Pemberton's Maneuver


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). In this patient obstruction of venous return is due to a combination of mediastinal adenopathy and constrictive pericarditis due to amyloidosis.