Overview of Reflexes
MUHAMMED SHAREEF VP
BOT,MOT
Reflexes
What is a motor reflexes?
- A reflex is an involuntary motor
response to sensory stimulus.
.
Cont..
Types
Deep tendon reflexs (DTR)
Superficial reflexs
Primitive reflexes
Cont..
What information dose reflex
examination provides?
1) reflex assessment provides
information about both the sensory
and motor systems
Cont…
2) Indicates damage to spinal cord , nerve root,
or muscle
Deep tendon reflexes
The deep tendon reflex (DTR) results from stimulation
of the stretch-sensitive IA afferents of the
neuromuscular spindle producing muscle contraction
via a monosynaptic pathway.
• It is are assessed to determine possible central and
peripheral nervous system dysfunction.
Testing equipment- reflex hammer
Instrument used to examine deep
tendon reflex
Reflex hammer
Cont…
Things needs to be noted prior to
examination of DTR
DTRs are tested by tapping sharply
over the muscle tendon with a
standard reflex hammer or with the
tips of the therapist’s fingers.
To ensure adequate response, the
muscle is positioned in midrange
and the patient is instructed to relax.
Indications
Indications
1) Hyperactive reflex
indicates central nervous system
disorder.
2) Decreased or absent reflex indicates
peripheral nerve injury.
Gradings
reflexes are graded on a 0 to 4+
scale:
0 Absent, no response
1+ Slight reflex, present but
depressed, low normal
2+ Normal, typical reflex
3+ Brisk reflex, possibly but not
necessarily abnormal
4+ Very brisk reflex, abnormal, clonus
Cont…
Reflex
Needs to be examined for both
sides .
• It need not be same for both the
sides .
Cont…
Deeptendon
reflexes
Cont…
JAW JERK REFLEX
The jaw jerk reflex or the
masseter reflex is a
stretch reflex used to test the status
of a patient's trigeminal nerve
(cranial nerve V) and to help
distinguish an upper cervical cord
compression from lesions that are
above the foramen magnum.
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BICEPD REFLEX
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brachioradialis reflex
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TRICEPS TENDON REFLEX
FINGER FLEXOR REFLEX
Other names
Hoffmann Hoffmann's, Jacobson's
sign, snapping reflex, trumnr sign
Cont….
reflex (Hoffmann's sign,
sometimes simply "Hoffmann's",
also finger flexor reflex)[1] is a
neurological examination finding
elicited by a reflex test which can
help verify the presence or absence
of issues arising from the
corticospinal tract. It is named after
neurologist Johann Hoffmann.'s
reflex, digital reflex
Cont…
A positive Hoffman sign indicates
an upper motor neuron lesion and
corticospinal pathway dysfunction
likely due to cervical cord
compression.
However, up to 3% of the population
has been found to have a positive
Hoffman without cord compression
or upper motor neuron disease.
Cont..
s in the upper extremities (UEs)
include squeezing the knees together,
clenching the teeth, or making a fist
with the contralateral extremity.
DTRs are increased in UMN syndrome
(e.g., stroke)
decreased in LMN syndrome (e.g.,
peripheral neuropathy, nerve root
compression),
Cont…
Cont..
Response= flexion of index finger
and extension of thumb
Hamstring reflex…
The reflex muscle contraction was
elicited by striking the index finger of
the supporting hand placed on the
medial hamstring tendon (tendons
of semitendinosus,
semimembranosus) just above the
knee join (postero-medially) with
a reflex hamme.
Cont….
Cont…
Knee reflex
Other names
Pateller or quadriceps reflex
Cont..
Ankle reflex
Other name
Achilles reflex
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2 Superficial Cutaneous Reflexes
Superficial cutaneous reflexes are elicited
with a light stroke applied to the skin.
The expected response is brief
contraction of muscles innervated by the
same spinal segments receiving the
afferent inputs from the cutaneous
receptors.
Cont…
Types of Cutaneous reflex
1 plantar reflex
2 abdominal reflexes
3 cremastic reflex,
4 Geigel reflex
5 corneal reflex
Cont…
Plantar reflex
The plantar reflex is a reflex elicited
when the sole of the foot is
stimulated with a blunt instrument
laterlly .
Cont…
In healthy adults, the plantar reflex
causes a downward response of the
hallux (flexion).
An upward response (extension) of
the hallux is known as the Babinski
response or Babinski sign, named
after the neurologist Joseph Babinsk
Cont..
Abdominal reflex
Abdominal reflexes are obtained
by stroking the abdomen from
lateral to medial with strokes
beginning just above the umbilicus,
lateral to the umbilicus, and just
below the umbilicus directed toward
the umbilicus.
Cont…
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cremasteric reflex
The cremasteric reflex is a
superficial (i.e., close to the skin's
surface) reflex observed in human
males. This reflex is elicited by
lightly stroking or poking the superior
and medial (inner) part of the thigh—
regardless of the direction of stroke.
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INDICATION
Pathology in cortico spinal tract
Geigel reflex
in the female, a contraction of the mu
scular fibers at the upper edge of the
Poupart ligament on gently stroking t
he inner side of the thigh; analogue o
f the cremasteric reflex in males.
Corneal reflex
The corneal reflex, also known as
the blink reflex, is an involuntary
blinking of the eyelids elicited by
stimulation of the cornea (such as by
touching or by a foreign body),
though could result from any
peripheral stimulus.
Cont…
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refrences
Physical Rehabilitation(Susan
B.O’Sullivan)
E journels
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