A paratenon is a thin fascial covering that decreases friction while serving as a conduit for blood vessels. The tendon is covered by a paratenon and not a tendon sheath. The strongest and largest tendon in the human body attaches the triceps surae (soleus and gastrocnemius) muscle to the calcaneal tuberosity. The Achilles tendon can be palpated just superior to the posterior aspect of the calcaneus.
Deep tendon reflexes remain an essential component of the neurologic exam that can guide further clinical decisions and differentiate between upper motor neuron and lower motor neuron pathology. Įxamining the DTRs such as the Achilles reflex provides insight into the function of the reflex arc and its' symmetry or lack thereof when compared to the contralateral side.
As for all deep tendon reflexes, the Achilles reflex is then interpreted by grading the response using a 0 to 4 scale and comparing it to the contralateral limb and nearby reflexes. It is a myotatic (deep tendon) reflex that can be elicited easily with a reflex hammer to assess the S1 nerve root of the lumbosacral plexus.
Since then, the Achilles reflex test, also called the ankle jerk test, has remained an essential component of the lower extremity neurologic exam. The deep tendon reflexes (DTR), particularly the tricep, patellar, and Achilles reflexes, were initially described by Wilhelm Heinrich Erb and Carl Friedrich Otto Westphal in adjacent articles simultaneously published in 1875 in the German Archives for Psychiatry and Nervous Diseases.
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