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Refleks

V. Sutarmo Setiadji

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A long distance pathway process

initiate by a stimulus or a change in the

environment as an information which isreceived by sense organ, integrates the

information, and uses the nervous

system, endocrine system, or both, toreact appropriately.

Definition of reflex

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Physiological Reflex:

- Somatic reflex the effector is skeletelmuscles

- Autonomic reflex the effectors are the

heart, smooth muscles, or glands

Pathological Reflex:

- Reflex which is arise in a pathologicalconditions

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Other classification of reflex:

- Ipsilateral- Contralateral

- Monosinaps

- Multisinaps

- Stretch reflex

- Withdrawal reflex

- Spinal Reflexes- Central reflexes

- Unconditioned reflex

- Conditioned reflex

- Segmental

- Intersegmental

- Walking reflex

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Ujung akson

Dendrit

Soma

Axon hillockAkson

Lempeng sinapsTakik Ranvier

Sel Schwann

Sel Saraf = Neuron

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The reflex arc

- It may contains only two neurons,the sensory (afferent) and motor

(efferent) neurons and has single

synapse (monosynaptic) and has nointerneuron

- Or contains more than two neurons

and synapses (polysynaptic)

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Skin

Sensory receptor

Afferent fiber

Spinal cord

Efferent fiber

Muscle as an effector)

Centralnervoussystem

Reflex arc, the simplest neural circuit

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Kulit

Reseptor indra

Saraf aferen

Medula spinalis(sumsum tulang

belakang)

Saraf eferen

Otot (sebagai efektor)

Sistemsarafpusat

Upper motor neuron/

neuron dari pusat yang

lebih tinggi

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The sensory receptors it may a specialreceptor cells (rods and cones in eyes,

hair cells in cochlea and vestibular

apparatus, receptor cells in taste buds)or the end of sensory nerve fiber in

other senses with or without special

structures.

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There are four kinds of effector

: skeletal muscle,

: smooth muscle

: the heart

: glands

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Percobaan Pavlov:

- Pada anjing yang lambungnya dilubangi untuk

dipasangi kateter.

- Setiap kali mulutnya disuapi makanan, keluar

liur lambung melalui kateter. Begitu setiap kali.

- Setiap kali bel dibunyikan, meski berkali-kali,tidak keluar liur lambung.

- Tetapi bila bel dibunyikan setiap kali sebelum

mulutnya disuapi makanan pada selang waktuyang pendek, lama-lama bunyi bel sendiri dpt

menimbulkan sekresi liur lambung.

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Percobaan Pavlov membuktikan bahwa:

- Antara reseptor dan kelenjar liur lambung

terdapat lengkung refleks yang telah berfungsisebelum percobaan dimulai.

- Antara reseptor pendengaran di telinga dan

kelenjar liur lambung secara anatomi telahdihubungkan oleh lengkung refleks, tetapi

mula-mula lengkung refleks belum berfungsi.

- Setelah menjalani latihan beberapa kali,

lengkung refleks yang belum berfungsi dapat

menjadi berfungsi.

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Percobaan Pavlov diakui sebagai

dasar- dasar proses belajar

Refleks terkondisi (terbentuk karena

latihan)

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Reflex Neural Stimulus and response

segment

Deep tendon

Achilles S1 Plantar flexion upon striking the tendon (normal)

Biceps C5, C6 Elbow flexion upon striking the tendon (normal)

Brachioradialis C5, C6 Radial deviation upon striking the tendon (normal)

Jaw Cranial V, Mouth closes upon striking anterior chin

(normal)Exaggerated (UMNL)different with Chvosteks

sign

Medial hamstring L5, S1 Knee flexion upon striking the semimembranosis tendon

(normal)

Lateral hamstring S1, S2 Knee flexion upon striking the biceps femoris tendon (normal)

Patellar L2,L3,L4Knee extension upon striking the infrapatellartendon (normal)

Tibialis posterior L4, L5 Plantar flexion and inversion upon striking the tibialis

posterior just behind the medial malleolus (normal)

