NEUROFYSIOLOGIE
INHOUDSOPGAVE
1. reflexen .............................................................................................................................................. 5
1.1 Definitie..................................................................................................................................................... 5
1.2. Reflexboog op elektrofysiologisch niveau...................................................................................................... 6
1.3. Reflex: onbewust vs bewust........................................................................................................................... 6
2. thalamus ............................................................................................................................................ 7
2.1. Relaycentrum ................................................................................................................................................. 7
2.1. somatosensorische cortex ............................................................................................................................. 7
3. soorten reflexen.................................................................................................................................. 8
3.1. locatie receptor/effector................................................................................................................................ 8
3.2. functioneel ..................................................................................................................................................... 8
4. proprioceptieve reflex ......................................................................................................................... 8
4.1. Proprioreceptoren .......................................................................................................................................... 8
4.2. spierspoelen ................................................................................................................................................... 9
4.3. eigenreflex = myotatische reflex .................................................................................................................. 10
4.4. Beëindigen eigenreflex ................................................................................................................................ 11
4.5. modulatie eigenreflex .................................................................................................................................. 11
4.6. Golgi peeslichaampjes ................................................................................................................................. 12
4.7. long-loop reflex ............................................................................................................................................ 13
4.8. Proprioceptieve reflexen .............................................................................................................................. 13
snoutreflex (pathologisch indien aanwezig)................................................................................................... 13
bicepspees-, brachioradialis -, tricepspeesreflex ........................................................................................... 13
kniepeesreflex................................................................................................................................................. 14
peesreflexen ................................................................................................................................................... 14
5. exteroceptieve reflexen..................................................................................................................... 14
5.1. buigreflex ..................................................................................................................................................... 14
5.2. gekruiste strekreflex .................................................................................................................................... 15
5.3. Exteroceptieve reflexen ............................................................................................................................... 15
palmomentale reflex ...................................................................................................................................... 16
buikhuidreflex ................................................................................................................................................. 16
voetzoolreflex – Babinnski .............................................................................................................................. 16
1
,6. primitieve reflexen ............................................................................................................................ 16
1. geëvokeerde potentialen................................................................................................................... 17
1.1. evaluatie EP ............................................................................................................................................ 17
2. types geëvokeerde potentialen.......................................................................................................... 18
2.1. VEP – SETUP ............................................................................................................................................ 18
visuele stimulus .............................................................................................................................................. 19
golfpatroon ..................................................................................................................................................... 19
processing visuele informatie ......................................................................................................................... 20
NPN pieken ..................................................................................................................................................... 21
VEP interpretatie ............................................................................................................................................ 21
pathologieën ................................................................................................................................................... 21
2.2. S(S)EP ...................................................................................................................................................... 22
meetelektroden .............................................................................................................................................. 22
neurale generatoren ....................................................................................................................................... 23
S(S)EP – interpretatie...................................................................................................................................... 24
S(S)EP – indicaties ........................................................................................................................................... 25
2.3. (B)AEP ..................................................................................................................................................... 25
1. CNS elektrochemie ............................................................................................................................ 27
2. elektro-encefalografie: EEG ............................................................................................................... 27
3. EEG................................................................................................................................................... 27
3.1. oorsprong EEG ........................................................................................................................................ 28
relevantie thalamus ........................................................................................................................................ 29
3.2. EEG setup ................................................................................................................................................ 30
3.3. EEG signalen ........................................................................................................................................... 31
3.4. EEG artefacten ........................................................................................................................................ 31
3.5. voordelen EEG vs andere CNS beeldvorming .......................................................................................... 32
magnetoencephalography (MEG) .................................................................................................................. 32
functional magnetisch resonance imaging (fMRI).......................................................................................... 33
Positron emission tomography (PET) ............................................................................................................. 33
3.6. EEG hersengolven ................................................................................................................................... 33
3.7. EEG analyse............................................................................................................................................. 34
4. hersengolven .................................................................................................................................... 35
4.1. gamma () golven ................................................................................................................................... 35
4.2. Beta () golven........................................................................................................................................ 35
4.3. Alfa () golven ........................................................................................................................................ 35
4.4. theta () golven ...................................................................................................................................... 36
4.5. delta () golven ....................................................................................................................................... 36
2
