![Symptoms of acute HIV infection](https://upload.wikimedia.org/wikipedia/commons/1/1b/Symptoms_of_acute_HIV_infection.svg)
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an
illness
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a
medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body.
Signs and symptoms
Signs
A medical sign is an
objective
Objective may refer to:
* Objective (optics), an element in a camera or microscope
* ''The Objective'', a 2008 science fiction horror film
* Objective pronoun, a personal pronoun that is used as a grammatical object
* Objective Productions, a Brit ...
observable indication of a disease, injury, or abnormal physiological state that may be detected during a
physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
, examining the patient history, or diagnostic procedure.
These signs are visible or otherwise detectable such as a
rash
A rash is a change of the human skin which affects its color, appearance, or texture.
A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cr ...
or
bruise
A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close ...
. Medical signs, along with
symptom
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
s, assist in formulating diagnostic hypothesis. Examples of signs include
elevated blood pressure,
nail clubbing
Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe nails associated with a number of diseases, mostly of the heart and lungs.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. ...
of the fingernails or toenails, staggering
gait, and
arcus senilis and arcus juvenilis of the eyes.
Indications
A ''sign'' is different from an "''
indication''" – the activity of a condition 'pointing to' (thus "indicating") a remedy, not the reverse (viz., it is not a remedy 'pointing to' a condition) – which is a specific reason for using a particular
treatment.
Symptoms
A symptom is something felt or experienced, such as pain or dizziness. Signs and symptoms are not mutually exclusive, for example a subjective feeling of fever can be noted as sign by using a thermometer that registers a high reading.
Cardinal signs and symptoms
Cardinal signs and symptoms are specific even to the point of being
pathognomonic Pathognomonic (rare synonym ''pathognomic'') is a term, often used in medicine, that means "characteristic for a particular disease". A pathognomonic sign is a particular sign whose presence means that a particular disease is present beyond any doub ...
. A cardinal sign or cardinal symptom can also refer to the major sign or symptom of a disease.
Abnormal
reflexes can indicate problems with the
nervous system
In biology, the nervous system is the highly complex part of an animal that coordinates its actions and sensory information by transmitting signals to and from different parts of its body. The nervous system detects environmental changes th ...
. Signs and symptoms are also applied to physiological states outside the context of disease, as for example when referring to the
signs and symptoms of pregnancy, or the symptoms of
dehydration
In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
. Sometimes a disease may be present without showing any signs or symptoms when it is known as being
asymptomatic.
The disorder may be discovered through tests including scans. An
infection
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
may be asymptomatic which may still be
transmissible.
Signs vs. symptoms
Signs are different from experienced symptoms. A sign of a disorder is something that may be observed by another or detected during a medical examination or procedure.
For example
high blood pressure
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
may be noted as a sign during an examination for which there have been no reported symptoms. A symptom is something experienced and reportable by a person such as a
headache
Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches.
Headaches can occur as a result ...
or
fatigue. Signs and symptoms may overlap, such as a bloody nose, which the individual experiences as unusual (symptom) and which others observe (sign).
The
CDC
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
lists various diseases by their signs and symptoms such as for
measles which includes a high fever,
conjunctivitis
Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva, outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may ...
, and
cough
A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three pha ...
, followed a few days later by the measles
rash
A rash is a change of the human skin which affects its color, appearance, or texture.
A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cr ...
.
Syndrome
Signs and symptoms are often non-specific, but some combinations can be suggestive of certain
diagnoses
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine "cause and effect". In systems enginee ...
, helping to narrow down what may be wrong. A particular set of characteristic signs and symptoms that may be associated with a disorder is known as a
syndrome
A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek σύνδρομον, meaning "concurrence". When a syndrome is paired ...
. In cases where the underlying cause is known the syndrome is named as for example
Down syndrome
Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual dis ...
and
Noonan syndrome
Noonan syndrome (NS) is a genetic disorder that may present with mildly unusual facial features, short height, congenital heart disease, bleeding problems, and skeletal malformations. Facial features include widely spaced eyes, light-colored ...
. Other syndromes such as
acute coronary syndrome
Acute coronary syndrome (ACS) is a syndrome (a set of signs and symptoms) due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. The most common symptom is centrally loca ...
may have a number of possible causes.
