REFLEXES THE CODES OF NEUROLOGY

reflexesneurologytaskindumankapak21432

SUPERFICIAL REFLEXES

Selcen Duran

Kırşehir Ahi Evran University, Faculty of Medicine, Department of Neurology, Kırşehir, Türkiye

Duran S. Superficial Reflexes. In: Duman T, editor. Reflexes The Codes of Neurology. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.75-87.

ABSTRACT

Superficial reflexes are involuntary muscle contractions that occur in response to stimulation of the skin’s surface. These reflexes are polysynaptic in nature, regulated by supraspinal centers (reticular formation, basal ganglia, cerebellum), and are typically assessed as either present or absent. unlike withdrawal reflexes, superficial reflexes involve the activation of localized muscle groups in response to non-painful stimuli. The absence of superficial reflexes may be observed under physiological conditions; however, when accompanied by pyramidal signs, such absence is considered clinically significant. This chapter discusses interscapular, superficial abdominal, gluteal, superficial anal, cremasteric, bulbocavernosus, plantar and, masseter inhibitory reflexes.

Keywords: Superficial reflex; Cutaneous reflex; Interscapular reflex; Superficial abdominal reflex; gluteal reflex; Superficial anal reflex; Cremasteric reflex; Bulbocavernosus reflex; Plantar reflex; Masseter inhibitory reflex

