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Deep Tendon Reflexes (DTR)

A reflex is a motor response to a sensory stimulation that is used in an assessment to observe the integrity of the nervous system. They elicit a muscle contraction when the muscle's tenon is stimulated.

DTR Procedure Guidelines

The patient should be relaxed. The muscle should be placed on a slight stretch. A reflex hammer taps the tendon with an anticipated immediate response. Both sides of the body should be assessed. Reflexes can be graded as normal, exaggerated, or depressed, or no a scale of 0-4.

Grade 0

No Resonse

Grade 1+

Diminished/depressed response

Grade 2+

Active normal response

Grade 3+

Brisk/exaggerated response

Grade 4+

Very brisk/hyperactive; abnormal response

Biceps Tendon

C5-C6 Spinal Level; Contraction of the biceps muscle

Brachioradialis Tendon

C5-C6 Spinal Level; Elbow flexion and/or forearm pronation

Triceps Tendon

C7-C9 Spinal Level; Elbow extension or contraction of the triceps muscle

Patellar Tendon

L3-L4 Spinal Level; Knee extension

Tibialis Posterior Tendon

L4-L5 Spinal Level; Plantar flexion/inversion of the foot

Achilles Tendon

S1-S2 Spinal Level; Plantar flexion of the foot

Deep Tendon Reflexes (DTR)

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