Reflexes and Signs for Staff Nurse Exams

reflexes and signsIf we look at the question papers, we can see frequently asked questions about reflexes and signs. Questions about major syndromes also will be asked. That we will deal in another article. This article deals in detail about important reflexes and signs that nurses need to study before appearing for competitive staff nurse exams. 

Frequently asked Reflexes and Signs in staff nurse exams

What is a reflex?

Reflex may be defined as a specific motor response elicited by a specific stimuli

To be precise, there is around 356 reflexes. so its difficult for a nursing student to study all those. So what we can do in this area? We can learn frequently asked reflexes in all competitive staff nurse exams. Try to revise these often as its very difficult to remember. So lets start

1. Abdominal reflexes – contractions of the abdominal muscles on scratching of the abdominal wall.

2. Achilles tendon reflex – The ankle jerk reflex, also known as the Achilles reflex, occurs when the Achilles tendon is tapped while the foot is dorsi-flexed. A positive result would be the jerking of the foot towards its plantar surface.

3. Babinski’s reflex – Dorsiflexion of the big toe on stimulating the sole of the foot; normal in infants but in others a sign of a lesion in the central nervous system, particularly in the pyramidal tract. Called also Babinski’s phenomenon or sign and toe phenomenon or sign.

4. Babkin reflex –  Pressure by the examiner’s thumbs on the palms of both hands of the infant results in opening of the infant’s mouth; it is elicited in many newborn infants, normal and abnormal, except when lethargic or comatose.

5. Cremasteric reflex –  Stimulation of the skin on the front and inner side of the thigh retracts the testis on the same side.

6. Doll’s eye reflex – When the head is rotated laterally, the eyes deviate synergistically in the opposite direction; assessed in premature infants and the comatose to test for integrity of function of the oculomotor nerves and brain stem. Called also Cantelli’s sign and doll’s eye sign.

7. Geigel’s reflex – A reflex in the female corresponding to the cremasteric reflex in the male; i.e., on stroking of the inner anterior aspect of the upper thigh there is a contraction of the muscular fibers at the upper edge of Poupart’s ligament;

8. Jaw reflex or jaw jerk reflex – Closure of the mouth caused by a downward blow on the lower jaw while it hangs passively open. It is seen only rarely in health, but is very noticeable in lesions of the corticospinal tract.

9. Kocher’s reflex – Contraction of the abdominal muscle on compression of the testicle;

10. Landau reflex – When an infant is held in the prone position, the entire body forms a convex upward arc; gentle pressure on the head or gravity flexes the neck and hip, reversing the arc.

11. Moro’s reflex or Moro embrace reflex – Flexion of an infant’s thighs and knees, fanning and then clenching of the fingers, with arms first thrown outward then brought together as if in an embrace, produced by a sudden stimulus such as the table being struck next to the child, or by sudden extension of the neck when the head is allowed to fall backward or the child is pulled up by both hands from a lying position and then let go. It is seen normally in infants up to 3 to 4 months of age.

12. Peristaltic reflex – When a portion of the intestine is irritated or distended, the area just proximal contracts and the area just distal relaxes.

13. Gag Reflex – Pharyngeal reflex, contraction of the constrictor muscle of the pharynx elicited by touching the back of the pharynx;

14. Pilomotor reflex – The production of goose flesh on stroking the skin;

15. Plantar reflex – Irritation of the sole contracts the toes;

Important signs in medicine

There is around 456 signs in medicine. So its difficult to learn the signs fully. But what we can do is learn the frequently asked ones or the important ones. Lets study

What is a sign?

Sign is an objective evidence of a disease ie evidence that is perceptible to the examining nurse.

Then, What is symptom?

Symptom is subjective sensation of the patient.

Important Signs

1. Abadie’s sign – Spasm of the levator palpebrae superioris muscle; a sign of Graves’ disease.

2. Allis’ sign – Relaxation of the fascia between the crest of the ilium and the greater trochanter: a sign of fracture of the neck of the femur.

3. Auspitz sign – Appearance of multiple fine bleeding points when a scale is removed from a psoriatic plaque, caused by thinning of the epidermis over the dermal papillae.

4. Babinsky sign – The Babinski reflex occurs after the sole of the foot has been firmly stroked. The big toe then moves upward or toward the top surface of the foot. The other toes fan out. Normal upto 2 year old.

5. Bamberger’s sign – Presence of signs of consolidation at the angle of the scapula, which disappear when the patient leans forward; a sign of pericardial effusion.

