Psych a electrophysiology
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Psych a electrophysiology

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Psych a electrophysiology Psych a electrophysiology Presentation Transcript

  • MD Psych - Neurophysiology • • • • Electrophysiology Sensory functions Physiology of Pain Motor system – – – – – – Reflexes Motor pathways Cerebellum Basal ganglia Posture and balance Overview • • • • Sleep, arousal Memory and emotions Evoked potentials Neurotransmitters • www.slideshare.net/vajira54
  • Neuromuscular Physiology Prof. Vajira Weerasinghe Department of Physiology Faculty of Medicine University of Peradeniya
  • • Nerve conduction • NMJ • Muscle contraction
  • Nerve conduction • Electrochemical basis • concentration gradient, membrane permeability ionic channels • Resting membrane potential (RMP) • K+ efflux, Na/K pump • Leaky channels • Action potential (AP) • depolarisation, repolarisation • Voltage-gated channels • Propagation of AP • Local current flow
  • Membrane potential • A potential difference exists across all cell membranes – This is referred to as “Resting Membrane Potential” (RMP) – Inside is negative with respect to the outside
  • What are excitable tissues? • They are capable of generating electrochemical impulses and transmitting them along the membrane
  • excitable neuron Non-excitable Red cell muscle GIT • Excitability of a tissue depends on its membrane potential – Excitable tissues have more negative RMP ( - 70 to - 90 mV) – Non-excitable tissues have less negative RMP ( - 40 mV)
  • Resting Membrane Potential • This depends on following factors – Ionic distribution across the membrane – Membrane permeability – Other factors • Na+/K+ pump
  • Factors contributing to RMP • One of the main factors is K+ efflux (Nernst Potential: -94mV) • Contribution of Na influx is little (Nernst Potential: +61mV) • Na/K pump causes more negativity inside the membrane • Negatively charged protein remaining inside due to impermeability contributes to the negativity • Net result: -70 mV inside
  • Ionic channels Na+ K+ • Leaky channels (K-Na leak channel) – More permeable to K – Allows free flow of ions
  • Na/K pump 2 K+ ATP 3 Na+ ADP • Active transport system for Na-K exchange using energy • It is an electrogenic pump since 3 Na influx coupled with 2 K efflux • Net effect of causing negative charge inside the membrane
  • Action Potential (A.P.) • When an impulse is generated – Inside becomes positive – Causes depolarisation – Nerve impulses are transmitted as AP
  • isation Depol ar sation Repolari +35 RMP -70 Hyperpolarisation
  • Physiological basis of AP • When the threshold level is reached – – – – – – – – Voltage-gated Na channels open up Since Na conc outside is more than the inside Na influx will occur Positive ion coming inside increases the positivity of the membrane potential and causes depolarisation When it reaches +35, Na channels closes Then Voltage-gated K channels open up K efflux occurs Positive ion leaving the inside causes more negativity inside the membrane – Repolarisation occurs
  • Physiological basis of AP • Since Na has come in and K has gone out • Membrane has become negative • But ionic distribution has become unequal • Na/K pump restores Na and K conc slowly – By pumping 3 Na ions outward and 2 K ions inward
  • m gate -70 Na+ Threshold level Na+ +35 Na+ outside outside outside inside inside inside h gate • At rest: the activation gate is closed • At threshold level: activation gate opens – Na influx will occur – Na permeability increases to 500 fold • when reaching +35, inactivation gate closes – Na influx stops • Inactivation gate will not reopen until resting membrane potential is reached
  • -70 At +35 n gate outside outside inside inside K+ K+ – At rest: K channel is closed – At +35 • K channel open up slowly • This slow activation causes K efflux – After reaching the resting still slow K channels may remain open: causing further hyperpolarisation
