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Monday, February 29, 2016

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


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 

?Shefer sign/?Schaefer Sign 

Squeezing the Achilles tendon 

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)

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