Triceps C7 Elbow extension upon striking the triceps tendon (normal)

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SuperficialAbdominal

Upper T7-T10 Movement of the umbilicus toward the

Lower T10-L1 area being stroked (normal); if

unilateral, pinpointing the involved

quadrant indicates the approximate

level of lesion

Anal S2-S4 Anal sphincter contracts with touching or stroking

the perianal skin (normal)

Cremasteric T12, L1, L2 Scrotum contracts and testicle retracts with stroking

the skin on the anterior, inner thigh (normal);

unilateral absence indicates LMNL injury at L1, L2;

bilateral absence indicates UMNL

Gluteal L4, L5S1-S3 Gluteal muscles contract with stroking the overlyingskin (normal).

Lumbar T12-L5 Back extensor muscles contract with stroking the

skin overlying the erector spinae muscles (normal)

Plantar S1, S2 Toes flex with lightly stroking the plantar surface of the foot (normal)

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Clonus UMNL Antagonist and agonist muscle groups rapidly

alternate involuntary contraction and relaxation with

a sudden, forced stretch of a muscle (pathological);

usually performed at the wrist (extension), ankle

(dorsiflexion), or knee (downward force on the

patella to stretch the quadriceps)

Babinski UMNL(Pyramidal Tract) Great toes extend andother toes splay (extend and abduct) with stroking

the lateral plantar surface and across the sole foot

(pathological)

Chaddock Great toes extend and other toes splay with strokingthe side of the foot distal to the lateral malleolus

(pathological)

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Gordon Great toes extend and other toes splay with

compressing or squeezing the calf muscle

(pathological)

Oppenheim Great toes extend and other toes splay with stroking

downward on the anteriomedial tibial surface(pathological)

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Gamma Motor Neuron

Motor neurons which activate the contractile regions of

intrafusal muscle fibers, thus adjusting the sensitivity

of the muscle spindles to stretch. Gamma motor

neurons may be "static" or "dynamic" according to

which aspect of responsiveness (or which fiber types)

they regulate. The alpha and gamma motor neurons are

often activated together (alpha gamma coactivation)

which allows the spindles to contribute to the control

of movement trajectories despite changes in musclelength.

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Gamma motoneurons (-motoneurons), also calledgamma motor neurons, are a component of the fusimotor

system, the system by which the central nervous system

controls muscle spindle sensitivity. The fusimotor system

refers to the combination ofmuscle spindlesand -motoneurons. The function of the muscle spindle is to

provide proprioceptive feedback for the movement, position

and extension ofmuscles.

-Motoneurons are located in the brainstem and spinal cord

and are smaller than their-motoneuron counterparts, whichare responsible for controlling skeletal muscle.

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http://en.wikipedia.org/w/index.php?title=Fusimotor_system&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Fusimotor_system&action=edit&redlink=1http://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Proprioceptivehttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Brainstemhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/%CE%91-motoneuronhttp://en.wikipedia.org/wiki/%CE%91-motoneuronhttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/%CE%91-motoneuronhttp://en.wikipedia.org/wiki/%CE%91-motoneuronhttp://en.wikipedia.org/wiki/%CE%91-motoneuronhttp://en.wikipedia.org/wiki/Spinal_cordhttp://en.wikipedia.org/wiki/Brainstemhttp://en.wikipedia.org/wiki/Musclehttp://en.wikipedia.org/wiki/Proprioceptivehttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Muscle_spindlehttp://en.wikipedia.org/wiki/Central_nervous_systemhttp://en.wikipedia.org/w/index.php?title=Fusimotor_system&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Fusimotor_system&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=Fusimotor_system&action=edit&redlink=1


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Function

-Motoneurons regulate the gain of the stretch reflex by

adjusting the level oftension in the intrafusal muscle

fibers of the muscle spindle. This mechanism sets the

baseline level of activity in -motoneurons and helps to

regulate muscle length and tone. For example,stimulation of a -Motoneuron from higher centers

contracts the ends of the intrafusal fibres and

consequently stretches the middle part of the muscle

(where 1a sensory neurons are located). Theseafferent neurons are therefore innervated and go on to

synapse with alpha-motoneurons.

