Reflexes

Question 1

What is a reflex?

Answer 1

A fast, involuntary muscle movement produced in response to a stimulus. Can occur at spinal levels of the brain.

Question 2

Negative Result

Answer 2

Normal - responses are equal on both sides of the body.

Question 3

Positive result

Answer 3

Diminished  = one side is less is less responsive than other -> can indicate compression at a spinal level.
Absent = no response -> more significant compression at spinal level.
Brisk = a more exaggerated response on one side -> can be a more serious ‘non-musculoskeletal’ problem e.g brain tumour

Question 4

Quadriceps (L3, L4)

Answer 4

• Sitting over edge of plinth
• Locate quadriceps tendon between apex of patella and the tibial tubercle.
• Firmly tap quadriceps tendon with hammer 6 times
• Watch for contraction of quadriceps and extension of knee

Question 5

Tendoachilles (S1, S2)

Answer 5

• prone, with foot relaxed over end of plinth
• passively dorsiflex foot, and check Tibialis Anterior is relaxed
• locate the tendoachilles, above posterior calcaneus, and tap 6 times with hammer
• watch for plantarflexion of the foot

Question 6

Babinski

Answer 6

• supine, ankle relaxed
• strokes from heel, up lateral side and platar part of foot
• watching for flexion of the toes
• Negative test = flexion of toes
• Positive test = extension of great toe, and downward movement of other toes (this would suggest an upper motor neurone lesion)

Question 7

Clonus

Answer 7

• supine lying
• rapidly, passively dorsiflex the ankle and allow foot to return to position
• observe and feel the response
• Negative test = foot slowly lowers back down
• Positive tear = jerky movement of foot (suggest an upper motor neurone lesion)