,5. EEG analyse ...................................................................................................................................... 37
6. epilepsie ........................................................................................................................................... 37
6.1. EEG epilepsie ........................................................................................................................................... 38
6.2. soorten epilepsie ..................................................................................................................................... 38
partiële epilepsie ............................................................................................................................................ 38
gegeneraliseerde epilepsie ............................................................................................................................. 38
7. slaap EEG .......................................................................................................................................... 39
7.1. slaap-waakcyclus .................................................................................................................................... 39
8. EEG – EMG in proefdieren.................................................................................................................. 39
1. inleiding............................................................................................................................................ 39
2. sensorisch systeem ........................................................................................................................... 40
2.1. sensorische receptoren ........................................................................................................................... 40
3. somatosensorisch systeem ................................................................................................................ 40
3.1. exteroceptie: 1e sensorisch neuron ......................................................................................................... 41
corpusculaire eindorganen ............................................................................................................................. 41
behaarde vs niet-behaarde huid .................................................................................................................... 42
mechanoreceptoren ....................................................................................................................................... 42
thermoreceptoren .......................................................................................................................................... 46
nocireceptoren ............................................................................................................................................... 47
overzicht receptoren ...................................................................................................................................... 48
3.2. Exteroceptie: 2e sensorisch neuron ......................................................................................................... 49
dorsale kolom – mediale leminiscus systeem ................................................................................................ 49
anterolateraal systeem ................................................................................................................................... 50
3.3. Exteroceptie: 3e sensorisch neuron ......................................................................................................... 50
4. pijn ................................................................................................................................................... 51
4.1. pijnperceptie ........................................................................................................................................... 51
4.2. acute vs chronische pijn .......................................................................................................................... 52
acute pijn ........................................................................................................................................................ 52
chronische pijn................................................................................................................................................ 53
4.3. pijnmatrix................................................................................................................................................ 53
4.4. pijnmodulatie .......................................................................................................................................... 55
1. anatomie motoriek ........................................................................................................................... 56
2. motorcortex...................................................................................................................................... 56
3. cerebellum........................................................................................................................................ 57
3.1. anatomie cerebellum .............................................................................................................................. 58
3
, 3.2. functionele anatomie cerebellum ........................................................................................................... 59
vestibulocerebellum ....................................................................................................................................... 59
spinocerebellum ............................................................................................................................................. 60
cerebrocerebellum ......................................................................................................................................... 60
3.3. cerebellaire laesies.................................................................................................................................. 61
3.4. samenvatting functies cerebellum.......................................................................................................... 61
cortex – cerebellum – cortex .......................................................................................................................... 62
4. basale ganglia ................................................................................................................................... 62
4.1. loop cortex – basale ganglia – cortex ..................................................................................................... 64
5. descenderende pathways .................................................................................................................. 64
6. motoriek........................................................................................................................................... 65
6.1. steunmotoriek......................................................................................................................................... 65
6.2. doelwitmotoriek...................................................................................................................................... 66
6.3. planning motoriek................................................................................................................................... 67
6.4. samenvatting anatomie motoriek .......................................................................................................... 67
7. spiegelneuronen ............................................................................................................................... 68
1. inleiding............................................................................................................................................ 69
1.1 viscerale reflexboog ................................................................................................................................ 69
1.2. autonom zenuwstelsel ................................................................................................................................. 70
2. hypothalamus ................................................................................................................................... 70
2.1. homeostase.................................................................................................................................................. 70
2.2. hypothalamus en limbisch systeem ............................................................................................................. 71
2.3. rol autonoom zenuwstelsel ..................................................................................................................... 71
3. perifeer autonoom zenuwstelsel........................................................................................................ 72
3.1. neurotransmitters in AZS ............................................................................................................................. 73
3.2. eindorganen autonoom Zenuwstelsel ......................................................................................................... 75
hypothalamus: fight or flight reactie .............................................................................................................. 75
4. bijniermerg ....................................................................................................................................... 76
4.1. HPA as: cortisol = stersshormoon ................................................................................................................ 76
4.2. hypothalamus: neuroendocrien systeem..................................................................................................... 77
5. effectorcellen: gladde spiercellen....................................................................................................... 77
5.1. single-unit spiertype .................................................................................................................................... 77
5.2. multi-unit spiertype ..................................................................................................................................... 78
5.3. antagoniserende orgaaneffecten ........................................................................................................... 79
4
INHOUDSOPGAVE
