Ptchy reviewer (Reflexes/Neuro Evaluation)

Reflex

 A rapid response generated by the nervous system as a reaction to a sensory stimulus

 Involuntary motor response initiated by a stimulus, applied to peripheral receptors
Reflex Arc (Shows us what happens inside the body)

 Basic unit of integrated reflex activity

 Anatomical nervous pathway of reflex

5 components
1. Receptor – The stimulus
2. Sensory nerve/Afferent Nerve – Brings information to the center
3. Center – The brain and spinal cord (Processes the information)
4. Efferent/Motor Nerve – Bring information into the Effector
5. Effector Organ (Muscle) – Will then act accordingly to the info
Different types of Reflexes
A. Superficial
Cutaneous reflexes provoked by tactile stimulus to a localized area of skin or mucous
membrane.
 A. Corneal Reflex/Blink Reflex/Conjunctival Reflex
-Test by getting a cotton then touch conjunctival, response is blinking
-Used to test brain stem
 B. Pharyngeal Reflex (Gag reflex)
-Reflexive constriction of pharynx / elevation of uvula
-Importance of pharyngeal reflex is to prevent Choking
-Test by using tongue depressor
-Used to check if brain stem is working (Afferent = CN9/Efferent = CN10)
 C. Abdominal Reflex
-Procedure
 Stroke Above umbilicus if T8, T9, T10
 Stroke Below Umbilicus if T10, T11, T12
Normal response would be contraction

 D. Cremasteric Reflex
-Test by Stroking the superior and medial part of the thigh.
-Positive response would be contraction of the cremasteric muscle
-To test if patient has upper motor neuron lesion/lower motor neuron lesion
-Used if there is corticospinal tract lesion (SCI)
B. Deep reflexes

 Jaw jerk
 Biceps
 Triceps
 Brachioradialis
 Knee
 Ankle
Jendrassik maneuver –(Reinforcement technique for reflexes) Grasp Fingers and try to
pull away.
C. Visceral Reflexes – Unconscious, automatic stereotyped responses to a stimulation
involving visceral receptors and effectors and somewhat slower responses
 E.g – Contraction of digestive system, Defecating, Vomitting
D. Pathologic reflexes
 We check these bilaterally (Left and Right)
 If both are positive, Indication for Upper motor neuron lesion (Stroke, SCI)
 Abnormal responses to normal stimulus
1. Banbinski
(Best known and most important pathologic reflex)
2. Chaddock’s
(Useful alternative to the Babinski sign)
(Stroke lateral side of the foot/Beneath lateral malleolus)
(+ sign extreme plantar response/ Extension of big toe)
3. Oppenheim’s
(Stroking the anteromedial tibial surface)
4. Gordon’s
(Squeezing the calf muscle)
(+sign same with Babinski)
5. Hoffman’s
(“Flicking “ of the terminal phalanx of the index middle or ring finger)
(Response: Reflex flexion of distal phalanx of thumb and distal phalanx of
index or middle finger)
6. Rossolimo’s
(Lower extremity pathologic reflex)
(Test: Plantar surface of the toes)
(Response: Plantar Flexion of toes)
7. Schaeffer’s
(Similar to Gordon’s)
(Test: Pinching the middle third of achilles)
(Response: Flexion of foot and toes)