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{{Infobox_Disease |
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  DiseasesDB    = |
  ICD10          = |
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{{SI}}
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{{CMG}}
{{CMG}}; {{M.P}}
 


{{SK}} Tracheal tug sign


==Overview==
==Overview==
'''Oliver's sign''', or the '''tracheal tug sign''', is an abnormal downward movement of the [[Vertebrate trachea|trachea]] during [[systole]] that can indicate a dilation or [[aneurysm]] of the [[aortic arch]].
Oliver's sign is an abnormal downward movement of the [[Vertebrate trachea|trachea]] during [[systole]] that can indicate a dilation or [[aneurysm]] of the [[aortic arch]].  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 [[Vertebrate trachea|trachea]] may be felt if an aneurysm is present.


==Physical examination technique==
==Historical Perspective==
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.
The sign was first described by English military [[surgeon]] William Silver Oliver in 1878.


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


==Etymology==
===Life Threatening Causes===
The sign was first described by English military [[surgeon]] William Silver Oliver in 1878.
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
*[[Aortic aneurysm]]
*[[Aortic dissection]]


==Causes==
===Common Causes===
===Common Causes===
*[[Aneurysms]] Associated with [[Aortic Dissection]]
*[[Aortic aneurysm]]
 
*[[Aortic dissection]]
*[[Atherosclerosis ]]
*[[Atherosclerosis ]]
*[[Cystic medial necrosis]]
*[[Cystic medial necrosis]]
 
*[[Marfan's syndrome ]]
*[[Marfan's syndrome ]]
*[[Trauma]]
*[[Trauma]]


===Causes by Organ System===
===Causes by Organ System===
{|style="width:82%; height:100px" border="1"
{|style="width:82%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|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]] 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" | [[Aortic dissection]], [[aortic aneurysm]], [[annuloaortic ectasia]], [[aortitis]], [[arterial tortuosity syndrome]], [[atherosclerosis]], [[Beals syndrome]], [[bicuspid aortic valve]], [[cystic medial necrosis]], [[giant cell arteritis]], [[HANAC syndrome]], [[hypertension]], [[infective endocarditis]],  [[kawasaki disease]], [[Loeys-Dietz syndrome]], [[MASS phenotype]], [[polyarteritis nodosa]], [[septic emboli]], [[aortic stenosis|unicuspid aortic valve]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 68: Line 55:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"| [[Acromegaly]], [[Diabetes ]], [[Hyperlipidemia]]
|bgcolor="Beige"| [[Acromegaly]], [[diabetes]], [[hyperlipidemia]]
|-  
|-  
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| [[High BMI]], [[Smoking]]
|bgcolor="Beige"| [[obesity]], [[smoking]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|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="Beige"| [[Beals syndrome]], [[cystic medial necrosis]], [[HANAC syndrome]], [[Loeys-Dietz syndrome]], [[Marfan's syndrome]], [[MASS phenotype]], [[polycystic kidney disease]], [[pseudoxanthoma elasticum]], [[Turner syndrome]], [[Ehlers-Danlos syndrome ]], [[Shprintzen syndrome]], [[aortic stenosis|unicuspid aortic valve]], [[Weill-Marchesani syndrome]]
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
Line 92: Line 78:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"| [[Aortitis]] by contiguous spread from adjacent structrues, [[Chagas disease]], [[Infective endocarditis]], [[Quaternary syphilis]], [[Salmonella]], [[Septic emboli]], [[Tuberculosis ]]
|bgcolor="Beige"| [[Aortitis]], [[chagas disease]], [[infective endocarditis]], [[quaternary syphilis]], [[salmonella]], [[septic emboli]], [[tuberculosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''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]], [[Ehlers-Danlos syndrome]], [[HANAC syndrome]], [[Loeys-Dietz syndrome]], [[Marfan's syndrome]], [[pseudoxanthoma elasticum]], [[relapsing polychondritis]], [[Shprintzen syndrome]], [[Weill-Marchesani syndrome]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 136: Line 122:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Behçet disease]], [[Giant cell arteritis]], [[Kawasaki disease]], [[Polyarteritis nodosa]], [[Scleroderma]]
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[Behçet disease]], [[giant cell arteritis]], [[Kawasaki disease]], [[polyarteritis nodosa]], [[scleroderma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
Line 144: Line 130:
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Injury]]
|bgcolor="Beige"| [[Chest trauma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Aging ]], High [[BMI]]
|bgcolor="Beige"| [[Aging ]], [[obesity]]
|-
|-
|}
|}
Line 163: Line 149:
*[[Aging ]]
*[[Aging ]]


*[[Aneurysm]]s Associated with [[aortic dissection]]
*[[Aortic aneurysm]]
 
*[[Aortic dissection]]


