You are currently viewing Nails : How To Physically Examine ? [Mnemonics]

The Mnemonic “LEAP ON” will help in physical examination of nails during your clinical rounds as well as during med exams.

Changes in nail are often a harbinger of other systemic diseases. This is why a thorough physical examination is very essential to remove other possible health conditions

Here is a step by step examination sequence of nails in the form of a mnemonic 


Step By Step Approach to Examining Nails

    • L – Look across the nail bed from the side of each finger.
    • E – Estimate the interphalangeal depth at the level of the distal interphalangeal joint and nail bed.
    • A – Assess the nail-bed (hyponychial) angle.
    • P – Place the nails of corresponding (ring) fingers back to back and look for Schamroth’s window sign.
    • O – Observe for fluctuant movement of the nail on the nail bed using thumbs and index fingers.
    • N – Note if the interphalangeal depth ratio is >1, the nail fold angle is >190 degrees, and Schamroth’s window sign is absent.

Mnemonic: LEAP ON


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department