This document discusses the examination of reflexes. It begins by defining a reflex and describing the components of a reflex arc. It then describes different types of reflexes, including superficial (cranial and spinal) reflexes and deep tendon reflexes (also cranial and spinal). For each type of reflex, it provides details on the neurological pathway and instructions for eliciting the reflex during an examination. The purpose of examining reflexes and potential abnormalities are also outlined. The document primarily serves to inform physicians on how to properly examine the various reflexes and interpret the results.
Reflex activity is the response to a peripheral stimulation that occurs without our consciousness.
Is an involuntary response to a stimulus.
It is a type of protective mechanism.
Reflex activity is the response to a peripheral stimulation that occurs without our consciousness.
Is an involuntary response to a stimulus.
It is a type of protective mechanism.
Largest part of hind brain.
Called “ silent area/Little Brain ”
Weight- 150 gms.
Cerebellar cortex is a large folded sheet, each fold is called Folium.
Connected to brain stem by 3 pairs of peduncles- Superior (Brachium conjunctiva), Middle (Brachium Pontis) & Inferior (Restiform body) peduncle.
Mechanism of Respiration
By Prof. Dr. R. R. Deshpande
• This PPT has following Imp Contents – 1) Mechanism of Respiration 2) 2 Stages of Respiration 3) Muscles of Respiration 4) Bucket Handle movement of ribs 5) Pump Handle movement of Sternum 6) Role of Expiratory Muscles 7) Role of Accessory Muscles 8) Respiration & Ayurved
• Visit – www.ayurvedicfriend.com
Phone – 922 68 10 630
Mail ID – professordeshpande@gmail.com
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
Largest part of hind brain.
Called “ silent area/Little Brain ”
Weight- 150 gms.
Cerebellar cortex is a large folded sheet, each fold is called Folium.
Connected to brain stem by 3 pairs of peduncles- Superior (Brachium conjunctiva), Middle (Brachium Pontis) & Inferior (Restiform body) peduncle.
Mechanism of Respiration
By Prof. Dr. R. R. Deshpande
• This PPT has following Imp Contents – 1) Mechanism of Respiration 2) 2 Stages of Respiration 3) Muscles of Respiration 4) Bucket Handle movement of ribs 5) Pump Handle movement of Sternum 6) Role of Expiratory Muscles 7) Role of Accessory Muscles 8) Respiration & Ayurved
• Visit – www.ayurvedicfriend.com
Phone – 922 68 10 630
Mail ID – professordeshpande@gmail.com
Some slides are taken from different textbooks of medicine like Davidson, Kumar and Clark and Oxford, and some from other presentations made by respected tutors. I'm barely responsible for compilation of various resources per my interest. These resources are free for use, and I do not claim any copyright. Hoping knowledge remains free for all, forever.
result
receptor
effector
PATELLAR REFLEX
a stretch reflex
Golgi tendon organ in quadriceps femoris
quadriceps femoris & hamstrings
Hitting the patellar tendon with a reflex sledge just underneath the patella extends the muscle
axle in the quadriceps muscle. This creates a flag which heads out back to the spinal line and
neural connections (without interneurons) at the level of L4 in the spinal line, totally autonomous
of higher focuses. From that point, an alpha engine neuron leads an efferent motivation back to
the quadriceps femoris muscle, activating withdrawal. This withdrawal, composed with the
unwinding of the opposing flexor hamstring muscle causes the leg to kick. This is a reflex of
proprioception which keeps up stance and adjust, permitting to keep one\'s adjust with little
exertion or cognizant thought.
The patellar reflex is a clinical and exemplary case of the monosynaptic reflex curve. There is no
interneuron in the pathway prompting to withdrawal of the quadriceps muscle. Rather the bipolar
tactile neuron neurotransmitters specifically on an engine neuron in the spinal string. Be that as it
may, there is an inhibitory interneuron used to unwind the hostile hamstring muscle (Reciprocal
innervation).
This trial of an essential programmed reflex might be impacted by the patient intentionally
hindering or overstating the reaction; the specialist may utilize the Jendrassik move as a
diversion or redirection so as to guarantee a more legitimate reflex test.
ACHILLES REFLEX
stretch reflex
muscle spindle
gastrocnemius
The lower leg jolt reflex, otherwise called the Achilles reflex, happens when the Achilles
ligament is tapped while the foot is dorsi-flexed. A positive result would be the twitching of the
foot towards its plantar surface. Being a profound ligament reflex, it is monosynaptic. It is
likewise an extend reflex. These are monosynaptic spinal segmental reflexes. When they are in
place, uprightness of the accompanying is affirmed: cutaneous innervation, engine supply, and
cortical contribution to the relating spinal fragment.
