REFLEJOS MEDULARES MOTORES

Z6,-Como usted sabe hay ciertos re ejos que producen una acción motora y que están
negrados a nivel medular. En los siguientes esquemas están representados tres de estos
Telejos, por las bras que participan en ellos debe de identi car de que re ejos se trata.
Anoteen el guión en que consisten estos re ejos.
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 - A

- Hay cuatro re ejos miotáticos o de estiramiento que se suelen emplear habitualmente

en la clínica: bicipital, tricipital, rotuliano y aquíleo. Anote como se exploran estos
re ejos e indique que semento medular participa principalmente en cada uno de ellos.
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 Re ejos
Los re ejos son muy similares a los tactismos, pues son
respuestas relativamente jas y estereotipadas al estímulo,
que están de acuerdo con la de nición de comportamiento
que
innato en el sentido de que son el resultado de mecanismos
nerviosos heredados, En muchos respectos, es difícil hacer
una distinción rápida y segura entre los tactismos y los re-
ejos, Hablando en términos generales, los tactismos orien-
tan todo el cuerpo mediante un número de respuestas re-
ejas especí cas. Los re ejos, como el re ejo de espanto o
el de enderezamiento, pueden implicar la mayor parte del
cuerpo o todo él, pero generalmente son respuestas de una
parte
parte del cuerpo, como la exión de una plernapierna en res-
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 CONDUCTA ESTEREOTIPADA 115

puesta a un estímulo doloroso o la contracción de la pupila

ante una luz intensa. Es claro que tales re ejos son adapti-
vOSy, en relación con la conducta, relativamente invariables.
Aun así, no es necesaria mucha observación de los re ejos
para ver que existe alguna variación en ellos, especialmente
en los vertebrados superiores y en re ejos dependientes de
niveles del sistema nervioso más altos que la médula es-
pinal.
En general, existen dos clases de re ejos: los re ejos tó-
nicos son ajustes relativamente lentos y de larga duración
que mantienen el tono muscular, la postura y el equilibrio.
Los re ejos fásicos son ajustes rápidos y de corta duración,
como los que se ven en la respuesta de exión. Los re ejos
pueden estar organizados en varios niveles del sistema ner-
vioso y pueden ocurrir en varios grados de complejidad;
generalmente, los de mayor complejidad dependen de los
segmentosmás altos del sistema nervioso. En los vertebrados,
como hemos explicado en otro lugar, los re ejos de simple
exión y extensión, incluyendo el caminar, pueden estar
organizados dentro de unos pocos segmentos de la médula
espinal, Pero la alternación coordinada de exionesy exten-
SIonesque componen la locomoción está organizada en mu-
chos segmentos de la médula espinal y normalmente re-
quiere la in uencia del mesencéfalo, Lo mismo sucede con
los re ejos de enderezamiento, que comprenden formas
complejas de respuestas para mantener la cabeza y el cuer-
po alineados en posición vertical en lo que se re ere a la
gravedad.
Muchos modos de comportamiento son combinaciones
complejas de re ejos simples. En un tiempo se creyó que
conducta compleja podía ser entendida enteramente
en estos términos, y que aun el aprendizaje y el pensamiento
no eran sino combinaciones complejas de re ejos innatos y
condicionados o de re ejos innatos y adquiridos. Aunque es
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 116 LA CONDUCTA EN EL REINO ANIMAL

teóricamente posible analizar casi todos los comportamien-

tos en sus re ejos componentes, en muy raras ocasiones se
ha hecho con éxito, y ha sido evidente que muchos tipos de
comportamiento -por ejemplo, los modos instintivos-
comprenden siempre algo más que un encadenamiento com-
plejo de re ejos simples con relaciones invariables de estímu-
lo y respuesta.
No obstante, la respuesta re eja es una de las formas prin-
cipales de adaptación en el reino animal, En el curso de la
evolución, los re ejos se convirtieron en rasgos menos des-
tacados del comportamiento, pues se hicieron más variables
y estuvieron cada vez más sujetos a las in uencias modi -
cadoras de los mecanismos neurales superiores y son eclip-
sados por otras formas de adaptación.
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 Neuromuscular
Re exes of the Spinal
Cord and Brain Stem

