Tracheal Tug - a sign in aortic aneurysm & COPD - with video

This term refers to the downward displacement of the trachea in some conditions.

Tracheal tug is not an easy sign to elicit. The examiner has to stand behind the patient, bend the patient's neck backwards and grip the cricoid cartilage of the trachea. If tracheal tug is present, then the examiner will feel the pulling down sensation on the trachea during every heart beat or with inspiration depending on the cause of the tracheal tug.

There are two distinct tracheal tugs described in literature.

Tracheal Tug (Olivers sign) – Downward displacement of the cricoid cartilage with ventricular contraction – observed in patients with an aortic arch aneurysm

Original description of the technique: "Place the patient in the erect position, and direct him to close his mouth, and elevate his chin to the fullest extent, then grasp the cricoid cartilage between the finger and thumb, and use gentle upward pressure on it, when if dilatation or aneurism exist, the pulsation of the aorta will be distinctly felt transmitted through the trachea to the hand. This act of examination will increase laryngeal distress should this accompany the disease."


Tracheal Tug (Campbell’s sign) – Downward dispacement of the thyroid cartilage during inspiration – seen in patients with COPD

If you have any additional comments to make or resources to quote, you can do so by replying to this topic.

Here is a video that I have uploaded onto Youtube:



Notice how the thyroid cartilage (Adam's apple) moves down with each inspiration.