Physiology

Motor System
2

Semester
Barbon, MD | 07&12 03 2018
 Motor areas are defined as those from which movement
OUTLINE can be evoked by the lowest stimulus intensity
I. Functional Anatomy  The effects produced by lesions, anatomic experiments,
A. Cerebrum electrophysiological recordings, and modern imaging
B. Diencephalon studies in humans, several “motor” areas of the cerebral
C. Cerebellum cortex have been recognized
D. Brainstem Three Sub Areas
E. Spinal Cord  The primary motor cortex in the precentral gyrus
II. Descending Pathways  The premotor area just rostral to the primary motor cortex
A. Neuroanatomic Division  The supplementary motor cortex on the medial aspect of
B. Division Based on Area of Descent the hemisphere
C. Final Common Pathway  There are also cortical regions scattered across all cortical
D. Lesions lobes whose activity is related specifically to eye movement
III. Reflex  Some activities are initiated by impulses coming from the
A. Components of a Reflex parietal lobe
B. Forms of Reflex  They can affect the neurons of the motor area because we
must have sensations first before we see movements of the
skeletal muscles
I. FUNCTIONAL ANATOMY
A. CEREBRUM 1.1 Primary Motor Area (BA 4)
 Necessary to generate a voluntary movement, for example  The region of cortex from which movements are elicited
to make a reaching movement with your arm, you must with the least amount of electrical stimulation
first identify the target (or goal) and locate it in external  It is essentially congruent with Brodmann’s Area 4
space  It is located on the parts of the precentral gyrus that form
 Limb trajectory must be determined based on an internal the rostral wall of the central sulcus and the caudal half of
representation of your arm and, in particular, your hand the apex of the gyrus
relative to the target  This somatotopic organization is often represented as a
 Finally, a set of forces necessary to generate the desired figurine or in a graphic form called a motor homunculus
trajectory must be computed  Origin of motor commands
 These steps form a linear sequence, and traditionally it  Considered the cortical efferent zone
was thought that a hierarchy of motor areas carried out  Site of the motor homunculus
the successive steps  Greater number of muscle spindles, greater representation
 The motor cortex would then transmit commands, via the in the motor homunculus
descending pathways discussed earlier, to the spinal cord  Hand (thumb), foot and facial muscles
and brainstem motor nuclei
 Frontal – Motor 1.2 Premotor Area (BA 6)
 Parietal – Sensory Somatic
 This area lies rostral to the primary motor cortex and is
 Temporal – Sensory auditory
contained in Brodmann’s area 6 on the lateral surface of the
 Occipital – Sensory visual brain
 Pre-frontal Cortex – Judgment, ambitions, cognitive  It can be distinguished from the primary motor cortex by
functions of the brain the higher stimulus intensities needed to evoke movement
 The premotor area has been divided into two functionally
distinct subdivisions: dorsal and ventral
 The dorsal division (PMd) contains a relatively complete
map representing the leg, trunk, arm, and face
 The ventral division (PMv) is mostly limited to the arm and
face, with only a small leg representation. the PMv appears
to be specialized for control of upper limb and head
movement
 A second difference between the subdivisions is that PMd
contains a large representation of the proximal muscles,
whereas PMv has a large representation of the distal
muscles
 Responsible for posture at the start of planned complex
Fig 1. Motor areas of the Frontal Cortex. motor activity
 Receives major input from the posterior parietal cortex and
1. Cortical Motor Areas its output influences chiefly the medial descending pathway

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 Decreased activity will cause hyperkinetic behavior –
excessive
1.3 Supplementary Motor Area (BA 6, 8)
 Located mainly on the medial surface of the hemisphere,
just anterior to the primary motor cortex, and corresponds
to the medial portion of Brodmann’s area 6
 It is subdivided into two regions: the more posterior part is
referred to as the SMA proper (or just SMA), and the
anterior portion is called the pre-SMA
 SMA proper: it contains a complete somatotopic map, it
contributes to the corticospinal tract, and it is
interconnected with the other motor areas
 Pre-SMA is not strongly connected with the other motor
areas and spinal cord but rather is connected to the
prefrontal cortex
 There is a complete somatotopic map in the SMA. In
addition, stimulation of the SMA can produce vocalization
or complex postural movements, but it can also have the
Fig 2. Direct and Indirect Pathway.
opposite result, namely, a temporary arrest of movement
or speech
 Removal of the supplementary motor cortex retards
movement of the opposite extremities and may result in
forced grasping movements with the contralateral hand
 Concerned with mental rehearsal of a planned motor
activity
 Causes complex contraction that is usually bilateral
affecting mostly the upper extremities
 Needs a stronger stimulation to cause contraction

