神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件

神經(jīng)傳導(dǎo)功能檢測(cè)在臨床的應(yīng)用張杰敏神經(jīng)傳導(dǎo)功能檢測(cè)在臨床1第一部分神經(jīng)傳導(dǎo)檢測(cè)技術(shù)周?chē)窠?jīng)的解剖和生理特點(diǎn)解剖特點(diǎn)區(qū)絕大多數(shù)為混合神經(jīng):運(yùn)動(dòng)+感覺(jué)神經(jīng)兇神經(jīng)纖維:分有髓纖維和無(wú)髓纖維。電生理特點(diǎn)區(qū)可興奮性:將刺激轉(zhuǎn)化為神經(jīng)沖動(dòng)區(qū)可傳導(dǎo)性:具有雙向,絕緣的特點(diǎn)。第一部分神經(jīng)傳導(dǎo)檢測(cè)技術(shù)2神經(jīng)外膜神經(jīng)束膜神經(jīng)內(nèi)膜髓鞘軸索神經(jīng)纖維周?chē)窠?jīng)結(jié)構(gòu)剖析圖(縱向立體)神經(jīng)外膜3周?chē)窠?jīng)結(jié)構(gòu)剖析圖(橫切面)周?chē)窠?jīng)結(jié)構(gòu)剖析圖(橫切面)4光鏡InnerLip電鏡Medullarysheath光鏡5神經(jīng)傳導(dǎo)功能檢測(cè)原理及方法1.常規(guī)測(cè)試運(yùn)動(dòng)神經(jīng)傳導(dǎo)(MNC區(qū)感覺(jué)神經(jīng)傳導(dǎo)(SNC2.遲反應(yīng)測(cè)試(latereactionH反射(Hreflex)區(qū)F波(Fwaves)神經(jīng)傳導(dǎo)功能檢測(cè)原理及方法6運(yùn)動(dòng)神經(jīng)傳導(dǎo)MotorNerveConduction,MNC原理:區(qū)在神經(jīng)干某點(diǎn)給予電刺激后,從另一點(diǎn)或其效應(yīng)器上可記錄到神經(jīng)沖動(dòng)所產(chǎn)生的反應(yīng)電位,即動(dòng)作電位。運(yùn)動(dòng)神經(jīng)興奮引起肌肉收縮產(chǎn)生神經(jīng)肌肉復(fù)合動(dòng)作電位簡(jiǎn)稱M波。運(yùn)動(dòng)神經(jīng)傳導(dǎo)7方法:在神經(jīng)干上選擇兩點(diǎn)S1、S2,分別給予區(qū)MNC測(cè)試:定強(qiáng)度電流剝激,并在其支配肌肉上分別和距離計(jì)算出運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MCV)近端刺激點(diǎn)近端電位遠(yuǎn)端刺激點(diǎn)遠(yuǎn)端電位記錄點(diǎn)方法:8NerveEndIngMItochondriaClertSynapticPostsynaptic神經(jīng)肌接頭傳導(dǎo)NerveEndIng9參數(shù)測(cè)試:區(qū)潛伏期(Latency,L)區(qū)波幅(Amplitude,A)hbn區(qū)時(shí)程(Duration,D)Duration區(qū)運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度MotornerveConductionVelocity,MCV)MCV(m/s)S1,S2兩點(diǎn)間距(mm)(L2-L1)(ms)back參數(shù)測(cè)試:10神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件11神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件12神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件13神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件14神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件15神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件16神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件17神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件18神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件19神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件20神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件21神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件22神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件23神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件24神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件25神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件26神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件27神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件28神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件29神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件30神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件31神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件32神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件33神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件34神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件35神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件36神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件37神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件38神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件39神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件40神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件41神經(jīng)傳導(dǎo)功能檢測(cè)在臨床的應(yīng)用張杰敏神經(jīng)傳導(dǎo)功能檢測(cè)在臨床42第一部分神經(jīng)傳導(dǎo)檢測(cè)技術(shù)周?chē)窠?jīng)的解剖和生理特點(diǎn)解剖特點(diǎn)區(qū)絕大多數(shù)為混合神經(jīng):運(yùn)動(dòng)+感覺(jué)神經(jīng)兇神經(jīng)纖維:分有髓纖維和無(wú)髓纖維。電生理特點(diǎn)區(qū)可興奮性:將刺激轉(zhuǎn)化為神經(jīng)沖動(dòng)區(qū)可傳導(dǎo)性:具有雙向,絕緣的特點(diǎn)。第一部分神經(jīng)傳導(dǎo)檢測(cè)技術(shù)43神經(jīng)外膜神經(jīng)束膜神經(jīng)內(nèi)膜髓鞘軸索神經(jīng)纖維周?chē)窠?jīng)結(jié)構(gòu)剖析圖(縱向立體)神經(jīng)外膜44周?chē)窠?jīng)結(jié)構(gòu)剖析圖(橫切面)周?chē)窠?jīng)結(jié)構(gòu)剖析圖(橫切面)45光鏡InnerLip電鏡Medullarysheath光鏡46神經(jīng)傳導(dǎo)功能檢測(cè)原理及方法1.常規(guī)測(cè)試運(yùn)動(dòng)神經(jīng)傳導(dǎo)(MNC區(qū)感覺(jué)神經(jīng)傳導(dǎo)(SNC2.遲反應(yīng)測(cè)試(latereactionH反射(Hreflex)區(qū)F波(Fwaves)神經(jīng)傳導(dǎo)功能檢測(cè)原理及方法47運(yùn)動(dòng)神經(jīng)傳導(dǎo)MotorNerveConduction,MNC原理:區(qū)在神經(jīng)干某點(diǎn)給予電刺激后,從另一點(diǎn)或其效應(yīng)器上可記錄到神經(jīng)沖動(dòng)所產(chǎn)生的反應(yīng)電位,即動(dòng)作電位。運(yùn)動(dòng)神經(jīng)興奮引起肌肉收縮產(chǎn)生神經(jīng)肌肉復(fù)合動(dòng)作電位簡(jiǎn)稱M波。運(yùn)動(dòng)神經(jīng)傳導(dǎo)48方法:在神經(jīng)干上選擇兩點(diǎn)S1、S2,分別給予區(qū)MNC測(cè)試:定強(qiáng)度電流剝激,并在其支配肌肉上分別和距離計(jì)算出運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度(MCV)近端刺激點(diǎn)近端電位遠(yuǎn)端刺激點(diǎn)遠(yuǎn)端電位記錄點(diǎn)方法:49NerveEndIngMItochondriaClertSynapticPostsynaptic神經(jīng)肌接頭傳導(dǎo)NerveEndIng50參數(shù)測(cè)試:區(qū)潛伏期(Latency,L)區(qū)波幅(Amplitude,A)hbn區(qū)時(shí)程(Duration,D)Duration區(qū)運(yùn)動(dòng)神經(jīng)傳導(dǎo)速度MotornerveConductionVelocity,MCV)MCV(m/s)S1,S2兩點(diǎn)間距(mm)(L2-L1)(ms)back參數(shù)測(cè)試:51神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件52神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件53神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件54神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件55神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件56神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件57神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件58神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件59神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件60神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件61神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件62神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件63神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件64神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件65神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件66神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件67神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件68神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件69神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件70神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件71神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件72神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件73神經(jīng)傳導(dǎo)功能檢測(cè)在臨床應(yīng)用課件74神經(jīng)傳導(dǎo)功能檢