meningeal irritation sign

The meningeal irritation sign is a pathological reflex that causes the spinal cord membrane to be stimulated and affects the spinal nerve roots when the meningeal lesion is caused. Found in meningitis, subarachnoid hemorrhage and increased intracranial pressure. Common meningeal irritation has neck stiffness, leg lift test, and Brudzinski sign. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: Negative when normal. Positive: Found in meningitis, subarachnoid hemorrhage and increased intracranial pressure. Tips: It is best not to do too vigorous and excessive exercise a few days before the examination, to calm the children's emotions before the examination. Normal value 1. When the neck is raised straight, the normal neck has no resistance, and the lower jaw can touch the chest. 2, leg lift test normal people knee joint extension > 135 degrees before pain occurs. 3, Brunzinski (Brudzinski) slammed his pubic symphysis without double lower limb flexion. Clinical significance Abnormal result 1. Item rigidity is a symptom of meningeal irritation and has important diagnostic value. Because the meninges at the posterior cranial fossa are stimulated, and thus the cervical spinal cord 1 to 4 and the corresponding cervical nerve roots are involved, the inner deep muscles, trapezius muscles and sternocleidomastoid muscles of the neck are over-stressed and contracted. More common in various meningitis or meningeal irritative lesions, such as subarachnoid hemorrhage. Can also be seen in increased intracranial pressure, posterior fossa lesions, tetanus, neck disorders, such as cervical spondylosis, tuberculosis, trauma, deformity and so on. In normal infants, the flexor muscle tension is higher than that of the extensor muscle, so there may be a strong sign of the item, which has no pathological significance. 2, leg lift test positive seen in various causes of meningitis, meningeal encephalitis, subarachnoid hemorrhage, meningeal leukemia, meningeal tumor, occipital foramen, soft meningitis and other spinal nerve roots are stimulated. It has a wide range of pain, not only for the lower back and lower limbs, but also for the chest and back. Sciatica is positive on the affected side, negative on the healthy side, and the pain is limited to the waist and the affected limb. 3, Brunzinski (Brudzinski) sign positive more common in acute (suppurative) soft meningitis, tuberculous meningitis. People who need to be examined: patients with various diseases and injuries involving the meninges, spinal cord membrane, lumbar vertebrae hyperplasia, intervertebral disc prolapse, etc. involving the lumbosacral nerve. Positive results may be diseases: subarachnoid hemorrhage, cryptococcal meningitis, coma, lacunar infarction, amnesia syndrome, brain subarachnoid hemorrhage Taboo before inspection: 1. It is best not to do too vigorous and excessive exercise a few days before the examination to prevent excessive secretion of muscle lactic acid and muscle soreness which may affect the examination results. 2, a few days before the examination to fully relax the neck, to prevent neck fatigue and affect the test results. 3, children should be calmed before the children check the mood. Requirements for inspection: First, the neck is strong: 1. The optional lying position check can also select the seat position check. 2, during the seat down test, if the lower jaw can not touch the front chest and there is neck pain, do not use force to bow, to prevent sprained neck. 3. During the knee-knee test, if the lower jaw cannot touch the knee, do not over-strive and prevent strain. Second, lift leg test: 1. Take the supine position during the examination, the two lower limbs are close together and the muscles are relaxed. 2. When the leg is stretched and the knee is painful and resistant, do not continue to stretch. 3. If the doctor raises the patient's calf and stretches the knee, if there is pain, tell the doctor promptly so that the doctor can make the correct diagnosis and treatment. Third, the Bruzinski levy: to relax when checking, to prevent the inspection can not be carried out smoothly due to tension. Inspection process 1. Neck stiffness: The paralyzed patient is supine, and the patient's occipital part is supported by the hand to support the passive neck flexion to test the cervical muscle resistance. The neck stiffness is enhanced by the resistance to passive neck flexion, which is the most susceptible to extensor muscles when they are sick. In addition to the above-mentioned intracranial diseases, neck stiffness can also occur when suffering from cervical spondylosis, cervical arthritis, cervical tuberculosis, fractures, dislocations, and muscle injuries. 2. Lifting leg test: The paralyzed patient is supine, first bend one hip joint into a right angle, and then raise the lower leg with a finger. The normal person can extend the knee joint to 135 degrees or more. Positive expression is limited knee extension, accompanied by pain and flexor tendon. 3. Brudzinski's sign: The patient is lying on his back and the lower extremity is naturally straight. The doctor holds the patient's occiput with one hand and one hand on the chest of the patient, then bends the head forward; positive expression is the knee joint on both sides and Hip flexion. Not suitable for the crowd 1. Neck stiffness: A patient who is injured or deformed by the cervical vertebral body itself. 2, leg lift test: leg, hip joint, knee joint itself damage, deformity. 3, Bruzinski sign: the neck itself is damaged, deformed. Adverse reactions and risks May cause muscle soreness.

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