2. Basal Ganglia
 The basal ganglia are the deep nuclei of the cerebrum
 the basal ganglia do not receive input from the spinal cord,
but they do receive direct input from the cerebral cortex
 The main action of basal ganglia is on the motor areas of the
cortex by way of the thalamus
 Basal ganglia contribute to affective and cognitive functions
 Lesions of the basal ganglia produce abnormal movement
and posture
 The basal ganglia include caudate nucleus, putamen, and
globus pallidus

1.1 Corpus Striatum

 The term striatum, derived from the striated appearance of
these nuclei, refers only to the caudate nucleus and
putamen
Fig 3. Pathways for Parkinson’s disease and Huntington’s disease.
1.2 Direct vs Indirect Pathways
Direct Pathway 1.3. Hyperkinetic Disorders
 Enhances motor activity Chorea
 Controls rapid motor activity  Huntington’s disease/Huntington’s Chorea
 Decreased activity will cause hypokinetic behavior – really  Which results from a genetic defect that involves an
almost no movement autosomal dominant gene
 This defect leads to the preferential loss of striatal
Indirect Pathway GABAergic and cholinergic neurons that project to the GPe
 Reduces motor activity as part of the indirect pathway (and also degeneration of
 Controls slow motor activity the cerebral cortex, with resultant dementia)

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 Loss of inhibition of the GPe presumably leads to
diminished activity of neurons in the subthalamic nucleus
 Hence, the excitation of neurons of the GPi would be
reduced. This will disinhibit neurons in the VA and VL nuclei.
 The resulting enhancement of activity in neurons in the
motor areas of the cerebral cortex may help explain the
choreiform movements of Huntington’s disease
 The rigidity in Parkinson’s disease may in a sense be the
opposite of chorea because overtreatment of patients with
Parkinson’s disease with L-DOPA can result in chorea
 Caudate nucleus is mostly affected
 Underactivity of GABA/Ach; over activity of dopamine
 Release globus pallidus from inhibition - hyperkinesia
 Autosomal dominant dso (abN gene is located near the end
of the short arm of chr 4) – “pag meron ang isa sa family,
high chance na meron ang iba”
Fig 5. Athetosis.
 Age onset is between 30-50 y/o
Hemiballismus
 Excessive movements including the legs

Fig 4. Chorea.

Athetosis
Fig 6. Hemiballismus.
 Frequent slow movements due to muscular weakness
 Affecting the head and lower leg muscle
1.4 Hypokinetic Disorders
 Corpus striatum or thalamus is affected
Parkinson’s Disease
 “nag-scissor ang legs” – also seen in cerebral palsy
 Parkinson’s agitans (Parkinson’s disease)
 Common among older women
 Results from the widespread destruction of the substancia
 Young: worm-like movement
nigra and pars compacta that connects dopamine-secreting
 Old: snake-like movement
nerve fibers to the caudate nucleus and putamen 
 Writhing movements of the body specially involving the
decrease in dopaminergic activities with relative increase in
hands as well as the feet
cholinergic activities
 Exact opposite of Chorea
 Lack dopamine; excess in Ach
 Problem includes caudate, putamen and substancia nigra
 Nigro-striatal tract- uses dopamine
 Begins most often between 45 & 65 years ; at present seen
before the age of 30 yo (eg. Michael J. Fox)
 Tx: dopamine
 Effect on direct and indirect pathway
 Signs & Symptoms:
1. Akinesia – absence of movement (in severe cases)

