Reflexes

Question 1

Grade 0

Answer 1

Absent

Question 2

Grade 1+

Answer 2

Diminished response

Question 3

Grade 2+

Answer 3

Normal

Question 4

Grade 3+

Answer 4

Brisk response, increased response compared to normal

Question 5

Grade 4+

Answer 5

Very brisk response with clonus

Question 6

Biceps brachii

Answer 6

C5 (C6 contribution)

Question 7

Brachioradialis

Answer 7

C6 (C5 contribution)

Question 8

Triceps

Answer 8

C7 (C6 contribution)

Question 9

Patellar

Answer 9

L4 (L2, L3 contribution)

Question 10

Achilles

Answer 10

S1 (S2 contribution)

Question 11

Clonus

Answer 11

UMN lesion suspected, brisk (quick) DF stretch

+ test: rhythmic cycling continuing after stretch is removed

Question 12

Babinski test

Answer 12

UMN lesion, stroke at bottom of foot from lateral calcaneal area distally toward the toes and then medially

Normal: no reaction or flexion of the toes
Abnormal (+): great toe extension and other toes splay

Question 13

Hoffman’s

Answer 13

To detect corticospinal tract dysfunction

Grasping distal phalanx of 3rd digit with thumb and index
Abnormal: pt’s thumb flexes and adducts and the other fingers flex