Overview of Bekhterev-Jacobsohn Reflex
The Bekhterev-Jacobsohn reflex, or the Jacobsohn finger flexion sign, is a physical response first discovered by two neurologists, Dr Vladimir Bekhterev from Russia and Dr Louis Jacobsohn-Lask from Germany, in the early 1900s. It is a simple reaction that doctors can check during a routine exam without needing any special equipment.
This reflex happens when a doctor strokes the lower part of your arm (the distal radius), which causes your hand to move and your fingers to bend. Medical professionals find this reflex very important because it can help them identify where a nerve problem might be located. Specifically, it can indicate an issue with a part of the nervous system called the ‘pyramidal tract’ that affects the arm.
Interestingly, the Bekhterev-Jacobsohn reflex is similar to a few other reflexes in the body. For instance, the Bekhterev-Mendel reflex causes your toes to bend upwards when the top of your foot is tapped. It also works like two other reflexes in the arm – the Hoffmann sign and the Tromner reflex, both cause your thumb and index finger to bend when certain areas are tapped. All of these reflexes can point to possible issues with the ‘upper motor neurons’ – these are cells in your brain and spinal cord that control the voluntary movements of your muscles.
Anatomy and Physiology of Bekhterev-Jacobsohn Reflex
The Bekhterev-Jacobsohn reflex is a specific body response when someone puts pressure on the edge of your forearm. This area includes the brachioradialis tendon, which is near the wrist. Some scientists think that if this tendon reacts too strongly, it might be the key to the Bekhterev-Jacobsohn reflex. So, let’s talk a little more about the behavior of the brachioradialis tendon.
The brachioradialis reflex is a reaction deep inside your tendon controlled by the C5-C6 nerves and the radial nerve. This reflex happens when someone taps the brachioradialis tendon, which tickles sensors in your muscles. These sensors send a signal through the nerves to your spinal cord. After a quick stop in the spinal cord, a response is sent back to your brachioradialis muscle, causing your wrist to swing out – a completely normal response.
However, in certain conditions where your reflexes are overly strong, like with damage to the UMN (upper motor neurons), the control systems between the brain and the spinal cord get thrown off course. Without this check, the reflex response heightens, leading to bigger-than-normal or irregular reflexes. When it comes to the brachioradialis reflex, too-strong reflexes end up causing severe wrist bending or forearm twisting.
The Bekhterev-Jacobsohn reflex shows up when someone stimulates the upper area of your forearm near the wrist, with your arm laid flat. It involves the bending of the fingers and the hand spreading out. This is a faulted reflex often associated with damage to the UMN. Understanding these reflex patterns and the neuroscience behind them is important to finding and tracking down potential nerve damage.
Why do People Need Bekhterev-Jacobsohn Reflex
If a doctor suspects that you may have a problem with certain parts of your nervous system–known as the pyramidal tracts–they might rely on something called the Bekhterev-Jacobsohn reflex. This reflex is helpful in examining the upper part of your body, like your arms. While many tests can help find issues in the lower part of your body, like your legs, there are not as many for the upper body.
Alongside the Bekhterev-Jacobsohn reflex, your doctor might also use tests called the Hoffmann sign and the Tromner reflex. These tests can also point to issues with the upper motor neurons, which are a part of your nervous system that control things like muscle movement. They could suggest problems with the cervical spinal cord, which is the part of your spinal cord that’s located in your neck.
When a Person Should Avoid Bekhterev-Jacobsohn Reflex
There are certain situations where the Bekhterev-Jacobsohn reflex test, a medical exam that helps doctors understand certain health conditions, may not be recommended. If the patient has an open wound on the side of their forearm, doctors might not perform the test as it could interfere with the results or risk worsening the injury. Also, if the area around the test spot is very swollen, it might be challenging to get accurate results from the test.
