P. 1
Physio -Lab - Semi

Physio -Lab - Semi

|Views: 19|Likes:
Published by deeberto

More info:

Published by: deeberto on Aug 10, 2011
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as PPTX, PDF, TXT or read online from Scribd
See more
See less

10/01/2013

pdf

text

original

INTRODUCTION TO NEUROPHYSIOLOGY

ERWIN S. OCAMPO, PTRP

.

.

.

.

MENINGES .

Formation of CSF .

Peripheral Nervous System (PNS) The PNS is formed by the cranial and spinal nerves . 2. is enclosed in bone and wrapped in protective coverings (meninges) and fluidfilled spaces. CNS The CNS.General Plan of the Nervous System ANATOMICAL STRUCTURE 1. comprising the brain and spinal cord.

It controls the activities of the smooth muscles and glands of the internal organs (viscera) and the blood vessels and returns sensory information to the brain. 2. skin. Autonomic (Visceral) Nervous System (ANS) The ANS contains portions of the central and peripheral systems. and mucous membranes). .General Plan of the Nervous System PHYSIOLOGICAL STRUCTURE 1. Somatic Nervous System This innervates the structures of the body wall (muscles.

cognition). and the cerebellum . The most rostral part of the nervous system (cerebrum. or forebrain) is the most phylogenetically advanced and is responsible for the most complex functions (eg. . functions. The brain has a tiered structure . but essential. the brain stem. and spinal cord serve less advanced. medulla. the brain stem.Structural Units & Overall Organization The central portion of the nervous system consists of the brain and the elongated spinal cord. More caudally. can be subdivided into the cerebrum.

which are gray masses deep within the cerebral hemispheres. . the white matter consists of myelinated fibers and does not contain neuronal cell bodies or synapses . in a freshly sectioned brain. and the basal ganglia. it has a glistening appearance as a result of its high lipid-rich myelin content. sometimes called "gray matter"). ‡ white matter carries that name because.Structural Units & Overall Organization ‡ cerebrum (forebrain) consists of the telencephalon and the diencephalon. ‡ telencephalon includes the cerebral cortex (the most highly evolved part of the brain. subcortical white matter.

and medulla oblongata. contains a system of spaces called ventricles. The brain stem consists of the midbrain (mesencephalon). The brain. ‡ the spinal cord has a narrow central canal that is largely obliterated in adulthood. which is hollow.Structural Units & Overall Organization ‡ The major subdivisions of the diencephalon are the thalamus and hypothalamus. These spaces are filled with cerebrospinal fluid (CSF) . pons. ‡ cerebellum includes the vermis and two lateral lobes.

Structural Units & Overall Organization .

Functional Units .

are frequently grouped together into nuclei. or nerve cells. ‡ Nerve cells serving a common function. often with a common target. and connections that are grouped together outside the CNS are called ganglia. are specialized cells that receive and send signals to other cells through their extensions (nerve fibers. or axons). ‡ Nerve cells with common form. which accounts for about 2% of the body's weight. contains many billions (perhaps even a trillion) of neurons and glial cells. ‡ Other cellular elements that support the activity of the neurons are the glial cells . function.Functional Units ‡ Brain. ‡ neurons.

Functional Units .

Functional Units .

Neurons .

for example. a distance of less than 2 ft in infants or 4 ft or more in adults. reaching. are called interneurons. Nerve cells with long processes (eg. only from cell to cell in the cerebral cortex. ‡ Some neurons project from the cerebral cortex to the lower spinal cord. dorsal root ganglion cells) are larger than those with short processes. ‡ very short processes. .Neurons ‡ Motor neurons are usually larger than sensory neurons. with short axons that terminate locally. These small neurons.

The one axon of a neuron transmits impulses away from the cell body. and axon that carries the electrical nerve impulse. ‡ Dendrites are processes (extensions) that transmit impulses toward the cell body. . cell body. It is the cell membrane of the dendrites.Neurons ‡ cell body contains the nucleus and is essential for the continued life of the neuron.

‡ They have the layers called the myelin sheath. Without the myelin sheath. neurons would short-circuit. just as electrical wires would if they were not insulated.Neurons ‡ In the peripheral nervous system. myelin is a phospholipid that electrically insulates neurons from one another. axons and dendrites are wrapped in specialized cells called Schwann cells. .

the specialized cells found only in the brain and spinal cord. are called nodes of Ranvier. ‡ nuclei and cytoplasm of the Schwann cells are wrapped around the outside of the myelin sheath and are called the neurolemma.Neurons ‡ The spaces between adjacent Schwann cells. . These nodes are the parts of the neuron cell membrane that depolarize when an electrical impulse is transmitted. ‡ In the central nervous system. or segments of the myelin sheath. the myelin sheaths are formed by oligodendrocytes. one of the neuroglia (glial cells).

