MOTOR

NEUROPHYSIOLOGY
Components of reflex ARC
Motor Functions Of the Central Nervous System
Sensory information enter the spinal cord through the sensory (posterior)
roots. In the cord every sensory signal travels to two separate directions :
the appropriate motor response beginning in the

One branch Second branch

transmits signals to high terminates in the grey
er levels of CNS cause matter of the
conscious cord local
sensory perception segmental spinal
reflexes.
Spinal cord with simple reflexes, extending into

Brain stem with more complicated responses and finally extending to

Cerebrum where the most complicated responses are controlled.

Motor Functions of the spinal cord

 MOTOR FUNCTION OF THE SPINAL CORD

Sensory nerves
(afferents)

Receptors

Convergence
Interneurons ( allow for Divergence )
After discharge
To the intrafusal fibres
of the muscle spindle
 eff
To the extrafusal fibres of skeletal muscles

 MN

DRG = Dorsal root ganglia

 MN = Alpha motor neuron
(Prevents lateral spread of stimulus  MN = Gamma motor neuron
& cut short the  MN discharge)
•Each segment of the spinal cord contains several million neurons in
the grey matter :
I. Sensory Neurons :
• Present in the dorsal horn .

II. motor neurons :

• Present in the anterior (ventral ) horn of spinal cord .
• Their axons leave the spinal cord To skeletal muscle .

•Alpha-Motor Neurons
•Their axons are large and myelinated (A-α fibers) large
skeletal muscle fibers .
•Each α motor neuron + its axon + skeletal muscle fibers it supplies
= motor unit .
•Gamma-Motor Neurons ( γ- Motor Neurons )
•Are much smaller than α-motor neurons .
•Transmit impulses along A-γ fibers intrafusal fibers of
III. The Interneurons :
- They are smaller and more numerous than anterior
motor neurons .
- Present in all areas of grey matter .
-They have many interconnection with each other and
discharge to anterior motor neurons allows divergence,
convergence , facilitation , inhibition and prolongation
of the incoming signals.

N.B : Renshaw Cells : Are small inhibitory

interneurons present in the ventral horn of spinal cord.
 Motor functions of the spinal cord
Divided by two methods:
1.Monosynaptic Reflex (Stretch Reflex)

AND

2.Polysynaptic Reflexes
1. Superficial reflexes
2. Deep reflexes
3. Autonomic reflexes
 Second Method is:
Spinal reflexes

Somatic (Voluntary) Autonomic (involuntary,

reflexes Visceral) reflexes

Deep reflexes Superficial

(receptors in the muscles and tendons) reflexes
(receptors NOT in the muscles and
❑ stretch reflex (dynamic and tendons)
static) ❑ Abdominal Reflexes
❑ Golgi tendon reflex ❑ Cremasteric reflex
❑ flexor withdrawal reflex ❑ Planter reflex
❑ postural spinal reflexes
 1.Monosynaptic Reflex (Stretch Reflex)
The only one in the body

Component Of Stretch Reflex:

•Stimulus: Stretch of the muscle .
•Receptors : Muscle spindles .
•Afferent fiber : Thick myelinated A-ɑ fibers .
•Center : In spinal cord –monosynaptic .
•Efferent fibers : Thick myelinated A-α fibers .
•Response : Muscle contraction .
 PATHWAY OF STRETCH REFLEX
2o Afferent Io afferent (type A fibres)
(type A fibres)

DRG

Interneuron Muscle spindle

(intrafusal m. fibres)

MN Static  eff.

Renshaw Extrafusal M. fibres

Dynamic  eff.
cell

MNs  efferent
Muscle Spindle:
*Structure Of Muscle Spindles :
- Are capsulated, spindle-shaped structures binding at one side to the tendon and the other to the
fleshy extrafusal muscle fibres

- Each muscle spindle is formed of 8-12 intrafusal muscle fibers

- The central parts of the intrafusal muscle fibers are non – contractile and full of nuclei and
called " the receptor area " while the peripheral parts are striated and contractile .

Types of Skeletal muscle fibers

There are 2 types of intrafusal muscle fibers:
1.Nuclear Bag Fibers:

The nuclei are arranged in a Bag

In the centre of the receptor area .

1-3 in each spindle

1. 2. Nuclear chain Fibers:

The nuclei are arranged in a chain
throughout the receptor area .

7-10 in each spindle

*Innervations Of Muscle Spindle :
A) Afferent Innervations from Muscle Spindle:
Two types of sensory endings are found in the receptor area of the muscle spindle .
1) The primary endings (annulospiral endings).

2) The secondary endings (flower spray endings).

Primary endings Secondary endings

Shape Annulospiral Flower spray

Origin Nuclear bag & nuclear chain Nuclear chain fibers only
fibers .

Diameter Thick myelinated A α Myelinated, but smaller A β

fibers fibers

Rate of Rapidly adapting Slowly adapting

•Efferent Innervation :
•They are γ-motor fibers originating from γ-motor neurons in the anterior horn of the
spinal cord and excite the peripheral part of the intrafusal fibers.

