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Topic: Ankle jerk reflex

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	The Precise Neurological Exam (Site not responding. Last check: 2007-10-21)
		The triceps reflex is mediated by the C6 and C7 nerve roots, predominantly by C7.
		The knee jerk reflex is mediated by the L3 and L4 nerve roots, mainly L4.
		The ankle reflex is elicited by holding the relaxed foot with one hand and striking the Achilles tendon with the hammer and noting plantar flexion.
	endeavor.med.nyu.edu /neurosurgery/reflexes.html (761 words)

	Neurological Exam: Reflex Examination (Dialup) (Site not responding. Last check: 2007-10-21)
		Reflexes commonly measured include the jaw jerk, biceps, triceps, radial, knee, ankle, plantar and superficial skin responses.
		Deep tendon reflexes are graded but the scale is subjective and imprecise; 0 is the absence of any reflex, 2 is "normal" and 4 is maximally hyperactive and called clonus.
		Reflexes, tone and strength provide information regarding the nervous system from the cerebrum to the sacral cord and help distinguish central from peripheral injury.
	isc.temple.edu /neuroanatomy/lab/neuexam/reflex.htm (155 words)

	Glossary.14. quadriceps, receptor, radius and reflex
		The afferent and efferent limbs of the reflex are branches of a single nerve fiber, the axon (axonlike dendrite) of a sensory neuron.
		The reflex is diminished or abolished in lesions of the nerve supplying the muscle and tendon, lesions of posterior roots involving a sensory pathway as in tabes dorsalis, lesions of anterior root involving motor pathways, or lesions of lower motor neurons in anterior horns of gray matter of spinal cord, as in poliomyelitis.
		Cutaneous reflex caused by irritation of the skin or areas depending upon the spinal cord as a motor center, such as the scapular, epigastric, abdominal, cremasteric, gluteal, and plantar reflexes, or upon centers in the medulla, such as conjunctival, pupillary, and palatal reflexes.
	www.kneelsit.com /glossary/glossary14.html (1411 words)

	Ankle jerk reflex (Site not responding. Last check: 2007-10-21)
		The ankle jerk reflex, also known as the Achilles reflex, occurs when the Achilles tendon is tapped while the foot is dorsi-flexed.
		A positive result would be the jerking of the foot towards its plantar surface.
		The achilles reflex checks if the s1 and 2 nerve roots are intact and could be indicative of sciatic nerve pathology.
	www.bopedia.com /en/wikipedia/a/an/ankle_jerk_reflex.html (70 words)

	Medical Tests and Signs (Site not responding. Last check: 2007-10-21)
		Ankle Jerk Reflex: The Achilles tendon is struck by the examiner to test the reflex reactions related to L5-S1.
		Reflex chewing is seen in diffuse bilateral lesions of the frontotemporal cortex and is frequently seen in cases of dementia, incomplete paralysis (generalized paresis) and brain injury related to a lack of oxygen.
		Knee Jerk Reflex: This test is conducted by striking the Patellar tendons of the knee for reflex indications of a lesion in the L2, L3-L4 segments.
	www.defenseinformationcenter.com /pages/iimedicaltests.html (2732 words)

	Stretch reflex gain in cat triceps surae muscles with compliant loads -- Serres et al. 545 (3): 1027 -- The Journal of ...
		The mammalian stretch reflex is difficult to quantify because the sensors (muscle spindles and tendon organs) are an integral part of the muscle; the sense organs cannot be stretched without stretching the muscle, and the response is directly affecting both the muscle and the sensors.
		In fact, the reflex force and electromyographic responses to stretch increased with the contraction level, but their effect on the total reflex gain was cancelled by an associated increase in the intrinsic muscle stiffness, thus stressing the importance of considering the mechanical load on the feedback responses.
		Reflex force was calculated by subtracting the deafferented force responses from the responses obtained in the non-deafferented (decerebrate or spinal) conditions.
	jp.physoc.org /cgi/content/full/545/3/1027 (10166 words)

