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Classification of nerve fibres

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Classification of nerve
fibers
Dr. Sai Sailesh Kumar G
Peripheral nerve
It consists of bundle of nerve fibers
Three connective tissue sheets
Endoneurium –covers single nerve fibre
Perineurium – covers a bundle of nerve fibers
Epineurium – entire nerve trunk is surrounded
Peripheral nerve
May be purely sensory or motor or mixed nerve
Both myelinated and unmyelinated
Both small and large diameter fibers
Large diameter fibers
Conduct impulses faster than small diameter fibers
Less threshold for excitation
Refractory period is shorter
Concerned with proprioception, touch, pressure, and somatomotor function
Small diameter fibers
Conduct impulses slowly
Concerned with pain, temperature and autonomic functions
Properties of mixed nerve
Peripheral nerves usually is mixed nerves
Consists of nerve fibers of different diameters
Apart from the properties of nerve fibers, the peripheral nerve also has two
important properties
Compound action potential
Maximal stimulus

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NMP-4.pptx

  • 2. Peripheral nerve It consists of bundle of nerve fibers Three connective tissue sheets Endoneurium –covers single nerve fibre Perineurium – covers a bundle of nerve fibers Epineurium – entire nerve trunk is surrounded
  • 3. Peripheral nerve May be purely sensory or motor or mixed nerve Both myelinated and unmyelinated Both small and large diameter fibers
  • 4. Large diameter fibers Conduct impulses faster than small diameter fibers Less threshold for excitation Refractory period is shorter Concerned with proprioception, touch, pressure, and somatomotor function
  • 5. Small diameter fibers Conduct impulses slowly Concerned with pain, temperature and autonomic functions
  • 6. Properties of mixed nerve Peripheral nerves usually is mixed nerves Consists of nerve fibers of different diameters Apart from the properties of nerve fibers, the peripheral nerve also has two important properties Compound action potential Maximal stimulus
  • 7. Compound action potential Place two electrodes on the surface of the mixed nerve AP recorded with multiple peaks Mixed nerve has many nerve fibers with different conduction velocities Hence each peak for a particular group of nerve fiber First peak belongs to fastest conducting fiber Last peak for slowest conducting fibers
  • 8. Compound action potential Helps to determine the conduction velocity of different types of nerve fibers To evaluate effect of certain drugs such as local anaesthetics
  • 10. Maximal stimulus Mixed nerve has different types of nerve fibers To excite all of them Maximal stimulation is needed threshold stimulus may activate only few fibers
  • 11. Classification of nerve fibres Numerical classification Sensory nerve fibers are classified numerically Ia- Muscle spindle, annulospiral endings Ib- Golgi tendon organ II – muscle spindle- flower spray ending, touch, pressure III-pin, temperature, some touch receptors IV- pain
  • 12. Classification of nerve fibres Erlanger- Grasser classification Based on diameter and conduction velocity
  • 14. Classification of nerve fibres Physio clinical classification Functional
  • 16. On the basis of myelination Myelinated nerve fibers – enveloped by myelin sheath Unmyelinated nerve fibers – do not have myelin sheath
  • 17. Depending on the function Sensory fibers – carry sensory impulses to the CNS Motor fibers – carry motor impulses to muscles and glands
  • 18. Depending on NT released Cholinergic fibers –Release Ach Adrenergic fibers- Release nor epinephrine Dopaminergic fibers – releases dopamine
  • 19. Common causes of nerve injury Compression of nerve – ischemia Transection of nerve Crush injuries Toxic drugs Hyperpyrexia -condition where the body temperature goes above 106.7 degrees Fahrenheit (41.5 degrees Celsius) due to changes in the hypothalamus
  • 20. Types of nerve injuries According to Sunderland, nerve injuries are graded into five types Seddons classification is given in brackets
  • 21. First degree nerve injury (neurapraxia) Commonly seen Secondary to ischemia caused by pressure on the nerve for a definite perod Nerve losses its function temporarily due to ischemia Recovery is rapid and complete No evidence of nerve degeneration Saturday night paralysis
  • 22. Second degree nerve injury (Axonotmesis I) Compression of nerve for prolonged periods Damage to nerve at pressure point Axons undergo degeneration from the pressure point to the distal end Regeneration is possible Functional recovery is fairly rapid and complete Eg: Carpal tunnel syndrome
  • 23. Second degree nerve injury (Axonotmesis I) Carpal tunnel syndrome is a common condition that causes numbness, tingling, and pain in the hand and forearm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist.
  • 24. Third degree nerve injury (Axonotmesis II) Along with axon Endoneurial tube also disrupted Recovery is slow, poor and incomplete
  • 25. Fourth degree nerve injury (Axonotmesis III) Fascicle is disrupted Damage to perineurium Regeneration is poor and incomplete
  • 26. fifth degree nerve injury (Neurotmesis) Along with axon all the three sheaths are damaged Complete section of nerve trunk Regeneration is not possible unless the cut ends are brought closer by surgery