Bobbing of the head with each heartbeat like a bird walking is known as:

Appeared in: DSSSB 6 September 2024

Explanation

De Musset's sign is the rhythmic bobbing or nodding of the head that is synchronous with the heartbeat.
It is a classic sign of severe aortic regurgitation (aortic insufficiency).
The head bobbing is caused by the forceful ejection of a large volume of blood (large stroke volume) from the left ventricle into the aorta, which creates a hyperdynamic pulse that is transmitted to the arteries of the head and neck.

Option A: This is an ophthalmologic sign where the eyes appear to be driven downward, revealing the sclera above the iris.
Option B: This refers to visible capillary pulsations in the nail beds, not head movement.
Option D: This is characterized by systolic pulsations of the uvula, which is located in the oropharynx.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Peripheral signs of aortic regurgitation as background academic context rather than a clinical decision trigger.
Recognizing peripheral signs like De Musset's sign is a crucial bedside assessment skill for nurses, as it can be an early indicator of severe, hemodynamically significant aortic regurgitation.
Prompt identification allows for further diagnostic workup (like an echocardiogram) and timely management to prevent complications such as heart failure.
What if? If a patient with De Musset's sign also has a 'water-hammer' (Corrigan's) pulse and a wide pulse pressure on blood pressure measurement, the suspicion for severe aortic regurgitation is very high, and the nurse should prepare for urgent cardiovascular assessment and potential intervention.

How to Approach the Question

First, identify the key clinical sign described in the question stem: 'bobbing of the head with each heartbeat'.
This is a factual recall question that tests your knowledge of medical eponyms for specific clinical signs.
Systematically review the options, recalling the definition for each sign.
Match the description of head bobbing to the correct term, which is De Musset's sign.
Eliminate the other options by confirming their definitions: Sunsetting sign involves the eyes, Quincke's sign involves the nail beds, and Muller's sign involves the uvula.

Concept Tested & Keywords

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Practise the full DSSSB 6 September 2024

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