	GC1135 LAB: Human Reflexes (Site not responding. Last check: 2007-10-21)
		The patellar tendon reflex ("knee-jerk" reflex) is a monosynaptic stretch reflex that assesses the nervous tissue between (and including) the L2 and L4 segments.
		The calcaneal reflex ("Achilles" or "ankle-jerk" reflex) is a stretch reflex that assesses the nervous tissue between (and including) the first two sacral segments.
		The plantar reflex is a superficial spinal reflex that depends both on functional upper-level motor pathways and on the cord-level reflex arc.
	www.gen.umn.edu /courses/1135/lab/reflexlab/reflexlab.html (1320 words)

	Virtual Naval Hospital: United States Naval Flight Surgeon Manual: Third Edition 1991: Chapter 7: Neurology (Site not responding. Last check: 2007-10-21)
		Reflexes in the lower extremity include the quadriceps reflex (knee jerk) and the gastrocnemieus reflex (ankle jerk).
		Cutaneous abdominal reflexes should be tested for both superficial function by scratching from the margins toward the umbilicus and observing a quivering motion of the abdominal muscles.
		Other superficial cutaneous reflexes are the cremasteric reflex (in males), tested by stroking the thigh and observing the ascent of the testicles, the anal wink reflex (anus contraction to light pin prick), and the Bulbocavernosis reflex (contraction of the anal sphincter by stretching the penis).
	www.vnh.org /FSManual/07/02GeneralNeurol.html (2110 words)

	Excitability changes in human peripheral nerve axons in a paradigm mimicking paired-pulse transcranial magnetic ...
		The soleus H reflex was used in experiments to determine the effects of an intervening synapse on the neural volleys produced in the conditioning-test paradigm.
		The H reflex recovery curves suggest that the recovery cycle for the reflex response is influenced by the recovery of excitability of the stimulated afferent axons.
		As with all experiments involving H reflexes, the reflex response was sensitive to central and peripheral factors, and this probably explains the greater variability in the H reflex recovery curve than that of peripheral nerve (compare error bars in Fig.
	jp.physoc.org /cgi/content/full/542/3/951 (6937 words)

	THE MERCK MANUAL, Sec. 14, Ch. 165, Neurologic Approach To The Patient
		The biceps reflex is innervated predominantly by C-5; the radial, by C-6; the triceps, by C-7; the quadriceps knee jerk, by L-4; and the ankle jerk, by S-1.
		Hypoactive reflexes can be augmented by Jendrassik's maneuver, in which the patient locks his hands and vigorously pulls apart as the tendon in the lower extremity is tapped.
		The superficial abdominal reflex is elicited by lightly stroking the four quadrants of the abdomen with a pin.
	www.merck.com /pubs/mmanual/section14/chapter165/165c.htm (2545 words)

	PPT Slide (Site not responding. Last check: 2007-10-21)
		The patellar (or knee-jerk) reflex involves an extension of the leg due to contraction of the quadriceps, which is activated by a light tap applied to the patellar ligament.
		Achilles reflex (ankle jerk) involves extension of the foot in response to a light tap on the Achilles’ tendon.
		This reflex occurs in children under age one and a half years old and is due to incomplete myelination of the nervous system.
	www.bridgewater.edu /departments/psychology/sensation/lect004/tsld018.htm (262 words)

	Virtual Naval Hospital: United States Naval Flight Surgeon Manual: Third Edition 1991: Chapter 7: Neurology (Site not responding. Last check: 2007-10-21)
		The L-5 radiculopathy causes weaknessof the dorsiflexors and evertors of the foot and numbness and pain overthe lateral aspect of the leg and ankle and dorsal aspect of the foot.
		The most common disc syndrome in the cervical region is a C-6 radiculopathy, which causes weakness of theproximal upper extremity (deltoid, biceps, and wrist flexors), diminished biceps and brachioradialis reflex, numbness over the thumb and index finger, and pain in the arm radiating to the thumb and index finger.
		The peroneal nerve may be entrapped at the fibular head, either due to trauma or compression (prolonged leg crossing) and results in weakness of the dorsiflexor of the ankle and toes, foot evertors, and numbness of the dorsal aspect of the foot.
	www.vnh.org /FSManual/07/10CommonSpine.html (3143 words)

