Reflex assessment is an essential part of neurological examination when suspecting radiculopathy as abnormal deep tendon reflexes may help you identify the pathological disc level. in their systematic review from 2017, Lemeunier et al. report that a complete peripheral neurological examination when suspecting cervical radiculopathy has a sensitivity of 83% and specificity of 28%. The positive and negative likelihood ratios were 1.15 and 0.6 respectively, which is why we attribute this assessment a rather weak clinical value but it is still the best tool we have.
The most important upper extremity reflexes are the biceps tendon reflex for levels C5, C6 and the triceps tendon reflex for level C7.
You can grade the reflex according to a commonly used 5 grade scale:
0=no response, which is always abnormal
1+=slight but definitely present response, which may or may not be normal
2+=brisk response, which is usually considered normal
3+=very brisk response, which may or may not be normal
4+=clonus, which is always abnormal
Biceps Reflex: 24% Sn, 95% Sp
With the patient in a recumbent position, slightly flex the forearm, palpate the biceps tendon and apply a brisk tap to it using a reflex hammer.
Bring the patient’s arm into slight abduction and with the relaxed forearm hanging freely. To elicit the triceps reflex, tap the tendon at the proximal to the olecranon.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
Other parts of the neurological examination of the upper limb are:
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.