POSTURE AND

EQUILIBIRIUM
DR ARPANA HAZARIKA
POSTURE –Posture refers to subconscious
adjustment of tone in different muscle so
as to maintain balance during displacement
of body caused by gravity or acceleration.
Maintenance of an erect posture in man is
more difficult than quadruped animal
because the tall body has to be maintained
over a erect posture over a small base
provided by two feets
 Posture is maintained through reflex
adjustment of tone in proximal extensor
muscles .As gravity is the main force tending
to displace the body The proximal extensor
muscle are also called antigravity muscle.The
standing man can fall in any direction,The
muscles which oppose the fall act as
antigravity muscle depending on the direction
of fall therefore muscles of trunk and limb act
as antigravity muscles
Physiology Of Body Balance
 In posture regulation, sensory systems of
body help, these include: visual system,
vestibular apparatus (semicircular canals,
utricle & saccule), stretch receptors in
muscles & ligaments of neck, pressure
receptors in sole & palm & also on the surface
of body.
Systems regulating body balance
•Humans use three
CNS
systems: 1- Cerebral
cortex
2- Brainstem
3- Cerebellum Muscle commands
visual -1
-1

Vestibular -2

-2

Proprioceptive -3
MECHANISM
At any given moment in any position of the body
the posture is maintained by alteration of tone
of
different muscles of the body which is controlled
by stretch reflex
The stretch reflex is a spinal reflex influenced by
supra spinal control. The input to higher center
involved in the control of muscle tone
through certain reflexes significantly contribute
to the maintenance of tone and posture.
The two mechanism involved in maintenance
of posture
MUSCLE TONE
POSTURAL REFLEX
Posture is maintained through reflex adjustment
of tone in the antigravity muscle
Postural control is required not only for holding
the body in erect position but also fixing the body
parts over adjoining body segments
The centre of gravity of head passes in front of
Atlanto occipital joint thus the head has a
tendency to roll forward.To hold the head in an
erect position cervico occipital muscle must be
maintained in a constant tension in the upright
position gravity tends to displace the body
downward stretching quadriceps muscle
as the legs flex at the knees
The muscle stretch evokes discharge from the
muscle spindle of the quadriceps leading to
reflex contraction.This ensures that knee joint
the main weight bearing joints do not give
away under the effect of gravity

