The Supinator Jerk - CETL

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Supinator DMCdeS 11.11.01

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The Supinator Jerk 1. What it is. A contraction of the supinator muscle when the supinator tendon is stretched. 2. What it tests. A reflex arc involving the 5th and 6th cervical segments. 3. The stimulus A sharp tap over the supinator tendon using a patellar hammer. 4. How to elicit it • Bend the patient’s arm at the elbow so it is lying relaxed across the lower part of the chest. • Gently support the arm by holding it against the chest • Identify the supinator tendon just above the elbow • Swing the patellar hammer down and strike the supinator tendon sharply. Don’t put your finger on the tendon.. 5. Grade and interpret the response This is the same as for the knee jerk 6. Confirm the finding Repeat the observation 7. Test the other side. 8. What can go wrong • The commonest problem is failure to identify the supinator tendon properly. • You find no reflex because the patient is not relaxed. Say “ Relax you shoulders” this works better than asking them to relax their arm.

Supinator DMCdeS 11.11.01

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• You find no reflex because the striking the patient’s arm is painful. They have some other problem there. • You poked at the tendon rather than striking it sharply. The tendon has to be stretched fairly quickly to elicit the reflex. • You did not stretch the tendon enough to start with. • You hit the muscle and not the tendon. Muscle contraction under these circumstances is a direct response and not dependent on an intact reflex arc.

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The Supinator Jerk - CETL

Supinator DMCdeS 11.11.01 1 The Supinator Jerk 1. What it is. A contraction of the supinator muscle when the supinator tendon is stretched. 2. What ...

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