Chapter

Systems Organization After Nerve Repair Or Transfer

Thomas M. Brushart

in Nerve Repair

Published on behalf of Oxford University Press

Published in print May 2011 | ISBN: 9780195169904
Published online September 2012 | e-ISBN: 9780199965168 | DOI: http://dx.doi.org/10.1093/med/9780195169904.003.0011
Systems Organization After Nerve Repair Or Transfer

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  • Sensory and Motor Systems
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The properties of denervated muscle fibers are respecified by the activity level of the reinnervating motoneuron, and the force generated by a motor unit gradually becomes proportional to the size of its motoneuron. Only 50-75% of muscle spindles and Golgi tendon organs are reinnervated, many of these respond abnormally to stretch, and the monosynaptic stretch reflex does not recover. The motor system can compensate for nerve transfer in higher primates and humans, but is unable to compensate for the disordered reinnervation that follows nerve repair even in young humans. Cutaneous sensory receptors are reinnervated in reduced numbers and have altered receptive field properties. Sensory cortex in area 3b and both the cuneate nucleus and VP nucleus of the thalamus undergo rapid changes in response to denervation in non-human primates. Initial cortical territories are restored after nerve crush, but digital projections remain highly disordered after nerve transection and repair.

Chapter.  16988 words.  Illustrated.

Subjects: Sensory and Motor Systems ; Rehabilitation Medicine

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