S1_L1: Reflexes Flashcards

1
Q

This is an involuntary motor output and nearly instantaneous movement in response to a stimulation.

A

Reflex

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2
Q

TRUE OR FALSE: Reflexes are symmetrical. It does not receive nor need conscious thought.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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3
Q

Reflex responses happen (1)_______ to prevent us from being (2)_______

A
  1. automatically
  2. harmed

NOTE: it is for self-preservation

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4
Q

Reflexes are (1)_______ and can be modified to perform (2)_______ tasks and maintain (3)_______

A
  1. adaptable
  2. motor
  3. balance

Source: Ganong (Chapter 12)

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5
Q

Determine the number of synapses of a reflex

  1. ankle reflex
  2. stretch reflex
  3. deep tendon reflexes
  4. withdrawal reflex
  5. triceps reflex

A. Monosynaptic reflex
B. Polysynaptic reflex

A
  1. A
  2. A
  3. A
  4. B
  5. A
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6
Q

This is the basic unit of integrated reflex activity

A

Reflex Arc

Source: Ganong (Chapter 12)

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7
Q

An activity in the reflex arc generates (1)_______ action potentials in the (2)_______ nerve

A
  1. all-or-none
  2. afferent
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8
Q

TRUE OR FALSE: Reflex activity is specific in that a particular stimulus elicits a particular response. Ascending inputs from higher brain regions play an important role in modulating and adapting spinal reflexes.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

Source: Ganong (Chapter 12)

A

C. Only the 1st statement is true

Note: It is descending inputs

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9
Q

Activity in the reflex arc starts in a (1)______ with a (2)______

A
  1. sensory receptor
  2. receptor potential

Source: Ganong (Chapter 12)

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10
Q

TRUE OR FALSE: The number of action potentials is proportional to the size of the receptor potential.

A

True

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11
Q

Somatic reflex - involve the (1) _______ muscles, while autonomic reflex - involve the (2)_______ muscles

A
  1. skeletal
  2. smooth
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12
Q

_______ is the integrative area for the cord reflexes

A

Cord gray matter

Source: Guyton (Chapter 55)

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13
Q

TRUE OR FALSE: When tendon reflex are tested, limbs on each side should be flexed to 90 degrees and strike for 5 times.

A

False

It must only be placed in identical positions and elicited in the same manner.

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14
Q

TRUE OR FALSE: Receptor potential’s magnitude is proportional to the strength of the stimulus

A

True

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15
Q

Tendon reflexes are elicited because of change in (1)_____ or (2)_____ tension in a muscle

A
  1. length
  2. tension
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16
Q

You tested a pt’s knee jerk with him sitting on the edge of a bed, with his feet dangling. With a reflex hammer, you tap his patellar tendon. As a result, his leg kicked out, then immediately came to a rest.

What grade will this response be given?

A

2+ (normoreflexia)

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17
Q

You tested a pt’s knee jerk with him sitting on the edge of a bed, with his feet dangling. With a reflex hammer, you tap his patellar tendon. As a result, his leg kept swinging out repetitively.

What grade will this response be given?

A

4+

NOTE: This is a very brisk, with clonus response (repetitive jerky movement noted after elicitation of reflex)

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18
Q

You tested a pt’s knee jerk with him sitting on the edge of a bed, with his feet dangling. With a reflex hammer, you tap his patellar tendon. However, tghe leg does not respond.

What grade will this response be given?

A

0 (areflexia)

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19
Q

TRUE OR FALSE: Tendon reflexes can excite either GTO or muscle spindle, or both at the same time

A

True

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20
Q

Match the following neurons/ cells to its corresponding description.

  1. located in the anterior horns of the spinal cord
  2. present in all areas of the cord gray matter
  3. small and highly excitable, often exhibiting spontaneous activity and capable of firing as rapidly as 1500 times per second

A. Anterior Motor Neurons
B. Interneurons
C. Renshaw Cells
D. A & B
E. A & C

A
  1. E
  2. B
  3. B
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21
Q

Match the following neurons/ cells to its corresponding description.

