2024 전기조절과 신경계(운동) PDF

Contents Part I: Communication in the body; Control of the body (1) Electrical Signal; Excitable tissue Humoral Signals (2) Introduction on the Nervous system Organization of the Nervous System Part II. The Motor System The Sensory System The Higher F...

Contents Part I: Communication in the body; Control of the body (1) Electrical Signal; Excitable tissue Humoral Signals (2) Introduction on the Nervous system Organization of the Nervous System Part II. The Motor System The Sensory System The Higher Function of the Brain No. Date Lectures Professor Human Anatomy Course Introduction/Human Dissection Physiology/ 1 Sep. 3 & Physiology Concept and Humoral Control of the Body Soo Hwan Lee Human Anatomy 2 Sep. 10 & Physiology Electrical control of the Body/ The Nervous system (Motor) Eun Joo Baik Human Anatomy 3 Sep. 24 & Physiology The Muscular System/ The Cardiovascular system/ ECG Soo Hwan Lee Human Anatomy The Respiratory System/ Autonomous N 4 Oct. 1 & Physiology ervous System Eun Joo Baik Human Anatomy 6 Oct. 8 & Physiology The Gastrointestinal System/ The Endocrine System Soo Hwan Lee Human Anatomy 7 Oct. 15 & Physiology The Renal System/ The Nervous System(Sensory: General) Eun Joo Baik Human Anatomy The Nervous system (Special Senses)/ 8 Oct. 29 & Physiology The Higher Function of the Brain/EEG Eun Joo Baik How can we transmit signals to the Brain Introduction of the Nervous System How the brain control the body? 사진=클립아트코리아 아주대학교 의료인공지능 전공과정 의과대학 생리학 백은주 5042 [email protected]  인간 지능 vs 인공 지능 “인간 뇌는 오류 기계’ 수업후 기억 쉬운 일반화, 다양하고 많은 편견, 기억왜곡 등 수학적 완결성 스스로 학습을 통해 기고, 걷고, 뛸 수 있다. 예견과 예상’Expectation’ 경험후 수정; 실수를 통해 배우는 동물 기억과 판단 Comprehension이 필요한 일 인공지능의 한계 Part1. Objectives Cell Membrane Potential 막전위 Action Potential 활동전위 Cable Theory 케이블이론 Nerve Impulse 신경흥분파 Synapse 시냅스 Central Nervous System vs Peripheral Nervous system 중추신경계와 말초신경계 Autonomic nervous system 자율신경계 Excitable tissue (흥분성 조직) Neuron vs Wire conductor Organic electrochemical neurons and analogy with the biological neurons. Cable property Cell Membrane Potential (세포막전위) Electrically charged or polarized Distribution of ions; Na+, K+ Resting membrane potential Graded potential Action Potential (활동전위) Cell Membrane Potential(세포막전위) Resting membrane potential 안정막전위 Recording electrode and stimulating electrode 기록전극과 자극전극 Electrotonic Potential; Graded potential Action Potential (활동전위) Measurement of Membrane Potential 막전위측정 1  Generating Mechanism of Membrane potential 막전위발생기전 Ionic distribution Driving force Membrane Potential Ion channel (이온통로) Ion selectivity Driving force States of Channel Opening of Channel Ion channel (이온통로) Na+ & K+ Equilibrium Potential (평형전압)  Equilibrium potential 평형전압 Flux of ions is determined by electrochemical driving force and conductance. Nernst potential Nernst Equation;  막의 특성 (Resistor and Capacitor) Equivalent circuit model Resistance; the relative inability of an electrical charges to migrate from one point to a another, reciprocal of conductance Conductance (γ) ; The ability for electrical charge to flow through the membrane Capacitance (Cm) ; the amount of electric charge stored on a conductor to a difference in electric potential. Shape of action potential Polarized Depolarization Repolarization Hyperpolarization Spike All or none Afterpotential Propagation Voltage-gated Na+ channel and voltage-gated K + channel Voltage-gated Driving force Inactivation Voltage-gated Delayed Rectifier Recording of Action potential 활동전위 기록 Electrotonic Potential Graded response Passive (cable) property Time constant Length constant Action Potential Threshold All or none Self propagation Time constant 시간상수 Vm(t) = Im R(1-e-t/τ) e, the value of 2.72, is base of the system of natural logarithms τ, equals RC, the product of the resistance and capacitance of the membrane called the membrane time constant Time constant = Rm·Cm (Ωcm ∙f/cm ) = Ωf = v/Amp · Amp sec /v = sec  Length constant 시간상수 ; is the distance over which an electrotonically conducted signal falls to 37%(1/e) of its initial length Vm(x) = Vo