Reflexes

Biceps Brachii Reflex

Musculocuntaneos nerve c5c6, elbow flexion

Biceps tendon in cubital fossa

Brachioradialis reflex

Radial nerve c5c6, elbow flexion and slight radial deviation, Brachioradialis tendon proximal/dorsal to radial styloid

Triceps brachii reflex

Radial nerve c5-c8, elbow extension, triceps tendon proximal to olecranon process

Scapulohumeral reflex

dorsal scapular nerve c4c5, scapular adduction, vertebral border of scapula

Pectoral reflex

Medial and lateral pectoral nerves, adduction and internal rotation of humerus, anterior axillary fold

Deltoid reflex

Axillary nerve c5c6, abduction of the humerus, deltoid tendon proximal to deltoid tubercle

Finger flexion reflex

Median nerve c6-t1, finger flexion, palmar surface of distal phalanges of medial 4 fingers

Quadriceps/patellar reflex

Femoral nerve L2-L4, knee extension, patellar ligament

Achilles reflex (ankle jerk)

Tibial nerve L4-S3, ankle plantar flexion

Adductor reflex

obturator nerve L2-L4, hip adduction, tendon of adductor magnus proximal adductor tubercle

Hamstring reflex

Tibial branch of sciatic nerve L4-S3, knee flexion, tendon of semitendinosus or long head of biceps femoris

Grade 0

Absent (no visible or palpable contraction)

Grade 1+

Hyporeflexia (slight or sluggish contraction with little or no joint movement

grade 2+

Normal (slight contraction with slight joint movement)

Grade 3+

Hyper reflex is brisk contraction with moderate joint movement

Grade 4+

Abnormal strong contraction with 1-3 beats clonus

Grade 5+

Abnormal strong contraction with sustained clonus

Hoffman's reflex procedure and response

Support fingers at DIP joint, maintain neutral Wrist, MCP slight extension, IP in slight flexion

Flick distal phalanx into flexion causing slight stretch to flexor digitorum profundus

Normal response little to to no flexion of thumb and index finger

Abnormal response opposition of thumb and index finger

Babinski reflex

Patient should have socks and shoes off, knee extended with

support of distal limb/foot without touching plantar surface

of foot •

Provide unpleasant/noxious stimulus to plantar surface in a

sweeping motion beginning at calcaneus and moving distally

along lateral edge (lasting about 1 second) •

Normal response = downgoing toes (flexion) •

Abnormal response = upgoing/fanning of toes (extension/

abduction)