Systematic case-taking / by Henry Lawrence McKisack.

  • McKisack, Henry Lawrence.
Date:
1912
Catalogue details

Licence: In copyright

Credit: Systematic case-taking / by Henry Lawrence McKisack. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    downward the patella, the leg being fully extended. It is only found when the knee-jerk is exaggerated. Ankle clonus is a rhythmical contraction of the calf muscles, observed in conditions of exalted reflexes; it is demonstrated by putting the muscles in question on the stretch by pressure on the sole of the foot, causing the foot to be flexed dorsally. This may be enough to produce the clonus, but it is usually necessary to give a stimulus by sudden pressure on the sole, further in- creasing the flexion of the foot. This phenomenon is rarely foimd in health. A single jerk [ankle-jerk) on strik- ing the tendo AchiUis is similarly a sign of increased reflexes. Arm-jerks may be found at times in health, but are usually an evidence of excessive reflex activity. The following may be mentioned : Wrist-jerk: a tap on the extensor tendons just above the wrist causes the hand to be extended. Elbow-jerk, an extension of the bent forearm on striking the triceps tendon just above the joint; a flexion of this joint may also be obtained by striking the biceps or supinator longus tendons. Scapulo- humeral reflex, an external rotation of the arm on striking the spinal border of the scapula; when the reflex is ex- aggerated more extensive motions of the arm occur. Jaw-jerk, not usually found in health. The patient’s mouth being open, one finger of the observer is placed, pleximeter fashion, on the chin, and a downward stroke is given with the finger of the other hand ; an upward jerk of the jaw follows, and if pressure be kept up clonic contractions may occur. (2) Skin or superficial reflexes are of less diagnostic value, as, with the exception of the dorsal flexion of the toe, their occurrence is uncertain in health and disease. They are useful at times in estimating the level at which