Practical 8 reflexes
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This document provides information on human reflexes including: 1. It classifies human reflexes into monosynaptic, polysynaptic, superficial and deep reflexes and provides examples such as the patellar reflex. 2. It describes the components of the stretch reflex arc including the receptor, afferent neuron, central connection, efferent neuron, and effector. 3. It discusses tendon jerks including types, assessing centers in the spinal cord, and their clinical significance in evaluating motor system integrity.
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Reflexes
This document discusses the physiology of reflexes. It defines a reflex as a coordinated involuntary motor response initiated by a stimulus to peripheral receptors. Reflexes are classified based on their clinical presentation, anatomical pathway, number of synapses involved, and functional purpose. Monosynaptic reflexes like the stretch reflex involve only one synapse, while polysynaptic reflexes have multiple synapses. Characteristics of reflexes like summation, irradiation, and fatigue are also described.
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Blood supply of nervous system
The nervous system receives its blood supply from arteries that branch throughout the brain and spinal cord. The brain is supplied by the internal carotid and vertebral arteries, which form the circle of Willis at the base of the brain. These arteries further branch to supply specific regions like the cerebrum, cerebellum, and brainstem. The spinal cord receives blood from the anterior and posterior spinal arteries as well as segmental arteries that enter through vertebral foramina. Veins drain blood from the brain and spinal cord into dural sinuses and internal vertebral plexuses.
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Degeneration and regeneration of nerve fibers
1. When a nerve is injured, degenerative changes occur in both the distal and proximal portions of the nerve fiber.
2. The degree of injury can be classified into 5 categories, from mild conduction block (1st degree) to complete nerve transaction (5th degree).
3. Wallerian degeneration describes the breakdown of the distal nerve fiber segment after injury, while retrograde degeneration involves pathological changes that occur in the nerve cell body and proximal axon.
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This document discusses the physiology of reflexes. It defines a reflex as a coordinated involuntary motor response initiated by a stimulus to peripheral receptors. Reflexes are classified based on their clinical presentation, anatomical pathway, number of synapses involved, and functional purpose. Monosynaptic reflexes like the stretch reflex involve only one synapse, while polysynaptic reflexes have multiple synapses. Characteristics of reflexes like summation, irradiation, and fatigue are also described.
Clinical Anatomy Circle Of Willis & Cavernous Sinus
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Cranial nerves
This document provides an overview of the nervous system and several cranial nerves. It begins with an introduction to the nervous system and its organization into the central and peripheral nervous systems. Key terms like neuron, nucleus, tract, nerve, and plexus are defined. The 12 pairs of cranial nerves are then introduced, and five specific cranial nerves - V (trigeminal), VII (facial), IX (glossopharyngeal), X (vagus), and XII (hypoglossal) are examined in more detail, including their nuclear connections, functional components, course through the body, and branches. Clinical testing and applied anatomy are also discussed for each nerve.
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The brainstem
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Blood supply to heart
The heart receives its blood supply from two coronary arteries - the right and left coronary arteries. These branch directly off the aorta. The right coronary artery supplies the right atrium and ventricle as well as parts of the left ventricle and septum. The left coronary artery is larger and supplies the left atrium and ventricle as well as parts of the right ventricle. Blood is drained from the heart by the coronary sinus and smaller cardiac veins which drain into the right atrium. Disruptions to this delicate blood supply can cause chest pain or heart attacks.
Cardiac conduction system
The cardiac conduction system is made up of four main structures that stimulate contraction of the heart muscle in a coordinated way. The sinoatrial node acts as the pacemaker and initiates electrical impulses throughout the heart. The atrioventricular node receives impulses from the atria and slows conduction to allow for proper atrial contraction before ventricular contraction. Impulses then travel through the atrioventricular bundle and Purkinje fibers to coordinate simultaneous contraction of the ventricles. An electrocardiogram is used to measure the electrical activity of the heart and detect any abnormalities.
reflexes, clasifications, and functions.
The document discusses reflexes and the reflex arc. It defines a reflex arc as the anatomical nervous pathway of a reflex, which consists of 5 components: a receptor, sensory neuron, integration center in the spinal cord, motor neuron, and effector organ. It describes different types of reflexes like stretch reflexes, superficial reflexes, deep tendon reflexes, and visceral reflexes. It also covers topics like reflex properties, classifications of reflexes, and clinical considerations regarding reflex testing.
Degeneration and regeneration of
1. When a nerve is injured, degenerative changes occur in both the injured nerve fiber and the nerve cell body. These changes are collectively known as Wallerian degeneration.