This maintains the leg as a pillar and thus

counteract displacement of the body
In human flexors of upper extremity and
extensors of lower extremity are the main
antigravity muscle.Retractors of neck,elavators
of joint,supraspinatus,extensors of back,rectus
muscle of abdominal wall,extensor of knee and
ankle are the muscle which exert greater
degree of tone,when these muscle completely
relax, the body collapses
MAINTENANCE OF MUSCLE TONE
STRETCH REFLEX
Plays the main role in maintenance of muscle
tone
CENTRE FOR MUSCLE TONE-The centre for
muscle tone lies in anterior motor neuron of
spinal cord which are stimulated through Ý
motor neuron discharge
pyramidal fibres which terminate on them.
Mainly the extrapyramidal system is
responsible for maintaining tone.It consist of
basal ganglia,motor nuclei of reticular
formation of brain stem,Vestibular nuclei and
descending fibres to the spinal cord.Activity of
gamma and alpha motor neurone isa modified
by both extrapyramidal and pyramidal system
Supraspinal control on muscle tone is exerted
by facilitatory and inhibitory area in the brain
stem through gamma motor neurons.
Bulbo recticular facilitatory area is located in
the pons and discharges facilatatory impulses
from vestibular nuclei,facilitatory portion of
cerebral cortex
cerebellum and basal ganglia.The facilitatory
area continues to discharge impulses causing
activation of gamma motor neurons.This
causes stretching of muscle spindle resulting
into reflex partial contraction of the muscle
under resting states
BULBO RECTICULAR INHIBITORY AREA
is located in the lower part of medulla.This area
has no intrinsic activity of its own.It becomes
activated only when it receives signal
from cerebellum or cerebral cortex and in turn
inhibits bulboreticular facilitatory area to
some extent but without support from cerebrum
or cerebellum
ROLE OF CEREBELLUM
Cerebellum is the site of alpha gamma
linkage.Therefore in presence of cerebellum
the muscle tone is maintained through both
alpha and gamma activity vestiulocerebellum
which includes floculonodular lobe as its
principal component and nucleus fastigi and
vernal parts
are concerned with control of body posture
and equilibirium
AFFERENTS TO CEREBELLUM concerned with
control of body posture and equilibirium
vestibulocerebellar tract which carry input
from vestibular nuclei which convey afferent
From macula of saccule and utricle for static
equilibirium and from ampullary crests
of saccule and utricle for static equilibirium
from ampullary crests of semicircular ducts
for kinetic equilibirium
Spinocerebellar tract and cuneocerebellar tract
carry feedback about tone of muscle or
positionof limbs of space
Reticulocerebellar tracts bring feedback
about activities of extrapyramidal tract
EFFERENT-The floculonodular and fastigial
nuclei project output fibres through inferior
Peduncle to vestibular and reticular nuclei of
brain stem .The vernal cerebellum sends back
the information to spinal cord indirectly
through fastigial nuclei
MECHANISM –The efferents from the
cerebellum influence the spinal motor neuron
To keep the body upright through the
vestibulospinal and reticulospinal tract and
regulate the position of the eyes in relation to
movements of the head by connecting motor
nuclei of extraocular muscle via medial
longitudinal fasciculus
CONTROL OF MUSCLE TONE-Spinocerebellum
is mainly concerned with control of muscle
tone and anticipatory adjustment of muscle
contraction during movement
Spinocerebellum is projected into the
cerebellar nuclei fastigi ,emboliformis and
globosus.Fibres from the nuclei pass through
fastigiobulbar ,cerebelloreticular and
olivoreticular tract carry proprioceptive and
tactile input from the limbs,trunk,neck and
other parts of the body.These give feedback
about tone and position of limb and body
Spinocerebellum also receives auditory and visual
impulse through tectocerebellar tract.Italso
receives auditory and visual signal through
tectocerebellar tract.It also receives the cortical
impulse via pontine nuclei
The efferents –spinocerebellar is projected into the
cerebellar nuclei fastigi ,emboliformis and
Globossus .Fibres from these nuclei pass through
cerebello olivary tract and ultimately to the α and
Ý motor neurons through the reticulospinal and
olivary tract
Spinocerebellum regulates the postural reflex
by modifying muscle tone.It facilitates the
gamma motor neurons in the spinal cord via
cerebello-vestibulospinal and cerebello
reticulospinal tract
POSTURAL REFLEXES
The postural reflexes help to maintain the
body in an upright and balanced position .
They also provide adjustment necessary to
maintain a stable posture during voluntary
activity
REFLEX ARC of postural reflex is as follows
Afferent pathways of reflex are from eyes
The vestibularapparatus and the
proprioceptors
Integrating centres are formed by neuronal
network in the brain stem and spinal cord
Efferent pathways consist of α motor neuron
supplying the various skeletal muscle which
form the effector organ
TYPE OF POSTURAL REFLEX
There are two types
STATIC REFLEX-These are elicited by
gravitational pull and involve sustain
contraction of muscle
STATOKINETIC REFLEX-These reflexes are
called phasic reflex are elicited by accelatory
displacement of body
They maintain a stable postural background
for voluntary activity.
Both types of postural reflexes are integrated
at various level in the CNS from the spinal
cord to cerebral cortex are also affected by
Pyramidal tracts
STATIC REFLEXES –are primarily involved in
adjustment to displacement produced by
gravity. These are of three types
 Local static reflex
 Segmental static reflex
 General static reflex
1.Local static reflex -The local static reflex
exert their effect on the same limb from which
the stimulus is applied
Reflex control of antigravity muscle tone
POSITIVE SUPPORTING REACTION
NEGATIVE SUPPORTING REACTION

Reflex control of antigravity muscle tone

The most important of local static reflex
is basic stretch reflex controlling tone in
extensor muscle which keep the body upright
 Positive supporting reflex or reaction is
characterised by simultaneous reflex
contraction of both flexor and extensor of limb
converting into a solid rigid pillar.

