Physiologic Classification Of Nerve

Fibers
1. General Classification Of Nerve Fibers

• The fibers are divided in to types A and C fibers, and

the type A fibers are further subdivided in to alpha
,beta , gamma and sigma fibers.
• Type A fibers are the typical large and medium sized
myelinated fibers of spinal nerves, that transmit
impulses at velocities as great as 120 m/sec.
• Type C fibers are the small unmyelinated nerve
fibers, that transmit impulses as slowly as 0.5 m/sec.
2. Alternative Classification
• Group Ia : Fibers from the annulospiral endings of
muscle spindles (average about 17 microns in
diameter).
• Group Ib : Fibers from the Golgi tendon organ
(average about 16 microns in diameter).
• Group II : Fibers from most discrete cutaneous
tactile receptors (average about 8 microns in
diameter).
• Group III : Fibers carrying temperature, crude, touch,
and pricking pain sensations (average about 3
microns in diameter).
• Group IV : Unmyelinated fibers carrying pain, itch,
temperature, and crude touch sensations (0.5 to 2
microns in diameter).
 Effect of Local Anaesthesia on
Afferent Nerve Fiber Impulses

The local anaesthetic agent prevents the

increase in sodium permeability of the nerve
membrane.
In a normal afferent nerve-fiber an effective
stimulus will cause depolarization and give rise
to an impulse.
When the axonal limiting membrane has been
stabilized by a local anaesthetic agent
depolarization is prevented and no impulse is
Pain
• Pain is a protective mechanism.

Types of Pain and Their Qualities

1- Fast pain:
• Is felt with in about 1 second after a pain stimulus is
applied.
2- Slow pain :
• Begins only after 1 second or more and there
increases slowly over many seconds and sometimes
even minutes.
 Pain Receptors and Their Stimulation
• Pain receptors are free nerve endings.
• The pain receptors in the skin and other tissues are
all free nerve endings. They are wide spread in the
superficial layers of the skin as well as in certain
internal tissues such as periosteum, the arterial walls,
the joint surfaces and the flax and tentorium in the
cranial vault.
Pain Stimuli :
Pain can be elicited by multiple types of stimuli. They
classified as mechanical, thermal, and chemical pain
stimuli.
• In general , fast pain is elicited by the mechanical and
thermal types of stimuli, whereas slow pain can be
elicited by all three types .

• Some of the chemicals that excite the chemical type of

pain are bradykinin, serotonin, histamin, potassium
ions, acids, and proteolytic enzymes.

• The chemical substances are especially important in

stimulating the slow, suffering type of pain that ocurrs
after tissue injury.
Pain Theory
Gate Control Theory

• The passage of afferent pain impulses is either

inhibited or facilitated in the gelatinosa of the
spinal cord or the caudal nucleus of the
trigeminal nerve.
• Cells transmitting via the anterior and/or lateral
spinothalamic tracts must be activated.
• The Gate Control Theory postulates that an
intermediary cell acts as a ‘gate’ to each
transmitting cell and normally inhibits its
activity.
 Gate control theory
• The gate control theory of pain, is the idea that
the perception of physical pain is not a direct
result of activation of nociceptors, but instead is
modulated by interaction between different
neurons, both pain-transmitting and non-pain-
transmitting. The theory asserts that activation of
nerves that do not transmit pain signals can
interfere with signals from pain fibers and inhibit
an individual's perception of pain.
 Contd

• Gate control theory asserts that activation of nerves which do not transmit
pain signals, called nonnociceptive fibers, can interfere with signals from
pain fibers, thereby inhibiting pain. Afferent pain-receptive nerves, those that
bring signals to the brain, comprise at least two kinds of fibers - a fast,
relatively thick, myelinated "Aδ" fiber that carries messages quickly with
intense pain, and a small, unmyelinated, slow "C" fiber that carries the
longer-term throbbing and chronic pain. Large-diameter Aβ fibers are
nonnociceptive (do not transmit pain stimuli) and inhibit the effects of firing
by Aδ and C fibers.
• The peripheral nervous system has centers at which pain stimuli can be
regulated. Some areas in the dorsal horn of the spinal cord that are involved
in receiving pain stimuli from Aδ and C fibers, called laminae, also receive
input from Aβ fibers.[3] The nonnociceptive fibers indirectly inhibit the effects
of the pain fibers, 'closing a gate' to the transmission of their stimuli.[3] In
other parts of the laminae, pain fibers also inhibit the effects of
nonnociceptive fibers, 'opening the gate'.[3]
• An inhibitory connection may exist with Aβ and C fibers, which may form a
synapse on the same projection neuron
•The A and B fibers tranismit impulses
conveying common sensation and are
inhibitory, whilst the C fibers transmit
impulses concerned with pain and diminish
the inhibitory effect of the inter mediary
cell.

•It is suggested that the activity of the

intermediary cell is governed by the
balance between the afferent impulses
carried in the axons of the rapidly
conducting thick myelinated A and B fibers
and the more slowly conducting thin non-
myelinated C fibers.
Pathways for Transmission of Pain
Impulses in Orofacial Region

• Impulses originating in the nerve-endings of the dental pulp &

the supporting structures of the teeth are conveyed to the CNS
by the second(maxillary) & the third (mandibular) divisions of
the TRIGEMINAL nerve.
• From cell bodies in the Gasserian ganglion , these neural
pathways pass to the sensory nucleus of the V nerve which is
situated in the medulla oblangata & extends to the level of the
second cervical segment of the spinal cord.
• Then they pass via the trigeminal lemniscus to the postero
-ventral nucleus of the thalamus &then via connecting neurons
to the brain.
• Interruption of these neural pathways at any level may abolish
the sensation of pain.