Plantar Reflexes and its equivalents with youtube video

The Normal Plantar Reflex

Nocireceptive relfex
Root value : S1

Stroking the lateral aspect of the sole with a sharp object produces (In increasing order of stimulus)

1. Flexion of all five toes 
2. Dorsiflexion and inversion of foot (with stronger stimuli)
3. Contraction of adductors of thigh, sartorius and tensor fascia lata.

Different resposnses

Normal: Flexor/Downgoing plantar reflex  (as mentioned above)

Babinski Sign (Extensor/ upgoing plantar reflex)

Components of extensor reflex are 

1. Dorsiflexion of great toe (precedes all other movements)
2. Fanning (outspreading) and extension of remaining four toes 
3. Dorsiflesion of ankle. flexion of knee and hip joint 
4. Contraction of fascia tensor lata 

Equivocal/incomplete/variable response

No Response 

Withdrawal reflex

Preparing for Exam : Check if you have all necessary instruments necessary for CNS examination 

Plantar Equivalents 

Oppenhiems sign 

Heavy pressure applied by thumb and index finger over the medial aspect of tibial (shin) from above down ward

Gordon Reflex

Squeezing or applying pressure over the calf muscle 

LMN UMN lesion of bladder 

?Shefer sign/?Schaefer Sign 

Squeezing the Achilles tendon 

Know the physiology behind the upper motor and lower motor neuron lesion.

Chaddock Sign 

Striking the skin just below lateral malleolus and moving anterior /in circular fashion 

Bing sign 

Prinking the dorsum of foot or great toe by a pin

Moniz sign 

Forceful passive flexion of ankle 

Gonda sign 

Forceful stretching or snapping of distal phalanges of euther the 2nd or the 4th toe 

Brissauds reflex

Contraction of tensor fascia lata in amputated/absent great toe patients or complete paralysis of extensors of toe

Rossimillo Sign 

Tap the ball of the foot or flick the distal phalages of toe into extension nad allow them to fall back to their normal position produces  PLANTIFLEXION of ALL phalanges. (Only sign with Plantiflexion of great toe)

Equivalent of Hoffmann's Sign 

Hoffmann sign 

Flex the distal interpalangeal joint of the middle finger and now flick it down suddenly, response is brisk flexion and abduction of thumb as well as flexion of the other fingers.

Videos

All reflexes in one video

Sources
http://www.ncbi.nlm.nih.gov/books/NBK397/
www.youtube.com
Harrisons Text Book Of Medicine
Bedside Clinics In Medicine 6e (Arup Kumar Kundu)

Strawberry Sign In Medicine

Strawberry cervix:  trichomoniasis. (Trichomonas vaginalis)

erythematous cervix with pinpoint areas of exudation

Strawberry gallbladder: cholesterolosis

Change in the gall bladder bladder wall due to excessive Cholesterol

Strawberry gingivitis/gums:  

Wegener's granulomatosis: immunologically mediated uncommon multisystemdisorder affecting aerodigestive tract

Sarcoidosis

Strawberry nevus/hemangioma: capillary hemangioma
benign condition appearing after birth characterized by endothelial prolifeartion 

Find all the terms named after Kocher 

Strawberry tongue:

Glossitis with hyperplastic fungiform Papillae
Scarlet Fever :GABH Streptococcus Infection
kawasaki disease: Vasculitis seen in Children
Toxic Shock Syndrome: Fatal illness caused by toxins of Staphylocccus aureus and streptococcus Pyogenes

Strawberry Shaped Nasal Mass: rhinosporidiosis

Chronic granulomatous disease caused by Rhinosporidium seeberi, characterised by production of polyps and other manifestations of hyperplasia of nasal mucosa

Strawberry skin : sarcoidosis

Strawberry shaped skull: 
Edward syndrome 

Trisomy 18

KOCHERS- All terms named after Theodor Kocher

Emil Theoder Kocher was a 1909 Nobel laureate who was a swiss researcher and physician. many instruments, surgical procedures, incision used to open various parts of the body and many clinical signs has been named after him to commemorate his outstanding achievement in the field of medicine. The following are some of the terms named after him 

Kocher's forcep/Clamp

It is a strong hemostatic forceps with serrated blades with interlocking teeth at the tip.

Kocher's sign

When clinician places his hands on patient’s eye and lifts it higher, patients eyelids springs up more quickly than the eyebrow, seen in Graves' Ophthalmopathy.

Kocher's incision

1.     In abdomen, it is an oblique  incision in right upper quadrant for open cholecystectomy. 

2.     In neck, it is  a transverse, slightly curved incision about 2 cm above the sternoclavicular joints

All other surgical incisions in the abdomen. 

Kocher's Maneuver:

1.     Kocherisation is a surgical maneuver to expose structures in the retroperitoneum behind the duodenum and pancreas; for example to control hemorrhage from the inferior vena cava or aorta, or to facilitate removal of a pancreatic tumor.

2.     In shoulder dislocation it is a maneuver used to reduce dislocations by externally rotating the shoulder, before adducting and internally rotating it.

Kocher's Reflex:

It is a sign elicited as contraction of abdominal muscles, in response to testicular compression.

Kocher's vein

The middle thyroid vein is named as Kocher's vein.

All the conditions with Strawberry signs 

Kocher's Test: 

The test to elicit obstruction is trachea is named as Kocher's test. Slight compression of the lateral lobe of thyroid gland produces stridor. If the test is positive, it signifies that the patient has an obstructed trachea.

Kocher's Point:

Common entry point for an intraventricular catheter to drain cerebral spinal fluid from the cerebral ventricles. It is located 2.5 centimeters from the midline (at approximately the mid-pupillary line) approximately 11 cm posterior to the nasion

Kocher–Debre–Semelaigne syndrome

A type of Hypothyroidism in infancy or childhood is named as Kocher-Debre-Semelaigne Syndrome. The components of which are: lower extremity or generalized muscular hypertrophy, myxoedema, short stature and cretinism.

Exception

Though named as Kocher, the following are totally different Kochers and not to be confused with Emil Theoder Kocher.

Kocher Criteria

It is a criteria to differentiate Septic Arthritis from transient synovitis in children with hip joint inflammation .It is named after Mininder S. Kocher, who was an orthopedic surgeon.

Kocher Approach

It is a incision on the skin and deep down the muslces to elbow. It is a Posterolateral Approach to Elbow allowing the  exposure of the entire distal humerus as well as radial head, radial neck, and biceps tuberosity.

Kocher's interval

It is a interneural interval between the ANCONEUS and the Extensor carpi Ulnaris

Sources (SRB Textbook of surgery, Wikipedia and online resources)