North American Registry of Midwives (NARM) Practice Exam

Which sign is typically measured by flexing the thigh and extending the knee to check for meningeal irritation?

1. Brudzinski's sign

2. Kernig's sign

3. Chandelier sign

4. Goodell's sign

The correct answer is: Kernig's sign

Kernig's sign is the correct answer as it specifically refers to the pain or resistance experienced when flexing the thigh at the hip and then attempting to extend the knee. This maneuver tests for meningeal irritation, which occurs when the meninges—the protective membranes covering the brain and spinal cord—are inflamed. In the case of meningitis or other conditions that affect the meninges, this action can elicit discomfort or an involuntary reflex to resist the extension of the leg. This sign is particularly useful in a clinical setting to help identify potential central nervous system infections. Other signs mentioned in the options have different diagnostic purposes. Brudzinski's sign, for instance, involves involuntarily bending the knees when the neck is flexed and is also indicative of meningeal irritation, but it’s a different maneuver compared to Kernig’s. The Chandelier sign is related to pelvic inflammatory disease and presents with pain upon palpation of the cervix, while Goodell's sign is an indication of cervical softening during pregnancy and is not connected to meningeal irritation. Understanding these distinctions is crucial for effectively evaluating and diagnosing conditions involving the nervous system and reproductive health.