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Peripheral Nervous System - The Relationship With Peripheral Polyneuropathy

Peripheral polyneuropathy is a cause of great suffering

The brain centralizes the control of all body functions through the nervous and peripheral system

The peripheral nervous system it is a source of “annoyance”, due to the peripheral polyneuropathy that was installed, greater since 2014, maybe 2015.

In the name of clarity of the facts, the problem started a decade earlier and has been the cause of endless nights and nights of insomnia caused by pain and unpleasant sensations. Many years ago my left hand began to open and close, as if my brain were looking for it! Another inconvenience, I often felt my right arm as if plunged into flames (it's crazy) and my right arm plunged into ice (also crazy).

The pains, from boring and unpleasant, became disconcerting and overwhelming.

I lived, for years and years, in the search for understanding the phenomenon, as well as in the search for relief.

Relief for damage to my Peripheral Nervous System

Finding the source of neuropathic pain and relieving it is a difficult undertaking.

And that's why I share, here on the Soropositive Blog, some information about…Sistema Nervoso Periférico

The Peripheral Nervous System

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Peripheral Nervous System, what is it?

Numbness, tingling, and weakness are some of the most common reasons people see a neurologist. The first step is usually to decide if the problem is in the central nervous system (brain and spinal cord). Otherwise, the problem is likely to lie with the nerves that extend into the body.

The peripheral nervous system encompasses all the nerves that flow between the spinal cord and muscles, organs and skin. A thorough understanding of the peripheral nervous system is considered one of the most distinguishing features among neurologists and other physicians.


What are peripheral nerve cells

There are many categories of nerve cells, each transmitting slightly different information to the brain along stringy processes called axons. Also, some of these axons are wrapped in a protective layer called myelin, which can accelerate the electrical transmission of messages along the axon. For example, motor neurons have large myelinated axons that extend from the spinal cord to different muscles to control their contraction.

Sensory neurons come in many categories. great axons myelinated carry information about vibration, light touch and our perception of our body in space (proprioception). — This increases the risk of falls —. Finely myelinated fibers send information about acute pain and low temperature. Very small, unmyelinated fibers convey messages about burning pain, feeling hot, or itchy.

In addition to motor and sensory axons, the peripheral nervous system also includes autonomic nerve fibers. The autonomic nervous system is responsible for controlling critical daily functions that, fortunately, are mostly located beyond our conscious control, such as blood pressure, heart rate and sweating.

All of these different axonal fibers travel together like bundles of wires in a cable. This “cable” is large enough to be seen without a microscope and is what is commonly called a nerve.


Organization of the Peripheral Nervous System

Except for the cranial nerves, all the peripheral nerves travel from and to the spinal cord. Sensory nerves enter the spine near the back of the spinal cord and motor fibers exit at the front of the cord. Shortly thereafter, all the fibers combine to form a nerve root. This nerve will travel through the body, sending branches at appropriate locations.

In many places, such as the neck, arm, and leg, nerve roots combine, mix, and then give off new branches. This mixture, called the plexus, is something like a complicated free-form interchange and ultimately allows signals from one source (eg, axons that exit the spinal cord at level C6) to end up traveling along fibers of a different level. from the spinal cord (eg C8) to the same destination (eg a muscle such as the latissimus dorsi). An injury to this plexus can have complicated results that can confuse someone unaware of this plexus.


How Neurologists Use Peripheral Nervous System Anatomy
When a patient suffers from numbness and/or weakness, it is the neurologist's job to locate the source of the problem. Often, the part of the body that feels weak or numb does not contain the nerve responsible for the symptom.

For example, imagine that someone suddenly discovers that their foot keeps dragging on the ground as they walk. The cause of this person's feet weakness probably not on foot, but due to nerve damage elsewhere in the body.

By talking to this patient and doing a careful physical examination, the neurologist can determine the source of the weakness. Your doctor will recognize that the muscles responsible for keeping the foot off the ground while walking include the extensor digitorum longus, which receives innervation from the common peroneal nerve. When people sit with one knee over the other, this nerve can be compressed, causing mild weakness and foot drop.

If, however, the physical examination also reveals that the patient cannot stand on tiptoe on that foot, the neurologist will no longer suspect the peroneal nerve. The muscles that point to the foot are innervated by the anterior tibial nerve, which branches before the common peroneal nerve.

The anterior tibial and common peroneal nerves carry fibers that are originally sent from the spinal cord at the L5 level. This means that the problem is not compression in the knee, but closer to where the nerves exit the spinal cord. The probable cause is lumbar radiculopathy, which, in extreme cases, may require surgery to correct it.


Why take these exams?
The example given is intended to demonstrate how knowledge of the peripheral nervous system, combined with careful physical examination and listening to the patient, can make the difference between just telling a patient to stop crossing their legs or saying they may need surgery. on the back. 

Similar examples can be given for almost any part of the body. For this reason, all medical students, not just neurologists, learn the importance of the peripheral nervous system.


Credits
  • Alport AR, Sander HW, Clinical Approach to Peripheral Neuropathy: Anatomic Localization and Diagnostic Testing. Continuum; Volume 18, No. 1, February 2012
  • Blumenfeld H, Neuroanatomy through Clinical Cases. Sunderland: Sinauer Associates Publishers 2002


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