Neurology is a branch of medicine. Doctors specializing in this area are trained in the diagnosis and treatment of patients with related disorders. They can also take part in clinical research, study and eliminate disorders of the musculoskeletal system. But the main focus of their work is the nervous system and all its components. With a comprehensive examination of the patient, the doctor checks for the presence of healthy plantar and abdominal reflexes. Based on the data obtained, a conclusion is made.
Health professionals use the term “Babinsky reflex”. It involves checking the foot and is an integral part of any neurological examination. The reaction of the big toe to the actions of the doctor indicates how easily impulses are transmitted from the central nervous system to the spinal cord. A plantar reflex with a pathological reaction indicates possible diseases of the nervous system.
Neurophysiology
The principle of the plantar reflex is not fully understood. But the following can be said. Each part of the skin of the body reflexively reacts to external stimuli, and the goal of such a response is to eliminate them.
The doctor follows the foot with certain movements, and a normal reaction involves squeezing the sole. In case of anomaly or pathology, in response to touching the foot, the thumb extends in the wrong direction - out. The position of the other joints does not change.
The considered reflex serves as a connecting link between the spinal cord and the higher centers of the nervous system. When the corticospinal tract is not functioning properly, leg extension is due to signals that normally stimulate flexion of the toes.
Other factors
The detection of plantar reflexes in pathology may be due to other reasons:
- In children under one year old - when the cerebral cortex is not yet fully developed, and some processes are inhibited.
- In deep sleep or coma - with slow transmission of nerve impulses.
- With general anesthesia, anesthesia or electroshock therapy.
- In the postictal stage of epilepsy.
- In a state of intoxication.
- With hypoglycemia.
- In hypnosis.
- With physical exhaustion and marathon walking.
- Under the influence of special drugs (scopalamine, barbiturate).
Procedure
The patient takes a lying position. His foot adheres to the ankle, with the other hand the doctor gropes for the center of the foot.
The line along which the movement is made begins a few centimeters from the heel. It is held to the base of the fingers, along the edge, and then passes through the transverse arch of the foot. The reflex should last five or six seconds.
Clinical significance
The plantar reflex is a segmental reaction of the spine to protect the foot. The clinical significance is that the anomaly reliably indicates disorders in the corticospinal system.
Thus, the effect of extension of the finger is observed in structural lesions such as hemorrhage, brain and spinal cord tumors, multiple sclerosis, as well as in pathological metabolic conditions such as hypoglycemia, hypoxia and anesthesia.
Normal and pathological reactions to plantar stimulation were briefly described by Babinsky in his study: “Normally, tingling of the sole provokes flexion of the thigh, legs, feet and fingers. In pathology, on the contrary, extension occurs.”
It turned out that the identification of plantar reflexes gives more accurate results compared with clinical and electromyographic recordings.
Oral communication and examination
Some conclusions about the health of the nervous system can be drawn through a theoretical survey of the patient. Even features that are determined by special examinations can be identified verbally.
For example, to study how a person feels the temperature, it is enough to ask about the difficulties with the assessment of this water parameter. As for touch sensitivity, the patient can be checked for the accuracy of removing any item from his pocket.
However, some important data can only be obtained by examining the patient. In addition, the information obtained from the dialogue is unreliable. You need to be sure of the authenticity of the words of the informant: he must be careful, not have difficulty communicating, provide true data.
Reflexes of both groups are tested in both newborns and adults. They provide the necessary information about the state of the human nervous system. Thus, when checking the abdominal reflex, a person's tendency to scoliosis can be detected. This reaction is absent in two thirds of patients with multiple sclerosis.
From the foregoing, it follows that reflexes characterize the integrity and functionality of the nervous system (neuromuscular connections, peripheral nerve, nerve root, spinal cord) and are extremely useful in anatomical diagnostics.