1. Reflexes

2. Normal reflexes depend on normal function in the nervous system There are two kinds of reflexes – 1. Somatic or Deep reflexes – A. stretch reflexes – achilles, patellar tendon reflexes – B. withdrawal reflexes – 2. Superficial or cutaneous reflexes

3. Testing reflexes Use the flat end of the reflex hammer! Use a sharp, quick tap – don’t be a wimp! Sometimes you can’t observe a reflex – don’t panic, it’s probably you or your “patient” is nervous and not relaxed An absent reflex could mean a delay or prevention of sensory transmission along a lower motor neuron – But hypothyroidism can also produce this An overactive reflex can result from disruptions in the upper motor neurons in the spinal cord or brain – Can result from hyperthyroidism

4. Achilles Reflex Tests the S1,S2 nerve roots and the sciatic nerve Have your partner sit on a chair or table so that both feet hang over the edge Locate the achilles tendon of the right foot and tap it with the reflex hammer What happens?

5. Patellar Tests the L3,L4 nerve roots and the femoral nerve Have your partner sit on a chair or table sp that both feet hang over the edge Locate the patellar tendon of the right leg and tap it with the hammer What happens? Have your partner count down from 99 to 32 Tap it again – was the response greater or less? Repeat this on the left leg?

6. Biceps Reflex Tests the C5,C6 nerve roots and the musculocutaneous nerve Have your partner rest their arm on a table with the palm facing up Place your thumb on the biceps tendon – have your partner flex their forearm to help find it Tap your thumbnail with the hammer What happens?

7. Triceps reflex Tests the C7,C8 nerve roots and the radial nerve Have your partner flex one arm at the elbow and hold their arm Tap the triceps tendon with the hammer using the pointed end What happens? Test each arm

8. Superficial Reflex – The Babinski reflex Using the handle of the hammer – stroke the underside of you partner’s foot using an upward motion from heel to toes What happens?

9. Ciliospinal Have one person sit in a chair – observe their pupils Have another person unexpectedly touch a piece of ice to the back of the neck What happens?