Neurological Examination of the Leg 6: Reflexes

Learning Points:

  • The patient must be relaxed and positioned properly before starting.
     
  • Reflex response depends on the force of your stimulus.
    Use no more force than you need to provoke a definite response.
     
  • Reflexes can be reinforced by having the patient perform isometric contraction of other muscles
    (Jendrassik's manouevre or clenched teeth).
     
  • Reflexes should be graded on a 0 to 4 "plus" scale:

 

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Tendon Reflex Grading Scale
Grade Description
0
Absent
1+ or +
Hypoactive
2+ or ++
"Normal"
3+ or +++
Hyperactive without clonus
4+ or ++++
Hyperactive with clonus
 

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for other examinations
Power
(grades)
Power
(tests)
Reflexes
Abnormal Plantar
response
Co-ordination Sensation
Sensation Dermatomes
(revision)
Pain or pinprick
Sensation
(vibration)
Sensation
(joint position)
Sensation
(ankle joint position)
Sensation
(temperature)
Gait
(Romberg's)