Ministry of education and science of ukraine sumy State University medical institute department of Physiology and Pathophysiology icon

Ministry of education and science of ukraine sumy State University medical institute department of Physiology and Pathophysiology




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Practical work #1 “Research of clinically important reflexes."


Materials and equipments: neurological hammers.


Procedure:

In this exercise, a number of reflex arcs will be tested that are initiated by distinctive stretch receptors within muscles. These receptors, called muscle spindles, are embedded within the connective tissue of the muscle and consist of specialized thin muscle fibers (intrafusal fibers) that are innervated by sensory neurons. The intrafusal fibers are arranged in parallel with the normal muscle cells (extrafusal fibers), so that stretch of the muscle also places tension on the intrafusal fibers. Located within the spindles, the intrafusal fibers respond to the tension by causing the stimulation (depolarization) of the sensory neuron. The sensory neuron arising from the intrafusal fiber synapses with the motor neuron in the spinal cord that, in turn, innervates the extrafusal fibers. The resultant contraction of the extrafusal fibers of the muscle releases tension on the intrafusal fibers and decreases stimulation of the stretch receptors. In a typical clinical examination, this reflex is elicited by striking the muscle tendon with a rubber mallet, creating a momentary stretch. When the extrafusal muscle fibers contract during the stretch reflex, they produce a short, rapid movement of the limb (the jerk). This is very obvious for the kneejerk reflex, but can be quite subtle for the biceps- and triceps-jerk reflexes. Use of the flexicomp allows the limb movement to be seen as a tracing on the computer screen.



  1. Procedure for knee-jerk reflex – tests femoral nerve



1. Allow the subject to sit comfortably with his or her legs

free.

2. Strike the ligament portion of the patellar tendon just below

the patella (kneecap), and observe the resulting contraction

of the quadriceps muscles and extension of the lower leg.



  1. Procedure for ankle-jerk reflex – tests medial popliteal nerve



  1. Have the subject kneel on a chair with his or her back to

you, and with feet (shoes and socks off) projecting over

the edge.

2. Strike the Achilles (calcaneal) tendon at the level of the

ankle and observe the resulting plantar extension of the

foot.



  1. Procedure for biceps-jerk reflex – tests musculocutaneous nerve

1. With the subject’s arm relaxed but fully extended on the

desk, gently press his or her biceps tendon in the

antecubital fossa with your thumb or forefinger and strike

this finger with the mallet.


2. If this procedure is performed correctly, the biceps

muscle will twitch but usually will not contract

strongly enough to produce arm movement.


  1. Procedure for triceps-jerk reflex – tests radial nerve

  1. Have the subject lie on his or her back with the elbow

bent, so that the arm lies loosely across the abdomen.



  1. Strike the triceps tendon about 2 inches above the

elbow. If there is no response, repeat this procedure,

striking to either side of the original point.


  1. If this procedure is correctly performed, the triceps

muscle will twitch but usually will not contract strongly enough to produce arm movement.



  1. ^ A cutaneous reflex: the plantar reflex and Babinski’s sign


The plantar reflex is elicited by cutaneous (skin) receptors of the foot and is one of the most important neurological tests. In normal individuals, proper stimulation of these receptors located in the sole of the foot results in the flexion (downward movement) of the great toe, while the other toes flex and come together. The normal plantar reflex requires the uninterrupted conduction of nerve impulses along the pyramidal motor tracts, which descend directly from the cerebral cortex to motor neurons lower in the spinal cord. Damage anywhere along the pyramidal motor tracts produces a Babinski reflex, or Babinski’s sign, to this stimulation, in which the great toe extends (moves upward) and the other toes fan laterally. Infants exhibit Babinski’s sign normally because neural control is not yet fully developed.


1. Have the subject lie on his or her back with knees

slightly bent, and with the thigh rotated so that

the lateral (outer) side of the foot is resting on the floor

2. Applying firm (but not painful) pressure, draw the tip blunt probe along the lateral border of the sole, starting the heel and ending at the base of the big toe.

Observe the response of the toes to this procedure.