1. reflexen .............................................................................................................................................. 5
1.1 Definitie..................................................................................................................................................... 5
1.2. Reflexboog op elektrofysiologisch niveau...................................................................................................... 6
1.3. Reflex: onbewust vs bewust........................................................................................................................... 6
2. thalamus ............................................................................................................................................ 7
2.1. Relaycentrum ................................................................................................................................................. 7
2.1. somatosensorische cortex ............................................................................................................................. 7
3. soorten reflexen.................................................................................................................................. 8
3.1. locatie receptor/effector................................................................................................................................ 8
3.2. functioneel ..................................................................................................................................................... 8
4. proprioceptieve reflex ......................................................................................................................... 8
4.1. Proprioreceptoren .......................................................................................................................................... 8
4.2. spierspoelen ................................................................................................................................................... 9
4.3. eigenreflex = myotatische reflex .................................................................................................................. 10
4.4. Beëindigen eigenreflex ................................................................................................................................ 11
4.5. modulatie eigenreflex .................................................................................................................................. 11
4.6. Golgi peeslichaampjes ................................................................................................................................. 12
4.7. long-loop reflex ............................................................................................................................................ 13
4.8. Proprioceptieve reflexen .............................................................................................................................. 13
snoutreflex (pathologisch indien aanwezig)................................................................................................... 13
bicepspees-, brachioradialis -, tricepspeesreflex ........................................................................................... 13
kniepeesreflex................................................................................................................................................. 14
peesreflexen ................................................................................................................................................... 14
5. exteroceptieve reflexen..................................................................................................................... 14
5.1. buigreflex ..................................................................................................................................................... 14
5.2. gekruiste strekreflex .................................................................................................................................... 15
5.3. Exteroceptieve reflexen ............................................................................................................................... 15
palmomentale reflex ...................................................................................................................................... 16
buikhuidreflex ................................................................................................................................................. 16
voetzoolreflex – Babinnski .............................................................................................................................. 16
1
,6. primitieve reflexen ............................................................................................................................ 16
1. geëvokeerde potentialen................................................................................................................... 17
1.1. evaluatie EP ............................................................................................................................................ 17
2. types geëvokeerde potentialen.......................................................................................................... 18
2.1. VEP – SETUP ............................................................................................................................................ 18
visuele stimulus .............................................................................................................................................. 19
golfpatroon ..................................................................................................................................................... 19
processing visuele informatie ......................................................................................................................... 20
NPN pieken ..................................................................................................................................................... 21
VEP interpretatie ............................................................................................................................................ 21
pathologieën ................................................................................................................................................... 21
2.2. S(S)EP ...................................................................................................................................................... 22
meetelektroden .............................................................................................................................................. 22
neurale generatoren ....................................................................................................................................... 23
S(S)EP – interpretatie...................................................................................................................................... 24
S(S)EP – indicaties ........................................................................................................................................... 25
2.3. (B)AEP ..................................................................................................................................................... 25
1. CNS elektrochemie ............................................................................................................................ 27
2. elektro-encefalografie: EEG ............................................................................................................... 27
3. EEG................................................................................................................................................... 27
3.1. oorsprong EEG ........................................................................................................................................ 28
relevantie thalamus ........................................................................................................................................ 29
3.2. EEG setup ................................................................................................................................................ 30
3.3. EEG signalen ........................................................................................................................................... 31
3.4. EEG artefacten ........................................................................................................................................ 31
3.5. voordelen EEG vs andere CNS beeldvorming .......................................................................................... 32
magnetoencephalography (MEG) .................................................................................................................. 32
functional magnetisch resonance imaging (fMRI).......................................................................................... 33
Positron emission tomography (PET) ............................................................................................................. 33
3.6. EEG hersengolven ................................................................................................................................... 33
3.7. EEG analyse............................................................................................................................................. 34
4. hersengolven .................................................................................................................................... 35
4.1. gamma () golven ................................................................................................................................... 35
4.2. Beta () golven........................................................................................................................................ 35
4.3. Alfa () golven ........................................................................................................................................ 35
4.4. theta () golven ...................................................................................................................................... 36
4.5. delta () golven ....................................................................................................................................... 36
2
