1.

Unlike extremity reflexes which use muscle spindles to trigger the response,
most superficial reflexes are Superficial reflexes, provoked by Sharp Stroking
stimuli to a localized area of Skin or Mucous membrane

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

superficial reflexes?
- No they are either present or not present

3. What type of problem is it when the superficial reflexes are absent

bilaterally?
- Upper motor neuron lesion

4. What type of problem is in when the superficial reflexes are absent

unilaterally?
- Lower motor neuron lesion

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)
o Postural imbalances from studying
o Forward head position when studying
o Aerobic exercise encouraged

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

information would you need to acquire?
o What area are you feeling the headaches?
o When did you first start getting these headaches?
o How long does each headache usually last?
o Do you ever feel nauseous with headaches?
 o Do your headaches progress or have they gotten worse?
o What type of pain are you feeling in your head?
o Are you getting any radiated pain?
o Does anything relieve the headaches?
o Have you had any treatment for headaches previously?
o Any other signs or symptoms that you have noticed recently?
o Where do you usually study?
o How is your study space set up?
o Is there any time of day that you notice your headaches are worse?

3. List the muscles (trigger points that are likely to refer pain to the head
leading to tension headaches?
o Suboccipital muscles
o Masseter

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 positive

Stoop Test False positive

Brachial Plexus Nerve Tension Test

Upper Limb Nerve Tension Test 1

(ULNNT)

Gluteal Reflexes present

Superficial Visceral Abdominal present

Reflexes

Djerine’s Triad (Cough,Valsalva and negative

Sneeze)

Lhermittes Sign Negative