• 2 types of γ-motor nerves to muscle spindle :

1.γ-dynamic ( γ-d ) fibers : Excite mainly the nuclear bag intrafusal fibers .
2.γ static ( γ-s) fibers: Excite mainly the nuclear chain intrafusal fibers .
Who’s stimulates the γ-motor nuerons
Is the ?????
•Functions Of γ Efferent Fibers :
1.Through which the Supraspinal control on the stretch reflex occurs

2.They Increase The Response Of The Muscle To Stretch

So, Muscle spindles are stimulated when :

1. Stimulation γ- efferent contract the peripheral of intrafusal fibers Stretch of
receptor area .
2. The whole muscle is stretched Stretch of receptor area .
* Conversely the muscle spindles are inhibited by :
•Active muscle contraction .
•Passive muscle shortening .

•Types Of Stretch Reflex:

•1) Static stretch reflex:
* Maintained stretch to the muscle Maintained afferent discharge along
primary and secondary endings maintained muscle tone

•2) Dynamic Stretch Reflex:

*Sudden stretch of the muscle strong signal is transmitted along the primary
endings strong contraction of the muscle followed by sudden relaxation .
*It is the basis of tendon jerks.

•3) Negative Stretch Reflex:

*Sudden shortening of a muscle reflex muscle inhibition.
Functions Of Stretch Reflex :
1) Maintains body position against the effect of gravity.

2) Role Of Muscle Spindle In Voluntary Movements :

Whenever signals are transmitted from the motor cortex to α-motor
neurons, almost always γ- motor neurons are stimulated simultaneously
“ Co-activation “. This very important because :
•It keeps the length of the receptor portion unchanged keeps the
muscle spindle from opposing the muscle contraction .
•It maintains the proper damping function of the muscle spindle .

*Importance:
1-allows the brain to save Energy.
2-Adjusts the degree of muscle contraction to the heaviness of the
load .
3-It could compensates for fatigue or other abnormalities
DYNMIC STRECH REFLEX
(VIA NUCLEAR BAG FIBER)
Supraspinal Control Of Stretch Reflex :
•Through regulating the activity of γ motor neuron .
•The Supraspinal centers are either Facilitatory or inhibitory.
Facilitatory centers Inhibitory centers
Facilitatory reticular Inhibitory reticular formation
formation . (Pons) (Medulla)

Motor area 4 Motor Area 6

Caudate nucleus Lentiform nucleus

Vestibular nuclei Red nucleus

Neocerebellum Paleocerebellum
* Facilitatory reticular formation
1. Has intrinsic activity
2. Discharge its excitatory along ventral reticulospinal tract γ motor neurons .

3. All Supraspinal Facilitatory centers , stimulate Facilitatory reticular formation

Ventral reticulospinal tract γ - motor neurons .

4. Except The vestibular nucleus sends to both Ventral reticulospinal tract

and Vestibulospinal tract .

•The inhibitory reticular formation

1. Has no intrinsic activity
2. All inhibitory stimulate the inhibitory reticular formation. Inhibition signals travel
along Lateral reticulospinal tract inhibition of γ motor neurons .

3. Except The red nucleus also sends to both Lateral reticulospinal tract
and Rubrospinal tract .
* Facilitatory and inhibitory centers do not affect ɑ-motor neurons directly
* Clinical Application of stretch reflex :
1) Muscle Tone :
* Static stretch reflex is the basis of muscle tone .
* Muscle tone is a state of maintained reflex contraction of the muscle
especially the antigravity muscle.

Importance of muscle tone :

1- Maintains erect posture of the body against the effect of Gavity
2- Maintains (Keeps) the viscera in position (specially in animals )
3- Helps venous return and lymph flow .
4- Helps regulation of body temperature .

*Examination of a muscle tone is a clinical method to determine the sensitivity and

integrity of stretch reflex and to localize the site of lesion in CNS :

- Normal stretch reflex = Normal muscle tone.

- (atonia ) Loss of muscle tone = Interruption of the reflex arc .
- Hypotonia (decreased muscle tone ) = Inhibited stretch reflex .
- Hypertonia ( increased tone ) = Facilitated stretch reflex .
 (A) Static stretch reflex
(Form the basis of muscle tone via nuclear chain fiber)
Secondary aff.
Primary aff.
To the brain DRG

Interneuron Muscle spindle (intrafusal fibres)

Extrafusal fibres

MN  eff.  eff. MN = Alpha motor neuron

MN = Gamma motor neuron
MN
Renshaw cell

Maintained stretch of a muscle → stimulation of the secondary afferent

→ Sustained contraction of the muscle via  motor neuron discharge.
 (B) Dynamic stretch reflex
( Form the basis of tendon jerks)

