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Reflex, Stretch: Reflex contraction of a muscle in response to stretching, which stimulates muscle proprioceptors.
 Science Education: Essentials of Physical Examinations III

Motor Exam II

JoVE Science Education

Source:Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

There are two main types of reflexes that are tested on a neurological examination: stretch or deep tendon reflexes, and superficial reflexes. A deep tendon reflex (DTR) results from the stimulation of a stretch-sensitive afferent from a neuromuscular spindle, which, via a single synapse, stimulates a motor nerve leading to a muscle contraction. DTRs are increased in chronic upper motor neuron lesions (lesions of the pyramidal tract) and decreased in lower motor neuron lesions and nerve and muscle disorders. There is a wide variation of responses and reflexes graded from 0 to 4+ (Table 1). DTRs are commonly tested to help localize neurologic disorders. A common method of recording findings during the DTRs examination is using of a stick ure diagram. The DTR test can help distinguish upper and lower motor neuron problems and can assist in localizing nerve root compression as well. Although the DTR of nearly any skeletal muscle could be tested, the reflexes that are routinely tested are: brachioradialis, biceps, triceps, patellar, and Achilles (Table 2). Superficial reflexes are segmental reflex responses that result from stim

 Science Education: Essentials of Physical Examinations III

Cranial Nerves Exam I (I-VI)

JoVE Science Education

Source: Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

During each section of the neurological testing the examiner uses the powers of observation to assess the patient. In some cases cranial nerve dysfunction is readily apparent: a patient might mention a characteristic chief complaint (such as loss of smell or diplopia), or a visually evident physical sign of cranial nerve involvement, such as in facial nerve palsy. However, in many cases a patient's history doesn't directly suggest cranial nerve pathologies, as some of them (such as sixth nerve palsy) may have subtle manifestations and can only be uncovered by a careful neurological exam. Importantly, a variety of pathological conditions that are associated with alterations in mental status (such as some neurodegenerative disorders or brain lesions) can also cause cranial nerve dysfunction, therefore any abnormal findings during a mental status exam should prompt a careful and complete neurological exam. The cranial nerve examination is applied neuroanatomy. The cranial nerves are symmetrical, therefore while performing the examination each side should be compared to the other. A physician should approach the examination in a systematic fashion an

 JoVE Immunology and Infection

Right Ventricular Systolic Pressure Measurements in Combination with Harvest of Lung and Immune Tissue Samples in Mice

1Department of Environmental Medicine, New York University School of Medicine, Tuxedo, 2Division of Allergy, Pulmonary, & Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, 3Division of Pulmonary Medicine, New York University School of Medicine


JoVE 50023

 JoVE Bioengineering

Surgical Technique for the Implantation of Tissue Engineered Vascular Grafts and Subsequent In Vivo Monitoring

1Department of Physiology & Bio-Physics, State University of New York Buffalo School of Medicine, 2Department of Pediatrics, State University of New York Buffalo School of Medicine, 3Department of Chemical and Biological Engineering, State University of New York Buffalo School of Engineering


JoVE 52354

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 JoVE Medicine

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention

1Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 2Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, 3Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, 4Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania


JoVE 51079

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 JoVE Neuroscience

A Behavioral Assay for Mechanosensation of MARCM-based Clones in Drosophila melanogaster

1Department of Biology, College of the Holy Cross, 2School of Medicine, Georgetown University, 3Department of Biochemistry, Giesel School of Medicine, Dartmouth College, 4School of Medicine, Tufts University, 5Transgenomic Inc., 6Department of Molecular, Cell and Cancer Biology, UMass Medical School


JoVE 53537

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