Types of Neuroglia .

And from the synaptic terminals to the cell body called (retrograde transport). This occurs via several types of axonal transport. new protein must be synthesized and moved to the axon. ‡ Because ribosomes are not present in the axon. Retrograde transport is similar to rapid anterograde transport. . Fast transport involves microtubules extending through the cytoplasm of the neuron.Axonal Transport ‡ axons transport materials from the cell body to the synaptic terminals (anterograde Transport). which differ in terms of the rate and the material transported. Anterograde transport may be fast (up to 400 mm/d) or slow (about 1 mm/d).

After injury to the axon. ± In general. crushed. .Axonal Transport ‡ axon can be injured by being cut or severed. or compressed. whereas those within the CNS do not tend to regenerate. axons within peripheral nerves can regenerate quickly after they are severed. or chromatolysis. the neuronal cell body responds by entering a phase called the axon reaction.

because the neurotransmitter causes the postsynaptic neuron to depolarize (become more negative outside as Na ions enter the cell) and transmit an electrical impulse to another neuron. A chemical inactivator cell body or dendrite of the postsynaptic neuron quickly inactivates the neurotransmitter. meaning that the neurotransmitter causes the postsynaptic neuron to hyperpolarize (become even more positive outside as K ions leave the cell or Cl ions enter the cell) and therefore not transmit an electrical impulse. ‡ ‡ ‡ . muscle cell. however.Synapse ‡ The small gap or space between the axon of one neuron and the dendrites or cell body of the next neuron is called the synapse. Some synapses. Within the synaptic knob (terminal end) of the presynaptic axon is a chemical neurotransmitter that is released into the synapse by the arrival of an electrical nerve impulse. Many synapses are termed excitatory. or gland. are inhibitory.

TYPES OF SYNAPSES IN THE CNS .

‡ ‡ ‡ . Groups of nerve cells are connected by pathways formed by bundles of axons. and interneurons.Neuronal Groupings & Connections ‡ ‡ ‡ ‡ Nerve cell bodies in the spinal cord. certain tracts are referred to as lemnisci. These networks are called the neuropil Within the brain. these compact groups of nerve cell bodies are called ganglia. which act as short relays within the nucleus. or funiculi . Aggregates of tracts in the spinal cord are referred to as columns. In the peripheral nervous system. there are no discrete bundles of axons. in others. axons are intermingled with dendrites and do not run in bundles so that pathways are difficult to identify. brain stem. In some pathways. the axon bundles are sufficiently defined to be identified as tracts. and cerebrum form compact groups. or fasciculi. In some regions of the brain. whose axons carry impulses to other parts of the nervous system. or nuclei Each nucleus contains projection neurons.

SYNAPSE .

TYPES OF NEURONS
‡ Neurons may be classified into three groups: sensory neurons, motor neurons, and interneurons. ‡ Sensory neurons (or afferent neurons) carry impulses from receptors to the central nervous system. ‡ Receptors detect external or internal changes and send the information to the CNS in the form of impulses by way of the afferent neurons. ‡ The central nervous system interprets these impulses as a sensation. ‡ Sensory neurons from receptors in skin, skeletal muscles, and joints are called somatic; those from receptors in internal organs are called visceral sensory neurons. ‡ Motor neurons (or efferent neurons) carry impulses from the central nervous system to effectors. ‡ two types of effectors are muscles and glands. ‡ Motor neurons linked to skeletal muscle are called somatic; those to smooth muscle, cardiac muscle, and glands are called visceral.

Types of Neurons
Structural classification scheme is based on the number of processes 1. Multipolar neurons have many dendrites and a single axon.The dendrites vary in number and in their degree of branching. Most of the neurons within the CNS and motor neurons are multipolar.

Types of Neurons
2. Bipolar neurons have two processes: a dendrite and an axon The dendrite often is specialized to receive the stimulus, and the axon conducts action potentials to the CNS. Bipolar neurons are located in some sensory organs, such as in the retina of the eye and in the nasal cavity.

Unipolar neurons have a single process extending from the cell body .Types of Neurons ‡ 3. . One branch extends to the CNS. ± This process divides into two branches a short distance from the cell body. and the other branch extends to the periphery and has dendrite like sensory receptors. The two branches function as a single axon.

Types of neurons .