,5. EEG analyse ...................................................................................................................................... 37
6. epilepsie ........................................................................................................................................... 37
6.1. EEG epilepsie ........................................................................................................................................... 38
6.2. soorten epilepsie ..................................................................................................................................... 38
partiële epilepsie ............................................................................................................................................ 38
gegeneraliseerde epilepsie ............................................................................................................................. 38
7. slaap EEG .......................................................................................................................................... 39
7.1. slaap-waakcyclus .................................................................................................................................... 39
8. EEG – EMG in proefdieren.................................................................................................................. 39
1. inleiding............................................................................................................................................ 39
2. sensorisch systeem ........................................................................................................................... 40
2.1. sensorische receptoren ........................................................................................................................... 40
3. somatosensorisch systeem ................................................................................................................ 40
3.1. exteroceptie: 1e sensorisch neuron ......................................................................................................... 41
corpusculaire eindorganen ............................................................................................................................. 41
behaarde vs niet-behaarde huid .................................................................................................................... 42
mechanoreceptoren ....................................................................................................................................... 42
thermoreceptoren .......................................................................................................................................... 46
nocireceptoren ............................................................................................................................................... 47
overzicht receptoren ...................................................................................................................................... 48
3.2. Exteroceptie: 2e sensorisch neuron ......................................................................................................... 49
dorsale kolom – mediale leminiscus systeem ................................................................................................ 49
anterolateraal systeem ................................................................................................................................... 50
3.3. Exteroceptie: 3e sensorisch neuron ......................................................................................................... 50
4. pijn ................................................................................................................................................... 51
4.1. pijnperceptie ........................................................................................................................................... 51
4.2. acute vs chronische pijn .......................................................................................................................... 52
acute pijn ........................................................................................................................................................ 52
chronische pijn................................................................................................................................................ 53
4.3. pijnmatrix................................................................................................................................................ 53
4.4. pijnmodulatie .......................................................................................................................................... 55
1. anatomie motoriek ........................................................................................................................... 56
2. motorcortex...................................................................................................................................... 56
3. cerebellum........................................................................................................................................ 57
3.1. anatomie cerebellum .............................................................................................................................. 58
3
, 3.2. functionele anatomie cerebellum ........................................................................................................... 59
vestibulocerebellum ....................................................................................................................................... 59
spinocerebellum ............................................................................................................................................. 60
cerebrocerebellum ......................................................................................................................................... 60
3.3. cerebellaire laesies.................................................................................................................................. 61
3.4. samenvatting functies cerebellum.......................................................................................................... 61
cortex – cerebellum – cortex .......................................................................................................................... 62
4. basale ganglia ................................................................................................................................... 62
4.1. loop cortex – basale ganglia – cortex ..................................................................................................... 64
5. descenderende pathways .................................................................................................................. 64
6. motoriek........................................................................................................................................... 65
6.1. steunmotoriek......................................................................................................................................... 65
6.2. doelwitmotoriek...................................................................................................................................... 66
6.3. planning motoriek................................................................................................................................... 67
6.4. samenvatting anatomie motoriek .......................................................................................................... 67
7. spiegelneuronen ............................................................................................................................... 68
1. inleiding............................................................................................................................................ 69
1.1 viscerale reflexboog ................................................................................................................................ 69
1.2. autonom zenuwstelsel ................................................................................................................................. 70
2. hypothalamus ................................................................................................................................... 70
2.1. homeostase.................................................................................................................................................. 70
2.2. hypothalamus en limbisch systeem ............................................................................................................. 71
2.3. rol autonoom zenuwstelsel ..................................................................................................................... 71
3. perifeer autonoom zenuwstelsel........................................................................................................ 72
3.1. neurotransmitters in AZS ............................................................................................................................. 73
3.2. eindorganen autonoom Zenuwstelsel ......................................................................................................... 75
hypothalamus: fight or flight reactie .............................................................................................................. 75
4. bijniermerg ....................................................................................................................................... 76
4.1. HPA as: cortisol = stersshormoon ................................................................................................................ 76
4.2. hypothalamus: neuroendocrien systeem..................................................................................................... 77
5. effectorcellen: gladde spiercellen....................................................................................................... 77
5.1. single-unit spiertype .................................................................................................................................... 77
5.2. multi-unit spiertype ..................................................................................................................................... 78
5.3. antagoniserende orgaaneffecten ........................................................................................................... 79
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