A reflex is a rapid, predictable motor response to a
stimulus
Reflexes may: (a) be inborn (intrinsic) or learned
(acquired) (b) involve only peripheral nerves and the spinal cord (aka: spinal
reflexes) (c) Involve higher brain centers as well
Reflex Arc - There are five components of a reflex arc (i) Receptor
– site of stimulus (ii) Sensory neuron – transmits the afferent impulse to the
CNS (iii) Integration center – either monosynaptic or polysynaptic region
within the CNS (iv) Motor neuron – conducts efferent impulses from the integration
center to an effector (v) Effector – muscle fiber or gland that responds to the
efferent impulse
Innate Reflexes
Innate reflexes: Reflexes you are born with.
The are genetically or developmentally programmed
Examples:
Withdrawing from pain
Suckling
Chewing
Tracking objects with the eyes
Acquired Reflexes
Acquired reflexes are learned motor patterns
Generally more complex than innate reflexes
Examples:
Slamming on the break when driving
Professional skier making quick adjustments in body position
Reflexes
Visceral (Autonomic) reflexes regulate body functions
Digestion, blood pressure, sweating ect…
Somatic reflexes involve skeletal muscles
Function to maintain posture, balance and locomotion
Spinal reflexes: The important interconnections
and processing events occur in the spinal cord.
Cranial reflexes: The integration center is in the
brain
Types of Reflexes
Monosynaptic reflexes: The sensory neuron synapse
directly on a motor neuron.
The delay between stimulus and the response is minimized.
The synapse is considered the integration center
Polysynaptic reflexes: There is at least one
interneuron between the sensory and motor neuron
More complex responses
Upper Motor Neurons:
Upper motor neurons: Starts in the motor cortex of the brain
and terminates within the medulla (another part of the brain) or within the
spinal cord.
Damage to upper motor neurons can result in spasticity and
exaggerated reflexes (because of the loss of inhibition) “Spastic Paralysis”
Lower Motor Neurons
Lower motor neurons go from the spinal cord to a muscle.
The cell body of a lower motor neuron is in the spinal cord
and its termination is in a skeletal muscle.
The loss of lower motor neurons leads to weakness, twitching
of muscle (fasciculation), and loss of muscle mass (muscle atrophy).
“Flaccid Paralysis”.
Reflexes
Intact reflexes require
Intact sensory afferent nerves (coming to the spinal cord)
Intact synapse within the spinal cord
Intact efferent motor nerves coming from the spinal column
Adequately functioning muscle.
Reflexes can also be modified by conditions higher in the
cord than the relevant
Synapse including the brain it self.
The purpose of testing reflexes is to check the integrity of
the system as a whole.
An absent reflex indicates a problem somewhere in the reflex
arc but it does not tell you where.
Stretch Reflexes
Stretching of the muscle activates a muscle spindle.
A muscle spindle is a bundle of specialized skeletal muscle
fibers that act as sensory receptors.
An impulse is transmitted by afferent fibers to the spinal
cord
Motor neurons in the spinal cord cause the stretched muscle
to contract
The integration area in the spinal cord causes the
antagonist muscle to relax (reciprocal inhibition)
Stretch Reflex Example
Patellar Reflex (L2, L3, L4)
Tap the patellar tendon
muscle spindle signals stretch of muscle
motor neuron activated & muscle contracts
Quadriceps muscle contracts
Hamstring muscle is inhibited (relaxes)
Reciprocal innervation (polysynaptic- interneuron)
antagonistic muscles relax as part of reflex
Lower leg kicks forward
sensory and motor connections between muscle and spinal cord
are intact.
Stretch Reflex Example : Ankle Jerk (S1, S2)
Stretch the Achilles tendon by pushing up with your left
hand on the ball of the foot (extend the ankle): Swing the
patellar, hammer onto the tendon, striking it sharply.
Measure the response by: feeling the push
against, your left hand and observing, the contraction of the calf
muscles.
Stretch Reflex Example: Biceps jerk (C5, C6)
Bend the patient’s arm at the elbow so it is lying relaxed
across the lower part of the chest.
Find the long head of biceps tendon in the antecubital fossa
and stretch it by pushing down on it with your thumb.
Swing the patellar hammer down and strike your thumb
sharply.
Grading Reflexes
Grading of reflexes:
0+ = absent
1+ = hyporeflexic (reduced reflex)
2+ = normal
3+ = hyperreflexia (exaggerated reflex)
4+= clonus
Say “one plus”
Conditions such as hypothyroidism and spinal shock diminish
reflexes.
Stimulant drugs, anxiety, and hyperthyroidism increase
reflexes.
Tendon Reflexes
Controls muscle tension by causing muscle relaxation that
prevents tendon damage.
Golgi tendon organs in tendon.
Activated by stretching of tendon.
Inhibitory neuron is stimulated (polysynaptic).
Motor neuron is hyperpolarized and muscle relaxes.
Both tendon & muscle are protected
Flexor Reflex
Withdrawal reflex.
When pain receptors are activated it causes automatic
withdrawal of the threatened body part.
Reciprocal inhibition: Interneurons in the spinal cord
prevent a stretch reflex in the antagonistic muscles.
Crossed Extensor Reflex
Complex reflex that consists of an ipsilateral withdrawal
reflex and a contralateral extensor reflex.
This keeps you from falling over, for example if you step on
something painful.
When you pull your foot back, the other leg responds to hold
you up.
Cutaneous Reflexes
Elicited by gentle cutaneous stimulation
Important because they depend on upper motor pathways
(Brain) and spinal cord reflex arcs.
Cutaneous Reflexes Plantar Reflex
Tests spinal cord from L4 to S2
Indirectly determines if the corticospinal tracts of the
brain are working
Draw a blunt object downward along the lateral aspect of the
plantar surface (sole of foot)
Normal: Downward flexion (curling) of toes
Abnormal Plantar Reflex Babinski’s Sign
Great toe dorsiflexes (points up) and the smaller toes fan
laterally.
Happens if the primary motor cortex or corticospinal tract
is damaged.
Normal in infants up to one year old because their nervous
system is not completely myelinated.