  1. spinal glycinergic inhibitory interneurons
  2. directly innervate the skeletal muscle fibers
  3. where almost all sensory signals from spinal nerves or signals from the brain are transmitted first

A. Anterior Motor Neurons
B. Interneurons
C. Renshaw Cells
D. A & B
E. A & C

A
  1. C
  2. A
  3. B

Source: Guyton (Chapter 55)

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22
Q

Interconnections among the (1)_____ and (2)______ are responsible for most of the integrative functions of the spinal cord

A
  1. interneurons
  2. anterior motor neurons
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23
Q

What are the 2 types of anterior motor neurons?

A

alpha motor neurons and gamma motor neurons

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24
Q

type A alpha (Aα) motor nerve fibers innervate (1)______ fibers, while type A gamma (Aγ) motor nerve fibers innervate (2)_______ fibers

A
  1. extrafusal
  2. intrafusal
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25
Q

Intrafusal fibers constitute the middle of the _______, which helps control basic muscle tone.

A

muscle spindle

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26
Q

This is when the stimulation of each motor neuron tends to inhibit adjacent motor neurons

A

Lateral inhibition

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27
Q

Which of these utilizes lateral inhibition?

A. Anterior Motor Neurons
B. Interneurons
C. Renshaw Cells

A

C. Renshaw Cells

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28
Q

These fibers run from one segment of the cord to another and provide pathways for the multi segmental reflexes

A

Propriospinal Fibers

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29
Q

What tract carry instantaneous information from both the muscle spindles and the Golgi tendon organs directly to the cerebellum?

A

Dorsal spinocerebellar tracts

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30
Q

TRUE OR FALSE: Both the GTO and muscle spindle are almost entirely for the purpose of extrinsic muscle control. These operate almost completely at a subconscious level.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

D. Only the 2nd statement is true

*intrinsic muscle control

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31
Q

Determine whether the description is for a muscle spindle or for GTO.

  1. excitatory in nature
  2. inhibitory in nature
  3. sensitive to stretch
  4. sensitive to tension or rate of change of tension
  5. distributed all throughout the muscle belly

A. Muscle Spindle
B. Golgi Tendon Organ

A
  1. A
  2. B
  3. A
  4. B
  5. A
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32
Q

The following statements are true about muscle spindles, EXCEPT:

A. Deeply ingrained with nerve endings
B. Spindle-like or fusiform-shaped muscle sensory receptor
C. Send information to the nervous system about muscle length or rate of change of length
D. Central portion functions as a sensory and motor receptor
E. None of the above

A

D. Central portion functions as a sensory and motor receptor

NOTE: Only as a sensory receptor

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33
Q

TRUE OR FALSE: Muscle spindles provide information on joint position.

A

True

NOTE: This is because changes in muscle length are associated with changes in joint angle

Source: Ganong (Chapter 12)

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34
Q

The central portion of the muscle spindle is _____

A. Contractile
B. Non-contractile

A

B. Non-contractile

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35
Q

What are the 2 types of sensory endings at the central receptor area of the muscle spindle?

A
  1. Primary afferent ending/Annulospiral ending
  2. Secondary afferent ending/FlowerSpray ending
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36
Q

Determine the type of sensory endings at the central receptor area of the muscle spindle.

  1. Type II fibers
  2. Encircles the central portion of intrafusal fibers
  3. Faster nerve conduction velocity
  4. Excited by both the nuclear bag intrafusal fibers and the nuclear chain fibers
  5. Only excited by the nuclear chain fibers

A. Annulo-spiral ending
B. Flower-Spray ending

A
  1. B
  2. A
  3. A
  4. A
  5. B
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37
Q

How fast is the nerve conduction velocity of the annulo-spiral endings?

A

70-120m/s

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38
Q

What kind of nerve fibers do the annulo-spiral endings ahve?

A

Type Ia fibers

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39
Q

TRUE OR FALSE: Both branches of the annulo-spiral endings innervate the nuclear bag and nuclear chain.

A

False.

NOTE: One branch innervates nuclear bag. The other branch innervates nuclear bag and nuclear chain.

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40
Q

Determine the muscle spindle intrafusal fiber.