e-x/λ λ ; Membrane length constant x ; Distance from the site of current injection Vo ; Change in membrane potential produced by the current flow at the site of the current electrode Time constant and Action Potential Propagation; Electrotonic conduction ; not propagated along the length of the cell; so called local response (1) conducted to the trigger zone Axon hillock and Action Potential Electrotonic Potential Graded response Passive (cable) property Time constant Length constant Action Potential Threshold All or none Self propagation Characteristics of Action Potential - All-or none - Frequency mode Transmission of myelinated fiber and unmyelinated fiber 유수신경섬유와 무수신경섬유의 흥분전달 - Saltatory conduction 도약전도 Synapse 시냅스 Synaptic Transmission Excitatory and Inhibitory Neurotransmitters Types of Synapse 시냅스 형태 Neurotransmitters 신경전달물질  Glutamate receptors Ionotropic receptor 이온이동성 수용기 Ionophore 이온운반체 Synaptic potential 시냅스 전위 End Plate 종판 Acetylcholine-gated Ion channel Both Na+ K+ Electrotonic potential-like Not action potential by the makers of Kenhub  Synaptic transmission in chemical synapse 1. Action potential in the presynaptic cell 2. Ca++ influx in presynaptic terminal 3. Secretion of neurotransmitter 4. Binding of neurotransmitter on postsynaptic receptor - synaptic cleft 5. Inhibitory or Excitatory Postsynaptic Potential - Inhibitory neurotransmitter - Excitatory neurotransmitter 6. Action potential in the postsynaptic cell Central Nervous System and Peripheral Nervous System 32 Structure of Central Nervous System 33 Spinal nerve Cranial nerve Peripheral nerve fibers; somatic motor and autonomic motor 36 The Nervous System: Motor System 백은주 031-219-5042 [email protected]  Part2: Objectives How can we control our muscular system (motion)? How can we control our inner organ? 1. Alpha motor neuron vs gamma motor neuron 2. Spinal Reflex 3. Brainstem 4. Descending motor pathways in the spinal cord 5. Motor cortex 6. Function of Cerebellum 7. Function of Basal ganglia How can we move? (기저핵) (소뇌)  Motor Unit Upper motor neuron Lower motor neuron Voluntary movement Involuntary movement Spinal cord lesions Alpha Motor Neuron vs Gamma Motor Neuron 근육의 감각기관 Proprioceptors in the Muscle (1) Muscle spindle (근방추); sensing length change (2) Golgi tendon organ (골지 건); sensing tension (over-stretch) Spinal Reflex(척수반사) Reflex arc Knee Jerk Monosynaptic Reflex Hyperreflexia Hyporeflexia Normoflexia Knee jerk, Stretch reflex, Monosynaptic reflex, Myotactic reflex 무릎반사, 신전반사, 단일시냅스반사, 근고유감각반사 A segmental phenomenon Antagonistic inhibition; Disynaptic inhibitory reflex The alpha motor neurons receives facilitatory and inhibitory inputs Receptor and Effector Golgi tendon reflex (Inverse stretch reflex, Autogenic inhibition, Tendon reflex  Flexion reflex 1) Receptors; nociceptors (A and C fibers) 2) Effector organs; flexors in the physiologic, not anatomic 3) Polysynaptic (multisynaptic) pathways Crossed Extensor reflex Central pattern generators  Central Pattern Generator Central pattern generator (CPG)-based locomotion control. Bio-inspired CPG-based robotic locomotion control. The proposed CPG hardware implementation is based on coupled insulator-to-metal phase-transition nano-oscillators (IMT-NOs) Coactivation of alpha and gamma motoneurons Gamma loop Topographic Organization of the Ventral Horn  BRAIN STEM Components: Medulla, Pons, Midbrain, Diencephalon Function: Regulation of blood pressure, respiratory center, Temperature regulation, sleep, consciousness and arousal Reticular formation (망상체, 그물체) Vestibular nuclei (전정핵) 1) Cranial nerves and their nuclei 2) Ascending lemniscal pathways 3) Reticular nuclei 4) Descending pathways 5) Pathway to and from the cerebellum  Reticular formation 1) Somatic motor control: tone, balance, posture 2) Cardiovascular control 3) Pain modulation 4) Ascending reticular activating system: regulator of consciousness, Arousal, Attention, Sleep, Awareness 5) Habituation Descending Motor Pathways 1. Pyramidal vs extrapyramidal pathway Corticospinal tract 2. Motor area  Lateral vs Medial motor system (1) Lateral motor pathways - Pyramidal tract, rubrospinal tract - Control of distal muscles (2) Medial motor pathways - Control proximal muscles - Posture and ability to stand or sit upright in a three-dimensional, gravitational field - Control righting reflexes such as vestibulispinal system  Vestibular system reflexes 1) Vestibular receptors 2) Vestibular nuclei(VN) - Excitatory to antigravity alpha motoneurons. 