INTRODUCTION TO NEUROPHYSIOLOGY

ERWIN S. OCAMPO, PTRP

MENINGES

Formation of CSF

General Plan of the Nervous System

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

General Plan of the Nervous System

PHYSIOLOGICAL STRUCTURE 1. Somatic Nervous System This innervates the structures of the body wall (muscles, skin, and mucous membranes). 2. Autonomic (Visceral) Nervous System (ANS) The ANS contains portions of the central and peripheral systems. 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.

Structural Units & Overall Organization

The central portion of the nervous system consists of the brain and the elongated spinal cord. The brain has a tiered structure , can be subdivided into the cerebrum, the brain stem, 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, cognition). More caudally, the brain stem, medulla, and spinal cord serve less advanced, but essential, functions.

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, sometimes called "gray matter"), subcortical white matter, and the basal ganglia, which are gray masses deep within the cerebral hemispheres. white matter carries that name because, in a freshly sectioned brain, it has a glistening appearance as a result of its high lipid-rich myelin content; the white matter consists of myelinated fibers and does not contain neuronal cell bodies or synapses .

Structural Units & Overall Organization

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

Structural Units & Overall Organization

Functional Units

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

Functional Units

Functional Units

Neurons

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

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

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

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

Types of Neuroglia

Axonal Transport
axons transport materials from the cell body to the synaptic terminals (anterograde Transport). And from the synaptic terminals to the cell body called (retrograde transport). Because ribosomes are not present in the axon, new protein must be synthesized and moved to the axon. This occurs via several types of axonal 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). Retrograde transport is similar to rapid anterograde transport. Fast transport involves microtubules extending through the cytoplasm of the neuron.

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

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. 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. A chemical inactivator cell body or dendrite of the postsynaptic neuron quickly inactivates the neurotransmitter. Many synapses are termed excitatory, 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, muscle cell, or gland. Some synapses, however, are inhibitory, 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.

TYPES OF SYNAPSES IN THE CNS

Neuronal Groupings & Connections

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

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.

Types of Neurons
3. Unipolar neurons have a single process extending from the cell body .
This process divides into two branches a short distance from the cell body. One branch extends to the CNS, 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

Neuroglia of the CNS

Astrocytes (astro-s tz, aster is Greek, 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. Astrocytes play a role in regulating the extracellular composition of brain fluid. The endothelial cells with their tight junctions form the blood=brain barrier, which determines what substances can pass from the blood into the nervous tissue of the brain and spinal cord.
The blood brain barrier protects neurons from toxic substances in the blood, 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 . Astrocytes also help to control the composition of interstitial fluid by regulating the concentration of ions and gases and by absorbing and recycling neurotransmitters.

 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. The choroid plexuses secrete the cerebrospinal fluid that circulates through the ventricles of the brain.

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

Neuroglia of the CNS

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

ELECTRICAL IMPULSE

NERVE IMPULSE Polarization the neuron is not carrying an electrical impulse) Neuron membrane has a (+ ) charge outside and a ( - ) charge inside. Na ions are more abundant outside the cell. K ions and negative ions are more abundant inside the cell. Sodium and potassium pumps maintain these ion concentrations Neuron membrane becomes very permeable to Na ions, which rush into the cell. The neuron membrane then has a (+ ) charge outside and a ( - )charge inside.

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, and subsequent depolarization, which similarly affects the next part of the membrane, and so on. The depolarization continues along the membrane of the neuron to the end of the axon. Repolarization immediately Neuron membrane becomes very permeable to K ions, which rush Follows depolarization) out of the cell. This restores the + charge outside and - charge inside the membrane. The Na ions are returned outside and the K ions are returned inside by the sodium and potassium pumps. The neuron is now able to respond to another stimulus and generate another impulse.

ACTION POTENTIAL OF A NERVE

CONDUCTION OF ACTION POTENTIALS Types of Fibers

A fibers are large and myelinated, conduct rapidly, and carry various motor or sensory impulses. 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. These fibers serve autonomic functions. C fibers are the smallest and are nonmyelinated; they conduct impulses the slowest and serve pain conduction and autonomic functions

TYPES OF NERVE FIBER

SENSORY NEURONS

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. 2. Spatial summation occurs when two or more presynaptic terminals simultaneously stimulate a postsynaptic neuron. 3. Temporal summation occurs when two or more action potentials arrive in succession at a single presynaptic terminal. 4. 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.

Neuronal Pathways and Circuits

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

CONVERGENT AND DIVERGENT PATHWAY

CONVERGENT DIVERGENT

LEVELS OF SPINAL CORD CONTROL

1. SPINAL CORD LEVEL

Spinal reflexes such as widrawal reflex, cross extensor reflex, etc..
Walking movements Some reflexes that control blood vessel and some visceral functions.

2. Lower brain level

Consist of brainstem, cerebeellum, hypothalamus, thalamus and basal ganglia
Subconsious control of arterial ppressure and respiration Equilibrium and balance Feeding reflexes ; Head and Neck reflexes Some emotioal patterns, pain, pleasure responses

3. Cortical and higher brain level

Languange Memory Cognition and Perception Modify, control, regulate spinal and lower brain level function.