.

meaning star) are neuroglia that are star-shaped because of cytoplasmic processes that extend from the cell body Astrocytes have an extensive cytoskeleton of microfilaments that enables them to form a supporting framework for blood vessels and neurons. ± The blood brain barrier protects neurons from toxic substances in the blood. The endothelial cells with their tight junctions form the blood=brain barrier. allows the exchange of nutrients and waste products between neurons and the blood. and prevents fluctuations in the composition of the blood from affecting the functions of the brain . which determines what substances can pass from the blood into the nervous tissue of the brain and spinal cord. Astrocytes play a role in regulating the extracellular composition of brain fluid.Neuroglia of the CNS ‡ Astrocytes (astro¯-s ¯tz. ‡ ‡ ± . aster is Greek. Astrocytes also help to control the composition of interstitial fluid by regulating the concentration of ions and gases and by absorbing and recycling neurotransmitters.

‡ The choroid plexuses secrete the cerebrospinal fluid that circulates through the ventricles of the brain. .‡ Ependymal cells line the ventricles (cavities) of the brain and the central canal of the spinal cord Specialize ependymal cells and blood vessels form the choroid plexuses which are located within certain regions of the ventricles.

and they phagocytize necrotic tissue. and foreign substances that invade the CNS. .‡ Microglia are specialized macrophages in the CNS that become mobile and phagocytic in response to inflammation. microorganisms.

If the cytoplasmic extensions wra primany times around the axons. A single oligodendrocyte can form myelin sheaths around portions of several axons .Neuroglia of the CNS ‡ Oligodendrocytes have cytoplasmic extensions that can surround axons. they form myelin sheaths.

ELECTRICAL IMPULSE .

) charge inside. . The Na ions are returned outside and the K ions are returned inside by the sodium and potassium pumps. Depolarization (generated by a stimulus) Propagation of the impulse Depolarization of part of the membrane makes adjacent from point of stimulus membrane very permeable to Na ions. which rush Follows depolarization) out of the cell. The neuron membrane then has a (+ ) charge outside and a ( . Na ions are more abundant outside the cell. and so on. The depolarization continues along the membrane of the neuron to the end of the axon.NERVE IMPULSE Polarization the neuron is not carrying an electrical impulse) Neuron membrane has a (+ ) charge outside and a ( . This restores the + charge outside and . Repolarization immediately Neuron membrane becomes very permeable to K ions. which similarly affects the next part of the membrane. Sodium and potassium pumps maintain these ion concentrations Neuron membrane becomes very permeable to Na ions. which rush into the cell.)charge inside. The neuron is now able to respond to another stimulus and generate another impulse. K ions and negative ions are more abundant inside the cell. and subsequent depolarization.charge inside the membrane.

ACTION POTENTIAL OF A NERVE .

These fibers serve autonomic functions. They are most susceptible to injury by mechanical pressure or lack of oxygen. ‡ B fibers are smaller myelinated axons that conduct less rapidly than A fibers. conduct rapidly.CONDUCTION OF ACTION POTENTIALS Types of Fibers ‡ A fibers are large and myelinated. and carry various motor or sensory impulses. they conduct impulses the slowest and serve pain conduction and autonomic functions . ‡ C fibers are the smallest and are nonmyelinated.

TYPES OF NERVE FIBER .

SENSORY NEURONS .

.

Inhibitory and excitatory presynaptic neurons can converge on a postsynaptic neuron. The activity of the postsynaptic neuron is determined by the integration of the EPSPs and IPSPs produced in the postsynaptic neuron.SPATIAL AND TEMPORAL SUMMATION 1. Presynaptic action potentials through neurotransmitters produce Local potentials in postsynaptic neurons. . The local potential consummate to produce an action potential at the trigger zone. Temporal summation occurs when two or more action potentials arrive in succession at a single presynaptic terminal. 3. 4. Spatial summation occurs when two or more presynaptic terminals simultaneously stimulate a postsynaptic neuron. 2.

Neuronal Pathways and Circuits 1. Divergent pathways have a few neurons synapsing with many neurons. Oscillating circuits have collateral branches of postsynaptic neurons synapsing with presynaptic neurons. Convergent pathways have many neurons synapsing with a few neurons. . 2. 3.

CONVERGENT AND DIVERGENT PATHWAY ‡ CONVERGENT ‡ DIVERGENT .

LEVELS OF SPINAL CORD CONTROL .

. ± Walking movements ± Some reflexes that control blood vessel and some visceral functions. cross extensor reflex. SPINAL CORD LEVEL ‡ Spinal reflexes such as widrawal reflex.. etc.1.

thalamus and basal ganglia ± Subconsious control of arterial ppressure and respiration ± Equilibrium and balance ± Feeding reflexes . Lower brain level ‡ Consist of brainstem. pain.2. hypothalamus. cerebeellum. pleasure responses . Head and Neck reflexes ± Some emotioal patterns.

