Nerve conduction Sompol Tapechum M.D., Ph.D. Department of Physiology

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Nerve conduction Sompol Tapechum M.D., Ph.D. Department of Physiology Faculty of Medicine Siriraj Hospital

Objectives นักศึกษาสามารถบอกประโยชน์ของการวัด nerve conduction velocity ได้ นักศึกษาสามารถบอกวิธีการวัด nerve conduction velocity ได้ นักศึกษาสามารถบอกปัจจัยที่มีผลต่อ nerve conduction velocity ของ axon ได้

Nervous system

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

Spinal nerve and Cranial nerve

Nerve structure Nerve = Bundle of axon Component of nerve Motor Somatic Autonomic Sensory Visceral

Axon Motor neurons Sensory neurons Orthodromic Antidromic Orthodromic

Types of axon

Type of axon

Information Processed Table I Somatosensory Receptors and their Peripheral Axons Receptor Type Axon3 Group CAP Peak Conduction Velocity Axon Diameter Information Processed Muscle Spindle: Annulospiral endings Ia Aa 70 - 120 m/sec 12 - 20 mM Muscle length and velocity Muscle Spindle: Flower Spray endings II Ab 30 - 70 m/sec 6 - 12 mM Muscle length Golgi Tendon Organ Ib Muscle tension Joint: Pacinian Joint movement Joint: Ruffini Joint angle Joint:  Golgi Tendon Organ Joint torque Meissner corpuscle Touch, flutter or movement Pacinian corpuscle Vibration Ruffini corpuscle Skin stretch Hair follicle II & III Ab & Ad 10 - 70 m/sec 2 -12 mM Touch movement Merkel complex Fine touch Free Nerve Endings III Ad 5 - 30 m/sec 1 - 6 mM Sharp pain or cool/cold IV C 0.5 - 2 m/sec < 1.5 mM Dull or aching pain,  or touch or warm

Nerve conduction

Sensory conduction study Antidromic

Sensory conduction study Orthodromic

Motor conduction study Orthodromic

Median nerve

Motor conduction study: Median nerve

Motor neuron Neuromuscular junction

Neuromuscular junction

Nerve conduction velocity NCV = D1-D2 L1-L2 D1 Latency (s) L1 L2

Sensory conduction study: Median nerve

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

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.

Carpal tunnel syndrome

Nerve injury

Axon regeneration 2-4 mm/day

Myasthenia gravis

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