Biceps reflex-elicited by
striking the biceps tendon of the flexed elbow; examiner supports the forearm with one arm while placing the thumb against the tendon and striking the thumb with the reflex hammer;
Biceps reflex, normal response
flexion at the elbow and contraction of the biceps
Biceps reflex, location
Triceps reflex, elicited by
flexing patient's arm at elbow and positioned in front of the chest; examiner supports the arm and identifies the triceps tendon by palpating 2.5 to 5 cm (1 to 2 in) above the elbow.
Triceps reflex, normal response
contraction of the triceps muscle and extension of the elbow.
Triceps reflex, location
Brachioradialis reflex, elicited by
With patient's forearm resting on the lap or across the abdomen, gently strike the hammer 2.5 to 5 cm (1 to 2 in) above the wrist;
Brachioradialis reflex, normal response
flexion and supination of the forearm.
Brachioradial reflex, location
Patellar reflex, elicited by
striking the patellar tendon just below the patella, patient may be in a sitting or a lying position; If supine, examiner supports the legs to facilitate relaxation of the muscles.
Patellar Reflex, normal response
Contractions of the quadriceps and knee extension.
Patellar reflex, location
Achilles or Ankle reflex, elicited by
Foot is dorsiflexed at the ankle and the hammer strikes the stretched Achilles tendon
Achilles or Ankle reflex, normal response
plantar flexion.
Achilles reflex, location
Clonus,
When the foot does not come to rest after being abruptly dorsiflexed is called sustained clonus, which indicates the presence of CNS disease and necessitates further evaluation.
Ankle Clonus, location
Reflexes, 0
No response
Reflexes: 1+
Diminished (hypoactive)
Reflexes: 2+
Normal
Reflexes: 3+
Increased (may be interpreted as normal)
Reflexes: 4+
Hyperactive (hyperreflexia)
On the stick figure, representation, normal plantar reflexes are denoted by arrows facing
Downward
Superficial reflexes include
Corneal reflex,
Gag reflex.
Corneal reflex is tested by
lightly touching the outer corner of each eye with a clean wisp of cotton.
Normal corneal reflex,
blinking in response to touch.
Abnormal corneal reflex and nursing considerations
absence of blinking in response to touch; indicates the need for eye protection, and possible lubrication to prevent dryness.
Gag reflex is tested by
gently touching the back of the pharynx with a cotton tipped applicator, first on one side of the uvula, then the other.
Absent gag reflex on one or both sides may be seen following a ______, and requires careful evaluation and treatment of the resultant swallowing dysfunction to prevent ______________.
stroke,
aspiration of food and fluids.
Pathologic reflexes include
Plantar, or Babinksi
Elicitation of the Babinski reflex occurs by
stroking the lateral aspect of the sole of the foot.
Babinski reflex, normal response in non-infants.
Plantar flexion and drawing together of toes.
Babinski reflex, abnormal response in non-infants
Dorsiflexion and spreading out of toes, indicates CNS disease of the motor system.
Age related changes in neurologic function.
Slower conduction and response time.
Slower mental functions.
Loss of visual and auditory acuity.
Decrease balance and reflexes.
Slowed gait and wide base of support.
Dulled tactile sensation.
Less efficiency of temperature regulation.
Decreased reaction