Neurological Diagnosis: Reflexes

Question 1

McCarthy Reflex

Answer 1

• Abnormal Response: Contraction of the orbicularis occuli muscle upon percussion of supraorbital ridge (glabella)
  
  • Indicates: Upper motor neuron lesion in the head

Question 2

Indirect Light Reflex

Answer 2

• Response: Contralateral pupillary constriction when light is shined in the eye
• Afferent: Optic Nerve II (ipsilateral)
• Efferent: Oculomotor Nerve III (contralateral)
• Integrating Center: Midbrain

Question 3

Hoffman Reflex

Answer 3

• Abnormal Response: Clawing of the fingers (flexion) and thumb (flexion and adduction) upon flicking tip of index finger into extension
  
  • Indicates: Upper motor neuron lesion of the upper extremity

Question 4

Ciliospinal Reflex

Answer 4

• Response: Pupillary dilation when examiner pinches the base of the neck at the cervical sympathetic chain
• Afferent: Cervical Sympathetic Chain
• Efferent: Cervical Sympatheic Chain
• Integrating Center: T1-T2 Spinal Cord

Question 5

Pharyngeal Reflex

Answer 5

• Response: Gagging upon touching the back of the throat with a tongue depressor
• Afferent: Glossopharyngeal Nerve IX
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 6

Uvular Reflex

Answer 6

• Response: Raising of the uvula upon phonation or touching with a tongue depressor
• Afferent: Glossopharyngeal Nerve IX
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 7

Babinski Reflex

Answer 7

• Abnormal Response: Dorsiflexion of the big toe and fanning or splaying of other toes upon stimulation of the plantar surface of the foot
  
  • Indicates: Upper motor neuron lesion of the lower extremity

Question 8

Direct Light Reflex

Answer 8

• Response: Ipsilateral pupillary constriction with light is shined in the eye
• Afferent: Optic Nerve II (ipsilateral)
• Efferent: Oculomotor Nerve III (ipsilateral)
• Integrating Center: Midbrain

Question 9

Carotid Sinus Reflex

Answer 9

• Response: Reduction in heart rate when examiner presses the carotid sinus
• Afferent: Glossopharyngeal Nerve IX
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 10

Gordon Sign

Answer 10

Squeezing the calf

• Positive: Dorsiflexion of the big toe and fanning or splaying of other toes upon squeezing the calf
  
  • Indicates: Upper motor neuron lesion of the lower extremity

Question 11

Gag Reflex

Answer 11

• Response: Gagging upon touching the back of the throat with a tongue depressor
• Afferent: Glossopharyngeal Nerve IX
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 12

Plantar Reflex

Answer 12

• Response: Plantarflexion (curing) of toes upon stroking the sole of foot
• Afferent: Tibial Nerve
• Efferent: Tibial Nerve
• Integrating Center: Spinal Cord S1-S2

Question 13

Schaefer Sign

Answer 13

• Positive: Dorsiflexion of the big toe and fanning or splaying of other toes upon squeezing the achilles tendon
  
  • Indicates: Upper motor neuron lesion of the lower extremity

Question 14

Glabella Reflex

Answer 14

• Abnormal Response: Contraction of orbicularis occuli muscle upon percussion of supraorbital ridge (glabella)
  
  • Indicates: Upper motor neuron lesion in the head

Question 15

Corneal Reflex

Answer 15

• Response: Blinking and tearing of the eye upon touching the cornea with a cotton wisp
• Afferent: Trigeminal Nerve V
• Efferent: Facial Nerve VII
• Integrating Center: Pons

Question 16

Abdominal Reflex

Answer 16

• Response: Umbilicus deviates to the stoked side. Absence is normal only if bilateral
• Afferent: Upper T7-T10, Lower T11-T12
• Efferent: Upper T7-T10, Lower T11-T12
• Integrating Center: Spinal Cord T7-T12

Question 17

Chaddock Sign

Answer 17

• Positive: Dorsiflexion of the big toe and fanning or splaying of other toes upon stroking down the lateral leg around the lateral malleolus
• Indicates: Upper motor neuron lesion of the lower extremity

Question 18

Palateal Reflex

Answer 18

• Response: Raising of the uvula upon phonation or touching with a tongue depressor
• Afferent: Glossopharyngeal Nerve IX
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 19

Interscapular Reflex

Answer 19

• Response: Drawing inward of scapula when skin or interscapular space is irritated
• Afferent: T2-T7 Spinal Nerves
• Efferent: Dorsal Scapular Nerve
• Integrating Center: T2-T7 Spinal Cord

Question 20

Oppenheim Sign

Answer 20

• Positive: Dorsiflexion of the big toe and fanning or splaying of other toes upon application of pressure to the anterior tibia stroking downward
• • Indicates: Upper motor neuron lesion of the lower extremity

Question 21

Tromner Reflex

Answer 21

• Abnormal Response: Flexion of the fingers and thumb upon tapping palmar surface or tips of middle three fingers
  
  • Indicates: Upper motor neuron lesion of the upper extremity

Question 22

Oculocardiac Reflex

Answer 22

• Response: Reduction in heart rate when examiner presses the eye
• Afferent: Trigeminal Nerve V
• Efferent: Vagus Nerve X
• Integrating Center: Medulla

Question 23

Accommodation Reflex

Answer 23

• Response: Convergence of the eyes with pupillary constriction
• Afferent: Optic Nerve II
• Efferent: Oculomotor Nerve III
• Integrating Center: Occipital Cortex

Question 24

Ankle Clonus Reflex

Answer 24

• Abnormal Response: Continued involuntary contraction (sustain plantar flexion) of foot upon quick focible dorsiflexion of the foot
  
  • Indicates: Upper motor neuron lesion of the lower extremity