Lecture 4: PNS Flashcards
Nervous structures outside the brain and spinal cord with the exception of the dorsal root ganglia
Peripheral Nervous System
PNS allows the ____ to receive information and take action
CNS
All nervous system structures enclosed by bone are considered part of the ______
CNS
Spinal nerve lesions are expressed in what way?
Myotomal/dermatomal pattern
Peripheral nerve lesions are expressed in what way?
peripheral nerve pattern
What parts of the neuron are in the spinal region?
nerve root
dorsal ganglia
spinal nerve
What parts of the neuron are in the peripheral region?
rami, plexus
axons and nerve endings
Postganglionic ANS
Where are afferent neuron cell bodies located?
Dorsal Root Ganglia
What type of neurons carry sensory information from the outer body toward the CNS?
Afferent (sensory) Neurons
Where are efferent neuron cell bodies located?
Ventral horn of the spinal cord
What type of neurons relay commands from CNS to smooth and striated muscles and glands (effectors)?
Efferent (motor) Neurons
Where are interneurons located?
within the CNS in the brain and spinal cord
What do interneurons do?
Process information locally and convey information short distances
Another name for a bundle of peripheral axons
Nerves
Clusters of peripheral neuronal cell bodies
Ganglia
Pick up stimuli from inside of outside of the body
Sensory Endings
Axon terminals of motor neurons innervate effectors (muscle fibers and glands)
Motor Endings
Cable-like tissues in PNS
nerves
Nerve Trunk
a large cable like tissue grouped by numerous fascicles
Nerve fascicles
groups of axons bound into bundles
Small-diameter axons that share Schwann cells are referred to as:
unmyelinated
Large-diameter axons that are fully wrapped by individual Schwann cells are referred to as:
myelinated
___________ is a layer of delicate connective tissue surrounding the axon
endoneurium
___________ is a layer of connective tissue surrounding a nerve fascicle
perineurium
__________ is a tough fibrous sheath surrounding a whole nerve
epineurium
Nerve fibers with different diameters have different __________ ___________.
Conduction velocities
________ results in fascicle gliding within the nerve and the nerve gliding relative to other structures
Movement
somatic peripheral nerves are usually mixed, consisting of _______, __________, and ______ axons
sensory
autonomic
motor
Sensory input and motor output is divided into 4 main subdivisions:
somatic sensory
visceral sensory
somatic motor
visceral motor (autonomic nervous system)
Somatic Sensory General Somatic Senses (Skin)
touch, pain, vibration, pressure, temperature
Somatic Sensory Proprioceptive Senses (Skeletal muscle)
detect stretch in tendons and muscle
provide information on body position
orientation and movement of body in space
Somatic Sensory Special Senses
hearing, balance, vision
Viceral Sensory General Visceral Senses
sensory neurons monitor stretch, temperature, chemical changes, and irritation
Viscera pain perceived to be somatic in origin is called
referred pain
Visceral Sensory Special Senses
olfaction (smell)
gustation (taste)
General somatic Motor Senses
signals contraction of skeletal muscles
under voluntary control
Visceral Motor makes up:
ANS
Parasympathetic/sympathetic
Regulates the contraction of smooth and cardiac muscle; controls the function of visceral organs
____ pairs of spinal nerves attach through dorsal and ventral nerve roots
31
Spinal nerves are named according to the spinal cord segment from which they originate. How many spinal nerves are in each segment?
8 cervical 12 thoracic 5 lumbar 5 sacral 1 coccygeal
Dorsal roots contain ________ fibers
sensory
Ventral roots contain _____ fibers arising from ______ ______ _______
motor
anterior gray column
Dorsal Root ganglion are home to:
afferent cell bodies
Outside the intervertebral foramen, spinal nerves re-branch as _______ and _______ ______
dorsal
ventral rami
Dorsal Rami Supply What?
