Reflexes: Classification, Types, and Clinical Tests
A reflex is an involuntary, automatic, and stereotyped motor response to a specific sensory
stimulus, mediated through a reflex arc.
Reflex Arc
The basic neural pathway through which reflex action occurs. It consists of 5 essential components:
1. Receptor – detects stimulus (e.g., muscle spindle, skin).
2. Afferent (sensory) neuron – carries impulse to spinal cord/brainstem.
3. Integration center – synapse(s) in spinal cord or brainstem.
- Monosynaptic (1 synapse, e.g., stretch reflex).
- Polysynaptic (multiple interneurons, e.g., withdrawal reflex).
4. Efferent (motor) neuron – carries command to effector.
5. Effector – muscle or gland producing response.
Physiology of Reflex
1. Stimulus activates receptor.
2. Afferent impulse travels via sensory neuron.
3. Integration occurs at spinal cord/brainstem.
4. Motor output sent via efferent neuron.
5. Response is involuntary, rapid, stereotyped (e.g., knee jerk).
Classification of Reflexes
A. Based on Anatomical Pathway: Monosynaptic, Polysynaptic
B. Based on Development: Primitive, Acquired
C. Based on Function: Superficial, Deep tendon, Visceral, Pathological
D. Based on Clinical Testing: Superficial, Deep, Pathological
Common Reflex Tests
Reflex Root Level / Nerve Method of Testing Normal Response
Biceps jerk C5–C6, Musculocutaneous Tap tendon in cubital fossa Elbow flexion
Triceps jerk C7–C8, Radial nerve Tap tendon above olecranon Elbow extension
Knee jerk L2–L4, Femoral nerve Tap patellar tendon Knee extension
Ankle jerk S1–S2, Tibial nerve Tap Achilles tendon Plantarflexion
Plantar reflex L5–S1 Stroke sole of foot
Normal: plantar flexion; Abnormal: Babinski sign
Pathological Reflexes
- Babinski sign: Dorsiflexion of great toe, fanning of others.
- Hoffman’s reflex: Flicking distal phalanx → thumb/index flexion.
- Clonus: Rhythmic contractions on sudden stretch.
- Jaw jerk exaggerated: UMN lesion above pons.
