Patellar reflex help

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mrslackalot

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  1. MD/PhD Student
So how hard do you hit in order to determine if someone is hyperreflexive (patellar)? I mean if you hit hard enough, everyone will get a big reflex. Can't find any good videos online.
 
3+ is often a judgement call. You look for asymmetry between sides, you check for spread to another joint or into the contralateral limb, and you seek other signs of hyperreflexia (upgoing toes, Hoffmans).
 

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a nice one from Harrison's -

It is important to determine the smallest stimulus required to elicit a reflex rather than the maximum response.

Good set of videos here - http://www.neuroexam.com/neuroexam/
 
Look for clonus. sustained v non-sustained. you can also try the quad tendon just suprapatellar and move proximally. also try the crossed adductor response.
 
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