Study Guide Questions: 5.

1. Unlike extremity reflexes which use muscle spindles to trigger the response,
most superficial reflexes are cutaneous reflexes, provoked by tactile stimuli to a
localized area of skin or mucous membranes.

2. Are superficial reflexes graded? What term is used to describe the

superficial reflexes?
Whether they are absent or present
3. What type of problem is it when the superficial reflexes are absent
bilaterally?
Upper motor neuron
4. What type of problem is in when the superficial reflexes are absent
unilaterally?
Lower motor neuron, or something just affecting one side

Case study 1
Jack is a 40-year-old labourer who has decided to change his career. He has
decided to enroll into University and has been undertaking his studies now for
around two years. Jack now presents to you with headaches which seem to be
worse with studying. Upon taking the case history, he mentions his mother suffers
the same problem

ASSUME ALL OTHER EXAMINATION AND CASE HISTORY FINDINGS ARE

UNREMARKABLE.
Jack has been diagnosed with tension headaches.
1. List the statements (clues) in the case history that aligns with the
diagnosis of tension headaches. Use the script concordance. (Found in
Moodle)
a. Headaches – brought on by studying

2. The above case history is incomplete. What further questions or what

information would you need to acquire?
a. LODSTRAPPA
b. Point to where it hurts
c. When did you first notice the headaches?
d. How long do they usually last?
e. Are they getting better or worse?
f. What type of pain is it? – dull or sharp
g. Do you feel the pain anywhere else?
h. Does anything makes the pain better?
i. Does anything make the pain worse?
 j. Have you been to see anyone about your headaches before?
k. Have you ever had headaches before the most recent episodes?
l. Have you noticed anything else that has changed since getting the
headaches?

3. List the muscles (trigger points that are likely to refer pain to the head
leading to tension headaches?
a. Suboccipitals

For case study 1 indicate the likely

outcome for the following tests. Is it
likely to be positive or negative?
Discuss false positives and
negatives.
Pelvic Rock Test Negative

Hoovers Test Negative

Stoop Test Negative

Brachial Plexus Nerve Tension Test Negative

Upper Limb Nerve Tension Test 1 Negative

(ULNNT)

Gluteal Reflexes Negative

Superficial Visceral Abdominal Negative

Reflexes

Djerine’s Triad (Cough,Valsalva and Possibly

Sneeze)

Lhermittes Sign Negative

False positive = test is positive but the disease is absent

False negative = test is negative but the disease is present