Lab 9 - Pathological Reflexes Flashcards
Spasticity
Motor disorder characterized by velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks resulting in hyperexcitability of a stretch reflex
Muscle tone
Sensation of resistance felt as one manipulates a joint through ROM
What are 3 components of muscle tone
- Physical inertia of the extremity
- Mechanical/elastic characteristics of muscle and connective tissue
- Reflex muscle contraction
List 5 different characteristics of tone and describe their movements
T or F: Muscle tone and movement is a cause-and-effect relationship
F, there is a correlation but not a cause
What is the grading scale for tone
Where are the 5 areas and movements we use that assess tone
- Elbow flexion/extension
- Shoulder abduction/adduction
- Hip abduction/adduction
- Ankle plantarflexion/dorsiflexion
- Knee flexion/extension
How to assess tone and why
- Tell client what you are doing
- Get them into appropriate positioning
- Move limb up and down at different speeds and different angles
WHY: We want to assess tone to see if it prevents or enhances movements and could be result of movement impairments
How to assess the pendular reflex
To test knee extension tone. Client is seated with knee extended and thigh supported on bed. Drop passive leg over side of bed and count pendular swings (2 or 3 is considered normal)
How to assess Hoffmans reflex and what does it tell us
- Hold patients hand well supported in palm of your hand
- Examiner blocks the pip of 3rd digit into extension with thumb and finger
- Using other hand flix the terminal phalanx of the the 3rd finger into flexion
Positive result = slight palmar or digit flexion of thumb and index finger meaning there is an issue with the upper motor neuron
How to assess plantar response (Babinski sign) and what does it tell us
A strong j-shaped stroking stimulus is applied to the sole of the foot along lateral surface and up across the ball of the foot
Normal response = flexion of the big toe or no response at all
Abnormal response = extension of the big toe which is a sign of corticospinal dysfunction
How to assess clonus
Patient is in supine and examiner cradles calf in one hand and places client’s heel in other hand with their foot aligned up to the forearm. Quick dorsiflexion movement of foot is performed and feel for a 1,2, 3 beat or sustained clonus response
What are the 5 frontal lobe reflexes
- Grasping
- Groping
- Glabellar
- Snout
- Gegenhalten
What is important when assessing any pathological reflexes and why do we assess pathological reflexes
Assess bilaterally and to see if there is loss of cortical inhibition
how to assess the grasping reflex and what is an abnormal response
Move edge of reflex hammer across patient’s palm from their wrist to fingertip
Abnormal: Obligatory finger flexion or grasp of the reflex hammer
