Common percussion methods for diagnostic hammer

Diagnostic hammer is also percussion hammer. Diagnostic hammer is the main diagnostic tool for doctors to check the neuromuscular reflex of patients, mainly used for the physical examination of patients. Doctors assess the patient's condition by observing the reflexes and infering the patient's nerve damage.

1.Biceps reflex (C5-6, musculocutaneous nerve)

Forearm is placed in a mild pronation and semi-flexion position. The examiner places the thumb on the biceps tendon and taps the thumb with a percussion hammer. Reflex activity is represented by flexion of the forearm.

2.Triceps reflex (C6-7, radial nerve)

The forearm of the patient is placed in the pronation and semi-flexion position. The examiner holds the elbow joint with his hand and taps the triceps tendon above the olecranon with a percussion hammer. Reflex activity is manifested as forearm stretching.

3.Radial membrane reflex (C5-8, radial nerve)

The forearm is placed in a slightly flexion and semi-pronation position, and the radial styloid process is struck with a percussion hammer. Reflex movement: elbow bending, forearm pronation, sometimes with finger flexion.

4.Knee tendon reflex (L2-L4, femoral nerve)

When sitting, the knee flexion is 90°, and the lower leg drops naturally. In the supine position, the knee joint is about 120° flexion position. Tap the quadriceps tendon just below the knee with a percussion hammer. Reflex activity is calf extension.

5.Achilles tendon reflex (S1-S2, tibial nerve)

The tester holds the foot with the hand and makes the ankle slightly dorsiflexion. After tapping the Achilles tendon with a percussion hammer, the gastrocnemius and soleus muscles contract, thus the ankle joint flexes toward the plantar surface.

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