Deep Tendon Reflexes - A Definitive Guide
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- Опубліковано 1 чер 2024
- A review of the deep tendon reflexes (a.k.a. muscle stretch reflexes), including how to check and document them, and common etiologies of reflex abnormalities.
#reflexes #neurology #physicalexam #physicaldiagnosis
5:46 - Biceps
6:28 Brachioradialis
8:16 - Triceps
9:25 - Patella
10:13 - Ankle
Cheers
This is the best explanation of Deep Tendon Reflexes I ever saw. This is the true art and science of Medicine. Thank you .
I wanted to right exact the same thing
Your videos on different topics are of great help to all. They are the best guides. Thanx.
Thank you Dr. Eric. I can see how much effort you put in to explain each and every topic so clearly and with so many references. I have great respect for you. I'm a resident in internal medicine in Kashmir. We still use the notation on our patient files routinely here.
Love your videos Dr. Strong. I am a nurse practitioner student and they are very helpful. Keep up the good work.
It’s like you read my mind! I really needed this thank you for breaking it down.
Great as always Dr. Strong
The metal at the end caught me off guard! Good taste. Very informative info on reflex testing as well.
The best teaching video I ever watched
Thank you very much
Just came to say I love definitive guides.
This is best explanation I ever saw in my study
Thanks soooooo match doctor
You are such amazing ❤❤
Thanks for putting efforts in making these useful videos.
Thank you so much. You made it look very easy.
Thank you dr eric for this very informative channel
Great tips on eliciting the achilles reflexes from the supine position.. Almost all of my patients are supine on the ED cot, and I struggle to get a response from my patients often.
Great video of all those I watched on DTR. Thank you.
Excellent demonstration .. thankyou very much Sir
Super helpful! Very clear examination and testing. Many thanks!
We aren't able to film at the med school at the moment, so we improvised a little.
This was great! Thanks!
Thank you to your wife for volunteering 😅
@@rumit9946 I think she said this was the last time...
Thank you for this extremely helpful tutorial
amazing as usual, thanks a lot doctor.
Best video on reflex ever
Very informative. Thanks for sharing.
Thank you very much Dr. Strong.
Thank you so much. I have an exam next week and this was actually so helpfull,💞
Very informative sir.
Thanks !
Thank you for this amazing video!
Thanks its excellent presentation
excellent lecture!
Thank you for your wonderful explanation about reflexes sir you had given a complete understanding explanation sir....thank you so much sir...same way I am expecting all clinical methods to learn from you sir🙏🏽🙏🏽🙏🏽🙏🏽
Thank you so much Sir for Informational video🙏🙏
This is amazing!! Thank you
Thank you Dr. Strong
Great job Dr. Strong. As usual, this video on reflex exam far exceeds any learning experience I had on reflexes (lecture, textbook, or other video). I find the most common problem with the reflex exam in my trainees is total absence of reflex exam. Absence of exam, in turn, is likely caused in large part by lack of adequate understanding of and confidence with the exam, which this video can correct.
Also, I'm buying a Babinski hammer on your recommendation. I'll be interested to see if it improves my reflex exam skills and/or on the fly neurological exam teaching.
Thanks for the kind words Dr. Gowen. I completely agree on the lack of reflex testing being associated with a lack of confidence - applies to much of the physical exam! I hope the Babinski turned out to be a good investment!
Highly recommended 👌
very helpful thank you rmt student have a great day.
Thanks Dr. Strong
Thank you sir you are my role model
Among students in Germany Trömner reflex hammer is very common. We also learn about tibialis posterior reflex (L5/S1) and Trömner reflex (C7/C8). Not sure if relevant in clinical practice. Definitely one of your coolest videos :)
As an American non-neurologist, I've never seen either of those checked in practice, though I wouldn't infer that means they shouldn't be. I'm not familiar enough with them to have an opinion.
@@StrongMed real educated men answer like this. nice man
Nice explain
Thank you. So very helpful. Awesome video. Sorry I bought the Taylor hammer. LOL! But I got the Queen square now.
Thank you very much!
The best Video
this video is very helpful :) thanx
جزاك الله خيرا
Thank you so much 💕
Thanks Dr Eric I love you so much you really help me alot I love Aproach Series
I appreciate
From SOMALIA
magacaga ka garty ina somalia thy ✌
Aaad iyo aaad yariisow
Thank you very much
Oh no, I have the Taylor hammer only, and I'll be in emergency medicine rotations today. 🤦🏾♂️🤦🏾♂️🤦🏾♂️
Thank you sir.❤
Start a series on CVS or Neurological system
What a great explanation! Thank you. What would you suggest using if none of the suggested options are available? For instance, I work in HEMS and have to elicit DTRs for my high risk OB transports. This is an extremely difficult environment to test DTRs, and reflex hammers and other devices like that are not readily stocked or available. Would the handle of shears work? Or some other easily available object?
Wow, I haven't before had to consider eliciting reflexes in a helicopter before!
Anything long with a relatively heavy striking end will work. I would think that shears would be better than either your fingertips or the head of a stethoscope, but I've never compared them. But give it a go, and let us know if it does the job!
@@StrongMed thank you! I’ll give it a go!
