 | This article needs additional citations for verification .(December 2020) |
The patellar reflex, also called the knee reflex or knee-jerk, is a stretch reflex which tests the L2, L3, and L4 segments of the spinal cord. Many animals, most significantly humans, have been seen to have the patellar reflex, including dogs, cats, horses, and other mammalian species. [1]
Striking of the patellar tendon with a reflex hammer just below the patella stretches the muscle spindle in the quadriceps muscle. [2] [3] This produces a signal which travels back to the spinal cord and synapses (without interneurons) at the level of L3 or L4 in the spinal cord, completely independent of higher centres. [4] From there, an alpha motor neuron conducts an efferent impulse back to the quadriceps femoris muscle, triggering contraction. [3] This contraction, coordinated with the relaxation of the antagonistic flexor hamstring muscle causes the leg to kick. [4] There is a latency of around 18 ms between stretch of the patellar tendon and the beginning of contraction of the quadriceps femoris muscle. [5] This is a reflex of proprioception which helps maintain posture and balance, allowing to keep one's balance with little effort or conscious thought.
The patellar reflex is a clinical and classic example of the monosynaptic reflex arc. [3] There is no interneuron in the pathway leading to contraction of the quadriceps muscle. Instead, the sensory neuron synapses directly on a motor neuron in the spinal cord. [3] However, there is an inhibitory interneuron used to relax the antagonistic hamstring muscle (reciprocal innervation).
This test of a basic automatic reflex may be influenced by the patient consciously inhibiting or exaggerating the response; the doctor may use the Jendrassik maneuver in order to ensure a more valid reflex test.
After the tap of a hammer, the leg is normally extended once and comes to rest. The absence or decrease of this reflex is problematic, and known as Westphal's sign. This reflex may be diminished or absent in lower motor neuron lesions and during sleep. On the other hand, multiple oscillation of the leg (pendular reflex) following the tap may be a sign of cerebellar diseases. Exaggerated (brisk) deep tendon reflexes such as this can be found in upper motor neuron lesions, hyperthyroidism, [6] anxiety or nervousness. The test itself assesses the nervous tissue between and including the L2 and L4 segments of the spinal cord. [1]
The patellar reflex is often tested in infants to test the nervous system. [7]
Wilhelm Heinrich Erb (1840–1921) and Carl Friedrich Westphal (1833–1890) simultaneously reported the patellar tendon or knee reflex in 1875. [8] The term knee-jerk was recorded by Sir Michael Foster in his Textbook of physiology in 1877: "Striking the tendon below the patella gives rise to a sudden extension of the leg, known as the knee-jerk." [9]
The term began to be used figuratively from the early 20th century onwards. O. O. McIntyre, in his New York Day-By-Day column in The Coshocton Tribune, October 1921, wrote: "Itinerant preacher stemming Broadway on a soap box. And gets only an occasional knee-jerk." [9]
Spasticity is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.
In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous response to a stimulus.
The somatic nervous system (SNS), or voluntary nervous system is the part of the peripheral nervous system associated with the voluntary control of body movements via skeletal muscles.
A reflex arc is a neural pathway that controls a reflex. In vertebrates, most sensory neurons do not pass directly into the brain, but synapse in the spinal cord. This allows for faster reflex actions to occur by activating spinal motor neurons without the delay of routing signals through the brain. The brain will receive the input while the reflex is being carried out and the analysis of the signal takes place after the reflex action.
The quadriceps femoris muscle is a large muscle group that includes the four prevailing muscles on the front of the thigh. It is the sole extensor muscle of the knee, forming a large fleshy mass which covers the front and sides of the femur. The name derives from Latin four-headed muscle of the femur.
The withdrawal reflex is a spinal reflex intended to protect the body from damaging stimuli. The reflex rapidly coordinates the contractions of all the flexor muscles and the relaxations of the extensors in that limb causing sudden withdrawal from the potentially damaging stimulus. Spinal reflexes are often monosynaptic and are mediated by a simple reflex arc. A withdrawal reflex is mediated by a polysynaptic reflex resulting in the stimulation of many motor neurons in order to give a quick response.
Reciprocal inhibition describes the relaxation of muscles on one side of a joint to accommodate contraction on the other side. In some allied health disciplines, this is known as reflexive antagonism. The central nervous system sends a message to the agonist muscle to contract. The tension in the antagonist muscle is activated by impulses from motor neurons, causing it to relax.