Lower leg of the patient is casual. It is useful to bolster the bundle of the foot at any rate to some
degree to put nearly strain in the Achilles ligament, however don\'t totally dorsiflex the lower
leg. A little strike is given on the Achilles ligament utilizing an elastic mallet to evoke the
reaction. In the event that you are not ready to evoke a reaction, a Jendrassik move can be
attempted by having the patient container their fingers on every hand and attempt to pull the
hands separated. A positive reaction is set apart by an energetic plantarflexion of the foot. The
reaction is additionally evaluated into Grade 1-4 as indicated by the reflex reviewing framework
plantar reflex
reflex elicited
downward response of the hallux
upward response (extension) of the hallux
The plantar reflex is a reflex inspired when the sole of the foot is invigorated with a limit
instrument. The reflex can take one of two.
Reflexes are important to understand for all medical professional it is an assessment tool for patients with neurological conditions.
a god knowledge of primitive reflexes can be effective for pediatric health care as well. it helps us in identifying any developmental delay in children.
Lower limb neurological examination frequently appears in OSCEs. You’ll be expected to pick up the relevant clinical signs using your examination skills. This lower limb neurological examination OSCE guide provides a clear, concise, step-by-step approach to performing a neurological examination of the lower limb
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
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STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
2. Contents
Reflex
Purpose of examination
Superficial reflexes (Cranial and spinal reflexes)
Deep or tendon reflexes (Cranial and spinal
reflexes)
3. Reflex
Reflex is defined as an involuntary response to a
stimulus.
It depends on integrity of reflex arc, which consists
of receptor, afferent nerve, center, efferent nerve
and effector organ.
Reflex can be Monosynaptic or polysynaptic.
6. Purpose of examination
Whether the reflex is present or absent.
If present whether its normal or showing signs that influences
from higher centres are defective.
If absent, whether the arc is breached on the motor or
sensory side.
Whether any abnormalities are unilateral, bilateral, affecting all
reflexes or whether a definite level can be detected in the nervous
system at which abnormalities first appear because reflex
‘levels’ may be helpful as sensory level.
10. Corneal reflex
Mediated by opthalmic division of trigeminal nerve
Make the subject to sit comfortably
Ask the subject to fix his gaze at a distant object or the ceiling
Bring the cotton wisp from the side of the subject and touch the
lateral edge of the cornea at its conjunctival margin
Observe that the subject blinks his eyes
Elicit the corneal reflex on the other side and compare.
12. Conjunctival reflex
Mediated by opthalmic division of trigeminal nerve
Make the subject to sit comfortably
Ask the subject to fix his gaze at a distant object or the ceiling
Bring the cotton wisp from the side of the subject and touch the
bulbar part of conjunctiva
Observe that the subject blinks his eyes
Elicit the corneal reflex on the other side and compare.
13. Pupillary reflexes
Mediated by third cranial nerve
Light reflex- direct, indirect and Accommodation reflex
Light reflex- direct
Make the subject to sit comfortably
Ask the subject to fix his gaze at a distant object
Shine a bright light in one eye with the torch
Observe immediate constriction of pupil in the same eye
Elicit the light reflex on the other side and compare
14. Pupillary reflexes
Mediated by third cranial nerve
Light reflex- direct, indirect and Accommodation reflex
Light reflex- in direct
Make the subject to sit comfortably
Ask the subject to fix his gaze at a distant object
Hold the cardboard on the forehead and bridge of the nose
Shine a bright light in one eye with the torch
Observe immediate constriction of pupil of both eyes
Elicit the light reflex on the other side and compare
15. Pupillary reflexes
Mediated by third cranial nerve
Light reflex- direct, indirect and Accommodation reflex
Accommodation reflex
Make the subject to sit comfortably
Ask the subject to fix his gaze at a distant object
Bring your index finger midway between and near the eyes of the subject
Ask the subject to look at the tip of the index finger
Observe the constriction of pupil and convergence of eyes.
16. Ciliospinal reflex
The ciliospinal reflex (pupillary-skin reflex) consists of dilation of
the ipsilateral pupil in response to pain applied to the neck, face,
and upper trunk.
If the right side of the neck is subjected to a painful stimulus, the
right pupil dilates (increases in size 1-2mm from baseline).
18. Plantar reflex
Position the patient so that knee is slightly flexed, and thigh externally
rotated.
