Oliver's sign: Difference between revisions

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Revision as of 16:15, 11 July 2013

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Oliver's sign, or the tracheal tug sign, is an abnormal downward movement of the trachea during systole that can indicate a dilation or aneurysm of the aortic arch.

Physical examination technique

Oliver's sign is elicited by gently grasping the cricoid cartilage and applying upward pressure while the patient stands with his or her chin extended upward.

Due to the anatomic position of the aortic arch, which overrides the left main bronchus, a downward tug of the trachea may be felt if an aneurysm is present.

Etymology

The sign was first described by English military surgeon William Silver Oliver in 1878.

Causes

Common Causes

Aneurysms Associated with Aortic Dissection

Causes by Organ System

Cardiovascular	Aneurysms Associated with Aortic Dissection, Annuloaortic ectasia, Aortitis by contiguous spread from adjacent structrues, Arterial tortuosity syndrome, Atherosclerosis , Bicuspid aortic valve, Cystic medial necrosis, Familial history of aneurysm and dissections, Giant cell arteritis, HANAC syndrome, Hypertension, Infective endocarditis, Inflammation of aortic arch, Kawasaki disease, Polyarteritis nodosa, Septic emboli, Unicuspid aortic valve
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	No underlying causes
Endocrine	Acromegaly, Diabetes , Hyperlipidemia
Environmental	High BMI, Smoking
Gastroenterologic	Polycystic kidney disease
Genetic	Polycystic kidney disease, Cystic medial necrosis, Familial history of aneurysm and dissections, Genetic factors, HANAC syndrome, Loeys-Dietz syndromes, Marfan's syndrome , Pseudoxanthoma Elasticum, Turner’s Syndrome, Type IV Ehlers-Danlos syndrome , Unicuspid aortic valve
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	Aortitis by contiguous spread from adjacent structrues, Chagas disease, Infective endocarditis, Quaternary syphilis, Salmonella, Septic emboli, Tuberculosis
Musculoskeletal/Orthopedic	Acromegaly, Ankylosing spondylitis, Loeys-Dietz syndromes, Marfan's syndrome , Pseudoxanthoma Elasticum, Relapsing Polychondritis, Type IV Ehlers-Danlos syndrome
Neurologic	No underlying causes
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	Ankylosing spondylitis, Behçet disease, Giant cell arteritis, Kawasaki disease, Polyarteritis nodosa, Scleroderma
Sexual	No underlying causes
Trauma	Injury
Urologic	No underlying causes
Miscellaneous	Aging , High BMI

