MANUAL PHYSIOLOGY PRACTICAL - Repository:The Medical ...

FM/UOJ
2. Tendon (deep) reflexes:
Tendon reflexes are monosynaptic reflexes where sudden stretch of the muscle
spindles results in brief contraction of the muscle. This shows the integrity of the reflex
pathway and excitability of the anterior horn cells. In order to produce sudden stretch the
patient should be completely relaxed; the muscle should be slightly stretched by passive
movement of the limb and a single sharp blow is given with a soft rubber hammer. The
response is assessed by observing the sudden slight movement of the distal part or
preferably observing the muscle belly contracting. Always compare the response with
opposite side.
Exercise: What changes occur in reflex response in upper motor, lower motor, cerebella
and Basal ganglia lesions?
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2.1. Knee jerk:
Get the patient in a bed, completely relaxed. Pass one hand under the knee
and lift the joint a little. Strike the patellar tendon at the middle. This reflex can also be
tested while the patient is seated up, longs dangling freely over the edge of the bed.
List the muscles and the spinal segments involved:
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2.2. Ankle reflex:
Bend the knee slightly and place the leg on the opposite leg. Hold the foot
and dorsiflex the ankle slightly. Strike the tendon at the posterior surface and look for the
response or preferably feel the force by the hand holding the foot.
List the muscles and the spinal segments involved:
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2.3. Biceps jerk:
Flex the elbow to a right angle and keep the forearm in a semiprone position.
Place your thumb or index finger of one hand on the biceps tendon and strike over your
finger. (Explain why biceps tendon was not stretched by extension of the elbow)
List the muscles and the spinal segments involved:
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Neurology
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