As a nurse and nursing student, you will learn how to assess the deep tendon reflexes. In this article, I will discuss how to assess the brachioradialis tendon reflex along with a video demonstration.
The deep tendon reflex examination is part of the neuro assessment for the nursing head to toe assessment. This assessment is usually conducted during the head-to-toe nursing assessment. Nurses do not routinely assess the deep tendon reflexes unless they work in settings such as labor and delivery or neurology or a patient’s condition warrants it (electrolyte imbalances etc.).
Why do nurses assess the deep tendon reflexes?
It helps evaluate the lower motor neurons/fibers at certain levels of the body. For example, the triceps reflex evaluates C7 to C8, and the brachioradialis reflex evaluate C5 to C6.
Grading Scale for Deep Tendon Reflexes
4+ Hyperactive (clonus)
3+ Brisker than normal (hyperreflexive)
1+ Diminished (hyporeflexive)
Demonstration on How to Assess Brachioradialis Deep Tendon Reflex
How to Assess the Brachioradialis Deep Tendon Reflex
- Find the brachioradialis tendon (this takes practice and is one of the most difficult tendons to locate)
- Locate the styloid process on the wrist (nodule on the wrist) and go 2-3 cm above the process
- Relax the patient’s forearm by resting it on their thigh.
- Tap the tendon briskly with the reflex hammer TIP: don’t swing the hammer too slow or fast and don’t leave the hammer on the tendon after tapping the tendon
Expected Response of the Brachioradialis Deep Tendon Reflex
You will see the forearm flex at the elbow and the hand supinate (palm will turn upward).