PhysRehab Ch. 5: Examination of DTR's (Myostatic (stretch) Reflexes Flashcards
Jaw (CN V)
Stimulus: Patient is sitting, with jaw relaxed and slightly open. Place finger on top of chin; tap downward on top of finger in a direction that causes the jaw to open. Response: Jaw rebounds and closes
Biceps Musculocutaneous nerve (C5, C6)
Stimulus: Patient is sitting with arm flexed and supported. Place thumb over the biceps tendon in the cubital fossa, stretching it slightly. Tap thumb or directly on tendon. Response: Slight contraction of elbow flexors
0 to 4+ scale: Reflex
0 Absent, no response 1+ Slight reflex, present but depressed, low normal 2+ Normal, typical reflex 3+ Brisk reflex, possibly but not necessarily abnormal 4+ Very brisk reflex, abnormal, clonus
Triceps Radial nerve (C6, C7)
Stimulus: Patient is sitting with arm supported in abduction, elbow flexed. Palpate triceps tendon just above olecranon. Tap directly on tendon. Response: Slight contraction of elbow extensors
Brachioradialis (supinator) Radial nerve (C5, C6)
Stimulus: Patient is sitting with arm flexed onto the abdomen. Place finger on the radial tuberosity and tap finger with hammer. Response: Slight contraction of elbow flexors, slight wrist extension or radial deviation
Achilles (ankle jerk) Tibial (S1–S2)
Stimulus: Patient is prone with foot over the end of the plinth or sitting with knee flexed and foot held in slight dorsiflexion. Tap tendon just above its insertion on the calcaneus. Maintaining slight tension on the gastrocnemius-soleus group improves the response. Response: Slight contraction of plantarflexors
Involuntary, predictable, and specific response to a stimulus dependent on an intact reflex arc (sensory receptor, afferent neurons, efferent neurons, and responding muscles or gland)
Reflex
Finger flexors Median nerve (C6–T1)
Stimulus: Hold hand in neutral position. Place finger across palmar surface of distal phalanges of four fingers and tap. Response: Slight contraction of finger flexors
Results from stimulation of the stretch-sensitive IA afferents of the neuromuscular spindle producing muscle contraction via a monosynaptic pathway.
Deep Tendon Reflex
Quadriceps (patellar, knee jerk) Femoral nerve (L2, L3, L4)
Stimulus: Patient is sitting with knee flexed, foot unsupported. Tap tendon of quadriceps muscle between the patella and tibial tuberosity. Response: Slight contraction of knee extensors
Hamstrings Tibial branch, sciatic nerve (L5, S1, S2)
Stimulus: Patient is prone with knee semiflexed and supported. Palpate tendon at the knee. Tap on finger or directly on tendon. Response: Slight contraction of knee flexors
Stimulus: Patient is sitting, with jaw relaxed and slightly open. Place finger on top of chin; tap downward on top of finger in a direction that causes the jaw to open. Response: Jaw rebounds and closes
Jaw (CN V)
Stimulus: Patient is sitting with arm flexed and supported. Place thumb over the biceps tendon in the cubital fossa, stretching it slightly. Tap thumb or directly on tendon. Response: Slight contraction of elbow flexors
Biceps Musculocutaneous nerve (C5, C6)
Stimulus: Patient is sitting with arm supported in abduction, elbow flexed. Palpate triceps tendon just above olecranon. Tap directly on tendon. Response: Slight contraction of elbow extensors
Triceps Radial nerve (C6, C7)
Stimulus: Patient is sitting with arm flexed onto the abdomen. Place finger on the radial tuberosity and tap finger with hammer. Response: Slight contraction of elbow flexors, slight wrist extension or radial deviation
Brachioradialis (supinator) Radial nerve (C5, C6)
