fiber, including the myelin sheath, distal to the lesion.
This process iscalled
It takes some days to extend throughout the distal part of the nerve so thatfor perhaps 3 or 4 days or more the distal section of the nerve remainsexcitable and can conduct impulses.
The fibrous framework of the bundle of nerve fibres remains intact and fillswith a chain of Schwann cells so that ultimately nerve are guided in theirproper channels to reform the complete nerve processes.
This kind of injury is called an
The length of time needed for full recovery to occur will depend on the siteof the lesion and the length of nerve that has to grow.
An example of this type of lesion may be observed in a radial nerve palsyassociated with fractured shaft of the humerus.
Neurotmesis (Third-degree Injury):
If, instead of compression, the injury is such as to disrupt all tissues of the nerve fiber – such as a cut through the nerve – then the distal segment will degenerate completely.
Since the tissues are totally disrupted the axon filaments will not readilyfind correct channels down which to regrow so that recovery is at bestimperfect.
This lesion is called a
Such lesions often require surgery to ensure that the two cut ends aresufficiently approximated to allow successful growth.
A lesion of this type would be observed if ulnar nerve were severed by acut on the front of the wrist.
All these types of nerve lesion may be partial or complete, and there may bea combination of two of them.
If all the nerve fibres supplying a muscle degenerate, the reactionscharacterizing
are observed, while if only some of thefibres degenerate the reaction is that of
The reactions observed in lesions of the anterior horn cells depend on theextent of the damage.
Defects of the Neuromuscular Junction (NMJ):
Occasionally, as in the disease
, reduction of voluntarypower is due to faulty conduction at the neuromuscular junction.
Methods other than electrical stimulation provide the most satisfactory aids todiagnosis of such conditions.