NREMT Paramedic Practice

Brudzinski's sign is characterized by which response?

1. Pain in the lower back

2. Automatic flexing of the knees when the neck is bent

3. Loss of coordination in the legs

4. Irregular respirations

The correct answer is: Automatic flexing of the knees when the neck is bent

Brudzinski's sign is a clinical indication often assessed during a neurological examination, particularly when meningitis is suspected. The key feature of Brudzinski's sign is that when the neck is passively flexed, the patient involuntarily flexes their knees and hips. This response occurs because of the irritation of the meninges – the protective membranes covering the brain and spinal cord – which results in a reflexive action to relieve discomfort caused by stretching these membranes. When the meninges are inflamed, as in the case of meningitis, any movement of the neck can trigger discomfort or pain, prompting this involuntary response. Therefore, the presence of automatic flexing of the knees (the correct answer) indicates a positive Brudzinski's sign and can be an important diagnostic clue in assessing central nervous system conditions. Other responses, such as loss of coordination or irregular respirations, are not characteristic of Brudzinski's sign and indicate different neurological issues. Pain in the lower back could relate to various conditions but does not directly pertain to the sign itself. Thus, identifying the correct physiological response is crucial for understanding and diagnosing conditions related to inflammation of the central nervous system.