  1. has 2 subtypes: dynamic and static
  2. one to three in each spindle
  3. three to nine in each spindle
  4. innervated by type Ia and II
  5. nuclei aligned in a chain throughout the receptor area

A. Nuclear bag muscle fibers
B. Nuclear chain fibers

A
  1. A
  2. A
  3. B
  4. B
  5. B
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41
Q

The polar ends of a muscle spindle is contractile because of the presence of (1)____ and (2)_____ filaments.

A
  1. actin
  2. myosin
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42
Q

Gamma efferent fibers are _____

A. Inhibitory
B. Excitatory
C. Both

A

B. Excitatory

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43
Q

Stretching the muscle spindles (1)______ the rate of firing, whereas shortening the spindle (2)_______ the rate of firing

A
  1. increases
  2. decreases
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44
Q

TRUE OR FALSE: Spindles can send to the spinal cord either positive signals to indicate stretch or negative signals to indicate that the muscle is unstretched

A

True

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45
Q

Determine the response of the muscle spindle receptor.

  1. Slow lengthening/stretching of muscle
  2. Degree of muscle contraction remains constant
  3. When lengthening stops, there’s an extra rate of smaller static responses
  4. Elicited by signals from annulospiral/primary ending only
  5. Stimulated by rapid stretch or unstretch

A. Static Response
B. Static Response

A
  1. A
  2. A
  3. B
  4. B
  5. B
46
Q

Static response responds to (1)_____ of receptor, while dynamic response responds to the (2)_____ of (3)_____ of receptor length

A
  1. length
  2. rate
  3. change
47
Q

Determine the response of gamma motor nerves.

  1. excites mainly the nuclear bag intrafusal fibers
  2. excites mainly the nuclear bag intrafusal fibers

A. Gamma-dynamic (gamma-d)
B. Gamma-static (gamma-s)

A
  1. A
  2. B
48
Q

TOPIC: Myotatic reflex

The stimulus that initiates this reflex is (1)______ of the muscle, and the response is (2)______ of the muscle being stretched.

A
  1. stretch
  2. contraction
49
Q

This pathways allows a reflex signal to return with the shortest possible time delay back to the muscle after excitation of the spindle

A

Monosynaptic pathway

50
Q

Arrange the monosynaptic pathway in correct sequence.

  1. spinal cord
  2. muscle
  3. sensory receptor
  4. afferent neuron
  5. efferent neuron
A

34152

51
Q

In the monosynaptic pathway, most fibers do not reach level of the (1)______ but at level of (2)______. It is faster than (3)______.

A
  1. cerebrum
  2. spinal cord
  3. polysynaptic reflex
52
Q

This is the stretch reflex of the quadriceps femoris muscle, because the tap on the tendon stretches the muscle

A

Knee jerk reflex

53
Q

Determine the kind of stretch reflex.

  1. Elicited by the continuous static receptor signals transmitted by both primary and secondary endings.
  2. Signals transmitted by primary sensory endings of the muscle spindles
  3. Caused by rapid stretch or unstretch, sudden stretch of muscle spindles
  4. The reflex functions to oppose sudden changes in muscle length
  5. Causes the degree of muscle contraction to remain reasonably constant

A. Static Stretch Reflex
B. Dynamic Stretch Reflex

A
  1. A
  2. B
  3. B
  4. B
  5. A
54
Q

This is the ability to prevent oscillation or jerkiness of body movements.

A

Damping/Smoothing

55
Q

_________ consists of a netlike collection of knobby nerve endings among the fascicles of a tendon. This is encapsulated muscle sensory receptor through which muscle tendon fibers pass

A

Golgi Tendon Organ (GTO)

56
Q

The GTO has a local cord signal excites a single inhibitory interneuron that inhibits the (1)_______. It directly inhibits the (2)________ without affecting adjacent muscles

A
  1. anterior motor neuron
  2. individual muscle
57
Q

The GTOs uses what type of nerve fibers?

