REFLEXES

(v2012, LONG SHEET). Lecturer: D.G. Simbulan, Jr., PhD Long sheet 8.5 by 11 ----------------------------------------------------------------------------------------------------------------------------- ---------------

Please read also recommended reference textbooks. I. INTRODUCTION: Most, if not all, responses or reactions of the body or parts of the body to changes in the environment (stimuli) are reflex in nature. Reflexes are among the most basic of neuronal functions and involve some of the simplest neuronal circuits. Reflexes are essential elements of behavior. DEFINITIONS: 1. Definition of reflex a stereotyped response to specific stimulus; any response that occurs automatically without conscious effort. 2. Two types of reflexes: a. Simple or basic reflex built-in, unlearned responses, e.g., closing of eyes when an object moves towards them. Processed and integrated in spinal cord and brain stem. b. Acquired or conditioned reflex results from practice and learning, e.g., steering car wheel to follow a curve done automatically but after considerable training effort. Integrated, processed in higher brain centers. 3. Reflex arc basic unit of integrated neural activity; anatomical basis for the reflex. 4. Parts of reflexes: a. Afferent limb i. Receptor sense organs ii. Afferent or sensory neuron and nerve b. Center one or more synapses in CNS i. Spinal cord ii. brain c. Efferent limb i. Efferent or motor neuron and nerve ii. Effectors 1. Glands exocrine and endocrine 2. Muscles a. Smooth b. Skeletal c. Cardiac
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5. Reflex arcs vary in complexity. 1. Simple at level of the spinal cord 2. More complex at the level of the brain stem 3. Most complex in the cerebral cortex 6. Stimulus a change in the external/ internal environment. In the body, changes in temperate, pressure, electrolyte concentration, etc., can act as stimuli. 7. Adequate stimulus a stimulus to which a receptor is most sensitive or to which it haes a low threshold, e.g., eye sensitive to lights; see stars when punched. 8. Threshold stimulus the weakest stimulus that a sensory receptor can reliably detect and activate primary afferent fibers. 9. Motor unit - a single motor neuron and the muscle cells it synapses on. Each muscle cell belongs to only one motor unit. Size of motor units varies and depends on muscle function: small muscle tat generate very finely controlled movements (e.. extra-ocular muscles of the eyes, motor units tend to be small and may contain just a few muscle fibers); large muscles that generate strong forces, e.g.,gastrocnemius muscle of the leg, tend to have large motor units with more than several thousand muscle fibers.

10.Two types of motor neurons: a. Alpha motor neurons innervate the main force-generating muscle fibers (extrafusal fibers). b. Gamma motor neurons innervate only the fibers of the muscle spindle (the intrafusal fibers) 11.Motor neuron pool the groups of all motor neurons innervating a single muscle. 12.Bell-Magendie law the principle that in the spinal cord, the dorsal roots are sensory and the ventral roots are motor. 13.Type of reflexes (based on site of receptors):

a. Deep reflexes reflexes that result from stimulation of receptors present in muscles or tendons. e.g., stretch reflex b. Superficial reflexes result from stimulation of the receptors present in the skin and mucous membrane they are all polysynaptic, e.g., withdrawal reflex or scratch reflex. c. Visceral reflexes clinically important reflexes micturition, defecation, and erection. Not all reflex activity involves clear-cut reflex arcs: 1 response may be mediated through neurons, or hormones, or both; 2 local response may not be due to hormones or nerves, but by local metabolites.

II. SPINAL REFLEXES Spinal cord reflexes, investigated using spinal animal or decerebrate preparation, consist of two main types of reflex arcs: 1. Monosynaptic made up of a two-neuron pathway from receptor to effector (the afferent or sensory neuron has a direct synaptic connection with the efferent / motor neuron , without the intervention of interneurons), e.g., stretch or myotatic reflex which is the most rapid of all reflexes, utilizing Ia afferent which are the largest diameter, fastest \conducting of any afferent nerves. 2. Multi-synaptic / Polysnaptic - made up of a few or several interneurons intersposed between the afferent and efferent neurons, e.g., withdrawal reflex In both mono- and polysynaptic arcs, the activity is modified by such phenomena as spatial and temporal summation, subliminal fringe effects, and other laws.