2. Nerve injuries are classified into five degrees of severity based on the extent of damage. First degree injuries involve temporary conduction block while fifth degree injuries involve complete nerve transaction.
3. When a nerve is injured, degenerative changes occur in the distal and proximal parts of the injured nerve fiber as well as the corresponding nerve cell body. This involves breakdown of the axon and myelin sheath as well as changes in the nerve cell body.
Clinical aspects of the nervous system
This document provides an overview of clinical neuroanatomy and disorders of the nervous system. It begins by explaining why the study of the nervous system is important for understanding neurological diseases. It then outlines the functional and anatomical subdivisions of the nervous system. The remainder of the document discusses various neurological disorders categorized by the areas of the nervous system they affect, such as the peripheral nerves, neuromuscular junction, brainstem, basal ganglia, cerebellum, and memory/cognition. Examples of specific diseases are provided for each category.
Heart sounds
Heart sounds are produced when the heart valves snap shut during each cardiac cycle. The two main sounds are S1 and S2, which occur when the atrioventricular and semilunar valves close at the beginning and end of ventricular systole, respectively. Abnormal heart sounds called murmurs occur due to turbulent blood flow caused by issues like valvular abnormalities or narrowing of blood vessels. The four main types of murmurs are aortic stenosis, aortic regurgitation, mitral regurgitation, and mitral stenosis, each occurring at different times in the cardiac cycle and with distinct sound qualities.
Anatomy and blood supply of spinal cord
The spinal cord extends from the foramen magnum to the L1-L2 vertebral level in adults. It is protected by vertebrae and surrounded by three meninges. It has cervical, thoracic, lumbar, and sacral regions. It contains ascending and descending tracts that transmit sensory and motor signals. The anterior spinal artery supplies the anterior two-thirds and segmental arteries also contribute.
Circle of willis
The circle of Willis is an arterial circle of blood vessels at the base of the brain that connects the left and right internal carotid arteries and the left and right vertebral arteries. It ensures adequate blood flow to the brain when one of the feeding arteries is blocked or narrowed. Strokes can occur if an embolism blocks blood flow within the circle of Willis. Aneurysms, which are weak bulges in artery walls, sometimes form and rupture at junction points in the circle of Willis, causing hemorrhagic strokes. The subclavian steal syndrome occurs when stenosis of the subclavian artery causes blood to be stolen from the vertebral artery, compromising blood flow to the brain.
Heart sounds
The document discusses heart sounds, describing the four main sounds - S1, S2, S3, and S4. S1 occurs with the closing of the atrioventricular valves, coinciding with the R wave of an ECG. S2 occurs with the closing of the semilunar valves, coinciding with the T wave. S3 occurs during rapid ventricular filling between the T and P waves. S4 occurs during atrial systole between the P wave and Q wave. Heart sounds provide diagnostic value for assessing cardiac diseases and can be studied using a stethoscope, microphone, or phonocardiogram.
The cerebellum
The cerebellum is located in the posterior cranial fossa. It has three lobes - the anterior, posterior and flocculonodular lobes. It receives inputs from various parts of the brain and spinal cord via afferent pathways and sends outputs to motor areas of the brain via efferent pathways. The cerebellum plays key roles in motor control such as regulation of muscle tone and coordination of skilled voluntary movements, control of equilibrium and learning of new motor skills. Dysfunction of the cerebellum results in disturbances of posture, ataxia and intention tremors which can be assessed using clinical tests.
DEMONSTRATION- reflex.ppt
1. The document describes how to test various superficial and deep reflexes through elicitation techniques and provides clinical significance of reflex assessment.
2. Superficial reflexes include plantar, abdominal, and cranial nerve reflexes while deep reflexes tested are knee jerk, ankle jerk, biceps, triceps, and brachioradialis jerks.
3. Abnormal reflexes can indicate lesions in the sensory, motor or central pathways and provide clues to neurological conditions like diabetes, thyroid disorders, or spinal cord injuries. Precise diagnosis requires correlating reflex findings with the clinical picture.
Human reflexes
Human reflexes
Definition: It is involuntary response of an organ to a stimulus.
- It is the arrangement of neurons through which the reflex is carried out.
- It is usually formed of:
Afferent (sensory) neuron.
2) An interneuron (may be absent).
3) nerve center (cell body of the efferent neuron).
4) Efferent (motor) neuron.
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Ventricles of the brain
The document discusses the anatomy and functions of the brain ventricles. It describes the four ventricles - the left and right lateral ventricles, the third ventricle, and the fourth ventricle. The ventricles are lined with ependymal cells and filled with cerebrospinal fluid (CSF), which is produced by the choroid plexus. CSF circulates through the ventricles, provides cushioning and protection to the brain, and is absorbed by the arachnoid granulations. Increased CSF pressure can cause conditions like hydrocephalus and papilledema. A lumbar puncture is described as a method to examine CSF in different medical conditions.
