deep tendon reflex

腱反射、深部腱反射

WordNet

1. with head or back bent low; "a deep bow"
2. the central and most intense or profound part; "in the deep of night"; "in the deep of winter"
3. literary term for an ocean; "denizens of the deep"
4. to an advanced time; "deep into the night"; "talked late into the evening" (同)late
5. strong; intense; "deep purple"; "a rich red" (同)rich
6. exhibiting great cunning usually with secrecy; "deep political machinations"; "a deep plot"
7. extending relatively far inward; "a deep border"
8. extreme; "in deep trouble"; "deep happiness"
9. having great spatial extension or penetration downward or inward from an outer surface or backward or laterally or outward from a center; sometimes used in combination; "a deep well"; "a deep dive"; "deep water"; "a deep casserole"; "a deep gash"; "deep massage"; "deep pressure receptors in muscles"; "deep shelves"; "a deep closet"; "surrounded by a deep yard"; "hit the ball to deep center field"; "in deep space"; "waist-deep"
10. large in quantity or size; "deep cuts in the budget"
11. marked by depth of thinking; "deep thoughts"; "a deep allegory"
12. relatively deep or strong; affecting one deeply; "a deep breath"; "a deep sigh"; "deep concentration"; "deep emotion"; "a deep trance"; "in a deep sleep"
13. relatively thick from top to bottom; "deep carpets"; "deep snow"
14. to a great distance; "penetrated deep into enemy territory"; "went deep into the woods"
15. very distant in time or space; "deep in the past"; "deep in enemy territory"; "deep in the woods"; "a deep space probe"
16. manage or run; "tend a store"
17. have a tendency or disposition to do or be something; be inclined; "She tends to be nervous before her lectures"; "These dresses run small"; "He inclined to corpulence" (同)be given, lean, incline, run
18. have care of or look after; "She tends to the children"
19. an automatic instinctive unlearned reaction to a stimulus (同)reflex response, reflex action, instinctive reflex, innate reflex, inborn reflex, unconditioned_reflex, physiological reaction
20. a cord or band of inelastic tissue connecting a muscle with its bony attachment (同)sinew
21. (of leaves) bent downward and outward more than 90 degrees

PrepTutorEJDIC

1. (表面から下方または内部へ)『深い』 / (程度が)非常な,深い / 奥行きの深い,奥まった / 奥深くて測りしれない,深遠な / 《補語にのみ用いて》(…の)奥深いところにいる(ある)《+『in』+『名』》 / (思想・感情などが)深い,強い / (色が)濃い / (音・声が)低い,太い / 『深く』 / 〈C〉(特に海洋の)『深い所』;海溝 / 《the~》《文》海 / 《the~》《古》(冬などの)さなか
2. 〈人が〉(…の)『傾向がある』,(…)しがちである / 〈物事が〉(ある方向に)向かう,(ある状態に)向かう
3. 〈人・動植物など〉‘の'『世話をする』,めんどうをみる / 《米》〈店〉‘の'番をする / 《tend to+名》…に気をつける,心を配る
4. 反射(刺激に対する無意識の反応) / 《複数形で》反射的な動き / (光などの)反射,反射光;映像 / 反射性の / (カメラが)レフ鋼の,反射型の
5. 腱(けん)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/10/05 09:26:02」(JST)

wiki en

[Wiki en表示]

The stretch reflex (myotatic reflex) is a muscle contraction in response to stretching within the muscle. It is a monosynaptic reflex which provides automatic regulation of skeletal muscle length.

When a muscle lengthens, the muscle spindle is stretched and its nerve activity increases. This increases alpha motor neuron activity, causing the muscle fibers to contract and thus resist the stretching. A secondary set of neurons also causes the opposing muscle to relax. The reflex functions to maintain the muscle at a constant length.

