Maxillomandibulocardiac reflex in a dog

Background

The trigeminocardiac reflex (TCR) is a brainstem reflex that may be observed in anaesthesia during surgical procedures stimulating the intracranial or peripheral portion of the trigeminal nerve. The peripheral TCR is divided into the oculocardiac reflex and the maxillomandibulocardiac reflex based on the affected sensory branches of the trigeminal nerve. In veterinary medicine the oculocardiac reflex has been described, however the maxillomandibulocardiac reflex has never been reported.

Case presentation

A 5-year-old male Epagneul Breton was presented for surgical management of an upper lip mass. During surgery, a sudden severe bradycardia and a decrease in systemic arterial blood pressure developed. The occurrence of a maxillomandibulocardiac reflex was suspected on the basis of the temporary link between surgical stimulation and haemodynamic changes. Three doses of atropine were given before starting a dopamine infusion due to lack of response. The dopamine infusion normalized heart rhythm and blood pressure. The dog recovered uneventfully and he was discharged 24 h later with a sinus rhythm and no sign of recurrence of arrhythmias.

Conclusion

The TCR is a rare but potentially life-threatening complication of procedures involving the sensory areas innervated by the three branches of the trigeminal nerve and it may cause bradycardia with hypotension. The use of a β1-adrenergic receptor agonist such as dopamine may be indicated in cases of a refractory response to the conventional treatment with atropine.

     

Input-output relation in a flexor reflex

Observations have been made upon a typical flexor reflex with the aim of disclosing the changes in amount, latency, and temporal configuration of reflex discharge that take place as afferent input is varied from zero to maximal for the band of cutaneous myelinated afferent fibers that extends upward from approximately 6 µ in diameter (group II fibers). Reflex threshold is reached at 6 to 12 per cent maximal afferent input. From threshold to maximal input the relation between input and amount of output is essentially linear, latency on the average decreases, the shorter central paths in general gain preference, but the known minimum pathway, one of three neurons, does not transmit unless aided by convergent activity. Flexor reflex discharge may occur in several bursts suggesting the existence of closed chain connections in the internuncial pools of the spinal cord. At any given input there is, in successively elicited reflexes, little correlation between latency and amount of discharge, at first sight a surprising result for each variable can be taken as a measure of excitability status of the motoneuron population. However, latency of discharge indicates excitability at the beginning of the reflex event whereas amount of discharge is an expression of excitability over the entire period of discharge. Given a constantly and rapidly fluctuating excitability absence of correlation between these variables would be an anticipated result.     

Straining urethral reflex: description of a reflex and its clinical significance. Preliminary report

The present communication describes a reflex, which I call 'straining urethral reflex', and discusses its clinical significance. The study was performed on 17 healthy volunteers with a mean age of 39.6 years. The intrarectal pressure (representative of the intra-abdominal pressure) was measured by means of a balloon-tipped catheter introduced into the rectum and connected to a pressure transducer. A concentric needle electrode was introduced into the external urethral sphincter. The subject was asked to strain, and the urethral sphincter electromyographic activity and the intrarectal pressure were recorded. Two types of straining were investigated: sudden and slow. The procedure was repeated in 10 subjects after urethral sphincter infiltration with xylocaine or saline. On sudden straining, the external urethral sphincter contracted. The anesthetized sphincter did not respond, while the saline-infiltrated sphincter responded to sudden straining. Slow sustained straining did not evoke the reflex response. The latency of the reflex was calculated. The external urethral sphincter contraction on sudden straining guards against the involuntary opening of the vesical neck and urinary leak under stress conditions of a sudden increase in the intra-abdominal pressure. The reflex may prove significant in the diagnosis of micturition control disorders. It can thus be included as an investigative tool in urologic practice.     

The vegetative component of a conditioned reflex]

Defensive and alimentary conditioned reflexes were studied on normal cats and cats with neural isolation of the neocortex. The cardiac component of the conditioned reflexes is elaborated in decorticated animals at a similar rate and is as steady as in normal cats. Motor conditioned reactions in decorticated cats are difficult to elaborate. Both in normal and decorticated cats unconditioned pain stimulation evokes tachycardia, while a conditioned signal, paired with this unconditioned stimulus, produces bradicardia. Ban assumption has been made that the primary conditioned reaction consists in the appearance of a certain emotional state which changes the cardiac rhythm in a typical way.     

Baroreceptor influence on a spinal cardiovascular reflex

A stretch of the walls of the thoracic aorta, performed in vagotomized cats without obstructing aortic flow, induces increases in heart rate, myocardial contractility, and arterial pressure. These reflex responses are still present after high spinal section. Cats under chloralose-urethane anesthesia were vagotomized and one carotid sinus was isolated and perfused with arterial blood at constant flow. The contralateral carotid sinus nerve and both aortic nerves were sectioned. A stretch of the walls of the thoracic aorta between the 7th and 10th intercostal arteries induced a reflex increase in mean arterial pressure 29 +/- 2 mmHg (mean +/- SE). Stepwise increases of carotid sinus pressure (CSP) or electrical stimulation of the carotid sinus nerve induced stepwise decreases of this reflex response. At maximal baroreceptor stimulation (CSP 212 +/- 9 mmHg) the reflex response to aortic stretch was reduced by 42%. These experiments show that this spinal cardiovascular reflex is at least partially under the inhibitory control of the baroreceptor input.     

A matrix analysis for a conjugate vestibulo-ocular reflex

The technique of matrix analysis is used to compare the connectivity between vestibular neurons and oculomotor neurons of the two eyes that would generate a conjugate vestibulo-ocular reflex (VOR). The technique shows that the connectivity is normally anatomically symmetric. The technique is also used to determine the types and loci of adaptation within the VOR that will maintain conjugacy. Adaptation is divided into1) that evoked by changes in visual feedback, which requires VOR or system-specific changes and2) that produced by changes in the canals or muscles, which requires deficit-specific adaptation. In the former case, the adaptation could best be achieved by an additive alteration of the vestibularmotoneuron projections. In the latter case, the appropriate adaptations would be serial, multiplicative changes, applied at the level of the vestibular neurons when the canals are at fault or at the level of the motoneurons of the eye whose muscles are impaired. The analysis thus suggests multiple loci of plasticity within the VOR, specialized for adapting to different deficits.