The nurse is assessing the deep tendon reflexes of a client with preeclampsia. Which method is used to elicit the biceps reflex?
A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.
B. The nurse loosely suspends the client’s arm in an open hand while tapping the back of the client’s elbow.
C. The nurse instructs the client to dangle her legs as the nurse strikes the area below the patella with the blunt side of the reflex hammer.
D. The nurse instructs the client to place her arms loosely at her side as the nurse strikes the muscle insert just above the wrist.
Correct Answer: A. The nurse places her thumb on the muscle inset in the antecubital space and taps the thumb briskly with the reflex hammer.
The biceps reflex is elicited by placing your thumb on the biceps tendon and striking the thumb with the reflex hammer and observing the arm movement. Repeat and compare with the other arm. Using a reflex hammer, deep tendon reflexes are elicited in all 4 extremities. Note the extent or power of the reflex, both visually and by palpation of the tendon or muscle in question.
Option B: This elicits the triceps reflex. The triceps reflex is measured by striking the triceps tendon directly with the hammer while holding the patient’s arm with your other hand. Repeat and compare to the other arm. The triceps reflex is mediated by the C6 and C7 nerve roots, predominantly by C7.
Option C: This elicits the patellar reflex. The patellar reflex is a deep tendon reflex, mediated by the spinal nerves from the levels L2, L3, and L4 in the spinal cord, predominantly in the root L4. The patellar reflex test is performed to determine the integrity of the neurological function, which is accomplished by hitting the patellar tendon below the knee cap with a test hammer
Option D: This elicits the radial nerve. For the testing of the brachioradialis reflex, the examiner places the patient in a seated position. From there, the clinician uses his or her forearm to support the patient’s forearm in a slightly pronated position. The physician supports the patient’s forearm rather than asking the patient to maintain the position to achieve relaxation of the muscle. Once in position, the physician delivers a series of quick hits to the area of the styloid process of the radius at the point of brachioradialis insertion.