Terms
When a disease is evidenced by symptoms it is known as symptomatic. There are many conditions including
subclinical infection
A subclinical infection—sometimes called a preinfection or inapparent infection—is an infection that, being subclinical, is nearly or completely asymptomatic (no signs or symptoms). A subclinically infected person is thus a paucisymptomatic ...
s that display no symptoms, and these are termed
asymptomatic. Signs and symptoms may be mild or severe, brief or longer-lasting when they may become reduced (
remission), or then recur (
relapse
In internal medicine, relapse or recidivism is a recurrence of a past (typically medical) condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or ...
or
recrudescence
Recrudescence is the revival of material or behavior that had previously been stabilized, settled, or diminished. In medicine, it is usually defined as the recurrence of symptoms after a period of remission or quiescence, in which sense it can som ...
) known as a
flare-up
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
. A flare-up may show more severe symptoms.
The term
chief complaint The chief complaint, formally known as CC in the medical field, or termed presenting complaint (PC) in Europe and Canada, forms the second step of medical history taking. It is sometimes also referred to as reason for encounter (RFE), presenting pro ...
, also "presenting problem", is used to describe the initial concern of an individual when seeking medical help, and once this is clearly noted a
history of the present illness
Following the chief complaint in medical history taking, a history of the present illness (abbreviated HPI) (termed history of presenting complaint (HPC) in the UK) refers to a detailed interview prompted by the chief complaint or presenting sympt ...
may be taken. The symptom that ultimately leads to a
diagnosis
Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different disciplines, with variations in the use of logic, analytics, and experience, to determine " cause and effect". In systems engin ...
is called a cardinal symptom.Some symptoms can be misleading as a result of
referred pain
Referred pain, also called reflective pain, is pain perceived at a location other than the site of the painful stimulus. An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in ...
, where for example a pain in the right shoulder may be due to
an inflamed gallbladder and not to presumed muscle strain.
[Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e]
Prodrome
Many diseases have an early
prodromal
In medicine, a prodrome is an early sign or symptom (or set of signs and symptoms) that often indicates the onset of a disease before more diagnostically specific signs and symptoms develop. It is derived from the Greek word ''prodromos'', meaning ...
stage where a few signs and symptoms may suggest the presence of a disorder before further specific symptoms may emerge.
Measles for example has a prodromal presentation that includes a hacking cough, fever, and
Koplik's spots
Koplik's spots (also Koplik's sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself. They are characterized as clustered, white lesions on the buccal mucosa (opposite the lower 1st & 2nd ...
in the mouth.
Over half of
migraine
Migraine (, ) is a common neurological disorder characterized by recurrent headaches. Typically, the associated headache affects one side of the head, is pulsating in nature, may be moderate to severe in intensity, and could last from a few hou ...
episodes have a prodromal phase.
Schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
has a notable prodromal stage,
as has
dementia
Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...
.
Nonspecific symptoms
Nonspecific symptoms are very general and thus can be associated with a wide range of conditions. In other words, they are not specific to (not particular to) any one condition. Most signs and symptoms are at least ''somewhat'' nonspecific, as only
pathognomonic Pathognomonic (rare synonym ''pathognomic'') is a term, often used in medicine, that means "characteristic for a particular disease". A pathognomonic sign is a particular sign whose presence means that a particular disease is present beyond any doub ...
ones are ''highly'' specific. But certain nonspecific signs and symptoms are ''especially'' nonspecific and especially common. They are also known as constitutional symptoms when they affect the sense of well-being. They include unexplained weight loss, headache, pain, fatigue, loss of appetite, night sweats, and malaise.
Vital signs
Vital signs
Vital signs (also known as vitals) are a group of the four to six most crucial medical signs that indicate the status of the body's vital (life-sustaining) functions. These measurements are taken to help assess the general physical health of a ...
are the four signs that can give an immediate measurement of the body's overall functioning and health status. They are
temperature
Temperature is a physical quantity that expresses quantitatively the perceptions of hotness and coldness. Temperature is measured with a thermometer.
Thermometers are calibrated in various temperature scales that historically have relied o ...