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1. Bradykinesia – slow in initiating movements (more common
than akinesia)
2. Lack of facial expressions (masked face) – but their cortical
activity is normal
3. Lack of associated movements
4. Difficulty in initiating and stopping movements
5. Shuffling (festinating) gait – small, short movements, their
arms don’t sway
6. (Hyperkinesia) Cog-wheel rigidity – “catches” during passive
motion, minsan rigid tapos minsan parang magiging normal
7. Lead pipe rigidity – if there is continuous activity
8. Passive (resting) tremors – “pill rolling” (hands tremor,
characteristic movement, common in aging population
B. DIENCEPHALON
 Hypothalamus and parts of the Limbic System
(Hippocampal and Parahippocampal regions) have minimal
effect on the skeletal muscles; they affect mostly visceral
tissues, especially the hypothalamus
 The thalamus is another important part; this area of the NS
acts a relay station; they do not modify motor impulses;
intercommunication between the different parts of the
CNS involved in motor control
C. CEREBELLUM
 Helps regulate movements and posture and also involved
in some forms of motor learning
 Its major role is for motor coordination (rate, range, force
and direction of the movement)
1. Divisions of Cerebellum
1.1 Neocerebellum
 Corresponds to the lateral portion
 Receives indirect input from the cerebrum by way pontine
nuclei
 Concerned with motor planning and programming
1.2 Paleocerebellum
 Corresponds primarily to the intermediate portion.
 Receives proprioceptive and spinal cord input.
 Regulates truncal and proximal limbs movements
(maintenance of posture)
 It smooths and coordinates movements that are ongoing
1.3 Archicerebellum
 Corresponds primarily to the flocculonodular lobe.
 Dominated by vestibular input.
 Regulates eye movement, stance and gait (equilibrium and
learning)
2. Manifestation of Cerebellar Lesions
Motor Dysfunctions in Cerebellar Disease
 Incoordination, malequilibrium and problems with muscle
o Ataxia
o Dysmetria/Pastpointing – unable to do finger-to-
nose test
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o Dysdiadochokinesia/Adiadochokinesia – unable
to perform alternating hand or feet movement
o Decomposition of movement – e.g. hindi na kaya
ng patient magsulat nang maayos na gaya ng dati
niyang sulat noong wala pang cerebellar damage
o Dysarthria – difficulty in speaking because of
extra movement
o Intension tremors – no tremors at rest. Tremors
upon movement
 Malequilibrium and Disturbances in muscle tone
o Astasia - loss of muscle endurance
o Asthenia - loss of muscle strength
o Atonia/Hypotonia - absent / diminished muscle
tone
D. BRAINSTEM
 Mostly for control of muscles involved in maintaining
posture; mostly axial or truncal
 Collectively known as anti-gravity muscles
 Provides background contraction
o Trunk
o Neck
o Proximal portions of the limbs
 Supports the body against gravity
 Majority are extensors, except for extensors of the upper
extremities
 Also includes the muscles elevating the jaw
1. Midbrain
2. Pons
 Pons is the most active in promoting continuous activity of
the muscles to maintain posture involuntarily
 Even withour cortical activity, we can maintain posture, as
long as the brainstem is active, where we have the reticular
activating system
1.1 Reticular Formation
 Pontine reticulospinal tract is generally stimulatory on both
extensors and flexors, but greater effect on extensors
3. Medulla Oblongata
1.1 Reticular Formation
 Medullary reticulospinal tract is generally inhibitory on both
extensors and flexors, but greater effect on extensors
E. SPINAL CORD
 The cord gray matter is the integrative area for the cord
reflexes.
 Sensory signals enter the cord almost entirely through the
sensory (posterior) roots. After entering the cord, every
sensory signal travels to two separate destinations: (1) One
branch of the sensory nerve terminates almost immediately
in the gray matter of the cord and elicits local segmental
cord reflexes and other local effects. (2) Another branch
transmits signals to higher levels of the nervous system-to
higher levels in the cord itself, to the brain stem, or even to
the cerebral cortex.
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 Aside from the sensory relay neurons, the other neurons  The lateral corticospinal axons terminate at all spinal cord
are of two types: (1) anterior motor neurons and (2) levels, primarily on interneurons, but also on motor
interneurons neurons
 Corticospinal pathway is critical for the fine independent
control of finger movement

Fig 7. Typical Organization of the Cord Gray Matter in a Single Cord

Segment.

Anterior Motor Neurons

 Located in each segment of the anterior horns of the cord
gray matter are several thousand neurons that are 50 to 100
percent larger than most of the others and are called
anterior motor neurons. They give rise to the nerve fibers
that leave the cord by way of the anterior roots and directly
innervate the skeletal muscle fibers
 The neurons are of two types: alpha motor neurons and
gamma motor neurons

Interneuron
 Interneurons are present in all areas of the cord gray
matter-in the dorsal horns, the anterior horns, and the
intermediate areas between them
 They are small and highly excitable, often exhibiting
spontaneous activity and capable of firing as rapidly as 1500
times per second
 Can be both excitatory and inhibitory
II. DESCENDING PATHWAYS
A. NEUROANATOMIC DIVISION
1. Pyramidal
 Cerebral cortex → internal capsule → transverse the
midbrain in the cerebral peduncle → basilar pons →
pyramids on the ventral surface of the medulla
1.1 Lateral Corticospinal Tract
 Part of Lateral System
 The corticospinal fibers continue caudally and in the most
caudal region of the medulla, about 90% of them cross the
opposite side
 They then descend in the contralateral lateral funiculus as
the lateral corticospinal tract
Fig 8. Lateral and Ventral Corticospinal Pathway.
1.2 Corticobulbar
 Part of Lateral System
 Axons leave the tract as it descends the brainstem and
terminate in the various cranial nerve motor nuclei
 Part of the corticobulbar tract ends contralaterally in the
portion of the facial nucleus that supplies muscles of the
lower part of the face and in the hypoglossal nucleus. This
component of the corticobulbar tract is organized like the
lateral corticospinal tract. The remainder of the
corticobulbar tract ends bilaterally.
 CN 1,2, and 8 are not involved
 Concerned with the activity of the motor nuclei of several
cranial nerves (all except 1,2, 8 because they are sensory)
 Can influence motor neurons controlling neck muscles,
facial muscles, jaw muscles, extraocular muscles, and
tongue