A

Type Ib

58
Q

This stimulated by increased tension in the connecting muscle, signals are transmitted to the spinal cord to cause reflex effects in the respective muscle

A

Golgi Tendon Reflex

59
Q

This stimulated by increased tension in the connecting muscle, signals are transmitted to the spinal cord to cause reflex effects in the respective muscle

A

Golgi Tendon Reflex

60
Q

When tension is so great, inhibitory effect can lead to sudden and instantaneous relaxation of the whole muscle.

What reaction is being referred by the statement above?

A

Lengthening reaction

61
Q

When tension is so great, inhibitory effect can lead to sudden and instantaneous relaxation of the whole muscle.

What reaction is being referred by the statement above?

A

Lengthening reaction

62
Q

GTO inhibits the muscle contraction, therefore it _______ the muscle

A

lengthens

63
Q

TRUE OR FALSE: The lengthening reaction is a protective mechanism to prevent tearing of the muscle or avulsion of the tendon from its attachments to the bone

A

True

64
Q

The golgi tendon reflex is ______

A. Excitatory
B. Inhibitory
C. Both

A

B. Inhibitory

65
Q

TRUE OR FALSE: The Golgi Tendon Reflex provides a positive feedback mechanism that prevents the development of too much tension on the muscle. It equalizes contractile forces of the separate muscle fibers

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

D. Only the 2nd statement is true

NOTE: It is a negative feedback. Fibers that exert excess tension become inhibited by the reflex. Fibers that exert too little tension become more excited because of the absence of reflex inhibition

66
Q

This is a stretch reflex that causes the agonist muscle to contract and simultaneously causes antagonist to relax. It often exist between the muscles on the two sides of the body

A

Reciprocal Inhibition

67
Q

This is a neuronal circuit that causes this reciprocal inhibition

A

Reciprocal innervation

68
Q

This reflex is elicited most powerfully by stimulation of pain endings. It is also called nociceptive reflex or pain reflex.

A

Flexor Reflex

69
Q

TRUE OR FALSE: The flexor reflex pass directly to the anterior motor neurons. It has one reciprocal inhibition circuit to enable for muscle withdrawal.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

B. Both statements are false

NOTE: Pathways for eliciting the flexor reflex do not pass directly to the anterior motor neurons but instead pass first into the spinal cord interneuron pool of neurons. Diverging circuits to spread the reflex to the necessary muscles for withdrawal

70
Q

TRUE OR FALSE: A weak stimulus causes one quick flexion movement. A strong stimulus causes prolonged flexion and sometimes a series of flexion movements.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

71
Q

Circuits to cause (1)_______ that lasts many fractions of a second after the stimulus is over. Because of this, reflex can hold the irritated part away from the stimulus for (2)____ to (3)_____ seconds after the irritation is over.

A
  1. afterdischarge
  2. 0.1
  3. 3
72
Q

This is when part of the body other than the limbs is painfully stimulated, the part will be withdrawn from the stimulus.

What reflex is this?

A

Withdrawal reflex

73
Q

TRUE OR FALSE: The withdrwal reflex is a monosynaptic reflex.

A

False.

It is polysynaptic

74
Q

Phis is properly part of the withdrawal reflex that when a strong stimulus is applied to a limb, the response includes not only flexion and withdrawal of that limb but also extension of the opposite limb.

A

Crossed Extensor Reflex

75
Q

This is also known as the inverse stretch reflex

A

Autogenic Inhibition

76
Q

What is the receptor for autogenic inhibition?

A

Golgi tendon organ

77
Q

When there is an increase (1)______, the GTO senses it and causes the (2)______ muscle to (3)_______

A
  1. tension
  2. agonist
  3. relax
78
Q

TRUE OR FALSE: The harder a muscle is stretched, the stronger is the reflex contraction. However, when the tension becomes great enough, contraction suddenly ceases and the muscle relaxes

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

79
Q

TRUE OR FALSE: When the muscle is relaxed, it can stretch more

A

True

80
Q

These are very old reflexes that is usually exhibited by newborns and infants

A

Primitive Reflexes

81
Q

TRUE OR FALSE: Having normal primitive reflexes in adulthood is normal

A

False

These reflexes should be supressed

82
Q

What lobe gradually suppresses the function of primitive reflexes?