INTRODUCTION Most re ex arcs involve several synapses (multisynap-

tic), but a few involve only one synapse (monosynaptic),
The nervous system and the endocrine system are primarily
such as that between the afferent and efferent neurons. Some
responsible for the integration and control of body func-
re exes involve afferent and efferent neurons on the same
tions. Of all organ systems within the human body, the cen-
side of the brain and spinal cord (ipsilateral re exes),
tral nervous system (the brain and spinal cord) has perhaps
whereas others involve afferent neurons on one side of the
the most complex physiology. Functions of the central ner-
brain and spinal cord and efferent neurons on the other side
vous system range from single activation and re ex control
(contralateral re exes). The simple spinal re ex activity
of skeletal muscle, smooth muscle, and glandular secretory
shown in gure 10.I is an example of multisynaptic ipsilat-
cells to extremely complex functions of memory, abstract
eral and contralateral re exes and serves to illustrate the
thought, association, and language.
functional aspects of the spinal re ex arc.
The re ex arc is a basic structural and functional unit
The receptor is stimulated (in this case, pain receptors
of the nervous system. The re ex arc allows the body to
in the nger), and a neural impulse is generated. The affer-
react automatically and involuntarily to a variety of internal
ent neuron conducts the impulse into the posterior horn of
and external stimuli so as to maintain homeostasis. Nearly
the spinal gray matter by way of the posterior root of the
every function of the body involves re exes. Some re exes
spinal nerve. The afferent neuron synapses with associa-
are structurally and functionally simple, such as the with-
tion neurons (internuncial neurons, interneurons), which
drawal re ex illustrated in gure 10.1. Other re exes, such
relay the information to efferent neurons on the same side
as those involved with controlling heart function, respira- of the spinal cord (ipsilateral) and on the opposite side
tion, and body uid and electrolyte balance, are more com- (contralateral). The efferent neurons, in this case, are large
plex. Nevertheless, all re ex arcs have common features. alpha motor neurons (motoneurons) located in the anterior
Each re ex arc consists of the following components:
horn of the spinal gray matter, which supply skeletal mus-
Receptor: a specialized structure at the beginning of a cles. The efferent neuron transmits impulses out of the
sensory neuron that receives the original stimulus spinal cord, by way of the anterior root of the spinal nerve,
to skeletal muscles (in this case, exor muscles of the fore-
Afferent neuron: the sensory neuron that relays sensory
information from the receptor into the brain or spinal arm). Both ipsilateral exion and contralateral exion
cord of the forearms occur, thereby removing the stimulus
(hammer) as well as the injured nger from the area. The
CNS (central nervous system) center: a center in the spinal
re ex activity illustrated is an example of an ipsilateral-
cord or brain where information is relayed across one
contralateral exion re ex.
or more synapses from the afferent neuron to the
Re ex arcs that use skeletal muscles as effectors are
efferent neuron
usually not composed exclusively of excitatory neurons.
Efferent neuron: the motor or secretomotor neuron that Some association or interneurons are inhibitory. When ex-
transmits information out of he central nervous system ion is re exively initiated in an extremity, as at the knee,
to an effector contraction of the opposing extensor muscles is simultane-
Efector: smooth, cardiac, skeletal muscle cells or secretory ously inhibited ( gure 10.2). Conversely, contraction of ex-
cells (in glands) that respond to the application of a tensors also involves re ex inhibition of exors at the same
stimulus to the receptor joint. This pattern of skeletal muscle control at a movable
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 To Brain for Interpretation
Posterior

Posterior Root Ganglion

Posterior
Ascending (Sensory) Tract
Root

-AssociationNeuron

-f-> <HO-+ - Sensory Neuron

Anterior
Root 4.---
Motor Neuron (Lower
Anterior Motor Neuron)

Effector
(Motor End Plate
Skeletal Muscle)

lpsilateral Withdrawal
Contralateral
Withdrawal

Sensor
(Free Nerve Endings)

FIGURE 10.1 A simple spinal re ex: ipsilateral and contralateral withdrawal

joint is called reciprocal inhibition. When a person steps re exes maintain posture and skeletal muscle tonus. Exten-
on a tack with the right foot, the exors of the right knee sor re exes involve the contraction of the extensor muscles
re exively contract as the extensors of the right knee are si- in response to the muscle stretch; the patellar re ex (knee
multaneously inhibited, causing the injured foot to be with- jerk) is an example. Flexor re exes (e.g., withdrawal re ex)
drawn. However, for the person to remain standing, the involve the contraction of the exor muscles, usually in re-
contralateral knee must be extended, so the contralateral sponse to cutaneous stimuli. Other re exes involve visceral
pattern of reciprocal inhibition is reversed; that is, extensors rather than somatic components; the pupillary re ex, ac-
contract as exors are inhibited. commodation re ex, vasopressor re exes, and carotid sinus
It is important to remember that skeletal muscles are re ex are examples.
not directly inhibited, because neuromuscular junctions are
excitatory. Inhibition of skeletal muscle contraction occurs
as a result of inhibiting the alpha motoneurons that inner-
Experimental Objectives
vate the muscle bers and not inhibiting the muscle bers 1. To record re ex tonus for right and left leg exion in
at the neuromuscular junctions. the frog and to observe the occurrence of spinal
Impulses generated in the re ex arc are also relayed up re exes in the absence of the brain.
and down the spinal cord and to the brain. This relaying of 2. To demonstrate the re ex origin of skeletal muscle
impulses permits a coordination of re ex activities and in- tonus.
forms the brain so that interpretation of the stimulus (in this 3. To observe the effects of spinal shock on re ex
case, localization of pain) takes place. activity.
Re exes may be classi ed by the activity that results 4. To become familiar with human neuromuscular
from the passage of impulses over the re ex arc. Postural re exes and their usefulness in physical diagnosis.
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 To Brain
Posterior

