Westphal's sign is the clinical
correlate
In statistics, correlation or dependence is any statistical relationship, whether causal or not, between two random variables or bivariate data. Although in the broadest sense, "correlation" may indicate any type of association, in statistics ...
of the absence or decrease of patellar reflex or knee jerk.
Patellar reflex
The patellar reflex, also called the knee reflex or knee-jerk, is a stretch reflex which tests the L2, L3, and L4 segments of the spinal cord.
Mechanism
Striking of the patellar tendon with a reflex hammer just below the patella stretches the mus ...
or knee jerk is a kind of deep or
stretch reflex
The stretch reflex (myotatic reflex), or more accurately "muscle stretch reflex", is a muscle contraction in response to stretching within the muscle. The reflex functions to maintain the muscle at a constant length. The term deep tendon reflex is ...
where an application of a stimulus to the
patellar tendon
The patellar tendon is the distal portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity. It is also sometimes called the patellar ligament as it forms a bone to bone connection when t ...
such as strike by a solid object or hammer caused the leg to extend due to such stimulus causes the
quadriceps femoris
The quadriceps femoris muscle (, also called the quadriceps extensor, quadriceps or quads) is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large ...
muscle to contract.
It is named for
Karl Friedrich Otto Westphal
Karl Friedrich Otto Westphal (23 March 1833, in Berlin – 27 January 1890, in Kreuzlingen) was a German psychiatrist from Berlin. He was the son of Otto Carl Friedrich Westphal (1800–1879) and Karoline Friederike Heine and the father of Alexa ...
(1833-1890).
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Associated conditions
Westphal's sign has a clinical significance used in determining neurodisorders or diseases such as:
* receptor damage, peripheral nerve disease, involving the
dorsal(sensory) columns
The posterior grey column (posterior cornu, dorsal horn, spinal dorsal horn, posterior horn, sensory horn) of the spinal cord is one of the three grey columns of the spinal cord. It receives several types of sensory information from the body, inc ...
of the spinal cord and cerebellar lesions
* lesions present within the
motor cortex
The motor cortex is the region of the cerebral cortex believed to be involved in the planning, control, and execution of voluntary movements.
The motor cortex is an area of the frontal lobe located in the posterior precentral gyrus immediately a ...
of the brain or the
pyramidal tracts
The pyramidal tracts include both the corticobulbar tract and the corticospinal tract. These are aggregations of efferent nerve fibers from the upper motor neurons that travel from the cerebral cortex and terminate either in the brainstem (''cort ...
which it combined with muscular spasms
* complete interruption of sensory and/or motor impulse transmission in the
femoral nerve
The femoral nerve is a nerve in the thigh that supplies skin on the upper thigh and inner leg, and the muscles that extend the knee.
Structure
The femoral nerve is the major nerve supplying the anterior compartment of the thigh. It is the largest ...
References
*
Symptoms and signs: Nervous system
Examination of the knee
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