Reflexes Test

TESTS FOR REFLEXES

• Deep tendon reflexes with selected site stimulus
  - Biceps reflex (C5, C6): flexion of arm at elbow
  - Triceps reflex (C6, C7): extension of arm at elbow and contraction of triceps muscles
  - Brachioradialis (supinator) reflex (C5, C6): flexion at elbow and pronation of forearm
  - Quadriceps (knee-jerk or patellar) reflex (L2, L3, L4): extension of leg at knee and contraction of quadriceps
  - Achilles (ankle-jerk) reflex (S1, S2)

• Superficial reflexes
  - Pharyngeal reflex (CN IX, CN X)
  - Upper Abdominal reflex (T8, T9, T10): upward movement of umbilicus toward stimulus above umbilicus
  - Lower Abdominal reflex (T10,T11,T12): downward movement of umbilicus toward stimulus below umbilicus
  - Cremasteric reflex (T12, L1) Elevation of ipsilateral testicle (the side stimulated)
  - Gluteal reflex (L4-S3): contraction of anal sphincter with gloved finger insertion

• Pathologic reflexes in adults - documented as "positive for ___"
  - Babinski reflex (Plantar) (L4-S2): stroking lateral sole of foot causes dorsiflexion of great toe with fanning of other toes (normal expectation in children up to age 18 months on the average)
  - Chaddock reflex (L4-S2): stroking below lateral malleolus causes dorsiflexion of great toe with fanning of other toes
  - Ankle Clonus: Brisk dorsiflexion of foot with knee flexed causes up and down movement of foot; found in severe preeclampsia
  - Oppenheim: stroking tibial surface causes great toe fans out
  - Gordon: squeezing calf muscle; great toe fans out
  - Hoffmann: flicking middle finger down; flexion of the thumb

• Common expected reflexes - normal for all ages
  - Gag
  - Corneal