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http://en.wikipedia.org/wiki/Stretch_reflexhttp://en.wikipedia.org/wiki/Tensionhttp://en.wikipedia.org/wiki/Intrafusal_muscle_fiberhttp://en.wikipedia.org/wiki/Intrafusal_muscle_fiberhttp://en.wikipedia.org/w/index.php?title=1a_sensory_neuron&action=edit&redlink=1http://en.wikipedia.org/w/index.php?title=1a_sensory_neuron&action=edit&redlink=1http://en.wikipedia.org/wiki/Intrafusal_muscle_fiberhttp://en.wikipedia.org/wiki/Intrafusal_muscle_fiberhttp://en.wikipedia.org/wiki/Tensionhttp://en.wikipedia.org/wiki/Stretch_reflex


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Jendrassik's maneuver

Ern Jendrassik, Hungarian physician, 1858

1921] A method used to facilitate elicitation ofthe deep tendon reflexes of the lower

extremities. The patient hooks together the

fingers of the hands and attempts to pull them

apart. While this pressure is maintained, the

patellar or Achilles tendon reflex is tested.

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Sistem Saraf Motorik Somatik

Sistem Saraf Motorik Autonom

Ganglion

Paravertebral / IntramuralTrunkus Simpatikus

Fungsinya dipengaruhi oleh kemauan

Fungsinya automatis/tidak dapat dikendalikan kemauan

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Asetlkolin

Sistem Saraf Motorik SomatikOtot Rangka

Alat Dalam

Asetilkolin Noradrenalin

Asetilkolin

Asetilkolin

Sistem Saraf Motorik Autonom Simpatik

Sistem Saraf Motorik Autonom Parasimpatik

Neurotransmiter

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Pupillary fibers follow the optic tract (posterior third of the optic tract) and separate from the optic tract just anterior to the lateral geniculate body They then enter the midbr) Pupillary fibers follow the optic tract (posterior third of the optic tract) and separate from the optic tract just anterior to the lateral geniculate body They then enter the mid


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Pupillary fibers follow the optic tract (posterior third of the optic tract) and separate from the optic tract just anterior to the lateral geniculate body. They then enter the midbr) Pupillary fibers follow the optic tract (posterior third of the optic tract) and separate from the optic tract just anterior to the lateral geniculate body. They then enter the mid

Pupillary fibers follow the optic tract

(posterior third of the optic tract) and

separate from the optic tract just anteriorto the lateral geniculate body. They then

enter the midbrain, where they synapse

to pretectal nucleus. The pupillary fibers

leave the pretectal nucleus and distributes

approximately equally to both Edinger-

Westphal nuclei. This tract is called the

tectotegmental tract.

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Thus, the optic tract

carries pupillary fibers from both eyes,

and the tectotegmental tract carriespupillary fibers from both pretectal nuclei.

From these pupillary fiber arrangements,

both pupils constrict in the consensuallight reflex.

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Refleks pupil

Miosis: menyempitnya pupil bila intensitas

cahaya meningkat. Retina N.II Tract. Opt

CGL midbrain pretectal area

Interneuron Nucl.EW (badan

sel saraf praganglion) ganglionnya

terdapat di organ yang dipersarafi

mata m. sfingter pupil (circular

pupillary muscle) kontraksi.

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Midriasis: melebarnya pupil bila intensitas

cahaya menurun

Retina N.II Tract. OptCGL pretectal area

Interneuron posterolateral

portion of the hypothalamustrunkus simpatikus (ggl.servikalis

II) m.pupilaris radialis kontraksi.

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Nerve Injuryand

Regeneration

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Causes of Nerve Injury

- Physical injury (Trauma)

- Ischemia/hypoxia (vasoconstriction/

hemorrhagic)- Infection/autoimmune

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