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Samenvatting - Zenuwstelsel
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Een volledige samenvatting van de module 'Zenuwstelsel' uit kwartaal 6 MGZ. Voor de volledige inhoud: zie de inhoudsopgave.
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Samenvatting‘Zenuwstelsel’
Daan Beers
Q6 – MGZ
,Inhoudsopgave
Anatomie centraal zenuwstelsel ....................................................................................................... 4
Neuronen ....................................................................................................................................... 4
Gliacellen ....................................................................................................................................... 4
Astrocyten ................................................................................................................................. 4
Oligodendrocyten ...................................................................................................................... 4
Microgliacellen .......................................................................................................................... 4
Ependymcellen .......................................................................................................................... 5
Hersenvliezen................................................................................................................................. 5
Dura mater ................................................................................................................................ 5
Arachnoïd mater ........................................................................................................................ 5
Pia mater ................................................................................................................................... 5
Cerebrospinale vloeistof ................................................................................................................. 5
Bloedvoorziening hersenen ............................................................................................................ 6
Doorbloeding van de diepe structuren ....................................................................................... 6
Veneuze systeem ....................................................................................................................... 6
Bloedvoorziening ruggenmerg ................................................................................................... 8
Macroscopie hersenen ................................................................................................................... 8
Frontale kwab ............................................................................................................................ 8
Temporale kwab ........................................................................................................................ 8
Pariëtale kwab ........................................................................................................................... 9
Occipitale kwab ......................................................................................................................... 9
Limbische kwab ......................................................................................................................... 9
Totaaloverzicht .......................................................................................................................... 9
Baansystemen ............................................................................................................................. 10
Sensorische baansysteem ........................................................................................................ 10
Thalamus ................................................................................................................................. 11
Motorische baansystemen ....................................................................................................... 11
Piramidebanen ........................................................................................................................ 12
Hersenstam.................................................................................................................................. 12
Nervus olfactorius (I) ............................................................................................................... 12
Nervus opticus (II).................................................................................................................... 13
Nervus oculomotorius, trochlearis & abducens (III-IV-VI) ......................................................... 13
Nervus trigeminus (V) .............................................................................................................. 13
Nervus facialis (VII) .................................................................................................................. 13
Nervus vestibulocochlearis (VIII) .............................................................................................. 13
Nervus glossofaryngeus (IX) ..................................................................................................... 14
Nervus vagus (X) ...................................................................................................................... 14
Nervus accesorius (XI) .............................................................................................................. 14
Nervus hypoglossus (XII) .......................................................................................................... 14
Ruggenmerg ................................................................................................................................ 14
Parasympatische zenuwstelsel ................................................................................................. 15
Sympatische zenuwstelsel........................................................................................................ 15
Blaas ........................................................................................................................................ 15
Cerebellum................................................................................................................................... 15
Verbindingen binnen het cerebellum ....................................................................................... 16
Somatotopie van het cerebellum ............................................................................................. 16
Basale ganglia ............................................................................................................................. 17
Perifere zenuwstelsel ...................................................................................................................... 18
Spiercellen ................................................................................................................................... 18
2
, Reflexen ....................................................................................................................................... 19
Reflexboog .............................................................................................................................. 19
Histologie zenuwweefsel ................................................................................................................. 20