Anterior

Spinal Cord

Extensor
Alpn
xtensor
Alpha
Flexor
Alpha Flexor
Alpa

Knee Knee
Flexion Extension

10.2 Coupled ipsilateral exion-contralateral extension re exes

FIGURE
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 Clinical Neuromuscular Re exes
in the Human
The functional integrity of re ex arcs is tested to obtain ob-
jective evidence regarding the function of muscles, periph-
eral nerves (motor and sensory), and the central nervous
system. Conclusions drawn from testing re exes are not the
sole considerations in diagnosis but rather are considered in
conjunction with other symptoms and signs of pathophysi-
ology. The following are several re exes commonly tested
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 in physical diagnosis. Methods of eliciting some of these sometimes in children up to age 4 (physiologic
re exes are shown in gure 10.8. Additional re exes are Babinski). The Babinski re ex in an adult may occur
listed in table 10.1. temporarily during sleep and in epileptics immediately
after a seizure, but usually it signi es a lesion in the
1. Plantar re ex: Have your laboratory partner assume a corticospinal tracts or peripheral nerve damage.
supine position on the laboratory table. Remove the 2 Achilles tendon re ex (ankle jerk): Instruct your
sock and shoe from one foot. Press on the heel to laboratory partner to sit on the edge of the laboratory
rmly brace his or her foot. Using a blunt dissecting table with feet relaxed. Strike the Achilles tendon
needle, stroke lightly the outer border of the sole of the sharply with a patellar hammer or the side of the hand.
foot from the heel to the origin of the toes, then across This strike will cause the tendon to stretch the
the ball of the foot medially. (Never stroke downward gastrocnemius muscle, initiating a re ex contraction of
from the toes to the heel.) If the re ex is normal, the the muscle and a resultant plantar exion of the foot.
toes will adduct and plantar ex. If the re ex response 3. Patellar re ex (knee jerk): As your laboratory partner
is abnormal, the toes will abduct instead of adduct and sits on the edge of the laboratory table with legs
dorsi ex instead of plantar ex. This abnormal re ex relaxed, strike his or her knee sharply with a patellar
response is called a complete Babinski re ex. An hammer (or the side of the hand) just below the patella
incomplete Babinski re ex is characterized by (kneecap). This strike will cause the tendon of the
dorsi exion of the big toe and plantar exion of the quadriceps femoris muscle to stretch, initiating a re ex
other four toes. The Babinski re ex is normally contraction of the muscle and resulting in extension of
obtained in infants up to the age of 6 months and the leg.
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 4. Corneal re ex (blink re ex): Touch the cornea of your 6. Biceps tendon re ex (biceps jerk): Ask your laboratory
laboratory partner's eye by approaching it from the partner to sit at the edge of the laboratory table with an
side with a wisp of cotton. Bilateral blinking of the lids
arm relaxed on top of the table. Gently press the biceps
should occur. In some lesions of the brain stem and
tendon in the antecubital fossa (anterior elbow) with
lesions of the trigeminal nerve in which the cornea
becomes anesthetic, the re ex is absent.
your fore nger to stretch the biceps a bit. Maintaining
a gentle pressure, strike this nger with the patellar
5. Ciliospinal re ex: Have your laboratory partner sit and
look straight ahead. Using a dissecting needle or pin, hammer. If the re ex is normal, the forearm will ex.
lightly scratch the skin of your partner's neck while This re extests for the functional integrity of the
observing his or her pupils. Ipsilateral pupillary musculocutaneousnerve and the lower cervical
dilation should occur in response to the scratch. Repeat segments of the spinal cord.
the test for the re ex, using the opposite side of the
neck.
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 Name Method
of re ex of eliciting

Corneal Touching cornea

Palatal Touching soft palate

Upper abdominal Stroking abdomen

Lower abdominal Stroking abdomen

Plantar Stroking sole of foot

Jaw jerk Striking middle of chin

Biceps Striking biceps tendon

Triceps Striking triceps tendon

Knee jerk Striking patellar tendon

Achilles Striking Achilles tendon

Light Shining light on retina

Ciliospinal Causing pain

Oculocardiac Pressure on eyeball

Carotid sinus Pressure on carotid sinus area

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 TABLE 10.1 Spinal cord and brain stem re exes

Name Method Afferent Efferent

of re ex of eliciting nerve Center nerve Effect
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