lecture 26 Flashcards
What do spinal reflexes refer to?
also reflexes engaging the brain stem and cranial nerves
What can Alpha motor neurons be referred to ask?
Final Common Path
- as only 3x outputs
-motor neurons compose majority of outputs
-final common path for motor commands
Motor commands are coming mainly from the Forebrain
Synaptic inputs from:
1. Descending tracts (corticospinal/pyramidal tract. or Reticulospinal tract from reticular formation of brain stem)
-form synapses with motor neurons
2. Spinal Interneurons - either in spinal cords or brain stem. (Local) Excitatory(glutamate) or inhibitory(GABA)
3. Proppriospinal neurons -located in spinal cords brachio or lumbar enlargements. Long axons up or down. assist in synchronization/coordination of motor neurons controlling upper and lower limbs- movements arent completely independant (e.g. esp in locamotion)
4. Afferent fibres -(Type Ia) from muscle spindles
-this final common path integrating number of things. have to make decision to respond or not to respond to all these inputs, and whether to fire or not to fire an AP- will spread down axon and cause ACh release and contraction of all muscles of motor unit being activated
What are the 4x main groups of synaptic inputs?
- Descending tracts
- Spinal Interneurons
- Proppriospinal neurons
- Afferent fibres
What are 2x examples of Descending tracts of synaptic inputs?
Cortico spinal (pyramidal) tract Reticulospinal tract-from reticular formation of brain stem
What are the key features of motor neurons?
axon
proximal dendrites
cell body densly covered with presynaptic terminals (ball like) 1000s
-some synaptic terminals are excitatory or inhibitory
–synaptic intergration
How does the motor system control movements?
the motor system controls movements together/in synchrony with SENSORY systems
- cannot just send a command to muscles to do movement.
- also important to receive feedback information from muscles or sensory structures
- how much progress occurred (bucket too heavy to lift)
What is the direction of flow of sensory commands?
from muscles/tendons/joints(proprioceptors) –> back to CNS
-inform them about what has happened
–as Motor system controls movements together/in coordination with the sensory systems (feedback)
5x External sensory receptors e.g.
1. Retina (see what is going on)
2. Vestibular (info about vestibular position)
3. Auditory (hear what is going on)
4. Olfactory (smell influences movement-bacon and eggs facilitate movement)
5. Skin receptors (touch important signalling/tactile
“interaction of motor commands with sensory information coming from propriorecpetors and external receptors is key”
-movement disorders are the most frequent symptoms seen in neurological patients
- most movement disorders can occurs either a disruption of motor pathways. Or also as a result of disruption of sensory pathways
–if any one of these 2x systems fail, the movement will suffer
What are 5x examples of External sensory receptors?
- retina
- vestibular
- auditory
- olfacory
- skin receptors
What is the relationship between neurological disorders, movement disorders and motor and sensory system interaction and disruption?
“interaction of motor commands with sensory information coming from propriorecpetors and external receptors is key”
- movement disorders are the most frequent symptoms seen in neurological patients
- most movement disorders can occurs either a disruption of motor pathways. Or also as a result of disruption of sensory pathways
- -if any one of these 2x systems fail, the movement will suffer
What are the main receptors which control movement?
- Muscles spindles (monitor muscle length (L) and Speed of length changes: (dL/dt))
- can detect vibration easily, or tiny stretches (micron) - Golgi tendon organs (monitor changes in muscle tension)
- Pain receptors in the skin (can induce movement)–initiated e.g. withdrawal reflex
- Joint receptors (monitor position, signal hyperextension or hypoflexion at the joint to the CNS as not usual)-position of limbs
What are the 3x types of reflexes which are induced?
- Stretch reflex
- Revers/Inverse myotatic reflex
- Flexion/Withdrawl reflex, and the cross-extension reflex
Why are reflexes explored?
- learn how reflexes induce movement
- Clinical relevance in neurological disorders, when dealing with movement deficits, there are changes in reflexes
- need to examine reflexes
- some will be abolished, exaggerated and/or unstable
- testing will give a clue as to what is happening
What are the 5x elements of Spinal reflex Pathways?
Somatic
- Receptors (that are engaged)
- Afferent (sensory) fibres
- Central synaptic relay(s)/connections
- Efferent (motor) fibres - coming out of brain
- Effectors (skeletal muscles)-target group of muscles. therefore not heart
Stretch reflex
myotatic reflex = tendon reflex = monosynaptic reflex (one synapse engaged)
- only stretch reflex is monosynaptic- al other reflexes are polysynaptic (involve more than one synapse in CNS)
1. Receptors (IN muscle spindles) detect : change L and dL/dt
2. Afferent fibres: 1a
3. Synaptic Relays: Ia afferents to a alpha MNs motor nurons (also 2nd synapse from MN to muscle) - even though “mono”synaptic - is referring to synapses in the Central nervous system
4. Afferent fibres: Axons of a alpha MNs motor neurons
5. Effectors muscles (extrafusal)
What are the 3x other names for stretch reflex?