Results: drawn the reflex arcs investigated reflexes, sign of their components.





Knee-jerk reflex Ankle-jerk reflex





Biceps-jerk reflex Triceps-jerk reflex




Plantar reflex Babinski reflex


Conclusion: What are the receptors, and why arises tendinous reflexes?

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Teacher’s signature ___________________

^ Work for the independent exercise:


1. What changes characterized syndrome Brown-Sekar? What linked these changes?

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  1. What is the deferens between of spinal shock in frogs and monkeys? What is the evidence?

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3. Draw the diagram of gamma-efferent loop. Explain the mechanism of its function_____________________________

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4. The man wounded in the spinal cord segment II-IV lumbar segments. Which of spinal motor reflexes may disappear as a result of this defeat?

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5. In humans afflicted spinal cord in the area of I-II sacral segments. Which of spinal motor reflexes may disappear as a result of this defeat?

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PRACTICAL CLASS #9 Data_________________

^ THEME:"RESEARCH OF ROLE OF MIDDLE AND INTERMEDIATE BRAIN IS IN ADJUSTING OF MOTIVE AND VEGETATIVE FUNCTIONS. FUNCTIONS OF BARK OF LARGE HEMISPHERES"


Questions for discussion:

  1. Cerebellum and Its Functions.

  2. The decerebrate rigidity.

  3. Clinical Abnormalities of the Cerebellum

  4. Midbrain. and Its Functions.

  5. Vegetative Control Functions of the Thalamus

  6. Vegetative Control Functions of the Hypothalamus

  7. Basal Ganglia—Their Motor Functions. Functions of Specific Neurotransmitter Substances in the Basal Ganglial System. Clinical Syndromes Resulting from Damage to the Basal Ganglia

  8. Physiologic Anatomy of the Cerebral Cortex. Functions of Specific Cortical Areas

  9. Electroencephalography.


Literature:

Guyton, Arthur C. Textbook of medical physiology – Ch. 56,57,58.


Practical work #1 : "Study of functional asymmetry of bark large hemispheres."


Materials and equipment: centimetric tape, ruler, dynamometer.


Procedure:

  1. Evaluation of leading hand.

1. Detection of morphological asymmetry:
- measure the length of each omitted from hand shovels acromial appendix to the end of third phalanxes. Presenter is a hand that is longer from the other by more than 0.2 cm;

- measure the height of the nail bed thumbs (using a ruler). Leading hand is higher nail bed.

Length of the right hand____________,

length of the left hand _____________.

The height of the thumb nail bed of the right hand, ___________________,
The height of the thumb nail bed of the left hand ___________________.

2. Detecting functional asymmetries:
- plexus fingers brush. Considered a leading hand, the thumb which was on top;

  • crossing hands (outside of Napoleon). Considered a leading hand, wrist which will be on the other hand forearm above ;

  • applause. The leading hand makes drums movements (test has a high information value);

  • dynamometry. Leading arm measured muscle strength in the first place. In the leading arm strength more. Indicators of power in the hands of three-time measurement is more resistant to leading hand. The hand is leading if its strength exceeds 2 kg.;

  • test the accuracy of hand movement. Draw a circle on paper. Right handed man make movements by pencil anti-clockwise, left-handed - clockwise;

  • raising test subjects lying on the floor. Items are usually lifted from the floor leading hand;

When plexus fingers above the thumb was _______________ hands.
When crossing the hands on the forearm ___________ ___________ hands revealed brush hands.

During the applause of drums carries __________ hand movements.

The Power of muscles of the right hand __________,

The Power of muscles of the left hand __________.

Circle drawn for (against) clockwise.

Subjects lifted ___________ hand



  1. Evaluation of leading legs:
    - filling up foot to the other. Often the top is the leading foot;

  • step forward, step back. These actions leading leg performs first;

  • length measurement step. Measure the length 5 - 10 steps. Steps leading legs have more length.


