Reflex action. Classification of Reflexes. Muscle spindle & Muscle tone.

Dermatome:

Area of skin supplied by a spinal nerve or a segment of spinal cord. Trunk horizontal band (T2 T12) Limbs specific pattern There is overlapping of adjacent dermatomes. We can assess the level of damage from dermatomes. There are 31 pairs of spinal nerves. Region-wise: 8 cevical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal.

Reflex action:

An automatic response to a stimulus, without the involvement of will or consciousness, e.g., light is thrown on eye pupil constricts. Advantage: protective value. Purpose: quick response, save time, prevents damage to body tissues.

Reflex arc:

Reflex action involves specific organization called reflex arc. Reflex arc has 5 components: Receptor Sensory / afferent neuron Centre Motor / efferent neuron Effector / target cell

Components of a reflex arc:

Receptors: respond to stimuli by producing impulses. Impulses from receptors are carried by sensory neurons to the centre. Centre is the integrating part & is always in CNS In the centre there is 1 or more than 1 synapse between afferent & efferent neurons. Efferent neuron carries impulses from centre to target cells. Target cells are responding cells (skeletal, cardiac, smooth muscles & glands). Integrity of reflex arc is essential for reflex action. If arc is broken at any point no reflex action.

Classification of reflex:
Depending upon number of synapses in reflex arc: Monosynaptic (e.g: stretch reflex like knee jerk) Disynaptic (e.g: golgi tendon organ reflex) Polysynaptic / multisynaptic (e.g: withdrawal reflex) Depending upon conditioned / unconditioned or acquired / inborn: Inborn / unconditioned: present at birth. (e.g: light reflex, salivation on introduction of something in mouth, defecation reflex without higher control).

Acquired / conditioned: develop in response to a conditioned stimulus (ringing of bell) with the help of an unconditioned stimulus (sight of food, smell of food). On sight / smell of food salivation (unconditioned). On ringing of bell salivation (conditioned). PAVLOVS EXPERIMENTS: Animal is kept in cage. First bell is rung & then animal is served food. Practiced many times. Bell is rung without serving food salivation (acquired reflex in response of a conditioned stimulus with the help of an unconditioned stimulus.

Superficial, deep, visceral & pathological reflexes: Superficial reflexes: receptors are in superficial parts of body. (mucus, cutaneous) Corneal Conjunctival Superficial abdominal Plantar Cremasteric

Deep reflexes / tendon jerks: receptors are present in deeper tissues. Biceps jerk Triceps jerk Knee jerk Ankle jerk Supinator reflex Scapular reflex

Visceral reflexes: receptors are in viscera. Light reflex Micturition reflex Defecation reflex Oculo-cardiac reflex Baro-receptor reflex Bain-bridge reflex

Pathological reflexes: in diseased states. Babinski sign Ankle clonus Knee clonus

Monosynaptic reflexes:
Example: Stretch reflex / myotatic reflex: Whenever a skeletal muscle is stretched, it contracts. Stimulus: is stretch. Response: is contraction. Receptors: are muscle spindle.

Ends of muscle spindle are fused with sides of muscle fibers. So when a change in muscle size occurs, they are stretched.
Inside each spindle are modified muscle fibers called intrafusal fibers. Number of muscle spindles vary.

Muscle fibers involved in fine skilled movements (hand muscles) have increased number of muscle spindles.

2 types of fibers in muscle spindles:

Nuclear bag fibers: 1-3 in number in each spindle. Nuclei in central dilated portion. Nuclear chain fibers: 3-9 in number. Ends are attached with sides of nuclear bag fibers.
Nuclei are present in the form of a chain BAG CHAIN Nuclei in central dilated portion throughout the length of fiber

The end portion of intrafusal fibers contain contractile components (actin & myosin filaments). Central portion of fibers is without actinmyosin filaments. It is called receptor portion.

Sensory nerve supply of intrafusal fibers: 2 types of sensory nerve endings:

Primary or annulospiral: Present around central portion of both nuclear bag & nuclear chain fibers. Endings of type IA fibers with conduction velocity: 70-120 m/sec. Secondary or flower spray: Endings of type II nerve fibers. Velocity is 30-70 m/sec. Only around nuclear chain fibers.

NUCLEAR CHAIN FIBERS ARE SUPPLIED BY BOTH TYPES OF NERVE ENDINGS

Motor nerve supply of intrafusal fibers:

Gamma efferents supply end portion of intrafusal fibers & end portions are contractile. Conduction velocity: 15-30 m/sec. Forms 30% of nerve fibers in the ventral root of spinal nerve (motor root). *Alpha motor neuron supply the extrafusal fibers.