*[[Ankylosing spondylitis]]
*[[Ankylosing spondylitis]]
Line 169: Line 157:
*[[Annuloaortic ectasia]]
*[[Annuloaortic ectasia]]


*[[Aortitis]] by contiguous  spread from adjacent structrues
*[[Aortitis]]  


*[[Arterial tortuosity  syndrome]]
*[[Arterial tortuosity  syndrome]]
Line 175: Line 163:
*[[Atherosclerosis ]]
*[[Atherosclerosis ]]


*[[Polycystic kidney disease]]
*[[Beals syndrome]]


*[[Behçet disease]]
*[[Behçet disease]]


*[[Bicuspid aortic valve]]
*[[Bicuspid aortic valve]]
*[[Chagas disease]]


*[[Cystic medial necrosis]]
*[[Cystic medial necrosis]]


*[[Diabetes  ]]
*[[Diabetes  ]]
*Familial history of  [[aneurysm]] and [[dissections]]
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Genetic factors]]
*[[Ehlers-Danlos syndrome]]


*[[Giant cell arteritis]]
*[[Giant cell arteritis]]


*High [[BMI]]
*[[HANAC syndrome]]


*[[Hyperlipidemia]]
*[[Hyperlipidemia]]
Line 199: Line 187:
*[[Infective endocarditis]]
*[[Infective endocarditis]]


*[[Inflammation of aortic arch]]
*[[Kawasaki disease]]


*[[Kawasaki  disease]]
*[[Loeys-Dietz syndrome]]


*[[Loeys-Dietz syndromes]]
*[[MASS phenotype]]


*[[Marfan's syndrome ]]
*[[Marfan's syndrome ]]
*[[Obesity]]


*[[Polyarteritis nodosa]]
*[[Polyarteritis nodosa]]
*[[polycystic kidney disease]]


*[[Quaternary  syphilis]]
*[[Quaternary  syphilis]]


*[[Relapsing Polychondritis]]
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Relapsing polychondritis]]
*[[Salmonella]]
*[[Salmonella]]


Line 218: Line 212:


*[[Septic emboli]]
*[[Septic emboli]]
*[[Shprintzen syndrome]]


*[[Smoking]]
*[[Smoking]]


*[[Pseudoxanthoma Elasticum]]
*[[Pseudoxanthoma elasticum]]


*[[Takayasu's arteritis]]
*[[Takayasu's arteritis]]


*[[Trauma]]
*[[chest trauma|Trauma]]


*[[Tuberculosis ]]
*[[Tuberculosis ]]
Line 231: Line 227:
*[[Turner syndrome]]
*[[Turner syndrome]]


* Type IV [[Ehlers-Danlos  syndrome ]]
*[[aortic stenosis|Unicuspid aortic valve]]
 
*[[Unicuspid aortic valve]]
 
*[[HANAC syndrome]]


*[[Chagas disease]]
*[[Weill-Marchesani syndrome]]
{{col-end}}
{{col-end}}


==References==
{{Reflist|2}}


==See also==
[[Category:Crowdiagnosis]]
* [[Aortic aneurysm]]
[[Category:Up-To-Date]]
* [[Cardarelli's sign]]
 
{{Eponymous medical signs for circulatory and respiratory systems}}
 
 
 
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Physical examination]]
[[Category:Physical examination]]

Latest revision as of 13:52, 11 June 2015


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]

Synonyms and keywords: Tracheal tug sign

Overview

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

Historical Perspective

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

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Causes by Organ System

Cardiovascular Aortic dissection, aortic aneurysm, annuloaortic ectasia, aortitis, arterial tortuosity syndrome, atherosclerosis, Beals syndrome, bicuspid aortic valve, cystic medial necrosis, giant cell arteritis, HANAC syndrome, hypertension, infective endocarditis, kawasaki disease, Loeys-Dietz syndrome, MASS phenotype, 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 obesity, smoking
Gastroenterologic Polycystic kidney disease
Genetic Beals syndrome, cystic medial necrosis, HANAC syndrome, Loeys-Dietz syndrome, Marfan's syndrome, MASS phenotype, polycystic kidney disease, pseudoxanthoma elasticum, Turner syndrome, Ehlers-Danlos syndrome , Shprintzen syndrome, unicuspid aortic valve, Weill-Marchesani syndrome
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease Aortitis, chagas disease, infective endocarditis, quaternary syphilis, salmonella, septic emboli, tuberculosis
Musculoskeletal/Orthopedic Acromegaly, ankylosing spondylitis, Ehlers-Danlos syndrome, HANAC syndrome, Loeys-Dietz syndrome, Marfan's syndrome, pseudoxanthoma elasticum, relapsing polychondritis, Shprintzen syndrome, Weill-Marchesani 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 Chest trauma
Urologic No underlying causes
Miscellaneous Aging , obesity

Causes in Alphabetical Order

References


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