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 They have ipsilateral and contralateral transmission
Left Corticobulbar Tract
 Has greater contralateral control, both upper and lower
 Ipsilateral, it has only control over the upper portion , no
control on the lower portion
 Lower portion on the ipsilateral side is controlled by the
right corticobulbar tract
 Nerves before the motor nucleus – upper motor neurons
 Nerves after the motor nucleus that will control the muscles
– lower motor neurons
Notes: Example
 If there is an injury to the left corticobulbar tract
before the CNVII nucleus (upper motor neurons),
there will be problems in the lower right side of the
face, the area that is controlled by the left
corticobulbar tract only
 If the injury is the neurons after the nucleus, there will
be paralysis on the same side (ipsilateral)
 Remember:
o Upper motor neurons → Contralateral,
lower portion
o Lower motor neurons → Ipsilateral, both
upper and lower portions
Fig 9. Corticobulbar Pathway.
2. Extrapyramidal
1.1 Medial/Anterior Corticospinal Tract
 Part of Medial System
 The remaining uncrossed axons continue caudally in the
ventral funiculus on the same side as the ventral
corticospinal tract
 Many of these fibers ultimately decussate at the spinal cord
lever at which they terminate
 Fibers mostly come from premotor cortex
 20% track crosses over in anterior gray horns before
synapsing
 Responsible for the control of the proximal musculature
1.2 Tectospinal Tract
 Originates in the deep layers of the superior colliculus
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 Axons cross to the contralateral side, just below the
periaqueductal gray matter
 Descends in the ventral funiculus of the spinal cord to
terminate on the medial group of interneurons in the upper
cervical spinal cord
 Regulates head movement in response to visual, auditory,
and somatic stimuli
1.3 Vestibulospinal Tract
Lateral
 Originates in the lateral vestibular nucleus, also known as
Deiter’s nucleus
 Descends ipsilaterally through the ventral funiculus of the
spinal cord and ends on interneurons
 Supplies extensor muscles of the proximal part of the limb
that are important for postural control
 Inhibits flexor motor neurons
Medial
 Originates from the medial vestibular nucleus
 Descends in the ventral funiculus of the spinal cord to the
cervical and mid-thoracic levels
 Ends on the medial group of interneurons
 Mediates adjustment in head position in response to
angular acceleration of the head
1.4 Reticulospinal Tract
 Pontine Reticulospinal Tract
o The cells that give rise to the pontine
reticulospinal tract are in the medial pontine
reticular formation
o Tract descends in the ventral funiculus → Ends on
the ipsilateral medial group of interneurons
o This excites motor neurons to the proximal
extensor muscles to support posture
 Medullary Reticulospinal Tract
o Arise from the neurons of medial medulla
(nucleus gigantocellularis)
o Tracts descend bilaterally in the ventral lateral
funiculus → End mainly on interneurons
associated with medial motor neuron cell groups
o Function is mainly inhibitory
1.5 Rubrospinal Tract
 Part of Lateral System
 Originates in the magnocellular portion of the red nucleus,
which is located in the midbrain tegmentum
 This fibers decussate in the midbrain → pons → medulla →
take up the position just ventral to the lateral corticospinal
tract in the spinal cord
 Preferentially affect motor neurons controlling distal
musculature
 Red nucleus receive input from the cerebellum and from
the motor cortex, thus making this an area of integration of
activity from these two motor systems
B. DIVISION BASED ON AREA OF DESCENT
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1. Lateral Descending Pathways o No fibrillations
 Originate from a wide region of cerebral cortex o Spasticity (clasp-knife reaction/clonus)
o Primary motor o (+) Babinski sign (upgoing Babinski)
o Premotor  If UMN is damaged
o Supplementary o The descending fiber tract is damaged → No
o Cingulate motor areas of the frontal lobe stimulation of the inhibitory association neuron
o Somatosensory cortex ot the parietal lobe → No inhibition of the α motor neuron → α motor
 Cells of origin of these tracts include both large and small neurons will continue firing Ach → Skeletal
pyramidal cells of layer V of the cortex, including the giant muscle will become rigid (spastic paralysis)
pyramidal cells of Betz  If patellar reflex is performed in UMN lesion
 Pathways o Stimulation → Continuous release of Ach →
1. Lateral Corticospinal Tract Hyperreflexia
2. Corticobulbar Tract  Note: This is why when eliciting Chaddock’s Babinski, or
3. Rubrospinal Tract Oppenheim’s reflexes, there will be exaggeration of
response in UMN lesion
2. Medial Descending Pathways  Muscle atrophy in UMN lesion – may be present, but
 Originate in the cortex or brainstem secondary to disuse
 End in the medial ventral horn on the medial group of
interneurons Babinski Reflex
 Connect bilaterally with motor neurons that control the  Stroke the plantar aspect of the foot from the lateral
axial musculature upwards, then going to the medial next to the toes
 Contributes to balance and posture  Normal: tickling sensation
 Contributes to the control of proximal limb muscles  (+) Babinski reflex: indicates upper motor neuron lesion;
 End on the medial group of other bilateral function includes fanning of the toes, dorsiflexion of the big toe; normal in
swallowing or wrinkling of the brow infants
 Pathways
1. Medial Corticospinal Tract Chaddock Reflex
2. Vestibulospinal Tract  Modified Babinski reflex
3. Tectospinal Tract  Stroke the dorsum of the foot like the way in Babinski refle
4. Reticulospinal Tract (lateral → medial)
 Reaction is same as the Babinski reflex
C. FINAL COMMON PATHWAY
 Decisions about whether the synaptic input from various Oppenheim Reflex
sources will cause particular muscle fibers to contract are  Stroking the shin going downwards
made at the level of the α motor neuron  Reaction is the same as the Babinski reflex

