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Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

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Page 1: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Spinal Cord Reflexes

Dr. Shaikh Mujeeb AhmedAssistant ProfessorAlMaarefa College

CNS BLOCK 424

Page 2: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Objectives

• Describe the components of spinal reflexes.• Enumerate different types of spinal cord

reflexes.• Explain the mechanism of spinal cord reflex

occurs and their control.• Explain the clinical conditions which can affect

the spinal cord reflex.

Page 3: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

What is a reflex.

• Any response that occurs automatically without conscious effort.

Page 4: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

What are the types of reflexes.

Number of synapse

Monosynaptic

Polysynaptic

Location of receptor

Superficial

Deep

Visceral

Development

Simple/Basic

Acquired

Page 5: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Reflex Arc

• Receptor

• Affrent Nerve

• Center

• Efferent Nerve

• Effector organ

Page 6: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Fig 13.1 – Monosynaptic and polysynaptic reflexes Silverthorn 2nd Ed

Page 7: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Stretch Reflex

• Sudden stretch to a muscle leads to contraction of that muscle is known as stretch reflex.

• The basic unit of this activity is a reflex arc comprises of;

1. Sense organ.2. Afferent neuron.3. Center4. Efferent neuron5. Effector organ.

Page 8: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424
Page 9: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Reflex Arc

Receptor• Muscle spindle

Afferent neuron

• Sensory Nerve

Center• Spinal Segment

Efferent neuron

• Motor Nerve

Effector Organ

• Skeletal Muscle

Receptor

• Muscle spindle

Afferent

neuron

• Ia fiber (primary)• II fiber (secondary)

Center

• Spinal Segment

Efferent

neuron

• Gamma motor neuron

Effector

Organ

• Intrafusal muscle fibers

Page 10: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Reflex arc

Page 11: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Skeletal Muscle Reflexes

• How do they work?– Receptors in muscle send info to CNS– CNS decides should muscle contract (or relax) in

response– CNS sends appropriate signal via somatic motor

neurons• Somatic motor neurons are always excitatory:

– CNS activates if contraction is right response– CNS inhibits if relaxation is right response

Page 12: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Receptors

• Muscle receptors:– Sense muscle length and/or tension

• Two types of stretch receptors:– Muscle spindles– Golgi tendon organs

Page 13: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Muscle Spindle Structure

• Consist of collections of specialized muscle fibers known as intrafusal fibers– Lie within spindle-shaped connective tissue

capsules parallel to extrafusal fibers– Each spindle has its own private efferent and

afferent nerve supply– Play key role in stretch reflex

Page 14: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Fig 13.3 – Sensory receptors in muscle Silverthorn 2nd Ed

Page 15: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Two types of intrafusal fibres:1. Nuclear bag fibres: central

area is dilated filled with group of nuclei (2 / spindle)

2. Nuclear chain fibres: smaller than nuclear bag fibres and have one line of nuclei spread in a chain along the receptor area (3-9 /spindle)

Receptor for the stretch reflex: Muscle Spindle

Page 16: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Muscle spindle

Page 17: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Golgi Tendon Organs

• Composed of:– Nerve fiber endings that wind between collagen

fibers inside connective tissue capsule• If muscle is stretched:

– Free nerve endings are pinched and they fire• Activation of Golgi tendon organs:

– Inhibits alpha motor neurons and decreases muscle contraction

Page 18: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Fig 13.6 – Muscle reflexes Silverthorn 2nd Ed

Page 19: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Muscle Spindle Function

Page 20: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Stretch Reflex

• Primary purpose is to resist tendency for passive stretch of extensor muscles by gravitational forces when person is standing upright

• Classic example is patellar tendon, or knee-jerk reflex

Page 21: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Patellar Tendon Reflex

Page 22: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

The Golgi tendon reflex (inverse stretch reflex)

• excessive tension on the muscle (passive stretch of tendon or active muscle contraction) >> muscle relaxes opposite response to stretch reflex.

• The receptors are Golgi tendon organs in muscle tendons stimulated >> muscle contract and pulled on the tendon (tension)

• stimulate golgi organ>> A fibers > spinal cord > excitation of inhibitory interneuron>> inhibit alpha motor neuron > muscle relaxation

• Protect muscle from rupture

Page 23: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

The Golgi tendon reflex (inverse stretch reflex)

Page 24: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Withdrawal reflex(flexor reflex)

• Stimulation of pain receptors in hand → impulses to spinal cord via A or C fibres → interneurons → anterior horn cells → stimulate hand flexor muscles → move the hand away from the injurious stimulus.

• Its a polysynaptic reflex. • Stimulation of flexors muscle accompanied by

inhibition of extensors.• Inhibitory inter neurons synapse with extensor

motor neurons known as reciprocal innervations (reciprocal inhibition).

Page 25: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Reciprocal inhibition

Page 26: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Crossed Extensor Reflex

Extension of opposite limb

Flexion & withdrawal of stimulated limb

Painful Stimuli

Page 27: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Fig 13.8 – Flexion reflex and the crossed extensor reflex Silverthorn 2nd Ed

Page 28: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Crossed extensor reflex

Page 29: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Clinical Importance of reflexes

• To test the integrity of reflex arc.• Localization of neurological lesion.• Identifying the type of lesion.• Monitoring the progress of neurological

deficit.

Page 30: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

• Deep tendon reflexes are absent in lower motor neuron lesion.

• The become exaggerated in upper motor neuron lesions.

• Pendular jerks are observed in cerebellar lesions.

Clinical Importance of reflexes

Page 31: Spinal Cord Reflexes Dr. Shaikh Mujeeb Ahmed Assistant Professor AlMaarefa College CNS BLOCK 424

Centers for reflexesReflex Center (root value)

Deep tendon reflex

Biceps Jerk and Brachioradialis C5/C6

Triceps Jerk C6/C7

Knee Jerk / Patellar reflex L2-L4

Ankle S1

Superficial reflex

Corneal reflex (blink reflex) 5th and 7th cranial nerve

Abdominal reflex T7 – T-12

Plantar reflex L5-S1