Signs to Know - Nurse Practitioner boards

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Ortolani's Click
a click is heard or felt as dislocation is reduced (developmental dysplasia of hip) (good until one year)
Barlow's Maneuver
Feeling of a slip as the femoral head slips away from the acetabulum (toward the butt) (good until 6 mo)
Auspitz sign
droplets of blood when scales removed = psoriasis
Herald patch + christmas tree
pityriasis rosea
Koplick Spots
white with red ring inside cheek from rubeola or mumps
slapped cheek and lacy exanthem
Erythema Infectiosum or Fifths disease
Thumb sign
swelling of the epiglottis, which may be visible on a lateral radiograph in patients with Epiglottitis
Steeple Sign
tapering of the upper trachea on a frontal chest radiograph reminiscent of a church steeple suggestive of
Croup
Galeazzi's Sign (aka Allis sign)
uneven knee heights - DDH
Gower's Maneuver
patient that has to use their hands and arms to "walk" up their own body from a squatting position due to
lack of hip and thigh muscle strength = muscular dystrophy
Fat pad/Sail sign
Elbow fracture
(in kids, a posterior fat pad sign suggests a condylar fracture of the humerus. In adults it
suggests a radial head fracture)
Adam's sign
Forward bend test for scoliosis
Kernig's Sign
Flex hips 90 degrees pain with extension of leg = meningitis or subarachnoid hemorrhage
Brudzinski's Sign
Involuntary flexion of legs when neck is passively flexed = meningitis
Café au lait spots
neurofibromatosis (tumors and seizures)
Howell-Jolly Bodies and target cells
Sickle Cell Anemia
Burtonian Lines
Thin, blue-black discoloration of gingival border = lead poisoning
Goodwell’s Sign
Softening of the cervix (pregnancy indication)
Chadwick's Sign
bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow observed 6-8
weeks after conception
Hegar's Sign
Softening of the cervicouterine junction
Chvostek sign
tap the facial nerve in front of the tragus and the ipsilateral muscles of face contract - indicative of
hypocalcemia
Dix-Hallpike or Nylen-Barany maneuver
+ = Vertigo & nystagmus when quickly move pt to supine position with head 30 degrees lower than
table and to turned to the side at 45 degree
McBurney's Point
RLQ of abdomen that is one-third of the distance from the anterior superior iliac spine to the umbilicus
(location of appendix)
McMurray's Test
audible/palpable click when knee is raised with tibia externally rotated and then straightened- one hand
on knee other on foot
Lachman's Test
drawer test for acl or pcl test knee at 20-30 degrees one hand on thigh other on proximal tibia, pull tibia
forward to assess anterior motion of tibia to femur (intact ACL should prevent anterior movement)
Apley's Grind test
flex knee 90 degrees with patient prone put pressure on heel hands and rotates leg laterally and medially,
repeat while pulling up on leg (+ = limited ROM or pain)
Straight leg raise
lie supine, leg elevated off table produces radiating or sciatic pain - herniated disc
Pelvic Rock test
Screens for sacroiliac joint dysfunction. Place hands on bilateral anterior superior illac spines and
attempt to rotate SI joint, or side lying apply pressure to ilium (+ = pain at SI joint)
Prehn's sign
lifting the scrotum relieves pain of epididymitis
Romberg Test
Evals proprioception and cerebellar fxn; stand with feet together, arms at side, close eyes. + = loss of
balance
Finger to Nose test
Tests cerebellar function - patient alternately points from their nose to examiner's finger
Heel to shin test
Tests cerebellar function - runs heel of one foot along the shin of the opposite leg fairly quickly
Cullen's sign
bruising or bluish discoloration and/or edema around the umbilicus = pancreatitis, ruptured ectopic
pregnancy, aortic rupture, abdominal trauma
Grey Turner's Sign
bruising or bluish discoloration of the flanks indicative of retroperitoneal hemorrhage = pancreatitis
Myerson's Sign / Glabellar tap sign
tapping between eyebrows, above bridge of nose (glabella) produces a sustained blink response =
Parkinson's Disease
Murphy's sign
Deep pain on inspiration while fingers are placed under right rib cage = cholecystitis
Psoas sign
RLQ pain with passive right leg elevation off table or with right thigh extension side lying =
appendicitis
Obturator sign
RLQ pain with internal rotation of flexed right thigh = appendicitis
Rovsing's Sign
RLQ pain when pressure is applied to the LLQ = appendicitis
Kerley B lines
Horizontal lines on CXR = heart failure
Levine's sign
Clenched fist over chest sign = ischemic chest pain
Palm Sign
palm of the hand to the chest = ischemic chest pain
Arm Sign
touching the left arm with right arm = ischemic chest pain
Pointing Sign
pointing to chest with 1 finger = non-ischemic chest pain
Babinski's Sign
big toe remains extended or extends itself and other toes fan out when the sole of the foot is stimulated
(normal in children until age 2). If seen child over 2 years or adult = CNS disorder (ALS, brain
tumor/injury, meningitis, MS, spinal cord injury/defect, stroke)
Battle Sign
bruising around the mastoid process (behind ears) = serious head / brain injury
Blue Dot Sign
tender nodule with blue discoloration on the upper pole of the testicle = testicular torsion
Cremaster Reflex
lightly stroke superior and medial thigh - normal response is elevation of the ipsilateral testicle =
negative elevation seen in testicular torsion (not 100%)
Finkelstein's Test
grasp the thumb and ulnar deviate the hand sharp and quick towards pinky = + De Quervain's
tenosynovitis
Homan's Sign
pain in the calf on forceful and abrupt dorsiflexion of the patient's foot at the ankle = possible DVT
Pel Epstein fever
cyclic fever = rarely seen in Hodgkin's lymphoma
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