1. Size Principle 1.1 Decorticate vs Decerebrate Rigidity

 First motor units to be activated, either by voluntary effort Decerebrate Rigidity
or during reflex action are those with the smallest motor  (+) excitability of extensors – all body parts extended
axons  (+) tonic labyrinthine reflexes
 As more motor units are recruited, motor neurons with  (+) tonic neck reflexes
progressively larger axons become involved, and they  (+) spinal reflexes
generate progressively larger amounts of tension  (-) righting reflexes – because the midbrain cannot exert its
 Size principle effect on the muscles
o Motor units are recruited in order of motor  Extension and hyperpronation of arms, extension, and
neuron axon size internal rotation f legs → Opisthonos (arching of the neck
and back)
D. LESIONS
1. Upper Motor Neuron
Brainstem Injury Above the Midbrain
 Neurons in all motor pathways under direct/indirect control
 (+) righting reflexes (midbrain function)
by the cerebral cortex, cerebellum, and basal ganglia
 (+) tonic labyrinthine reflexes
 Manifestations
 (+) tonic neck reflexes
o Hypotonia
 (-) spontaneous movement (automaton)
o Weakness and clumsiness
 Lacks the decerebrate rigidity (decorticate)
o Initially no muscle atrophy
o Decorticate rigidity – flexion of arms with
o Difficulty of performing voluntary movements
extension and internal rotation of legs
o Hyperactive reflexes
 Commonly caused by severe hypoglycaemia, massive
o No fasciculations
stroke, hunger

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Notes:
2. Lower Motor Neuron Complete Transection of the Spinal Cord
 α and γ motor neurons of the spinal cord and the motor  Permanent paraplegia
components of the cranial nerve nuclei o Initially flaccid → spastic paraplegia
 Neurons having final direct link with the muscles  Loss of sensations
 Manifestations  Spinal shock (loss of spinal reflexes)
o Immediate muscle weakness and atrophy o Lasts for a minimum of 2 weeks
o Hypoactive/absent reflexes  Observed below the level of injury
o With fasciculations and fibrillations
 Recovery is possible for some somatic and autonomic
o Flaccidity – reduced muscle tone
reflexes like knee jerk, flexor (withdrawal) reflexes,
o (-) Babinski sign (downgoing Babinski)
micturition, erection
 If LMN is damaged
o Lower motor neuron is damaged → No release of
Spinal Cord Injuries
Ach → No muscle contractions → Flaccid paralysis
 Amyotropic Lateral Sclerosis
 If patellar reflex is performed in LMN lesion
 Syringomyelia
o Stimulations → Skeletal muscle has no supply of
 Brown-Sequard syndrome
Ach from α and γ motor neuron → No response
 Tabes Dorsalis
 Fibrillation – muscle is contracting but you cannot see
 Fasciculation – the muscle is contracting and you can see it;
may be due to a compression of a peripheral nerve
III. REFLEX

