Patient Lying Down

Observe flexion at the elbow, and watch for and feel the contraction of the biceps muscle.

The Triceps Reflex (C6, C7). Flex the patient's arm at the elbow, with palm toward the body, and pull it slightly across the chest. Strike the triceps tendon above the elbow. Use a direct blow from directly behind it. Watch for contraction of the triceps muscle and extension at the elbow.

If you have difficulty getting the patient to relax, try supporting the upper arm as illustrated on the right. Ask the patient to let the arm go limp, as if it were "hung up to dry." Then strike the triceps tendon.

The Supinator or Brachio-radialis Reflex (C5, C6). The patient's hand should rest on the abdomen or the lap, with the forearm partly pronated. Strike the radius about 1 to 2 inches above the wrist. Watch for flexion and supination of the forearm.

The Abdominal Reflexes. Test the abdominal reflexes by lightly but briskly stroking each side of the abdomen, above (T8, T9, T10) and below (T10, T11, T12) the umbilicus, in the directions illustrated. Use a key, the wooden end of a cotton-tipped applicator, or a tongue blade twisted and split longitudinally. Note the contraction of the abdominal muscles and deviation of the umbilicus toward the stimulus. Obesity may mask an abdominal reflex. In this situation, use your finger to retract the patient's umbilicus away from the side to be stimulated. Feel with your retracting finger for the muscular contraction.

Abdominal reflexes may be absent in both central and peripheral nervous system disorders.
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