Pemberton's Maneuver
PEMBERTON'S SIGN
Pemberton's sign is an indication of thoracic inlet onstruction. The maneuver is performed by having the patient elevate his or her arms so they touch the sides of their heads (click image to see video). This tends to "cork off" the thoracic inlet, particularly when there is a mediastinal mass (classically a substernal goiter). This patient has superior vena cava obstruction due to mediastinal adenopathy; he also has constrictive pericarditis, which has contributed to impaired right heart return and neck vein distension.