DEN BULONG-ADUL, M.D.

DEPARTMENT OF PHYSIOLOGY COLLEGE OF MEDICINE/PHYSICAL THERAPY

Reflex Physiology

Human Reflex Physiology

Reflexes are rapid, predictable and involuntary motor responses to stimuli There are two groups: 1. Autonomic reflexes (or visceral) 2. Somatic reflexes

REFLEX
Functional unit of the nervous system Reactions in external environment are mediated through the SOMATIC REFLEX ARC Regulation/adjustment of visceral function is accomplished thru the AUTONOMIC REFLEX ARC Through reflex reaction, organ function maybe regulated based on sensory information from organ itself or from external sensors

 reflex - a rapid, wired" motor response to a specific stimulus; involuntary, subconscious 1. somatic reflex - skeletal muscle 2. visceral (autonomic) reflex smooth muscle, cardiac muscle, visceral organs, glands

Autonomic
These reflexes activate smooth muscle, cardiac muscle and the glands of the body

 Regulate body functions such as: digestion, elimination, blood

pressure, salivation and sweating

Somatic Reflex
Stimulate skeletal muscle An example is the rapid withdrawal of hand from a hot object.

Reflex
A reflex is a rapid, predictable motor response

to a stimulus Reflexes may: Be inborn (intrinsic) or learned

(acquired) Involve only peripheral nerves and the spinal cord Involve higher brain centers as well

REFLEX ACTION
Simple reflex pathways Receptor, transmitter, effector Receptor: any kind of sensory
nerve ending capable of detecting bodily sensations (touch, smell, sight) Transmitter: transmits impulses from detected

sensation w/c may be a single neuron or several neurons connected in series Effector: muscle/gland controlled by nerves

Reflex Action Resulting involuntary activity

in some peripheral tissue, due to action of efferent nerves as a consequence of stimulation of afferent nerve

Reflex Arc
Pathway taken by impulse to produce the reflex action Important that it shd be intact

 Destruction of any component part of reflex arc results in loss of reflex act The basic unit of integrated reflex activity

The Reflex Arc

The key components of a reflex arc are: receptor, efferent
nerve/sensory neuron, interneuron (may be absent)/center (brain/spinal cord), efferent nerve/motor neuron and effector (e.g. muscle/gland).

The receptor detects stimuli and produces graded potentials that cause the

formation of nerve impulses in the neurons. The nerve impulses then produce rapid responses in muscle (jump due to sound).

stimulus sensory neuron section 1 receptor 3 integration center skin 4 Motor neuron 5 effector spinal cord in x-

Reflex Arc
five components of a reflex arc: Receptor site of stimulus Sensory neuron transmits the

afferent impulse to the CNS Integration center either monosynaptic or polysynaptic region within the CNS Motor neuron conducts efferent impulses from the integration center to an effector Effector muscle fiber or gland that responds to the efferent impulse

In mammals, the connection

between afferent and efferent somatic neurons is generally in the brain or spinal cord. The afferent neurons enter via the dorsal roots or cranial

nerves and have their cell bodies in the dorsal root ganglia or in the homologous ganglia on the cranial nerves. The efferent fibers leave via the ventral roots or corresponding motor cranial nerves. The principle that in the spinal cord the dorsal roots are sensory and the ventral roots are motor is known as the Bell Magendie law.

I. RECEPTORS
site where stimulus is received Specialized structures stimulated by changes in the external environment &

also by changes w/in the body itself Can transform diff. types of energy into nerve impulses

II.Sensory Neuron - transmits the signal from receptors (AFFERENT nerve fiber) to the CNS III. Integration center - point where sensory and motor neurons integrate information to respond monosynaptic pathway sensory neurons synapse

directly with the motor neuron polysynaptic pathway - one or more "interneurons" between sensory and motor neurons

IV. Motor Neuron - transmits motor signal from CNS to the effector organ via EFFERENT nerve V. The Effector - the muscle or organ that responds to signal of the motor neuron

Activity in the reflex arc starts in a sensory receptor with a receptor potential
whose magnitude is

proportional to the strength of the stimulus

generates all-or-none action potentials in the afferent nerve number of action potentials
proportional to the size of the generator potential. In the central nervous system (CNS), the responses are again graded in terms of EPSPs & IPSPs at the synaptic junctions.

