stretch REFLEX

DR AINUL HUDA SULAIMAN

PHYSIOLOGY
MEDICAL SCIENCE 1 DEPARTMENT
Learning outcome
• At the end of the topic, the students should be able to:
• Explain the function of muscle spindle & Golgi tendon organ
• Explain the components of the stretch reflex
• Give examples of stretch reflex and their control levels
• Differentiate static and dynamic stretch reflex
• Explain the control of gamma efferent neuron discharge
• Explain the functions of stretch reflex
• Explain the clinical significance of a stretch reflex
Motor function of the spinal cord
• Sensory information/input is integrated at all level of nervous system
and leads to appropriate motor responses that begins from the spinal
cord ranging from the simple muscle reflexes, extend to the brain
stem for more complicated response and finally extend to the
cerebrum where more complicated muscle skills are controlled.
• Without neuronal circuit in the spinal cord, any complex motor
control system in the brain could not cause purposeful muscle
movement.
• Brain can send command to the spinal cord, but the circuit to set the
command in motion is in the cord.
Organization of the spinal cord for motor functions
(cord reflexes)
Organization of the spinal cord for motor
functions (cord reflexes)
• Sensory signal enter the cord thru posterior/dorsal root.
• It branches to
• terminate in the grey matter to elicit local segmental cord reflexes;
• transmit signal to higher level, to brain stem and even to cerebral cortex.
• Synapse in the grey matter with interneuron or anterior motor neuron
• Anterior motor neuron (AMN): located in each segment of the
anterior/ventral horn of the grey matter. Leave the cord by anterior roots
and directly innervate the skeletal muscle fibres. Two types – alpha &
gamma motor neurons.
• Interneuron: present in dorsal horns, anterior horns and intermediate
areas between them. Highly excitable; spontaneous firing capability. Have
many connections with one another and also with aMN.
Alpha & gamma motor neurons
• Alpha motor neurons: innervate extrafusal skeletal muscle fibres and
causes contraction.
• Gamma motor neurons: innervate intrafusal muscle fibres, a
specialized fibre and a component of muscle spindle. Too small to
generate significant force.
• Reflex contraction or relaxation of muscle fibres received sensory
input from muscle sensory receptors: 1) muscle spindle; 2) Golgi
tendon organs.
Alpha & gamma motorneuron (MN) and
interneuron
Muscle spindle
Muscle spindle
• Spindle shaped organs - intrafusal fibres encapsulated in sheaths,
innervated by sensory and motor nerve fibres.
• Parallel to the extrafusal fibres.
• Information about muscle length or rate of change of length.
• Intrafusal fibre is a skeletal muscle fibre but the midportion lacking of
actin and myosin filaments (doesn’t contract when either end of
them do).
• Two types of intrafusal fibres: nuclear bag fibres (nuclei accumulated
in centre) & nuclear chain fibres (nuclei arranged along the fibre).
Muscle spindle

• Receptor portion is the central portion.

• Stretching the midportion stimulates it and fires AP through afferent
fibres.
• It can be excited in 2 ways:
• Lenghtening the whole muscle (extrafusal fibres) stretches the midportion of
the spindle
• Contraction of the end portions of the spindle’s intrafusal fibres stretches
the midportion of the spindle eventhough the length of the entire muscle
does not change
• It has both sensory and motor innervation
Muscle spindle: sensory & motor innervation
• Group Ia afferent nerve: innervate
central region of both nuclear bag
and nuclear chain fibres (primary
ending). Fast conduction velocity.
• Group II afferent nerves: primarily
innervate nuclear chain fibres
(secondary ending). Intermediate
conduction velocity.
• Gamma dynamic (gamma-d)
synapse on nuclear bag fibres in
‘plate endings’
• Gamma static (gamma-s) synapse
on nuclear chain fibres in ‘trail
endings’ that spread over longer
distance.
Function of muscle spindle

• Correct changes in muscle length when extrafusal muscle fibres are

shortened (by contraction) or lengthened (by stretch).
• Muscle stretched → extrafusal fibre lengthened → intrafusal fibre also
lengthened.
• Group Ia afferent detect the velocity of length change and group II
afferent detect the length of the muscle fibre. Muscle stretched →
activates group Ia and group II sensory afferent.
• Stimulates the alpha MN that innervates the extrafusal fibres in the same
muscle → contracts.
• The original lengthening is opposed when the reflex causes muscle to
contract and shorten.
 ALPHA & GAMMA COACTIVATION

• WHEN WHOLE MUSCLE CONTRACTS, MUSCLE

SPINDLE DOES NOT BECOME FLAIL OR SLACKEN.
• COACTIVATION OF ALPHA & GAMMA
MOTORNEURON.
• WHEN ALPHA MN ACTIVATED, IT ACTIVATES
GAMMA MOTOR NEURON AS WELL →
CONTRACTION EITHER END OF MUSCLE SPINDLE.
• KEEP MIDPORTION STRETCHED TO MAINTAIN
SENSITIVITY TO CHANGE IN MUSCLE LENGTH.
 GOLGI TENDON ORGANS
• STRETCH RECEPTOR FOUND IN TENDONS, ARRANGED
IN SERIES WITH MUSCLE.
• MUSCLE CONTRACTS, EXTRAFUSAL FIBRES SHORTEN,
GOLGI TENDON ORGANS TENSE AND ACTIVATED.
STIMULATES GROUP IB AFFERENT FIBRES.
• IB AFFERENT SYNAPSE ON INHIBITORY
INTERNEURONS, THEN SYNAPSE ON THE ALPHA MN.
• INHIBIT FIRING OF ALPHA MOTOR NEURON →
RELAXATION OF THE SAME MUSCLE.
• TENSION ON TENDON IS REDUCED.
Reflexes