  • Propagation of AP • When one area is depolarised • A potential difference exists between that site and the adjacent membrane • A local current flow is initiated • Local circuit is completed by extra cellular fluid
  • Propagation of AP • This local current flow will cause opening of voltage-gated Na channel in the adjacent membrane • Na influx will occur • Membrane is deloparised
  • Propagation of AP • Then the previous area become repolarised • This process continue to work • Resulting in propagation of AP
  • Propagation of AP
  • Propagation of AP
  • Propagation of AP
  • Propagation of AP
  • AP propagation along myelinated nerves • Na channels are conc around nodes • Therefore depolarisation mainly occurs at nodes
  • AP propagation along myelinated nerves • Local current will flow one node to another • Thus propagation of A.P. is faster. Conduction through myelinated fibres also faster. • Known as Saltatory Conduction
  • Demyelinating disorders • Peripheral demyelination – Guillain Barre Syndrome (GBS) – Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) • Central demyelination – Multiple Sclerosis (MS)
  • Nerve fibre types • Classify according to – velocity of conduction – diameter of fibre – myelination
  • faster Myelinated Type Diameter (uM) Velocity (m/s) Aα 10-20 60-120 Aβ 5-15 40-80 Aγ 2-8 10-50 Aδ 1-5 6-30 B 1-4 1-4 C 0.5-2 0.5-2 Unmyelinated slower
  • Aα type • Alpha motor neuron • Proprioceptive
  • Aβ type • Proprioceptive • Mechanoreceptive
  • Aγ type • Gamma motor neuron
  • Aδ type • Pain • Temperature
  • B type • Autonomic preganglionic
  • C type • Pain • Temperature • Autonomic postganglionic
  • Sensory classification • • • • • Ia: Muscle spindle (A alpha) Ib: Golgi tendon organ (A beta) II: Muscle spindle, mechanoreceptive (A beta) III: Pain and temp (A delta) IV: Pain and temp (C)
  • Membrane stabilisers • Membrane stabilisers (these decrease excitability) • Increased serum Ca++ – Hypocalcaemia causes membrane instability and spontaneous activation of nerve membrane – Reduced Ca level facilitates Na entry – Spontaneous activation • • • • Decreased serum K+ Local anaesthetics Acidosis Hypoxia • Membrane destabilisers (these increase excitability) • • • • • Decreased serum Ca++ Increased serum K+ Alkalosis Caffeine strychnine
  • NMJ function • Pre-synaptic membrane • Ca channels • Acetycholine release • Postsynaptic membrane • Acetylcholine receptors • Ligand-gated channels • Synaptic cleft • cholinesterase
  • Synapse • A gap between two neurons • More commonly chemical • Rarely they could be electrical (with gap junctions)
  • ♦ Although an axon conducts bothways, conduction through synapse is oneway ♦ presynaptic neuron to postsynaptic neuron ♦ A neurone receives more than 10000 synapses. Postsynaptic activity is an integrated function
  • Presynaptic terminal (terminal knob, boutons, end-feet or synaptic knobs) ♦ Terminal has synaptic vesicles and mitochondria ♦ Mitochondria (ATP) are present inside the presynaptic terminal Vesicles containing neurotransmitter (Ach)
  • Presynaptic terminal (terminal knob, boutons, end-feet or synaptic knobs) ♦ Presynaptic membrane contain voltage-gated Ca channels ♦ The quantity of neurotransmitter released is proportional to the number of Ca entering the terminal ♦ Ca ions binds to the protein molecules on the inner surface of the synaptic membrane called release sites ♦ Neurotransmitter binds to these sites and exocytosis occur
  • Ca2+ Ca2+
  • • Postsynaptic membrane contain receptors for the neurotransmitter released • eg: Acetylcholine receptor Na+ Ach •This receptor is Ach-gated Na+ channel •When Ach binds to this, Na+ channel opens up •Na+ influx occurs
  • • Na+ influx causes depolarisation of the membrane – End Plate Potential (EPP) • This is a graded potential • Once this reaches the threshold level • AP is generated at the postsynaptic membrane