Gamma motoneurons regulate how sensitive the stretch reflex is by tightening or relaxing the fibers within the spindle. There are several theories as to what may trigger gamma motoneurons to increase the reflex's sensitivity. For example, alpha-gamma co-activation might keep the spindles taut when a muscle is contracted, preserving stretch reflex sensitivity even as the muscle fibers become shorter. Otherwise the spindles would become slack and the reflex would cease to function.

This reflex has the shortest latency of all spinal reflexes including the Golgi tendon reflex and reflexes mediated by pain and cutaneous receptors.

Examples

A person standing upright begins to lean to one side. The postural muscles that are closely connected to the vertebral column on the side will stretch. Because of this, stretch receptors in those muscles contract to correct posture.

Other examples (followed by involved spinal nerves) are responses to stretch created by a blow upon a muscle tendon:

• Jaw jerk reflex (CN V)
• Biceps reflex C5/C6
• Brachioradialis reflex C6
• Extensor digitorum reflex C6/C7
• Triceps reflex C7/C8
• Patellar reflex L2-L4 (knee-jerk)
• Ankle jerk reflex S1/S2

Another example is the group of fibers in the calf muscle, which synapse with motor neurons supplying muscle fibers in the same muscle. A sudden stretch, such as tapping the Achilles' tendon, causes a reflex contraction in the muscle as the spindles sense the stretch and send an action potential to the motor neurons which then cause the muscle to contract; this particular reflex causes a contraction in the soleus-gastrocnemius group of muscles. Like the patellar reflex, this reflex can be enhanced by the Jendrassik maneuver.

Supraspinal control

The central nervous system can influence the stretch reflex via the gamma motoneurons, which as described above control the sensitivity of the reflex.

Inhibitory signals arrive at gamma neurons through the lateral reticulospinal tract from Brodmann area 6, the paleocerebellum and the red nucleus. Facilitatory signals arrive through the ventral reticulospinal tract from Brodmann area 4, the neocerebellum and the vestibular nucleus. [Citation Needed]

Spinal control

• Withdrawal reflex
• Damping & Loading reflex
  • Jendrassik maneuver

Pathology

Grading of stretch reflexes upon tapping muscle tendon

Grade	Response	Significance
0	no response	always abnormal
1+	slight but definitely present response	may or may not be normal
2+	brisk response	normal
3+	very brisk response	may or may not be normal
4+	clonus	always abnormal

The clasp-knife response is a stretch reflex with a rapid decrease in resistance when attempting to flex a joint. It is one of the characteristic responses of an upper motor neuron lesion.

See also

• Reflex
• Proprioception

References

External links

• Reflex, Stretch at the US National Library of Medicine Medical Subject Headings (MeSH)
• "Stretch reflex" at Dorland's Medical Dictionary

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 成人における詳細な神経学的検査 the detailed neurologic examination in adults
• 2. 新生児の神経学的検査 neurologic examination of the newborn
• 3. 末梢神経疾患および筋疾患の鑑別診断 differential diagnosis of peripheral nerve and muscle disease
• 4. 成人におけるギラン・バレー症候群の臨床的特徴および診断 clinical features and diagnosis of guillain barre syndrome in adults
• 5. 小児における身体的診察：背部、四肢、神経系、皮膚、およびリンパ節 the pediatric physical examination back extremities nervous system skin and lymph nodes

English Journal

• A Rare Case of Painful Trigeminal Neuropathy Secondary to Lateral Medullary Infarct: Neuroimaging and Electrophysiological Studies.

• Huang CT1, Lo CP2, Chen YC1, Tu MC1.
• Acta neurologica Taiwanica.Acta Neurol Taiwan.2015 Jun;24(2):63-8.
• PURPOSE: To report a rare case of painful trigeminal neuropathy after lateral medullary infarct and probe its underlying pathogenesis on the basis of neuroimaging and electrophysiological study.CASE REPORT: A 45-year-old man presented acute onset of unsteady gait followed by paroxysmal and electric
• PMID 26179839

• Clinical availability of the deep tendon reflex test using a novel apparatus in healthy subjects.