1.1 Nerve Damage  Reflex

 Muscle atrophy in LMN lesion o A relatively predictable, involuntary, and
o Cause: denervation of the muscle stereotyped response to an eliciting stimulus
o Note: There is marked atrophy, massive atrophy o Almost involuntary
 Kung hindi mo pa iiinnervate ang muscle , mag—atrophy o They do not involve cortical activity
kaagad. Lahat ng muscle kapag hindi nagagamit ay nag-a- o Mostly spinal cord and brainstem neurons
atrophy. o Rapid, stereotyped involuntary responses
o Least affected by a stimulus
o Needed for postural activity
1.2 UMN vs LMN Lesion
 Reflex arc
o Basic circuit that underlies a reflex
Table 1. UMN vs LMN Lesion
o Parts: afferent limb (sensory receptors and
UMN Lesion LMN Lesion axons), central component (synapses and
Paralysis Spastic Flaccid interneurons within CNS), efferent limb (motor
neurons)
Pathologic
+ - A. COMPONENTS OF A REFLEX
Reflex
1. Receptors
Reflexes Hyperreflexia Hyporeflexia 1.1 Muscle Spindle
 Found in almost all skeletal muscles
 Particularly concentrated in muscles that exert fine motor
Fasciculation - + control (e.g. small muscles of the hand and eye)
 Spindle or fusiform-shaped organ
Fibrillation - +  Composed of a bundle of specialized muscle fibers richly
innervated both by sensory and motor axons
 About 100 μm in diameter, 10 mm long
Atrophy Due to disuse Due to denervation  The innervated part of the muscle spindle is encased in a
connective tissue capsule
Muscle Tone Increase Decrease  Lie between regular muscle fibers and are typically located
near the tendinous insertion of the muscle
 The distal ends of the spindle are attached to the connective
Clonus + - tissue within the muscle (endomysium)
 Muscle spindles lie in parallel with the regular muscle fibers
 The muscle fibers within the spindle are called intrafusal
fibers
 Intrafusal fibers
o Narrower

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o Do not run the length of the muscle Notes:
o Too weak to contribute muscle tension Voluntary Movements
o Types: nuclear bag and nuclear chain fibers
 Involve cortical activity/cortical neurons
o Sensory supply includes single group Ia afferent
 Needs activation of neurons in the cerebral cortex
and a variable number of group II afferent fibers
first; pre-central gyrus/frontal lobe
 Motor supply to a muscle spindle consists of two types of γ
 Characterized by two features
motor axons: dynamic and static γ motor axons
o Purposeful (goal directed)
o Static: when the muscle is allowed to shorten, its
o Largely learned (improves with practice);
firing rate will decrease proportionately
also involves lateral cerebellum
o Dynamic: its activity overshoots during muscle
(cerebrocerebellum)
stretch and undershoots during muscle
shortening
Involuntary Movements
 Muscle spindles respond to changes in muscle length
 Involuntary movement is reserved for smooth/cardiac
because they lie in parallel with the extrafusal fibers
muscles; they generate their own impulses
 The change in tension is sensed by mechanoreceptors of the
 Although there are involuntary skeletal muscles, we
Ia and II spindle afferents
do not refer them as involuntary; the proper term is
 γ motor neurons adjusts the sensitivity of the spindle
reflex; the impulses are generated by neurons,
o γ motor neuron system allows the muscle spindle neuronal function
to operate over a wide range of muscle lengths
while retaining high sensitivity to small changes in
Rhythmic Motor Patterns
length
 initially voluntary movements; when frequently
 When a dynamic γ motor neuron is activated, the response
utilized, muscles will eventually perform reflex
of the group Ia afferent fiber is enhanced, but the activity of
activities
the group II afferents is unchanged
 Stereotype, repetitive movements that occur in reflex
 When a static γ motor neuron discharges, the
– like fashion after voluntary initiated
responsiveness of the group II afferents and the static
 E.g. Driving a car
responsiveness of the group Ia afferents are increased
 Also needed for maintenance of posture; postural
 They signal muscle length
support movements
 Stretch-sensitive receptors
 What is needed for us to have activity in the skeletal
muscles? Intact reflex arc!

Reflex Action
 May involve simultaneous contraction of some
muscles and relaxation of other muscles
 That is why we have what we call agonist and
antagonistic muscles for us to have a well-coordinated
movement of the body
 Simultaneous with muscle activity, we also observe
visceral activities
 May involve either somatic or visceral responses
which could occur simultaneously
 Involves activation of one or several synapses;
synapses could be somatic for skeletal muscles or
visceral (autonomic neurons) that will control visceral
tissues
 Happens without conscious perception
 Voluntary activities also involve an intact reflex arc
 Impulses are modified in various parts of the CNS
 Basal ganglia modify both fast and slow movements
 Cerebellar activity modify fast movements