When filling up foot to the other, top is ___________ leg.
The first step performs ___________ leg.
Average length of the right steps ___________,
Average length of the left steps ___________


  1. Evaluation of leading the eye:
    - test "nictation" eye. Proposed blink one eye. Of course, close non-leading eye;

  • Rozenbah test. Target set in the fixing eye pencil hand drawn and then alternately close one, the second eye. Leading the eye is that, when you close the pencil is "shifted" in his direction. If the pencil "moves" when you close both eyes, the presenter is that when you close the pencil which moves to larger distances;

  • consideration in telescopes. Used as a rule, driving the eye;


When nictation __________ closed eye.

When you close the right eye pencil moves on ________ cm
When closing the left eye pencil moves on ________ cm
In consideration of items used in telescopes _________eye


  1. ^ Evaluation of leading ear:
    - test "whisper". Experimenter reads the words in a whisper. Target returns driving ear toward speaking;

- test "phone conversation”. Often this is used for driving the ear;

- test "ticking clock". Examiner offered to assess the volume ticking clock. Clock is applied primarily to lead the ear.


As a side conversation returns __________ ear.
For telephone calls using ___________ ear.
Clock ticking estimated ___________ ear.



  1. ^ Rating touch:

- Recognition test numbers painted on the back surface of the wrist (from 0 to 9 - Foster Test). Rather, perfect recognize the numbers drawn at the leading hand;

- test guessing coins (1, 2, 5, 10 cents). Shorter response time and perfect in the leading hand;

- test of ability to carry tactile information in the visual field. Examiner offered to draw figures from memory, which enjoyed without visual control, right and left hands (no instructions). A perfect and shorter time to leading the side.


Faster and perfect recognized figures drawn on __________ hand.
Specifically guessed coins by __________ hand.
More precisely drawn figures by __________ hand .


Results: The majority of samples to determine a leading hand, leading foot, driving the eye, ear, driving, leading the side.


1. Evaluation of leading hand:


Leading hand is __________________.


2. Evaluation of leading legs.


Leading leg is ____________________


3. Evaluation of the leading eye.


Leading eye is ____________________


4. Evaluation of the leading ear.


Leading ear is ____________________


5. Rating touch.

Leading hand is ____________________


Conclusion: To conclude the existence of distinct functional asymmetry (all samples or right or left), the absence of functional asymmetry - ambidexterity (equality tests left and right), the existence of functional asymmetry of the elements ambidexterity (most of the samples for one side, but not all ). Make a general conclusion about the leading hemisphere.

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Teacher’s signature ___________________


^ Work for the independent exercise:

1. A person experiencing asthenia, muscle dystonia and imbalance. Which department CNS is infected? How else can identify the symptoms of the patient, if this assumption is correct?


_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


2. In humans, there hypokinesia and tremor alone. On the destruction of which is evidenced by the CNS? What other symptoms can be detected in the patient, if this assumption is correct?

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3. Where localized pathological process if the patient in the presence of vision and hearing no turning head and eyes toward the source of sound and light?

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4. At what level of CNS located centers that provide support to anti gravitational body posture in mammals? Which thing you can confirm?

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5. Patients with cerebral blood flow violated the act of swallowing. Which department of the brain is infected?

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6. What is nistahm? Where is the nerve center of this reflex?

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PRACTICAL CLASS #10 Data:_______________


^ THEME10: "INVESTIGATION OF THE MECHANISMS OF NERVOUS REGULATION OF AUTONOMIC FUNCTIONS.”


Questions for discussion:

  1. Features of the autonomic nervous system.

  2. Reflex arc of vegetative reflex.

  3. Physiologic Anatomy of the Metasympathetic Nervous System.

  4. Physiologic Anatomy of the Parasympathetic Nervous System.

  5. Physiologic Anatomy of the Sympathetic Nervous System.

  6. Neurotransmitters and Receptors of the Autonomic Nervous System

  7. Basic Characteristics of Sympathetic Function

  8. Basic Characteristics of Parasympathetic Function

  9. Function of the Adrenal Medullae. Sympatho-adrenal system.

  10. Dual Innervation.

  11. Autonomic Reflexes. “Alarm” or “Stress” Response of the Sympathetic Nervous System


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