UMEM Educational Pearls

Category: Neurology

Title: Deep Tendon Reflexes

Keywords: DTR's, deep tendon reflexes (PubMed Search)

Posted: 10/25/2007 by Aisha Liferidge, MD (Updated: 6/13/2024)
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Don't forget to do  thorough assessment of deep tendon reflexes on physical examination when appropriate.  DTR assessment can help localize a lesion and determine a diagnosis (i.e. thyroid disease, Guillain Barre, spinal cord and peripheral nerve lesions).

DTR Assessment Scale:

  • 4+ - very brisk, hyperactive with clonus<
  • 3+ - brisker than normal
  • 2+ - average, normal
  • 1+ - somewhat diminished, low normal
  • 0 - no response

Major DTR Assessment Locations:

  • Triceps (C6, C7)
  • Supinator or Brachioradialis (C5, C6)
  • Knee (L2, L3, L4)
  • Ankle (mainly S1)
  • Plantar (L5, S1)