Introduction to Clinical Medicine III

OSCE Checklist for Evaluator (Reflexes)

Student Name/Surname:

Date: 09.12.2021.
Protocol (Max.: 10 points) P PP F
Deep tendon reflexes examination checklist
1 Meets the patient and introduces himself/herself

2 Washes the hands;

Asks and persuades the patient to relax, position the limbs properly and
3
symmetrically;
4 Holds the reflex hammer loosely between the thumb and index finger;

5 Strikes the tendon briskly , quickly, directly using a rapid wrist movement;

The Brachioradialis Reflex (C5, C6).

Asks The patient to rest his hand on the abdomen or on the lap, with the forearm
6 partially pronated;
Strikes the radius with the point or flat edge of the reflex hammer, about 1 to 2
7
inches above the wrist;
8 Performs symmetrical assessment for comparison of both sides;

The Biceps Reflex (C5, C6).

Asks the patient to partially flex his arm at the elbow with foremarm in
9
hemipronation, rest the arm on lap.
10 Places the thumb firmly on the biceps tendon of the patient ;
Strikes with the reflex hammer so that the blow is aimed directly through your
11
fingure toward the biceps tendon.
Performs symmetrical assessment for comparison of both sides; (can be performed
12
directly on the tendon, without putting the finger on it).
The Triceps Reflex (C6, C7).
Flexes the patient’s arm at the elbow, with palm toward the body, and pulls it
13
slightly across the chest;
14 Strikes the triceps tendon with a direct blow behind and just above the elbow;
15 Performs symmetrical assessment for comparison of both sides;
Asks the patient to let the arm “hung up to dry.” then strikes the triceps tendon ; (in
16
case of difficulty in relaxation);
Watches and assesses for contraction of the triceps muscle and extension at the
17
elbow;
 The Quadriceps (Patellar) or knee reflex (L2, L3, L4).
Asks the patient to be either in sitting or in supine position as long as the knee is
18
flexed;
19 Strikes briskly with the hammer the patellar tendon just below the patella;

20 Places the hand on the patient’s anterior thigh in order to feel this reflex response;
Notes and makes assessment of contraction of the quadriceps with a brisk
21
extension at the knee;
22 Performs symmetrical assessment for comparison of both sides;
The Achilles (Ankle) Reflex (Primarily S1);
Asks the patient while sitting, partially dorsiflex the foot at the ankle and persuades
23
the patient to relax;
Ask the patient to kneel on a chair so that his ankles are hanging loose over the
24
edge.
25 Strikes the Achilles tendon directly
26 Performs symmetrical assessment for comparison of both sides;

27 Summarises findings;

Comment:

Sum: 0.0