Examination of the nervous system normally includes testing the tendon reflexes, for example the knee jerks, with a tendon hammer (also known as a reflex hammer). The reflexes may be absent (0), diminished (-), normal (+) or brisk (+++). The plantar reflexes are also checked. The normal plantar response is a downgoing (↓) movement (plantar flexion) of the big toe. An upgoing(↑) toe (extensor or Babinski response) is abnormal.

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