Questions and Answers
Match the following descriptions with their corresponding signs or measures:
Purpura or petechia of the skin = may occur with meningococcemia Brudzinski's sign = passive flexion of the neck resulting in flexion of the hips and knees Kernig's sign = straightening of the knee with a flexed hip resulting in back and neck pain Peripheral white count = measure of infection
Match the following signs with their corresponding actions or observations:
Brudzinski's sign = passive flexion of the neck resulting in flexion of the hips and knees Kernig's sign = straightening of the knee with a flexed hip resulting in back and neck pain Peripheral white count = assessed through blood tests CRP and/or ESR = other measures of infection
Match the following descriptions with their clinical signs:
Purpura or petechia of the skin = may indicate meningococcemia Brudzinski's sign = seen with passive neck flexion causing hip and knee flexion Kernig's sign = back and neck pain when straightening a flexed hip Peripheral white count = can indicate infection level
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Study Notes
Decerebrate Rigidity or Abnormal Extensor Posturing
- Decerebrate posture is a sign of severe brain injury characterized by rigidity in the arms and legs due to damage to the brainstem.
- It is depicted by a patient lying on their back with their arms extended and legs straightened.
Decorticate Posturing
- Characterized by elbows, wrists, and fingers being flexed, and legs being extended and rotated inward.
- May be accompanied by purpura or petechia of the skin, which can occur with meningococcemia.
- Assessment includes meningeal irritation tests, such as:
- Brudzinski's sign: passive flexion of the neck resulting in flexion of the hips and knees.
- Kernig's sign: straightening of the knee with a flexed hip resulting in back and neck pain, present in 50% of cases.
- Diagnosis may also involve:
- Peripheral white count.
- Other measures of infection, such as CRP and/or ESR.
Brudzinski's Sign
- Indicates meningeal irritation, a symptom of conditions like meningitis, subarachnoid hemorrhage, or central nervous system infections.
Nuchal Rigidity
- Also known as neck stiffness, a common symptom of meningeal irritation.
- Characterized by resistance to passive flexion of the neck.
- Patients may have difficulty touching their chin to their chest.
Kernig's Sign
- A clinical test to assess meningeal irritation.
- Involves flexing the patient's hip and knee to a 90-degree angle.
- Resistance to further flexion or pain in the lower back or posterior leg indicates a positive sign, suggesting meningeal irritation.
Meningeal Irritation
- Occurs when the meninges (protective membranes surrounding the brain and spinal cord) become inflamed.
- Causes include bacterial or viral infections, subarachnoid hemorrhage, and chemical irritation.
- Symptoms may include headache, fever, nausea, vomiting, and photophobia.
Neck Stiffness
- A common symptom of meningeal irritation and Brudzinski's sign.
- May be accompanied by pain or discomfort in the neck, back, or head.
- Assessed by attempting to passively flex the patient's neck.
Cerebrospinal Fluid Examination
- A diagnostic test to assess for central nervous system infections or inflammation.
- Involves collecting a sample of CSF through a lumbar puncture (spinal tap).
- Examination may include tests for cell count, protein and glucose levels, and bacterial or viral cultures.
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Description
Identify the signs of severe brain injury through decerebrate posture, characterized by rigidity in the arms and legs due to brainstem damage.