Patellar Reflex The Patellar Reflex is tested by tapping the patellar tendon right below the kneecap, with a small hammer. When a doctor or nurse raps the tendon, the patient immediately kicks their leg out. The quick knee jerk reflex occurs within the spinal cord. The reflex indicates that a section of the spinal cord, and the nerves extending from it are working properly (Staff, 2007). The doctor tests the patient for the patellar reflex to ensure that there are no problems within the spinal cord. The pathway of the reflex extends from the patellar tendon to the motor nerves in the spinal cord. The patellar tendon, which is located below the kneecap connects to the quadriceps muscles, which is located at the top of the thigh (Staff, 2007). …show more content…
The reflex causes the ipsilateral pupil to dilate (Campbell & DeJong, 2005). The ciliospinal reflex is a test of ocular sympathetic function (Turner, 2012). The ciliospinal reflex depends primarily on the integrity of the sensory nerve fibers from the area of the skin being stimulated, the upper thoracic sympathetic motor neurons, and the ascending cervical sympathetic chain (Rand Swenson, 2008). The sympathetic fibers that supply the dilator pupillae muscles are believed to originate in the posterolateral hypothalamus. The sympathetic fibers project and synapse in the sympathetic cell column from vertebrae C8 to T2. This cell column is called the ciliospinal center of Budge. Once the fibers exit the spinal cord, they travel through the stellate ganglion, the inferior cervical ganglion, and the middle cervical ganglion to synapse in the superior cervical ganglion at the carotid artery bifurcation. From the bifurcation the fibers travel with the internal carotid artery, and then enter the cavernous sinus. From the cavernous sinus they travel along the abducens nerve. The fibers enter the orbit through the superior orbital fissure, and pass through the ciliary ganglion, without synapsing. Finally the fibers enter the eye through the ciliary nerves and terminate on the dilator pupillae muscle (Chaudhuri & Gupta, 2012). Doctor’s test this reflex in cases of suspected Horner’s