Reflexes - superficial, deep 1/11

Question 1

What type of reflex?

• Must have intact sensory and motor spinal cord tracts
• Polysynaptic reflux

Answer 1

superficial reflex

Question 2

How to grade superficial reflex?

Answer 2

Present or absent

Indicate abnormal response such as large difference between right and left side

Question 3

What superficial reflex test spinal level T8 to L1? what is normal response?

Answer 3

abdominal reflex

Contraction of abdominal and deviation of umbilicus and direction of stimulus

Question 4

What superficial reflex test CN5 and 7? what is normal response?

Answer 4

corneal blink reflex

Both eyes will blink with contact to eye

Question 5

what directions do you give patient for corneal reflex?

Answer 5

look up and away from me

then stroke eye with cotton

Question 6

What superficial reflex test spinal level L1-2? what is normal response?

Answer 6

cremasteric reflex

Brisk and brief elevation of ipsilateral testicle

Question 7

What superficial reflex test CN9 and 10? what is normal response?

Answer 7

gag reflex

normal gag, may be absent in some pop

Question 8

What superficial reflex test spinal level L5-S1? what is normal response?

Answer 8

plantar reflex
flexion of toes
abnormal babinski - toes splay

Question 9

what cranial nerves does gag reflex test?

Answer 9

CN 9 and 10

Question 10

what cranial nerves does corneal reflex test?

Answer 10

CN 5 and 7

Question 11

what spinal levels does abdominal reflex test?

Answer 11

T8-L1

Question 12

what spinal levels does cremasteric reflex test?

Answer 12

L1-2

Question 13

what spinal levels does plantar reflex test?

Answer 13

L5-S1

Question 14

purpose of Jendrassik maneuver?

Answer 14

Distract the patient, Decreased gaurding, and increase reflex activity
eg. interlock fingers and pull apart

Question 15

what causes DTR?

Answer 15

Muscle contraction when muscle tendon is stimulated due to reflex arc involving spinal or brain stem segment in a rating specific muscles

Question 16

how is DTR graded?

Answer 16

0-4 grade
grade 0 = no response
1+ = diminished/depressed response
2+ normal
3+ brisk/exaggerated
4+ very brisk, hyperactive

Question 17

what DTR grades are always abnormal?

Answer 17

0 and 4+

Question 18

what is normal DTR grade?

Answer 18

2+

Question 19

what spinal levels tested with biceps tendon? what do you hit with reflex hammer?

Answer 19

C5-6

thumb over biceps tendon at elbow

Question 20

what spinal levels tested with brachioradialis tendon? what do you hit with reflex hammer?

Answer 20

C5-6

radius 1-2 inches superior to wrist

Question 21

what spinal levels tested with triceps tendon? what do you hit with reflex hammer?

Answer 21

C6-7

directly above elbow

Question 22

what spinal levels tested with patellar tendon? what do you hit with reflex hammer?

Answer 22

L3-4

inferior to patella

Question 23

what spinal levels tested with achilles tendon? what do you hit with reflex hammer?

Answer 23

S1-2
flex foot to stretch achilles
strike achilles tendon above foot

Question 24

where is the lesion?
absent DTR
sensory loss on nerve distribution

Answer 24

afferent arc of reflex - nerve or dorsal horn

Question 25

where is the lesion?
absent DTR
paralysis, fasciculations, or atrophy in nerve distribution

Answer 25

efferent art of reflex - efferent nerve and/or anterior horn

Question 26

Common etiologies of peripheral neuropathy?

Answer 26

Diabetes
Alcoholism
Vitamin deficiencies, eg. pernicious anemia vitamin B12
Certain cancers
Certain toxins-lead, arsenic, vincristine