• Kim YW1.
• Journal of physical therapy science.J Phys Ther Sci.2015 Feb;27(2):317-20. doi: 10.1589/jpts.27.317. Epub 2015 Feb 17.
• [Purpose] The aim of this study was to investigate the clinical usefulness of a novel apparatus intended to improve the consistency and reliability of the deep tendon reflex (DTR) test. [Subjects] The participants included 50 healthy adults (25 male and 25 female) between 20 and 31 years of age wh
• PMID 25729159

• Posterior reversible encephalopathy syndrome as presenting form of very early systemic sclerosis.

• Pedraza MI1, Barbado J2, Ruiz M1, Guerrero ÁL1.
• Case reports in neurological medicine.Case Rep Neurol Med.2015;2015:290378. doi: 10.1155/2015/290378. Epub 2015 Feb 23.
• Introduction. Posterior Reversible Encephalopathy Syndrome (PRES) is an increasingly recognized clinical and radiological entity with a wide spectrum of symptoms. Its mechanism depends on failure of the blood-brain barrier due to high systemic blood pressure (BP) and loss of integrity of vascular en
• PMID 25802777

Japanese Journal

• 多発性単神経炎を呈し緩徐進行性の運動障害を主徴とした原発性シェーグレン症候群の1例

• 臨床神経学 55(10), 753-758, 2015
• NAID 130005103331

• 多発性単神経炎を呈し緩徐進行性の運動障害を主徴とした原発性シェーグレン症候群の1例

• 臨床神経学 advpub(0), 2015
• NAID 130005094171

• Clinical availability of the deep tendon reflex test using a novel apparatus in healthy subjects

• Journal of Physical Therapy Science 27(2), 317-320, 2015
• NAID 130004835164

Related Links

• Deep Tendon Reflexes - Clinical Methods - NCBI Bookshelf

In a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body ...

• Deep tendon reflex | definition of deep tendon reflex by ...

a brisk contraction of a muscle in response to a sudden stretch induced by a sharp tap by a finger or rubber hammer on the tendon of insertion of the muscle. Absence of the reflex may be caused by damage to the ...

Related Pictures

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★リンクテーブル★

リンク元	「腱反射」
拡張検索	「absent deep tendon reflex」
関連記事	「deep」「tend」「reflex」

「腱反射」

　　[★]

英

tendon reflex, tendon jerk

同

筋伸展反射、深部腱反射 deep tendon reflex, DTR　⇔　(対)表在反射

関

深部反射

• 腱や骨の叩打によって引き起こされる単シナプス反射。
• 腱の叩打により筋紡錘で生じた求心性インパルスがIa求心性線維(Ia感覚線維)を介して反射中枢に達し、単シナプス的にα運動ニューロンを経て筋を収縮させる反射

反射の異常

亢進

• 反射中枢レベル以上の錐体路障害

• 大脳より抑制性インパルスを受けているため。

消失

• 反射弓の障害
• 下位運動ニューロン、神経根、末梢神経、筋など

表記方法

程度

BET

• 消失 absent －
• 減弱 diminished ±
• 正常 normal　＋
• やや亢進 slightly exaggerated　＋＋
• 亢進 moderately exaggerated　＋＋＋
• 著明な亢進 markedly exaggerated　＋＋＋

「absent deep tendon reflex」

　　[★]

• 深部腱反射消失

関

abnormal reflex、absent gag reflex、absent reflex、decreased gag reflex、decreased reflex、hyperreflexia、hyporeflexia、pendular reflex

「deep」

　　[★]

• adj.

• 深い、深部の、(病名)深在性の

関

deep-seated、profound

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　

「tend」

　　[★]

• 傾向がある、しやすい

関

apt、liable、predispose、susceptible

　 　 　 　 　

「reflex」

　　[★]

• n.

• 反射

関

reflect、reflection、reflective