Physical examination maneuver

Physical Exam

Finger-to-nose

🎬
Video coming September 2026

How to Perform

Ask the patient to alternately touch the tip of their own nose and then your fingertip held at arm's length, repeating as you move your finger to different positions. Watch the movement for accuracy and smoothness, including any overshoot (dysmetria) or a tremor that worsens as the finger nears a target (intention tremor).

How to Interpret

Showing 2 of 8 findings

Stroke

Limb ataxia (dysmetria) in a patient with acute dizziness
Rule in
Very helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Strong
Ataxia (limb or gait) in a patient with confirmed acute ischemic stroke
Rule in
HelpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Limited

References

  • Feys P, Davies-Smith A, Jones R, Romberg A, Ruutiainen J, Helsen WF, Ketelaer P. Intention tremor rated according to different finger-to-nose test protocols: a survey. Arch Phys Med Rehabil. 2003;84(1):79-82. doi:10.1053/apmr.2003.50068. PMID 12589625.
  • Tao WD, Liu M, Fisher M, et al. Posterior versus anterior circulation infarction: how different are the neurologic deficits? Stroke. 2012;43(8):2060-2065. doi:10.1161/STROKEAHA.112.652420. PMID: 22678088.
  • Litvan I, Goetz CG, Jankovic J, et al. What is the accuracy of the clinical diagnosis of multiple system atrophy? A clinicopathologic study. Arch Neurol. 1997;54(8):937-944. PMID: 9267967.
  • Runchey S, McGee S. Does this patient have a hemorrhagic stroke? Clinical findings distinguishing hemorrhagic stroke from ischemic stroke. JAMA. 2010;303(22):2280-2286. PMID: 20530782.
  • Shah VP, Oliveira J E Silva L, Farah W, et al. Diagnostic accuracy of the physical examination in emergency department patients with acute vertigo or dizziness: a systematic review and meta-analysis for GRACE-3. Acad Emerg Med. 2023;30(5):552-578. doi:10.1111/acem.14630. PMID: 36453134.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.

Related Systems / Regions

NeurologicalUpper Extremities

Related Bedside Tests

🎬Video coming Sept 2026
Gait Assessment
Rule in:VHStroke, HFalls, HVascular Parkinsonism +24 more
Rule out:SHDementia, SHVascular Parkinsonism, MHFalls +24 more
🎬Video coming Sept 2026
Heel-to-shin
aka Heel-knee-shin test
Rule in:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia
Rule out:IECerebellar Disease, IEMultiple Sclerosis, IESensory Ataxia
🎬Video coming Sept 2026
Pronator Drift
Rule in:VHBrain Tumor, VHFunctional Neurologic Disease, HStroke +5 more
Rule out:VHFunctional Neurologic Disease, VHStroke, MHBrain Tumor +5 more
🎬Video coming Sept 2026
Babinski Reflex
aka Plantar reflex
Rule in:VHUpper Motor Neuron Lesion, VHVascular Parkinsonism, IEMotor Neuron Disease +4 more
Rule out:SHUpper Motor Neuron Lesion, NHVascular Parkinsonism, IEMotor Neuron Disease +4 more
🎬Video coming Sept 2026
Patellar Deep Tendon Reflex
aka Knee jerk
Rule in:VHPeripheral Neuropathy, SHLumbosacral Radiculopathy, IECerebellar Disease +5 more
Rule out:SHPeripheral Neuropathy, ICLumbosacral Radiculopathy, IECerebellar Disease +5 more
🎬Video coming Sept 2026
Tandem Gait
aka Heel-to-toe walking
Rule in:HAtypical Parkinsonism, SHParkinson Disease, SHVestibular Dysfunction +4 more
Rule out:HAtypical Parkinsonism, HParkinson Disease, SHVestibular Dysfunction +4 more