Trachea dips with each pulse

aneurysm or dilatation of the aortic arch

• Says pulsation of larynx in aortic regurgitation is Oliver-Cardarelli sign. Maybe. See below. [101]
• Contains a thorough discussion of the Oliver and Cardarelli signs, which are distinct. The Oliver sign is a tracheal tug felt when displacing the larynx superiorly, while the Cardarelli sign is felt with leftward laryngeal displacement. Presumably any condition in which the aortic arch is dilated can cause a tracheal tug, including, but certainly not restricted to, aortic regurgitation. [102]
• Libman, the great New York diagnostician, describes the exact opposite of the tracheal tug: tracheal fixation.

  This is determined by attempting to push the larynx upward, by pushing upon the cricoid cartilage. Usually there is a good degree of mobility. When the sign is definite, the larynx cannot be budged. I do not lay stress on the absence of the sign except in young people with a long neck. In individuals with a short neck, I do not lay stress on the absence of the sign. [sic.]

  This is odd wording -- was there a misprint? Tracheal fixation indicates mediastinal disease, e.g. mediastinal adenopathy in tuberculosis, but especially neoplasia. Libman notes that a tracheal tug and fixation may both be present when there is an aortic aneurysm. [103]
• Mistakenly calls examination for mediastinal fixation the "tracheal tug" technique. [104]