Tendon reflex may refer to:
The rectus femoris muscle is one of the four quadriceps muscles of the human body. The others are the vastus medialis, the vastus intermedius, and the vastus lateralis. All four parts of the quadriceps muscle attach to the patella by the quadriceps tendon.
The stretch reflex, or more accurately "muscle stretch reflex", is a muscle contraction in response to stretching a muscle. The function of the reflex is generally thought be maintaining the muscle at a constant length but the response is often coordinated across multiple muscles and even joints. The term deep tendon reflex is often wrongfully used by many health workers and students to refer to this reflex. "Tendons have little to do with the response, other than being responsible for mechanically transmitting the sudden stretch from the reflex hammer to the muscle spindle. In addition, some muscles with stretch reflexes have no tendons ".
Alpha (α) motor neurons (also called alpha motoneurons), are large, multipolar lower motor neurons of the brainstem and spinal cord. They innervate extrafusal muscle fibers of skeletal muscle and are directly responsible for initiating their contraction. Alpha motor neurons are distinct from gamma motor neurons, which innervate intrafusal muscle fibers of muscle spindles.
A reflex hammer is a medical instrument used by practitioners to test deep tendon reflexes. Testing for reflexes is an important part of the neurological physical examination in order to detect abnormalities in the central or peripheral nervous system.
Hyporeflexia is the reduction or absence of normal bodily reflexes (areflexia). It can be detected through the use of a reflex hammer and is the opposite of hyperreflexia.
Biceps reflex is a deep tendon reflex (DTR) test that examines the function of the C5 reflex arc and the C6 reflex arc. The test is performed by using a tendon hammer to quickly depress the biceps brachii tendon as it passes through the cubital fossa. Specifically, the test activates the stretch receptors inside the biceps brachii muscle which communicates mainly with the C5 spinal nerve and partially with the C6 spinal nerve to induce a reflex contraction of the biceps muscle and jerk of the forearm.
The triceps reflex, a deep tendon reflex, is a reflex that elicits involuntary contraction of the triceps brachii muscle. It is sensed and transmitted by the radial nerve. The reflex is tested as part of the neurological examination to assess the sensory and motor pathways within the C7 and C8 spinal nerves.
Hoffmann's reflex is a neurological examination finding elicited by a reflex test which can help verify the presence or absence of issues arising from the corticospinal tract. It is named after neurologist Johann Hoffmann. Usually considered a pathological reflex in a clinical setting, the Hoffmann's reflex has also been used as a measure of spinal reflex processing (adaptation) in response to exercise training.
The axon reflex is the response stimulated by peripheral nerves of the body that travels away from the nerve cell body and branches to stimulate target organs. Reflexes are single reactions that respond to a stimulus making up the building blocks of the overall signaling in the body's nervous system. Neurons are the excitable cells that process and transmit these reflex signals through their axons, dendrites, and cell bodies. Axons directly facilitate intercellular communication projecting from the neuronal cell body to other neurons, local muscle tissue, glands and arterioles. In the axon reflex, signaling starts in the middle of the axon at the stimulation site and transmits signals directly to the effector organ skipping both an integration center and a chemical synapse present in the spinal cord reflex. The impulse is limited to a single bifurcated axon, or a neuron whose axon branches into two divisions and does not cause a general response to surrounding tissue.
The Golgi tendon reflex (also called inverse stretch reflex, autogenic inhibition, tendon reflex) is an inhibitory effect on the muscle resulting from the muscle tension stimulating Golgi tendon organs (GTO) of the muscle, and hence it is self-induced. The reflex arc is a negative feedback mechanism preventing too much tension on the muscle and tendon. When the tension is extreme, the inhibition can be so great it overcomes the excitatory effects on the muscle's alpha motoneurons causing the muscle to suddenly relax. This reflex is also called the inverse myotatic reflex, because it is the inverse of the stretch reflex.
A spinal interneuron, found in the spinal cord, relays signals between (afferent) sensory neurons, and (efferent) motor neurons. Different classes of spinal interneurons are involved in the process of sensory-motor integration. Most interneurons are found in the grey column, a region of grey matter in the spinal cord.
{{cite book}}: |website= ignored (help)