The triceps reflex, a deep tendon reflex, is a reflex that elicits involuntary contraction of the triceps brachii muscle. It is sensed and transmitted by the radial nerve. The reflex is tested as part of the neurological examination to assess the sensory and motor pathways within the C7 and C8 spinal nerves.

Testing

The test can be performed by tapping the triceps

tendon A tendon or sinew is a tough band of fibrous connective tissue, dense fibrous connective tissue that connects skeletal muscle, muscle to bone. It sends the mechanical forces of muscle contraction to the skeletal system, while withstanding tensi ...

A tendon is a strip or sheet of

connective tissue Connective tissue is one of the four primary types of animal tissue, a group of cells that are similar in structure, along with epithelial tissue, muscle tissue, and nervous tissue. It develops mostly from the mesenchyme, derived from the mesod ...

that transmits the force generated by the contraction of muscle to the bone by attaching with it. Thus, in simple words, a tendon attaches a muscle to a bone with the sharp end of a

reflex hammer A reflex hammer is a medical instrument used by practitioners to test deep tendon reflexes, the best known possibly being the patellar reflex. Testing for reflexes is an important part of the neurological examination, neurological physical examin ...

while the forearm is hanging loose at a right angle to the arm. A sudden contraction of the triceps muscle causes extension,A straightening at the elbow joint) of the forearm and indicates a normal reflex.

Reflex arc

The arc involves the stretch receptors in the triceps tendon, from where the information travels along the radial nerve, through the C7/C8 nerve root to the spinal cord, and the motor signal for contraction returns through the radial nerve.A reflex arc is the path in the nervous system through which the sensory information (stimulation—sudden stretching of the triceps tendon in this case) travels to the spinal cord in form of an

action potential An action potential (also known as a nerve impulse or "spike" when in a neuron) is a series of quick changes in voltage across a cell membrane. An action potential occurs when the membrane potential of a specific Cell (biology), cell rapidly ri ...

through a

sensory neuron Sensory neurons, also known as afferent neurons, are neurons in the nervous system, that convert a specific type of stimulus, via their receptors, into action potentials or graded receptor potentials. This process is called sensory transduc ...

, and comes in contact with a

motor neuron A motor neuron (or motoneuron), also known as efferent neuron is a neuron whose cell body is located in the motor cortex, brainstem or the spinal cord, and whose axon (fiber) projects to the spinal cord or outside of the spinal cord to directly o ...

at a

synapse In the nervous system, a synapse is a structure that allows a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or a target effector cell. Synapses can be classified as either chemical or electrical, depending o ...

, which also carries an action potential back to the muscle of origin and results in its (triceps's) contraction. Note that the contact between the sensory and motor neurons does not require immediate involvement of the brain making it involuntary, though the sensation of stretch (as the hammer hits the skin and tendon beneath) and contraction of the muscle are both sent to the brain making the subject aware of the entire testing procedure.

Test indicators

* Absence of a reflex (areflexia): If no reflex is elicited then it is essential to try again with ''reinforcement'', with the patient clenching his or her teeth just as the reflex hammer strikes. If true, it can indicate a lower motor neuron lesion or a problem in the neuromuscular junction. * Hyperreflexia (a response far larger than considered normal): Indicates a potential

upper motor neuron Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles ...

lesion.

Absence of reflex

An absence of reflex can be an indicator of several medical conditions:

Myopathy In medicine, myopathy is a disease of the muscle in which the muscle fibers do not function properly. ''Myopathy'' means muscle disease ( Greek : myo- ''muscle'' + patheia '' -pathy'' : ''suffering''). This meaning implies that the primary defec ...

neuropathy Peripheral neuropathy, often shortened to neuropathy, refers to damage or disease affecting the nerves. Damage to nerves may impair sensation, movement, gland function, and/or organ function depending on which nerve fibers are affected. Neuropa ...

spondylosis Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense, it refers to spinal osteoarthritis, the age-related degeneration of the spinal column, which is the most common cause of spondylosis. The degener ...

, sensory nerve disease, neuritis, potential

lower motor neuron Lower motor neurons (LMNs) are motor neurons located in either the anterior grey column, anterior nerve roots (spinal lower motor neurons) or the cranial nerve nuclei of the brainstem and cranial nerves with motor function (cranial nerve lower ...

lesion A lesion is any damage or abnormal change in the tissue of an organism, usually caused by injury or diseases. The term ''Lesion'' is derived from the Latin meaning "injury". Lesions may occur in both plants and animals. Types There is no de ...

, or poliomyelitis. Other medical problems that may cause irregular reflexes include

Hyperthyroidism Hyperthyroidism is a endocrine disease in which the thyroid gland produces excessive amounts of thyroid hormones. Thyrotoxicosis is a condition that occurs due to elevated levels of thyroid hormones of any cause and therefore includes hyperth ...

Notes

References

External links

Illustration of reflex testing
{{Reflex Reflexes