 Welcome to nursing school explain at this video on the grading of reflexes or DTRs deep tendon reflexes, and why do we assess reflexes? Well, that usually has something to do with the patient's neurologic system because a reflex is a an involuntary muscle contraction and we somehow stimulate the tendon that then causes the adjacent muscles to contract and So conditions would be any kind of brain injuries spinal cord injuries as well as any kind of neurologic disease You can think about as well as some thyroid disorders or especially Electrolyte imbalances can cause some problems with deep tendon reflexes So please also watch the video on the the assessment of the patella reflex where I demonstrate the assessment and And when it comes to the grading the important thing is to know that a plus two is considered normal Everything above or below that is abnormal. So if a plus two is normal Anything less would be less of a response and a normal response is basically just a little bit of a jerking of that Extremity so in case where when we are assessing the patella reflex we're striking the patella tendon makes the lower leg Reflex out meaning that that quadriceps muscle is being stimulated to contract pulling their leg up there And it would just be a little bit of a pendulous kind of a movement And you can see in my assessment video of what a normal reflex looks like But if it's not quite to that extent if it's diminished and we grade it as a plus one if there's no response at all It's a zero Now if it's more or stronger than normal than what we expect It would be a plus three and if it's a plus four it's considered hyper active and that basically means or it's also termed as clonus so a Muscular clonus meaning that there's continuous involuntary contraction just after striking that site of the reflex assessment very briefly and that muscle is just Continuously firing and that reflex is just hyperactive and that neuromuscular junction can just not release So this is the grading of reflexes. Thank you for watching this video I'll also check out my other assessment videos grading of edema and other clinical skills so that you become more familiar and Well worse in the clinical setting. Thanks for watching. See you soon