1st reflex to recover after spinal shock:

1st reflex to recover form spinal shock is bulbocavernosus reflex(S2-S4) It refers to anal sphincter contraction in response to squeezing the glans penis or tugging on the Foley( see figure) During lumbar injury,- If all reflexes are gone, then its spinal shock- If there is symmetrical loss +/- bowel or bladder involvement (which occurs in saddle anaesthesia), it is conus medullaris syndrome- If there is asymmetrical loss, then it is cauda equina syndrome.