DEEP TENDON REFLEXES

Question 1

Function of testing deep tendon reflexes

Answer 1

assess integrity of the peripheral and central nervous systems; diagnosis of central and peripheral nervous system disorders

Question 2

Procedure DTR testing:

Answer 2

-use of a reflex hammer on tendon being tested;
assess bilaterally; wide end of hammer- broad tendons (patellar and triceps)

tap the tendon briskly to adequately activate the muscle spindle; hold handle somewhat loosely, and the motion should originate from your wrist in a quick “flicking’ motion

assess when the patient is as relaxed as possible;

** TEST UNAFFECTED SIDE FIRST

Question 3

SCORING DTR

Answer 3

0- no reflex,
1+ minimal or depressed response,
2+ normal response,
3+ overly brisk response,
4+ extremely brisk response with clonus, which is an involuntary repetitive back and forth motion

LACK OF REFLEX- LMN INJURY
EXAGGERATED REFLEX- UMN INJURY

Question 4

Reasons for hypotonic or hypertonic DTR

Answer 4

hypotonic DTR- due to injury or compression along the nerve pathway (bulging or herniated nucleus pulpossis); can also be caused by stenosis of intervertebral foramen, peripheral nerve injury, or peripheral nervous system disorders ; usually found unilaterally (LMN)

hypertonic DTRs- central nervous system pathology; injury to the cortex or corticospinal tract at any point superior to the synapse at the spinal cord (prevent inhibitory, descending modulation); usually bilateral; often seen in individuals with severe traumatic brain injury (UMN injury)

Question 5

Nerve root associated with biceps brachii tendon?

Answer 5

C5 (C6)

Question 6

Nerve root associated with brachioradialis

Answer 6

C6 (C5)

Question 7

Nerve root associated with triceps brachii?

Answer 7

C7 (C6)

Question 8

Nerve root associated with patellar tendon

Answer 8

L4 (L2, L3)

Question 9

Nerve root associated with biceps brachii tendon?

Answer 9

C5 (C6)

peripheral nerve: musculocutaneous

Question 10

Nerve root associated with brachioradialis

Answer 10

C6 (C5)

peripheral nerve: radial nerve

Question 11

Nerve root associated with triceps

Answer 11

C7 (C6)

peripheral nerve: radial nerve

Question 12

nerve root associated with patellar tendon

Answer 12

L4 (L2, L3)

peripheral nerve: femoral nerve

Question 13

nerve root associated with achilles tendon:

Answer 13

S1 (S2)

peripheral nerve: tibial nerve