 The positive supporting reflex or reaction plays

an important role in steading the ankle joint in
standing position


At the ankle joint both the dorsiflexion and
plantar flexion are possible. The dorsiflexion
of the foot would tip the body forward.The
stabilisation of ankle joint in intermediate
position is possible by simultaneous
contraction of extensor and flexor of foot
brought about by positive supporting reaction

NEGATIVE SUPPORTING REACTION
Negative supporting reaction refers to
disappearance of positive supporting reaction.
It is also an active phenomenon initiated by
stretch of extensor muscle.This helps the limb
to be used for activities
Segmental static reflex
The segmental static reflex are characterised
by a bilateral reflex response when stimulus
Is applied to one limb .The best example of
segmental static reflex is crossed extensor
response component of withdrawal reflex
General static reflex are characterised by a
Generalised effect from the many muscle group
in the body in response to a stimulus

That arises from one side of body

It can be divided into three groups
a]Attidudinal or statotonic
Long loop reflex
Righting reflex
vi) RIGHTING REFLEXES:

 When an animal who

is asleep, wakes up
(animal may be lying
on its side or on the
back)  the animal
assumes an upright
posture, through a
series of reflexes
called righting
reflexes.
vii) HOPING REACTION:
 When a standing animal is pushed from its
lateral side  animal makes hoping
movements  to maintain its upright
posture.
 RECEPTORS: Muscle spindles
 CENTRE: In cerebral cortex
vii) HOPING REACTION:
 When a standing animal is pushed from its
lateral side  animal makes hoping
movements  to maintain its upright
posture.
 RECEPTORS: Muscle spindles
 CENTRE: In cerebral cortex
Statotonic also known as attitudinal reflexes
Are initiated when the attitude of the body is
changed these reflexes are of two types
 Tonic labyrynthine reflex
 Tonic neck reflex
 Tonic labyrinthine reflex-These reflexes are
produced in response to alteration in the
position of the head relative to the
horizontal Plane.This reflex increase or
decrease the tone of the skeletal muscle in
accordance to the attitude of head while
standing on inclined plane
Stimulus for tonic labyrinthine reflex is gravity
Receptors for these reflexes are in the otolith
organ are present in the labyrinthine
apparatus
Afferent impulses are generated from the
receptors along the vestibular nerve
Centre –for these reflex are in the vestibular
and reticular nuclei present in the medulla
oblongata
iv) TONIC LABYRINTHINE
REFLEX:

 STIMULUS: Gravity.
 RECEPTORS: Autolith
organs, especially in
utricle & saccule (in
absence of neck
movement).
 When head is dorsiflexed
 extension of all 4
limbs in animals.
 When head is
ventroflexed  decreased
extension of all 4 limbs.
 CENTRE: Vestibular nuclei
of medulla.
Reflex response-The labyrinthine reflexes
are particularly effective in extensor muscle.
The impulses from labyrinthine exert the same
effect on all four limbs
TONIC NECK REFLEX
These reflexes are produced in response to
alteration in the position of the neck
Stimulus for tonic neck reflex is stretch of
neck muscle
Receptor for tonic neck reflexs are probably
Pacinian corpuscle in the ligaments of cervical
Joints particularly atlanto occipital joint and
also muscle spindle of neck muscle
Centre for these reflexes lies in the medulla
oblongata
Efferent path are the long corticospinal tract
Reflex response obtained depending on the
Position of the head in relation to the body
VENTROFLEXION OF HEAD causes flexion of
Forelimb and extension of the hind limbs
 DORSIFLEXON OF HEAD causes extension of
the forelimbs and flexion of the hind limbs
 Turning of head sideways
v) TONIC NECK REFLEX:
 When neck is extended 
forelimbs extention & hind
limbs  flexed.
 When neck is flexed 
forelimbs become flexed &
hindlimbs become extended.
 When head is turned to 1 side,
on that side limb extend, other
side is flexed, through tonic
neck reflex.
 RECEPTORS: Muscle spindles,
paccinian corpuscles in
ligaments of neck & vertebral
joints.
 CENTRE: Spinal cord & medulla.
 These reflexes are used in
posture maintenance in
humans.
tonic neck reflexes
tonic neck reflexes
tonic neck reflexes
tonic neck reflexes
tonic neck reflexes
ROLE OF DIFFERENT REGIONS OF NERVOUS
SYSTEM IN MAINTENANCE OF POSTURE