Referanslar

  1. McGee S. Evidence-based physical diagnosis e-book. Philadelphia : Elsevier Health Sciences, 2021:569-71. [Link]
  2. Campbell WW, Barohn RJ, DeJong RN. DeJong’s the Neurologic Examination 8th ed. Philadelphia: Wolters Kluwer, 2020:922-28. [Link]
  3. Goetz, CG. Textbook of Clinical Neurology. Philadelphia: Saunders Elsevier, 2007:243-60. [Link]
  4. Suri V. Clinical Neurological Examination and Localiza tion. New Delhi, Delhi India: Springer Nature Singapore, 2021:91-5. [Link]
  5. Barrett KE, Barman SM, Boitano S, Brooks HL. Ganong’s Review of Medical Physiology 23 rd. ed. New York: McGraw-Hill Education, 2009:149-55. [Crossref]  [PubMed]
  6. Snell RS. Clinical neuroanatomy 7th.ed. Philadelphia: Lippincott Williams & Wilkins, 2010:100-6. [Link]
  7. Hagbarth K. Spinal withdrawal reflexes in the human low er limbs. Journal of neurology, neurosurgery, and psychiatry. 1960;23(3):222. [Crossref]  [PubMed]
  8. Brazis P, Biller J, Gruener G. DeMyer’s The Neurologic Examination: A Programmed Text, 7th ed. New York: McGraw Hill LLC, 2016:276-81. [Link]
  9. N, Kumar. Handbook of Neurological Examination, 2nd. ed. New Delhi: PHI Learning Pvt. Ltd, 2023:172. [Link]
  10. Pryse-Phillips W. Companion to clinical neurology, 3rd. ed. Oxford: Oxford University Press, 2009:529. [Crossref]  [PubMed]
  11. Ramanathan R. Physiology Practical Manual, 1st ed. E-Book. New Delhi: Elsevier India;, 2023:197.
  12. Pal GK. Textbook Of Practical Physiology, 2nd ed. Chennai: Orient Longman Private Limited, 2006:269.
  13. Arslan OE. Neuroanatomical Basis of Clinical Neurology. Boca Raton: CRC Press, 2014:264-65. [Crossref]
  14. Khurana I, Khurana A, Kowlgi NG Textbook of Medical Physiology, 3rd Edition-E-book. New Delhi: Elsevier India, 2019:955.
  15. Suckling CW. On the Diagnosis of Diseases of the Brain, Spinal Cord, and Nerves. London: HK Lewis, 1887. p. 166-7. [Crossref]  [PubMed]
  16. Evans RC. Illustrated Orthopedic Physical Assessment. St. Louis: Mosby, 2009:509.
  17. Bramwell B. Diseases of the Spinal Cord. Edinburgh: Y.J. Pentland, 1884:112-30.
  18. Hagbarth K, Kugelberg E. Plasticity of the human abdominal skin reflex. Brain. 1958;81(3):305-18. [Crossref]  [PubMed]
  19. Wartenberg R. Studies in reflexes: history, physiology, synthesis and nomenclature: study II. Archives of Neurology & Psychiatry. 1944;52(5):341-58. [Crossref]  [PubMed]
  20. Langworthy OR.The Mechanism Of The Abdominal And Cremasteric Reflexes: Collective Review. Chicago: Ar chives Of Neurology & Psychiatry. 1930;24(5):1023-33. [Crossref]  [PubMed]
  21. Madonick MJ. Statistical control studies in neurology. The cutaneous abdominal reflex. Neurology. 1957;7(7):459-65. [Crossref]  [PubMed]
  22. Boes CJ. The history of examination of reflexes. Journal of neurology. 2014;261:2264-74. [Crossref]  [PubMed]
  23. Fine EJ, Darkhabani MZ. History of the development of the neurological examination.Francois Boller, Kenneth L. Stanley Finger. Handbook of clinical neurology. 2009;95:213-33. [Crossref]  [PubMed]
  24. Monrad-Krohn H, Kornfeldt F. The Cremasteric Reflex In Its Relation To The Abdominal Reflex. Chicago: Archives Of Neurology & Psychiatry. 1925;13(4):490-6. [Crossref]  [PubMed]
  25. SG, Waxman. Clinical Neuroanatomy 27/E . New York: McGraw-Hill Education; 2013:57,309.
  26. Dover AR, Innes JA, Fairhurst K. Macleod’s Clinical Examination E-Book : Elsevier, 2023:157.
  27. Alpert JN. The Neurologic Diagnosis: A Practical Bedside Approach. New York: Springer New York, 2011:89-91. [Crossref]  [PubMed]
  28. Ross RT. How to Examine the Nervous System. Totowa: Humana Press, 2007:173-74.
  29. Glynn M, Drake WM. Hutchison’s Clinical Methods E-Book: Hutchison’s Clinical Methods E-Book. Elsevier, 2022:348.
  30. Sarma G. Neurological Examination: A Structured Approach. New Delhi: Jaypee Brothers Medical Publishers Pvt. Limited, 2018:307-13.
  31. Ray BK. Bedside Neurology: Clinical Approach. New Delhi: Jaypee Brothers Medical Publishers Pvt Limited, 2022:33.
  32. Dick J. The deep tendon and the abdominal reflexes. Journal of Neurology, Neurosurgery & Psychiatry. 2003;74(2):150-3. [Crossref]  [PubMed]