,
heart rate
Heart rate (or pulse rate) is the frequency of the heartbeat measured by the number of contractions (beats) of the heart per minute (bpm). The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excr ...
,
breathing rate
The respiratory rate is the rate at which breathing occurs; it is set and controlled by the respiratory center of the brain. A person's respiratory rate is usually measured in breaths per minute.
Measurement
The respiratory rate in humans is me ...
, and
blood pressure. The
ranges
In the Hebrew Bible and in the Old Testament, the word ranges has two very different meanings.
Leviticus
In Leviticus 11:35, ranges probably means a cooking furnace for two or more pots, as the Hebrew word here is in the dual number; or perhaps ...
of these measurements vary with age, weight, gender and with general health.
A digital application has been developed for use in clinical settings that measures three of the vital signs (not temperature) using just a
smartphone
A smartphone is a portable computer device that combines mobile telephone and computing functions into one unit. They are distinguished from feature phones by their stronger hardware capabilities and extensive mobile operating systems, whic ...
, and has been approved by
NHS England. The application is registered as ''Lifelight First'', and ''Lifelight Home'' is under development (2020) for monitoring-use by people at home using just the camera on their smartphone or tablet. This will additionally measure
oxygen saturation
Oxygen saturation (symbol SO2) is a relative measure of the concentration of oxygen that is dissolved or carried in a given medium as a proportion of the maximal concentration that can be dissolved in that medium at the given temperature. It ca ...
and
atrial fibrillation. Other devices are then not needed.
Syndromes
Many conditions are indicated by a group of known signs, or signs and symptoms. These can be a group of three known as a triad: a group of four known as a tetrad, and a group of five known as a petrad. An example of a triad is
Meltzer's triad presenting
purpura
Purpura () is a condition of red or purple discolored spots on the skin that do not blanch on applying pressure. The spots are caused by bleeding underneath the skin secondary to platelet disorders, vascular disorders, coagulation disorders, ...
a rash,
arthralgia
Arthralgia (from Greek ''arthro-'', joint + ''-algos'', pain) literally means ''joint pain''. Specifically, arthralgia is a symptom of injury, infection, illness (in particular arthritis), or an allergic reaction to medication.
According to MeSH, ...
painful joints, and
myalgia painful and weak muscles. Meltzer's triad indicates the condition
cryoglobulinemia
Cryoglobulinemia is a medical condition in which the blood contains large amounts of pathological cold sensitive antibodies called cryoglobulins – proteins (mostly immunoglobulins themselves) that become insoluble at reduced temperatures. ...
.
Huntington's disease
Huntington's disease (HD), also known as Huntington's chorea, is a neurodegenerative disease that is mostly inherited. The earliest symptoms are often subtle problems with mood or mental abilities. A general lack of coordination and an uns ...
is a
neurodegenerative disease
A neurodegenerative disease is caused by the progressive loss of structure or function of neurons, in the process known as neurodegeneration. Such neuronal damage may ultimately involve cell death. Neurodegenerative diseases include amyotrophic ...
that is characterized by a triad of motor, cognitive, and psychiatric signs and symptoms.
A large number of these groups that can be characteristic of a particular disease are known as a
syndrome
A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek σύνδρομον, meaning "concurrence". When a syndrome is paired ...
.
Noonan syndrome
Noonan syndrome (NS) is a genetic disorder that may present with mildly unusual facial features, short height, congenital heart disease, bleeding problems, and skeletal malformations. Facial features include widely spaced eyes, light-colored ...
for example, has a diagnostic set of unique facial and musculoskeletal features.
Some syndromes such as
nephrotic syndrome may have a number of underlying causes that are all related to diseases that affect the
kidney
The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...
s.
Sometimes a child or young adult may have symptoms suggestive of a
genetic disorder
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
that cannot be
identified even after
genetic testing
Genetic testing, also known as DNA testing, is used to identify changes in DNA sequence or chromosome structure. Genetic testing can also include measuring the results of genetic changes, such as RNA analysis as an output of gene expression, or ...
