Ep-PAINE-nym



Levine’s Sign

 

Other Known AliasesPalm Sign, Cossio’s Sign, Cossio-Levine’s Sign

DefinitionClenched fist held over the sternum while a patient is describing their chest pain and classically is the right hand, as cardiac pain can refer to the left arm.

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Clinical SignificanceThere is very little significance to this sign and has been studied to only have a 14% sensitivity for cardiac chest pain, but is a classic physical exam finding and frequent pimp fodder.

History – Named after Samuel Albert Levine (1891-1966), who was an American cardiologist and attending physician at The Brigham Hospital in Boston, MA, and assistant professor of medicine at Harvard University.  He graduated Harvard at the age of 20 and was the first physician to diagnose President Franklin Roosevelt with poliomyelitis.  He was a pioneer in coronary thrombosis research and was the second physician to ever diagnose the condition, which he described it in his classic book Clinical Heart Disease in 1936. 

Samuel-Albert-Levine-1964.jpgImage result for samuel a levine

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He is also the namesake of The Levine Scale, a 1 to 6 grading system to characterize the intensity  of heart murmurs, and Lown-Ganong-Levine syndrome, which is a pre-excitation syndrome causing a shortened PR interval with normal QRS complexes in tachycardia.

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The Levine Scale

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Lown-Ganong-Levine Syndrome

 


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Edmondstone WM. Cardiac chest pain: does body language help the diagnosis? BMJ. 1995;311(7021):1660-1. [pubmed]
  6. Levine HJ.  Profiles in Cardiology: Samuel A. Levine (1891-1966).  Clin Cardiol.  1992;15:473-476
  7. Bedford DE. Samuel Albert Levine (1891-1966). British heart journal. 1966; 28(6):853-4. [pubmed]
  8. Silverman ME, Wooley CF. Samuel A. Levine and the history of grading systolic murmurs. The American journal of cardiology. 2008; 102(8):1107-10. [pubmed]
  9. Lown B, Ganong WF, Levine SA. The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action. Circulation. 1952; 5(5):693-706. [pubmed]

Ep-PAINE-nym



Wood’s Lamp

 

Other Known Aliases – Ultraviolet (UV)-A lamp, blacklight

Definition – Handheld UV light that emits UV-A (long-wave) light with a violet filter, which blocks most of the visible light, and only allows the UV-A through

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Clinical Significance – There are many medical applications for using UV light for quick, bedside diagnosis.  One of these is for fungal infections of the skin, most commonly Tinea infections.  Tinea infections will fluoresce under UV-A light.

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Tinea versicolor

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Tinea capitis

 

History – Named after Robert W. Wood (1868-1955), who was an American physicist, inventor, and a pioneer in infrared and ultraviolet photography.  In 1903, he developed a filter that would block visible light, but be transparent to both infrared and ultraviolet light.  He won several awards and honors in the field of optics (he even has a crater on the moon named after him) and is the namesake of the R.W. Wood Prize of the Optical Society of America, which recognizes outstanding discovery, achievement, or invention.

Robert Williams Wood.png


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Ponka D, Baddar F. Wood lamp examination. Canadian family physician Medecin de famille canadien. 2012; 58(9):976. [pubmed]
  6. Ducharme EE, Silverberg NB. Selected applications of technology in the pediatric dermatology office. Seminars in cutaneous medicine and surgery. 2008; 27(1):94-100. [pubmed]

Ep-PAINE-nym



Ishihara Test

 

Other Known AliasesPseudo-isochromatic plates

DefinitionTest for detecting color blindness using different color dots to outline numbers

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Clinical SignificanceAllows for quick assessment of color blindness using different styles plates (a full test is 38 plates) and even differentiate between different types of color blindness.  Research has proven that a score of 12 out of 14 red/green plates indicates normal color vision with a sensitivity of 97% and a specificity of 100%.

History – Named after Shinobu Ishihara (1879-1963), who developed these while working as a military surgeon for the Japanese army during World War I as a better way of assessing color blindness in troops.  He first published these findings in 1917 in Japan and it was first translated and reviewed in the American Journal of Ophthalmology in June 1918 extolling its usefulness.


 


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Ishihara S.  Tests for Color Blindness.  AJO. 1918;1(6):457 [article]
  6. Ishihara S.  Tests for Color Blindness.  1972 [book]
  7. http://www.eyemagazine.com/feature/article/ishihara

Ep-PAINE-nym



Epstein’s Pearls

 

Other Known Aliasesnone

DefinitionSmall, fluid filled cysts on the hard palate of newborns that are most commonly found along the median palatal raphae.

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Clinical SignificanceNone.  These are completely normal and occur in 65-80% of newborns.  The are formed by epithelium that becomes trapped during palatal development.

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History – Named after Alois Epstein (1849-1918), who was a Czechoslovakian pediatrician, graduating from the University of Prague in 1873.  His career was highlighted by becoming the first physician-in-chief for the University of Prague hospital in 1873 and being appointed to professor at the University of Prague in 1884.  He first described these findings in 1880.