• Reflex: any response that occurs automatically without conscious

effort.
• simple/basic reflexes – built-in, unlearned responses. Eg. pulling hand away
from a burning hot object.
• Acquired/conditioned reflexes – a result of practice and learning. Eg. pianist
striking a particular key upon seeing note on the music staff. Musicians read
music and plays the notes automatically but only after considerable
conscious training effort. Eg. sports skills, must override the basic reflexes to
perform the skill like learning to dive into the water.
Classification of reflexes
Stretch reflex arc
• Neural pathway involved in accomplishing reflex activity
• Five basic components:
• Sensory receptor (arrival of stimulus and activation of receptor)
• Afferent pathway (activation of sensory neuron)
• Integrating centre (information processing)
• Efferent pathway (activation of motor neuron)
• Effector (response by effector)
• REFLEX RESPONSE IS PREDICTABLE Because PATHWAY IS ALWAYS THE
SAME.
Components of stretch reflex
 STRETCH REFLEX
• MOST BASIC OF THE SPINAL REFLEX: ONE
SYNAPSE BETWEEN SENSORY AFFERENT AND
MOTOR EFFERENT NERVES.
• KNEE-JERK REFLEX: TAPPING THE PATELLAR
TENDON → ACTIVATES IA AFFERENT →
SYNAPSE AND ACTIVATED ALPHA MN →
CONTRACTION OF THE QUADRICEPS MUSCLE
→ FORCES THE LOWER LEG TO EXTEND.
• AT THE SAME TIME IT CAUSES RELAXATION TO
THE ANTAGONISTIC MUSCLE (THE
HAMSTRING) – RECIPROCAL INHIBITION
Stretch reflex: knee-jerk
Dynamic & static stretch reflex

• Dynamic stretch reflex

• Elicited by dynamic signal transmitted from primary endings of the muscle
spindles.
• Muscle suddenly stretched/unstretched, strong signal transmitted causes
instantaneous strong reflex contraction/relaxation of the same muscle.
• Over within a fraction of a second, then the weaker static stretch reflex
continues for a prolonged period afterwards.
• Static stretch reflex
• Elicited by the continuous static receptor signals by both primary and
secondary endings.
• It causes the degree of muscle contraction to remain reasonably constant.
Control of gamma efferent neuron discharge
• Controlled by descending facilitatory tracts from areas in the brain – it
adjusted the sensitivity of muscle spindle for postural control.
• Pontine reticular nuclei
• Transmit excitatory signals into cord through pontine reticulospinal tract, terminate
on AMN that excites muscles of the body and supports it against gravity.
• High degree of natural excitability. If unopposed by the medullary reticular system,
causes powerful excitation of antigravity muscles throughout the body.
• Medullary reticular nuclei
• Transmit inhibitory signals to the same antigravity AMN via medullary reticulospinal
tract.
• Receive strong input collaterals from the corticospinal tract and other motor
pathways, activates it to counterbalance the excitatory signals from the pontine
reticular system, so under normal conditions the body muscles are not abnormally
tense.
Other factors that increase gamma discharge

• Anxiety increased discharge – hyperactive tendon reflex in anxious

patients.
• Stimulation of skin by noxious agents increased gamma motor discharge
to ipsilateral flexor muscle spindles.
• Jendrassik’s maneuver – try to pull the hands apart when flexed fingers
are hooked together facilitates knee-jerk reflex. Due to increased gamma
neuron discharge initiated by afferent impulse from the hands.
• The maneuver exaggerates lower limb reflexes by reducing some of the
normal descending inhibition from the brain to the reflex arc. It also
prevents conscious inhibition of the reflex.
Functions of stretch reflex
• Maintain length of muscle
• Anti-gravity function- gamma efferent system is excited specifically by signals from bulboreticular
facilitatory region of brain stem. This area is concerned with anti-gravity contractions. Its activation → stretch reflex on
the muscles involved during walking, running and maintaining balance.

• To reduce physiological tremor/to get smooth contraction (damping

function) – Prevent oscillation or jerkiness of body movements. Signal from spinal cord transmit in unsmooth
form, intensity ↑@↓. without muscle spindle, contraction is jerky. Muscle spindle able to smooth muscle contraction
even if the signals are jerky.

• To stabilize body position during tense action – bulboreticular facilitatory region

transmit signal to gamma nerve fibres to intrafusal fibres. shortens the end of the spindles and stretch the midportion,
↑ signal. If spindles on both sides of the joint activated simultaneously, it produce tight tense muscle opposing each
other at the joint. Joint become strongly stabilized.
Clinical significance of stretch reflex
• To determine how much background excitation/facilitation the brain
is sending to the spinal cord.
• Knee jerk or other muscle jerks can be used to assess sensitivity to
stretch reflex.
• Either strike the tendon or the muscle belly to elicit dynamic stretch
reflex.
• ↑↑ number of facilitatory impulse from the brain to the spinal cord,
muscle jerks are exaggerated.
• ↓↓ facilitatory impulse from the brain causes muscle jerks to be
weakened or absent.