Reflexes Powerpoint Slides 2024 PDF

https://www.npr.org/sections/health-shots/2017/05/28/529821714/in-the- age-of-digital-medicine-the-humble-reflex-hammer-hangs-on Introduction to reflexes Erica Hwang, PT, DPT, NCS Special thanks to Paige Rothbulm  Objectives  Understand the definition of a Reflex  Learn...

https://www.npr.org/sections/health-shots/2017/05/28/529821714/in-the- age-of-digital-medicine-the-humble-reflex-hammer-hangs-on Introduction to reflexes Erica Hwang, PT, DPT, NCS Special thanks to Paige Rothbulm  Objectives  Understand the definition of a Reflex  Learn how to Elicit Reflexes  Understand the grading reflexes in preparation for lab  Understand which Deep Tendon Reflexes correspond with what spinal segments  Have exposure to abnormal muscle tone and potential causes  What is a Reflex  Made possible by neural pathways called reflex arcs which Is it a reflex…? can act on an impulse before that impulse reaches the brain  An automatic, involuntary response to a stimulus that does not receive or need conscious thought  Can be inhibited – contextual and https://tenor.com/search/cat-hits-other-cat-gi flexible  Types of Reflexes Somatic Autonomic Skeletal muscles Smooth muscles Excitatory Inhibitory (Stretch) Ex.) Knee-jerk Ex) Dropping a heavy weight Muscle Spindles Golgi tendon organs https://www.ahajournals.org/doi/  Types of Reflexes Somatic Skeletal muscles Monosynaptic Polysynaptic Ex.) Knee-jerk Ex.) Withdrawal Reflex Muscle Spindles Also involves Interneurons https://www.pharmacy180.com/article/somatic-nervous-system-3566/ Monosynaptic Reflex 1. Stimulus 2. Afferent neuron/Sensory stretch receptor 3. Synapse in the spinal cord 4. Efferent neuron/Motor neuron 5. Response  Reflex Arc Summary  Sensory to motor pathway occurring at the spinal level Is it a reflex…?  No direct cortical control Don’t you I’m gonna  CNS can anticipate, and inhibit do it …. …  Allows a very rapid motor response  Brain also receives the sensory https://tenor.com/search/cat-hits-other-cat-gifs information Nope!  How to elicit a Deep Tendon Reflex  How to elicit a Deep Tendon Reflex:  Take up the slack in the muscle by putting the joint in a neutral position  Utilize reflex hammer to strike the tendon with a quick, brief tap  If you can’t see movement or a muscle contraction, palpate the muscle upon repeating the tap  Consider utilizing a reinforcement maneuver- be sure to utilize bilaterally for appropriate comparison  Always compare bilaterally  Jendrassik Maneuver  Used for testing reflexes (with the exception of UE)  How to perform:  Hook the fingers together & resist contralateral pull as much as you can  Elicit a reflex during the isometric pulling action  Function: Acts as a distraction (1)  Jendrassick maneuver increase the excitability of reflex circuitries (2)  For UE reflexes, you may have the patient make a first with the opposite extremity, count, or give the names of their family members (1)  Deep Tendon reflex Testing  Biceps (C5-6)  Brachioradialis (C5-6)  Triceps (C6,7,8)  Patellar (L2,3,4) This Photo by Unknown Author is licensed under CC BY-SA  Achilles Tendon (S1-2) *In Green is the primary nerve root tested with each muscle  Determining the Degree of Muscle Reflex Activity for DTR Hypo 0 Absent, no response (flaccidity) tonia 1+ Minimal/Decreased response (hypotonia) 2+ Normal response Brisk/strong, exaggerated response 3+ (mild/moderate hypertonia) Hype r 4+ Sustained response, clonus (severe hypertonia) tonia  Abnormalities of Muscle Tone Hypertonia Upper motor neuron (UMN) syndrome Hyperreflexia and/or clonus (rapid contract/relax) Spasticity Often see after CVA Velocity-dependent resistance to passive stretch Rigidity Classic symptom of Parkinson’s Increased/uniform resistance throughout ROM (independent of velocity) Abnormalities of Muscle Tone Clonus Abnormalities of Muscle Tone Gait after CVA Abnormalities of Muscle Tone (continued)  Hypotonia  Can be due to Lower motor neuron (LMN) injury  Flaccidity (decreased or absent muscle tone)  Diminished (or absent) resistance to passive movement and reflexes  Characteristic of Down Syndrome  Commonly assessed in pediatrics  Dystonia  ‘Disordered’ tone & involuntary movements of body  Transmission of motor impulses to/from cerebral cortex & cerebellum  Observation of resting posture Palpation of muscle belly Muscle Tone Passive motion testing* Assessment Active motion testing* *vary speed of movements to test for tone Let’s Practice!  References 1. Walker HK. Deep Tendon Reflexes. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 72. Available from: https://www.ncbi.nlm.nih.gov/books/NBK396/ 2. Ertuglu LA, Aydin A, Kumru H, Valls-Sole J, Opisso E, Cecen S, Türker KS. Jendrassik maneuver effect on spinal and brainstem reflexes. Exp Brain Res. 2019 Dec;237(12):3265-3271. doi: 10.1007/s00221-019-05668-y. Epub 2019 Oct 24. PMID: 31650212.