Neurological Disorders Q 76

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Which of the following assessment data indicated nuchal rigidity?

  

     A. Positive Kernig’s sign

     B. Negative Brudzinski’s sign

     C. Positive homan’s sign

     D. Negative Kernig’s sign

    

    

Correct Answer: A. Positive Kernig’s sign

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A positive Kernig’s sign indicated nuchal rigidity, caused by an irritative lesion of the subarachnoid space. Brudzinski’s sign is also indicative of the condition. To elicit the Kernig sign, clinicians typically perform the exam with the patient lying supine with the thighs flexed on the abdomen, and the knees flexed. The examiner then passively extends the legs. In the presence of meningeal inflammation, the patient will resist leg extension or describe pain in the lower back or posterior thighs, which indicates a positive sign.

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Option B: Brudzinski’s sign is characterized by reflexive flexion of the knees and hips following passive neck flexion. To elicit this sign, the examiner places one hand on the patient’s chest and the other hand behind the patient’s neck. The examiner then passively flexes the neck forward and assesses whether the knees and hips flex. Upon passive neck flexion, a positive test results when the patient flexes his knees and hips.

Option C: Homan’s sign test also called dorsiflexion sign test is a physical examination procedure that is used to test for deep vein thrombosis (DVT). A positive Homan’s sign in the presence of other clinical signs may be a quick indicator of DVT. Clinical evaluation alone cannot be relied on for patient management, but when carefully performed, it remains useful in determining the need for additional testing (like D-dimer test, ultrasonography, multidetector helical computed axial tomography (CT), and pulmonary angiography)

Option D: When the meninges in the spinal cord and spinal nerves are inflamed, patients will resist stretching the cord and the nerves to prevent pain resulting from this inflammation. These clinical maneuvers appear to provoke this stretching.; this is why contractures occur when performed, resulting in a positive test.

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