Range of stimulation of thermoreceptors:

Cold receptors Warm Cold pain Warm pain Anaesthesia

receptors receptors receptors (no action
potential)

*Discharge *discharge *discharge *discharge * at zero

between between between above 45 degrees
temperature temperature temperature 5- degrees
10-43 degrees 30-50 degrees 15 degrees

*maximal *maximal
discharge at 25 discharge st 45
*maximal
degrees degrees
discharge at 5
degrees

- Steriognosis

Def: ability to detect shape of object put in hand with eyes closed

*this depends on previous knowledge of the object----A beta fiber

Pass in dorsal column

- Vibration

Def: rhythmic repetitive pressure sense (ability to feel vibration on bony prominences
----cause magnification of stimulus )

*tested by tunning fork

*on bony prominenses

*from below upwards

*to detect level of nerve injury

*it is tested for both sides of the body

*to test hemianaesthesia

*receptors

1-Meisner corpuscle—up to 80c/sec

2-Painian corpuscle – up to 500 c/sec

*if the vibration sense is depressed this may be

1-degenerate posterior column (Dorsal column) as in diabetes

2-Pernicious anemia

- Tactile discrimination

Def: ability to detect two points touched at same time as two points not one with
distance between them is threshold distance.

T.D.–tip of hand 1-2 mm

T.D.—back---1-2 cm.

Threshold distance is affected by:

1-number of receptors

2-number of afferents

3-area of representation in cortex

4-central convergence

• -1-Biceps jerk:
• Stimulus ---sudden tap on tendon of biceps
• Receptor---muscle spindle (nuclear bag)
• Afferent----primary ending
• Center -----C5,C6
• Efferent ----myelinated
• Response---contraction of biceps (flex elbow) then
• relax
• 2-Triceps jerk:

• Stimulus ---sudden tap on tendon of triceps

• Receptor---muscle spindle (nuclear bag)

• Afferent----primary ending

• Center -----C6,C7

• Efferent ----myelinated

• Response---contraction of triceps (extend elbow)

• then relax

• 3-Knee jerk:

• Stimulus ---sudden tap on tendon of Quadriceps

• Receptor---muscle spindle (nuclear bag)

• Afferent----primary ending

• Center -----L2,L3,L4

• Efferent ----myelinated

• Response---contraction of Quadriceps (extend

• knee) then relax

• 4-Ankle jerk:

• Stimulus ---sudden tap on tendon of Achilles

 • Receptor---muscle spindle (nuclear bag)

• Afferent----primary ending

• Center -----S1,S2

• Efferent ----myelinated

• Response---contraction of gastrocnemius muscle

• (planter flexion of ankle)

• Clinical significance of tendon jerk:

Absent exaggerated Weak Pendular

LMNL 1-nervous Should be Neocerebellar

repeated by lesion
2-hyperthyroid
jan drassek
3-UMNL maneuver

*If normal---
normal

* if weak---
weak

-Babiniski sign :

Scratching the skin of the lateral side of the sole of foot

Normal --- planter flexion of toes

Positive babiniski sign ----dorsi flexion of big toe and fanning of toes
Causes of positive babiniski sign

Normal -----infant below one year

Deep sleep

Pathological -----UMNL

Pyramidal tract lesion

Complete TS of spinal cord

Deep coma