Degeneration/Regeneration : Recovery of Function Flashcards
Degeneration in the PNS
1) Axon is cut
2) Proximal and distal ends seal off leaking axoplasm and swell
3) Rapid degeneration of axon and myelin sheath in zone of injury
4) BV damage
5) Macroglia & microglia absorb and destroy debris
6) Glial cells proliferate and form scar tissue
Orthograde degeneration
- away from cell body
- Begins immediately
- Glial cells push old axon away from post-synaptic target
- Entire distal axon degenerates
(distal or proximal depends on whether the neuron is sensory or motor)
Retrograde degeneration
- toward cell body
- lesion is close to cell body, the whole neuron may die
Transneural Degeneration
- secondary neuronal death
- dependent on the number of neurons prior to/after the injured neuron
Orthograde transneural degeneration
-1st order neuron lesioned with multiple 2nd order neurons needing to synapse with the lesioned 1st order neuron
Retrograde transneural degeneration
-2nd order neuron lesioned that had multiple 1st order neurons synapsing on it
Recovery of Function
- No single mechanism
- collective contribution of several mechanisms
- multiple intervention approaches
Early Mechanisms of Recovery
Resolution of…
- spinal shock
- edema
- Diaschisis
Spinal Shock
- transient suppression of all reflex and motor activity below level of lesion
- immediate effect of spinal damage
- Initial: paralyzed & anesthetized, Autonomics are suppressed; loss of circulatory tone, urine retention, and anhidrosis (absence of sweating)
Resolution of Spinal Shock
-Presence of spasticity means period of spinal is ending or has ended
Edema
- Local or remote
- compress cell body or axon > causing focal ischemia > disrupts neural function, synthesis and transportation of NT
- synapse become inactive and silent
Cytogenic edema
accumulation of intracellular fluid
Vasogenic edema
proteins and fluid leaking from damaged blood vessels
Resolution of Edema (Blood Clot resolution)
Corticosteroids
Osmotic diuretics
Hyperbaric O2
Ice pack cooling 48-72hrs
Diachisis
- Sudden functional depression of neural networks distant from the primary site can be due to a reduction in blood flow and/or metabolism
- 2nd order neurons are being inhibited
Resolution of Diachisis
-early recovery of function following stroke is due to the resolution of diaschisis