nerve conduction sompol tapechum m.d., ph.d. department of physiology faculty of medicine siriraj...
TRANSCRIPT
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Nerve conduction
Sompol Tapechum M.D., Ph.D.Department of PhysiologyFaculty of Medicine Siriraj
Hospital
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Objectives
• นั�กศึ�กษาสามารถบอกประโยชนั�ของการวั�ด nerve conduction velocity ได�
• นั�กศึ�กษาสามารถบอกวั�ธี�การวั�ด nerve conduction velocity ได�
• นั�กศึ�กษาสามารถบอกป�จจ�ยที่�!ม�ผลต่%อ nerve conduction velocity ของ axon ได�
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Nervous system
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Structure of Nervous system
• Central nervous system (CNS)– Brain
• Cerebrum• Cerebellum• Brainstem
– Spinal cord
• Peripheral nervous system (PNS)– Nerves
• Cranial nerve 12 pairs• Spinal nerve 31 pairs
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Spinal nerve and Cranial nerve
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Nerve structure
• Nerve = Bundle of axon
• Component of nerve– Motor
• Somatic• Autonomic
– Sensory• Somatic• Visceral
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AxonS
enso
ry n
euro
nsM
otor
neu
rons
Orthodromic
Antidromic
Orthodromic
Antidromic
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Types of axon
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Type of axon
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Table ISomatosensory Receptors and their Peripheral Axons
Receptor Type Axon3 Group CAP Peak Conduction Velocity Axon Diameter Information Processed
Muscle Spindle: Annulospiral endings Ia A 70 - 120 m/sec 12 - 20 M Muscle length and velocity
Muscle Spindle: Flower Spray endings II A 30 - 70 m/sec 6 - 12 M Muscle length
Golgi Tendon Organ Ib A 70 - 120 m/sec 12 - 20 M Muscle tension
Joint: Pacinian II A 30 - 70 m/sec 6 - 12 M Joint movement
Joint: Ruffini II A 30 - 70 m/sec 6 - 12 M Joint angle
Joint: Golgi Tendon Organ II A 30 - 70 m/sec 6 - 12 M Joint torque
Meissner corpuscle II A 30 - 70 m/sec 6 - 12 M Touch, flutter or movement
Pacinian corpuscle II A 30 - 70 m/sec 6 - 12 M Vibration
Ruffini corpuscle II A 30 - 70 m/sec 6 - 12 M Skin stretch
Hair follicle II & III A & A 10 - 70 m/sec 2 -12 M Touch movement
Merkel complex II A 30 - 70 m/sec 6 - 12 M Fine touch
Free Nerve Endings III A 5 - 30 m/sec 1 - 6 M Sharp pain or cool/cold
Free Nerve Endings IV C 0.5 - 2 m/sec < 1.5 M Dull or aching pain, or touch or warm
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Nerve conduction
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Sensory conduction study
• Antidromic
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Sensory conduction study
• Orthodromic
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Motor conduction study
• Orthodromic
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Median nerve
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Motor conduction study:Median nerve
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Motor neuron
Neuromuscularjunction
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Neuromuscular junction
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Nerve conduction velocity
D1
D2
Latency (s) L1
L2
NCV = D1-D2L1-L2
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Sensory conduction study:Median nerve
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Purposes of Nerve conduction study
• To diagnose nerve damage or destruction
• To follow up nerve regeneration after damage
• To evaluate diseases of nerve or muscle
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Normal nerve conduction velocity
• normal conduction velocity– approximately 50 to 60 meters per second .– may vary from one individual to another and
from one nerve to another .
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Carpal tunnel syndrome
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Nerve injury
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Axon regeneration
2-4 mm/day
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Myasthenia gravis