Sensory and motor pathways
This document discusses sensory and motor pathways in the human body. It begins by listing the key learning outcomes, which include describing sensory receptors, pathways in the spinal cord and brain, motor neurons and tracts, and the corticospinal tract. It then discusses myelinated and non-myelinated nerve fibers, how they conduct impulses, and their roles. The document proceeds to explain sensory pathways from receptors to the brain, motor pathways from the brain to muscles, and provides diagrams of sensory and motor tracts in the spinal cord. It concludes by describing functions of sensory and motor neurons.
Dorsal column
The document describes several ascending pathways in the spinal cord that transmit sensory information to the brain. It focuses on the dorsal column medial lemniscal pathway, which transmits information about touch, pressure, vibration and proprioception. This pathway involves three neurons: primary sensory neurons that travel through dorsal roots to the spinal cord, secondary neurons that form tracts in the spinal cord and brainstem, and tertiary neurons that connect the thalamus to the primary sensory cortex. Damage to this pathway results in the loss of discriminative touch and proprioception below the level of lesion.
Coronary circulation
The coronary circulation supplies blood to the heart muscle. It consists of an arterial supply from the right and left coronary arteries, which branch off the aorta. The right coronary artery supplies the right atrium and ventricle as well as parts of the left ventricle and septum. The left coronary artery supplies the left atrium and ventricle as well as parts of the right ventricle and septum. Venous drainage occurs through the coronary sinus and smaller cardiac veins that drain directly into the atria or cavities of the heart. Obstructions of the coronary arteries can cause myocardial infarction and angina pectoris, while coronary angioplasty techniques are used to treat arterial narrowing and blockages.
Vestibular apparatus
The vestibular apparatus contains the organs that sense equilibrium - the utricle, saccule, and three semicircular canals. Hair cells within these organs detect linear and angular acceleration. When stimulated, hair cells trigger nerve impulses that travel to the brainstem and cerebellum to maintain posture and balance. Disorders like vertigo, motion sickness, and Meniere's disease can disturb equilibrium by affecting the vestibular apparatus.
The brainstem
The brainstem consists of three parts - the midbrain, pons, and medulla. It connects the spinal cord to the forebrain and contains nuclei that control vital functions like breathing and heart rate. It also contains tracts that relay signals between the spinal cord and higher brain centers. The reticular formation is a network of fibers and neurons throughout the brainstem that plays roles in motor control, sensory processing, autonomic functions, and maintaining alertness. Important structures in the brainstem include the cranial nerve nuclei, pyramidal tract, olives, and red nucleus.
Anatomy of midbrain
The brain stem is located between the cerebrum and spinal cord, and consists of the midbrain, pons, and medulla oblongata. The midbrain connects the forebrain to the pons and cerebellum. It contains important centers for visual and auditory reflexes, and gives rise to the trochlear nerve. Key structures in the midbrain include the superior and inferior colliculi, oculomotor nucleus, red nucleus, and substantia nigra. The midbrain serves to relay motor and sensory signals between the spinal cord and forebrain.
MIDBRAIN basic anatomy and applied aspects.
The document provides an overview of the anatomy and structures of the midbrain. It notes that the midbrain connects the pons and cerebellum to the forebrain, is about 0.8 inches long, and is traversed by the cerebral aqueduct filled with CSF. Key structures discussed include the crus cerebri, oculomotor nerve, superior and inferior colliculi, brachium, and trochlear nerve. The midbrain is divided into cerebral peduncles, tectum, and tegmentum. Transverse sections show structures like the substantia nigra, red nucleus, and tracts. Blood supply comes from the posterior cerebral, superior cerebellar, and basilar arteries.
Functional areas of the brain
The document summarizes the functional areas of the cerebral cortex. It describes the different types of cerebral cortex and their layers. It discusses the main functional areas including motor, sensory and association areas. Specific areas are outlined like the primary motor cortex, somatosensory cortex, visual and auditory cortices. Brodmann areas are referenced in relation to the different functional regions of the cerebral cortex.
Anatomy of right atrium
This document provides an anatomical overview of the right atrium, right ventricle, pulmonary valve, and tricuspid valve. It describes the external features and internal structures of the right atrium, including its tributaries that receive venous blood. It notes the smooth posterior sinus venarum and rough anterior pectinate part. It also describes the components, surface markings, and location of the tricuspid and pulmonary valves. Finally, it outlines the triangular shape of the right ventricle and notes its inflowing and outflow parts, as well as the muscular ridges within.