3. control. . Cortical and higher brain level ± Languange ± Memory ± Cognition and Perception ± Modify. regulate spinal and lower brain level function.

SPINAL CORD .

‡ The nerves are named according to their respective vertebrae: 8 cervical pairs. those that emerge from the spinal cord. the horse s tail. 12 thoracic pairs. The dorsal root ganglion is an enlarged part of the dorsal root that contains the cell bodies of the sensory neurons. 5 sacral pairs. literally. and 1 very small coccygeal pair. 5 lumbar pairs.SPINAL NERVE ‡ 31 pairs of spinal nerves. . ‡ Notice that the lumbar and sacral nerves hang below the end of the spinal cord (in order to reach their proper openings to exit from the vertebral canal). ‡ The dorsal root is made of sensory neurons that carry impulses into the spinal cord. this is called the cauda equina.

it is made of the axons of motor neurons carrying impulses from the spinal cord to muscles or glands. ‡ Spinal cord reflexes are those that do not depend directly on the brain. ‡ ventral root is the motor root. although the brain may inhibit or enhance them. .SPINAL NERVE ‡ ganglion means a group of cell bodies outside the CNS. These cell bodies are within the vertebral canal and are thereby protected from injury.

Stretch reflex a muscle that is stretched will contract. 2. (5) effector that responds. . A reflex is an involuntary response to a stimulus. The patellar reflex is also used clinically t assess neurologic functioning. 4. Flexor reflex a painful stimulus will cause withdrawal of the body part. Reflex arc the pathway of nerve impulses during a reflex: (1) receptors. these reflexes are protective.these reflexes help keep us upright against gravity. (4) motor neurons. (2) sensory neurons. as are many other reflexes. (3) CNS with one or more synapses. 3.REFLEX ARC 1.

Effector performs its characteristic action. Sensory neurons transmit impulses from receptors to the CNS. 3. . Receptors detect a change (the stimulus) and generate impulses. 4.COMPONENT OF REFLEX ARC 1. Motor neurons transmit impulses from the CNS to the effector. 2. Central nervous system contains one or more synapses (interneurons may be part of the pathway). 5.

PATELLAR REFLEX .

REFLEX ARC .

a) Autonomic reflexes.Reflex ‡ a rapid. heart and glands b) Somatic reflexes. involuntary reaction and predictable response to a stimulus.stimulate skeletal muscles .regulate activity of smooth muscles.

basic functional unit of nervous system: a) Receptor b) Afferent neuron c) Interneuron d) Efferent neuron e) Effector .Reflex Arc Reflex Arc.neuronal pathway.

muscles contract in response to stretching force applied or when the load increases.SPINAL CORD REFLEXES STRETCH REFLEX.or Patellar reflex: ‡ the stretching of the muscles & tendon incl. ‡ impt. Knee-Jerk Reflex. in determining function of higher CNS centers .the simplest reflex.extends the leg. sensory receptors causes contraction of the quadriceps femoris muscles-----.

* All spinal reflexes below the level of injury are lost for a few weeks after a severe spinal cord injury.maintains posture and coordinates muscular activity. .SPINAL CORD REFLEXES ‡ Descending neurons w/in spinal cord synapse w/ neurons of stretch reflex---.

2. . Sensory receptors in the muscle detect stretch of the muscle. Descending neurons also synapse with neurons of stretch reflex Stimulation of motor neurons causes the muscle to contract and resist being stretched 3. 4. Sensory neurons conduct action potentials to the spinal cord (the center of patellar reflex) Sensory neurons synapse with motor neurons.Spinal Cord Reflex 1.

stim. the normal response in adults is flexion of the toes (if extension---.OTHER KINDS OF STRETCH REFLEXES: a. Pupillary Reflex.pupillary constriction.plantar flexion c.iris muscles contract---.centered in the brainstem light receptors in eye receive the bright light----.involves cutaneous skin receptors. . Plantar Reflex. Triceps Reflex.in infants.lower arm extends as the triceps brachii muscles reflexively contracts b. shows extension of toes & fanning of toes (Babinski response) .may indicate damage to the myelin sheath) . of Achilles tendon ----.

to remove a limb or other part from a painful stimulus 3-neuron reflex arc (w/ interneuron) ‡ Painful stimulus----action potential (thru dorsal root) ----.spinal cord (synapse with interneuron and motor neurons)---.stimulate flexor muscles to remove limb from source of pain .WITHDRAWAL REFLEX.

