Musculocutaneous Nerve: Sixth Cervical Root, Biceps and Brachialis Muscles The patient should be supine with his arms at his sides and his elbows flexed to 30-45 degrees. His arms are supine.
Stand on the right side of the examining table to examine the right biceps reflex. Put your left index and middle fingers on the biceps tendon as shown in Figure 13-2A. Push your lingers into the antecubital fossa and partially supinate your hand, stretching the skin in the antecubital fossa. This lengthens the biceps tendon and puts it very slightly on the stretch. Then hit your fingers with the hammer. Keep the direction of the hammer head parallel to the long axis of the biceps muscle as in Figure 13-2B.
A normal response is contraction of the biceps muscle, usually not strong enough to cause forearm flexion. With a suprasegmental lesion other muscles (eg, finger flexors or brachioradialis) may contract and there may be a greater contraction of the biceps, often causing forearm flexion. With a segmental le-
sion (C6 root) the biceps will not contract, but small contractions of the finger flexors may be seen. This is known as inversion of the biceps reflex.
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