Blood supply to heart
The heart receives its blood supply from two coronary arteries - the right and left coronary arteries. These branch directly off the aorta. The right coronary artery supplies the right atrium and ventricle as well as parts of the left ventricle and septum. The left coronary artery is larger and supplies the left atrium and ventricle as well as parts of the right ventricle. Blood is drained from the heart by the coronary sinus and smaller cardiac veins which drain into the right atrium. Disruptions to this delicate blood supply can cause chest pain or heart attacks.
Cardiac conduction system
The cardiac conduction system is made up of four main structures that stimulate contraction of the heart muscle in a coordinated way. The sinoatrial node acts as the pacemaker and initiates electrical impulses throughout the heart. The atrioventricular node receives impulses from the atria and slows conduction to allow for proper atrial contraction before ventricular contraction. Impulses then travel through the atrioventricular bundle and Purkinje fibers to coordinate simultaneous contraction of the ventricles. An electrocardiogram is used to measure the electrical activity of the heart and detect any abnormalities.
reflexes, clasifications, and functions.
The document discusses reflexes and the reflex arc. It defines a reflex arc as the anatomical nervous pathway of a reflex, which consists of 5 components: a receptor, sensory neuron, integration center in the spinal cord, motor neuron, and effector organ. It describes different types of reflexes like stretch reflexes, superficial reflexes, deep tendon reflexes, and visceral reflexes. It also covers topics like reflex properties, classifications of reflexes, and clinical considerations regarding reflex testing.
Degeneration and regeneration of
1. When a nerve is injured, degenerative changes occur in both the injured nerve fiber and the nerve cell body. These changes are collectively known as Wallerian degeneration.
2. Nerve injuries are classified into five degrees of severity based on the extent of damage. First degree injuries involve temporary conduction block while fifth degree injuries involve complete nerve transaction.
3. When a nerve is injured, degenerative changes occur in the distal and proximal parts of the injured nerve fiber as well as the corresponding nerve cell body. This involves breakdown of the axon and myelin sheath as well as changes in the nerve cell body.
Clinical aspects of the nervous system
This document provides an overview of clinical neuroanatomy and disorders of the nervous system. It begins by explaining why the study of the nervous system is important for understanding neurological diseases. It then outlines the functional and anatomical subdivisions of the nervous system. The remainder of the document discusses various neurological disorders categorized by the areas of the nervous system they affect, such as the peripheral nerves, neuromuscular junction, brainstem, basal ganglia, cerebellum, and memory/cognition. Examples of specific diseases are provided for each category.
Heart sounds
Heart sounds are produced when the heart valves snap shut during each cardiac cycle. The two main sounds are S1 and S2, which occur when the atrioventricular and semilunar valves close at the beginning and end of ventricular systole, respectively. Abnormal heart sounds called murmurs occur due to turbulent blood flow caused by issues like valvular abnormalities or narrowing of blood vessels. The four main types of murmurs are aortic stenosis, aortic regurgitation, mitral regurgitation, and mitral stenosis, each occurring at different times in the cardiac cycle and with distinct sound qualities.
Anatomy and blood supply of spinal cord
The spinal cord extends from the foramen magnum to the L1-L2 vertebral level in adults. It is protected by vertebrae and surrounded by three meninges. It has cervical, thoracic, lumbar, and sacral regions. It contains ascending and descending tracts that transmit sensory and motor signals. The anterior spinal artery supplies the anterior two-thirds and segmental arteries also contribute.
Circle of willis
The circle of Willis is an arterial circle of blood vessels at the base of the brain that connects the left and right internal carotid arteries and the left and right vertebral arteries. It ensures adequate blood flow to the brain when one of the feeding arteries is blocked or narrowed. Strokes can occur if an embolism blocks blood flow within the circle of Willis. Aneurysms, which are weak bulges in artery walls, sometimes form and rupture at junction points in the circle of Willis, causing hemorrhagic strokes. The subclavian steal syndrome occurs when stenosis of the subclavian artery causes blood to be stolen from the vertebral artery, compromising blood flow to the brain.
Heart sounds
The document discusses heart sounds, describing the four main sounds - S1, S2, S3, and S4. S1 occurs with the closing of the atrioventricular valves, coinciding with the R wave of an ECG. S2 occurs with the closing of the semilunar valves, coinciding with the T wave. S3 occurs during rapid ventricular filling between the T and P waves. S4 occurs during atrial systole between the P wave and Q wave. Heart sounds provide diagnostic value for assessing cardiac diseases and can be studied using a stethoscope, microphone, or phonocardiogram.
