Physical examination maneuver

Physical Exam

Biceps Deep Tendon Reflex

also known as Biceps jerk
🎬
Video coming September 2026

How to Perform

With the patient's arm relaxed and the elbow partially flexed, place your thumb or finger firmly over the biceps tendon in the antecubital fossa and strike your own thumb with the reflex hammer. The normal response is reflex flexion of the elbow.

How to Interpret

Showing 4 of 7 findings

C5-C6 Radiculopathy

Hyporeflexia (≤1+) at biceps
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited

Cervical Radiculopathy

Diminished or absent biceps reflex (≤1+)
Rule in
Somewhat helpful
Rule out
—
Evidence:Limited

Peripheral Neuropathy

Multi-level hyporeflexia pattern (Achilles, patellar, and biceps reflexes all impaired)
Rule in
Very helpful
Rule out
Minimally helpful
Evidence:Limited

Upper Motor Neuron Lesion

Hyperreflexia (≥3+) at biceps
Rule in
Helpful
Rule out
Somewhat helpful
Evidence:Limited

References

  • Wainner RS, et al. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003;28(1):52-62. PMID: 12544957.
  • Li ZF, Niu XL, Nie LL, Chen LP, Cao CF, Guo L. Diagnostic value of clinical deep tendon reflexes in diabetic peripheral neuropathy. Arch Med Sci 2023;19(5):1201-1206. doi:10.5114/aoms.2020.100656. PMID 37732044. PMC10507750.
  • Teitelbaum JS, Eliasziw M, Garner M. Tests of motor function in patients suspected of having mild unilateral cerebral lesions. Can J Neurol Sci. 2002 Nov;29(4):337-344. doi:10.1017/S0317167100002201. PMID: 12463489.
  • Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine (Phila Pa 1976). 2003 Jan 1;28(1):52-62. doi:10.1097/00007632-200301010-00014. PMID 12544957.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Related Systems / Regions

NeurologicalUpper Extremities

Related Bedside Tests

🎬Video coming Sept 2026
Achilles Deep Tendon Reflex
aka Ankle jerk
Rule in:VHPeripheral Neuropathy, HUpper Motor Neuron Lesion, SHHypothyroidism +5 more
Rule out:VHPeripheral Neuropathy, SHUpper Motor Neuron Lesion, NHS1 Radiculopathy +4 more
🎬Video coming Sept 2026
Patellar Deep Tendon Reflex
aka Knee jerk
Rule in:VHPeripheral Neuropathy, HUpper Motor Neuron Lesion, SHL3-L4 Radiculopathy +4 more
Rule out:SHPeripheral Neuropathy, SHUpper Motor Neuron Lesion, IEFemoral Nerve Injury +3 more
🎬Video coming Sept 2026
Babinski Reflex
aka Plantar reflex
Rule in:VHUpper Motor Neuron Lesion, IEMotor Neuron Disease (ALS), IEMultiple Sclerosis +2 more
Rule out:SHUpper Motor Neuron Lesion, IEMotor Neuron Disease (ALS), IEMultiple Sclerosis +2 more
🎬Video coming Sept 2026
Pronator Drift
Rule in:VHBrain Tumor, HStroke, NHUpper Motor Neuron Lesion +1 more
Rule out:VHStroke, MHBrain Tumor, NHUpper Motor Neuron Lesion +1 more
🎬Video coming Sept 2026
Brachioradialis Deep Tendon Reflex
aka Supinator jerk
Rule in:NHCervical Radiculopathy, IEC5 or C6 Cervical Radiculopathy
Rule out:NHCervical Radiculopathy, IEC5 or C6 Cervical Radiculopathy
🎬Video coming Sept 2026
Proprioception Toe Test
Rule in:HPeripheral Neuropathy, SHPeripheral Neuropathy (Large-fiber) or Dorsal Column Pathology
Rule out:VHPeripheral Neuropathy