. In such cases the term
SWAN (syndrome without a name) may be used. Often a diagnosis may be made at some future point when other more specific symptoms emerge but many cases may remain undiagnosed. The inability to diagnose may be due to a unique combination of symptoms or an overlap of conditions, or to the symptoms being atypical of a known disorder, or to the disorder being extremely rare.
Positive and negative
Sensory symptoms can also be described as positive symptoms, or as negative symptoms depending on whether the symptom is abnormally present such as tingling or itchiness, or abnormally absent such as
loss of smell. The following terms are used for negative symptoms –
hypoesthesia
Hypoesthesia or numbness is a common side effect of various medical conditions that manifests as a reduced sense of touch or sensation, or a partial loss of sensitivity to sensory stimuli. In everyday speech this is generally referred to as nu ...
is a partial loss of sensitivity to moderate stimuli, such as pressure, touch, warmth, cold.
Anesthesia
Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...
is the complete loss of sensitivity to stronger stimuli, such as pinprick.
Hypoalgesia
Hypoalgesia or hypalgesia denotes a decreased sensitivity to painful stimuli.
Hypoalgesia occurs when nociceptive (painful) stimuli are interrupted or decreased somewhere along the path between the input (nociceptors), and the places where they ...
(analgesia) is loss of sensation to painful stimuli.
Symptoms are also grouped in to negative and positive for some
mental disorder
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
s such as
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
.
Positive symptoms
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
are those that are present in the disorder and are not normally experienced by most individuals and reflects an excess or distortion of normal functions.
[Understanding Psychosis](_blank)
, Mental Health Illness of Australia. Examples are
hallucinations,
delusions, and bizarre behavior.
Negative symptoms
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...
are functions that are normally found but that are diminished or absent such as
apathy
Apathy is a lack of feeling, emotion, interest, or concern about something. It is a state of indifference, or the suppression of emotions such as concern, excitement, motivation, or passion. An apathetic individual has an absence of intere ...
and
anhedonia
Anhedonia is a diverse array of deficits in hedonic function, including reduced motivation or ability to experience pleasure. While earlier definitions emphasized the inability to experience pleasure, anhedonia is currently used by researchers t ...
.
Neuropsychiatric
Neuropsychiatric symptoms are present in many
degenerative disorders including
dementia
Dementia is a disorder which manifests as a set of related symptoms, which usually surfaces when the brain is damaged by injury or disease. The symptoms involve progressive impairments in memory, thinking, and behavior, which negatively affe ...
, and
Parkinson's disease
Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...
. Symptoms commonly include
apathy
Apathy is a lack of feeling, emotion, interest, or concern about something. It is a state of indifference, or the suppression of emotions such as concern, excitement, motivation, or passion. An apathetic individual has an absence of intere ...
,
anxiety
Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
, and
depression.
Neurological and psychiatric symptoms are also present in some
genetic disorder
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
s such as
Wilson's disease
Wilson's disease is a genetic disorder in which excess copper builds up in the body. Symptoms are typically related to the brain and liver. Liver-related symptoms include vomiting, weakness, fluid build up in the abdomen, swelling of the legs, ...
.
Executive dysfunction
In psychology and neuroscience, executive dysfunction, or executive function deficit, is a disruption to the efficacy of the executive functions, which is a group of cognitive processes that regulate, control, and manage other cognitive processes ...
is an often found symptom in many disorders including
schizophrenia
Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...
, and
ADHD
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inapp ...
.
Radiologic
Radiologic sign
A radiologic sign is an objective indication of some medical fact (that is, a medical sign) that is detected by a physician during radiologic examination with medical imaging (for example, via an X-ray, CT scan, MRI scan, or sonographic scan). ...
s are abnormal
medical findings on
imaging scanning. These include the
Mickey Mouse sign Mickey Mouse sign is a medical sign resembling the head of Mickey Mouse, the Walt Disney character. Presented for the very first time at the CHIVA's Meeting, Berlin 2002 by Dr. Lurdes Cerol, this sign has been described as the image at the groin whe ...
and the
Golden S sign
In medicine, the Golden S sign is a sign seen on imaging of the chest that suggests a central lung mass or lung collapse. It was first described by Dr. Ross Golden (1889-1975) in 1925 in association with bronchial carcinoma, but it is also seen ...
