TRAKLINDAS 5 - PEMERIKSAAN NEUROLOGI REFLEKS

Summary

In this educational video, Dr. Komang Yunita Wiryaning Putri, a neurologist, demonstrates various neurological reflex tests. These include tendon reflexes, pathological reflexes, and their significance in diagnosing upper and lower motor neuron lesions. The video covers techniques for testing reflexes such as the biceps, triceps, patellar, Achilles, and others. Dr. Yunita explains how to assess each reflex, the expected responses, and how to compare results between the left and right sides. The video is aimed at helping viewers understand the practical aspects of neurological examinations.

Takeaways

• 😀 The video is a tutorial on performing neurological examinations, specifically reflex tests.
• 😀 Dr. Komang Yunita Wiryaning Putri, a neurologist, demonstrates various tendon reflex tests.
• 😀 Reflex tests help evaluate whether a patient has upper or lower motor neuron lesions.
• 😀 Normal reflex response is graded as positive 2, with muscle contraction or joint movement.
• 😀 Reflexes can be diminished in lower motor neuron lesions, with responses of 0 or 1.
• 😀 Increased reflexes (positive +3 or +4) indicate upper motor neuron lesions, potentially with clonus.
• 😀 Biceps reflex is tested by tapping the biceps tendon and assessing for forearm flexion.
• 😀 Triceps reflex is tested by tapping the triceps tendon with the arm in a slightly pronated position.
• 😀 Patellar reflex is tested by tapping the patellar tendon and checking for lower leg extension.
• 😀 Achilles reflex involves tapping the Achilles tendon to assess foot flexion, indicating gastrocnemius contraction.
• 😀 Clonus, Babinski, and other pathological reflexes are tested using specific stimuli like scraping or tapping to observe abnormal responses.

Q & A

What is the purpose of performing tendon reflex tests?

Tendon reflex tests help evaluate whether a patient has lesions in the upper or lower motor neurons by assessing the response of muscles and joints when a tendon is tapped with a reflex hammer.

How do you assess reflexes for upper motor neuron lesions?

For upper motor neuron lesions, reflexes are usually exaggerated, with responses of +3 or +4, and can include clonus or reflex spread.

What is the significance of a reflex score of 0 or +1 in tendon reflex testing?

A reflex score of 0 or +1 typically indicates a lower motor neuron lesion, as there is either no contraction or a reduced muscle response to the tendon tap.

How is the biceps reflex tested?

The biceps reflex is tested by positioning the patient's arm so that the elbow joint is at an angle of more than 90 degrees, placing a finger on the biceps tendon, and tapping gently with a reflex hammer. The expected response is flexion of the forearm at the elbow.

What is the correct positioning for testing the triceps reflex?

For the triceps reflex, the patient's arm should be slightly pronated. The examiner taps the triceps tendon directly with the reflex hammer, with no support for the hand, to assess the expected response of forearm extension at the elbow.

How is the patellar reflex tested?

The patellar reflex is tested by positioning the patient’s knees with the examiner's left hand and tapping the patellar tendon with the reflex hammer using the right hand. The response should be knee extension due to quadriceps contraction.

What is the response expected from the Achilles reflex test?

In the Achilles reflex test, the expected response is plantar flexion of the foot due to contraction of the gastrocnemius muscle when the Achilles tendon is tapped.

How is the Babinski reflex assessed?

The Babinski reflex is assessed by stroking the lateral part of the sole of the foot from posterior to anterior with the blunt end of the reflex hammer. A positive response is dorsiflexion of the big toe and fanning of the other toes.

What is the clinical significance of a positive Babinski or other pathological reflexes?

A positive Babinski reflex or other pathological reflexes (such as the Hoffmann or Tromner reflexes) suggest possible damage to the upper motor neurons, often indicating neurological conditions affecting the central nervous system.

What is the purpose of comparing reflex responses between the right and left sides?

Comparing reflex responses between the right and left sides helps to identify asymmetries or abnormal responses that may point to neurological disorders affecting one side of the body more than the other.