I am learning so much from these videos! Dr. Strong, do you have a Patreon page, by chance?
I do: www.patreon.com/strongmedicine. Unfortunately, it's been dormant since COVID hit. With remote schooling my kids and helping to redesign our med school's curriculum to virtual format only, I had to free up bandwidth, and my Patreon was a casualty of that. With US COVID cases surging (with hosptial census now high), and kids still at home, I haven't been able to give it any attention.
When reflex responses are absent this could be a clue that the spinal cord, nerve root, peripheral nerve, or muscle has been damaged👍
Great video as always. Is it true that hyperreflexia is suggestive of an upper motor neuron lesion and hyporeflexia is suggestive of a lower motor neuron lesion?
Yes, that is a general principle. I chose not to explicitly state that in the video because I was trying to keep it relatively short and sufficiently discussing the difference between upper and lower motor neuron disease would add a few minutes to the runtime. It also feels a little like an oversimplification (e.g. acute stroke with hyporeflexia, ALS being an upper and lower motor neuron disease but usually causing only hyperreflexia) without a longer explanation of the exceptions.
Thank you sir
amazing
doc i just had a reflex test by a orthopedic doctor my kness didnt bump he hit me few times ,what do you think any never damage.i live ur video by the way ,,
I have very strong patellar reflexes. I get embarrassed as I usually kick the doc performing the test. I always have to apologise. Its like I'm taken over by Jackie Chan for a split second.
The best ever
Thank you Dr Strong . Good lecture and I even know from you that distracting procedure named , I will get a new hammer.
Thank you
This man is subtly hilarious😂😂
Would you say that the L4 reflexes 9:49 on her is considered a 3+?
شكرا جزيلا
Sir, make a video of cranial nerve examination
more videos also .... superficial reflexes and other neuro exams.....pls
I was hoping to do a much longer video on the whole neuro exam, but my model (i.e. my wife) isn't super excited about being filmed. Also, filming an exam video in front of a green screen was not very satisfying. So I think I may need to defer the rest of the exam until I can safely film with standardized patients in our simulation center again - best case scenario, summer 2021. But we'll see...
I personally prefer a Queen's Square or a Babinski because none of the others have necessary weight! But the more pointed hammers used by neurologists are doubtless more of use for them, because they need to precisely hit the exact part of the tendon they're aiming for. For a non-neuro like myself, larger heavy hammers are better! Harder to muck it up.
Thanks
Please list the name/brand/model of the telescoping hammer you're using. Thanks
This is the hammer I was using in the video: www.amazon.com/Prestige-Babinski-Telescoping-Reflex-Hammer/dp/B00062N496
However, it has the same problem as discussed in the product reviews: loose hinge. I ended up superglueing it in position.
I don't know how durable it is over the long-term, but I've also used this MDF hammer and found it much better (though >2x as expensive): www.amazon.com/MDF-Telescoping-Neurological-superficial-Free-Parts/dp/B00AZF36R4/ref=sr_1_4?dchild=1&keywords=mdf+babinski+hammer&qid=1605703265&s=industrial&sr=1-4
@@StrongMed Thanks 👍. Keep up the great work
I wonder, what's stopping my Lecturers from teaching me like this
Thanks m8
nice new color grading
Thanks! This was a particularly nice comment since the color grading was driving me crazy this time around, and I couldn't get myself satisfied with it. I usually film in front of a white screen and key it out, but with the white sheet on the exam table, it wasn't an option.
I got my reflex hammer at home depot. It works great.
Pls explain in detail history taking and case presentation of medicine long and short cases.
♥️♥️
With your eliciting the Brachioradialis reflex, the forearm is going into pronation, rather than supination !!!!!
❤❤❤❤❤❤❤❤
Tq
Was the knee jerk on the video considered normal?
Yes. There is a range of normal, and this person's knee jerk might be on the upper end of that range, but not in itself abnormal. If the patellar reflexes were asymmetric, that would be abnormal. Or if those were a person's patellar reflexes, but every other reflex was difficult to obtain, that also might suggest something worthy of further investigation.
I find when a patient can’t relax, it helps if I make it a joke and ask them to pretend to relax. Helps 60%+ of the time, IME. maybe it’s the distraction as you said. 🤷🏻♀️
My ankle reflex Grade is 0, so even walking takes 50% more effort than anyone else 😂😂
wtf I can't tingle to this.
Why aren't you wearing your glasses ?
I had laser eye surgery 7-8 years ago that mostly corrected my farsightedness, but which induced some nearsightedness. So I now use glasses with reading and using screens, but not generally at other times.
It's sad that educational videos (that are as good as this one) have 100x less views than the 8 yo putting hot sauce in his eyes for entertainment.
Thanks for the sentiment! While more views are always nice (all things being equal), my target audience is probably much smaller than that of the 8 year old with hot sauce. So as long as people who will most benefit from my videos are the ones seeing them, I'd still consider 1% of the views a success!
Dude seems very judgmental, nothing wrong with the Taylor hammer and no patient ever complains about being struck lightly in rapid succession..
Judgmental? About a hammer? Really?
@@StrongMed maybe judgmental is a strong word 😅
Thanks
Thanks
Thanks