All-or-none responses are

generated in the efferent nerve. When these reach the effector, they again set up a graded response.

When the effector is smooth

muscle, responses summate to produce action potentials in the smooth muscle When the effector is skeletal muscle, the graded response is always adequate to produce action potentials that bring about muscle contraction.

The connection between the

afferent and efferent neurons is usually in the CNS, and activity in the reflex arc is modified by the multiple inputs converging on the efferent neurons or at any synaptic station within the reflex loop.

KIND OF REFLEX
UNCONSCIOUS REFLEX Those in which the subject is
not aware of the act Glandular secretions, salivary, gastric, pancreatic, etc.

CONSCIOUS REFLEXES Aware of the act Muscular reflexes Simple or complex

SIMPLE REFLEX
Results from stimulation of a neuron causing a response from a single muscle Winking reflex: orbicularis oculi Results from an object striking

or appearing to strike the cornea Inhibited only w/ difficulty

The simplest reflex arc is one with a single synapse between the afferent and efferent neurons. Such arcs are monosynaptic, and reflexes occurring in them are called monosynaptic reflexes. Reflex arcs in which one or more interneuron is interposed between the afferent and efferent neurons are called polysynaptic reflexes.

 There can be anywhere from

two to hundreds of synapses in a polysynaptic reflex arc.

Axon Reflex
Simplest reflex Involves single neuron Each sensory nerve fiber in a spinal nerve normally has several branches Some terminates on blood
vessels, beneath the skin Stimulating single sensory receptor in skin causes an impulse to travel into branches of fiber as well as upward to the cord

When impulse reaches the

terminals near blood vessel, histamine is probably secreted dilatation of blood vessels

2 neuron reflex
Next level of reflex arc Involves spinal cord Sensory impulses transmitted to cord, returned directly back to muscle or other effectors Ex: stretch reflex Muscle transmitted to spinal
cord by 1 neuron, 2nd neuron transmits impulse directly back to muscle muscle tightens & resist stretch

Complex Reflex
Involves several efferent nerves Response of several muscles Complex Coordinated Reflex When efferent nerves respond
one after another in an orderly sequence series of muscle contractions (characteristic of a purposeful reflex act) Walking, running, swimming

Monosynaptic Reflexes: The Stretch

Reflex
Stretch Reflex When a skeletal muscle with an
intact nerve supply is stretched, it contracts. Stimulus that initiates the reflex:

stretch of the muscle Response: contraction of the muscle

being stretched. Sense organ: a small encapsulated spindlelike or fusiform shaped structure called the muscle spindle, located within the fleshy part of the muscle.

The impulses originating from

the spindle are transmitted to the CNS by fast sensory fibers

that pass directly to the motor neurons which supply the same muscle. The neurotransmitter at the central synapse

glutamate. The stretch reflex is the best

known and studied monosynaptic reflex typified by the knee jerk reflex

Structure of Muscle Spindles

Each muscle spindle has three essential elements: a group of specialized
intrafusal muscle fibers with contractile polar ends and a

noncontractile center, large diameter myelinated afferent nerves (types Ia and II) originating in the central portion of the intrafusal fibers small diameter myelinated efferent nerves supplying the polar contractile regions of the intrafusal fibers

Changes in muscle length are associated with changes in joint angle muscle spindles provide
information on position (ie, proprioception).

Muscle Spindles

Operation of the Muscle Spindles Function of Muscle Spindles

When the muscle spindle is stretched, its sensory endings are distorted and receptor potentials are generated. These in turn set up action potentials in the sensory fibers at a frequency proportional to the degree of stretching.

