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PHYSICAL SIGNS

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Sign Description, Finding Indication
Doll's Eye Sign Dissociation between movement of the eyes and of the head. Eyes moves up and head moves down.
Babinski's Sign Fanning of big toe when you stroke the plantar aspect of the foot CNS: Pyramidal Tract Lesion
Chaddock's Sign Great toe fanning when you touch the external malleolar skin CNS: Corticospinal tract lesions
Eyelash Sign Stroking eyelash produces no movement of lids.

Stroking eyelash produces movement of lids.

CNS: Organic stroke.

CNS: Functional hysteria

Hoffman's Sign

Digital Reflex

Nipping nail of middle finger cause flexion of terminal phalanx of thumb. Unilaterally. CNS: Pyramidal Tract Disease
Clenched Fist (Levine's) Sign Holding clenched fist over chest to describe constricting, pressing pain CV: Angina Pectoris
de Musset's Sign Rhythmic jerking movement of the head CV: Aortic Insufficiency
Ewart's Sign Dullness, bronchial breathing, bronchophony over the angle of the left scapula. CV: Pericardial effusion
Hamman's Sign Crunching sound synchronous with heartbeat. CV: Mediastinal Emphy-sema, Pneumopericardium
Hill's Sign Exaggerated femoral artery systolic pressure (60 to 100 mm Hg higher) over brachial systolic pressure. CV: Aortic Insufficiency
Homan's Sign Pain in back of calf or knee when foot is dorsiflexed. CV: Thrombosis in veins of calf
Kussmaul's Sign Paradoxical increase in jugular venous distension when patient inspires. CV: Cardiac Tamponade
Osler's Sign Painful erythematous swellings in skin and subcutaneous tissues of hands and feet. CV: Endocarditis
Joffroy's Sign No forehead wrinkling when the eyeballs are rolled upward. Endocrine: Grave's Disease
Möbius Sign Impaired ocular convergence (accommodation) Endocrine: Grave's Disease
Stellwag's Sign Infrequent and incomplete blinking. Endocrine: Grave's Disease
Kestenbaum's Sign Decrease in number of arterioles crossing optic disk margins. Eye: Optic Atrophy
Marcus Gunn Pupillary Sign Flashlight swung from one eye to the other eye, then both pupils dilate (when they should constrict). Eye: Cataract, optic nerve defects
Cullen's Sign Periumbilical darkening of the skin GI: Intraperitoneal hemorrhage, from hemorrhagic pancreatitis or ectopic pregnancy
Grey Turner's Sign Local discoloration of the skin of the loins GI: Acute hemorrhagic pancreatitis
Groove Sign Firm nodes in groin above and below inguinal ligament, with a groove along the ligament. GI: Lymphogranuloma Venereum
Kehr's Sign Violent pain in the left shoulder GI: Ruptured Spleen
Puddle Sign Patient gets on all fours, and palpating at one end allows auscultation at the other end of the abdomen. Stethoscope moves from most dependent position gradually contralaterally. GI: Ascites
Rovsing's Sign Pain in right abdomen at McBurney's Point when pressure is exerted on left abdomen. GI: Appendicitis
Bárány's Sign Irrigate ear with cold water: should lead to nystagmus on opposite side.

Irrigate ear with warm water: should lead to nystagmus on same side.

This sign shows no nystagmus

Head and Neck: Labyrinthine disease, such as Meniere's Disease
Battle's Sign Postauricular ecchymosis Head and Neck: fracture of the base of the of the skull.
Brudzinski's Sign (1) Contralateral leg reflex: passive flexion of leg on one side elicits reflex on the opposite side.

(2) Passively flex neck, and hips and knees flex spontaneously.

Infectious: Meningitis
Kernig's Sign Patient lies on back and flexes thigh upward, then complete extension of leg is impossible. Infectious: Meningitis
Pastia's Sign Hemorrhagic transverse lines at bend of elbow, wrist, or inguinal region. It persists after desquamation. Infectious: Scarlet Fever
Romberg's Sign Close eyes and lose gait; ataxia. Infectious: Tabes Dorsalis
Winterbottom's Sign Swelling of posterior cervical lymph nodes. Infectious: African Sleeping Sickness (Trypanosomiasis)
Chvostek's Sign Facial irritability. Unilateral spasm induced by tap over the facial nerve. Muscular: Tetany
Trousseau's Sign Upper arm compressed by a tourniquet or blood-pressure cuff causes carpal spasm. Muscular: Tetany
Braxton Hicks Contractions Irregular uterine contractions after third month of pregnancy. OB/GYN: Pregnancy
Chadwick's Sign Bluish discoloration of cervix and vagina OB/GYN: Pregnancy
Drawer Sign Forward sliding (anterior cruciate) or backward sliding (posterior cruciate) of the tibia. Skeletal: Disruption of anterior (forward slide) or posterior (backward slide) cruciate ligaments of knee.
Lasègue's Sign When patient is supine with hip flexed up, dorsiflexion of the ankle causes pain. Skeletal: Sciatic Nerve irritation (Sciatica)
Nikolsky's Sign Sliding pressure of thumb pressed against skin separates outer layer from basal dermis. Skin: Pemphis Vulgaris

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