- Diagnosis
- History
- Examination
- Investigations
- History
- Management
- Procedures
Encyclopaedia of Clinical Signs
Encyclopaedia of Clinical Signs
A
- Abdominal Bruits
- Abdominal Distension
- Abdominal Guarding
- Abdominal Masses
- Abdominal Pulsation
- Abdominal Rigidity
- Abdominal Scars
- Abnormal Dentition
- Abnormal Gait
- Absent Corneal Reflex
- Absent Lower Limb Pulses
- Absent Pharyngeal Reflex
- Absent Pupillary Light Reflexes
- Acetone Breath
- Adie’s Tonic Pupil
- Affect
- Alcoholic Foetor
- Angular Cheilitis
- Anisocoria (Unequal Pupils)
- Anomia
- Anosmia
- Antalgic Gait
- Anterior Draw Test
- Anterograde Amnesia
- Apley Scratch Test
- Appearance
- Apprehension Test
- Appropriateness of Affect
- Apraxia
- Apraxic Gait
- Argyll Robertson Pupil
- Arm Elevation Test
- Arterial Skin Changes
- Arterial Ulcers
- Arteriovenous Fistulas
- Asterixis
- Asymmetric Soft Palate Rise
- Ataxic Gait
- Atrophic Glossitis
- Auditory Acuity
- Auditory Hallucinations
- Augmentation Test
B
C
- Callosities of the Ankle and Foot
- Capillary Refill Time
- Caput Medusae
- Carotid Auscultation
- Carotid Bruit
- Category Fluency
- Central Cyanosis
- Central Visual Fields
- Centre of Gravity
- Cervical Hyperlordosis
- Charcot Foot
- Chest Expansion
- Chest Wall Tenderness
- Cheyne-Stokes Respiration
- Chorea
- Circumlocution
- Claw Hand
- Claw Toe
- Clonus
- Cog Wheel Rigidity
- Collapsing Pulse
- Colour Vision
- Conceptualisation
- Confusion
- Conjunctival Pallor
- Continuous Murmur
- Cool Extremities
- Cough
- Cover Test
- Cozen’s Test
- Crackles / Crepitations
- Cullen’s Sign
D
- Dactylitis
- Decreased Tactile Fremitus
- Dehydration
- Dental Caries
- Dental Erosions
- Dental Trauma
- Depressive Thought Content
- Diabetic Retinopathy
- Diastolic Murmur
- Digital Clubbing
- Diplopia
- Disordered Reading
- Disordered Writing
- Displaced Apex Beat
- Dissociative Symptoms
- Distal Weakness
- Distractibility
- Double Impulse Apex Beat
- Dull Percussion Note
- Dupuytren’s Contracture
- Dysdiadochokinesis
- Dysmegalopsia
- Dystonia
E
F
G
H
- Haemorrhoids
- Halitosis
- Hallucinations
- Hallux Valgus
- Hand of Benediction
- Harsh Speech
- Heberden’s Nodes
- Heel Walking
- Heel-to-Shin Test
- Hepatomegaly
- Herniae
- High-Arched Palate
- Hoarseness
- Homonymous Hemianopia
- Homonymous Quadrantanopia
- Hyperactivity
- Hyperaesthesia
- Hypernasal Speech
- Hyperpigmentation
- Hyperreflexia
- Hyperresonant Percussion Note
- Hypertension
- Hypertensive Retinopathy
- Hypoaesthesia
- Hypophonia
- Hyporeflexia
- Hypotension
I
- Illusions
- Impaired Accommodation
- Impaired Digit Span
- Impaired Rapid Foot Tapping
- Increased Anal Sphincter Tone
- Increased Body Mass Index
- Increased Glabellar Reflex
- Increased Tactile Fremitus
- Increased Temperature
- Increased Vocal Resonance
- Increased Waist-Hip Ratio
- Ingrown Toenails
- Inhibitory Control
- Injection Sites
- Insight
- Intensity of Affect
- Intention Tremor
- Internuclear Ophthalmoplegia
- Irregular Pulse
- Irritability
J
K
L
- Lability of Mood
- Lead Pipe Rigidity
- Leg Length Discrepancy
- Leg Tenderness
- Lesser Toe Deformities
- Leukonychia
- Level of Happiness
- Lhermitte’s Sign
- Lift Off Test
- Light Touch Sensation
- Limitation of Extraocular Movement
- Limited Active Movement
- Lip Pigmentation
- Lip Ulceration
- Liver Nodularity
- Log Roll Test
- Loss of Cervical Lordosis
- Loss of Chest Hair Distribution
- Loss of Lumbar Lordosis
- Loss of Proprioception
- Loud P2
- Lower Limb Erythema
- Lower Motor Neuron Weakness
- Lymphadenopathy
M
N
O
P
- Pain on Eye Movement
- Pain Sensation
- Pallor of the Nail Bed
- Palmar Crease Pallor
- Palmar Erythema
- Palpable Kidney
- Palpable Thrill
- Paradoxical Respiration
- Paraphasias
- Parasternal Heave
- Paronychia
- Patellar Apprehension Test
- Patellar Bulge Test
- Patellar Crepitus
- Patellar Tap
- Pectus Carinatum (Pigeon Chest)
- Pectus Excavatum (Funnel Chest)
- Peek Sign
- Pendular Nystagmus
- Percussion Myotonia
- Percussion Tenderness
- Perianal Blood
- Perianal Mass
- Perianal Rash
- Perianal Sinus / Fistula
- Periauricular Vesicles
- Pericardial Rub
- Perioral Telangiectasias
- Peripheral Nerve Enlargement
- Peripheral Visual Fields
- Pes Cavus
- Pes Planus
- Phalen’s Test
- Pharyngeal Erythema
- Pharyngeal Exudate
- Pitting Oedema
