Reflexes

Question 1

C5

Answer 1

Biceps

Question 2

C6

Answer 2

Brachioradialis

Question 3

C7

Answer 3

Triceps

Question 4

L2-3

Answer 4

Patellar Tendon (also maybe L4)
-knee jerk sluggish, PKB positive, pain on full SLR

Question 5

L4

Answer 5

SLR limited one side, neck flexion painful, weak or absent knee jerk, side flexion limited

Question 6

L5-S1

Answer 6

Achilles Tendon (also maybe S2)
-SLR limited one side, neck flexion painful, ankle decreased, crossed-leg raising pain (also S2)

Question 7

Superficial Reflexes

Answer 7

Test integrity of nervous system through response to stimulation of receptors in the skin.
Polysynaptic reflex: sensory signal must reach and ascend spinal cord to reach the brain. motor component must descend spinal cord to reach motor neurons

Question 8

Deep Tendon Reflexes

Answer 8

Can provide info as to the level of lesion that exists w/in the CNS. Elicit a mm. contraction when the mm’s tendon is stimulated due to the reflex arc involving the spinal or BS segment that innervates the specific mm. Absent reflex indicates a lesion in the reflex arc itself.

Hyperreflexia (clonic or hyperactive reflexes)–can indicate a suprasegmental lesion (above the level of the spinal reflex pathway/arc). Present w/ interrpution of cortical supply to the LMN, secondary to UMN lesion. (other findings determine localization of exact lesion that exists w/in CNS
Hyporeflexia ()diminished or absent response)–can indicate a disease that involves one or multiple components of the reflex arc

Absent DTR + sensory loss in specific n. = lesion is in afferent arc of the reflex, located in either the nerve or dorsal horn

Absent DTR + paralysis, fasciculations, or atrophy = lesion is in efferent arc of the reflex and may include the efferent nerve, anterior horn cells or both

Question 9

Abdominal Reflex

Answer 9

Superficial
Spinal Level: T8-L1
Normal Response: Contraction of abdominals and deviation of umbilicus in direction of simulus

Question 10

Corneal “blink” reflex

Answer 10

Superficial
Spinal Level: Trigeminal and Facial Nerves
Normal Response: Both eyes will blink

Question 11

Cremasteric Reflex

Answer 11

Superficial
Spinal Level: L1-L2
Normal Response: elevation on ipsilateral side

Question 12

Gag reflex

Answer 12

Superficial
Spinal Level: Glossopharyngeal and Vagus nerves
Normal Response: gag post stimulation

Question 13

Plantar Reflex

Answer 13

Superficial
Spinal Level: L5-S1
Normal Response: flexion of toes
Babinski reflex: flaring of toes indicates CNS lesion

Question 14

Reflex Grading Scale

Answer 14

0= no response (always abnormal)
1+=diminished /depressed (may or may not be normal)
2+=active normal response (normal)
3+=brisk/exaggerated (may or may not be normal)
4+=very brisk/hyperactive (always abnormal)