1. Where does the impulse of the plantar reflex go that is different from a muscle...

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Medical Sciences

1. Where does the impulse of the plantar reflex go that isdifferent from a muscle stretch reflex?( hint: tell me where theintegrating centers for each is located)
2. What is the difference between a monosynaptic reflex and apolysynaptic reflex? Which one is faster?
3.Describle the Jendrassick's Maneuver. How does it work?
4. What are the two types of hearing loss and how can they beidentified?
5. What is nystagmus? Why does it occur after the subject stopsspinning?
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1The PR is elicited by stroking the lateral or outer border of the sole of the foot with the thumb nail or a blunt point like the end of the handle of the reflex hammer or the tip of a key The stimulus is directed from the heel forwards towards the little toe and on reaching the foot pad directed transversely across the metatarsal pad from the little to the base of the great toe The stimulus should stop short of the base of the toes because extending the stroke to the base of the toes produces unpredictable movements Before eliciting the reflex the patient should be instructed to relax and let his limb remain as floppy as possible The Professor Department of Neurology G B Pant Hospital New Delhi 110 002 Introduction The plantar reflex PR is one of the most important and well studied reflex in the body and yet its elicitation and interpretation remains an art It is basically a polysynaptic superficial reflex designed to withdraw the stimulated part ie the foot from a potentially dangerous stimulus Anatomical considerations The reflex arc for the PR comprises of the afferent and efferent fibres in the tibial nerve and the L45 to S12 cord segments The reflexogenic area is the first sacral dermatome with the receptor nerve endings being located in the skin on the sole of the foot The afferent fibres travel in the tibial nerve which is a branch of the sciatic nerve to relay in the L45 to S12 cord segments The efferent fibres from the spinal cord travel back in the sciatic nerve which divides into two large branches just proximal to the knee Fibres supplying the toe flexors travel in the tibial nerve while those supplying the toe extensors travel in the peroneal nerve to reach the foot Injury or transection of the tibial nerve therefore would interrupt the afferent and efferent arcs of the normal plantar response leaving the toe extensor muscles innervated Interruption of the reflex arc can cause a diminution or absence of the reflex Supraspinal influences from the cortex also influence and modify the spinal reflex or response Impulse from the lumbosacral cord segments ascend up through the spinal cord and the brainstem to the parietal areas of the brain which in turn has connections with the motor centres of the cortex Efferent impulses from motor and premotor JIACM 2005 63 1937 194 Journal Indian Academy of Clinical Medicine Vol 6 No 3 JulySeptember 2005 leg should be positioned in such a way that the knee is straight or slightly flexed and the thigh externally rotated It is important to distract the patient with conversation after warning him that the sole of the foot will be scratched It is advisable to hold the See Answer

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