The femoral nerve acts as both the afferent and the efferent pathway, and the spinal root is L3-4.
The sitting patient
- The patient’s lower legs should hang in a relaxed position over the edge of the examination table.
- Check that the quadriceps muscle is relaxed.
- Strike the quadriceps tendon directly with the reflex hammer, between the patella and the tibial tuberosity [Figure 88]. Note the movement of the lower leg and contraction of the quadriceps muscle, for example by feeling the movement effect with your hand on the patient’s shin bone.
Figure 88
The supine patient
- Place your hand on one of the patient’s knees.
- The patient places the other (to be examined) leg across your hand.
- With your free hand, feel whether the quadriceps muscle is relaxed.
- Strike the quadriceps tendon between the patella and the tibial plateau
[Figure 89].
Figure 89
