This document defines reflexes and describes different types of reflexes including stretch reflexes, superficial reflexes, deep tendon reflexes, and how they are graded. It explains the basic reflex arc involving receptors, afferent nerves, spinal cord, efferent nerves, and effectors. Specific reflexes are defined such as plantar, abdominal, corneal, jaw jerk, biceps jerk. Reflexes play an important role in posture and protective mechanisms.

1. BY-VISHAL DEEP

2.  DEFINATION
 REFLEX ARC
 STRETCH REFLEX
 SUPERFICIAL REFLEXES
 DEEP REFLEXES
 REFLEX GRADING

3.  REFLEX IS A RESPONSE TO A PERIPHERAL
NERVOUS STIMULATION THAT OCOURS
WITHOUT CONCIOUSNESS
 IT IS A TYPE OF PROTECTIVE MECHANISM AND
IT PROTECTS THE BODY FROM IRREPAIRABLE
DAMAGE
 E.g WHEN HAND IS PLACED ON A HOT
OBJECT,IT IS WITHDRAWN IMMEDIATELY

4.  IT IS A ANATOMICAL NERVOUS PATHWAY FOR
A REFLEX ACTION.
 IT HAS 5 COMPONENTS
1. RECEPTOR
2. AFFERENT NERVE
3. SPINAL CORD
4. EFFERENT NERVE
5. EFFECTOR ORGAN

5.  ALSO CALLED AS MYOTATIC REFLEX
 IT IS THE REFLEX CONTRACTION OF MUSCLE
WHEN IT IS STRETCHED
 IT IS MONOSYNAPTIC REFLEX AND QUICKEST
REFLEX OF ALL
 PARTICULARLY,ANTIGRAVITY
MUSCLES(EXTENSOR MUSCLES) EXHIBIT A
SEVERE AND PROLONGED CONTRACTION
DURING STRETCH REFLEX

6.  PLAYS IMPORTANT ROLE IN MAINTAINING
POSTURE
 MUSCLE SPINDLE ACTS AS THE RECEPTOR
 STIMULATION OF MUSCLE SPINDLE ELICITS
STRETCH REFLEX
 INTRAFUSAL FIBERS PARALLEL TO
EXTRAFUSAL FIBERS , CONNECTED TO
MUSCLE TENDON BY CAPSULE

7. STRETCHING OF MUSCLE
CAUSES STRETCHING OF
MUSCLE SPINDLE
STIMULATES THE MUSCLE
SPINDLE AND DISCHARGES
SENSORY IMPULSE
SIGNAL TRANMITTED BY
PRIMARY AND SECONDARY
SENSORY NERVE FIBERS TO
ALPHA MOTOR NEURON IN
SPINAL CORD
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8. ALPHA MOTOR
NEURONS IN TURN
SEND MOTOR IMPULSE
THROUGH MOTOR
PATHWAY CAUSES
CONTRACTION OF
EXTRAFUSAL FIBERS

10.  ARE THE REFLEXES ELICITED FROM THE
SURFACE OF BODY
 TWO TYPES
1. MUCOUS MEMBRANE REFLEXES
2. CUTANEOUS OR SKIN REFLEX

11.  ARISE FROM THE MUCOUS MEMBRANE
 THEY ARE
1. CORNEAL REFLEX AND CONJUNCTIVAL
REFLEX
AFFERENT-OPTHALMIC DIVISION OF
TRIGEMINAL
CENTER-PONS
EFFERENT-FACIAL NERVE

12.  METHOD
PATIENT TURNS HIS EYES TO OPPOSITE
DIRECTION
THE EXAMINER SHOULD TOUCH CORNEA OR
CONJUCTIVA WITH STERILED COTTON
 RESPONSE
THERE IS BLINKING OR CLOSURE OF SAME EYE
(DIRECT RESPONSE) & OPPOSITE EYE
(CONSENSUAL RESPONSE)

13.  SIGNIFICANCE
1. UNILATERAL TRIGEMINAL NERVE LESION
DR & CR ABSENT ON AFFECTED SIDE
UNAFFECTED SIDE PRESENT
2. UNILATERAL FACIAL PALSY WITH WEAKNESS
OF OBICULARIS ORIS
DR- ABSENT CR- PRESENT ON AFFECTED
SIDE

14. 1. PLANTAR REFLEX(L5-S2)
 PROCEDURE
STROKING THE LATERAL BORDER OF THE
PLANTAR ASPECT OF FOOT(DOWN TO UP)
 RESPONSE
PLANTAR FLEXION
FLEXION OF TOES