The foot is rest on the couch. Ask the patient to let the foot remain closed.
The outer aspect of sole is then firmly stroked with the blunt point end of
knee hammer.
Then curve the stimulus towards the middle metatersophalengeal joint.
Do the stimulation slowly and allow yourself time to see what is
happening.
Normally great toe flex at the metatersophalengeal joint.
At the same time other toe will flex and close together.
20. Babinski’s sign
Extension of the great toe at the interphalengeal joint, and the
other toes open in a fanwise manner and are dorsiflexed.
It indicates UMN lesion above L5 segment.
22. Abdominal reflexes
The patient should first lie flat. Palpate gently to asses the degree of
relaxation and the sensitivity of the skin. Explain the patient the
procedure.
Lightly stroke the abdomen with a pencil, key or with the end of the
hammer in all quadrants of abdomen and lower margin of the thoracic
case.
Normal resultthe muscle contract and umbilicus moves in that direction.
Segmental innervation- Epigastric-T7-T9, Upper abdominal T9-T11,
Lower abdomen T11-T12
23. Abdominal reflexes
Abnormal response- Exaggerated abdominal reflexes occur in
psychoneurosis, nervousness.
Absent of reflex- UMN lesion above the level of reflex arc, LMN
lesion at
corresponding reflex arc, obesity, rigid abdomen.
27. Biceps Jerk (C5, C6)
Relax the forearm on examiners hand
Place the forefinger gently on the biceps tendon and then strike
the finger with hammer
Normal response – flexion of elbow and visible contraction of
biceps
29. Supinator Jerk (C5, C6)
Relax the forearm on patient’s body at pronation state. Strike the
lower end of radius about 5 cm above the wrist
Watch the movement of forearm and finger.
Contraction of brachioradialis and flexion of elbow results.
Also slight flexion of finger may occur.
31. Triceps Jerk (C6,C7)
By holding the patients hand, draw the arm across the trunk and
allow it to lie loosely in the new position.
Then strike the triceps tendon 5 cm above elbow.
Extension of elbow and visible contraction of triceps seen.
33. Knee Jerk (L2,L3,L4)
Patient supine, flex the knee 60ᵒ by placing the forearm under the
knee to be tested.
Strike the patellar tendon midway between its origin and insertion.
Extension of knee and visible contraction of quadriceps seen.
It can also be done with patient in high sitting on bed and leg
hanging at edge.
36. Ankle Jerk (S1, S2)
Patient in supine position, hip externally rotated, slightly flex the knee
(medial malleolus facing upward), dorsiflex the ankle by examiner as to
stretch the achillis tendon.
Strike the tendon on posterior surface.
The calf contracts and moves ankle.
The plantar flexion of foot can be felt by the hand of examiner.
Alternative method:- ask the patient to kneel on the chair so that the ankle
are hanging loose over the edge. Then strikes the achillis tendon.
Normal response – plantar flexion of the foot and the contraction of
gastrocnemius muscle.
38. Jaw Jerk
Ask the person to partially open the mouth.
Place a finger firmly on his chin.
Strike the finger with the help of knee hammer
Use the narrow end of knee hammer
Observe the immediate closure of the mouth.
This response is due to contraction of the elevators of the jaw.
40. Jendrassik’s Maneuver
This is performed by asking the subject to make a strong voluntary
muscular effort using following methods.
While testing the reflexes of the lower limb, ask the subject to hook
the fingers of two hands together and pull them apart (against one
another) as hard as possible.
While testing the reflexes of the upper limb, ask the subject to
clench his teeth or to make a fist in the other hand.
42. Abnormalities in tendon reflexes
Exaggeration
Reflex may be excessively brisk, the movement being a sudden,
short lived jerk. This type of reflex is seen of UMN lesion. Also seen
in fright, anxiety, after violent exercise but then return to normal on
rest.
.A reflex may be clonic :- the muscle that has been stretched goes
into clonic contraction until the stretch is relieved. It is seen in
pyramidal disease, and in tensed individual.
43. Abnormalities in tendon reflexes
Reduction or absent
Defective technique application
When there is breach of ant part of reflex system.E.g.- sensory
nerve(polyneuropathy), sensory root (tabes dorsalis), anterior horn
cell(poliomyelitis), the anterior root(spinal compression), the
peripheral nerve (trauma), the terminal nerve
ending(polyneuropathy) or the muscle itself(myopathy)
During cerebral or spinal shock phase which can be of some hour
to some days