SPINAL LEVEL REFLEXES .

support agonist muscle contraction and provide feedback about the muscle. . sensitivity of the stretch reflex and intactness of the spinal cord segment are tested by applying stretch of the deep tendon.SPINAL REFLEXES ‡ STIMULUS: Muscle Stretch ‡ Functions for maintenance of muscle tone. ‡ Clinically.

Agonist ( Reciprocal Inhibition) as well as synergestic muscle ( Facilitation ) . ‡ Reciprocal Innervation: describes the response a stretch stimulus can be on agonist ( Autogenic Facilitation).SPINAL REFLEXES ‡ Reciprocal Inhibition: via inhibitory interneuron the same stretch stimulus inhibits the agonist muscle.

INVERSE STRETCH REFLEX ‡ Stimulus : Muscle contraction ‡ Reflex Arc : Afferent Ib fiber from the Golgi Tendon organ via inhibitory interneuron to muscle of the origin ( Polysynaptic) ‡ Function : to provide agonist inhibition. dimunition of force of agonist contraction .

vestibulospinal and others ) ‡ Descending pathway excite gamma motor neurons causing contraction of muscle spindle and turn increase rate of firing from spindle afferents. . impulse are then conveyed to alpha motor neurons.Gamma Reflex Loop ‡ Stretch reflex forms part of this loop ‡ Allows muscle tension to come under control of descending pathways ( reticulospinal.

Widrawal Reflex ‡ Stimulus: Cutaneous sensory stimuli ‡ Reflex arc: cutaneous receptors via interneurons to largely flexor muscles: multi segmental response involving group of muscle. ( Polysynaptic ). widrawal mechanism to remove body parts from harmful stimuli. . ‡ Functions as to protective.

. flexors of one side are excited causing extensor on the same side to be inhibited: opposite responses occur on the opposite site ‡ Reflex arc: Cutaneous and muscle receptors diverging to many spinal cord motorneurons on the same side and opposite side. ‡ Function: Coordinates reciprocal limb activity such as Gait.Cross extension Reflex ‡ Stimulus: Noxious stimuli and receptor action of antagonist.

Review of Nerve Fibers .

temperature. touch . somatic motor ± Beta Touch. Pressure ± Gamma Motor to muscle spindles ± Delta pain.A .Fibers ‡ Large myelinated . fast conducting ± Alpha proprioception.

B . Automatic . conduct less rapidly.Fibers ‡ Small. ‡ Pregaanglionic. myelinated.

slowest conducting ‡ Dorsal Root : Pain. unmyelinated .response ‡ Sympathetic : Post Ganglionic Sympathetic .C Fibers ‡ Smallest. reflex.

Muscle Stretch Responses .

‡ Seen in lower motor neuron lesion. ‡ Also seen initially after suprasegmental/upper motor neuron lesion such as spinal shock and cerebral shock.Flaccidity ‡ Absent of Tone Hypotonia decrease of tone of the muscle. there is decrease or no resistance in PROM. . nerve root and peripheral injuries.

SPASTICITY ‡ Seen in Suprasegmental / Upper motor neuron lesion. wrist flexors and jaw. check to see if increasing speed increases the resistance Spasticity is velocity dependent ± Clasp type response: marked resistance to PROM suddenly gives way. spasmodic contraction. common in plantarflexors. there is increase resistance to PROM. . ± Clonus: maintained stretch stimulus produces cyclical.

‡ Hoffman s reflex plick of 2nd finger causing clonustype of response ‡ Bruxism involuntary clenching of teeth .

increase deep tendon reflexes . ± Hypereflexia . ± Indicative of corticospinal tract disruption.SPASTICITY ± Hyperactive cutaneous reflexes: babinski response : dorsiflexio of a big toe with fanning of the other toes in response to the stroking up the lateral side of the sole of the foot.

auditory receptors in the ears. pons. tactile receptors on the surface of the body.Sensory Part of the Nervous System Sensory Receptors ± activities of the nervous system are initiated by sensory experience exciting sensory receptors. ± information enters the central nervous system through peripheral nerves and is conducted immediately to multiple sensory areas in (1) the spinal cord at all levels. which transmits sensory information from the receptors of the entire body surface and from some deep structures. ± the somatic portion of the sensory system. and mesencephalon of the brain. (4) the thalamus. (5) areas of the cerebral cortex . whether visual receptors in the eyes. (2) the reticular substance of the medulla. or other kinds of receptors. (3) the cerebellum.

Resting Tremor. ‡ Lead pipe: uniform throughout range ‡ Cog-wheel: interrupted by series of jerks ‡ Seen in Parkinson s Dse. ‡ Seen in patient with basal ganglia/Nigrostriatal pathway. Bradykinesia ‡ Strenght and reflexes are not affected . ‡ Increase resistance to passive movement both agonist and antagonist muscle.RIGIDITY ‡ Increase resistance to PROM that is independent in velocity of movement.

