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    REFLEXES

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    Sonali Soumyashree
    This document discusses different types of reflexes and how they are tested. It describes the components of a reflex arc and explains that a reflex is an involuntary response to a stimulus. Deep tendon reflexes involve tapping a tendon and observing the muscle contraction response. Specific deep tendon reflexes tested include biceps, brachioradialis, triceps, knee jerk, and ankle jerk. Superficial reflexes include plantar and abdominal reflexes tested by stroking the skin.

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    REFLEXES

    Uploaded by

    Sonali Soumyashree
    85 views15 pages
    This document discusses different types of reflexes and how they are tested. It describes the components of a reflex arc and explains that a reflex is an involuntary response to a stimulus. Deep tendon reflexes involve tapping a tendon and observing the muscle contraction response. Specific deep tendon reflexes tested include biceps, brachioradialis, triceps, knee jerk, and ankle jerk. Superficial reflexes include plantar and abdominal reflexes tested by stroking the skin.

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    This document discusses different types of reflexes and how they are tested. It describes the components of a reflex arc and explains that a reflex is an involuntary response to a stimulus. Deep tendon reflexes involve tapping a tendon and observing the muscle contraction response. Specific deep tendon reflexes tested include biceps, brachioradialis, triceps, knee jerk, and ankle jerk. Superficial reflexes include plantar and abdominal reflexes tested by stroking the skin.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    85 views15 pages

    REFLEXES

    Uploaded by

    Sonali Soumyashree
    This document discusses different types of reflexes and how they are tested. It describes the components of a reflex arc and explains that a reflex is an involuntary response to a stimulus. Deep tendon reflexes involve tapping a tendon and observing the muscle contraction response. Specific deep tendon reflexes tested include biceps, brachioradialis, triceps, knee jerk, and ankle jerk. Superficial reflexes include plantar and abdominal reflexes tested by stroking the skin.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 15

    REFLEXES

    Presented by
    Sonali Soumyashree
    BPT, MPT(Neuro)
    Reflex
     A reflex is an involuntary, predictable and specific response to stimulus
    dependent on an intact reflex arc.
     SENSORY STIMULUS MOTOR RESPONSE
     Reflex is a stereotyped motor response to a specific sensory stimulus.
     This stimulus-response pathway is called a “reflex arc”.
     This reflex arc consists of 5 elements:
    o Receptor: muscle spindle
    o Afferent Neurons: Ia &II fibers.
    o Centre: Spinal cord
    o Efferent Neurons: Mptor Nerve
    o Effector: Muscle(Extrafusal fibers)
    REFLEXES
     For a reflex to occur ,the pathway and all the elements must
    be intact.
    Why reflex testing isnecessary?
     To know if reflex is present/absent.
     If present, normal/ abnormal(showing signs of higher centre
    abnormality)
     If absent, defect on the motor side/ sensory side.
    Reflexes
     Types of reflex:
     Deep Tendon Reflex
     Superficial Reflex
    Deep Tendon Reflex
    (DTR)
     DTR results from stimulation of stretch sensitive Ia afferents
    of the neuro-musculoskeletal spindle producing muscle
    contraction via a monosynaptic pathway.
     It is tested by tapping sharply over the muscle tendon with a
    standard reflex hammer.
     The muscle is positioned in mid range and the subject is
    instructed to relax.
     When the jerks are difficult to elicit Jenderassik maneuver is
    done, where the subject holds the fingers of the hand and
    pulls them apart and lower extremity jerk are tested.
    DEEP TENDON REFLEX
     The response is noted by looking:
    o Movement of the Joint
    o Contraction of muscle
     Grading is done on a scale of 0- 4+
    o 0 = No response
    o 1+ = Present but depressed/ below normal
    o 2+ = Average/ Normal
    o 3+ = Increased/ Brisker than normal
    o 4+ = Very brisk, hyperactive with clonus.

    Clinical Importance
    • DTR is increased in UMN lesion and decreased in LMN
    Physiology of DTR
    What is a monosynaptic pathway?
    Pathway/ reflex arc where one sensory neuron synapses with
    one motor neuron and only one neuro-transmitter is
    released.
    What is a Stretch Reflex?
    When stretch is applied to the muscle, the muscle spindle gets
    activated
    a) IIa sensory neuron from the spindle synapses
    directly with alpha motor neurons in the spinal cord which
    then causes the stretch muscle to contract.
    b) II a sensory neuron also synapse with inter-
    neurons that inhibit the alpha motor neurons of antagonistic
    muscles causing relaxation.
    Example: knee jerk
    When the patellar tendon is tapped, the Ia IIa afferents carry
    the sensation to spinal cord where they fuse with the alpha
    motor neuron which excites the extrafusal fibers of the
    stretched muscle and the muscle contracts.
    DEEP TENDON REFLEX
     Testing is done for:
     Jaw Jerk(Cranial Nerve V): The
     Biceps Jerk(C5,C6-Musculocutaneous Nerve):
     Brachioradialis jerk(C5,C6-Radial Nerve):
     Triceps Jerk(C6,C7-Radial Nerve):
     Knee Jerk(L2,L3,L4- Femoral Nerve):
     Ankle Jerk(S1,S2-Tibial Nerve):
    Superficial Cutaneous Reflex
     Superficial Reflexes are elicited with a light stroke applied to
    the skin.
     The response expected is brief contraction of muscle
    innervated by the same spinal segment receiving the afferent
    inputs from the cutaneous receptors.
     Superficial Reflexes can be divided into:
     Plantar Reflex
     Abdominal Reflex
    Superficial Cutaneous Reflex
    Plantar Reflex
     It is tested by applying a stroking stimulus on the sole of the
    foot along the lateral border and up across the ball of the
    foot.
     Normal response: Flexion of the big toe.
     Abnormal response(+Babiniski Sign): Upgoing/Dorsiflexion
    of big toe with fanning of lateral four toes.
     Indicative of UMN lesion.
    Superficial Cutaneous Reflex
    Abdominal Reflex
     It is elicited with brisk , light strokes over the skin of the
    abdominal muscles.
     The response is the deviationof the umbilicus towards area
    stimulated.
     Each quadrant should be tested in adiagonal direction.
     Umbilical deviation in a superior/lateral direction:T8-T9
    segments intact
    Superficial Cutaneous Reflex
     Umbilical deviation in inferior/lateral direction : T10-T12
    segments intact.
     Loss of response is abnormal and indicative of SCI .
     Reflexes may be absent in persons with obesity/abdominal
    surgeries.

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