The Gordon finger splay mark is a reflex that can only be triggered under pathological conditions. It is considered an uncertain pyramidal orbit sign and can also provide evidence of vegetative overexcitability.
What is the Gordon Finger Spreader?
The Gordon finger splitter was named after the American neurologist Alfred Gordon (1874-1953). In English, the reflex is also known as Gordon's finger phenomenon. During this reflex, pressure is applied to the pisiform bone (the rounded pea bone). Under pathological conditions, this pressure causes the fingers of the affected hand to extend and spread.
In healthy people, the finger splay sign usually cannot be triggered. It is considered to be an uncertain pyramid orbit sign and provides clues to diseases of the nervous system.
Function & task
The reflex test and thus also the test of the Gordon finger spreading mark is part of the general physical examination and in particular part of the neurological examination. In the reflex test, on the one hand, the physiologically existing reflexes are checked and, on the other hand, pathological reflexes are revealed. The result of checking the reflexes is also known as the reflex status.
The test is usually carried out with a reflex hammer. Most reflex hammers have two different sized rubber inserts on the top. The smaller of the two rubber inserts is used for the Gordon finger splitter. In doing so, the examiner exerts pressure on the pisiform bone. The pisiform bone acts as a sesamoid bone and is embedded in the tendon of the ulnar hand flexor (flexor carpi ulnaris muscle). It belongs to the carpal bones.
In a healthy person, the pressure on the pea bone has no effect. Under pathological conditions, the pressure is followed by extension and spreading of the fingers of the affected hand. The Gordon finger splitter is always checked by side-by-side comparison. The reflex response is documented in the categories normal, reduced, weakened, increased or absent. Under normal conditions, the response should be categorized as weakened or absent.
If there is a reaction to the pressure on the pisiform bone on one or even both sides, this is called a positive Gordon finger spreading sign. A positive Gordon finger spread sign is an indication of damage to the pyramidal tract. The pyramidal tract is a nerve tract in the brain and spinal cord that is responsible for the transmission of impulses from voluntary motor skills.
The pyramidal tract begins in the motor cortex of the parietal cortex. The fibers of the web run through every part of the brain. In the elongated spinal cord (medulla oblongata) the fibers of the pyramidal tract cross on the opposite side. The pyramidal tract usually ends in the spinal cord at the motor neurons of the anterior horn. Since a positive Gordon finger spreading sign provides evidence of damage to the pyramidal orbit, it is one of the pyramidal orbit signs.
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The Gordon finger splay sign becomes positive if the pyramidal tract is damaged. Such damage with disorders of fine motor skills, weakness in voluntary movements, mass movements and spastic increases in tone is also referred to as pyramidal tract syndrome. The pyramidal tract in the brain can be damaged by a stroke, for example. In the event of a stroke (apoplexy), there is a reduced blood flow to brain tissue. This is damaged or even dies. A vascular blockage can be the cause of a stroke. Cerebral hemorrhage can also result in apoplexy. Typical symptoms of a stroke are hemiplegia, language difficulties, nausea or loss of consciousness.
Multiple sclerosis (MS) can also lead to a positive Gordon finger splay sign if the pyramidal tract is involved. It is a chronic disease with multiple inflammations of nerve fibers. The myelin sheaths are particularly affected. The myelin sheaths act as electrical insulation for the nerve fibers. There is a lot of such inflammation in MS. They are found in the brain and spinal cord. The symptoms of multiple sclerosis are very diverse, so that problems often arise when making a diagnosis. Visual disturbances, swallowing and speech disorders, unsteady gait, incontinence or depressive moods can occur as part of the disease.
Another disease of the nervous system that also affects the pyramidal tract is amyotrophic lateral sclerosis (ALS). Like multiple sclerosis, ALS is a chronic inflammatory disease. The motor neurons are affected here. Motor neurons are nerve cells that are responsible for muscle movements. Both the motor neurons in the brain and the motor neurons in the anterior horn cells of the spinal cord can be affected. The degeneration of these motor nerve cells leads to increasing muscle weakness and muscle wasting. Paralysis and paresis are the result. Increased muscle tone can also result from damage to the first motor neuron. In this case, the Gordon finger splitter would also be positive.
In the further course of the disease, gait disorders, language disorders or swallowing disorders can occur. The patients are severely restricted in their coordination and often need help with everyday activities. The disease cannot be cured. The therapy is aimed solely at alleviating the symptoms.
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