1. صدق الله العظيم الاسراء اية 58

2. By Dr. Abdel Aziz M. Hussein Assist Prof. of Physiology Neurophysiology of Sensations

4. Peripheral Nervous System (PNS) Central Nervous System (CNS)

7. Cervical Thoracic Lumbar Sacral Cocygeal

10. NS has 3 main functional divisions; a) Sensory division of NS: Detects changes in internal and external environments and informs the CNS about them. b) Motor division of NS: Initiates and controls the activities of skeletal muscles Controls the activities of plain muscles, cardiac muscles and even glands. c) Intellectual division of NS: Consciousness, memory, learning, thoughts, emotions

11. Receptors Afferents Tracts Centers

13. 1) Def., Sensation is a conscious perception of particular feeling caused by stimulation of certain type of receptor by its adequate stimulus. 2) Classifications: Sensations GeneralSpecial Organic

14. 1) Special sensations: Vision, hearing, taste, smell and equilibrium 2) General sensations: Arise from receptors distributed allover the body Are classified into; a)Somatic sensations: from somatic structures e.g. skin b)Visceral sensations: from viscera 3) Organic senses: e.g. thirst, hunger and sexual desire

16. Def, These sensations arise from somatic structures of all the body i.e. skin and deep tissues e.g. sk ms Types: They include according to their adequate stimulus: 1.Mechanoceptive sensations: 2 types; – Tactile e.g. touch, pressure, and vibration sensations. – Proprioceptive sensations e.g. sense of position and movement 2. Pain sensation. 3. Thermal sensation; cold and warm.

18. Def., Feeling produced by application of light mechanical pressure to the skin Types: They include 2 types : 1.Crude touch 2.Fine touch

19. Def., Poorly localized touch sensation produced by touching the skin with diffuse ill defined object e.g. a piece of cotton or the touch of clothes.

20. Receptors: Free nerve endings Hair end organsPathway: Ventral or anterior spinothalamic tract

21. Def., Highly localized touch sensation produced by application of a well localized object to the skin e.g. a tip of a pencil or a head of a pin or teeth of a comb.

22. Receptors: Meissner's corpuscles Merkel's discsPathway: Dorsal column medial leminiscal system or gracile and cuneate tracts

23. Types: It includes : 1.Tactile localization: is the ability to localize the point of touch with eyes closed 2.Tactile discrimination : is the ability to perceive 2 points of touch with eyes closed as 2 separate points of touch 3.Stereognosis: is the ability to recognize a familiar object e.g. key with eyes closed

27. Pressure: It is a feeling produced by the application of heavy mechanical stimuli to the skin Vibration : It is a feeling of rhythmic pressure changes produced by the rapid repetitive stimulation of certain mechanoreceptors e.g. Pacinian and Meissner's corpuscles It is tested by use of tuning fork Pathway: Pathway: both sensations are carried by Gracile and Cuneate tract

30. Def : Feeling produced by stimulation of proprioceptors in skeletal muscle and joints Or It is the conscious perception of the position and movements of the different parts of the body, particularly the limbs and joints. Types: Types: a)Static or sense of position b)Dynamic or sense of movement of joints Pathway: Pathway: Dorsal column medial leminiscal system or Gracile and Cuneate tract

32. Significance: The brain and other motor centers e.g. basal ganglia, cerebellum use this information in the control of posture and movements N.B. Maintaining the body equilibrium or balance needs discharge from 3 kinds of receptors; 1.Proprioceptors of foot 2.Visual receptors 3.Vestibular receptors (Crista in semicircular canals and macula in utricle and saccule) in inner ear

34. Crista Amuplaris

35. Macula

37. Def : Unpleasant sensory and emotional experience associated with actual tissue damage.Significance: Pain is a protective mechanism for the body. It occurs whenever the tissues are damaged and it initiates protective reflex for removing the injurious stimulusReceptors: Free nerve endings Pathway: Pathway: lateral spinothalamic tract

39. Types: According to its source; 1.Cutaneous pain: pain comes from skin 2.Deep pain: pain comes from deep tissues e.g. skeletal muscle, joints, ligaments, and tendons and bone 3.Visceral pain: pain comes from viscera e.g. stomach According to its characters; 1.Fast pricking pain 2.Slow burning pain

40. Pathway or tract ReceptorsTool usedSensation Lateral spinothalamic tract Free nerve endingsPin Pain Ventral spinothalamic tract Free nerve endings and hair end organs Cotton wool Crude touch Dorsal column (gracile and cuneate tract) Meissner's corpuscles Merkels disc compass or pencil or coin Fine touch Dorsal column (gracile and cuneate tract) Pacinian Ruffini endings Different weights Deep pressure Dorsal column (gracile and cuneate tract) Pacinian Meissner’s corpuscles Tuning fork Vibration Dorsal column (gracile and cuneate tract) Muscle spindle Pacinian corpuscles Golgi tendon organs Finger or toe of the patient Proprioception

42. Def. Is the impairment of nerve functions due to high blood glucose Manifestations:

43. Sensory Neuropathy - Symptoms

44. Motor Neuropathy Symptoms

45. Autonomic Neuropathy Symptoms

46. Neuropathy - Signs

47. Glove and stock Hypoesthesia

48. Painless nature of diabetic foot disease

49. Sensory nerve damage

50. THANKS