Neuro Reflexes Flashcards
Reflex Arc
What does the reflex arc consist of?
–Stretch receptor
–Afferent peripheral nerve fibers
–Anterior horn cell
–Efferent nerve fibers
–Neuromuscular junction
Reflex Arc
Reflexes and Spinal Levels
Biceps
•C 5 & 6
Reflex Arc
Reflexes and Spinal Levels
Brachioradialis
•C 5 & 6
Reflex Arc
Reflexes and Spinal Levels
Triceps
•C 6 & 7
Reflex Arc
Reflexes and Spinal Levels
Knee/Patellar
•L 2, 3, & 4
Reflex Arc
Reflexes and Spinal Levels
Ankle
•S 1
Reflex Arc
Reflexes and Spinal Levels
Plantar response (Babinski)
•L5, S1
Grading Deep Tendon Reflexes
Absent
0 – 4+ scale or “sustained clonus”
0 Absent
Grading Deep Tendon Reflexes
Reflex present with reinforcement
0 – 4+ scale or “sustained clonus”
1+ Reflex present with reinforcement
Grading Deep Tendon Reflexes
Reflex present without reinforcement
0 – 4+ scale or “sustained clonus”
2+ Reflex present without reinforcement
(normal)
Grading Deep Tendon Reflexes
Brisker than average
0 – 4+ scale or “sustained clonus”
3+ Brisker than average
Grading Deep Tendon Reflexes
Very brisk, with beats of clonus
0 – 4+ scale or “sustained clonus”
4+ Very brisk, with beats of clonus
Grading Deep Tendon Reflexes
What is normal?
0 – 4+ scale or “sustained clonus”
2+ Reflex present without reinforcement
(this is the normal state)
Grading Deep Tendon Reflexes
What should you do if the patient sustains clonus?
0 – 4+ scale or “sustained clonus”
Sustained clonus (document # of beats)
Alternate involuntary contraction & relaxation in rapid succession.
clonus
Deep Tendon Reflexes
Which side of the hammer?
Biceps
Point
Deep Tendon Reflexes
Which side of the hammer?
Triceps
Point
Deep Tendon Reflexes
Which side of the hammer?
Brachioradialis
long edge
Deep Tendon Reflexes
Which side of the hammer?
Ankle
long edge
Deep Tendon Reflexes
Which side of the hammer?
Patellar
point
Deep Tendon Reflexes
When testing the ankle reflex, you should _______ the foot
slightly dorsiflexes the foot when testing ankle reflexes
If clonus is present, what are you assessing for?
•Assesses for CNS (UMN) disease
How do you test for clonus?
- Sharply dorsiflex the foot & hold in flexion
- Observe & feel for rhythmic oscillations between dorsi- and plantar flexion
What does the Plantar-“Babinski” reflex test for?
–Assesses upper motor neuron dysfunction
Plantar-“Babinski” test responses?
ABN = Fanning and abduction of toes. Babinski Response present or “toe upgoing”
________
–Normal =toes down going/flexion of toes and foot. “absent” or “toes downgoing”
Superficial Abdominal Reflexes
What is the test, what is normal?
- Patient supine; stroke each quadrant with reflex hammer
–In upper quadrants, stroke “up and out”
–In lower quadrants, stroke “down and out”
___________
Umbilicus should move TOWARD stimulation
Cremasteric Reflex
Test and normal
- Male Patient
- Stroke the inner thigh from proximal to distal (down)
____________
•The testicle and scrotum should rise on the side of the stimulus
____________
(if reflex is absent, may have testicular torsion, spinal injury or disease of neuromuscular junction)
Cremasteric Reflex
What if the reflex is absent?
(if reflex is absent, may have testicular torsion, spinal injury or disease of neuromuscular junction)
_____________
- Male Patient
- Stroke the inner thigh from proximal to distal (down)
____________
•The testicle and scrotum should rise on the side of the stimulus
____________
