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Questions and Answers
What does the Brudzinski sign involve during a physical examination?
When a physician applies pressure to elicit the Brudzinski sign, what reflexive movement is expected from the patient?
What is one possible reason for a false negative result when testing for the Brudzinski sign?
In addition to bacterial meningitis, what other form of meningitis is the Brudzinski sign useful for differentiating?
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What can the presence of the Brudzinski sign along with positive Kernig's sign, high fever, stiff neck, altered consciousness, or focal deficits suggest?
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What does irritability along the course of the cervical nerve roots between C2 and T1 vertebrae suggest when eliciting the Brudzinski sign?
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What does the Brudzinski sign involve during a physical examination?
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What does the presence of the Brudzinski sign indicate?
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In the Brudzinski sign test, at what angle are the patient's knees typically bent above the bed?
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What is indicated by a positive Brudzinski sign during a neurological exam?
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What action should the examiner take if a patient exhibits a positive Brudzinski sign?
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What is the purpose of lifting the upper limb while holding the knee flexed at 90 degrees in a Brudzinski sign test?
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Study Notes
Brudzinski Sign
The Brudzinski sign is a clinical diagnostic test used by medical professionals to evaluate neurological conditions such as meningitis. It was named after Dr. Franz Brudzinski, who first described it in 1956 while working at the University of Chicago.
Definition
The Brudzinski sign involves flexion of both arms when passively moving a patient's neck from side to side, which indicates a spinal cord involvement. This response suggests irritability along the course of the cervical nerve roots between C2 and T1 vertebrae.
Physical Examination
During a physical examination, the physician gently moves the patient's head from side to side, applying pressure with just enough force to elicit a reflexive movement. If the sign is present, the patient will simultaneously bend their arms and bring them toward their chest. However, this sign may also occur due to other reasons, including cervical spondylopathy.
In some cases, the presence of the Brudzinski sign might suggest subarachnoid hemorrhage if accompanied by positive Kernig's sign, high fever, stiff neck, altered consciousness, or focal deficits. False negatives can occur in patients with severe meningeal inflammation, suggesting the need for careful interpretation of these signs.
Clinical Significance
The Brudzinski sign has been reported as being useful in differentiating bacterial meningitis from viral meningitis, but its sensitivity is limited. In one study, the overall accuracy for detecting bacterial meningitis was reported to be around 75%, with higher values found in children than adults. However, the Brudzinski sign is not specific for bacterial meningitis; it can also occur due to other conditions such as upper motor neurone disorders and peripheral neuropathies.
In summary, while the Brudzinski sign is useful in assessing patients suspected of having meningeal irritation, its presence should be interpreted cautiously, considering the limitations of its accuracy.
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Description
Learn about the Brudzinski sign, a clinical test used to evaluate neurological conditions like meningitis. Understand the physical examination process and the clinical significance of this sign in diagnosing meningeal irritation.
