Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Testing muscle strength: grades of powerGrade Definition0 1 2 3 4- 4 4+ 5 Nomuscle contraction visible Barely visible muscle contraction Active movement of part oflimb with gravity eliminated Active movement of part of limb against gravity Activemovement against slight resistance Active movement against moderate resistance Activemovement against strong resistance Normal powerRelation of Reflexes to Spinal Cord Segments and PeripheralNervesReflex Site and mode of eliciation Response Muscle(s)Peripheral nerve(s)Cord segment(s)Scapulohumeral reflex Tap on lower end of medial border of scapulaAdduction and lateral rotation of dependent arm Infraspinatusand teres minor Suprascapular (axillary) C4-C6Biceps jerk Tap on tendon of biceps brachii Flexion at elbowBiceps brachii Musulocutaneous C5-C6Supinator jerk (also called radial reflex) Tap on distal end of radiusFlexion at elbowBrachioradialis (+bicepsbrachii and brachialis) Radial (Musculocutaneous) C5-C6Triceps jerk Tap on tendon of triceps brachii above olecranon, with elbowflexed Extension at elbow Triceps brachii RadialC7-C8Thumb reflex Tap on tendon of flexor pollicis longus in distal third of forearmFlexion of terminal phalanx of thumbFlexorpollicis longus Median C6-C8Extensor finger and hand jerk Tap on posterior aspect of wrist just proximalto radiocarpal jointExtension of hand and fingers (inconstant)Extensors of hand and fingers Radial C6-C8Flexor finger jerkTap on examiner's thumb placed on palm ofhand; sharp tap on tips of flexed fingers (Trömner's sign)Flexion offingers Flexor digitorum superficialis (and profundus) MedianC7, C8 (T1)Epigastric reflex (exteroceptive) Brisk stroking of skin downwards from nipplein mamillary line Retraction of epigastrium Transversus abdominisIntercostal T5, T6