The somatic motor and sensory fibers to smaller nerves that innervate the muscles and skin of the posterior head, neck, and trunk
Ventral Rami Supply What?
the muscles and skin of the limb and the lateral and anterior trunk
Where a ventral ramus communicates with a chain of sympathetic nerves
Sympathetic Rami
Another name for distal structures of ventral rami (all except for T2-T11)
nerve plexus
Four Nerve plexuses and their innervations
Cervical (C1-C4)
Brachial (C5-T1)
Lumbar (L1-L4)
Sacral (part L4-S4)
Phrenic nerve (C3-C5) is the sole nerve of the __________
diaphragm
The Cervical plexus carries efferent neurons to:
many muscles of the neck
The Cervical plexus carries afferent neurons from:
skin of the neck, shoulder, and scalp near ear
The brachial plexus carries efferent neurons to:
muscles of the shoulder, arm, forearm, and hand
The brachial plexus carries afferent neurons from:
skin of shoulder, arm, forearm, and hand
What are the main nerves of the brachial plexus?
Median Ulnar Radial Muculocutaneous Axillary
The lumbar plexus carries efferent neurons to:
muscles of the anterior pelvis, anterior and medial thigh
The lumbar plexus carries afferent neurons from:
skin of the anterior pelvis, anterior and medial thigh, and medial leg
The sacral plexus carries efferent neurons to:
muscles of the posterior pelvis, posterior thigh, anterior and posterior leg, and foot
The sacral plexus carries afferent neurons from:
skin of the posterior pelvis, posterior thigh, anterior and posterior leg, and foot
What muscles are innervated by the musculocutaneous nerve? (Elbow flexors, 3)
Coracobrachialis
Biceps brachii
Brachialis
What muscles are innervated by the median nerve?
Finger Flexors and Pronators
What muscles are innervated by the Ulnar nerve?
Finger Flexors
What muscles are innervated by the radial/axillary nerve?
Elbow/Finger extensors
What muscles are innervated by the femoral nerve?
Quads
What muscles are innervated by the Common Peroneal Nerve (Fibular)?
Ankle Dorsiflexors
Extensor of the Leg
What muscles are innervated by the Obturator nerve?
Hip abductors
What muscles are innervated by the Tibial nerve?
Plantar Flexors
Neuropathy with a single nerve involvement
Traumatic Myelinopathy
Mononeuropathy
neuropathy that is multifocal random, asymmetric involvement of individual nerves
Multiple mononeuropathy
Neuropathy that involves multiple peripheral nerves with symmetric distribution
Symptoms progress from distal to proximal
S/S of LMN disease
Polyneuropathy
What are some causes of injury to peripheral nerves
Trauma Compression (entrapment) Irritation Metabolic disorders Inflammatory (neuritis) Virus Age related changes
What type of pathology causes temporary damage to the myelin sheath that leads to a blockage of nerve conduction with no motor and sensory function distal to the injured nerve and can recover spontaneously over days or weeks?
Neurapraxia (Seddon’s Class 11)
What type of pathology causes axons and myelin sheaths to be damaged while Schwann cells, enoneurium, perineurium, and epineuirum remain in tact?
The axons degenerate distally and regeneration is about 1-2mm per day.
Axonotmesis (Seddon’s Class II)
What type of pathology causes a total severance/disruption of the entire nerve fiber as well as partial or total disruptions of connective tissues? It does not regenerate spontaneously and grafting is necessary to restore function.
Neurotmesis (Seddon’s Class III)
In what pathology is nerve conduction still in tact in the proximal and distal segment of the nerve, but not at the area of injury?
Neurapraxia (Class I)
In what pathology is there no nerve conduction distal to the site of injury?
Axontmesis (Class II) and Neurotmesis (Class III)
Where is the most common site of compression for the radial nerve?
Radial Groove
“Saturday Night Palsy” (wrist drop) is another name for:
neurapraxia
What type of traumatic myelinopathy is caused by compression of the median nerve?
Carpal Tunnel Syndrome
List 4 common causes of polyneuropathy
diabetes mellitus
virus infection
nutritional deficiencies
Autoimmune Disfunction
What are symptoms of small fiber involvement in polyneuropathy?
pain and temperature disturbances (numbness, painful paresthesias)
What are symptoms of large fiber involvement in polyneuropathy?
weakness, areflexia, sensory ataxia or loss of position and vibration sense