Lab No.

Objective:
Demonstrate the deep reflexes on a given subject.

Requirements:
Human subject and tendon hammer.

Theory:
Reflex Action:
Reflex action is a sudden and involuntary response to stimuli. It helps organisms to quickly
adapt to an adverse circumstance that could have the potential to cause bodily harm or even
death. Pulling our hands away immediately after touching a hot or cold object is a classic
example of a reflex action.

Reflex Arc:
A reflex arc is a neural pathway that controls a reflex. In vertebrates, most sensory neurons do
not pass directly into the brain, but synapse in the spinal cord. This allows for faster reflex
actions to occur by activating spinal motor neurons without the delay of routing signals
through the brain.,
Pathway of Reflex Arc:
There are two types: autonomic reflex arc (affecting inner organs) and somatic reflex arc (affecting
muscles). Autonomic reflexes sometimes involve the spinal cord and some somatic reflexes are
mediated more by the brain than the spinal cord.
During a somatic reflex, nerve signals travel along the following pathway:

1. Somatic receptors in the skin, muscles and tendons

2. Afferent nerve fibers carry signals from the somatic receptors to the posterior horn of the spinal cord or
to the brainstem
3. An integrating center, the point at which the neurons that compose the gray matter of the spinal cord or
brainstem synapse
4. Efferent nerve fibers carry motor nerve signals from the anterior horn to the muscles
5. Effector muscle innervated by the efferent nerve fiber carries out the response.

Classification Of Reflexes

There are several ways to classify the reflexes of the body. Following is the classification
This is based on the movement of the organs or parts of the body that move due to the reflex.
of reflexes.
Some reflexes that move the skeletal muscles are extensor, flexor, locomotor, and statokinetic.
Reflexesonthat
1. Based the involve
Type ortheFunction
function of internal organs include cardiovascular, digestive,
secretory, and excretory.

2. Based on the Degree of Complexity

 Reflexes can also be classified based on the degree of complexity of the neuron or nerve
organization within the reflex arcs. Under this category, these can be monosynaptic or
monosegmental reflexes that involve only one segment of the central nervous system and
multisynaptic or intersegmental reflexes that involve more than one segment of the central nervous
system.
Reflexesoncan
3. Based thebeDevelopment
innate reflexes and acquired reflexes where the former includes genetically
determined and the latter type includes learned reflexes.
4. Based on the Response
Reflexes can be somatic reflexes that control skeletal muscle contractions and include
superficial and stretch reflexes; the other one includes visceral or autonomic reflexes.
,

Conditions Affecting Deep Reflexes

Hyperactive deep tendon reflexes are seen in upper motor neuron lesions. Pathologically,
hyperactive DTRs may be the earliest sign of corticospinal tract abnormalities or other
descending pathways influencing the reflex arc due to a suprasegmental lesion, which means a
lesion above the level of the spinal reflex pathways. Hyperactive DTRs can be evoked by a much
lighter tendon tap than normal, have short latency, and reflex muscle activity may be seen in
motor neuron pools of synergistic muscles. For example, a tendon tap to the biceps brachii may
elicit wrist pronation.[11]
Hypoactive or absent deep tendon reflexes are seen in lower motor neuron lesions. Hypoactive
DTRs may be seen in disease states such as hypothyroidism, hypothermia, cerebellar
dysfunction, or beta-blockade.

Procedure:
Deep Reflexes

Procedure to Centers
S. No. Name of Reflex Result
elicit reflex
1 Patellar jerk / knee jerk With a tendon Contraction of L2, L3, L4
hammer strike quadriceps and
the patellar extension at
tendon knee joint
2 Ankle jerk With a tendon Due to S1, S2
hammer strike contraction of
the Achilles gastrocnemius
tendon muscle, flexion
at ankle joint
3 Biceps reflex Flex the arm, Contraction of C5,C6
with the help of biceps and
thumb feel the flexion of
biceps tendon elbow joint.
and strike
tendon hammer
on thumb.
4 Triceps reflex Strike the Contraction of C6, C7, C8
hammer on triceps and
triceps tendon. flexion of
elbow joint.
 5. Jaw Jerk Slightly open Masseter Cranial nerve 5
the mouth, place muscle contract
one finger on the resulting in
chin then tap closure of jaw
with another
finger or tendon
hammer.

Observation:
Deep Reflexes

S. No. Name of Reflex Result

Knee jerk Yes, Contraction of quadriceps and extension at knee joint

occur
1.

Ankle jerk Due to contraction of gastrocnemius muscle, flexion at ankle

joint occur
2.

Biceps reflex Contraction of biceps and flexion of elbow joint occur

3.

Triceps reflex Contraction of triceps and flexion of elbow joint occur

4.

Jaw jerk Masseter muscle contract resulting in closure of jaw occur

5.

Precautions
 Before eliciting the reflex, the procedure should be explained to the subject.
 The subject should be relaxed and proper exposure of the part of body tested is mandatory.
 Observe the movements of muscles being tested not the joint movement.
 Be sure that no joint disease is present.
Discussion:
 A stretch reflex is the contraction of a muscle in response to stretching of muscle spindles,
which are receptors that lie in parallel with extrafusal muscle fibers. The reflex is composed of a
two- neuron arc. The afferent neuron, whose cell body is in a sensory ganglion, innervates the
spindle. When the muscle spindle is stretched, this neuron fires and monosynaptically excites
alpha motoneurons in the anterior horn of the spinal cord. This alpha motoneuron is the second
neuron; it supplies the muscle that is being tapped or transiently stretched. The detailed
mechanisms underlying the operation of the spindle are quite complex, but considerable
knowledge about them is now available in the literature, and new details are added constantly.
The muscle spindle is a slender, spindle-shaped structure that is intermingled with the usual
muscle fibers. Each spindle is composed of two types of elongated, poorly staining fibers:
nuclear bag fibers and nuclear chain fibers. Each contains multiple nuclei. Six to ten of these
fibers lie within the spindle's connective tissue sheath. They are called "intrafusal" muscle fibers,
since they lie inside the fusiform structure, in contrast to the surrounding "extrafusal" fibers that
make up the contractile element of muscle.
Absent stretch reflexes indicate a lesion in the reflex arc itself. Associated symptoms and signs
usually make localization possible:
1. Absent reflexes and sensory loss in the distribution of the nerve supplying the reflex:
the lesion involves the afferent arc of the reflex—either nerve or dorsal horn.
2. Absent reflex with paralysis, muscle atrophy, and fasciculations: the lesion involves
the efferent arc—anterior horn cells or efferent nerve, or both.