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Hypokinetic (low volume), aortic stenosis, congestive heart failure, . palpate the radial and femoral pulses (on the left or right) at the same time.A delay between the upstroke of the right radial pulse and a femoral pulse who presence indicates coarctation of the aorta. Normal situation radial and femoral pulsations are felt equally and synchronously. Normal situation radial and femoral pulsations are felt equally and synchronously.the inequality between two radial pulses is known as radio radial delay. Extrapyramidal lesion - increased tension of muscle (not always).The radial and femoral pulses are palpated simultaneously.Paralysis of antagonist - increased knee jerk in paralysis of antagonist hamstring muscle.Early phase of neuritis - increased irritability of peripheral nerve.Psychoneurosis - anxiety -amplitude of movement is increased.Reflexes may be brisk if the patient is agitated, frightened, or anxious.As a sign of UMN lesion - pyramidal lesion and associated damage of reticulospinal and vestibulo spinal tract.Hyperactivity of muscle reflex is seen in the following conditions Hyperactivity of muscle indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.Babinski’s sign etc.)īrisk = Increase in amplitude of muscle contractionĮxaggerated = Increase in amplitude and duration of musle contration The term exaggerrated reflex means tbe amplitude and duration of the limb movement is more and brisk rellex means an increase in amplitude but not increase in duration,Brisk reflex may be a normal variant its presence may confuse us as abnormal but is only of pathological significance when it is asymmetrical (comparing with the other side) or if associated with other signs of UMN lesion (spasticity. Hyperreflexia can be either exaggerated or brisk is very difficult to differentiate between the two.In hyperactive stretch reflex there is increased speed of response, duration and amplitude of movement.