. When using imaging to find the cause of a complaint, another unrelated finding may be found known as an
incidental finding.
Cardinal
Cardinal signs and symptoms are those that may be diagnostic, and
pathognomonic Pathognomonic (rare synonym ''pathognomic'') is a term, often used in medicine, that means "characteristic for a particular disease". A pathognomonic sign is a particular sign whose presence means that a particular disease is present beyond any doub ...
– of a certainty of diagnosis.
Inflammation
Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
for example has a recognised group of cardinal signs and symptoms,
as does
exacerbations of chronic bronchitis, and
Parkinson's disease
Parkinson's disease (PD), or simply Parkinson's, is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly, and as the disease worsens, non-motor symptoms becom ...
.
In contrast to a pathognomonic cardinal sign, the absence of a sign or symptom can often rule out a condition. This is known by the Latin term ''
sine qua non
''Sine qua non'' (, ) or ''condicio sine qua non'' (plural: ''condiciones sine quibus non'') is an indispensable and essential action, condition, or ingredient. It was originally a Latin legal term for " conditionwithout which it could not be" ...
''. For example, the absence of known genetic mutations
specific
Specific may refer to:
* Specificity (disambiguation)
* Specific, a cure or therapy for a specific illness
Law
* Specific deterrence, focussed on an individual
* Specific finding, intermediate verdict used by a jury in determining the fina ...
for a
hereditary disease
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
would rule out that disease.
Another example is where the
vaginal pH
In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hymen. ...
is less than 4.5, a diagnosis of
bacterial vaginosis
Bacterial vaginosis (BV) is a disease of the vagina caused by excessive growth of bacteria. Common symptoms include increased vaginal discharge that often smells like fish. The discharge is usually white or gray in color. Burning with urination ...
would be excluded.
Reflexes
A
reflex is an automatic response in the body to a stimulus.
Its absence, reduced (hypoactive), or exaggerated (hyperactive) response can be a sign of damage to the
central nervous system
The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain and spinal cord. The CNS is so named because the brain integrates the received information and coordinates and influences the activity of all par ...
or
peripheral nervous system
The peripheral nervous system (PNS) is one of two components that make up the nervous system of bilateral animals, with the other part being the central nervous system (CNS). The PNS consists of nerves and ganglia, which lie outside the brain ...
. In the
patellar reflex (knee-jerk) for example, its reduction or absence is known as
Westphal's sign
Westphal's sign is the clinical correlate of the absence or decrease of patellar reflex or knee jerk. Patellar reflex or knee jerk is a kind of deep or stretch reflex where an application of a stimulus to the patellar tendon such as strike by a so ...
and may indicate damage to
lower motor neurons
Lower motor neurons (LMNs) are motor neurons located in either the anterior grey column, anterior nerve roots (spinal lower motor neurons) or the cranial nerve nuclei of the brainstem and cranial nerves with motor function (cranial nerve lower m ...
. When the response is exaggerated damage to the
upper motor neurons may be indicated.
Facies
A number of
medical condition
A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medica ...
s are associated with a distinctive facial expression or appearance known as a
facies
In geology, a facies ( , ; same pronunciation and spelling in the plural) is a body of rock with specified characteristics, which can be any observable attribute of rocks (such as their overall appearance, composition, or condition of formatio ...
An example is
elfin facies
Elfin (Elven) facies is a form of facies where the patient presents with facial characteristics bearing some similarities to those traditionally associated with elves. It is characterized by prominent forehead, widely spaced eyes, upturned nose, un ...
which has facial features like those of the
elf
An elf () is a type of humanoid supernatural being in Germanic mythology and folklore. Elves appear especially in North Germanic mythology. They are subsequently mentioned in Snorri Sturluson's Icelandic Prose Edda. He distinguishes "ligh ...
, and this may be associated with
Williams syndrome
Williams syndrome (WS) is a genetic disorder that affects many parts of the body. Facial features frequently include a broad forehead, underdeveloped chin, short nose, and full cheeks. Mild to moderate intellectual disability is observed in people ...