Causes in Alphabetical Order

Acromegaly

Aging

Aneurysms Associated with aortic dissection

Ankylosing spondylitis

Annuloaortic ectasia

Aortitis by contiguous spread from adjacent structrues

Arterial tortuosity syndrome

Atherosclerosis

Polycystic kidney disease

Behçet disease

Bicuspid aortic valve

Cystic medial necrosis

Diabetes

Familial history of aneurysm and dissections

Genetic factors

Giant cell arteritis

High BMI

Hyperlipidemia

Hypertension

Infective endocarditis

Inflammation of aortic arch

Kawasaki disease

Loeys-Dietz syndromes

Marfan's syndrome

Polyarteritis nodosa

Quaternary syphilis

Relapsing Polychondritis

Salmonella

Scleroderma

Septic emboli

Smoking

Pseudoxanthoma Elasticum

Takayasu's arteritis

Trauma

Tuberculosis

Turner syndrome

Type IV Ehlers-Danlos syndrome

Unicuspid aortic valve

HANAC syndrome

Chagas disease

@@ Line 32: / Line 32: @@
 ==Causes==
 ===Common Causes===
-*List the most common causes here.
+*[[Aneurysms]]  Associated with [[Aortic Dissection]]
+*[[Atherosclerosis ]]
+*[[Cystic medial  necrosis]]
+*[[Marfan's syndrome ]]
+*[[Trauma]]
 ===Causes by Organ System===
 {|style="width:82%; height:100px" border="1"
 |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
-|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aneurysms Associated with Aortic Dissection]],  [[Annuloaortic ectasia]],  [[Aortitis by contiguous spread from adjacent structrues]],  [[Arterial tortuosity syndrome]],  [[Atherosclerosis ]],  [[Bicuspid aortic valve]],  [[Cystic medial necrosis]],  [[Familial history of aneurysm's and dissections]],  [[Giant cell arteritis]],  [[HANAC syndrome]],  [[Hypertension]],  [[Infective endocarditis]],  [[Inflammation of aortic arch]],  [[Kawasaki disease]],  [[Polyarteritis nodosa]],  [[Septic emboli]],  [[Unicuspid aortic valve]]
+|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Aneurysms]] Associated with [[Aortic Dissection]],  [[Annuloaortic ectasia]],  [[Aortitis]] by contiguous spread from adjacent structrues,  [[Arterial tortuosity syndrome]],  [[Atherosclerosis ]],  [[Bicuspid aortic valve]],  [[Cystic medial necrosis]],  Familial history of [[aneurysm]] and [[dissections]],  [[Giant cell arteritis]],  [[HANAC syndrome]],  [[Hypertension]],  [[Infective endocarditis]],  [[Inflammation of aortic arch]],  [[Kawasaki disease]],  [[Polyarteritis nodosa]],  [[Septic emboli]],  [[Unicuspid aortic valve]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 68: / Line 76: @@
 |-bgcolor="LightSteelBlue"
 | '''Gastroenterologic'''
-|bgcolor="Beige"| [[Autosomal dominant polycystic kidney disease]]
+|bgcolor="Beige"| [[Polycystic kidney disease]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Genetic'''
-|bgcolor="Beige"| [[Autosomal dominant polycystic kidney disease]],  [[Cystic medial necrosis]],  [[Familial history of aneurysm's and dissections]],  [[Genetic factors]],  [[HANAC syndrome]],  [[Loeys-Dietz syndromes]],  [[Marfan's syndrome ]],  [[Pseudoxanthoma Elasticum]],  [[Turner’s Syndrome]],  [[Type IV Ehlers-Danlos syndrome ]],  [[Unicuspid aortic valve]]
+|bgcolor="Beige"| [[Polycystic kidney disease]],  [[Cystic medial necrosis]],  Familial history of [[aneurysm]] and [[dissections]],  [[Genetic factors]],  [[HANAC syndrome]],  [[Loeys-Dietz syndromes]],  [[Marfan's syndrome ]],  [[Pseudoxanthoma Elasticum]],  [[Turner’s Syndrome]],  Type IV [[Ehlers-Danlos syndrome ]],  [[Unicuspid aortic valve]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 84: / Line 92: @@
 |-bgcolor="LightSteelBlue"
 | '''Infectious Disease'''
-|bgcolor="Beige"| [[Aortitis by contiguous spread from adjacent structrues]],  [[Chaga's disease]],  [[Infective endocarditis]],  [[Quaternary syphilis]],  [[Salmonella]],  [[Septic emboli]],  [[Tuberculosis ]]
+|bgcolor="Beige"| [[Aortitis]] by contiguous spread from adjacent structrues,  [[Chagas disease]],  [[Infective endocarditis]],  [[Quaternary syphilis]],  [[Salmonella]],  [[Septic emboli]],  [[Tuberculosis ]]
 |-
 |-bgcolor="LightSteelBlue"
 | '''Musculoskeletal/Orthopedic'''
-|bgcolor="Beige"| [[Acromegaly]],  [[Ankylosing spondylitis]],  [[Loeys-Dietz syndromes]],  [[Marfan's syndrome ]],  [[Pseudoxanthoma Elasticum]],  [[Relapsing Polychondritis]],  [[Type IV Ehlers-Danlos syndrome ]]
+|bgcolor="Beige"| [[Acromegaly]],  [[Ankylosing spondylitis]],  [[Loeys-Dietz syndromes]],  [[Marfan's syndrome ]],  [[Pseudoxanthoma Elasticum]],  [[Relapsing Polychondritis]],  Type IV [[Ehlers-Danlos syndrome ]]
 |-
 |-bgcolor="LightSteelBlue"
@@ Line 144: / Line 152: @@
 |-bgcolor="LightSteelBlue"
 | '''Miscellaneous'''
-|bgcolor="Beige"| [[Aging ]],  [[High BMI]]
+|bgcolor="Beige"| [[Aging ]],  High [[BMI]]
 |-
 |}
@@ Line 174: / Line 182: @@
 *[[Cystic medial necrosis]]
+*[[Diabetes  ]]
+*Familial history of  [[aneurysm]] and [[dissections]]
 {{col-break|width=33%}}
-*[[Disease]] P
+*[[Genetic factors]]
-*[[Disease]] Q
-*[[Disease]] R
+*[[Giant cell arteritis]]
-*[[Disease]] ...
+*High [[BMI]]
+*[[Hyperlipidemia]]
+*[[Hypertension]]
+*[[Infective endocarditis]]
+*[[Inflammation of aortic  arch]]
+*[[Kawasaki  disease]]
+*[[Loeys-Dietz syndromes]]
+*[[Marfan's syndrome ]]
+*[[Polyarteritis nodosa]]
+*[[Quaternary  syphilis]]
+*[[Relapsing Polychondritis]]
 {{col-break|width=33%}}
-*[[Disease]] X
+*[[Salmonella]]
-*[[Disease]] Y
-*[[Disease]] Z
+*[[Scleroderma]]
+*[[Septic emboli]]
+*[[Smoking]]
+*[[Pseudoxanthoma Elasticum]]
+*[[Takayasu's arteritis]]
+*[[Trauma]]
+*[[Tuberculosis ]]
+*[[Turner syndrome]]
+* Type IV [[Ehlers-Danlos  syndrome ]]
+*[[Unicuspid aortic valve]]
+*[[HANAC syndrome]]
+*[[Chagas disease]]
 {{col-end}}