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Notes:  Mostly type A α neurons, some could be type A β and δ
(delta)
 Muscle with more muscle spindles → Greater  When we describe sensory afferent nerves, they are
precision/accurate activity → Mostly in the distal body describe mostly according to size
parts (hands, feet, head)  Group IA. Group IB, and Group II
 Once the muscle spindles are activated, the muscles  Mostly Type Aα, Type Aβ, Type Aδ
contract → Myotatic reflex
 Major stimulus is stretch → Group Ia and Group II 1.1 Type Ia
fibers are activated → Impulses go to the spinal cord  Largest diameter
→ Enters the dorsal root/dorsal horn of the spinal  Conduct 72-120 n/sec
cord  Forms a primary ending consisting of a spiral-shaped
 Muscle stretch → Spindle fibers → Group Ia and group terminal composed of branches of the group Ia fiber on
II neurons → Dorsal horn of SC → Ventral horn of SC each of the intrafusal muscle fibers
→ α and γ neurons → Muscle contraction  Sensitive to the amount of muscle stretch and to its rate
 Firing rate will maintain its increase until the stretch is
reversed
 Fibers form the annulospiral endings of muscle spindles
Table 2. Nuclear Bag vs Nuclear Chain  Average about 17 μm in diameter
NUCLEAR BAG NUCLEAR CHAIN
1.2 Type Ib
Size Larger Smaller
 Large diameter
Bunched together like  Conducts same velocity as group Ia fiber
Nuclei Chains  Terminals are wrapped about bundles of collagen fibers in
a bag of oranges
the tendon muscle
Types Bag1 and Bag2 -  Show an initial large increase in firing, reflecting the
increased tension on the muscle caused by stretch, but will
Bag1: Group Ia show gradual return toward its initial firing rate as tension
Fibers Group II on the muscle is lowered
Bag2: Group Ia, II
 Fibers form the Golgi tendon organs
γ motor axons
Bag1: Dynamic
Static  Average about 16 μm in diameter
Bag2: Static
1.3 Type II
Table 3. Intrafusal vs Extrafusal Fibers  Intermediate in size
INTRAFUSAL EXTRAFUSAL  Conduct 36-72 m/sec
 Group II afferent fiber forms a secondary ending, which is
Multiple, sensory and found on nuclear chain and bag2 fibers
Receives Single motor neuron
motor innervations  Respond to the amount of stretch
 Fibers from most discrete cutaneous tactile receptors and
from the flower-spray endings of the muscle spindles
1.2 Golgi Tendon
 Average about 8 μm
 A second type of mechanosensitive receptor associated
 These are β and γ-type A fibers in the general classification
with skeletal muscle is the Golgi tendon organ
 Innervated from the terminals of group Ib afferent fibers
1.4 Type III
 Diameter = 100 μm, length = 1 mm
 Sensory ending arranged in series with the muscle  Fibers carrying temperature, crude touch, and pricking pain
sensations
 Can be activated either by muscle stretch of by contraction
of the muscle  Average about 3 μm
 Stimulus sensed by the Golgi tendon organ is the force that  Are δ-type A fibers in the general classification
develops in the tendon to which it is linked
 Signal force 1.5 Type IV
 Tension-sensitive receptos  Unmyelinated fibers carrying pain, itch, temperature, and
 An encapsulated receptor crude touch sensation
 When GTO is stimulated → Ib neurons → Dorsal horn →  0.5-2 μm in diameter
Inhibitory interneuron → Inhibitory impulses go to the  Are type C fibers in the general classification
anterior motor nerves

2. Sensory Neurons

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Notes: Sensory Endings  A given skeletal muscle is supplied by a group of α motor
Primary Endings (Annulospiral) neurons located in a motor nucleus
 Group Ia  A motor unit is an α motor neuron and all of the skeletal
 Innervate both the nuclear bag and nuclear chain muscle fibers that its axon supplies
 Detect amount of muscle stretch but more sensitive to  Each skeletal muscle fiber is supplied by just one α motor
the rate of change of the muscle length neurons
 Velocity sensitive fibers  However, a given α motor neuron may innervate a variable
number of skeletal muscle fibers; the number depends on
 Importance: tells the center that the body part is in
how fine a control of muscle is required
motion
 Motor unit can be regarded as the basic unit of movement
 Dynamic position (Kinesthesia)

Secondary Endings 1.2 Gamma Motor Neurons

 Group II  γ motor neurons
 Innervate only the nuclear chain fibers o Smaller than α motor neuron
 Not sensitive to the rate of change of muscle length o Soma diameter = 35 μm
 Provides information about the static length of the o Do not supply ordinary skeletal muscle fibers
fibers o They synapse on specialized striated muscle
 Can only tell the lenth of the muscle fibers, the intrafusal muscle fibers, that are found
 Importance: it will only tell the center that the body within muscle spindles
part is stationary
 Static position