EXAMPLES OF SPINAL REFLEXES 1. STRETCH or MYOTATIC REFLEX the simplest reflex; passively stretching a skeletal muscle causes a reflexive contraction of that same muscle and relaxation of the antagonistic muscle, e.g., knee jerk or patellar reflex a light tap on patellar tendon pulls on and briefly stretches the quadriceps
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femoris muscle (an extensor) reflexive contraction of quadriceps and relaxation of semitendinosus muscle (a flexor). This is a key reflex that helps maintain posture; most rapid of all reflexes. It has two forms: a. Phasic stretch reflex elicited by primary endings of muscle spindles b. Tonic stretch reflex depends on both primary and secondary endings The stretch reflex is a monosynaptic reflex, mediated by Ia and II sensory fibers emanating from the muscle stretch receptor known as muscle spindles. Best studied in decerebrate animals, also in spinal animals that have recovered from spinal shock. Examples are seen in deep tendon reflexes, such as the patellar reflex, Achilles reflex, masseter, triceps, etc. The muscle that is stretched contains sensory receptor, known as the muscle spindle. The muscle spindle elicits the reflexive contraction. 2. INVERSE STRETCH (or INVERSE MYOTATIC) REFLEX / AUTOGENIC INHIBITION a relaxation in response to a strong muscle tension (muscle contraction stretches the tendon). The receptor for the inverse stretch reflex is the golgi tendon organ. The fibers from the golgi tendon organs make up the Ib group of myelinated, rapidly conducting sensory nerve fibers. Stimulation of these Ib fibers leads to the production of IPSPs on the motor neurons that supply the muscle from which the fibers arise. The Ib fibers end in the spinal cord on inhibitory interneurons that in turn terminate directly on the motor neurons. (They also make excitatory connections with motor neurons supplying antagonists to the muscle.) The inverse stretch reflex is a bi-synaptic reflex. 3. FLEXION REFLEX this is a polysynaptic reflex. This involves many receptors outside of muscle that contracts. Afferent volleys arising from activation of sensory receptors cause a. excitatory interneurons to activate alpha motoneurons that supply flexor muscles in the ipsilateral limb b. inhibitory interneurons to prevent the activation of alphamotoneurons that supply the antagonistic extensor muscles c. in addition, commissural interneurons evoke the opposite pattern of activityin the contralateral side of the spinal cord. This opposite pattern results in extension, the Crossed Extension Reflex. The conralateral effects helps the subject maintain balance.

The most powerful flexion reflex is the flexor Withdrawal Reflex ( a pain reflex):

a. nociceptors form the afferent limb of this reflex; include cutaneous, muscle, joint and visceral nociceptor b. there is considerable divergence of the primary afferent and interneuronal pathways in the flexion reflex involving major joints in a limb, e.g., hip, knee, ankle, in a strong flexor withdrawal reflex. III. SENSORY RECEPTORS OF DEEP REFLEXES: THE MUSCLE SPINDLE and GOLGI TENDON ORGAN

A. The Muscle Spindle a. Histology: spindle-shaped, about 100 microns in diameter, and up to 10 mm long. It lies freely in the lymph space between regular extrafusal muscle fibers , in parallel. Within a muscle spindle, there are two main types of intrafusal fibers: i. Nuclear bag fibers with several nuclei in central or equatorial region; generally two nuclear bag fibers per muscle spindle. 1. Nuclear bag fiber 1 has low level of myosin ATPase activity 2. Nuclear bag fiber 2 has a high level of myosin ATPase activity ii. Nuclear chain fibers with one row of nuclei; about 4 or more nuclear chain fibers per muscle spindle

b. Histology of sensory endings: There are two kinds of sensory endings in each spindle (composed of group Ia and II afferent fibers): i. Primary or annulospiral endings rapidly conducting group Ia afferent fibers; one branch of Ia fibers innervates innervates nuclear bag fiber 1; one branch innervates nuclear bag fiber 2 and nuclear chain fibers. Group Ia fibers belong to the largest diameter class of sensory fibers and conduct at 72 120 m/sec. Group Ia fibers wrap around the center of the nuclear bag and nuclear chain fibers ii. Secondary, or flower-spray endings are terminations of group II sensory fibers. Group II fibers are intermediate in size and
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conduct at 36 72 m/sec. Located nearer the ends of the intrafusal fibers , mainly on nuclear chain fibers (occasionally may contact a nuclear bag fiber).

