Reflexes Flashcards
How does a superficial reflex differ from a deep tendon reflex in terms of pathways?
Superficial must ascend teh cord to reach the brain and the motor componenet muscle descend the spinal cord to reach motor neruons
How are superficial reflexes graded?
present or absent
What are the 5 Superficial reflexes?
- abdominal reflex
- corneal blink reflex
- cremasteric reflex
- gag reflex
- plantar reflex
Abdominal reflex
What level is test, what is the procedure, and what is a normal response?
T8-L1
Stroke briskly with a blunt object from each quadrant of abdomen in diagonal manner towards umbilicus
Normal: contraction of abdominals and deviation of umbilicus in direction of stimulus
Corneal Blink Reflex
What level is test, what is the procedure, and what is a normal response?
trigeminal and facial nerves
Ask the patient to look up and away, stroke the cornea with a piece of cotton
Normal: both eyes will blink with contact to one eye
Cremasteric reflex
What level is test, what is the procedure, and what is a normal response?
L1-L2
scratch the skin of the upper medial thigh
Normal: brisk adn brief elevation of the testicle on ipsilateral side
Gag Reflex
What level is test, what is the procedure, and what is a normal response?
glosspharyngeal (CN IX) and vagus (X) nerves
therapist lightly stimulates each side of the back of the throat and notes the reaction
Normal: gag occur post stimulation
Plantar Reflex
What level is test, what is the procedure, and what is a normal response?
L5-S1
Stroke the lateral aspect of the sole of the foot with a blunt end of a reflex hammer from heel to ball of foot and medial to base of great toe
Normal: flexion of toes (babinski would be abnormal response)
Hyperreflexia with DTR is indicative of lesions where?
Hyporeflexia is indicative of lesions where?
Hyper: suprasegmental lesions
Hypo: lesion in the reflex arc itself
–> if there is sensory loss in same distribution of nerve then likely lesion in dorsal horn
–> if there is motor atrophy, fasiculations in the same distribution of the nerve then teh efferent nerve and anterior horn cells could be the lesion
How is the Jendrassik manuever performed?
locking fingers together and pulling against eachother
How are DTRs grade? what is the scale range?
0-4 0: no response 1+: diminished/depressed response 2+: active normal response 3+: brisk/exaggerated resposne 4+: very brisk/hyperactive
What spinal level is tested with Biceps Brachioradialis Tricps Patellar Achilles
Biceps: C5-C6 Brachioradialis: C5-C6 Triceps: C6-C7 Patellar: L3-L4 Achilles: S1-S2
where should the brachioradialis reflex be tested?
1-2 inches above the wrist
What is the most common reason for absent reflexes?
peripheral neruopathy
