basics

Muscle stretch reflex( deep tendon reflex)

0 =no response
1+ =diminished but present and might require
facilitation
2+ =usual response
3+ =more brisk than usual
4+ =hyperactive with clonus
If the stretch reflexes are difficult to elicit, the response
can be enhanced by reinforcement maneuvers, such as
hooking together the fingers of both hands while
attempting to pull them apart (Jendrassik maneuver).
While pressure is still maintained, the lower limb
reflexes can be tested. Squeezing the knees together
and clenching the teeth can reinforce responses to the
upper limbs.
 Primitive Reflexes
Primitive reflexes are abnormal adult reflexes that represent a regression to a
more infantile level of reflex activity. Redevelopment of an infantile reflex in an
adult suggests significant neurologic abnormalities.
Examples of primitive reflexes include the sucking reflex, in which the patient
makes sucking movements when the lips are lightly touched.
The rooting reflex is elicited by stroking the cheek, resulting in the patient turning
toward that side and making sucking motions with the mouth.
The grasp reflex occurs when the examiner places a finger on the patients open
palm. Attempting to remove the finger causes the grip to tighten.
Many times families mistake this response as a volitional action. The snout reflex
occurs when a lip-pursing movement happens when there is a tap just above or
below the mouth. The palmomental response is elicited by quickly scratching the
palm of the hand. A positive reflex is indicated by sudden contraction of the
mentalis (chin) muscle. It arises from unilateral damage of the prefrontal area of
the brain