A hollow or cracked pot sound is heard during percussion of skull is called?

Appeared in: NVS Staff Nurse - 2022

Explanation

Macewen's sign is the term for the 'cracked pot' or hollow sound produced when percussing (tapping) the skull.
This sound occurs because increased intracranial pressure has caused the cranial sutures (the joints between the skull bones) to separate.
It is a classic clinical sign of hydrocephalus in infants, a condition where excess cerebrospinal fluid accumulates in the brain.

Option A: Chadwick's sign is related to pregnancy, not neurology. It is the bluish or purplish discoloration of the cervix, vagina, and labia due to increased blood flow.
Option C: The sunsetting sign is a visual finding, not an auditory one. It involves the downward deviation of the eyes, making the sclera visible above the iris. While it is also a sign of increased intracranial pressure, it is not elicited by percussion.
Option D: The Babinski sign is a neurological reflex tested on the sole of the foot, not the skull. It involves the dorsiflexion (upward movement) of the big toe and fanning of the other toes.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pediatric neurological assessment signs as background academic context rather than a clinical decision trigger.
Early detection of Macewen's sign can lead to timely intervention for hydrocephalus, preventing long-term neurological damage. Nurses are often the first to notice subtle changes in an infant's head size or neurological status.
A key nursing responsibility is the daily measurement of head circumference in at-risk infants. Any crossing of percentiles on the growth chart requires immediate reporting.
What if? If a 'cracked pot' sound is heard in an older child or adult after head trauma, it would not be called Macewen's sign but would strongly suggest a depressed or comminuted skull fracture, which is a medical emergency.

How to Approach the Question

First, identify the key descriptive phrase in the question: 'hollow or cracked pot sound' and the action 'percussion of skull'.
This is a factual recall question that requires knowing the specific names of clinical signs.
Review the options and recall the definition for each sign.
Macewen's sign is specifically associated with a percussion sound on the skull.
Eliminate the other options by identifying what they describe: Chadwick's sign (pregnancy-related color change), Sunsetting sign (an eye finding), and Babinski sign (a foot reflex).
Select the option that directly matches the description of a 'cracked pot' sound on skull percussion.

Concept Tested & Keywords

QDvvReRi2qOI_vJ3NJPEa8

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1386-1388

Practise the full NVS Staff Nurse - 2022

Attempt every question from this paper in a timed mock, then review the full solution for each one.