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Nerve Conduction Neurobiomechanics
Nerve Conduction Neurobiomechanics
on Nerve Conduction
Daniel Robbins
Overview
This presentation is intended to bring together a fuller understanding
on nerve conduction and the mechanics that support and influence
conduction.
It is not intended to be an introduction to nerve conduction, or to
replace text book based learning. I aim to summarise the concepts
and illustrate areas that I found confusing whilst learning. Hopefully
this will aid the learning of others and create some areas for further
thought.
Initially I will provide a review of the principles of nerve conduction,
how the structure of nerves help control conduction and the areas
that I found difficult. Next I will cover how mechanical stresses affect
nerve conduction, how we measure stresses in nerves and how the
structure of nerves deals with these stresses.
Principles of Conduction
Quantifying Conduction
Conduction/membrane physiology
Action Potential:
a) Resting membrane potential (RMP) at
-70mV. Na+ on outside and K+ on inside
of cell
b) As depolarisation reaches threshold of
-55mV, the action potential is triggered.
Na+ rushes into cell. Membrane potential
reaches +30mV on action potential
c) Propagation of the action potential
Molecular Channels
The transfer of sodium and potassium molecules during nerve conduction
occurs via ion channels. The image below explains how these function.
Sodium/Potassium Pump
In addition to ion channels, molecule transfer occurs via sodium/potassium pumps
which work in the following manner.
Three sodium ions from inside the
cell first bind to the transport protein.
Then a phosphate group is
transferred from ATP to the transport
protein causing it to change shape
and release the sodium ions outside
the cell.
Two potassium ions from outside the
cell then bind to the transport protein
and as the phosphate is removed,
the protein assumes its original
shape and releases the potassium
ions inside the cell.
Confusion???
At this point I always struggled to picture everything in its
entirety.
If Molecule transfers provided electrochemical gradients which
created the action potentials what constrained them?
Intracellular fluids/contents where controlled by membrane
physiology but what happens outside of the cell? What controls
extracellular fluids?
After long, and fairly painful, research I found one article (Nakao
et al.1997) which seems to answer the question (at least in
rabbit facial nerves anyway). It seems that in addition to
intracellular pathways (axoplasmic transport systems), there are
also extracellular pathways. To illustrate this we have to go back
to nerve structure.
Nakao Y. Tabuchi T.Sakihama N.; Nakajima S. (1997) Extracellular fluid pathway inside the facial nerve fascicles The
Annals of otology, rhinology & laryngology 1997, vol. 106, no6, pp. 503-505
Axons
Endoneurium (Endo = inner)
Intracellular fluid (Intra = inside)
Perineurium (Peri = around)
Extracellular fluid 1 (Extra = outside)
Intrafascicular epineurium (Epi = upon)
Extrafascicular epineurium
Extracellular fluid 2
Conduction Summary
Neurobiomechanics
At the most basic level tissue stresses can be
divided into two areas : type and intensity.
Type is simply: tensile (pulling) or compressive
(pressing)
Intensity is simply: low, medium, high or
excessive.
Mueller and Maluf provided a good overview of the
effects of these stresses in their Tissue stress theory.
Stress/Activity Level
Low
Normal
High
No change
Max discharge
Excessive
Neuromuscular:
Max discharge
Axonal
rate
rate
Demyelination
Recruitment threshold
Recruitment
Activation during
MVC
threshold
Degeneration
activation during
MVC
motor unit synchronization
dendritic arborization
serotonergic neural activity
synaptic transmission
&
Mueller M, Maluf K. Tissue adaptation to physical stress: a proposed physical stress theory to guide physical
therapist practice, education, and research. Phys Ther. 2002;82:383 403.
Coppietersa,M.W, Butler, D.S. Do sliders slide and tensioners tension? An analysis of neurodynamic
techniques and considerations regarding their application. Manual Therapy 13 (2008) 213221
Load Cells
Load cells measure force via a direct attachment, much in the same way the a
fisherman will use a strain gauge to measure the weight of a caught fish.
The results of the above imposed stretch (displayed as relative strain) are
displayed on the next slide, the stretch was imposed for 60 minutes then
released. Continuous monitoring of nerve conduction was undertaken
simultaneously on both limbs to provide a baseline in addition to effects of
stretch on nerve conduction.
Wall E, Massie J, Kwan M, et al. Experimental stretch neuropathy: changes in nerve conduction under tension. J
Bone Joint Surg Br. 1992;74:126 129.
Stretch neurobiomechanics
Wall E, Massie J, Kwan M, et al. Experimental stretch neuropathy: changes in nerve conduction under tension. J
Bone Joint Surg Br. 1992;74:126 129.
Neurobiomechanics cont.
A similar study by Jou et al. displays the difference in somatosensory
evoked potentials (SSEPs ) when stretch is applied to the left limb only.
Jou I, Lai K, Shen C, Yamano Y. Changes in conduction, blood flow, histology, and neurological status following
acute nerve-stretch injury induced by femoral lengthening. J Orthop Res. 2000;18:149 155.
Structural defences
Nerve fibres are crimped which
helps to provide some defence
against stretch induced damage
Nerve Damage
Jou I, Lai K, Shen C, Yamano Y. Changes in conduction, blood flow, histology, and neurological status following
acute nerve-stretch injury induced by femoral lengthening. J Orthop Res. 2000;18:149 155.
Questions or feedback???