ARCHETYPE Deep tendon reflex response (openEHR-EHR-CLUSTER.deep_tendon_reflex.v0)

Name: Deep tendon reflex response
License: http://creativecommons.org/licenses/by-sa/4.0/

ARCHETYPE ID	openEHR-EHR-CLUSTER.deep_tendon_reflex.v0
Concept	Deep tendon reflex response
Description	Findings observed during the physical examination of a single deep tendon reflex.
Use	Use to record the observed findings during the physical examination of a single deep tendon reflex. This archetype has been specifically designed to be used in the 'Examination detail' SLOT within the OBSERVATION.exam or the CLUSTER.exam-nervous_system archetype. It can also be nested within any other relevant OBSERVATION or Physical examination-related family of CLUSTER archetypes, where clinically appropriate. In clinical scenarios requiring the documentation of more than one deep tendon reflex response, use a separate instance of this archetype for each tendon type, and also for each side in a paired reflex.
Misuse	Not to be used to represent superficial reflexes, such as superficial abdominal, sphincteric, and bulbospongiosus reflexes. Use appropriate archetypes for this purpose. Not to be used to represent pathological reflexes, such as Babinski, snout, rooting, or grasp reflexes. Use appropriate archetypes for this purpose.
Purpose	To record the findings observed during the physical examination of a single deep tendon reflex.
References
Copyright	© openEHR Foundation
Authors	Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2023-05-24
Other Details Language	Author name: Heather Leslie Organisation: Atomica Informatics Email: heather.leslie@atomicainformatics.com Date originally authored: 2023-05-24
Other Details (Language Independent)	Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/. Custodian Organisation: openEHR Foundation Current Contact: Heather Leslie, Atomica Informatics, Australia Original Namespace: org.openehr Original Publisher: openEHR Foundation Custodian Namespace: org.openehr MD5-CAM-1.0.1: C078D48F7C8AB6E4CA55E415B53DC30E Build Uid: a692ca56-c510-4723-a7cf-77e37543a3d4 Ip Acknowledgements: This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org. Revision: 0.0.1-alpha
Keywords
Lifecycle	in_development
UID	27762887-d4aa-47ef-9e1e-9b1b9c5e734f
Language used	en
Citeable Identifier	1013.1.6956
Revision Number	0.0.1-alpha
items
Reflex	Reflex: Identification of the deep tendon reflex or group of reflexes being examined. Choice of: Coded Text at0002::Right biceps [Testing the C5 and C6 nerve roots.] at0003::Left biceps [Testing the C5 and C6 nerve roots.] at0004::Right brachioradialis [Testing the C6 nerve root.] at0005::Left brachioradialis [Testing the C6 nerve root.] at0006::Right triceps [Testing the C7 nerve root.] at0007::Left triceps [Testing the C7 nerve root.] at0008::Right quadriceps [Also known as patellar or knee jerk. Testing the L4 nerve root.] at0009::Left quadriceps [Also known as patellar or knee jerk. Testing the L4 nerve root.] at0010::Right achilles [Also known as ankle jerk. Testing the S1 nerve root.] at0011::Left achilles [Also known as ankle jerk. Testing the S1 nerve root.] at0012::Jaw [Testing the 5th cranial nerve root.] Text
Relative response	Relative response: The elicited reflex response represented as relative to a 'normal' response. Choice of: Coded Text at0014::Increased [The elicited response appears increased, compared with normal.] at0015::Normal [The elicited response is considered within the expected range of responses.] at0016::Decreased [The elicited response appears decreased, compared with normal.] at0017::Absent [No response can be elicited.] Text
Graded response	Graded response: The elicited reflex response represented as a grade. Choice of: Ordinal 0: at0019::Absent [Reflex is not evident. May be recorded as '0' or '-'.] 1: at0020::Slight [Reflex is present but less than normal amplitude, or only seen with reinforcement. May be recorded as '+' or '1+'.] 2: at0021::Normal [Reflex is present at normal amplitude. May be recorded as '++' or '2+'.] 3: at0022::Brisk [Reflex is present at greater than normal amplitude. May be recorded as '+++' or '3+'.] 4: at0023::Non-sustained clonus [Reflex is repeating but not sustained. May be recorded as '++++' or '4+'.] 5: at0024::Sustained clonus [Reflex is repeating and sustained. May be recorded as '+++++' or '5+'.] Text
Augmented response	Augmented response: Was the response augmented or reinforced?
Comment	Comment: Additional narrative about the reflex response findings, not captured in other fields.
Other contributors	Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor) Silje Ljosland Bakke, Nasjonal IKT HF, Norway (openEHR Editor) SB Bhattacharyya, Sudisa Consultancy Services, India Lisbeth Dahlhaug, Helse Midt - Norge IT, Norway Shahla Foozonkhah, Iran ministry of health and education, Iran Hildegard Franke, freshEHR Clinical Informatics Ltd., United Kingdom (openEHR Editor) Mikkel Gaup Grønmo, FSE, Helse Nord, Norway (Nasjonal IKT redaktør) Ingrid Heitmann, Oslo universitetssykehus HF, Norway Hilde Hollås, DIPS ASA, Norway Evelyn Hovenga, EJSH Consulting, Australia Lars Ivar Mehlum, Helse Bergen HF, Norway Sabine Leh, Haukeland University Hospital, Department of Pathology, Norway Heather Leslie, Atomica Informatics, Australia (openEHR Editor) Ian McNicoll, freshEHR Clinical Informatics, United Kingdom Lars Morgan Karlsen, DIPS ASA, Norway Bjørn Næss, DIPS ASA, Norway Andrej Orel, Marand d.o.o., Slovenia Vladimir Pizzo, Hospital Sírio Libanês, Brazil Jussara Rotzsch, UNB, Brazil Anoop Shah, University College London, United Kingdom Line Silsand, Universitetssykehuset i Nord-Norge, Norway Norwegian Review Summary, Nasjonal IKT HF, Norway Nyree Taylor, Ocean Informatics, Australia (openEHR Editor) Rowan Thomas, St. Vincent's Hospital Melbourne, Australia Jon Tysdahl, Furst medlab AS, Norway John Tore Valand, Helse Bergen, Norway (openEHR Editor)
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