Neuronen ..................................................................................................................................... 20
Neuronaal cytoskelet ............................................................................................................... 20
Axonaal transport .................................................................................................................... 20
Synapsen ................................................................................................................................. 21
Cerebrum ..................................................................................................................................... 21
Piramidecellen ......................................................................................................................... 21
Cerebellum................................................................................................................................... 21
Purkinjecellen .......................................................................................................................... 21
Ruggenmerg ................................................................................................................................ 22
Bloed-hersenbarrière ................................................................................................................... 22
Plexus choroideus .................................................................................................................... 22
Perifere zenuw ............................................................................................................................. 22
Opbouw zenuwvezels .............................................................................................................. 23
Regeneratie ................................................................................................................................. 23
Beeldvorming van het zenuwstelsel ................................................................................................ 24
CT-scan ........................................................................................................................................ 24
MRI-scan...................................................................................................................................... 24
MRI-techniek ........................................................................................................................... 24
Herseninfarct................................................................................................................................... 26
Beeldvorming ............................................................................................................................... 26
Corticaal infarct ....................................................................................................................... 26
Lacunair infarct ........................................................................................................................ 26
Subcorticaal infarct .................................................................................................................. 26
Waterscheidingsinfarct ............................................................................................................ 27
Trombolyse .................................................................................................................................. 27
Herstel cerebrale schade .............................................................................................................. 27
Ziekte ven Parkinson ....................................................................................................................... 28
Substantia nigra........................................................................................................................... 28
REM-sleep behaviour disorder ...................................................................................................... 29
Locus coeruleus ....................................................................................................................... 29
Behandeling Parkinson ................................................................................................................. 29
Levodopa ................................................................................................................................. 29
Overige behandelingen ............................................................................................................ 29
Polyneuropathie .............................................................................................................................. 31
Typen axonen............................................................................................................................... 31
EMG ........................................................................................................................................ 31
3
, Anatomie centraal zenuwstelsel
In het zenuwstelsel komen twee specifieke type zenuwcellen
voor: neuronen en gliacellen.
Neuronen
Neuronen hebben talloze contacten met elkaar en met doelorganen. De cellichamen van
neuronen vormen de grijze stof in de cortex of de dieper gelegen kernen, terwijl de axonen
van deze neuronen de witte stof in de vezelbanen en de perifere zenuwen vormen.
Gliacellen
Gliacellen ondersteunen de neuronen bij het uitoefenen van hun functie. Er zijn 10 tot 50
maal zoveel gliacellen als neuronen in het zenuwstelsel. Er zijn vier typen gliacellen.
Astrocyten
Astrocyt zijn steuncellen in de zenuwbanen die liggen tussen bloedvaten en
neuronen en alleen aanwezig zijn in het CZS. Ze hebben verschillende functies,
waaronder het verwijderen van sommige neurotransmitters (GABA, ATP en
glutamaat à zie ‘Elektrische verschijnselen’), regelen de ionenconcentratie en
spelen een rol bij de ontwikkeling van het centrale zenuwstelsel door vorming
van geleidende uitlopers waarlangs neuronen kunnen groeien. De astrocyten
stimuleren ook het herstel van neuronen bij eventuele beschadigingen door
gliose, wat een non-specifieke verandering is van gliacellen die gaan
prolifereren of hypertrofie laten zien. Daarnaast hebben astrocyten een
ontgiftende functie. Ook zijn astrocyten mogelijk betrokken bij het ontstaan
van epilepsie en Parkinson.
- Fibreuze astrocyten hebben lange, meestal onvertakte uitlopers, die
voornamelijk in de witte stof voorkomen;
- Protoplasmatische astrocyten hebben veel korte, vertakte uitlopers,
die in de grijze stof worden aangetroffen.
Oligodendrocyten
De oligodendrocyten komen in geringere aantallen voor dan astrocyten, maar
zijn wel het meest voorkomende celtype in de witte stof. Ze vormen de
myelineschede van axonen in het centrale zenuwstelsel. De cellen van
Schwann hebben deze functie in het perifere zenuwstelsel. Een
oligodendrocyt kan ongeveer twaalf axonen omwikkelen.
Microgliacellen
Microgliacellen zijn hele kleine cellen met een ovale kern en korte uitlopers. Ze liggen
verspreid door het CZS en bevatten talrijke lysosomen. Het zijn de macrofagen van het CZS,
die schadelijke materialen, zoals virussen en schimmels uit het centrale zenuwstelsel
verwijderen door middel van fagocytose. Ze komen zowel in de witte als de grijze stof voor.
Ze komen niet zoveel voor als astrocyten, maar nog steeds meer dan neuronen zelf. Ze zijn
niet afkomstig van de neurale buis.
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