
There are 2 major triangles in the neck, containing other smaller triangles. 1. Anterior triangle: Midline of neck – Mandible – Anterior border of SCM Posterior triangle: Posterior border of SCM – Trapezius – Clavicle (level V); 2 triangles inside separated by inferior belly of omohyoid Surgically, cervical lymph nodes…
Clinical Skills and Approaches 
Autonomous Sensory Zones of Peripheral Nerves
Synonym: Autonomous area Definition: These are the regions where single nerve roots supply distinct and non-overlapping areas of skin. By their nature the “autonomous zones” represent only a small portion of any dermatome and only a few nerve roots have such autonomous zones. The size of autonomous zone for a…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Approaches to Middle ear and Mastoid surgery
Endomeatal (Transcanal or Transmeatal) Approach: Not used commonly in children owing to relatively small ear canal This incision is used when the mesotympanum and hypotympanum are the surgical sites A posterior tympanomeatal flap is raised to enter into the middle ear. The flap includes skin over the medial two-thirds of the bony…