Spinal cord reflex

Synapses between first-order sensory neurons and alpha motor neurons, either directly or by way of intemeurons, result in spinal cord reflexes. Reflexes are discussed in more detail in a subsequent section in this chapter. 

Muscle relaxants have some value for relief of spastic muscle disorders, that is, a state of increased muscle tone that results from an imbalance between central and spinal control of muscle tone. Spasticity is the result of a general release from supraspinal control and is characterized by heightened excitability of a- and y-motor systems and the appearance of primitive spinal cord reflexes. Treatment is difficult, since relief often can be achieved only at the price of increased muscle weakness. 

Goldstein, B.D. 1989. Changes in spinal cord reflexes following subchronic exposure to soman and sarin. Toxicol. Lett. 47 1-8. 

Excitation, leading to vomiting, miosis, hyperactive spinal cord reflexes (some only), convulsions (very rare)... 

Chang T., Schifi S.J., et al. (1994) Stochastic versus deterministic variability in simple neuronal circuits I. Monosynaptic spinal cord reflexes, Biophys. J. 67 671-683. 

Neurological symptoms result from demyelination of the spinal cord and are potentially irreversible. The symptoms and signs characteristic of a vitamin B 2 deficiency include paresthesis of the hands and feet, decreased deep-tendon reflexes, unsteadiness, and potential psychiatric problems such as moodiness, hallucinations, delusions, and psychosis. Neuropsychiatric disorders sometimes develop independently of the anemia, particularly in elderly patients. Visual loss may develop as a result of optic atrophy. 

Codeine (morphine methyl ether) resembles morphine in its general effect, but is less toxic and its depressant action less marked and less prolonged, whilst its stimulating action involves not only the spinal cord, but also the lower parts of the brain. In small doses in man it induces sleep, which is not so deep as that caused by morphine, and in large doses it causes restlessness and increased reflex excitability rather than sleep. The respiration is slowed less than by morphine (cf. table, p. 261). Cases of addiction for codeine can occur but according to Wolff they are rare. The best known ethers of morphine are ethylmorphine and benzyl-morphine [cf., table, p. 261), both used to replace morphine or codeine for special purposes. 

Peters s results for corycavine and corycavamine indicate that these two alkaloids produce narcosis in frogs followed by paralysis of the spinal cord, and in mammals increased secretion of tears and saliva and epileptiform convulsions without increase of reflex irritability they also adversely affect the heart. ... 

The large diameter A/l-afferent fibre enters the dorsal horn of the spinal cord through the medial division of the dorsal root. It then descends through the medial region of lamina I or II, or alternatively, curves around the medial (central) edge of the dorsal horn down to the ventral horn. On reaching deeper laminae, laminae IV and V, the AjS-fibres ascend back up into laminae III and IV where they repeatedly subdivide and form a characteristic termination pattern. The densest arborisation appears to occur in lamina III. Axons originating from specialised muscle stretch receptors have collaterals that pass ventrally to make monosynaptic connections with neurons of laminae V, VI and VII. Some also extend to laminae VIII and IX of the ventral horn where they synapse directly onto motor neurons and form the basis of monosynaptic reflexes. 

Sympathetic and parasympathetic nerves innervate the penis. In the flaccid state, OC2-adrenergic receptors mediate tonic contraction of the arterial and corporal smooth muscles. This maintains high penile arterial resistance and a balance exists between blood flow into and out of the corpora. With sexual stimulation, nerve impulses from the brain travel down the spinal cord to the thoracolumbar ganglia.3 A decrease in sympathetic tone and an increase in parasympathetic activity then occurs, causing a net increase in blood flow into the erectile tissue. Erections may also occur as a result of a sacral nerve reflex arc while patients are sleeping (nocturnal erections). 

