Nervous and mental diseases . ng segments of that muscle, and a tap nearthe anterior superior spinous process starts the tensor Jacioz latce knee-jerk, or patellar reflex, being easily examined and frequently modi-fied by disease, is one of the most important of the muscle reflexes. Itis elicited generally by having the patient cross one knee over the otherwhile sitting. The under limb, with the knee at a right angle, shouldsupport the upper, which gently rests over it with all muscles relaxed. Asmart, quick blow with an object of some ounces weight, as with the backof a thin book
Nervous and mental diseases . ng segments of that muscle, and a tap nearthe anterior superior spinous process starts the tensor Jacioz latce knee-jerk, or patellar reflex, being easily examined and frequently modi-fied by disease, is one of the most important of the muscle reflexes. Itis elicited generally by having the patient cross one knee over the otherwhile sitting. The under limb, with the knee at a right angle, shouldsupport the upper, which gently rests over it with all muscles relaxed. Asmart, quick blow with an object of some ounces weight, as with the backof a thin book or the ulnar border of the hand, upon the patellar ligamentor just above the patella, is followed by a contraction of the anterior thigh-muscles, causing the suspended foot to move forward an inch or two. Ifthe patient is in bed, the limb to be examined may be lightly placed overits extended fellow, crossing it at the knee, and then the blow employed,or with the patient on his side, the knees partly flexed, the same thing may. Method of eliciting ankle-clonus. be done. When difficulty is encountered in securing this response, it is tobe remembered that unless the muscles are fully relaxed the patient mayinhibit the phenomenon, or that it may be so slight as to escape the patient be placed on a high chair or on the edge of a table so that thelegs are pendent, and at the same time his attention be diverted, the jerkmay usually at once be shown. It can also be reinforced, as described byJendrassik, by having the patient grasp some object vigorously with hishands, or by merely clenching his hands at the time the tendon is children or very nervous cases this reinforcement may be secured bydirecting the patient to forcibly grasp the examiners hand. It shouldonly be considered abolished when, thus reinforced, with the limbs un-clothed, the eyes closed, and the unemployed hand of the examiner uponthe rectus femoris, no response can be detected. Similar plans of r
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