DTRs, Reflex Types, & TART

Question 1

Deep Tendon Reflex’s (DTRs)

nerve level* for Biceps brachii

*(big picture not pure innervation, from Dr. Hayes final overview)

Answer 1

C5

Question 2

Deep Tendon Reflex’s (DTRs)

nerve level* for Brachial-radialis

*(big picture not pure innervation, from Dr. Hayes final overview)

Answer 2

C6

Question 3

Deep Tendon Reflex’s (DTRs)

nerve level* for Triceps

*(big picture not pure innervation, from Dr. Hayes final overview)

Answer 3

C7

Question 4

Deep Tendon Reflex’s (DTRs)

nerve level* for Patellar

*(big picture not pure innervation, from Dr. Hayes final overview)

Answer 4

L4

Question 5

Deep Tendon Reflex’s (DTRs)

nerve level* for Achiles

*(big picture not pure innervation, from Dr. Hayes final overview)

Answer 5

S1

Question 6

Somato-somatic reflex

Answer 6

• Somato-somatic reflex is a localized somatic stimulus
  
  • producing patterns of reflex response in segmentally related somatic structures.
• They are named from the origin of the information and the locus of action
  
  • both somatic
• The most common of the somato-somatic spinal reflexes are the defensive reflexes
  
  • such as the withdrawal movements of a foot or hand from a noxious stimulus.

From FOM, 3^rd edition: “These somato-somatic reflexes occur when some stimulus is applied to a somatic structure. This initiates a volley of neural activity (often nociceptive) through the afferent limb of the reflex to the spinal cord. The afferent input activity flows through synapses into the interneurons of the spinal cord central gray, and finally into the ventral horn motor neurons. These motor neurons then cause somatic muscle contraction. The reflexes have at least one interneuron between the sensory input in the dorsal horn of the cord and the motor neurons of the ventral horn.

Question 7

Somato-visceral reflex

Answer 7

• Somato-visceral reflex is a localized somatic stimulus
  
  • producing patterns of reflex response in segmentally related visceral structures.

An acute biomechanical T5-9 group SD inducing GERD- or Gastritis-like symptoms

Question 8

Viscero-somatic reflex

Answer 8

• Viscero-somatic reflex is a localized visceral stimulus
  
  • producing patterns of reflex response in segmentally related somatic structures.

An acute nephrolithiasis causing T10-L1 paravertebral Hypertonicity

Left upper extremity or jaw pain with an evolving acute coronary syndrome

Question 9

Viscero-visceral reflex

Answer 9

• Viscero-visceral reflex is a localized visceral stimulus
  
  • producing patterns of reflex response in segmentally related visceral structures.

Abdominal distention inducing subsequent increased contraction of the gut muscle

Question 10

TART

Answer 10

TART are the palpable, qualitative diagnostic criteria used to make the clinical, medical diagnosis of Somatic Dysfunction.

• Tenderness (sensitivity/pain)
• Asymmetry
• Restricted range of motion
• Tissue texture abnormalities (TTA)

Question 11

Acute TART

Answer 11

Acute TART is equivalent with ACUTE SOMATIC DYSFUNCTION:

• Edematous/erythematous/boggy TTA with painful motion restriction.
• Asymmetry is present.
• Tenderness/sensitivity is usually sharp/stabby and can be indicative of acuity.

Question 12

Chronic TART

Answer 12

Chronic TART is equivalent with CHRONIC SOMATIC DYSFUNCTION:

• Cool/fibrotic/ropy/atrophic TTA with decreased range of motion, which may or may not be painful.
• Asymmetry is present
• Tenderness/sensitivity is usually dull/deep/itchy
  
  • Some say ‘burning’ is a quality of chronic SD, but you could definitely have a ‘burning’ sensation with an acute herniated nucleus pulposus, so I am less inclined to just lump that quality in with chronic SD (note from Fr. Hayes on final study guide)