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Areflexia
0
reflex absent
Hyporeflexive
1+
reflex slight, less than normal
Normal 2+
reflex in lower half of normal range
Normal 3+
reflex in upper half of normal range
Hyperreflexive
4+
reflex enhanced, more than normal
includes clonus, if present, which can be noted in an added description of the reflex
Biceps Reflex
taps the biceps tendon with hammer
cross legs and pull out if it’s not shown
can feel response and may not see a lot of motions
Brachioradialis Reflex
taps the BR tendon, closer to the distal end
Triceps Reflex
support the arm abduction with elbow flexion
Measuring Pathological Reflexes
Positive or Negative
Hoffman’s Test
flick the terminal phalanx of middle finger
Positive = reflex flexion of the distal thumb and index finger
Inverted Supinator Sign
same test as Brachioradialis reflex
Positive = hyperactive response of the finger flexor muscles or an “inversion” of the expected reflex