Trousseau sign of latent tetany
Encyclopedia
Trousseau sign of latent tetany is a medical sign
observed in patients with low calcium
. This sign may become positive before other gross manifestations of hypocalcemia such as hyperreflexia
and tetany
, but is generally believed to be more sensitive (94%) than the Chvostek sign
(29%) for hypocalcemia.
To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery
. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joint
s flex, the DIP
and PIP joints extend, and the fingers adduct
. The sign is also known as main d'accoucheur (French
for "hand of the obstetrician") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.
The sign is named after French physician Armand Trousseau
who described the phenomenon in 1861. It is distinct from the Trousseau sign of malignancy
.
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
observed in patients with low calcium
Calcium
Calcium is the chemical element with the symbol Ca and atomic number 20. It has an atomic mass of 40.078 amu. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust...
. This sign may become positive before other gross manifestations of hypocalcemia such as hyperreflexia
Hyperreflexia
Hyperreflexia is defined as overactive or overresponsive reflexes. Examples of this can include twitching or spastic tendencies, which are indicative of upper motor neuron disease as well as the lessening or loss of control ordinarily exerted by higher brain centers of lower neural pathways...
and tetany
Tetany
Tetany has two meanings, though both are related to the muscular system.* Tetany * Tetany The terms "tetany" and "tetanus" are distinct....
, but is generally believed to be more sensitive (94%) than the Chvostek sign
Chvostek sign
The Chvostek sign is one of the signs of tetany seen in hypocalcemia. It refers to an abnormal reaction to the stimulation of the facial nerve. When the facial nerve is tapped at the angle of the jaw , the facial muscles on the same side of the face will contract momentarily because of...
(29%) for hypocalcemia.
To elicit the sign, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. This will occlude the brachial artery
Brachial artery
The brachial artery is the major blood vessel of the arm.It is the continuation of the axillary artery beyond the lower margin of teres major muscle. It continues down the ventral surface of the arm until it reaches the cubital fossa at the elbow. It then divides into the radial and ulnar arteries...
. In the absence of blood flow, the patient's hypocalcemia and subsequent neuromuscular irritability will induce spasm of the muscles of the hand and forearm. The wrist and metacarpophalangeal joint
Metacarpophalangeal joint
The metacarpophalangeal joints are of the condyloid kind, formed by the reception of the rounded heads of the metacarpal bones into shallow cavities on the proximal ends of the first phalanges, with the exception of that of the thumb, which presents more of the characters of a ginglymoid joint...
s flex, the DIP
Distal interphalangeal joint
Distal interphalangeal joint can refer to:* Interphalangeal articulations of hand* Interphalangeal articulations of foot...
and PIP joints extend, and the fingers adduct
Adduction
Adduction is a movement which brings a part of the anatomy closer to the middle sagittal plane of the body. It is opposed to abduction.-Upper limb:* of arm at shoulder ** Subscapularis** Teres major** Pectoralis major** Infraspinatus...
. The sign is also known as main d'accoucheur (French
French language
French is a Romance language spoken as a first language in France, the Romandy region in Switzerland, Wallonia and Brussels in Belgium, Monaco, the regions of Quebec and Acadia in Canada, and by various communities elsewhere. Second-language speakers of French are distributed throughout many parts...
for "hand of the obstetrician") because it supposedly resembles the position of an obstetrician's hand in delivering a baby.
The sign is named after French physician Armand Trousseau
Armand Trousseau
Armand Trousseau was a French internist. His contributions to medicine include Trousseau sign of malignancy, Trousseau sign of latent tetany, Trousseau-Lallemand bodies , and the truism, "use new drugs quickly, while they still work."-Biography:A native of Tours, Indre-et-Loire, Armand Trousseau...
who described the phenomenon in 1861. It is distinct from the Trousseau sign of malignancy
Trousseau sign of malignancy
The Trousseau sign of malignancy is a medical sign found in certain cancers that is associated with venous thrombosis and hypercoagulability. It is also referred to as Trousseau syndrome and is distinct from the Trousseau sign of latent tetany.-History:...
.