The spinal cord is the most anatomically inferior portion of the CNS and its functions are at the lowest level of sophistication (see Table 6.1). As mentioned earlier, the spinal cord receives sensory input from the periphery of the body and contains the cell bodies of motor neurons responsible for voluntary and involuntary movements. Once again, the involuntary and neurologically simple reflexes are processed entirely at the level of the spinal cord. Voluntary, deliberate movements are initiated and controlled by thought processes in the cerebrum. The second important function of the spinal cord is to transmit nerve impulses to and from the brain. Ascending pathways carry sensory input to higher levels of the CNS and descending pathways carry impulses from the brain to motor neurons in the spinal cord. 

Interneurons are found in all areas of the spinal cord gray matter. These neurons are quite numerous, small, and highly excitable they have many interconnections. They receive input from higher levels of the CNS as well as from sensory neurons entering the CNS through the spinal nerves. Many intemeurons in the spinal cord synapse with motor neurons in the ventral hom. These interconnections are responsible for the integrative functions of the spinal cord including reflexes. 

Spinal reflexes are processed at the level of the spinal cord. 

A reflex occurs when a particular stimulus always elicits a particular response. This response is automatic and involuntary in other words, it occurs without conscious effort. Therefore, reflexes are specific, predictable, and, furthermore, often purposeful. For example, the withdrawal reflex causes a body part to be pulled away from a painful stimulus so that tissue injury is avoided. Spinal reflexes require no input from the brain because they are elicited entirely at the level of the spinal cord. However, while the reflex is underway, nervous impulses are also transmitted to the brain for further processing. In fact, input from the brain may modulate a reflex or alter the response to a stimulus through conscious effort. 

Figure 7.3 Components of a reflex arc. As illustrated by the components of the reflex arc, reflexes may be processed entirely at the level of the spinal cord with no need for input from the brain. A monosynaptic reflex has a single synapse between afferent and efferent neurons a polysynaptic reflex has two or more synapses between these neurons. In this case, intemeurons lie between the sensory and motor neurons. The more intemeurons involved, the more complex the response is.

A reflex is initiated by stimulation of a sensory receptor located at the peripheral ending of an afferent or first-order sensory neuron. This afferent neuron transmits impulses to the spinal cord. Within the gray matter of the spinal cord, the afferent neuron synapses with other neurons. As such, the spinal cord serves as an integrating center for the sensory input. The afferent neuron must ultimately synapse with an efferent or motor neuron. When the afferent neuron synapses directly with the motor neuron, it forms a monosynaptic reflex. An example of this type of reflex is the stretch reflex. When the afferent neuron synapses with an intemeuron that then synapses with the motor neuron, it forms a polysynaptic reflex, e.g., the withdrawal reflex. Most reflexes are polysynaptic. The motor neuron then exits the spinal cord to innervate an effector tissue, which carries out the reflex response. 

An example of the mechanism of the withdrawal reflex is illustrated in Figure 7.4. When a painful stimulus activates a sensory receptor on the right foot, action potentials are transmitted along the afferent neuron to the spinal cord. By way of divergence, this neuron synapses with several other neurons within the gray matter of the spinal cord ... 

Signals are also transmitted to the reticular formation of the brainstem by way of the spinoreticular tract. The reticular formation plays an important role in the response to pain. First, it facilitates avoidance reflexes at all levels of the spinal cord and, second, it is responsible for the significant arousal effects of pain. Signals from the reticular formation cause an increase in the electrical activity of the cerebral cortex associated with increased alertness. Furthermore, it sends nerve impulses to the hypothalamus to influence its functions associated with sudden alertness, such as increased heart rate and... 

An interneuron together with a sensory afferent and motor efferent form a polysynaptic reflex (Figure 2.2) this comprises the initial stage of information input (sensory afferent), the processing/computing an appropriate response (interneurons) and the execution of a behavioural response (motor efferent). The simplest reflexes in the nervous system are monosynaptic reflexes, such as the familiar tendon (knee) jerk, these do not involve an interneuron. The sensory afferent activated by the mechano-receptor (the tap of the patellar hammer) forms a synapse with the motor efferent in the spinal cord, which then causes the skeletal muscle to contract and the crossed leg to jerk forward. With a synaptic delay of 1 millisecond (ms), the time between input and output increases with the number of synapses introduced into the circuit. As an... 

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