The reflex hammer is a medical tool used to test neurological function and judge abnormalities in the nervous system. There are many shapes and designs, each designed to elicit slightly different reflex responses. Doctors use the hammer to stretch muscles and tendons, looking for a normal, timely motor response. Hyporeflexia or hyperreflexia could indicate injury or trauma.
The reflex hammer is a common medical tool used to elicit the deep tendon reflex response. Developed in the 1800s, it is probably one of the oldest and most widely recognized basic exam tools. This popular tool helps clinicians test neurological function and judge abnormalities in the central and peripheral nervous systems. Most people know a reflex hammer as the tool a doctor uses to tap a patient below the kneecap, but it can also be used on other parts of the body.
There are many shapes and designs of the basic reflex hammer. The Taylor hammer, or tomahawk, is the best known in the United States. It consists of a triangular rubber head attached to a straight metal handle.
Another famous reflex hammer is the Queen Square. The Queen Square hammer was developed for use in the National Hospital for Nervous Diseases in London, now known as the National Hospital for Neurology and Neurosurgery. It is a plastic rod with a sharp cone on one end and a small metal and plastic disc on the other end. Queen Square is the hammer most commonly chosen by neurologists in the UK.
Other reflex hammers developed over the years include the Babinski, Troemner, Berliner and Buck. Each malleus is designed to elicit slightly different reflex responses, including plantar, myotatic, and skin reflexes. These reflexes involve different areas of the body, including the foot, tendons and skin. A more recent addition to the market includes a hammer that claims to combine the functionality of five different hammers into one. It features an adjustable rotary head and meets the testing capabilities of Taylor, Troemner, Buck, Babinski and Berliner hammers.
Testing deep tendon reflexes using a reflex hammer is a simple task. The doctor uses hammer pulses to stretch the muscle and tendon. When the hammer strikes the muscle tendon, a response known as a reflex arc between the muscle and the spine or brainstem causes the muscles to contract immediately. Perhaps the best-known reflex test occurs when the hammer is applied directly under the patient’s kneecap, causing the lower leg to swing or kick.
When a doctor does a reflex exam, they’re looking for a normal, timely motor response. If the patient shows a weak or reduced response to the reflex test, this is referred to as hyporeflexia. Patients with the opposite response, a reflex that repeats itself or is exaggerated, show a condition known as hyperreflexia. Hypo- and hyperreflexia could indicate injury, trauma, or other problems along the motor neural pathways.
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