Neck stiffness
Xiangqiang 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. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: The neck should be fully relaxed a few days before the test to prevent the neck from being sore and affecting the test results. Normal value When looking up, the normal person's neck is soft and free to move, and the lower jaw can reach the chest, the neck is not resistant, and the lower limbs do not move when looking up. Clinical significance Abnormal results: 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. Need to check the crowd: a variety of meningitis or meningeal irritative lesions, increased intracranial pressure, posterior cranial fossa lesions, tetanus, neck disorders, such as cervical spondylosis, tuberculosis, trauma, deformity and other patients. Precautions Taboo before inspection: 1. The neck should be fully relaxed a few days before the examination to prevent the neck from being sore and affecting the test results. 2, children should be calmed before the children check the mood. Requirements for inspection: 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. Inspection process (1) The lying position examination method: the patient is supine, the examiner reaches the chest with one hand to fix the upper body, and the other hand lifts the head, first gently turns to both sides, and then the head is flexed forward. Normally, the neck is soft and free to move, and the chin can reach the chest, and the lower limbs do not move when looking up. If the patient's neck is stiff and resistant when looking up, the lower jaw cannot touch the chest, which is the item's rigidity. During the examination, it should be noted whether the patient's knee joints flex with the head. (2) Seat check method: 1 seat down test: the patient sits, the two lower limbs are straight, so that the lower limbs and the trunk are at right angles. The paralyzed patient should bow as much as possible. When normal, the lower jaw can reach his chest. If you look down, see the patient's part is stiff, can not make the lower jaw touch the front chest, and there is neck pain, which is the test positive, but also the item is straight. 2 Knee test: The patient is seated, the knees and hips are flexed as much as possible, and the lower jaw is placed as far as possible to contact the knee. Normally, the lower jaw should be able to contact the knee. If it is not accessible, it is a test positive and also an item of rigidity. (3) Pediatric examination method: The examiner holds the lower limbs of the sick child with one hand and holds the head of the sick child with another hand. If the child is raised, it can be seen that the lower body of the sick child is lifted together, which is the item of rigidity. Not suitable for the crowd Inappropriate population: Patients with injured or deformed cervical vertebral bodies themselves. Adverse reactions and risks Nothing.
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