Scribd
Upload
13 views

Reflexes 6

The document provides an overview of reflex activity, defining it as an involuntary response to stimuli that occurs without consciousness and outlining the components of the reflex arc. It details various deep tendon reflexes, their testing positions, stimuli, and responses, along with grading scales for reflex responses. Additionally, it discusses voluntary control of movement and synergy patterns associated with spasticity.

Uploaded by

Kural Arasan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
13 views

Reflexes 6

The document provides an overview of reflex activity, defining it as an involuntary response to stimuli that occurs without consciousness and outlining the components of the reflex arc. It details various deep tendon reflexes, their testing positions, stimuli, and responses, along with grading scales for reflex responses. Additionally, it discusses voluntary control of movement and synergy patterns associated with spasticity.

Uploaded by

Kural Arasan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 21

REFLEX

DEFINITION
• Reflex activity is the response to a peripheral
stimulation that occurs without our
consciousness.
• Is an involuntary response to a stimulus.
• It is a type of protective mechanism.
REFLEX ARC
Anatomical nervous pathway of reflex is called reflex arc.

COMPONENTS OF REFLEX ARC


• Receptor : site of stimulus
• Afferent nerve: transmit sensory impulse from the receptor
to stimulus.
• Center : receives the sensory impulses an in turn, it
generates appropriate motor impulses.
• Efferent nerve: transmit motor impulses from the center to
the effecter organ.
DEEP REFLEX
• Deep reflex are elicited from deeper structures
beneath the skin life tendon.
• Also known as tendon reflexes.
• Reflex initiated by muscle spindles must maintain
healthy muscle tone.
• Deep tendon reflex hammer is a medical
instrument to test deep tendon reflexes.

DTR HAMMER
GENERAL PRINCIPLES
• Choose a good hammer. A heavy hammer with
quality rubber head is good choice.
• Patient variables include age , body posture,
position of the limb, state of mind , level of
alertness , sedative drugs and room temperature.
• Examiner variables include the type of hammer
used, the site, direction, force and the speed of the
stimulus.
• Patient should be relaxed. If needed engage the
patient in conversation to distract his attention.
• Use increasing force of the tap, but avoid pain.
DEEP TENDON REFLEXES
•Jaw jerk.
•Biceps reflex.
•Supinator reflex.
•Triceps reflex.
•Knee jerk.
•Ankle jerk.
•Plantar reflex.
JAW JERK
• POSITION : Ask the patient to open the jaw to
1/3. Place your finger on the chin
• STIMULUS: chin
• RESPONSE: lower jaw goes up sharply.
BICEPS REFLEX (C5, C6)
• POSITION: The elbow is fixed to a right angle and
the forearm slightly pronated.
• STIMULI: Biceps tendon
• RESPONSE: Flexion of the elbow.
SUPINATOR REFLEX(C5,C6)

• POSITION: Elbow is semi flexed, forearm mid-


pronated
• STIMULUS: Radial styloid process
• RESPONSE: Elbow flexion
TRICEPS JERK (C7)
• POSITION: The arm is supported at the wrist and
flexed to a right angle.
• STIMULUS: Triceps tendon over the olecranon
process
• RESPONSE: Extension of the elbow
KNEE JERK (L3,L4)

• POSITION: High sitting.


• STIMULUS: Quadriceps tendon.
• RESPONSE: Extension of knee joint.
ANKEL JERK (S1)
• POSITION: supine, with thigh externally
rotated, abducted , knee semi
flexed.
• STIMULI: tendon just above the calcaneus.
• RESPONSE: Plantar flexion of the ankle.
PLANTAR REFLEX (BABINKI L5,S1)
• POSITION: knee is slightly flexed and the thigh
externally rotated.
• STIMULUS: the outer part of the sole is the
firmly stroked with a blunt pain.
• RESPOSE: the great toe will extend at the same
time the other toes abduct.
GRADINGS
• 0 : Absent.
• 1+: Diminished (OR) Response may be
considered normal for some reflex ,but
abnormal for other, more lively reflexes.
• 2+ :Normal (OR) Brisk response.
• 3+ :Exaggerated (OR) Very brisk response.
• 4+ :Clonus (OR) Markedly hyperactive reflex.
REFERENCE
• Neurological examination; Sarma.
• Handbook of Neurological Examination ;
Navneet Kumar.
VOLUNTARY
CONTROL
VOLUNTARY CONTROL
Voluntary movement is the expression of thought
through actions. All areas of the central nervous
system are involved.
EXAMPLE: walking, running , sitting talking,
chewing etc.
SYNERGY
• Synergy patterns are abnormal stereotyped
primitive, mass movement pattern associated
with spasticity.
• May involve the action of certain muscles in
combination that gives rise to abnormal pattern
not useful for functional activities.

Flexor synergy Extensor synergy


Flexor synergy Extensor synergy
Flexor synergy Extensor synergy
GRADES
• NILL : no contraction or movement.
• TRACE : very slight movement.
• POOR : movement is initiated with synergy.
• POOR+ : 1/3rd of the movement done without synergy
and rest of the movement with synergy, in gravity
eliminated plane.
• POOR++ : 2/3rd of the ROM done without synergy , rest
of the movement with synergy, in gravity eliminated
plane.
• POOR+++ : A little less than full ROM without synergy,
end range takes place with synergy.
• FAIR : Full ROM, without synergy, in eliminated gravity.

You might also like