Signs

Trousseau’s Sign

Trousseau’s Sign of latent tetany-To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery. In the absence of blood flow, the patient’s hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joints flex, the DIP and PIP joints extend, and the fingers adduct. The sign is also known as main d’accoucheur (French for “hand of the obstetrician“) because it supposedly resembles the position of an obstetrician’s hand in delivering a baby.

Trousseau’s sign of malignancy- Migratory thromboplebitis, due to hypercoagulable states.Seen in adenocarcinomas of the pancreas and lung

The Chvostek sign-

(also Weiss sign) is one of the signs of tetany seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw (i.e. masseter muscle), the facial muscles on the same side of the face will contract momentarily (typically a twitch of the nose or lips) because of hypocalcaemia (ie from hypoparathyroidism, pseudohypoparathyroidism, hypovitaminosis D) with resultant hyperexcitability of nerves. Though classically described in hypocalcaemia, this sign may also be encountered in respiratory alkalosis, such as that seen in hyperventilation, which actually causes decreased serum Ca2+ with a normal calcium level due to a shift of Ca2+ from the blood to albumin which has become more negative in the alkalotic state.

Chvostek’s sign may also be present in hypomagnesemia, frequently seen in alcoholics, persons with diarrhea, patients taking aminoglycosides or diuretics, because hypomagnesemia can cause hypocalcemia. Magnesium is a cofactor for Adenylate Cyclase. The reaction that Adenylate Cyclase catalyzes is the conversion of ATP to 3′,5′-cyclic AMP. The 3′,5′-cyclic AMP (cAMP) is required for Parathyroid hormone activation.

Target sign/Bulls eye sign

Seen in Congenital/infantile Hypertrophic Pyloric stenosis

Double bubble sign

Radiological appearance of Duodenal atresia,annular pancreas

Triple bubble sign

Jejunal atresia

Duodenal cutoff sign

Barium meal finding in superior mesenteric syndrome and in duodenal ileus

Colon Cutoff sign

Acute pancreatitis

Central dot sign

Pneumatic tyre sign

Sigmoid volvulus

Omega sign

Sigmoid volvulus

Boas sign

Acute Cholecystitis

Signs in appendicitis

1.Pointing sign

2.Rovsing sign

3.Copes sign

4.Bastede’s sign

5.Alder’s sign-Shifting tenderness

Pincer Sign

String sign of Kantor

Coning sign

Congenital megacolon

Albers sign

Tear drop Sign

In trapdoor fracture of inferior wall of orbit, coronal section of orbit  shows that the eyeball has migrated into the maxillary sinus appearing as a drop.

Bear track sign- Congenital hypertrophy of retinal pigment epithelium

Homan Sign- Calf tenderness on dorsiflexion of ankle

Robert sign -appearance of gas in great vessels,the surest sign of IUD

maxwell lyon sign – vernal conjunctivitis

Litten’s sign -is diaphragmatic movement seen on one side but not the other side in unilateral phrenic nerve palsy

Markle sign is jar tenderness in abdomen from heel drop as a localizing sign of peritoneal irritation

Pratt’s sign is in deep vein thrombosis – presence of three dilated veins or sentinel veins over the tibia; dilatation persists when legs are elevated to 45 degrees

1-Stallworthy sign is to diffrentiate proptosis of thyrotoxicosis and of retroorbital tumours. In thyrotoxicosis you can evert upper eye lid but in case of retro orbital tumors one cant evert eyelid-rxpg se liya

2-Slowing / irregular fetal heart rate on pressing the head down I to the pelvis and prompt recovery on release of pressure is termed Stallworthy’s sign in case of posterior placenta praevia, particularly with low insertion of cord, due to compression of placental vessels from fetal head

Adson’s sign is in thoracic outlet syndrome – decrease in ipsilateral radial pulse and/or presence of subclavian bruit while patient extending neck maximally – rotating head towards side being tested – and holding breath

Dalrymple sign is retraction of the upper eyelid in Graves’s disease – causing abnormal wideness of the palpebral fissure

Winterbottom’s sign is in West African trypanosomiasis (sleeping sickness – caused by Trypanosoma brucei gambiense – humans primary reservoir) – classic finding of posterior cervical triangle lymphadenopathy

Kanavel’s sign is four signs of tenosynovitis: 1. affected finger held in slight flexion; 2. pain over volar aspect of affected finger tendon upon palpation; 3. swelling of affected finger; 4. pain on passive extension of affected finger

D’Espine’s sign is breath sounds louder over C7 than adjacent lung – suggests lesion in posterior mediastinum – e.g. lymphoma – tuberculosis – etc.

Signs of Pregnancy

Placental sign- Bleeding at the time of next menstruation

Hartman sign- Implantation bleeding

Jacquemier’s sign(Chadwick’s sign) -Blue hue of vagina

Osiander’s sign - Increased pulsation felt through lateral fornix by 8 weeks.

Goodell’s sign – Softening of cervix

Piskacek’s sign – One half more firm than other half(site of implantation)

Hegar’s sign – Upper part of body of uterus enlarged,lower part empty(6-10wks)

Palmer’s sign – Rhythmic uterine contraction during bimanual examination

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