Patellar tendon reflex

In a study of diabetic Pima Indians, Nelson et al. (7) identified risk factors associated with a high probability for limb amputation among diabetic individuals. These included presence of diabetic retinopathy, nephropathy, hypertension, absent patellar tendon reflexes, and presence of medial arterial calciflcation. However, no single risk factorwas identified as being relatively more important than another. 

Not surprisingly, lead levels like these made many people sick and resulted in multiple adult deaths. Of the 404 cases of water-related lead poisoning documented by Bacup s health officer, 21 suffered from wristdrop 197 from headaches a few from spastic paralysis 206 from abdominal colic 148 from anemia several from insomnia and 339 exhibited the blue gum line. In 71 cases there was no patellar tendon reflex —that is, no knee-jerk in response to stimulation. Vision problems were not uncommon, including three cases of temporary blindness that lasted from a few minutes to a few days. Vertigo was also not uncommon while a sense of heat and burning in the soles of the feet was rare but not unheard of. In nearly every case the perspiration was lessened. In 148 cases, obstinate constipation was present and the faeces were hard and dry, and showed deficiency of bile. A forerunner of saturnine nephritis, albuminuria occurred in many individuals. Shooting pains in the hands, arms, back, and legs were very common, and usually mistaken for muscular rheumatism. ... 

A simple example of the muscle spirrdle reflex is the patellar tendon reflex. The knee, when flexed to 90 degrees, places the quadriceps muscle into a relatively stretched position The sudden strike of a hammer against the tendon resrrlts in a dynamic stretch of the spindle and firing of the la (and possibly II) fiber the alpha motor nemon is then stimulated and in tiun induces quadriceps contraction arrd knee extension (Fig. 6-4B). 

Keywords— Patellar tendon reflex. Motion analysis. 

This study investigated the ability of motion analysis in obtaining quantitative measurements for one of the DTR, the patellar tendon reflex which is commonly known as the knee jerk. Motion analysis is widely applied in area such as sports, rehabiUtation, gait analysis, prosthetics and orthotics [6], [7], Cameras capturing the motion of reflective markers attached on human joints produce 3D motion, allowing detail analysis of the motion at a specific joint. This method is hoped to solve problem in reflex assessment by providing objective results for the judgments. 

The patellar tendon reflex tests were carried out in the Motion Analysis Laboratory under the Department of Biomedical Engineering, University of Malaya, Kuala Lumpur, Malaysia. All tests were recorded and processed using the motion analysis system named Vicon Nexus 1.4. 

Patellar tendon reflexes were examined by tapping the tendon with a Queen Square reflex hammer. To study the effect of different tapping force on patellar tendon reflex, the Queen Square reflex hammer was released at three different angles. Firstly, tendon was tapped with reflex hammer released at 30° which was named Force 1. Taps were also applied at 60° named Force 2 and 90° which named Force 3. 

Quantification of Patellar Tendon Reflex by Motion Analysis... 

Quantification of patellar tendon reflex by motion analysis produced significant results. The technique of motion analysis is having great potential to further quantify deep tendon reflexes. The objective method to assess deep tendon reflexes is hoped to solve current problem in reflex assessment. 

A 28 year-old woman with Kearns-Sayre Syndrome, previously exposed multiple times to lidocaine, underwent planned tooth extraction after injection of articaine 1.5 ml (60 mg) with adrenaline (0.009 mg) (168). Within 5 minutes she complained of a feeling of heat, fatigue, weakness, and a desire to sleep. She was unable to walk or stand and had frequent urination. At 20 hours after the injection she had diffuse weakness, reduced tendon and absent patellar reflexes, and sub-clonic Achilles tendon reflexes. She recovered fully 48 hours after the injection. 

Lungs and chest, not including breast examination. Abnormal chest wall expansion, abnormal respiratory rate, abnormal breath sounds including wheezes or alveolar rales, impaired respiratory function, cyanosis, 12. Neurological Impaired equilibrium, coordination or speech pattern asymmetric deep tendon reflexes, sensory or positional abnormalities, abnormal patellar and Babinski s rellexes. ... 

Tapping on the patellar tendon using Force 2 is the normal tapping range applied by the physicians in clinical examination of reflexes. In order to study the effect of tapping force on reflex response, data obtained for Force 1 and Force 3 was compared to data for Force 2, which was the... 

An interneuron together with a sensory afferent and motor efferent form a polysynaptic reflex (Figure 2.2) this comprises the initial stage of information input (sensory afferent), the processing/computing an appropriate response (interneurons) and the execution of a behavioural response (motor efferent). The simplest reflexes in the nervous system are monosynaptic reflexes, such as the familiar tendon (knee) jerk, these do not involve an interneuron. The sensory afferent activated by the mechano-receptor (the tap of the patellar hammer) forms a synapse with the motor efferent in the spinal cord, which then causes the skeletal muscle to contract and the crossed leg to jerk forward. With a synaptic delay of 1 millisecond (ms), the time between input and output increases with the number of synapses introduced into the circuit. As an... 

---