, or
Donohue syndrome
Donohue syndrome (also known as leprechaunism) is an extremely rare and severe genetic disorder. ''Leprechaunism'' derives its name from the hallmark elvish features (small stature, bulging eyes, thick lips, and upturned nostrils) exhibited by the ...
. The most well-known facies is probably the
Hippocratic facies that is seen on a person as they near death.
Anamnestic signs
Anamnestic signs (from ''anamnēstikós'', ἀναμνηστικός, "able to recall to mind") are signs that indicate a past condition, for example paralysis in an arm may indicate a past
stroke
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
.
Asymptomatic
Some diseases including
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
s, and infections may be present but show no signs or symptoms
and these are known as
asymptomatic.
A gallstone may be asymptomatic and only discovered as an
incidental finding.
Easily spreadable viral infections such as
COVID-19
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
may be asymptomatic but may still be
transmissible.
History
Symptomatology
A symptom (from
Greek
Greek may refer to:
Greece
Anything of, from, or related to Greece, a country in Southern Europe:
*Greeks, an ethnic group.
*Greek language, a branch of the Indo-European language family.
**Proto-Greek language, the assumed last common ancestor ...
σύμπτωμα, "accident, misfortune, that which befalls", from συμπίπτω, "I befall", from συν- "together, with" and πίπτω, "I fall") is a departure from normal function or feeling. Symptomatology (also called semiology) is a branch of
medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
dealing with the signs and symptoms of a disease.
This study also includes the
indications of a
disease
A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
. It was first described as
semiotics
Semiotics (also called semiotic studies) is the systematic study of sign processes ( semiosis) and meaning making. Semiosis is any activity, conduct, or process that involves signs, where a sign is defined as anything that communicates something ...
by
Henry Stubbe
Henry Stubbe or Stubbes (1632–12 July, 1676) was an English Royal physician, Latinist, Historian, Dissident, Writer and Scholar.
Life
He was born in Partney, Lincolnshire, and educated at Westminster School. Given patronage as a child by the ...
in 1670 a term now used for the study of
sign communication.
Prior to the nineteenth century there was little difference in the powers of observation between physician and patient. Most medical practice was conducted as a co-operative interaction between the physician and patient; this was gradually replaced by a "monolithic consensus of opinion imposed from within the community of medical investigators".
[Jewson, N.D.,]
Medical Knowledge and the Patronage System in 18th Century England
", ''Sociology'', Vol. 8, No. 3 (1974), pp. 369–85.[Jewson, N.D.,]
The Disappearance of the Sick Man from Medical Cosmology, 1770–1870
", ''Sociology'', Vol. 10, No. 2, (1976), pp. 225–44. Whilst each noticed much the same things, the physician had a more informed interpretation of those things: "the physicians knew what the findings meant and the layman did not".
Development of medical testing
![Laennec - Théobald Chartran](https://upload.wikimedia.org/wikipedia/commons/a/a0/Laennec_-_Th%C3%A9obald_Chartran.jpg)
A number of advances introduced mostly in the 19th century, allowed for more objective assessment by the physician in search of a diagnosis, and less need of input from the patient.
During the 20th century the introduction of a wide range of
imaging
Imaging is the representation or reproduction of an object's form; especially a visual representation (i.e., the formation of an image).
Imaging technology is the application of materials and methods to create, preserve, or duplicate images.
...
techniques have made a huge impact on diagnostic capability. Other developments in the field of
genetics
Genetics is the study of genes, genetic variation, and heredity in organisms.Hartl D, Jones E (2005) It is an important branch in biology because heredity is vital to organisms' evolution. Gregor Mendel, a Moravian Augustinian friar wor ...
,
medical biochemistry, and
molecular diagnostics
Molecular diagnostics is a collection of techniques used to analyze biological markers in the genome and proteome, and how their cells express their genes as proteins, applying molecular biology to medical testing. In medicine the technique is ...
have also played major roles.
* In 1761 the
percussion
A percussion instrument is a musical instrument that is sounded by being struck or scraped by a beater including attached or enclosed beaters or rattles struck, scraped or rubbed by hand or struck against another similar instrument. Exc ...
technique for diagnosing respiratory conditions was discovered by
Leopold Auenbrugger
Josef Leopold Auenbrugger or Avenbrugger (19 November 1722 – 17 May 1809), also known as Leopold von Auenbrugger, was an Austrian physician who invented percussion as a diagnostic technique. On the strength of this discovery, he is consid ...