TRUNK and Neck into rigid extension. .DECEREBRATE RIGIDITY ‡ Seen in comatose patientwith brainstem lesions between superior colicullus and vestibular nucleus: results in increase tone and sustained posturing of all limbs.

ALPHA AND GAMMA MOTOR NEURONS .

ALPHA MOTOR NEURON ‡ Largest of the anterior Horn Cell ‡ Can be stimulated through monosynaptically by. ± Ia primary afferents and group of seconadry afferent of the muscle spindle. ± Corticospinal tract of the primates ± Lateral vestibulospinal tract fibers ± Reticulospinal tract and raphe spinal tract fibers .

‡ Not only innervate large extrafusal skeletal muscle fiber but also interneurons in the ventral horn (Renshaw Cells).ALPHA MOTOR NEURON ‡ They are influence through interneurons in the spinal cord gray matter in the response to the activation of segmental. intersegmental and supraspinal circuits. ‡ It innervates group of extrafusal muscle fibers within the specific muscle ‡ Contains motor units motor units in proximal muscles which is used for postural control than motor units in distal limb muscle. .

GAMMA MOTOR NEURONS ‡ Which also termed as Fusiform Neuron. ‡ They do not innervate extrafusal muscle fibers and susequently do not produce extrafusal muscle fibers. . ‡ Innervate muscle fibers within the muscle spindles of the skeletal msucle.

± Smaller ± Not excited monosynaptically by segmental inputs. ± Not involve in inhibitory feedback mechanism by Renshaw Cells.Difference of Gamma to Alpha Motor Neuron ‡ Gamma Motor neurons are. ± Tend to Discharge spontaneously .

. ‡ Beta Motor Neurons innervate both extrafusal and Intrafusal muscle fibers.Beta Motor Neurons ‡ Comparable in diameter to those of Alpha Motor Neurons.

Cutaneous reflex diminished ‡ With denervations.spasticity especially anti-gravity muscle. Fibrilation potentials. fasciculation ‡ Deficits: paralysis if nerve is interrupted limited ‡ Neurogenic atrophy: rapid and severe ‡ Weak and absent of voluntary muscle if nerve is interrupted .Clasp knife response ‡ Hyperreflexia: clonus exaggerated cutaneous and autonomic + babinski ‡ Muscle spasm: Flexor and extensors ‡ Presence of paralysis or paresis ‡ Presence of atrophy: disuse Lower Motor Neuron ‡ CNS / PNS ‡ Alpha motor neurons or roots. Peripheral and cranial spinal nerve.Difference of Lower and Upper Motor Neuron Lesion Upper Motor Neuron ‡ CNS ‡ Structure involve: UMN/Corticospinal tract ‡ Tone: Hypertonicity: velocity Dependent. motor fibers . ‡ Hypotonicity and Flaccidity ‡ DTR diminished or absent.

Motor Part of the Nervous System Effectors ‡ This is achieved by controlling (1) contraction of appropriate skeletal muscles throughout the body. . (2) contraction of smooth muscle in the internal organs. and (3) secretion of active chemical substances by both exocrine and endocrine glands in many parts of the body.

Motor Part of the Nervous System Effectors ‡ the skeletal muscles can be controlled from many levels of the central nervous system. and mesencephalon. (2) the reticular substance of the medulla. . pons. including (1) the spinal cord. (4) the cerebellum. (3) the basal ganglia. and (5) themotor cortex.

.

and glutamate. . inhibit it. glycine. histamine. or modify its sensitivity ‡ acetylcholine. epinephrine. ‡ first neuron secretes at its nerve ending synapse a chemical substance called neurotransmitter ‡ this transmitter in turn acts on receptor proteins in the membrane of the next neuron to excite the neuron. gamma-aminobutyric acid (GABA).Types of Synapses Chemical and Electrical ‡ Almost all the synapses used for signal transmission in the central nervous system of the human being are chemical synapses. norepinephrine. serotonin.

Electrical synapses
‡ characterized by direct open fluid channels that conduct electricity from one cell to the next. ‡ Most of these consist of small protein tubular structures called gap junctions that allow free movement of ions from the interior of one cell to the interior of the next.

Physiologic Anatomy of the Synapse
± anterior motor neuron in the anterior horn of the spinal cord. It is composed of three major parts: the soma, which is the main body of the neuron; a single axon, which extends from the soma into a peripheral nerve that leaves the spinal cord; and the dendrites, which are great numbers of branching projections of the soma that extend as much as 1 millimeter into the surrounding areas of the cord.

