Kernig’s Sign

A physical finding indicating meningeal irritation

Definition

Kernig’s sign is a clinical test for meningeal irritation. With the patient supine and hip flexed 90°, attempts to extend the knee elicit resistance and pain in the hamstrings and back.

Associated Conditions

  • Bacterial meningitis
  • Subarachnoid hemorrhage
  • Meningeal metastases
  • Tuberculous meningitis

Related Signs

  • Brudzinski's sign: Involuntary hip and knee flexion when the neck is flexed.
  • Nuchal rigidity: Stiff neck.
  • Photophobia, headache, fever, altered mental status: Classic meningitis triad.

Nursing Interventions

Suspect meningitis and initiate droplet precautions for bacterial meningitis until organism identified. Prepare for lumbar puncture. Administer empiric antibiotics promptly (do not delay for LP). Seizure precautions. Monitor for increased ICP.

NCLEX Relevance

Kernig and Brudzinski are classic meningitis cues (droplet precautions).