.
This method of tapping body cavities to note any abnormal sounds had already been in practice for a long time in cardiology.
[ Percussion of the thorax became more widely known after 1808 with the translation of Auenbrugger's work from Latin into French by ]Jean-Nicolas Corvisart
Jean-Nicolas Corvisart-Desmarets (15 February 1755 – 18 September 1821) was a French physician.
Born in the village of Dricourt (now in Ardennes), Corvisart studied from 1777 at the Ecole de Médecine in Paris, later qualifying as ''docte ...
.
* In 1819 the introduction of the stethoscope by René Laennec
René-Théophile-Hyacinthe Laennec (; 17 February 1781 – 13 August 1826) was a French physician and musician. His skill at carving his own wooden flutes led him to invent the stethoscope in 1816, while working at the Hôpital Necker ...
began to replace the centuries-old technique of immediate auscultation
Auscultation (based on the Latin verb ''auscultare'' "to listen") is listening to the internal sounds of the body, usually using a stethoscope. Auscultation is performed for the purposes of examining the circulatory and respiratory systems (hea ...
– listening to the heart by placing the ear directly on the chest, with mediate auscultation using the stethoscope to listen to the sounds of the heart and respiratory tract. Laennec's publication was translated into English, 1821–1834, by John Forbes
* The 1846 introduction by surgeon John Hutchinson (1811–1861) of the spirometer
A spirometer is an apparatus for measuring the volume of air inspired and expired by the lungs. A spirometer measures ventilation, the movement of air into and out of the lungs. The spirogram will identify two different types of abnormal ventilat ...
, an apparatus for assessing the mechanical properties of the lungs via measurements of forced exhalation and forced inhalation. (The recorded lung volumes
Lung volumes and lung capacities refer to the volume of air in the lungs at different phases of the respiratory cycle.
The average total lung capacity of an adult human male is about 6 litres of air.
Tidal breathing is normal, resting breath ...
and air flow rates are used to distinguish between restrictive disease (in which the lung volumes are decreased: e.g., cystic fibrosis
Cystic fibrosis (CF) is a rare genetic disorder that affects mostly the lungs, but also the pancreas, liver, kidneys, and intestine. Long-term issues include difficulty breathing and coughing up mucus as a result of frequent lung infections. O ...
) and obstructive diseases (in which the lung volume is normal but the air flow rate is impeded; e.g., emphysema
Emphysema, or pulmonary emphysema, is a lower respiratory tract disease, characterised by air-filled spaces ( pneumatoses) in the lungs, that can vary in size and may be very large. The spaces are caused by the breakdown of the walls of the alve ...
).)
* The 1851 invention by Hermann von Helmholtz
Hermann Ludwig Ferdinand von Helmholtz (31 August 1821 – 8 September 1894) was a German physicist and physician who made significant contributions in several scientific fields, particularly hydrodynamic stability. The Helmholtz Association, ...
(1821–1894) of the ophthalmoscope
Ophthalmoscopy, also called funduscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or funduscope). It is done as part of an eye examination and may be done as part ...
, which allowed physicians to examine the inside of the human eye.
* The () immediate widespread clinical use of Sir Thomas Clifford Allbutt's (1836–1925) six-inch (rather than twelve-inch) pocket clinical thermometer
A medical thermometer (also called clinical thermometer) is a device which is used for measuring human or animal body temperature. The tip of the thermometer is inserted into the mouth under the tongue (''oral'' or ''sub-lingual temperature''), ...
, which he had devised in 1867.[Allbutt, T.C., "Medical Thermometry", British and Foreign Medico-Chirurgical Review]
Vol. 45, No. 90, (April 1870), pp. 429–41
Vol. 46, No. 91, (July 1870), pp. 144–56.
/ref>
* The 1882 introduction of bacterial cultures by Robert Koch
Heinrich Hermann Robert Koch ( , ; 11 December 1843 – 27 May 1910) was a German physician and microbiologist. As the discoverer of the specific causative agents of deadly infectious diseases including tuberculosis, cholera (though the Vibrio ...
