Shallow reflex examination

A shallow reflex that stimulates the skin or mucous membrane to cause a reaction is called a shallow reflex. Commonly used corneal reflex examination, abdominal wall reflex examination, cremaster reflex examination, sputum reflex examination, anal reflex examination. Prepare the cotton, bamboo stick or slow needle to be used before inspection. Because emotional stress can affect the results of cremaster reflex, patients do not have to be too nervous and feel shy when doing cremaster reflex examination to prevent errors in the results. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: Prepare the required cotton, bamboo stick or slow needle before checking. The examiner was gentle and the subject remained emotionally stable. Normal value 1. It can be seen that the abdominal wall muscle contraction is normal when the abdominal wall reflects normal. 2. When the cremaster reflex is normal, the ipsilateral testicle is immediately lifted. 3. When the tendon reflex is normal, it can be seen that each toe is bent. If the above reaction is weakened or does not occur, the ankle reflex is weakened or disappeared. 4, when the anus reflex is normal, immediately see the anus contraction. 5. When the corneal reflex is normal, the bilateral orbital muscles contract. Clinical significance Abnormal result 1. Abdominal wall reflex is a normal reflex. If the abdominal wall is abnormally reflected, it has diagnostic value for many diseases. (1) Attenuation or disappearance of one side of the abdominal wall is seen in pyramidal tract damage, such as one side of the cerebral hemisphere lesions, most sclerosis. (2) One side of the abdominal wall is reflected in the unilateral chorea. (3) bilateral abdominal wall reflex hyperthyroidism is seen in extra-pyramidal system diseases such as Parkinson's disease and chorea, and occasionally in people with nervous or nervousness. (4) bilateral abdominal wall reflexes disappeared or disappeared without pathological significance, can be seen in the elderly, maternal, abdominal fat, abdominal wall relaxation or some abdominal diseases, such as peritonitis, ascites. 2, such as bilateral cremaster reflexes weakened or disappeared, suggesting that there is lumbar spinal cord injury, also seen in the elderly. Attenuation or disappearance of one side of the cremaster can be seen in pyramidal lesions, and can also be used in the diagnosis of certain surgical conditions (such as oblique hernia, varicocele, etc.). 3, sputum reflex is transmitted by the sacral nerve, through the lumbosacral spinal cord 2, still transmitted by the phrenic nerve. The ankle's reflex is weakened or disappeared, suggesting that the reflex arc is damaged. 4, weakened or disappeared anal reflexes indicate bilateral pyramidal or cauda equina damage. 5, corneal reflex can be affected by a variety of lesions. There are three common situations in which corneal reflex disappears. (1) Reflex arc afferent neuropathy The lesion of the trigeminal ocular branch, except for the sensory area of ​​the facial (the forehead skin), is accompanied by a decrease or disappearance of corneal reflex. When the lateral trigeminal nerve damage causes corneal paralysis, there is no reaction on both sides, and the bilateral reaction can still be caused when the contralateral corneal reflex is performed. The common cause of attenuated corneal reflex is the early symptoms of the first damage of the trigeminal nerve. As the lesion progresses, the corneal reflex disappears. Since the cerebellum is also distributed by the first branch of the trigeminal nerve, corneal reflexes may be weakened in the early stage of the cranial fossa, such as cerebellar hemorrhage, cerebellopontine angle cholesteatoma. It has been reported that ipsilateral corneal reflexes are weakened and/or disappeared, which is an important indication for localization diagnosis. (2) Efferent neuropathy of the corneal reflex (peripheral facial paralysis) The efferent nerve of the corneal reflex is the facial nerve. When the peripheral facial neuropathy occurs, the cornea can not be closed after being stimulated (blinking). In view of it, the corneal reflex disappears. When the lateral nerve is paralyzed, the ipsilateral corneal reflex disappears and the contralateral reflex exists. (3) One side of the cerebral hemisphere lesions unilateral corneal reflexes weakened or disappeared, often part of partial numbness, and in many cases of hemiplegia, the cornea may be the only numb area. Some people think that there is a corneal reflex center in the parietal lobe, which may be explained. If the bilateral corneal reflexes weaken or disappear, it indicates extensive damage on both sides of the brain (such as deep coma, cerebral edema, cerebral hypoxia), and invades the intracerebral reflex arc of corneal reflex. People who need to be examined: patients who are suspected of having nerve damage. Precautions Contraindications before inspection: Prepare the cotton, bamboo stick or slow needle to be used before inspection. Requirements for inspection: 1. Inspectors should pay attention to the strength when using cotton, bamboo sticks or blunt bamboo sticks to avoid excessive injury. 2, due to emotional stress can affect the results of cremaster reflex, so patients do not have to be too nervous and feel shy when doing cremaster reflex examination to prevent errors in the results. 3. The inspection should be carried out in the direction required by each inspection. Inspection process 1, corneal reflex examination method The examinee looks inward and upwards, and the physician uses a fine cotton swab to gently touch the patient's cornea from the outside of the cornea. Normally, the eyelid of the examinee is quickly closed, which is called direct corneal reflex. If the cornea is stimulated on one side, the eyelid closure reaction also occurs on the contralateral side, which is called indirect corneal reflex. Direct corneal reflex disappeared in the affected side of the sputum, both direct and indirect reflexes disappeared, seen in the affected side of the trigeminal (ocular branch) lesions and deep coma patients. 2, abdominal wall reflection inspection method The paralyzed patient is lying on his back, the lower limbs are slightly bent to relax the abdominal wall, and then the skin of the abdominal wall is gently stroked by the matchstick or the blunt bamboo stick in the upper, middle and lower parts. Abdominal muscle contraction can be seen in normal people in the stimulated area. 3, cremaster reflex examination method Use a matchstick or a blunt-tipped bamboo stick to gently smear the inner side of the skin from the bottom up. In normal people, it can cause ipsilateral cremaster contraction and lift the testicles. 4, when the sputum reflection check The paralyzed patient is supine, the hip and knee joint are straight, and the doctor holds the patient's ankle with a blunt-headed bamboo stick. The blunt-headed bamboo stick is used to slash the lateral side of the foot to the small toe joint and then to the toe side. The surface is flexed, and the reflection center is 1 to 2 knots in the iliac pulp. 5, anal reflex examination The examiner uses a cotton swab to gently stroke or use a pin to gently puncture the perineal skin around the anus of the patient. When normal, the anus is contracted immediately. If the above reaction is slow or does not occur, the anal reflex is weakened or disappeared. Not suitable for the crowd Inappropriate crowd: 1, abdominal wall reflex: patients with abdominal damage. 2, cremaster reflex: patients with severe testicular loss. 3. Phlegm reflex: a patient with a lower limb or hip joint disability or injury. 4, anal reflex: patients with anal, perineal injury. 5, corneal reflex: patients with eye pain or inflammation. Adverse reactions and risks Nothing.