16. 2.ABDOMINAL REFLEX (T7-T12)
 PROCEDURE
BY GENTLE STROKING OVER THE
ABDOMEN WITH BLUNT OBJECT(FROM OUT
TO IN)
 RESPONSE
CONTRACTION OF ABDOMINAL MUSCLE
TOWARDS THE AREA STIMULATED

17.  ARE THE REFLEX CONTRACTION OF MUSCLE
OR PART OF MUSCLE IN RESPONSE TO
STRETCH
 THE SUDDEN STRETCH BROUGHT BY
TAPPING THE TENDON EVOKES SHARP
MUSCULAR CONTRACTION
 TYPES-

18. 1. JAW JERK
 CENTER & SPINAL SEGMENT
PONS ,V CRANIAL NERVE
 PROCEDURE
PT IS SITTING OR SUPINE WITH JAW RELAX
AND SLIGHTLY OPEN
PLACE FINGER ON TOP OF CHIN & TAP ON
FINGER

19.  RESPONSE
JAW REBOUNDS AND CLOSES

20. 2.BISCEPS JERK (C5-C6)
 NERVE
MUSCULOCUTANOUS
 PROCEDURE
PT IN SITTING OR SUPINE WITH ARM FLEXED
AND SUPPORTED. KEEP FINGER ON BISCEPS
TENDON IN CUBITAL FOSSA AND GIVE A
BLOW ON FINGER
 RESPONSE
SLIGHT FLEXION OF ELBOW

21. 3.SUPINATOR JERK(C5-C6)
 NERVE
RADIAL
 PROCEDURE
PT IN SITTING OR SUPINE WITH ARM
FLEXED ON ABDOMEN. BLOW ON THE
TENDON OF BRACHIORADIALIS AT DISTAL
END OF RADIUS
 RESPONSE
SLIGHT FLEXION OF FOREARM WITH
SUPINATION

22. 4.TRICEPS JERK(C6-C7)
 NERVE
RADIAL
 PROCEDURE
PT SITTING OR SUPINE WITH ARM SUPPORTED
IN ABDUCTION & ELBOW FLEXED. BLOW ON
THE TRICEPS TENDON
 RESPONSE
SLIGHT EXTENSION OF ELBOW

23. 5.KNEE JERK(L2-L4)
 NERVE
FEMORAL
 PROCEDURE
PT IN SITTING WITH KNEE FLEXED & FOOT
UNSUPPOPRTED OR IN SUPINE .BLOW OVER
THE QUADRICEPS TENDON BETWEEN PATELLA
AND TIBIAL TUBEROSITY
 RESPONSE
SLIGHT EXTENSION OF KNEE

24. 5.ANKLE JERK(S1-S2)
 NERVE
SCIATIC
 PROCEDURE
PT IN PRONE WITH FOOT OVER END OF
PLINTH OR IN SITTING WITH KNEE FLEXED
AND ANKLE DORSIFLEXED OR IN SUPINE WITH
LRG IN FIGURE OF 4 OR IN STANDING .BLOW
ON THE ACHILLIS TENDON
 RESPONSE
PLANTAR FLEXION OF ANKLE

26.  0:ABSENT:NO VISIBLE OR PALPABLE MUSCLE .
. CONTRACTION WITH REINFORCEMENT
 1+:HYPOREFLEXIA:SLIGHT OR SLUGGISH
MUSCLE CONTRACTION WITH LITTLE OR NO Jt
MOVT . REINFORCEMENT MAY BE REQUIRED
TO ELICIT RESPONSE
 2+:NORMAL:SLIGHT MUSCLE CONTRACTION
WITH SLIGHT JOINT MOVT

27.  3+:HYPERREFLEXIA:CLEARLY VISIBLE,BRISK
MUSCLE CONTRACTION WITH SLIGHT JOINT
MOVT
 4+:ABNORMAL:STRONG MUSCLE
CONTRACTION WITH 1-3 BEATS OF
CLONUS.REFLEX SPREAD TO CONTRALATERAL
SIDE MAY BE NOTED
 5+:ABNORMAL:STRONG MUSCLE
CONTRACTION WITH SUSTAINED
CLONUS.REFLEX SPREAD TO CONTRALATERAL
SIDE MAY BE NOTED

28. 1.Physical Rehabilitation
By Susan B O'Sullivan, Thomas J Schmitz,
George Fulk
2. P.J. Mehta's Practical Medicine
3. Essentials of Medical Physiology
By K Sembulingam, Prema Sembulingam
4.WIKIPEDIA FOR PICTURES AND DIAGRAM
5.NEUROEXAM.COM FOR VIDEOS