All of the following are the deep tendon reflexes, EXCEPT:

Appeared in: DSSSB 12 August 2024

Explanation

The plantar reflex is classified as a superficial (or cutaneous) reflex, not a deep tendon reflex.
It is elicited by stimulating the skin on the lateral aspect of the sole of the foot with a blunt object.
Deep tendon reflexes (DTRs), in contrast, are muscle stretch reflexes initiated by briskly tapping a tendon with a reflex hammer.
The key differentiator is the method of stimulation: skin for superficial reflexes versus tendon for DTRs.

Option B: The Achilles reflex (ankle jerk) is a classic deep tendon reflex that assesses the integrity of the S1 and S2 spinal nerve roots.
Option C: The biceps reflex is a standard deep tendon reflex used to assess the function of the C5 and C6 spinal nerve roots.
Option D: The triceps reflex is a deep tendon reflex that evaluates the integrity of the C6 and C7 spinal nerve roots.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of neurological reflexes into deep tendon (muscle stretch) and superficial (cutaneous) types as background academic context rather than a clinical decision trigger.
Differentiating between reflex types is crucial in a neurological exam to accurately localize potential lesions within the central or peripheral nervous system.
An abnormal plantar response in an adult, known as the Babinski sign (great toe extends and other toes fan out), is a significant indicator of an upper motor neuron lesion affecting the corticospinal tract.
What if? If the patient were an infant under the age of 2, a Babinski sign (upgoing toe) would be a normal finding because the corticospinal tracts are not yet fully myelinated. The reflex integrates and becomes the normal downward-going response as the nervous system matures.

How to Approach the Question

Recognize the keyword 'EXCEPT', which signals that you must find the option that does not belong to the specified group.
The group is 'deep tendon reflexes'. Recall the definition: a reflex caused by striking a tendon.
Systematically review each option based on how it's tested.
Achilles, Biceps, and Triceps reflexes are all tested by tapping a tendon with a reflex hammer.
The Plantar reflex is tested by stroking the skin on the sole of the foot.
Conclude that the Plantar reflex is the exception because it is a superficial (cutaneous) reflex, not a deep tendon reflex.

Concept Tested & Keywords

Concept Tested: Classification of neurological reflexes into deep tendon (muscle stretch) and superficial (cutaneous) types.
Stem keywords: deep tendon reflexes, neurological assessment
Lead-in keywords: EXCEPT
Negative lead-in flag: Question asks for the exception.

Qq_fpxSkNRvRnOaIqCJhE

E6 Medicine Harrison 22e Part 2 p. 1285-1287

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 12-14

Practise the full DSSSB 12 August 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.