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1、临床医师-第六十六章周围神经损伤Chapter6peripheralnerveinjuryAnintroductiontothefirstquarterTheperipheralnervesaredividedintobrainnerves,spinalnervesandautonomicnerves,coveringallskin,mucousmembranes,muscles,bonejoints,bloodvesselsandinternalorgans・Itisacelloftheneuron,callednervefiber,andconsistsofaxon,my
2、elinsheathandSchwannsheath(figure661).Axonconstitutethecenteraxisofthenervefibers,containsmicrofilament,microtubule,mitochondria,andthegranularityofendoplasmicreticulumaxoplasmic,functionisthetransmissionofnerveimpulsesbetweenneuronsandnerveterminalstructure.Themyelinsheath,whichconsistsofm
3、yelinandprotein,iswrappedinanumberofsegments,alongtheaxon,andiscalledRanviernode,whichhastheabilitytopreventthespreadofexcitation.TheschwabbardismadeupofSchwanncells,whichisthepathwayofnerveregenegation・Theperipheralnervecanbedamagedbycutting,drawing,extrusion,etc・，whichcanbedividedintothre
4、etypes:Theneuropraxianervetemporarilylosesitsconductionfunctionandnervefibersdonotdegenerative.Theclinicalmanifestationmovementdisorderisobviousbutnotmuscleatrophy,thepainisdullandnotdisappear.Functionscanberestoredwithindaysorweekswithoutsequelae,suchastheparalysisofthetourniquet・2.Neurala
5、xoninterrupt(axonotmesis)nerveoppressedbybluntinjuryorpersistent,axonfracturereachtheaxonandmyelinsheathdegeneration,nerveliningtube,completeshaftlinealongtheschwannsheathlengthendings・Theclinicalmanifestationsoftheneuromaticmovement,sensoryloss,muscularatrophyandneurotrophicchangeswereperf
6、ormedinthisarea,butmanywereabletorecoverthemselves・Severecases,theformationofnerveparalysis,requireneurolysis・Thewordz，neurotme/zisagoodword・God，sbadfunctionisabookox.Aftertheneurodegenerationofthelesionandtheregenerationnerverupture,itsnearanddistalnervefiberwillbethefatherofWailer・Distala
7、xonandmyelinsheathforseveralhoursafterinjuryorstructurechange,2a3daysgraduallybrokendownintosmallersegmentsorpieces,5a6dayslater,thehyperplasiaofphagocytes,devouringremovedissolvedfractureofaxonandmyelinsheath・Meanwhile,sc