  • Ach release • An average human end plate contains 15-40 million Ach receptors • Each nerve impulse release 60 Ach vesicles • Each vesicle contains about 10,000 molecules of Ach • Ach is released in quanta (small packets) • Even at rest small quanta are released • Which creates a minute depolarising spike called Miniature End Plate Potential (MEPP) • When an impulse arrives at the NMJ quanta released are increased in several times causing EPP
  • Ach vesicle docking • With the help of Ca entering the presynaptic terminal • Docking of Ach vesicles occur • Docking: – Vesicles move toward & interact with membrane of presynaptic terminal • There are many proteins necessary for this purpose • These are called SNARE proteins • eg. Syntaxin, synaptobrevin etc
  • Axoplasmic transport • The process by which mitochondria, synaptic vesicles and other cytoplasmic constituents travel to and from the cell body • axon contains 100 times the volume of the cell body • proteins for neurotransmitters and membrane repair are constantly transported anterogradely – to maintain normal axonal function • If the axon is deprived of proteins because it is severed or crushed – the segment that is distal to the injury cannot support itself and will degenerate
  • NMJ blocking • Useful in general anaesthesia to facilitate inserting tubes • Muscle paralysis is useful in performing surgery
  • Earliest known NMJ blocker - Curare • Curare has long been used in South America as an extremely potent arrow poison • Darts were tipped with curare and then accurately fired through blowguns made of bamboo • Death for birds would take one to two minutes, small mammals up to ten minutes, and large mammals up to 20 minutes • NMJ blocker used in patients is tubocurarine • Atracurium is now used
  • Neuromuscular blocking agents • Non-depolarising type (competitive) – – – – – – – – Act by competing with Ach for the Ach receptors Binds to Ach receptors and blocks Prevent Ach from attaching to its receptors No depolarisation Prolonged action (30 min) Ach can compete & the effect overcomes by an excess Ach Anticholinesterases can reverse the action eg. • • • • Curare Tubocurarine Gallamine Atracurium
  • Neuromuscular blocking agents • Depolarising type (non-competitive) – Act like Ach, but resistant to AchE action – Bind to motor end plate and once depolarises – Persistent depolarisation leads to a block • Due to inactivation of Na channels – Two phases • Phase I – depolarisation phase – fasciculations • Phase II – paralysis phase – – – – Ach cannot compete Quick action (30 sec), short duration (10 min) Anticholinesterases cannot reverse the action eg. • suxamethonium • Ach in large doses • nicotine
  • Acetylcholine - + + + + - - - Na+ + + + + - - - Depolarization - - - + + + + Na+ - - - + + + +
  • Tubocurarine Acetylcholine Na+ Na+ + + + + + + + + - - - - - - - - Competitive neuromuscular blocking drugs
  • PHASE I Membrane depolarizes resulting in an initial discharge which produces transient fasciculations followed by flaccid paralysis + - + - + -+ - Na+ + - +- + + - Depolarized + - - + + + - - - - - - - -+ + + + - Na+ Depolarizing Neuromuscular blocking drugs
  • PHASE II Membrane repolarizes but the receptor is desensitized to effect of acetylcholine - - + + + - + - + - - + + - + - Repolarized + - - + + + + - + + - + - Depolarizing Neuromuscular blocking drugs
  • Neuromuscular blocking agents • AchE inhibitors – Inhibit AchE so that Ach accumulates and causes depolarising block • Reversible – Competitive inhibitors of AChE – Block can be overcome by curare • physostigmine, neostigmine, edrophonium • Irreversible – Binds to AChE irreversibly • , insecticides, nerve gases
  • NMJ disorders • Myasthenia gravis – Antibodies to Ach receptors – Post synaptic disorder • Lambert Eaton Syndrome (myasthenic syndrome) – Presynaptic disorder (antibodies against Ca channels) • Botulism – Presynaptic disorder – Binds to the presynatic region and prevent release of Ach