The cerebellum
The cerebellum is located in the posterior cranial fossa. It has three lobes - the anterior, posterior and flocculonodular lobes. It receives inputs from various parts of the brain and spinal cord via afferent pathways and sends outputs to motor areas of the brain via efferent pathways. The cerebellum plays key roles in motor control such as regulation of muscle tone and coordination of skilled voluntary movements, control of equilibrium and learning of new motor skills. Dysfunction of the cerebellum results in disturbances of posture, ataxia and intention tremors which can be assessed using clinical tests.
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3. Abnormal reflexes can indicate lesions in the sensory, motor or central pathways and provide clues to neurological conditions like diabetes, thyroid disorders, or spinal cord injuries. Precise diagnosis requires correlating reflex findings with the clinical picture.
Human reflexes
Human reflexes
Definition: It is involuntary response of an organ to a stimulus.
- It is the arrangement of neurons through which the reflex is carried out.
- It is usually formed of:
Afferent (sensory) neuron.
2) An interneuron (may be absent).
3) nerve center (cell body of the efferent neuron).
4) Efferent (motor) neuron.
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- 1. Practical 06: Human Reflexes Dr Shamshad Majamaah University KSA
- 2. 1. Classify the human reflexes and give example for each type. 2. Describe components of stretch reflex arc. 3. Discuss the types, center and clinical significance of tendon jerks. 4. Perform accurately various types of tendon jerk. Objectives
- 3. Defn: Involuntary ,quick ,protective response to a stimulus which depends on the integrity of a particular nervous pathway. Components: Reflex arc:
- 5. I:Depending on synapses involved Monosynaptic(Stretch) Polysynaptic Jaw jerk, Patellar(knee ) jerk, Ankle reflex Withdrawal reflex Superficial Deep Plantar, Abdominal ,Cremastric, Corneal, conjunctival Muscle stretch reflexes/Tendon reflexes, II
- 6. III Physiological Pathological Jaw jerk, Patellar(knee ) jerk, Ankle reflex Withdrawal reflex, Plantar, Abdominal ,Cremastric, Corneal, conjunctival Tendon reflexes, Babinski , rooting gasping , reversion of primitive reflexes IV: Other: Clonus
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- 9. Reflex Process Response root level Jaw Ask the subject to partially open the mouth Place your finger firmly on the chin and tap briskly Closure of the jaw Vth Cranial N Knee/ Patellar Ask the subject to be supine or sit with legs near edge of bed hanging freely or one leg crossed over other Tap the patellar tendon briskly Extension of leg Contraction of quadriceps muscle L2-4 Femoral N Ankle/ Achilles Ask the subject stand and place the leg In everted position . Slightly dorsiflex the foot and tap the achilles tendon briskly Contraction of calf muscle S1-2 Tibial N
- 10. Reflex Process Response Spinal cord root level Biceps Ask the subject to flex the elbow at right angle in semiprone position Place your thumb or index finger on the Bisceps tendon Contraction of Bisceps C5,6 Musulocutaneous N Triceps Ask the subject to flex elbow and rest the forearm across the chest Tap briskly on tendon Contraction of triceps C6,7,8 Radial N Supinator/ Brachiradialis Ask the subject to flex the elbow at right angle in semiprone position Tap briskly upon styloid process of radius Contraction of BR muscle and supination of elbow C5,6 Radial N
- 12. Jendrassik or reinforcement manoeuvre : Importance: Used to augment hypoactive reflexes Technique: Subject is asked to lock the hands and pull forcefully apart Or Ask the subject to clinch the teeth with force Dr. Erno Jendrassik
- 13. Clinical Significance of reflexes Assess the integrity of the motor system Decreased • LMN lesion • Peripheral nerve lesions, entrapment , monoeuropathy • Diabetes Mellitus, Hypothyroidism, Muscle diseases • Spinal cord injury with spinal shock, • Cerebellar diseases Bilateral absent of ankle jerk in cauda equina syndrome
- 14. Significance Increased Lesion injury involving UMN (Brain ,brain stem, spinal cord) • Severe chronic cases clonus with spasticity present • Common in stroke, • spinal cord injury, • cerebral palsy, • multiple sclerosis Clinical Significance of reflexes
- 15. Grade 0-4 Reflex Right Left Biceps Triceps Supinator/ Brachiradialis Knee Ankle Jaw Inference : Report :
- 16. Reference: Pflanzer: Experimental and Applied Physiology Laboratory Manual, 7th edition 2003 chapter 10 Neuromuscular reflexes of the spinal cord and brain stem 119 – 132. Internet: Medscape Text book of Manual of practical physiology : Prof A.K.Jain