SPINAL CORD

SPINAL NERVE
31 pairs of spinal nerves, those that emerge from the spinal cord. The nerves are named according to their respective vertebrae: 8 cervical pairs, 12 thoracic pairs, 5 lumbar pairs, 5 sacral pairs, and 1 very small coccygeal pair. 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); this is called the cauda equina, literally, the horse s tail. The dorsal root is made of sensory neurons that carry impulses into the spinal cord. The dorsal root ganglion is an enlarged part of the dorsal root that contains the cell bodies of the sensory neurons.

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. ventral root is the motor root; 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, although the brain may inhibit or enhance them.

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

COMPONENT OF REFLEX ARC

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

PATELLAR REFLEX

REFLEX ARC

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

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

SPINAL CORD REFLEXES

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

SPINAL CORD REFLEXES

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

Spinal Cord Reflex

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

3.

4.

OTHER KINDS OF STRETCH REFLEXES:

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

WITHDRAWAL REFLEX- 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

SPINAL LEVEL REFLEXES

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

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

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

Gamma Reflex Loop

Stretch reflex forms part of this loop Allows muscle tension to come under control of descending pathways ( reticulospinal, 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.

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

Cross extension Reflex

Stimulus: Noxious stimuli and receptor action of antagonist, 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.

Review of Nerve Fibers

A - Fibers
Large myelinated ; fast conducting
Alpha proprioception, somatic motor Beta Touch, Pressure Gamma Motor to muscle spindles Delta pain, temperature, touch

B - Fibers
Small, myelinated, conduct less rapidly; Pregaanglionic; Automatic

C Fibers
Smallest, unmyelinated , slowest conducting Dorsal Root : Pain, reflex- response Sympathetic : Post Ganglionic Sympathetic

Muscle Stretch Responses

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

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

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

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. Indicative of corticospinal tract disruption. Hypereflexia ; increase deep tendon reflexes

Sensory Part of the Nervous System Sensory Receptors

activities of the nervous system are initiated by sensory experience exciting sensory receptors, whether visual receptors in the eyes, auditory receptors in the ears, tactile receptors on the surface of the body, or other kinds of receptors. the somatic portion of the sensory system, which transmits sensory information from the receptors of the entire body surface and from some deep structures. 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; (2) the reticular substance of the medulla, pons, and mesencephalon of the brain; (3) the cerebellum; (4) the thalamus; (5) areas of the cerebral cortex

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

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

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

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. Not only innervate large extrafusal skeletal muscle fiber but also interneurons in the ventral horn (Renshaw Cells).

GAMMA MOTOR NEURONS

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

Difference of Gamma to Alpha Motor Neuron

Gamma Motor neurons are;
Smaller Not excited monosynaptically by segmental inputs. Not involve in inhibitory feedback mechanism by Renshaw Cells. Tend to Discharge spontaneously

Beta Motor Neurons

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

Difference of Lower and Upper Motor Neuron Lesion

Upper Motor Neuron CNS Structure involve: UMN/Corticospinal tract Tone: Hypertonicity: velocity Dependent,spasticity especially anti-gravity muscle;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; motor fibers ; Peripheral and cranial spinal nerve. Hypotonicity and Flaccidity DTR diminished or absent; Cutaneous reflex diminished With denervations; 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

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, including (1) the spinal cord; (2) the reticular substance of the medulla, pons, and mesencephalon; (3) the basal ganglia; (4) the cerebellum; and (5) themotor cortex.

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. 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, inhibit it, or modify its sensitivity acetylcholine, norepinephrine, epinephrine, histamine, gamma-aminobutyric acid (GABA), glycine, serotonin, and glutamate.

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

General Classification of Nerve Fibers.

Type A fibers are the typical large and medium-sized myelinated fibers of spinal nerves. 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.

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).

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

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).

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

Group IV
Unmyelinated fibers carrying pain, itch, temperature, and crude touch sensations (0.5 to 2 micrometers in diameter; they are type C fibers in the general classification).

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

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

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

Neurophysiologic Terms

Flexor Phasic, Type II

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

Extensor Tonic, Type I

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

Phasic and Tonic Response

Phasic response A brief muscle contraction Tonic response A sustained muscle contraction

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

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.

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

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

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.

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

Ia or Primary Afferent Fiber

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

II or Secondary Afferent Fiber

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

Fusiform Fibers of GAMMA MOTOR NEURONS

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

Dynamic Gamma Motor neurons

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

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.

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. Tension that produce by active muscle during contraction. 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

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

somatic senses can be classified into three physiologic types:

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

Other Classifications of Somatic Sensations.

Exteroreceptive sensations are those from the surface of the body. Proprioceptive sensations are those having to do with the physical state of the body, including position sensations, tendon and muscle sensations, 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). Visceral sensations are those from the viscera of the body; in using this term, one usually refers specifically to sensations from the internal organs. Deep sensations are those that come from deep tissues, such as from fasciae, muscles, and bone. These include mainly deep pressure, pain, and vibration

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

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

two special types of sensory receptors

(1) muscle spindles - 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. (2) Golgi tendon organs - which are located in the muscle tendons and transmit information about tendon tension or rate of change of tension.

Sensory Innervation of the Muscle Spindle.

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

Muscle Spindle