Surprisingly, the test can still provide useful information even for patients who have hand contractures. A contracture means the hand is bent or deformed, and can’t straighten out. But even with this condition, it doesn’t stop doctors from quite effectively performing the Bekhterev-Jacobsohn reflex test. This emphasizes how versatile the test is, even when patients have significant issues with their muscles or bones.
Equipment used for Bekhterev-Jacobsohn Reflex
The Bekhterev-Jacobsohn reflex is a type of medical test that can be done without any special equipment. The doctor may use their hand or fingers to lightly tap the patient’s wrist. A reflex hammer, a small tool used to check how your nervous system is responding, can also be used if it’s available. Different types of reflex hammers can be used for this test, and the doctor chooses one based on what they prefer to use.
The test is most accurate when the patient is sitting or lying down comfortably with their arm completely relaxed. This relaxation helps eliminate muscle tension that could interfere with the results of the test. This way, the doctor can properly check the reflex.
Who is needed to perform Bekhterev-Jacobsohn Reflex?
The Bekhterev-Jacobsohn reflex is a medical test that can be done by any healthcare professional who has been properly trained. This can include doctors, medical students, physician assistants, nurses, and other medical staff who are qualified. If you are a new healthcare worker who hasn’t done this test before, it’s very important that you first see someone else do it correctly. You can watch this in person or find a trustworthy video tutorial online.
Doing this test well takes practice – both in doing the test itself and in correctly understanding what the results mean. This is critical to making sure that the test is helpful for diagnosing patients. Basically, if you’re a healthcare worker learning this test, make sure to take your time, learn properly, and get enough practice. This way, you can accurately use the test to help diagnose patients.
How is Bekhterev-Jacobsohn Reflex performed
The Bekhterev-Jacobsohn reflex is a type of medical test performed by a doctor to check your nerve responses. To do this test, you’ll need to be sitting or lying on your back with your arms fully extended and relaxed. Your forearm should be supported to make sure it’s completely relaxed; it’s essential that there’s no tension in your arms, wrists, or fingers. You’d need to have your forearm and hand visible, so you might be asked to put on a hospital gown with the arm exposed.
Before the doctor starts the test, they’ll clean their hands for hygiene purposes. The doctor will then stand next to you on the side they’re testing, supporting your forearm and placing their thumb on the side of your hand (the palm should be facing upward). They will then tap the back of your forearm, over a bone called the distal radius, using a special medical hammer.
If the reflex is positive (which is not normal), your hand will move away from the middle of your body, and your fingers will bend, especially at the furthest knuckle joints. A negative (which is normal) reflex means your fingers will stay straight without any motion in the fingers or hand. The doctor may do the test a few times to accurately check your reflex response.
Possible Complications of Bekhterev-Jacobsohn Reflex
Side effects from the Bekhterev-Jacobsohn reflex, a medical test involving tapping on the lower part of your arm bone (distal radius), are quite unusual. In a few instances, there might be minor bruising, discomfort, or tenderness. However, these instances are not common and usually go away on their own without needing any treatment.
What Else Should I Know About Bekhterev-Jacobsohn Reflex?
When doctors look for signs of potential nerve damage, they use various tests to aid in deciding what the cause could be. One such test is the Bekhterev-Jacobsohn reflex. If the response of this test is abnormal, it indicates that there could be an injury to a portion of your nervous system known as the pyramidal tract, a pathway in the brain and spinal cord that helps in controlling your voluntary movements. Conditions such as stroke, multiple sclerosis, spinal cord injuries, and brain tumors can cause this kind of injury.
Dr. Jacobsohn noticed that this reflex test could be helpful in diagnosing conditions even in their mild or early stages. The test was demonstrated to be consistently present in cases of hemiplegia, a condition where one side of the body is paralyzed or weak.
The Bekhterev-Jacobsohn reflex test is usually performed alongside other similar tests, like the Hoffmann sign and the Babinski reflex. These focus on diagnosing nerve damage in the upper and lower parts of the body, to ensure accurate results in the overall assessment of your condition.