- Pleural Rub
- Poor Posture
- Posterior Draw Test
- Postural Hypotension
- Postural Tachycardia
- Postural Tremor
- Pressure-Loaded Apex Beat
- Pronator Drift
- Prostate Enlargement
- Prostate Nodularity
- Prostate Tenderness
- Proximal Muscle Fatigability
- Proximal Myopathy
- Psoriatic Plaques
- Psychogenic Tremor
- Psychomotor Agitation
- Psychomotor Agitation
- Psychomotor Retardation
- Psychotic Thought Content
- Ptosis
- Pull Test
- Pulsatile Abdominal Mass
- Pulsus Paradoxus
- Purpura
R
- Radio-Femoral Delay
- Radio-Radial Delay
- Raised Jugular Venous Pressure
- Range of Affect
- Raynaud’s Phenomenon
- Reactivity of Mood
- Rebound Tenderness
- Rectal Blood
- Rectal Mass
- Rectal Wall Tenderness
- Reduced Anal Sphincter Tone
- Reduced Body Mass Index
- Reduced Breath Sounds
- Reduced Facial Sensation
- Reduced Glabellar Reflex
- Reduced Glasgow Coma Scale
- Reduced Oxygen Saturation
- Reduced Range of Motion
- Reduced Temperature
- Reduced Visual Acuity
- Reduced Vocal Resonance
- Relative Afferent Pupillary Defect
- Relocation Test
- Repeated Movements
- Respiratory Distress
- Resting Tremor
- Retrograde Amnesia
- Richmond Agitation-Sedation Scale
- Rinne’s Test
- Romberg Test
- Roth Spots
- Rovsing’s Sign
S
- Sacral Oedema
- Salivary Gland Enlargement
- Scapular Winging
- Scleral Icterus
- Sclerodactyly
- Scoliosis
- Scratch Marks
- Shifting Dullness
- Short Leg Gait
- Simmonds-Thompson Text
- Simpson’s Test
- Skin Pallor
- Snapping Knee Joint
- Soft A2
- Spastic Gait
- Spasticity
- Spider Naevi
- Splenomegaly
- Splinter Haemorrhages
- Sputum
- Squat Test
- Stability of Affect
- Strabismus
- Straight Leg Raise
- Striae (Stretch Marks)
- Stridor
- Subconjunctival Haemorrhage
- Succussion Splash
- Swan Neck Deformity
- Systolic Murmur
T
- Tachycardia
- Tachypnoea
- Tandem Walking
- Tar Staining
- Telegraphic Speech
- Tenckhoff Catheters
- Testing for Golfer's Elbow
- The Angle of the Heel
- The Patient's Attitude
- Third Heart Sound
- Thomas Test
- Thoracic Hyperkyphosis
- Thoracic Scars
- Tics
- Tinel's Sign of the Elbow
- Tinel’s Sign at the Wrist
- Toe Walking
- Tongue Deviation
- Tongue Fasciculations
- Tongue Ulcers
- Tongue Wasting
- Tonsillar Swelling
- Torticollis
- Tracheal Deviation
- Tracheal Tug
- Trapezius and Sternocleidomastoid Weakness
- Trendelenburg Gait
- Trendelenburg Test
U
V
W
X
Z
Raised Jugular Venous Pressure
Overview
- The jugular venous pulsation can often be difficult to visualise, though can be a useful indicator of the fluid status of a patient. The JVP can also provide valuable clues regarding the presence of right ventricular failure, pulmonary hypertension and tricuspid regurgitation.
Look For
The pulsation of the jugular vein, between the sternal and clavicular heads of the sternocleidomastoid.
- Position the patient at 45 degrees and ask them to turn their head to the left. Hold a flashlight tangentially to the skin of the neck and inspect for the highest level of the jugular venous pulsation. Measure the vertical distance between the sternal angle and this level.
Interpretation
The JVP is elevated if the vertical distance between the sternal angle and the highest point of the pulse is greater than 4cm.
Significance
Elevated JVP is indicative of increased right ventricular filling pressure.
Causes of Elevated JVP
- Fluid overload - excessive IV fluids, renal disease, heart failure
- Right ventricular systolic failure - cor pulmonale, left ventricular failure
- Right ventricular diastolic failure - constrictive pericarditis, tamponade
- Pulmonary hypertension
Hepatojugular Reflex
How to Elicit
Gently press over the right upper quadrant for 10-15 seconds while inspecting the JVP.
Significance
The reflex temporarily increases venous return to the right atrium, making the jugular venous pulsation more pronounced.
Structure of the JVP
Significance
- A wave - right atrial contraction
- C wave - early ventricular contraction
- X descent - downward movement of the ventricle during systolic contraction
- V wave - filling of right atrium
- Y descent - opening of tricuspid valve in diastole
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Associated DiseasesBETA
Pericardial Disease
Left Ventricular Failure
Right Ventricular Failure
Heart Failure with Reduced Ejection Fraction
Pulmonary Hypertension