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The Neurologist in Film
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
We do not know how actors playing neurologists are instructed. If a reflex hammer is used, it is handled as a hammer and not with a loose swing moving the hammer and wrist through a 45- to 60-degree arc. There is tapping with a reflex hammer on muscles rather than tendons in The Death of Mr. Lazarescu. George Brent, as Dr. Frederick Steele in Dark Victory, has a clumsy use of the ophthalmoscope (Figure 3.4).
Evaluation of the Spine in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Ashish Dagar, Sarvdeep Singh Dhatt, Deepak Neradi, Vijay G Goni
Temperature: A test tube containing water at a temperature of 110°F (hot) and 45°F (cold) should be used. Alternatively, an alcohol swab, ice cube, steel handle of a reflex hammer (in winter) can be used for cold testing.
The nervous system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Tendon reflexes Testing the reflexes assesses the reflex arc and the supraspinal influences that operate on it. If the tendon of the stretched muscle is gently struck using a reflex hammer, the muscle briefly contracts. This demonstrates the integrity of the afferent and efferent pathways and the excitability of the anterior horn cells in the spinal segment of the stretched muscle.
Sepsis-associated encephalopathy and septic encephalitis: an update
Published in Expert Review of Anti-infective Therapy, 2021
Simone C. Tauber, Marija Djukic, Johannes Gossner, Helmut Eiffert, Wolfgang Brück, Roland Nau
Whereas focal neurological signs do not belong to the clinical picture of SAE, they are characteristic for SEE and SME. Therefore, repeated thorough neurological exams by experienced staff are mandatory in all patients with involvement of the central nervous system during sepsis. The neurological examination is a bedside test which requires basic equipment only: a flashlight, a reflex hammer, a device to apply pain stimuli (e.g., a spiky piece of wood), a tuning fork, and an ophthalmoscope. Simple scoring systems such as the Glasgow Coma Scale and the Confusion Assessment Method (CAM) are helpful to detect changes over time, but often are not sensitive enough to detect focal neurological signs. In SEE and SME, focal neurological signs depend on the localization of the lesions. Septic emboli frequently are located in the middle cerebral artery or its branches in both hemispheres.
Jean-Martin Charcot´s medical instruments: Electrotherapeutic devices in La Leçon Clinique à la Salpêtrière
Published in Journal of the History of the Neurosciences, 2021
Francesco Brigo, Albert Balasse, Raffaele Nardone, Olivier Walusinski
A closer look at these objects reveals they are something different. The French neurologist Guillaume-Benjamin-Amand Duchenne de Boulogne (1806–1875) had developed a noninvasive technique of muscle stimulation (localized electrization, électrisation localisée). He stimulated the muscles using a specific machine with cloth-covered electrodes and an induction coil to produce electricity. The machine was reproduced in detail in his work, On Localized Electrization and its Application to Pathology and Therapy (De l’Électrisation localisée et de son application à la physiologie, à la pathologie et à la thérapeutique; Duchenne de Boulogne 1855; see Figure 2). A closer look at the device in the painting reveals that it is not the apparatus invented by Duchenne. Furthermore, the shape of the second instrument is not that of a Skoda percussion hammer. More generally, it does not represent a reflex hammer at all, as the first medical hammer designed specifically to assess reflexes had not yet been invented (Lanska 1989).
Violins, medicine, and the art of listening
Published in Medical Teacher, 2019
The physician conducted a physical exam, asking the patient to do various motions. Hands raised to the ceiling, fingers wiggling in front, the occasional soft thud of a reflex hammer. The doctor excused herself from the room to speak with another musculoskeletal attending physician. She reenters the room with direct news.