(1) = excitatory synapse

(2) = excitatory synapse exciting
inhibitory interneuron
 2) Tendon Jerks or Deep Reflexes :
* The dynamic stretch reflex is the basis of tendon jerks .
* Sudden stretch of the muscle by tapping on its tendon
Rapid contraction followed by sudden relaxation
Determine the sensitivity and integrity of stretch reflex and to localize the site of lesion
in CNS :
A) Normal stretch reflex = Normal tendon jerks.
B) Absent Tendon Jerks (Areflexia) and Atonia :
** Occurs if the lesion interrupts the reflex arc , e.g .
poliomyelitis affecting AHCs .
C) Exaggerated tendon jerks ( Hyper reflexia ) and Hypertonia :
1- UMNL.
2- Hyperthyroidism .
3- Nervousness .
D) Weak Tendon jerks ( Hypo – reflexia ) and Hypotonia :
1- LMNL
2- Myxedema .
3- Sleep .
N.B : Tendon jerks and muscle tone are affect together in the same manner .
 3) Clonus : e .g . Knee or Ankle clonus :
* Is a state of rhythmic oscillation of the tendon jerk obtained
by sudden maintained stretch of the muscle . It occurs only if
the stretch reflex is supraspinally facilitated .
* Neurologists test patients for Clonus to determine the
degree of spinal cord facilitation.

If clonus occurs = high degree of facilitation .

 Golgi Tendon Reflex
(Inverse Stretch Reflex)
Severe stretch or severe contraction of a muscle
reflex sudden relaxation
Function: Protects against avulsion of the tendon (high tension in the muscle)
Afferent (Type A Fibres)

DRG

Golgi tendon organ

Inhibitory Skeletal muscle

Interneuron

+ = excitation
 motor neuron  efferent - = inhibition

Excessive tension (due to excessive

stretch or excessive contraction of Relaxation of the muscle
the muscle)
Component Of Golgi Tendon Reflex:
•Stimulus: Severe increase the tension in the muscle.
•Receptors : Golgi Tendon Organs.
•Afferent fiber : Thick myelinated A-β fibers .
•Center : In spinal cord –Polysynaptic .
•Efferent fibers : Thick myelinated A-ɑ fibers .
•Response : Sudden Muscle Relaxation .

•Function: Protective reflex Against

Avulsion of the tendon of the Muscle
GOLGI TENDON REFLEX
 Withdrawal and crossed-extensor
reflexes
Right lower limb (knee flexion):
1. Excitatory Interneurons to the
hamstring.
2. Inhibitory Interneurons to the
quadriceps. (reciprocal inhibition).

Left lower limb (knee extension):

3. Excitatory Interneurons to the
quadriceps.
4. Inhibitory Interneurons to the
hamstring
Brain:
5. Afferent neurons cross to the opposite
side to the thalamus and sensory
cortex for painful sensation.
 POSTURE
REFLEXES
❖A number of reflexes are involved in posture reflex.

❖These involve sensory information from visual ,

Auditory systems, vestibular system, muscle
spindle (stretch reflex), and proprioceptive
Muscle spindle+golgi
receptors and skin Pressure receptors.

❖All these afferent impulses are integrated by the

coordinated activity of the spinal cord, brain stem,
cerebellum, basal ganglion and cerebral cortex.
 Superficial reflexes
(receptors in the skin)

❑abdominal reflexes.

❑cremasteric reflex.

❑planter reflex

❑Corneal reflex
They help to localize the site of the lesion in spinal
cord.
1- Upper And Lower Abdominal Reflexes:
Scratching the skin of the abdomen reflex
contraction of:
* Upper abdominal muscle: The center in 7, 8, 9 and 10th
thoracic segments.
* Lower abdominal muscle: The center in 10, 11 and 12th
thoracic segments.

2) Cremastric Reflex:
* Scratching the skin of the inner aspect of the thigh
reflex contraction of cremastric muscle and elevation of the
testes. * Center: L1
 3. PLANTER REFLEX
BABINSKI'S REFLEX - AN UMN SIGN
 Adult Normal response : plantar flexion of the big toe and
adduction of the smaller toes

 Infant Normal response : Dorsoflexion (extension) of the big toe and

fanning of the other toes

 Pathological Response : Dorsoflexion (extension) of the big toe and

fanning of the other toes Indicative of upper motor neuron damage
Deep and superficial reflexes help in motor
examination to localize the lesions
Reflexes Site of the lesion
Biceps C5, C6
Deep reflexes Triceps C7, C8
(Jerks) Supinator C5, C6
Knee L3, L4
Ankle S1, S2
Abdominal T8 –T12
Cremastric L1, L2
Superficial
Planter S1 and S2
reflexes
Babinski sign UMNL
 Visceral (autonomic)
reflexes
❑Micturation reflex sympathetic L1 & L2

parasympathetic (S2,S3 and S4).

❑Defecation reflex sympathetic L1 & L2

parasympathetic (S2,S3 and S4).

❑Ejaculation reflex sympathetic L1 & L2

Erection parasympathetic (S2,S3 and S4).