Kernig's sign is associated with?

DSSSB Public Health Nurse - 2015

Medical & Surgical Nursing

Easy

Appeared in: DSSSB Public Health Nurse - 2015

Explanation

Kernig's sign is a key physical examination finding that indicates meningeal irritation, a hallmark of meningitis.
The sign is elicited by flexing the patient's hip and knee to 90 degrees while they are supine, and then attempting to straighten the leg.
A positive sign is characterized by pain and resistance to knee extension, which occurs because the movement stretches the inflamed meninges and spinal nerve roots.
This sign, along with Brudzinski's sign, helps in the early clinical diagnosis of meningitis, prompting further investigation like a lumbar puncture.

Option B: Spinal cord injury presents with motor, sensory, and autonomic deficits corresponding to the level of the spinal lesion, not with signs of meningeal irritation like Kernig's sign.
Option C: While a ruptured cerebral aneurysm can cause subarachnoid hemorrhage and subsequent meningeal irritation, Kernig's sign is a more direct and classic indicator of meningitis, which is a primary inflammatory process of the meninges.
Option D: Seizures are a result of abnormal electrical activity in the brain and manifest as convulsions or altered consciousness. Kernig's sign is a test of mechanical irritation of the meninges, not a sign of a seizure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Clinical signs of meningeal irritation as background academic context rather than a clinical decision trigger.
Nurses must be proficient in assessing for Kernig's and Brudzinski's signs in any patient with suspected meningitis (e.g., presenting with fever, headache, nuchal rigidity).
A positive sign is a critical finding that requires immediate reporting to the physician for prompt diagnostic workup (like a lumbar puncture) and initiation of antibiotic therapy to prevent severe neurological damage.
What if? If the patient is an infant under 1 year old, Kernig's and Brudzinski's signs are often absent or unreliable. The nurse should instead prioritize assessing for other signs of meningitis like a bulging fontanelle, high-pitched cry, irritability, and poor feeding.

How to Approach the Question

This is a factual recall question that tests your knowledge of a specific clinical sign.
First, identify the key term in the question stem: 'Kernig's sign'.
Recall the definition and clinical purpose of this sign. Kernig's sign is a physical maneuver used to test for meningeal irritation.
Next, analyze the options provided and determine which condition is primarily characterized by inflammation of the meninges.
Meningitis is, by definition, the inflammation of the meninges. Therefore, a positive Kernig's sign is directly associated with it.
Rule out the other options by recalling their primary signs and symptoms, which differ from meningeal irritation.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1568-1570

E6 Medicine Harrison 22e Part 1 pp. 1161-1163, 1169-1171