Cracked pot resonance sound on percussion of the skull known as:

Appeared in: DSSSB 12 August 2024

Explanation

Macewen's sign is the clinical term for a resonant 'cracked pot' sound heard upon percussion of the skull.
This sign indicates that the cranial sutures, which are not yet fused in infants, have separated.
The underlying cause is increased intracranial pressure (ICP), which forces the cranial bones apart.
It is a classic sign observed in infants with conditions such as hydrocephalus.

Option A: The sun setting sign is an ocular finding, not an auditory one. It describes the downward deviation of the eyes, revealing the sclera above the iris.
Option B: Gower's sign is related to muscle weakness, not a finding on the skull. It is a maneuver where a person uses their hands to 'climb up' their own legs to stand.
Option C: Charcot's sign is not a single entity and does not relate to skull percussion. It most commonly refers to Charcot's neurologic triad (seen in multiple sclerosis) or Charcot's biliary triad (seen in ascending cholangitis).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical assessment findings in increased intracranial pressure as background academic context rather than a clinical decision trigger.
Eliciting Macewen's sign is a critical, non-invasive assessment technique for detecting elevated intracranial pressure in infants whose fontanelles are still open.
A positive Macewen's sign is an urgent finding that requires immediate follow-up with neuroimaging (e.g., cranial ultrasound, CT, or MRI) to determine the cause of the increased ICP.
Early detection and intervention can prevent irreversible brain damage, developmental delays, and other severe complications associated with untreated hydrocephalus.

How to Approach the Question

First, identify the key descriptive phrase in the question stem: 'Cracked pot resonance sound on percussion of the skull'.
This is a factual recall question that requires you to know the specific medical term for this clinical sign.
Systematically review the definitions of the four named signs provided as options.
Match the description to the correct term. Macewen's sign is the specific name for the 'cracked pot' sound.
Eliminate the other options by recalling their definitions: Sun setting sign involves the eyes, Gower's sign involves muscles used for standing, and Charcot's sign refers to triads of symptoms in other diseases.

Concept Tested & Keywords

Q3wXdKwOM-HxProe2aWy63

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

Practise the full DSSSB 12 August 2024

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