Deep Tendon Reflex Exam by Dr Conwell
Now let's demonstrate the actual deep tendon reflex examination on our patient. The patient must be seated properly with the arms pronated on the lap. The patient must be relaxed. Now let's evaluate the brachial plexus or C5 through T1 of the upper extremities. We begin by doing the bicep reflex.
We start by having the doctor place his hand on the elbow, Bring the arm out, and then take the thumb, Gently traction down on the bicep tendon. And then as we talked about earlier, we stroke for rebound. So we stroke the bicep tendon for rebound and you can see the bicep contract. That's C5-C6. Next, we do the brachioradialis reflex, where we stroke the radial bone adjacent to the styloid process. And we look for extension of the thumb. That's C5-6 primarily 6.
Then we do the tricep reflex by gently bringing the arm out using the tip of the reflex hammer over the tricep tendon. This is C7 checking C7-C8. And we stroke for rebound. And we can see the contraction of the tricep.
See the contraction? That's C7-C8 primarily C7. Then next, we go to the wrist reflex by holding the patient's hand in your hand gently flexing the wrist, And tapping with the tip of the reflex hammer over the wrist flexors. And what you can see is the fingers flexing. That's C7-C8 primarily 8. And then we do the ulnar, which we hold the arm out, have the patient relax, drop the arm down, and we stroke the ulnar next to the ulnar styloid. And that's checking for C8, T1 And we get pronation of the wrist. Now, let's do the reflex of the lower extremity.
First, make sure the patient is in proper position and relaxed. Have the doctor raise the leg up gently with the leg resting against the hand. And we want to isolate the area - the infrapatellar tendon. And we want to use the pointed area of the reflex hammer. And we want to strike the infrapatellar tendon. Relax, please. And we can see the reflex. That's for L2-L3-L4 primarily L4.
That's the knee jerk or patellar reflex. Then let's go down and do the Achilles jerk or ankle jerk. The doctor gently dorsiflexes the foot ... Relax your foot, please.
... To stretch the Achilles tendon and taps the Achilles tendon. And you can see the plantar flexion of the foot. That's for S1- S2. Now I'm going to cross over and do a patellar jerk or the patellar reflex. The doctor raises the patient's leg gently and taps the infrapatellar tendon, stroking always for rebound. That's L4 primarily.
Then I'm going to dorsiflex the foot. And I'm going to tap the stretched Achilles tendon. And that's to check S1-S2.
Now let's demonstrate the actual deep tendon reflex examination on our patient. The patient must be seated properly with the arms pronated on the lap. The patient must be relaxed.…By: Dr Timothy Conwell