Muscle spindle is stimulated when its central portion is stretched by either of 2 ways:

When muscle is stretched, along with that, muscle spindle is also stretched, so gets stimulated.

Internal stretching: i-e., muscle spindle gets stretched without stretching of muscle, through gamma efferents which supply end portions of intrafusal fibers which contract so central portion is stretched stimulation. This is the mechanism of muscle tone.

Stretching of muscle can be Static/slow or Rapid/dynamic

STATIC / SLOW: When a static stretch is applied to a muscle increase in muscle length increased discharge of impulses from both primary & secondary nerve endings & remains increased as long as muscle is stretched. Nuclear chain fibers are involved.

RAPID / DYNAMIC: When a rapid stretch is applied rapid increase in length of muscle primary nerve endings discharge increases this discharge decreases when rapid increase in length stops. Nuclear bag fibers are involved in dynamic response (e.g., knee jerk)

WHEN CENTRE PORTION OF A MUSCLE SPINDLE IS STRETCHED, DISCHARGE OF IMPULSES FROM MUSCLE SPINDLE INCREASE & VICE VERSA

FUNCTIONS OF MUSCLE SPINDLE:

1) Helps to regulate length of muscle: & prevents length of muscle to go beyond limits. When a muscle is stretched, it contracts (stretch reflex). So increase in muscle length beyond limit is prevented & when muscle contracts & shortens discharge of impulses from muscle spindle decreases muscle relaxation so too much muscle shortening is also prevented. 2) Involved in muscle tone mechanism: 3) Are receptors in tendon jerks: which are clinically important. All tendon jerks are monosynaptic stretch reflexes & receptors are muscle spindles. 4) Stretch reflex helps in lifting of load / weight: muscle is stretched & it contracts, so helps in lifting. 5) For voluntary smooth movements: There is coactivation of alpha & gamma motor neurons. Whenever there is voluntary movement, impulses from motor cortex simultaneously go to alpha & gamma motor neurons smooth voluntary contraction

When muscle contracts only alpha efferents carrying impulses decreased discharge of impulses from muscle spindle relaxation (no voluntary smooth movement because at 1 end muscle is contracting & at other end it is relaxing).

MUSCLE CONTRACTS

When impulses come along alpha & gamma efferents simultaneously smooth voluntary movements muscle contracts but intrafusal fibers lengthen firing rate remains constant, discharge is not decreased because of gamma neuron co-activation.

Monosynaptic reflex / knee jerk / typical stretch reflex:

Stimulus quadriceps stretched spinal cord alpha motor neuron muscle (quadriceps contracts effect: leg jerks forward. (L3, L4). In UMN disease, tendon jerks become aggravated. In LMN disease (below the level of alpha motor neuron), they are decreased or absent. In UMN lesion (at or above the level of alpha motor neuron) inhibitory effect gone gamma efferents facilitated stretch reflex facilitated tendon jerks aggravated. Normally when alpha motor neuron was intact, contraction is followed by relaxation (normal stretch reflex).

STIMULUS: Blow to tendon

RECEPTOR:
Muscle spindle

AFFERENT
PATH: Action potential onto

INTEGRATING CENTRE:

Spinal cord L2, L3

Efferent path 1: Somatic motor neuron

Efferent path 2: Interneuron inhibiting somatic motor neuron

Effector 1: Quadriceps muscle

Effector 2: Hamstring muscle

Response: Quadriceps contracts

Response: Hamstring stays relaxed (reciprocal inhibition)

Human Physiology by Silverthorn

CLONUS: (In UMN lesion)

Regular, rhythmic contraction of muscle when subjected to sudden maintained stretch. Seen in facilitation of stretch reflex / facilitation of gamma neurons.
FOOT OF PATIENT

PALM OF HAND SUSTAINED PRESSURE

Muscle tone:

Continuous state of partial contraction in muscle Involvement of stretch reflex & muscle spindle, also called myotatic reflex. There is some continuous discharge of impulses from gamma motor neuron. Efferents go to end portions of intrafusal fibers & they contract, so central portion is stretched muscle spindle excitation internal stretching of muscle spindle. From muscle spindle impulses come along sensory nerve fiber to spinal cord & excite alpha motor neuron impulses go to skeletal muscle partial contraction.