  33. Bajaj J, Pateriya A, Thakur DS, Ratre S, Parihar V, Somashekar U, et al. Whether superficial abdominal reflex is affected by subcostal transverse abdominal incisions? A prospective, observational early experience. Journal of Neurosciences in Rural Practice. 2017;8(03):431-3. [Crossref]  [PubMed]
  34. Mosby. Mosby’s Medical Dictionary E-Book. St. Louis: Mosby, 2021:782.
  35. Elzanie A, Borger J. Anatomy, bony pelvis and lower limb, gluteus maximus muscle. Treasure Island, Florida: Stat Pearls [Internet],2019.
  36. Sembulingam K. Essentials of Medical Physiology: With Free Review of Medical Physiology. New Delhi: Jaypee Brothers Medical Publishers Pvt. Limited, 2019:862-70.
  37. HY Ko. A Practical Guide to Care of Spinal Cord Injuries: Clinical Questions and Answers. Singapore: Springer Nature Singapore, 2023:222. [Crossref]  [PubMed]
  38. Lamberti G, Giraudo D, Musco S. Suprapontine Lesions and Neurogenic Pelvic Dysfunctions: Assessment, Treatment and Rehabilitation. Springer International Publishing, 2019:25-33. [Crossref]  [PubMed]
  39. Rossolimo G. Der Analreflex, seine physiologie und pathologie. Neurologisches Centralblatt. 1891;4:257-9.
  40. Daniel EE, Tomita T, Tsuchida S, Watanabe M. Sphincters: Normal Function-Changes in Diseases. London: Taylor & Francis, 1992:313-32.
  41. Uher EM, Swash M. Sacral reflexes: physiology and clinical application. 1998;41(9):1165-77. [Crossref]  [PubMed]
  42. Kirshblum S, Eren F. Anal reflex versus bulbocavernosus reflex in evaluation of patients with spinal cord injury. Spinal Cord Ser Cases. 2020;6:2. [Crossref]  [PubMed]
  43. MM Roberts. Neurophysiology in neurourology. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2008;38(1):815-36. [Crossref]  [PubMed]
  44. Barleben A, Mills S. Anorectal anatomy and physiology. Surgical Clinics. 2010;90(1):1-15. [Crossref]  [PubMed]
  45. Chan C, Ponsford S, Swash M. The anal reflex elicited by cough and sniff: validation of a neglected clinical sign. Journal of Neurology, Neurosurgery & Psychiatry. 2004;75(10):1449-51. [Crossref]  [PubMed]
  46. Pedersen E, Harving H, Klemar B, Tørring J. Human anal reflexes. Journal of Neurology, Neurosurgery & Psychiatry. 1978;41(9):813-8. [Crossref]  [PubMed]
  47. Van Koughnett JA, da Silva G. Anorectal physiology and testing. Gastroenterol Clin North Am. 2013;42(4):713-28. [Crossref]  [PubMed]
  48. Pedersen E, Klemar B, Schrøder H, Tørring J. Anal sphincter responses after perianal electrical stimulation. Journal of Neurology, Neurosurgery & Psychiatry. 1982;45(9):770-3. [Crossref]  [PubMed]
  49. Adams AC, Clinic M. Mayo Clinic Essential Neurology. Oxford: Oxford University Press, 2018:469. [Crossref]  [PubMed]
  50. Larner AJ. Dictionary of Neurological Signs 2nd. ed. New York: Springer New York, 2006:85.
  51. Van Gijn J. The Babinski sign: the first hundred years. Journal of neurology. 1996;243:675-83. [Crossref]  [PubMed]
  52. Schwarz GM, Hirtler L. The cremasteric reflex and its muscle–a paragon of ongoing scientific discussion: A systematic review. Clinical Anatomy. 2017;30(4):498-507. [Crossref]  [PubMed]
  53. Sengul G, Ertekin C. Human cremaster muscle and cremasteric reflex: A comprehensive review. Clinical Neurophysiology. 2020;131(6):1354-64. [Crossref]  [PubMed]
  54. Mellick LB, Mowery ML, Al-Dhahir MA. Cremasteric Reflex. [prod.] StatPearls [Internet]. 2023.
  55. Bingöl-Koloğlu M, Tanyel FC, Anlar B, Büyükpamukçu N. Cremasteric reflex and retraction of a testis. Journal of pediatric surgery. 2001;36(6):863-7. [Crossref]  [PubMed]
  56. Ertekin C, Bademkiran F, Yildiz N, Ozdedeli K, Altay B, Aydogdu I, et al. Central and peripheral motor conduction to cremasteric muscle. Official Journal of the American Association of Electrodiagnostic Medicine. 2005;31(3):349-54. [Crossref]  [PubMed]
  57. Wan XH, Zeng R. Handbook of Clinical Diagnostics. Singapore: Springer Nature Singapore; 2019:260. [Crossref]  [PubMed]
  58. Zakaria Z, Abdullah MM, Halim SA, Ghani ARI, Idris Z, Abdullah JM. The neurological exam of a comatose patient: an essential practical guide. The Malaysian Journal of Medical Sciences: MJMS. 2020;27(5):108. [Crossref]  [PubMed]
  59. Yilmaz U, Yang CC, Berger RE. Dartos reflex: a sympathetically mediated scrotal reflex. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2006;33(3):363-8. [Crossref]  [PubMed]
