Muscle tone and reflex testing

Question 1

Reflex

Answer 1

• an involuntary, predictable and specific response to a stimulus dependent on an intact reflex arc (sensory receptor, afferent neuron, efferent neuron, responding muscle)
• there is also an influence from the brain

Question 2

Root levels for the DTR

Answer 2

• biceps C5 (C6)
• brachioradialis (C5) C6
• tricpes (C6) C7
• Patella (L2, L3) L4
• ankle S1 (S2)
  *outside () is what they mainly test

Question 3

reflex documentation scale

Answer 3

• 0 = absent/no visible or palpable muscle response
• 1+ hyporelexia/slight reflex present but depressed - low
• 2+ = normal
• 3+ = hyperreflexia/brisk reflex, possibly but not necessarily abnormal
• 4+ = abnormal/very brisk reflex, abnormal or clonus

Question 4

Hyporeflexia

Answer 4

• 0 and 1+
• generally occurs in lower motor neuron syndrome

Question 5

hyperreflexia

Answer 5

• 3+ and 4+
• generally occurs in upper motor neuron syndrome

Question 6

Jendrassik maneuver

Answer 6

• patient hooks fingers together and strongly pulls them apart

Question 7

Distraction techniques

Answer 7

• squeeze knees together for UE reflex, clench teeth, make tight fist

Question 8

Muscle tone definition

Answer 8

• resistance of muscle to passive elongation or stretch

Question 9

examination of tone

Answer 9

• observation of resting posture and palpation
• active motion testing/observation
• passive motion testing

Question 10

types of muscle tone

Answer 10

• spasticity
• rigidity
• dystonia

Question 11

Hypotonia

Answer 11

• hypotonia/flaccidity
• used to define decreased or absent muscle tone
• resistance to passive movement is diminished, stretch reflexes are dampened or absent and limbs are easily moved
• hyper extensibility of joints is common
• generally occurs with LMN syndrome

Question 12

Hypertonia types

Answer 12

• rigidity
• spasticity
• dystonia
• generally occurs with UMN

Question 13

rigidity hypertonia

Answer 13

• constant resistance throughout ROM that is independent of velocity
• lead pipe rigidity = hard to move limb
• cogwheel rigidity = gives a little and catches

Question 14

Spasticity hypertonia

Answer 14

• velocity dependent/increase in tone with increase resistance to passive stretch

Question 15

dystonia hypertonia

Answer 15

• prolonged involuntary movement characterized by twisting and writhing repetitive movements and increased tone

Question 16

Clonus

Answer 16

• usually determined by quick stretch into dorsiflexion
• characterized by cyclical, spasmodic, alternation of muscle contraction and relaxation in the response to sustained stretch of a spastic muscle

Question 17

Babinski

Answer 17

• determined by providing stimulation of the lateral to medial sole of the foot
• abnormal response is characterized by fanning of the great toe with fanning of the other toes

Question 18

Tone documentation

Answer 18

• 0 = absent/flaccid
• 1+ = hypotonia/decreased response
• 2+ = normal
• 3+ = hypertonia/exaggerated response
• 4+ = abnormal/sustained response