	The deep tendon and the abdominal reflexes -- Dick 74 (2): 150 -- Journal of Neurology, Neurosurgery, and Psychiatry
		The H reflex is the electrical equivalent of the tendon jerk,
		Tendon reflexes are brisk in the newborn (the plantar responses
		limb, the patellar reflex (quadriceps) and the ankle jerk (triceps
	www.jnnp.com /cgi/content/full/74/2/150 (3017 words)

	Biol 2401 Anatomy (Site not responding. Last check: 2007-10-21)
		Reflexes are rapid, predictable, involuntary motor responses to stimuli, they are mediated over neural pathways called reflex arcs.
		Reflex testing is a diagnostic tool for assessing the condition of the nervous system.
		Distorted, exaggerated or absent reflex responses may indicate degeneration or pathology of the NS Spinal cord injury, reflex tests help pinpoint the are or level of injury.
	www.accd.edu /pac/science/hopper/biol2401/labunit4/reflexes.htm (576 words)

	Uses of Reflexes
		For example, a plantar reflex is normally initiated by stroking the sole of the foot, and the usual response is flexion of the foot and toes.
		The Babinski reflex is present normally in infants up to the age of twelve months and is thought to reflect immaturity in their corticospinal tracts.
		This reflex is elicited in males by stroking the upper inside of the thigh.
	www.mhhe.com /biosci/ap/holehaap/student/olc2/n-reading27.html (430 words)

	GLOSSARY OF MEDICAL TESTS AND SIGNS
		Biceps Reflex: The tendon of the biceps is tapped.
		In corticospinal tract lesions, the reflex is excessive.
		Cremasteric Reflex (Males): A pin is used to stroke the inside of the thighs.
	www.ncpainmanagement.com /GlossaryOfTests.htm (2713 words)

	Sensorimotor integration at spinal level as a basis for muscle coordination during voluntary movement in humans -- ...
		The H reflex is influenced by changes in the excitability of the spinal motoneurons.
		Disynaptic reciprocal inhibition of the soleus H reflex (Sol H) was evoked by stimulation of the PN in the same way as in Fig.
		Conversely, in relation to dorsiflexion, a significant increase of the inhibition was seen before the onset of EMG in the ankle dorsiflexors, and this increase of inhibition was maintained throughout the ramp phase of the contraction.
	jap.physiology.org /cgi/content/full/96/5/1961 (5077 words)

	The Straight Dope: During a physical, why does the doctor tap your knee with a hammer?
		When the doctor tests your reflexes she's tapping the tendon that connects the muscle to the bone, which causes the muscle to stretch slightly.
		A faulty reflex in itself is not conclusive evidence that you have one of the problems above.
		If your patellar reflexes bite but your triceps reflexes are OK, that may mean you've got a lesion (injury) between your second lumbar vertebra and your--ah, never mind, only your doctor needs to know the details.
	www.straightdope.com /classics/a5_100.html (551 words)

	Knee jerk definition - Medical Dictionary definitions of popular medical terms
		The knee jerk is best tested by giving a smart tap on the patellar tendon while the lower leg hangs loosely at a right angle with the thigh.
		Absence of the knee jerk can be due to an abnormality in the "reflex arc" required for the reflex to occur (the muscle "spindles" or the nerve fibers going from the patellar tendon to the spinal cord and returning from the spinal cord to the quadriceps).
		It is less often referred to as the knee phenomenon, the knee reflex, the patellar tendon reflex, or the quadriceps reflex.
	www.medterms.com /script/main/art.asp?articlekey=4116 (524 words)

