Reflexes

Question 1

abdominal reflex

Answer 1

• T8-L1
• stroke briskly and lightly with a blunt object (tongue depressor) from each quadrant of the abdomen in a diagonal manner towards the umbilicus

normal response
- contraction of the abdominals and deviation of the umbilicus in the direction of the stimulus

Question 2

corneal “blink” reflex

Answer 2

• trigeminal and facial nerves
• ask the patient to look up and away from you; stroke the cornea using a piece of cotton

normal response
- both eyes will blink with contact to one eye

Question 3

cremasteric reflex

Answer 3

• L1-L2
• scratch the skin of the upper medial thigh

normal response
- a brisk and brief elevation of the testicle on the ipsilateral side

Question 4

gag reflex

Answer 4

• glossopharyngeal and vagus nerves
• the therapist lightly stimulates each side of the back of the throat and notes the reaction

normal response
- a gag will occur post stimulation; may be absent in some percentage of the normal population

Question 5

plantar reflex

Answer 5

• L5-S1
• stroke the lateral aspect of the sole of the foot with the blunt end of a reflex hammer from the heel to the ball of the foot and medially to the base of the great tow

normal response
- flexion of the toes

Question 6

hyperreflexia

Answer 6

• hyperactivity or clonic reflexes

- indicative of a suprasegmental lesion (a lesion above the level of the spinal reflex pathways)

Question 7

hyporeflexia

Answer 7

• diminished or absent response to tapping of the tendon

- indicative of a disease that involves one or multiple components of the reflex arc

Question 8

DTR grade 0

Answer 8

no response

always abnormal

Question 9

DTR grade 1+

Answer 9

diminished/depressed response

may or may not be normal

Question 10

DTR grade 2+

Answer 10

active normal response

normal

Question 11

DTR 3+

Answer 11

brisk/exaggerated response

may or may not be normal

Question 12

DTR 4+

Answer 12

very brisk/hyperactive

always abnormal

Question 13

peripheral neuropathy

Answer 13

• most common etiology surrounding absent reflexes
• diabetes
• alcoholism
• vitamin deficiencies
• certain cancers
• certain toxins
• present with sensory, motor or mixed impairments