3. Center
 Brainstem
 Spinal Cord
 Center → sensation

4. Motor Neurons
 Also called as anterior motor neurons
 Located in each segment of the anterior horns of the cord
gray matter
 They give rise to the nerve fibers that leave the cord by way
of anterior roots and directly innervate the skeletal muscle
fibers
 α motor neurons → extrafusal muscle fiber Fig 10. Sensory Fibers and Anterior Motor Neurons Innervating a
 Capable of generating tension; can really contract Skeletal Muscle.
 γ motor neurons → intrafusal muscle fiber
5. Effector
o Not responsible for contraction
o Functions as sensory receptors  Skeletal Muscles (extrafusal fibers)
o Another name of muscle spindle fibers  Effectors → reflex action
o Muscle spindles are the sensory receptors in the
body that contains both sensory and efferent B. FORMS OF REFLEX
nerves 1. Monosynaptic/Myotatic
 Also known as stretch reflex
1.1 Alpha Motor Neurons  Allows a reflex signal to return with the shortest possible
time delay back to the muscle after excitation of the spindle
 Skeletal motor neurons are innervated by large neurons
 Phasic Stretch Reflex
called α motor neurons in the ventral spinal cord or in
o Rapid, transient stretches
cranial nerve nuclei
 Tonic Stretch Reflex
 α motor neurons
o Slower or steady stretch applied to the muscle
o Large
o Multipolar
Dynamic Stretch Reflex
o 70 μm in diameter
 Elicited by potent dynamic signals transmitted from the
o Their axons leave the spinal cord through ventral
primary sensory endings of the muscled spindles, caused by
roots and from the brainstem via several cranial
stretch or unstretch
nerves
 When a muscle is stretched a strong signal is transmitted to
the spinal cord that causes an instantaneous strong reflex

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contraction of the same muscle from which the signal
originated
 The reflex functions to oppose sudden changes in muscle
length
 When you move a body part, it means you are performing
work
 There is greater activity of the skeletal muscles
 Strong, sudden → for carrying load, when doing work
 Involves activity mostly of the nuclear bag; same activity of
the nuclear chain (no change in the activity of the nuclear
chain)
 Grater activity of the group Ia neurons
 Oppose sudden changes in muscle length
 Activates α motor neurons and dynamic gamma fibers, but
the γ fibers affected are mostly the dynamic gamma fibers
 Group Ia neurons are involved un dynamic (mostly) but also
involved in static activities
 Static gamma fibers are mostly attached to the nuclear
chain; dynamic gamma fibers are attached to the nuclear
bag
 Activity of the dynamic γ fibers increases spindle sensitivity
to the rate of change of stretch (nuclear bag). Increases
phasic activity of the Ia fibers
C. Polysynaptic/Cross-Extensor
 Cross extensor reflex
o About 0.2 to 0.5 seconds after a stimulus elicits a
flexor reflex in one limb, the opposite limb begins
to extend
 Signals from sensory nerves cross to the opposite side of the
cord to excite extensor muscles
 It is certain that many interneurons are involved in the
circuit between the sensory neuron and the motor neuron
of the opposite side of cord responsible for the crossed
extension
REFERENCES
1. Hall JE. Guyton and Hall Textbook of Medical Physiology.
13th ed. New York: Saunders-Elsevier, 2016.
2. Koeppen BM, Stanton BA (eds). Berne and Levy Physiology.
6th updated ed. Philadelphia: Mosby-Elsevier, 2010.
3. Lecturer’s PPT

Static Stretch Reflex

 Elicited by continuous static receptor signals transmitted by
both primary and secondary endings
 It causes the degree of muscle contraction to remain
reasonably constant, except when the person’s nervous
system specifically will otherwise exercitation
 Importance of skeletal muscles in static response: for
maintenance of posture
 Weak, continuous → for posture/balance
 Involves activity of the nuclear bag and the nuclear chain,
but with greater activity of the chain
 Involves activation of group Ia and group II neurons, but
mostly group II
 Activates α motor neurons and static γ fibers, but the static
γ neurons are the ones mostly affected
 Activity of the static γ fibers increases spindle sensitivity to
steady, maintained stretch (nuclear chain). Increases tonic
activity of Ia fibers

2. Disynaptic/ Inverse Myotatic

 Also called lengthening reaction
 When the Golgi tendon organs of a muscle tendon are
stimulated by increased tension in the connecting muscle,
signals are transmitted to the spinal cord to cause reflex
effects in the respective muscles
 This reflex is entirely inhibitory
 Provides a negative feedback mechanism that prevents the
development of too much tension on the muscle
 Probably a protective mechanism to prevent tearing of the
muscle or avulsion of the tendon from its attachment to the
bone.
 Stimulates an inhibitory interneuron (spinal cord)
 Inhibiting alpha motor neurons
 Resulting to muscular relaxation

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