The role of different regions of nervous

system in the maintenance of posture can be
investigated by producing transection in the
neuraxis at various level
ROLE OF SPINAL CORD
SPINAL ANIMAL

The role of spinal cord in the maintenance

Of posture can be studied in a spinal animal
By a transection of spinal cord effects of
spinal cord transection
STAGE OF SPINAL SHOCK

STAGE OF REFLEX ACTIVITY

STAGE OF REFLEX FAILURE

SPINAL ANIMAL:

 The animal that

receives this
transection of spinal
cord at lower cervical
level to study various
reflexes.
 In spinal section,
reflexes with centers
in the spinal cord are
intact (e.g, withdrawal
reflex).
transection of brain stem at superior border of pons

decerebrate rigidity
midbrain

pons

medulla
 DECEREBRATE RIGIDITY:

 It is produced by
giving a mid-collicular
section (section in
midbrain between
superior & inferior
colliculi).
 This procedure is
called decerebration.
 Sherington introduced
this section in cats &
dogs & observed the
effects:
 DECEREBRATE RIGIDITY:

 It is produced by
giving a mid-collicular
section (section in
midbrain between
superior & inferior
colliculi).
 This procedure is
called decerebration.
 Sherington introduced
this section in cats &
dogs & observed the
effects:
IN HUMANS:

 Legs are extended.

 Arms are extended.
 Flexion at wrist.
 Head is dorsiflexed.
 Back is hyper-extended.
 Due to increased tone in
extensors.
 Increased gamma efferent
discharge.
 Stretch reflex or myotatic
reflex becomes
hyperactive.
removal of cortex

decortication
 DECORTICATE RIGIDITY:

 Wide spread lesion of

cerebral cortex.
 Patient is
unconscious.
 Legs are extended.
 Arms are moderately
flexed (A)
 When head is turned
to right side, on that
side arm becomes
extended (B)
MECHANISM OF STANDING MAN
A tall man has to stand over a narrow base of
feet ,therefore maintenance of an erect posture is
more difficult

REFLEX ADJUSTMENT IN MUSCLE TONE OF

ANTIGRAVITY MUSCLE
It is presumed that continued contraction of most
of the muscles of the trunk and leg muscle keeps
the posture upright
The effect of gravity has to be opposed by
reflex contraction of some of the antigravity
muscles all the time otherwise a standing man
can fall in any direction’
The different antigravity muscle which oppose
the fall
EXTENSORS OF THE TRUNK AND FLEXORS
OF LEG
Contract sufficiently to restore balance when
sways forward
RECTUS ABDOMINIS AND LEG EXTENSOR WORK
contract to restore the body balance
When body sways backward
CONTRALATERAL EXTERNAL OBLIQUE
Contralateral external oblique muscle mantains
when body leans sideways
Head has a tendency to sway more than the
trunk .Since the centre of gravity passes in
front of atlantooccipital joint,So to hold the
head in an erect position the cervicooccipital
Muscle are to be mantained in a state of
constant tension