3) Vestibulo-ocular reflex and Optokinetic reflex - VOR; eye movements that stabilize gaze during head movement - Optokinetic reflex; follow objects in motion with stationary head  Motor cortex 1. Primary motor cortex; Homunculus 2. Supplementary motor area, 보조운동영역 Contextural control 3. Premotor area, 전운동영역 Prepare for exercise, plan, learn new exercise “Mirror neuron”  Motor cortex 1. Primary motor cortex; Homunculus 2. Supplementary motor area, 보조운동영역 Contextural control, programming complex sequences of movement and coordinating bilateral movements 3. Premotor area, 전운동영역 Prepare for exercise, plan, learn new exercise, “Mirror neuron” Motor cortex 4. Cingulate cortex 5. Posterior Parietal cortex The cerebellum 1. Lobes; anterior, posterior, and flocculonodular lobes (1) Phylogenetic nomenclature 1) Flocculonodular lobe; archicerebellum 2) Anterior lobe; paleocerebellum 3) Posterior lobe; neocerebellum (2) Functional nomenclature 1) Vestibulocerebellum; flocculonodular lobe 2) Spinocerebellum; entire anterior lobe, and those parts of the posterior lobe that receive information from the spinal cord 3) Cerebrocerebellum ; the remainder of the posterior lobe Structure of cerebellum Cerebellar cortex 1) Granule cell layer; the innermost layer contains 10 billion granule cells as well as a smaller number of interneurons, called Golgi cells 2) Purkinje cell layer; the middle layer contains Purkinje cells 3) Molecular layer; the outer layer contains two types of interneurons, the basket cells and the stellate cells Output and input of Cerebellum Afferents; Mossy fibers and Climbing fibers Efferents; Purkinje cell axons  Cerebellar lesions A. Lesions in the vestibulocerebellum Loss of vestibular function(e.g. loss of equilibrium, ataxia) Wide-base gait B. Lesions in the spinocerebellum In cats, the ant. Lobe lesions increase the antigravity muscles’ tone C. Lesions in the cerebrocerebellum Smooth and coordinated movements is lost.  Motor deficits of cerebellar lesions 1) A major sign of cbll disease is decomposition of movement 2) Dysmetria 3) Intention tremor 4) Adiadochokinesia  The Basal Ganglia To aid the motor cortex in planning and generating motor commands 1. Basal nuclei; The basal ganglia consist of five nuclei. 1) Caudate nucleus 꼬리핵 2) Putamen 조가비핵 3) Globus pallidus 창백핵 4) Subthalamic nucleus 시상밑핵 5) Substantia nigra 흑질 * Striatum(neostriatum); 줄무늬체 caudate nucleus and putamen Components of Basal ganglia By naver 1) Caudate nucleus 미상핵 꼬리핵 2) Putamen 조가비핵 3) Globus pallidus 담창구, 창백핵 4) Subthalamic nucleus 시상밑핵 5) Substantia nigra 흑질  Circuits of Basal Ganglia Cortico-basal ganglia-thalamo-cortical loop Dopaminergic cell group Direct Path Cerebral Input Output Cerebral Thalamus cortex nuclei nuclei Cortex Brain stem Globus pallidus Subthalamic External seg. Nucleus Indirect Path Neurotransmitters of Basal ganglia Dopamine GABA Glutamate Motor control by Basal ganglia and Cerebellum Basal ganglia: Role of selecting and performing cognitive, executive, and emotional programs stored in the cerebral cortex Cerebellum: Posture maintenance and control balance, coordination, fine adjustments, and skilled motor learning Lesions of Basal ganglia; Dyskinesia (운동장애) Inability to maintain posture Hemiballism (subthalamic lesion) Huntington‘s chorea Parkinson’s disease Mechanisms and symptoms of Parkinson’s Disease Causes: Loss of Dopaminergic neuron in the substantia nigra Characteristic Sx; 1) Rigidity; lead-pipe rigidity, cogwheel rigidity 2) Hypokinesia 3) Resting Tremor Therapy: L-dopa, a precursor of dopamine Stem cell therapy Transplantation Deep Brain Stimulation Summary of Motor system