A9. Examination of deep tendon reflexes

• Radial reflex
  • C5-C6
  • Have patient sit at the edge of the table with their elbow in 90° flexion, palm facing medially
  • Hit the distal, radial part of the forearm with the hammer -> elbow flexion
• Biceps reflex
  • C5-C6
  • Have patient sit at the edge of the table with their elbow in 90° flexion, palm facing down
  • Hold your finger on the biceps tendon
  • Hit your finger with the hammer -> elbow flexion
• Triceps reflex
  • C7-C8
  • Have patient sit at the edge of the table with their shoulder abducted
  • Hold the patient’s upper arm for them and ask them to relax the forearm
  • Hit the triceps tendon with the hammer -> elbow extension
• Patellar reflex
  • L2-L4
  • Have patient sit at the edge of the table with their legs hanging freely
  • Hit the tendon of the quadriceps femoris, just below the patella -> knee extension
• Achilles reflex
  • S1 – S2
  • Have patient lying on their back
  • Sit next to the patient’s legs, flex the hip and knee
  • Fix the patient’s knee by squeezing it between your upper arm and your torso
  • Hold the patient’s foot in slight dorsiflexion by holding the ball of the foot
    • This puts some tension on the Achilles tendon
  • Hit the Achilles tendon with the hammer -> plantarflexion of ankle
  • Hit the middle of the plantar region of the foot -> plantarflexion of ankle