  • NMJ disorders • Snake venom (Presynaptic or postsynaptic disorder) – Krait (bungarotoxin) • Postsynaptic disorder – Cobra • Postsynaptic disorder – Russell’s viper • Presynaptic disorder
  • Botulinum toxin • Most potent neurotoxin known • Produced by bacterium Clostridium botulinum • Causes severe diarrhoeal disease called botulism • Action: – enters into the presynaptic terminal – cleaves proteins (syntaxin, synaptobrevin) necessary for Ach vesicle release with Ca2+ • Chemical extract is useful for reducing muscle spasms, muscle spasticity and even removing wrinkles (in plastic surgery)
  • Video clip
  • Organophosphates • Phosphates used as insecticides • Action – AchE inhibitors – Therefore there is an excess Ach accumulation – Depolarising type of postsynaptic block • Used as a suicidal poison • Causes muscle paralysis and death • Nerve gas (sarin)
  • Snake venom • Common Krait (bungarus caeruleus) – Produces neurotoxin known as bungarotoxin – Very potent • Causes muscle paralysis and death if not treated • Cobra – venom contain neurotoxin
  • Myasthenia gravis • Serious neuromuscular disease • Antibodies form against acetylcholine nicotinic postsynaptic receptors at the NMJ • Characteristic pattern of progressively reduced muscle strength with repeated use of the muscle and recovery of muscle strength following a period of rest • Present with ptosis, fatiguability, speech difficulty, respiratory difficulty • Treated with cholinesterase inhibitors
  • Muscle contraction • • • • • • T tubules Voltage-gated Ca channels Actin-myosin cross bridges Muscle contraction ATP release Reversal of the process
  • Muscle contraction • Depolarisation of the muscle membrane spreads through the muscle • Causes muscle contraction
  • Muscle contraction • Excitation - contraction coupling – Excitation : electrical event – Contraction : mechanical event
  • Ca++ Ca++
  • • AP spreads through t tubule into the muscle tissue • Close to the sarcoplasmic reticulum, AP activates a receptor (votage-gated Ca++ channel) • Ca flows to the myoplasm in the vicinity of actin & myosin
  • • Ca++ binds to troponin • Troponin shifts tropomyosin • Myosin binding sites in actin filament uncovered • Myosin head binds with actin • Cross bridges form • Filaments slide with ATP being broken down • Muscle shortens • New ATP occupies myosin head • Myosin head detaches • Filaments slide back • Cycling continues as long as Ca is available Actin Troponin Tropomyosin Myosin ATP
  • Actin Troponin Ca2+ Tropomyosin Myosin Binding Myosin binding sites Detachment Ca2+ Sliding Ca2+ Ca2+
  • Ca++ binds to troponin Tropomyosin exposes actin Ca++ Myosin ATP Actin Troponin myosin head binds to actin & cross bridge forms Filaments slide ATP is broken down New ATP comes, Ca is removed, ready to detach
  • • Relaxation – This occurs when Ca++ is removed from myoplasm by Ca++ pump located in the sarcoplasmic reticulum – When Ca++ conc is decreased – Troponin returns to original state – Trpomyosin covers myosin binding sites – Cross-bridge cycling stops
  • slow & fast fibres • Slow twitch fibre (type I fibre) • Fast twitch fibre (type II fibre)
  • Slow twitch fibre (type I fibre) – Slow cross-bridge cycling – slow rate of shortening (eg. soleus muscle in calf) – high resistance to fatigue – high myoglobin content – high capillary density – many mitochondria – low glycolytic enzyme content – They are red muscle fibres
  • Fast twitch fibre (type II fibre) – rapid cross-bridge cycling, – rapid rate of shortening (eg. extra-ocular muscles) – low resistance to fatigue – low myoglobin content – low capillary density – few mitochondria – high glycolytic enzyme content – fast twitch fibers use anaerobic metabolism to create fuel, they are much better at generating short bursts of strength or speed than slow muscles