Physiology

Sensory Fibres

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  • Conduction velocity of nerve fibres is increased by
    • Myelination
    • Increased diameter
    • Increased temperature
    • Increased external sodium ions
    • Decreased serum calcium
  • A-alpha fibres: muscle spindle afferents and skeletal muscle efferents
    • Largest diameter of any nerve fibre
  • A-gamma fibres: intrafusal fibres of muscle spindles
  • A-beta (type II) fibres: mechanoreceptors
    • Fast
    • Myelinated
  • A-delta (type III) fibres: mechanical “fast” nociceptors (cold, sharp acute injury pain)

    • Thinner
    • Slower than above
    • Myelinated
  • C (type IV) fibres: polymodal “slow” nociceptors (heat, dull inflammatory pain)

    • Thin
    • Slowest
    • Unmyelinated
  • All sensory fibres enter the spinal cord via the dorsal roots with cell bodies lying just before it in the dorsal root ganglia

  • Mechanoreceptors and proprioceptors:
    • Ascend in the dorsal columns
    • Synapse and then decussate at the level of the medulla
  • Nociceptors and temperature sensation:
    • Travel in the anterolateral, spinothalamic system
    • Ascend or descend 1-2 spinal segments before synapsing
      • A-delta synapse in lamina I
      • C fibres synapse in lamina II
    • Second order neurones decussate at the level of synapse and then ascend to the thalamus and synapse

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