	Influence of long-term spaceflight on neuromechanical properties of muscles in humans -- Lambertz et al. 94 (2): 490 -- ...
		The H reflex was elicited by a submaximal electrical stimulus (1-ms duration) to the posterior tibial nerve, with the cathode
		by a sudden releasing of the footplate of the ankle ergometer.
		Facilitation and inhibition of the human H reflex as a function of the amplitude of the control reflex.
	jap.physiology.org /cgi/content/full/94/2/490 (5543 words)

	Epidemiologic Notes and Reports Case of Paralytic Illness Associated With Enterovirus 71 Infection
		The left knee-jerk reflex was absent; the left ankle-jerk reflex was present but slightly weaker than the right.
		The plantar reflex was downgoing and equal bilaterally.
		Reflexes were present, but they were slightly weaker in the left leg than in the right.
	www.cdc.gov /mmwr/preview/mmwrhtml/00001050.htm (1433 words)

	Sprained Ankle Fetish (Site not responding. Last check: 2007-10-21)
		The patient states that she sprained her right ankle two days ago by...
		Ankle In anatomy, the ankle is the part of the lower limb that is located between the foot and the leg.
		Ankle jerk reflex The ankle jerk reflex, also known as the Achilles reflex, occurs when the Achilles tendon is tapped while the foot is dorsi-flexed.
	www.bomills.com /Sprained+Ankle+Fetish-33.html (473 words)

	Reflexes
		Reflexes are generally lost in proportion to weakness
		Reflexes may be lost proximally but normal distally in muscular dystrophies
		Aging: Tendon reflexes at ankles absent in 6% of normals over age 65
	www.neuro.wustl.edu /neuromuscular/mother/reflex.html (257 words)

	ankle - Hutchinson encyclopedia article about ankle
		Hinge joint connecting the lower leg and the foot.
		It is formed by the ankle bone (talus) that fits into a socket provided by the lower ends of the tibia and fibula.
		His ankle was throbbing, and he gave it an examination.
	encyclopedia.farlex.com /Ankle (168 words)

	The Virtual Hospital: Acute Low Back Problems in Adults: Assessment and Treatment
		Specific testing of the dorsiflexor muscles of the ankle or great toe (suggestive of L5 or some L4 nerve root dysfunction), hamstrings and ankle evertors (L5-S1), and toe flexors (S1) is also important.
		The ankle jerk reflex tests mostly the S1 nerve root and the knee jerk reflex tests mostly the L4 nerve root; neither tests the L5 nerve root.
		Pain below the knee at less than 70 degrees of straight leg raising, aggravated by dorsiflexion of the ankle and relieved by ankle plantar flexion or external limb rotation, is most suggestive of tension on the L5 or S1 nerve root related to disc herniation.
	www.janela1.com /vh/docs/v0004362.htm (666 words)

	Motor neurone disease Health Guide - Health Guides Online
		The most common form is demyelinating neuropathies where the myelin sheaths (fatty tissue layers that coat a nerve acting as insulators) of neurones are lost.
		An example of this is diabetic neuropathy where there can be motor or sensory symptoms (loss of sensation in hands and feet) with a loss of ankle jerk reflexes.
		If it is solely a motor neuropathy, there is asymmetric wasting of the quadriceps muscles with a decrease or loss of the knee jerk reflex.
	www.healthguidesonline.com /Motor_neurone_disease.html (2087 words)

	Re: F-wave value
		It measures the time it takes for the impulse from the point of stimulation up to the spinal cord and back down the peripheral nerve to the muscle that is being recorded.
		In simple term, H-reflex is the electrical equivalence of the ankle jerk.
		Normal values/the range of the H reflex latency is 25-35 msec.
	www.medhelp.org /forums/neuro/archive/13443.html (314 words)

	Achilles' tendon reflex (www.whonamedit.com)
		Ankle jerk, ankle reflex, tendo Achilles reflex, triceps surae reflex.
		The variations and their significance correspond closely to those of the knee jerk.
		It is exaggerated in upper motor neuron disease and diminished or absent in lower motor neuron disease.
	www.whonamedit.com /synd.cfm/138.html (138 words)

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