 Because the spindle is in parallel

with the extrafusal fibers, when the muscle is passively stretched, the spindles are also stretched, referred to as "loading the spindle." This initiates reflex contraction of the extrafusal fibers in the muscle. On the other hand, the spindle afferents characteristically stop firing when the muscle is made to contract by electrical stimulation of the -motor neurons to the extrafusal fibers because the muscle shortens while the spindle is unloaded

the spindle and its reflex

connections constitute a feedback device that operates to maintain muscle length if the muscle is stretched,
spindle discharge increases and reflex shortening is produced, if the muscle is shortened without a change in -motor neuron discharge, spindle afferent activity decreases and the muscle relaxes.

Dynamic and static responses of muscle spindle afferents influence physiological tremor

Reciprocal Innervation
When a stretch reflex occurs,
the muscles that antagonize the action of the muscle involved (antagonists) relax. Impulses in the Ia fibers from the muscle spindles of the protagonist muscle cause postsynaptic inhibition of the motor neurons to the antagonists. The pathway mediating this effect is bisynaptic. A collateral from each Ia fiber passes in the spinal cord to an inhibitory interneuron that synapses on a motor neuron supplying the antagonist

muscles.

Reciprocal Innervation
Anatomical arrangement by which muscles w/ antagonistic actions receive motor innervations connected to pre-motor neurons Its stimulation causes
excitation of 1 group of muscles, inhibition of antagonistic group Ex: flexor reflex

Excites biceps muscle, inhibits

the opposing triceps muscle on same side Opposite side of cord, impulses pass to stimulate intenuncial cell controlling the extensor muscles

of opposite limb extend (crossed extensor reflex)

True in all parts of body where opposing muscles exist Walking, swimming, etc. Complex coordinated reflex

Inverse Stretch Reflex

autogenic inhibition. Up to a point, the harder a muscle is stretched, the stronger is the reflex contraction. However, when the tension becomes great enough,

contraction suddenly ceases and the muscle relaxes. Relaxation in response to strong stretch

The receptor for the inverse

stretch reflex is in the Golgi tendon organ consists of a netlike collection of knobby nerve endings among the fascicles of a tendon.

Golgi Tendon Reflex

clasp-knife effect

 Passive flexion of the elbow, for

example, meets immediate resistance as a result of the stretch reflex in the triceps muscle. Further stretch activates the inverse stretch reflex. The resistance to flexion suddenly collapses, and the arm flexes. Continued passive flexion stretches the muscle again, and the sequence may be repeated. sequence of resistance followed by give when a limb is moved passively because of its resemblance to the closing of a pocket knife. It is also known as the lengthening reaction because it is the response of a spastic muscle to lengthening

Muscle Tone/Tonus
The resistance of a muscle to stretch If the motor nerve to a muscle is cut, the muscle offers very little resistance and is said to be flaccid. hypertonic (spastic) muscle the resistance to stretch is
high because of hyperactive stretch reflexes.

Normal tone: Somewhere between the states of flaccidity and spasticity

 hypotonic when the rate of -motor neuron discharge is low and hypertonic when it is high. muscles are hypertonic: the sequence of moderate
stretch muscle contraction, strong stretch muscle relaxation is clearly seen.

Polysynaptic Reflexes: The Withdrawal Reflex

Polysynaptic reflex paths branch
in a complex fashion The number of synapses in each

of their branches varies. Because of the synaptic delay at each synapse, activity in the branches with fewer synapses reaches the motor neurons first, followed by activity in the longer pathways. This causes prolonged bombardment of the motor neurons from a single stimulus and consequently prolonged responses.

