🔴Hepatology Bedside Pearls!
📢 The Traube's Space!
(Pic: Yang JC, West J Med 1991)
(1/n)
📢 The Traube's Space!
(Pic: Yang JC, West J Med 1991)
(1/n)
🟣Historical Snippet
🆔 Ludwig Traube(1818-1876) 🇩🇪
✔Under Josef Skoda & Carl Rokitansky
✔ 👫 of Virchow, Frerichs& Osler
Primary ❤- Resp, kidney & ❤
✔described in Lt pleural eff(esp TB)
✖Name it/ associate with splenomeg
(Arch Int Med 1992) (2/n)
🆔 Ludwig Traube(1818-1876) 🇩🇪
✔Under Josef Skoda & Carl Rokitansky
✔ 👫 of Virchow, Frerichs& Osler
Primary ❤- Resp, kidney & ❤
✔described in Lt pleural eff(esp TB)
✖Name it/ associate with splenomeg
(Arch Int Med 1992) (2/n)
🟡Boundaries
Original: med-liver, lat-spleen, sup-lower border heart
☑ Barkuns method(Am J Med 1989)
Med-6th CC jn
Lat- 9th rib AAL. (Some ref MAL)
Inf- subcostal plane
(Se 62%, Sp 72% 4 splenomeg)
(Fig: Adapted ref 2) (3/n)
Original: med-liver, lat-spleen, sup-lower border heart
☑ Barkuns method(Am J Med 1989)
Med-6th CC jn
Lat- 9th rib AAL. (Some ref MAL)
Inf- subcostal plane
(Se 62%, Sp 72% 4 splenomeg)
(Fig: Adapted ref 2) (3/n)
🟢Clinical imp!
Usually "tympanitic" ( not resonant!!)
❌Obliterated in
✔Lt effusion/fibrosis
✔Splenomeg
✔Lt liver enlarg
✔food/growth in fundus
🚫obese
(Hence, Traubes dullness isn't always =splenomeg!) ⛔ 💡💡
(4/n)
Usually "tympanitic" ( not resonant!!)
❌Obliterated in
✔Lt effusion/fibrosis
✔Splenomeg
✔Lt liver enlarg
✔food/growth in fundus
🚫obese
(Hence, Traubes dullness isn't always =splenomeg!) ⛔ 💡💡
(4/n)
🟡Other percussion methods: splenomeg
✔Castell's: dullness in left 8/9th ICS in full insp
(Se82%, Sp16%)
✔Nixon's: Rt Lat decubitus
Percuss along post axil line, then along a perpendicular to Lt subcostal margin. Dullness>8cm + (Se59%, Sp16%)
radiationoncology.ca/ascm/physical_…
✔Castell's: dullness in left 8/9th ICS in full insp
(Se82%, Sp16%)
✔Nixon's: Rt Lat decubitus
Percuss along post axil line, then along a perpendicular to Lt subcostal margin. Dullness>8cm + (Se59%, Sp16%)
radiationoncology.ca/ascm/physical_…
🟨Bonus for Quizzers
Other Traube's eponyms
🔷Traube's sign: AR
🔷Traube's Doppletone: AR
🔷Traube's phenomenon: pain on LIF pressure in appendicitis
🔷Traube-Herring-Mayer waves: cyclical 🔼 in BP due to baro®, chemo® reflexes
(6/n)
Other Traube's eponyms
🔷Traube's sign: AR
🔷Traube's Doppletone: AR
🔷Traube's phenomenon: pain on LIF pressure in appendicitis
🔷Traube-Herring-Mayer waves: cyclical 🔼 in BP due to baro®, chemo® reflexes
(6/n)
💡How to memorize.
Here's my cheat code I used to teach undergrads at AFMC, Pune
Remember: "AbC, NoP"
Remove the centre small case
"A"nt axillary= "C"astell (AbC)
"P"ost axillary= "N"ixon (NoP)
(7/n)
Here's my cheat code I used to teach undergrads at AFMC, Pune
Remember: "AbC, NoP"
Remove the centre small case
"A"nt axillary= "C"astell (AbC)
"P"ost axillary= "N"ixon (NoP)
(7/n)
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@drvishal82 @UjjwalSonika @AtoosaRabiee @wonglaihung @ashishchauhan__ @ashok_doctor @AnandVKulkarni2
🟡🟡🟡Extra Bonus
🟠Some lesser known signs for the clinical medicine enthusiast!
(Rastogi V, CM & R 2020)
🟠Some lesser known signs for the clinical medicine enthusiast!
(Rastogi V, CM & R 2020)
Se and sp wrt to palpation**
@threadreaderapp "unroll"
🌐Summary table
(Ref: S Mangione, Phy Diag Secrets 2nd Ed)
(Ref: S Mangione, Phy Diag Secrets 2nd Ed)
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