Читать книгу Neurology - Charles H. Clarke - Страница 127
Tendon Reflexes
ОглавлениеEnsure the patient is relaxed – with head and trunk supported. Minor asymmetry is common, and reduced knee jerks compared with ankle jerks. Reinforcement: ask the patient to clench their teeth and then relax. Original Jendrassik manoeuvre: hook fingers together and pull.
Do not miss slow relaxing reflexes: hypothyroidism.
Absent Reflex→Clonus nomenclature
| 0 | Absent with reinforcement | Almost always pathological |
| ± | Present with reinforcement | Sometimes normal; may be pathological |
| + | Present | Normal |
| ++ | Brisk | Normal |
| +++ | Very brisk | Pathological if tone increased; can be normal |
| CL | Clonus | >3 beats of ankle clonus = pathological; 2 beats may be normal |
Spinal levels of tendon reflexes, a.k.a. deep tendon reflexes – DTRs in US
| C5–6 | Supinator |
| C5–6 | Biceps |
| C7 | Triceps |
| C8 | Finger jerks |
| L(3)4 | Knee |
| S1 | Ankle |