COORDINATED & UNCOORDINATED REFLEXES

Multiple coordinated neuron reflexes are abundant in spinal cord

 A person who happen to touch a live coal withdraw the hand immediately (withdrawal reflex) Impulse travel in gray matter

excites several neurons impulses transmitted back to muscles Neurons are organized sends instantaneous series of impulses back to muscles & send especially selected impulses w/c causes contraction of muscles withdrawal of hand

Withdrawal Reflex
a typical polysynaptic reflex that
occurs in response to a usually painful stimulation of the skin or subcutaneous tissues and muscle. Response: flexor muscle contraction and inhibition of extensor muscles, so

that the body part stimulated is flexed and withdrawn from the stimulus. When a strong stimulus is applied to a limb, the response includes not only flexion and withdrawal of that limb but also extension of the opposite limb. This crossed extensor response is properly part of the withdrawal reflex.

More complex arc utilize the brain, cord & peripheral nerves Ex: person hit by an enemy Sensory impulse brought to
brain weighs the situation before reacting

 If conditions are favorable,

individual fights back, if not, he runs away A large amount of thinking, memory, judgement enter into the reaction, a very complicated process

COMPLEX INCOORDINATED REFLEXES

Those in which efferent nerves respond in a disorderly manner No coordination of muscle activity disorderly movements Results from overflow of

overwhelming stimulus Ex: spasmodic contractions of muscles during muscle cramps (cause of drowning among swimmers.)

CONDITIONED & UNCONDITIONED REFLEXES

Unconditioned Reflexes Inborn Follow a certain definite pre-established
path

Do not require activity of cortex May be protective, postural, alimentary Conditioned/Acquired Reflexes Established in course of individuals life Unstable; easily lost

 Established on another reflex w/c are either

inborn or previously conditioned

Appear after a formative process has been

completed in w/c cerebral cortex plays an essential role

Facilitation of Reflexes
Produced w/ frequent repetition of an act Neurons become more excitable to impulses from presynaptic terminals There is diminution of resistance in nerve tracts, & act is done w/ ease Ex: dexterity attained by

pianist after a series of attempts to play the same piece

Superficial Reflexes:
Corneal reflex Conjunctival reflex Pupillary reflexes Palatal reflex Pharyngeal reflex Abdominal reflex Cremasteric reflex Plantar reflex

SUPERFICIAL REFLEX
elicited by stimulating the

touch receptors in the skin or mucous which results in the contraction of a muscle or a group of muscles.

Superficial Reflexes
Initiated by gentle cutaneous stimulation Examples: Plantar reflex is initiated by
stimulating the lateral aspect of the sole of the foot

The response is downward flexion

of the toes

Indirectly tests for proper

corticospinal tract functioning

 Babinskis sign: abnormal

plantar reflex indicating corticospinal damage where the great toe dorsiflexes and the smaller toes fan laterally

TENDON/STRETCH REFLEX

Stretch and Deep Tendon Reflexes

For skeletal muscles to perform normally: The Golgi tendon organs

(proprioceptors) must constantly inform the brain as to the state of the muscle Stretch reflexes initiated by

muscle spindles must maintain healthy muscle tone

Stretch Reflex Deep (Tendon) reflexes:

Stretch reflexes. They are monosynaptic reflexes. Elicited by stimulation of muscle spindles, for which the muscle has to be passively stretched prior to the elicitation of the reflex. Jaw jerk

 Biceps jerk Triceps jerk Radial Supinator jerk Knee jerk Ankle jerk

Visceral reflexes:
Reflexes of micturition Reflexes of defecation Reflexes of sexual function

Visceral Reflexes Referred Pain

Pain stimuli arising from the
viscera are perceived as somatic in origin This may be due to the fact that visceral pain afferents travel along the same pathways as somatic pain

General Sensation
The bodys sensory receptors react to stimuli or

changes within the body and in the external environment. General senses: touch, pressure, pain, heat, cold, stretch, vibration and changes in position. Special senses: sight, hearing, equilibrium, smell and taste.

Sensory Reaction Classified According to the Source of their Stimulus

Exteroceptors: react to

stimuli in the external environment Interoceptors: are found in the internal visceral organs and include stretch receptor Propioceptors: like interoceptors but are restricted to skeletal muscles, tendons, joins, ligaments