A

Frontal lobe

83
Q

This is a learned response performed to a signal that was previously associated with an event of consequence.

A

Conditioned Reflex

84
Q

This maneuver will heighten (exaggerate) lower limb tendon reflexes by countering some of the normal descending inhibition the brain sends to the reflex arc.

A

Jendrassik Maneuver

85
Q

TRUE OR FALSE: Jendrassik Maneuver is part of the deep tendon reflex assessment

A

False

86
Q

___________ is when more alpha motor neurons are excited and is responsible for the increased firing leading to exaggerated response

A

Subliminal fringe

87
Q

The motor system can be divided into (1)______ and (2)________

A
  1. lower
  2. upper motor neurons
88
Q

The following are s/sx of UMNL, EXCEPT:

A. hypertonia
B. hyperreflexive
C. hypertonicity
D. spasticity
E. None of the above

A

E. None of the above

89
Q

In UMNL, when the descending cortical fibers are damaged, the inhibition of the (1)______ is absent. The result is repetitive, sequential contraction of flexors and extensors, also known as (2)_______.

A
  1. antagonists
  2. clonus
90
Q

An abnormal plantar extensor reflex happens during an UMNL. What is this reflex?

A

Babinski sign

91
Q

A (+) Babinski sign shows of a (1)______ of the great toe and (2)_____ of the other toes when the lateral aspect of the sole of the foot is scratched

A
  1. dorsiflexion
  2. fanning
92
Q

This is a form of muscle hypertonicity that offers increased resistance to stretch involving primarily the flexors in the upper limb and extensors in the lower limb and may be associated with muscle weakness

A

Spasticity

93
Q

TRUE OR FALSE: Amyotrophic lateral sclerosis (ALS) is an UMNL.

A

False

It is a disease that leads to lower motor neuron damage

94
Q

Lower motor neurons are located _____ the dorsal root ganglion

A

below

95
Q

Lower motor neurons are located _____ the dorsal root ganglion

A

below

96
Q

Lower motor neurons are located _____ the dorsal root ganglion

A

below

97
Q

This is the ability of muscle to resist stretch. It is assessed by passively moving the extremity

A

Muscle tone/ tonus

98
Q

This term is used when a muscle’s resistance to stretch is high because of hyperactive stretch reflexes.

A

Hypertonic/Spastic muscle

99
Q

This is the occurrence of regular, repetitive, rhythmic contractions of a muscle subjected to sudden, maintained stretch. It is also described as the oscillation of muscle jerks.

A

Clonus

100
Q

Sustained clonus with _____ or more beats is considered abnormal.

A

5

101
Q

TRUE OR FALSE: The higher center control of the brain can inhibit reflex

A

True

102
Q

TRUE OR FALSE: The patellar reflex is an example of a monosynaptic reflex

A

True

103
Q

TRUE OR FALSE: Jendrassik Maneuver should be performed by the patient during DTR assessment

A

False

104
Q

TRUE OR FALSE: The Golgi Tendon Organ is purely inhibitory

A

True

105
Q

TRUE OR FALSE: The presence of palmomental reflex in adults is always a red flag

A

False

106
Q

TRUE OR FALSE: The central portion of the muscle spindle can contract and be stimulated by stretch

A

False

107
Q

TRUE OR FALSE: Dynamic Stretch Reflex is stimulated by rapid stretch or unstretch

A

True

108
Q

TRUE OR FALSE: Hacking of the patellar tendon is an example of autogenic inhibition

A

False

109
Q

Which of the following can result to increase jump height (based from your knowledge of stretch reflex)?

A. Immediately jumping without bending the hips and knee
B. Squatting for 10 secs then jump
C. Quick bending the hip and knee prior to jumping
D. All of the above
E. None of the above

A

C. Quick bending the hip and knee prior to jumping

110
Q

Isometric contraction of the hamstring for 6 seconds following by stretch for 30 seconds will result in an increased hip flexion ROM due to _____.

A. Autogenic Inhibition
B. Reciprocal Inhibition

A

A. Autogenic Inhibition