Physiologic Anatomy of Synapse

Types of Sensory Receptors and the Sensory Stimuli They Detect

five basic types of sensory receptors
mechanoreceptors, - which detect mechanical compression or stretching of the receptor or of tissues adjacent to the receptor; 2) thermoreceptors, which detect changes in temperature, some receptors detecting cold and others warmth; 3) nociceptors - (pain receptors), which detect damage occurring in the tissues, whether physical damage or chemical damage; 4) electromagnetic receptors, which detect light on the retina of the eye; (5) chemoreceptors, which detect taste in the mouth, smell in the nose, oxygen level in the arterial blood osmolality of the body fluids, carbon dioxide concentration, and perhaps other factors that make up the chemistry of the body. 1)

Sensory Nerve Endings .

Classification of sensory receptors .

‡ Type C fibers are the small unmyelinated nerve fibers that conduct impulses at low velocities. The C fibers constitute more than one half of the sensory fibers in most peripheral nerves as well as all the postganglionic autonomic fibers. ‡ Type A fibers are the typical large and medium-sized myelinated fibers of spinal nerves.General Classification of Nerve Fibers. .

Classification of sensory receptors .

.

Group Ia ‡ Fibers from the annulospiral endings of muscle spindles (average about 17 microns in diameter. . these are a-type A fibers in the general classification).

these also are a-type A fibers). .Group Ib ‡ Fibers from the Golgi tendon organs (average about 16 micrometers in diameter.

Group II ‡ Fibers from most discrete cutaneous tactile receptors and from the flower-spray endings of the muscle spindles (average about 8 micrometers in diameter. . these are b.and gtype A fibers in the general classification).

crude touch.Group III ‡ Fibers carrying temperature. and pricking pain sensations (average about 3 micrometers in diameter. . they are d-type A fibers in the general classification).

and crude touch sensations (0.Group IV ‡ Unmyelinated fibers carrying pain. temperature. . they are type C fibers in the general classification).5 to 2 micrometers in diameter. itch.

Transmission of Signals of Different Intensity in Nerve Tracts Spatial and Temporal Summation .

. the stronger signals spread to more and more fibers. This is the phenomenon of spatial summation.Spatial Summation. ‡ effect of a moderate stimulus and a strong stimulus. Thus. with progressively more fibers being stimulated.

which is called temporal summation .Temporal Summation. ‡ A second means for transmitting signals of increasing strength is by increasing the frequency of nerve impulses in each fiber.

Neurophysiologic Terms .

crosses two joints. fast-twitch . Type II ‡ Located superficially. motor units that fatigue easily.Flexor Phasic. ‡ Composed primarily of large . ‡ Has high glycogen content and few oxidative enzymes. has long tendinous attachments. .

has broad attachments. . ‡ Has low glycogen content and many oxidative enzymes. crosses one joint. ‡ Composed primarily of small. Type I ‡ Located proximally. slow-twitch motor units that resistant to fatigue.Extensor Tonic.

Phasic and Tonic Response ‡ Phasic response A brief muscle contraction ‡ Tonic response A sustained muscle contraction .

Meissner s corpuscle and Krause and bulb.Encapsulated Exteroceptors ‡ Cutaneousreceptors that located in the dermis. ‡ These receptors rapidly adapt to touch . periosteum ligaments. and tendon surfaces. . Included in Pacinian corpuscles. pressure. cold and vibration stimuli. subcutaneous and intermuscular connective tissue.

Free Nerve Endings ‡ Cutaneous receptors primarily located in the dermis and around the base of hair follicle. . These receptors slowly adapt to diffuse touch. pain and temperature stimuli and display a prolonged after discharge pattern.

.A Fibers ‡ Fast conducting myelinated somatic nerve fibers that transmit impulse from excited cutaneous capsulated receptors. These fibers may associated with the production of phasic or mobilization responses.

These fibers may be associated with the production of tonic or stabilizing responses .C Fibers ‡ Slow conducting. predominantly unmyelinated somatic nerve fibers that impulse from excited free nerve endings.

Proprioceptor ‡ A receptor that located deep within the tissues of the body and response to changes in position. inner ear. tendons. movement and deep pressure. . ± Muscle. joints.

Muscle Spindle ‡ A proprioceptor located in the skeletal muscle parallel to the extrafusal fiber. . The main purpose of the muscle spindle is to provide information regarding muscle length back to CNS.

Two types ± Nuclear Bag ± Nuclear Chain .Intrafusal Fibers ‡ Muscle Fibers located within the muscle spindle.