c. Histology of gamma-motor neuron innervating muscle spindles : There are two types of gamma-motor neurons supplying muscle spindles. i. Dynamic gamma motor axons end with plate endings on nuclear bag fibers. ii. Static gamma motor axons end with trail endings on nuclear chain fibers; gamma motor axons are smaller in diameter than the alphamotor axons to extrafusal fibers, hence conduct more slowly at 12 48 m/sec. B. The Golgi Tendon Organ a. Consists of a netlike collection of knobby nerve endings among the fascicles of a tendon. b. Arranged in series with the extrafusal fibers c. Formed by the terminals of group Ib afferent fibers (also myelinated, rapidly conducting sensory nerve fibers) d. Stimulated by both passive stretch and active contraction of the muscle; muscle contraction is more effective than muscle stretch e. Signals force, rather than muscle length or rate of change of muscle length f. This is the sensory receptor for the inverse stretch reflex (inverse myotatic reflex)

Role of Stretch Reflex in Postural Reflexes The upright posture characteristic of man is produced, maintained, and restored when upset, by a series of coordinated reflexes called postural reflexes. Posture depends on the degree and distribution of muscle tone and muscle tone depends principally on stretch reflex, hence , the stretch reflex is the basic postural reflex.
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The role of the stretch reflex in the maintenance of posture is reinforced and modified by afferent impulses to the CNS (central nervous system) from: 1. proprioceptors of the muscles of the neck, trunk, and limbs; 2. Eyes; 3. Vestibular apparatus; 4. Exteroceptors of the skin. These impulses are integrated by coordinated activity of the spinal cord, brain stem, cerebellum, basal ganglia and cerebral cortex. (Neck muscles contain the largest concentration of muscle spindles of any muscle in the body).

IV. SUPERFICIAL REFLEXES - elicited by stimulation of mucous membrane and skin. They are all polysynaptic (pleurisynaptic). They include: 1. Corneal reflex 2. Snout reflex 3. Rooting reflex 4. Sucking reflex 5. Abdominal reflex 6. Plantar reflex (all toes flex) 7. Cremasteric reflex 8. Sphincter reflex, etc

2, 3, & 4 are functionally important in infants to ensure successful ingestion. They are pleasurable and reinforce thumb sucking. They disappear in childhood, but may reappear in senile patients (diminution of frontal lobe control).

Cremasteric muscle transposted abdominal muscle reflex, absent in upper (suprasegmental) motor neuron lesions.

V. VISCERAL REFLEXES / OTHER REFLEXES FOUND IN OTHER ORGAN SYSTEMS

A.

CARDIOVASCULAR SYSTEM REFLEXES 1. Bainbridge reflex right heart distention increase heart rate; tachycardia caused by an increase in venous return
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2. Baroreceptor reflex increased right atrial pressure increase in cardiac output increase in arterial pressure; in crease in heart rate or relieving stretch on high-pressure arterial receptors tachycardia, which increase stretch on high-pressure arterial receptors decrease stroke volume (SV) 3. Starlings law decrease initial fiber length decrease stroke volume, and vice versa. 4. Chemoreceptor reflexes 5. Ventricular receptor reflexes 6. Cushing reflex increase in arterial pressure occurs in response to an increase in intracranial pressure # 1, 2 and 3 affect cardiac output B. RESPIRATORY SYSTEM REFLEXES 1. Hering-Breuer reflex involves slowly adapting pulmonary stretch receptors (PSRs). Lung inflation decrease in tidal volume and increased respiratory; lung inflation inhibits inspiration and promotes expiration (less in adults, prominent in infants). This is a classic example of negative feedback. 2. Cough reflex like a respiratory scratch reflex 3. Diving reflex apnea in response to water applied to the face or nose C.

Pulmonary reflex lung inflation reflex systemic vasodilation

and a decrease in arterial blood pressure; lung deflation systemic vasoconstriction

D.

GASTROINTESTINAL SYSTEM REFLEXES 1. Intrinsic reflexes 2. Swallowing reflex 3. Gastroileal reflex 4. Intestinointestinal reflex
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5. Gastrocolic reflex 6. Colocolonic reflex 7. Vomiting reflex 8. Defecation reflex E. URINARY SYSTEM REFLEXES 1. Micturition reflex F. ENDOCRINE (REPRODUCTIVE) SYSTEM RELEXES 1. Let-down reflex release of pre-exising milk on oxytocin action on breast muscles 2. Ferguson reflex distention of cervix release of maternal oxytocin G. REFLEX CONTROL OF EYE 1. Pupillary light reflex 2. Vestibulo-ocular reflex 3. Opto-kinetic reflex

Ref: outline adapted from Dr. Lauro Escobars Lecture Notes (Professor Emeritus of Physio Dept.) William F. Ganong, 19th edition, Reflexes, Chapter 6, pp. 121 129 Read other recommended notes.