The biceps tendon reflex is assessed by having the patient relax the arm and pronate the forearm midway between flexion and extension. The examiner should place a thumb firmly on the biceps tendon. The hammer is then struck on the examiner's thumb. This is demonstrated in Figure 21-39. The examiner should observe for contraction of the biceps tendon, followed by
flexion at the elbow. The examiner may also palpate the contraction of the muscle. This procedure is a test of the nerves at roots C5 to C6.
The brachioradialis tendon reflex is performed by having the patient's forearm in semiflexion and semipronation. The arm should be rested on the patient's knee. If a triangular reflex hammer is used, the wide end should strike the styloid process of the radius about 2.5 to 5 cm above the wrist. The examiner should observe for flexion at the elbow and simultaneous supination of the forearm. The position is demonstrated in Figure 21-40. This procedure is a test of the nerves at roots C5 to C6.
The triceps tendon reflex is tested by flexing the patient's forearm at the elbow and pulling the arm toward the chest. The elbow should be midway between flexion and extension. Tap the triceps tendon above the insertion of the ulna's olecranon process about 2.5 to 5 cm above the elbow. There should be a prompt contraction of the triceps tendon with extension at
Figure 21-41 Technique for testing the triceps tendon reflex.
Figure 21-42 Another test of the triceps tendon reflex.
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