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Lewis DM. Bohn’s nodules, Epstein’s pearls, and gingival cysts of the newborn: a new etiology and classification. Journal – Oklahoma Dental Association. ; 101(3):32-3. [pubmed]
  6. Singh RK, Kumar R, Pandey RK, Singh K. Dental lamina cysts in a newborn infant. BMJ case reports. 2012; 2012:. [pubmed]
  7. Epstein A. Ueber die Gelbsucht bei Neugeborenen Kindern. Leipsic. 1880. [book]

Ep-PAINE-nym



Hesselbach’s Triangle

 

Other Known Aliases – Inguinal triangle, medial inguinal fossa

DefinitionAnatomical region of the abdominal wall outlined by the boundaries of the lateral margin of the rectus sheath, the inferior epigastric vessels, and the inguinal ligament.

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Clinical Significance – The area is where direct hernias protrude through the abdominal wall.

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History – Named after Franz Kasper Hesselbach (1759-1816), who was a German physician, surgeon, and anatomist in Hammelburg, Germany.  He had a prolific career surgical assistant and prosector under Karl Kasper von Siebold at The Juliusspital in Würberg, before obtaining his doctor of medicine there.  He is best known for his contributions to the surgery of hernias and has several other eponyms as well: Hesselbach’s fascia (cribriform fascia) and Hesselbach’s ligament (interfoveolar ligament.

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From his 1806 manuscript


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Tubbs RS, Gribben WB, Loukas M, Shoja MM, Tubbs KO, Oakes WJ. Franz Kaspar Hesselbach (1759–1816): anatomist and surgeon. World journal of surgery. 2008; 32(11):2527-9. [pubmed]
  6. Hesselbach HK. Anatomisch-chirurgische Abhandlung über den Urspurng der Leistenbrüche. Würzburg, Baumgärtner. 1806.
  7. Hesselbach HK. Neueste anatomisch-pathologische Untersuchungen über den Ursprung und das Fortschreiten der Keisten- und Schenkelbrüche. Würzburg, Stahel. 1814

Ep-PAINE-nym



Murphy’s Sign

 

Other Known AliasesMoynihan’s Method (using just the thumb with patient supine)

DefinitionInspiratory arrest with deep palpation in the right upper quadrant 

Clinical SignificanceAs the patient exhales, the abdominal organs move cephalad and under the diaphragm.  After full exhalation and during inspration, the organs move caudal back into the abdominal cavity.  When there is inflammation of the gallbladder, the patient will stop inhaling as the inflammed gallbladder touches the practitioner’s fingers during deep palpation of the right upper quadrant.

History – Named after John Benjamin Murphy (1857-1916), who was an American surgeon and early pioneer for many different surgical operations and techniques.  In fact, William James Mayo (co-founder of The Mayo Clinic) called him “the surgical genius of our generation”. 

In 1889, he advocated for and popularized early appendectomy in all suspected appendicitis cases and had over 200 successful cases to begin convincing his colleagues of the benefits of early surgery.  Dr. Murphy also pioneered treatment of tuberculosis with iatrogenic pneumothoraces and was the first surgeon to re-anastomose a transected femoral artery from a gunshot wound.  He was also a distinguished teacher and developed “wet clinics” at Mercy Hospital, where he operated and lectured to an audience of learners in a traditional operative theater.

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Dr. Murphy also attended to Theodore Roosevelt after an assassination attempt and was one of the founding members of the American College of Surgeons.  He is also the author of one of the more famous quotes pertaining to patient-centered care.


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com

Ep-PAINE-nym



Littre’s Hernia

 

Other Known Aliasesnone

DefinitionHernia involving a Meckel’s diverticulum 

Clinical SignificanceNo real clinical significance other than it is an extremely rare type of hernia, but is always included in the typical pimping barrage of surgery students.  It should also be included in the “zebras” of differential diagnoses of RLQ pain.

Image result for littre's herniaImage result for littre's hernia

History – Named after Alexis Littrè (1654-1726), who was a distinguished physician and prolific surgeon at the historic Salpêtriére Teaching Hospital in Paris.  He was inducted into the famed Académie des Sciences in part to his ridiculous dissection of over 200 cadavers in 1684.  He first described an femoral hernia involving an intestinal diverticulum in 1700 in one of his cadaver dissections.

 


References

  1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
  2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
  3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
  4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
  5. Skandalakis PN, Zoras O, Skandalakis JE, Mirilas P. Littre hernia: surgical anatomy, embryology, and technique of repair. The American surgeon. 2006; 72(3):238-43. [pubmed]
  6. Sturdy DJ.  Science and Social Status: The Members of the Academie Des Sciences 1666-1750. 1995.  Boydell Press
  7. Malling B, Karlsen AA, Hern J.  Littre Hernia: A rare case of incacerated Meckel’s diverticulum.  Ultrasound Int Open.  2017;3(2):E91-92.