6. Banana sign – A flattened and curved, banana like shape of the cerebellar hemispheres seen in axial section in sonography of the fetal skull; a sign of the Arnold-Chiari deformity.

7. Battle’s sign – Discoloration over the skin of the mastoid region of the skull, in the line of the posterior auricular artery, the ecchymosis first appearing near the tip of the mastoid process; seen in fracture of the base of the skull.

8. Biot’s sign – Biot’s respiration is an abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea.

9. Bird’s sign – A definite zone of dullness with absence of the respiratory sounds in hydatid disease of the lung.

10. Blumberg’s sign, pain on abrupt release of steady pressure (rebound tenderness) over the site of a suspected abdominal lesion; seen in peritonitis.

11. Braxton Hicks’ sign – Braxton Hicks contractions are intermittent uterine contractions that start in early pregnancy (before six months)

12. Brudzinski’s sign – In meningitis, flexion of the neck usually results in flexion of the hip and knee

13. Chadwick’s sign – A dark bluish or purplish-red and congested appearance of the vaginal mucosa, an indication of pregnancy

14. Chvostek’s sign or Chvostek-Weiss sign – Spasm of the facial muscles elicited by tapping the facial nerve in the region of the parotid gland; seen in tetany.

15. Cogwheel sign – Cogwheel rigidity is a combination of lead-pipe rigidity and tremor which presents as a jerky resistance to passive movement as muscles tense and relax.

16. Cole’s sign – Deformity of the duodenal contour as seen in the radiograph, a sign of the presence of duodenal ulcer.

17. Corrigan’s sign – Watson’s water hammer pulse, also known as Corrigan’s pulse or collapsing pulse, is the medical sign which describes a pulse that is bounding and forceful, rapidly increasing and subsequently collapsing, as if it were the sound of a waterhammer that was causing the pulse

18. Cullen’s sign – A bluish discoloration of the skin around the umbilicus sometimes associated with intraperitoneal hemorrhage, especially following rupture of the uterine tube in ectopic pregnancy.

19. Goodell’s sign – Softening of the cervix uteri as a sign of pregnancy.

20. Halo sign – A halo effect produced in the radiograph of the fetal head between the subcutaneous fat and the cranium; said to be indicative of intrauterine death of the fetus.

21.Hegar’s sign – Softening of the lower segment of the uterus, an indication of pregnancy.

22. Homans’ sign – Pain on passive dorsiflexion of the foot; a sign of thrombosis of deep calf veins

23. Kernig’s sign – A sign of meningitis: the patient can easily and completely extend the leg when in dorsal decubitus position but not when in the sitting posture or when lying with the thigh flexed upon the abdomen.

24. Kussmaul’s sign – Distention of the jugular veins on inspiration, seen in constrictive pericarditis and mediastinal tumor

25. Kopliks sign – Koplik spots (also Koplik’s sign) are a prodromic viral enanthem of measles manifesting two to three days before the measles rash itself.

26. McBurney’s sign – Tenderness at a point two-thirds the distance from the umbilicus to the anterior superior spine of the ilium; indicative of appendicitis. See also under point.

27. Macewen’s sign – On percussion of the skull behind the junction of the frontal, temporal, and parietal bones, there is a more resonant note than normal in internal hydrocephalus and cerebral abscess. Called also cracked-pot sound and cranial cracked-pot sound.

28. Murphy’s sign – A sign of gallbladder disease consisting of interruption of the patient’s deep inspiration when the physician’s fingers are pressed deeply beneath the right costal arch, below the hepatic margin.

29. Romberg’s sign – Swaying of the body or falling when standing with the feet close together and the eyes closed; the result of loss of joint position sense, seen in tabes dorsalis and other diseases affecting the posterior columns.

30. Rovsing’s sign – Pressure on the left side over the point corresponding to McBurney’s point will elicit the typical pain at McBurney’s point in appendicitis

31. Turner’s sign – Discoloration (bruising) and induration of the skin of the costovertebral angle caused by extravasation of blood in acute hemorrhagic pancreatitis.

32. Trousseau’s sign – A test for latent tetany in which carpal spasm is induced by inflating a sphygmomanometer cuff on the upper arm to a pressure exceeding systolic blood pressure for 3 minutes. A positive test may be seen in hypocalcemia and hypomagnesemia.

33. Wernicke’s sign – Hemiopic pupillary reaction – In hemianopia, a reaction due to damage of the optic tract, consisting in loss of pupillary constriction when the light is directed to the blind side of the retina; pupillary constriction is maintained when light stimulates the normal side. This sign cannot be seen with a bright light because of intraocular scatter onto the seeing half of the retina.

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