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Patellar (Knee) Deep Tendon Reflex Assessment

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 patellar 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)

2+ NORMAL

1+ Diminished (hyporeflexive)

0 Absent

Demonstration on How to Assess Patellar Deep Tendon Reflex

How to Assess the Patellar Deep Tendon Reflex

  1. knee jerk reflexFind the patellar tendon.
  2. Locate the knee cap area and have the patient extend the leg. You will find the tendon becomes more pronounce right below the knee cap.
  3. Now have the patient relax and dangle the leg.
  4. Tap with the reflex hammer briskly on the patellar tendon.

Expected Response of the Patellar Deep Tendon Reflex

You will see the lower leg extend.

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