Myotatic reflex
Tendon reflex
Monosynaptic reflex
-Knee Jerk
What are the components of the stretch reflex example of Knee Jerk?
Quadriceps
- muscle spindle embedded within. receives motor innervation from gamma motor neurons. also has sensory fibre connection from central part of muscle spindle
- afferent fibre= myelinated and fast conducting
- information sent via AP action potentials
- Dorsal Root ganglion contains cell bodies of all sensory neurons (from muscle spindles, temperature, pain, touch)
- Peripheral axons outside of root of spinal cord
- Central axon within root of spinal cord. synapse with alpha motor neurons
- Alpha motor nuerons sends its axon to make synaptic end plate/contact with extrafusal muscle fibres
Examination hammer strikes tendon of quadriceps which goes around the kneecap
- hit tendon as want to induce a tiny stretch of the muscle
- this is enough to activate many of these muscle spindles in synchrony
- and induce action potentials in Ia afferents. and evoke postsynaptic potentials in a Alpha motor neurons. will reach threshold, will trigger AP. cycle continues. Contraction of whole muscle/extrafusal muscle fibres
What are the properties of an afferent fibres?
Myelinated
fast conducting
Type 1A Afferent fibres = fastest conducting nerve fibres in body = 100ms (1 metre in 10 ms)
Can you resist a knee jerk?
no
is Involuntary
-exaggerated because of adrenlain
Stretch Reflex and Reciprocal Inhibition
Isn’t just contraction of Extrafusal muscles of stretching muscle
is also Parallel engagement of separate mechanism (Reciprocal inhibition of other muscles -are inhibited)
Additional synaptic relay : 1a afferents to 1a interneurons which Inhibits MNs innervating antagonists muscle
What is the additional synaptic relay elements of the Stretch reflex and Reciprocal Inhibition relationship?
1a afferents to –> 1a (inhibitory) interneurons –> which INHIBITS MNNs motor neurons which innervated Antagonist muscles
-knee jerk /biceps
Biceps and antagonistic triceps
-Hit tendon of biceps, biceps will contract, and at same time triceps relaxes
-make sense because if you have movement in one direction, something has to give up (reciprocal inhibition)
-Reciprocal inhibition is a standard feature of all Flexor reflexes in the upper limbs and lower limbs
Note: One more “collateral” branch of 1a afferents, which contacts group of cells, and activate/excite neurons of the spinocerebellar tract. Sends signal to /activates CNS to the cerebellum and further
-sensory feedback, telling brain what is going on at Spinal cord level
How does Reciprocal inhibition occur?
-Biceps and Triceps example
Muscle spindle in biceps –>
1a afferent of muscle spindle –> dorsal root ganglion contains neuron cell body –> excitatory synapse of alpha motor neurons
–> alpha motor neuron axon going to extrafusal muscle fibres
1a afferent has small colateral branch which makes synaptic contact with 1 a inhibitory interneuron cell.
1a inhibitory interneuron send inhibitory synapse (GABA/glysene) to a group of motor neurons that innervate triceps (antagonist)
-2x loops: contraction of biceps. and very soon/almost simultaneously, via the inhibitory interneuron, there is inhibition of alpha motor neuron activity (hyperpolorised if was firing action potential before (baseline tone)).
AP would stop. there would be no more muscle tone. relaxation of triceps muscle
What are the Commonly tested stretch reflexes and their segments?
- Jaw jerk (5th cranial nerve)
- Biceps jerk (C5,6)
- Triceps jerk (C7)
- Finger-flexion reflex (C8)
- Knee jerk (L3,4)
- Ankle jerk (S1)
Why is it often not enough to test just one reflex?
Test several as each reflex closes/has its reflex pass through different segments of spinal cord or brain stem
-segments = where reflex closes
Test multiple to very quickly conclude about the integrity of the reflex pathway
-if most reflexes are interacting and one isnt, then there may be an interruption of transmission at a particular level
Why do you use simple examination tools for testing reflexes/jerks, and not advanced technology?
doctors are irreplaceable
most important examination and diagnostic tool are our eyes, hands and our brains
Clinical contact with patient, when we look, touch,hearing, manipulate patient is extremely important first step of diagnosis process
-Technology provides sophisticate imaging tools (where spinal cord lesion occurs) but are expensive, and it takes time to get results
-during first doctor- patient you need to have a plan of action and human features allows you to over technology