留学生英语 周围神经peripheral nerve.ppt

Peripheral Nerve System Neurology Department Introduction Anatomy Peripheral nerves are made up of axon endoneurium Connective tissue perineurium epineurium Nerve trunks myelinated fibre unmyelinated fibre Myelin, protein-lipid complex function, insulating layer increase conduction rate Myelinated nerve are separated by nodes of Ranvier, at these points , the axons are bare. Impulses jump from one node to the next --- Saltatory Conduction Conduction in unmyelinated nerve is slower and dependent on the diameter of axon. Pathological processes Cause: damage of cell body,axon, myelin sheath, connective tissue, blood supply Three basic processes Wallerian degeneration Axon degeneration Demyelination 1.Wallerian degeneration Distal axon degeneration, following section or severe injury, with degeneration of the myelin. The process occurs within 7-10 days of injury and this portion of the nerve is inexcitable electrically. 2. axon degeneration Distal degenerated nerve is inexcitable electrically. Regeneration can occur since the basement membrane of the Schwann cell survives and act as a skeleton along which tha axon regrows up to a rate of about 1mm per day. 3. Demyelination Segmental destruction of the myelin sheath occurs without axonal damage. The primary lesion affects the Schwann cell and causes marked slowing of conduction or conduction block. Local demyelination is caused by inflammation, eg: Guillain-Barre syndrome. Symptoms of PNS Sensory symptoms Motor symptoms Negative symptoms: Large myelinated fibre disease (loss of touch and joint-position sense, proprioception) leading to: Difficulty discriminating textures feet and hands feeling like “cotton wool” Gait unsteady through loss of position sense Small unmyelinated fibre disease (loss of pain and temp