, initially for tuberculosis
Tuberculosis (TB) is an infectious disease usually caused by '' Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in ...
, being the first laboratory test to confirm bacterial infections.
* The 1895 clinical use of X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
s which began almost immediately after they had been discovered that year by Wilhelm Conrad Röntgen
Wilhelm may refer to:
People and fictional characters
* William Charles John Pitcher, costume designer known professionally as "Wilhelm"
* Wilhelm (name), a list of people and fictional characters with the given name or surname
Other uses
* Mount ...
(1845–1923).
* The 1896 introduction of the sphygmomanometer
A sphygmomanometer ( ), a blood pressure monitor, or blood pressure gauge, is a device used to measure blood pressure, composed of an inflatable cuff to collapse and then release the artery under the cuff in a controlled manner, and a mercury ...
, designed by Scipione Riva-Rocci
Scipione Riva Rocci (7 August 1863 in Almese, Piedmont – 15 March 1937 in Rapallo, Liguria) was an Italian internist, pathologist and pediatrician. He is best known for the invention of an easy-to-use cuff-based version of the mercury sphy ...
(1863–1937), to measure blood pressure.
Diagnosis
The recognition of signs, and noting of symptoms may lead to a diagnosis. Otherwise a physical examination
In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the pati ...
may be carried out, and a medical history
The medical history, case history, or anamnesis (from Greek: ἀνά, ''aná'', "open", and μνήσις, ''mnesis'', "memory") of a patient is information gained by a physician by asking specific questions, either to the patient or to other peo ...
taken. Further diagnostic medical tests such as blood tests, scans, and biopsies
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
, may be needed. An X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10 picometers to 10 nanometers, corresponding to frequencies in the range 30&nb ...
for example would soon be diagnostic or not of a bone fracture. A noted significance detected during an examination or from a medical test may be known as a medical finding.
Examples of signs and symptoms
* Ascites
Ascites is the abnormal build-up of fluid in the abdomen. Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. Symptoms may include increased abdominal size, increased weight, ab ...
* Nail clubbing
Nail clubbing, also known as digital clubbing or clubbing, is a deformity of the finger or toe nails associated with a number of diseases, mostly of the heart and lungs.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. ...
(deformed nails)
* Cough
A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three pha ...
* Death rattle
Terminal respiratory secretions (or simply terminal secretions),, known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throa ...
(last moments of life)
* Hemoptysis
Hemoptysis is the coughing up of blood or blood-stained mucus from the bronchi, larynx, trachea, or lungs. In other words, it is the airway bleeding. This can occur with lung cancer, infections such as tuberculosis, bronchitis, or pneumonia, a ...
(blood-stained sputum)
* Jaundice
Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme meta ...
* Organomegaly Organomegaly is the abnormal enlargement of organs. For example, cardiomegaly is enlargement of the heart. ''Visceromegaly'' is the enlargement of abdominal organs. Examples of visceromegaly are enlarged liver (hepatomegaly), spleen (splenomegaly
...
an enlarged organ such as the liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
(hepatomegaly
Hepatomegaly is the condition of having an enlarged liver. It is a non-specific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. Often, hepatomegaly will present as an abdomi ...
)
* Palmar erythema
Palmar erythema is reddening of the palms at the thenar and hypothenar eminences.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. .
Causes
It is associated with ...
(reddening of hands)
* Hypersalivation
Hypersalivation, or ptyalism, also known as sialorrhea or hypersialosis is the excessive production of saliva. It has also been defined as increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.Medscape ...
excessive (saliva)
* Unintentional weight loss
Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other con ...
See also
* Biomarker (medicine)
In medicine, a biomarker is a measurable indicator of the severity or presence of some disease state. More generally a biomarker is anything that can be used as an indicator of a particular disease state or some other physiological state of an org ...
* Focal neurologic signs
Focal neurologic signs also known as focal neurological deficits or focal CNS signs are impairments of nerve, spinal cord, or brain function that affects a specific region of the body, e.g. weakness in the left arm, the right leg, paresis, or pleg ...
References
{{DEFAULTSORT:Medical Sign
Symptoms