The fiber receptor is located in the equatorial changes in middle regions of both the bag and chain.Ia or Primary Afferent Fiber ‡ A large nerve fiber that forms part of the afferent nerve supply from the muscle spindle. ‡ Small changes in movement as well as rates of changes or movement are monitored by the Ia receptors .

‡ Controversy surrounds the function of the II afferent. maintained stretches in lengthened muscle ranges. autogenic facilitation and reciprocal inhibition. in conjunction with the Ia fiber. . that is. one theory is that excitation of this receptor in the flexor muscle yields a response similar to the Ia Fiber. make up the afferent nerve supply from the muscle spindle. The fiber receptor which primarily on the chain of intrafusal fiber. ‡ The II fiber receptor is highly sensitive to slow.II or Secondary Afferent Fiber ‡ A nerve fiber which.

Fusiform Fibers of GAMMA MOTOR NEURONS ‡ Nerve fibers that form efferent or motor supply to the muscle spindle. in close proximity with the cell bodies of the alpha motor neurons and are under the influence of higher centers. . The cell bodies of the gamma motor neurons are located in the ventral horn of the spinal cord.

primarily of the dynamic intrafusal fibers. ‡ They are associated with increases the dynamic response of Ia Fiber.Dynamic Gamma Motor neurons ‡ Motor neurons that innervate primarily the polar or contractile regions. .

Static Gamma Motor neurons ‡ Motorneurons that innervate the juxta region of both Bag and Chain intrafusal fiber in close proximity to the receptors of the II fibers. They are associated with biasing or internally stretching the bag and chain fibers and maintain muscle tone. .

‡ Tension that produce by active muscle during contraction.Golgi Tendon Organ ‡ Proprioceptors that are located primarily at the musculotendinous junction in series with muscle fibers. ‡ These receptors are extremely sensitive to muscle tension. ‡ The response by GTO excitation is autogenic inhibitation to the synergist reciprocal facilitation to antagonistic muscle group. .

Ib ‡ The nerve fiber that form the afferent nerve supply from the GTO. . Unlike the muscle spindle. GTO s do not have efferent innervation.

Renshaw Interneuron ‡ An interneuron that forms part of an inhibitory feedback circuit between the motorneurons to the cell bodies in the anterior horn of the spinal cord. ‡ Also exert an inhibitory influence on the inhibitory interneurons that forms a part of the final common pathway to the antagonistic musculature resulted to disinhibition may be equivalent to facilitation of the antagonistic groups. . ‡ Renshaw Cells can be affected by impulse from higher centers.

CLASSIFICATION OF SOMATIC SENSES .

which mean specifically vision. and equilibrium. These senses are in contradistinction to the special senses.somatic senses ± the nervous mechanisms that collect sensory information from all over the body. hearing. smell. . taste.

. which include both tactile and position sensations that are stimulated by mechanical displacement of some tissue of the body. which detect heat and cold. which is activated by any factor that damages the tissues. (2) the thermoreceptive senses. (3) the pain sense.somatic senses can be classified into three physiologic types: (1) The mechanoreceptive somatic senses.

including position sensations. one usually refers specifically to sensations from the internal organs. and bone.Other Classifications of Somatic Sensations. pain. ‡ Visceral sensations are those from the viscera of the body. ‡ Proprioceptive sensations are those having to do with the physical state of the body. These include mainly deep pressure. pressure sensations from the bottom of the feet. and even the sensation of equilibrium (which is often considered a special sensation rather than a somatic sensation). ‡ Exteroreceptive sensations are those from the surface of the body. and vibration . muscles. ‡ Deep sensations are those that come from deep tissues. such as from fasciae. in using this term. tendon and muscle sensations.

Ruffini s end-organs 6. pacinian corpuscles . hair end-organ 5.Tactile Receptors 1. Free nerve ending 2. Meissner s corpuscle 3. one type of which is Merkel s discs. expanded tip tactile receptors. 4.

Muscle Sensory Receptors Muscle Spindles and Golgi Tendon Organs And Their Roles in Muscle Control .

(2) Golgi tendon organs .two special types of sensory receptors (1) muscle spindles .which are located in the muscle tendons and transmit information about tendon tension or rate of change of tension. .which are distributed throughout the belly of the muscle and send information to the nervous system about muscle length or rate of change of length.

Lengthening the whole muscle stretches the midportion of the spindle and. contraction of the end portions of the spindle s intrafusal fibers stretches the midportion of the spindle and therefore excites the receptor. Even if the length of the entire muscle does not change.Sensory Innervation of the Muscle Spindle. . excites the receptor. therefore. . They are the primary ending and the secondary ending.Two types of sensory endings are found in this central receptor area of the muscle spindle. 2. 1.

Muscle Spindle .

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->