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Hysteria
Published in Francis X. Dercum, Rest, Suggestion, 2019
The cutaneous reflexes are almost uniformly preserved; they may, however, be lessened and in a few instances disappear. The latter, however, is never the case in those reflexes which are beyond the influence of the will. For example, in an anesthesia no matter how profound, the nipple will react, when touched, by contraction or erection, and this is also said to be true of the clitoris. Finally, the cremaster reflex is never influenced by hysteria; it likewise is a reflex independent of the will. Loss of the abdominal reflex, which has been described, but which I have never seen, may probably be due to the fact that the patient holds the abdominal wall tense and that he also closely observes the words and procedures of the doctor. It may be here stated that in performing many of the tests the patient should be so placed that he cannot see what is being done.
The nervous system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Abdominal reflex A light stroke applied over each of the four quadrants of the abdomen will, in healthy individuals, elicit a brisk contraction of the underlying muscles. The upper reflexes are subserved by segments T9–T10 and the lower by T11–T12. Particular attention should be paid to the symmetry of the abdominal reflex response, since its absence on one side may be good evidence of a UMN lesion.
The spine
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Neurological examination of the upper and lower limbs will focus on tone, power, coordination, reflexes, sensation and gait (Tables33.4and33.5). A rectal examination should be performed if there is any concern about cauda equina integrity. The superficial abdominal reflex is an upper motor neurone reflex. It is performed by stroking one of four abdominal quandrants in succession. The umbilicus should move toward the quandrant that was stroked. The reflex should be symmetrical from side to side. Absent or asymmetrical abdominal reflexes may indicate intraspinal pathology such as syringomyelia or spinal cord injury.
Novel method for restoration of anorectal function following spinal cord injury via nerve transfer in rats
Published in The Journal of Spinal Cord Medicine, 2020
Bingbo Bao, Kai Fu, Xianyou Zheng, Haifeng Wei, Pengbo Luo, Hongyi Zhu, Xiaozhong Zhu, Xingwei Li, Tao Gao
Over the past two decades, nerve transfers have been performed successfully and modified for different scenarios.8 With advancements in surgical design and management, nerve transfers are producing better functional outcomes in patients. In attempts to restore bladder function after SCI, prior studies focused on using the normal somatic reflex above the injury level to accomplish reinnervation. For example, Xiao et al.9,10 performed intradural anastomosis of the central end of the L4 spinal nerve anterior motor root with the peripheral end of the bladder-governing L6 spinal nerve anterior motor root in a rat model of L5 paraplegia. Using this method, they successfully established an artificial skin → CNS → bladder reflex pathway and confirmed its integrity using electrophysiological and neuroanatomical tracing techniques. Similarly, Hou et al.11,12 established an artificial bladder reflex arc via nerve root transfer involving abdominal reflex pathways above the paraplegic plane. Subsequent studies have used this nerve transfer approach to successfully restore control of bladder function in both SCI model rats and patients with SCI.13
Clinico-radiological correlation and surgical outcome of idiopathic spinal cord herniation: A single centre retrospective case series
Published in The Journal of Spinal Cord Medicine, 2021
Deepak Menon, Sruthi S. Nair, Bejoy Thomas, K. Krishna Kumar, Muralidharan Nair
This 27-year-old lady presented for evaluation of submammary circumferential tightening band like sensation which she had for the preceding three months. She had no symptoms pertaining to any other tract involvement. Her examination was essentially normal except for absent abdominal reflex. Her MRI revealed cord herniation at T5. At 6 months follow-up she was nearly normal except for occasional feeling of tightening localised to the submammary region (Figure 1).