  60. Belpiede A, Tinelli A, Crescini C, Stark M, Losito A, Cassetta R, et al. Post-partum hemorrhage: can it be prevented by assisting the natural physiological process. Ital J Gynaecol Obstet. 2021;33(2):2385-0868. [Crossref]
  61. Previnaire JG. The importance of the bulbocavernosus reflex. Spinal cord series and cases. 2018;4(1):2. [Crossref]  [PubMed]
  62. Bors E, Blinn KA. Bulbocavernosus reflex. The Journal of Urology. 1959;82(1):128-30. [Crossref]  [PubMed]
  63. Yang C, Bradley W. Reflex innervation of the bulbocavernosus muscle. BJU international. 2000;85(7):857-63. [Crossref]  [PubMed]
  64. Wester C, FitzGerald M, Brubaker L, Welgoss J, Benson J. Validation of the clinical bulbocavernosus reflex. Neurourology and urodynamics. 2003;22(6):589-91. [Crossref]  [PubMed]
  65. Blaivas JG, Zayed AA, Labib KB. The bulbocavernosus reflex in urology: a prospective study of 299 patients. J Urol. 1981;126(2):197-9. [Crossref]  [PubMed]
  66. Granata G, Padua L, Rossi F, De Franco P, Coraci D, Rossi V. Electrophysiological study of the bulbocavernosus reflex: normative data. Functional neurology. 2014;28(4):293. [Crossref]
  67. Wang ZY, Chen YH, Xu YY, Wang X, Shao B, Niu XT, et al. Altered bulbocavernosus reflex in patients with multiple system atrophy. Neurol Res. 2016;38(2):138-43. [Crossref]  [PubMed]
  68. Lavoisier P, Proulx J, Courtois F. Reflex contractions of the ischiocavernosus muscles following electrical and pressure stimulations. The Journal of urology. 1988;139(2):396-9. [Crossref]  [PubMed]
  69. Bassetti C. Babinski and Babinski’s Sign. Spine. 1995;20(23):2591-4. [Crossref]  [PubMed]
  70. McGee SR. Examination of the Reflexes. Evidence-Based Physical Diagnosis 4rd.ed. Edinburgh: Elsevier, 2018.p.563-73. [Crossref]  [PubMed]
  71. Walker HK, Hall WD, Hurst JW. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths, 1990:369-70. [Crossref]  [PubMed]
  72. Van Gijn J. The plantar reflex: a historical, clinical and electromyographic study. Rotterdam: Erasmus University, 1977. [Crossref]  [PubMed]
  73. Ambesh P, Paliwal VK, Shetty V, Kamholz S. The Babinski sign: a comprehensive review. Journal of the neurological sciences. 2017;372:477-81. [Crossref]  [PubMed]
  74. van Gijn J. The Babinski reflex. Postgraduate Medical Journal. 1995;71(841):645-8. [Crossref]  [PubMed]
  75. van Munster CE, Weinstein HC, Uitdehaag BM, van Gijn J. The plantar reflex: additional value of stroking the lateral border of the foot to provoke an upgoing toe sign and the influence of experience. Journal of neurology. 2012;259:2424-8. [Crossref]  [PubMed]
  76. R, Pourmand. Practicing Neurology: What You Need to Know, What You Need to Do. Totowa: Humana Press, 2008:23. [Crossref]  [PubMed]
  77. Kiziltan ME, Benbir G, Uzun NA, Gökdemir S. Auditory-evoked masseter inhibitory reflex. Neurosci Lett. 2010;475(1):12-5. [Crossref]  [PubMed]
  78. Caplan LR. Vertebrobasilar Ischemia and Hemorrhage. Cambridge: Cambridge University Press, 2015:155. [Crossref]  [PubMed]
  79. Benarroch EE. Basic Neurosciences with Clinical Applications. Oxford: Butterworth Heinemann/Elsevier, 2006:613-14.
  80. Aminoff MJ. Aminoff’s Electrodiagnosis in Clinical Neurology: Expert Consult . Philadelphia: Elsevier Health Sciences, 2012. p. 425-6. [Crossref]  [PubMed]
  81. Valls-Solé J. Neurophysiological assessment of trigeminal nerve reflexes in disorders of central and peripheral nervous system. Clinical Neurophysiology. 2005;116(10):2255-65. [Crossref]  [PubMed]
  82. Cruccu G, Ongerboer de Visser B. The jaw reflexes. Electroencephalogr Clin Neurophysiol, Suppl. 1999;52:243-7.
  83. Besser R, Caplan LR, Krämer G, Hopf HC. Brain-Stem Localization and Function. Berlin: Springer Berlin Heidelberg, 2012. p. 198-205. [Crossref]  [PubMed]
  84. Schoenen J, Jamart B, Gerard P, Lenarduzzi P, Delwaide P. Exteroceptive suppression of temporalis muscle activity in chronic headache. Neurology. 1987;37(12):1834-6. [Crossref]  [PubMed]
  85. Goulet JP, Velly AM. Orofacial Pain Biomarkers. Berlin: Springer Berlin Heidelberg, 2017:69-70. [Crossref]  [PubMed]
  86. Allen F, Hollenberg A. On the tactile sensory reflex. Quarterly Journal of Experimental Physiology: Translation and Integration. 1924;14(4):351-78. [Crossref]  [PubMed]