Which sign is used to assess meningeal irritation?

Which sign is used to assess meningeal irritation?

• A. Kernig's sign
• B. Brudzinski's sign
• C. Nuchal rigidity sign
• D. All of the above

Answer: (D)

Meningeal irritation shows up as specific signs when the coverings around the brain and spinal cord are inflamed, such as in meningitis or subarachnoid hemorrhage. Kernig’s sign is tested by having the patient lie supine, flexing the hip and knee to 90 degrees, then attempting to straighten the knee; pain or resistance during extension suggests a positive sign. Brudzinski’s sign involves passively flexing the neck; if this causes involuntary flexion of the hips and knees, it’s positive. Nuchal rigidity refers to stiff neck with limited ability to passively flex the neck. Each of these signs points to irritation of the meninges, and because a patient may show one sign but not another, clinicians assess all of them. That’s why the best answer is that all of these signs are used to assess meningeal irritation.

Meningeal irritation shows up as specific signs when the coverings around the brain and spinal cord are inflamed, such as in meningitis or subarachnoid hemorrhage. Kernig’s sign is tested by having the patient lie supine, flexing the hip and knee to 90 degrees, then attempting to straighten the knee; pain or resistance during extension suggests a positive sign. Brudzinski’s sign involves passively flexing the neck; if this causes involuntary flexion of the hips and knees, it’s positive. Nuchal rigidity refers to stiff neck with limited ability to passively flex the neck. Each of these signs points to irritation of the meninges, and because a patient may show one sign but not another, clinicians assess all of them. That’s why the best answer is that all of these signs are used to assess meningeal irritation.