Which of the following sets comprises standard meningeal signs?

• A. Nuchal rigidity, Brudzinski sign, Kernig sign
• B. Romberg sign
• C. Babinski sign
• D. Hoffmann sign

Answer: (D)

Signs of meningitis reflect irritation of the meninges. The classic set includes neck stiffness (nuchal rigidity) and two provocative maneuvers: Brudzinski sign, where neck flexion elicits hip and knee flexion, and Kernig sign, where inability or pain prevents straightening the leg when the hip is flexed. These responses arise specifically from meningeal irritation and are taught as the standard indicators of meningismus.

Other tests like Romberg assess balance and proprioception rather than meningeal irritation. Babinski and Hoffmann signs are upper motor neuron findings indicating corticospinal tract or cervical spinal involvement, not meningitis. So the signs that comprise standard meningeal signs are the neck stiffness plus the Brudzinski and Kernig signs.