Deep Tendon Reflexes

Question 1

What spinal level is being tested with biceps tendon testing? Describe position. What is the normal response?

Answer 1

Spinal Level C5*-C6 is being tested

Support the elbow in partial flexion in either sitting or supine and the thumb firmly over the bicep tendon at the elbow and strike the hammer through the thumb.

Normal response is elbow flexion/ contraction of bicep muscle

Question 2

What spinal level is being tested with brachioradialis tendon reflex? Describe procedure. What is a normal response?

Answer 2

C5-C6*

Rest patient’s forearm on yours with hand contact just distal to elbow and patients arm in neutral rotation (1/2 b/w supination and pronation), strike radius 1-2 inches proximal to wrist

Normal response: contraction of brachioradialis/ forearm supination and/ or elbow flexion

Question 3

What spinal level is being tested with tricep tendon reflex? Describe procedure. what is a normal response?

Answer 3

C6-C7*

Either support patient’s forearm with elbow flexed and shoulder extended and strike tricep tendon just proximal to olecranon process, or have patient extend/ horizontally adduct shoulder, with elbow flexed supporting arm just proximal to elbow and strike tricep tendon

Normal response is elbow extension

Question 4

What spinal level is being tested with patellar tendon reflex? Describe procedure. What is a normal response?

Answer 4

L3-L4

Have patient sitting with legs dangling off edge of table or chair and strike patellar tendon just inferior to patella

Normal response is knee extension/ quadriceps contraction

Question 5

What spinal level is being tested during an Achilles’ tendon reflex test? Describe procedure. What is considered a normal response?

Answer 5

S1-S2

Have patient sit with legs off of edge of table, passively move ankle into Dorsiflexion, and strike the Achilles’ tendon just proximal to calcaneus.

Normal response is plantar flexion of the ankle

Question 6

Which superficial reflex is being described: stroke the lateral aspect of the sole of the foot with the blunt end of a reflex hammer from the heel to the ball of the foot and medially to the base of the big toe? What is the normal response? Abnormal response?

Answer 6

PLANTAR REFLEX

Normal response- toe flexion

Abnormal response- BABINSKI (toes extend and abduct) indicates a CNS lesion

Question 7

What level of the spinal cord is being tested during the plantar reflex?

Answer 7

L5-S1

Question 8

What superficial reflex is being described: stroke briskly and lightly with blunt object from each quadrant of the abdomen in a diagonal manner toward the umbilicus? Normal response is contraction of the _ and deviation of the umbilicus in the _ of _.

Answer 8

ABDOMINAL REFLEX

Normal response is contraction of the ABDOMINALS and deviation of the umbilicus in the DIRECTION OF STIMULI

Question 9

which spinal level is being tested during the abdominal reflex?

Answer 9

T8-L1

Question 10

Which superficial reflex tests the trigeminal and facial nerves? Glossopharyngeal and vagus nerves?

Answer 10

CORNEAL ‘BLINK’ REFLEX- trigeminal and facial

GAG REFLEX- glossopharyngeal and vagus

Question 11

Which superficial reflex is being described: scratch the skin of the upper medial thigh? Normal response is a brisk and brief _ of the _ on the ipsilateral side. Which spinal level is being tested?

Answer 11

Cremasteric reflex

Normal response is brisk and brief ELEVATION of the TESTICLE on the Ipsilateral side.

L1-L2