Porth's Essentials of Pathophysiology, 4e

823

Organization and Control of Neural Function

C h a p t e r 3 4

Neuroglial Cells of the Peripheral Nervous System

the dendrites and the axon. The proteins and other mate- rials used by the axon are synthesized in the cell body and then flow down the axon through its cytoplasm. The cell body of the neuron is equipped for a high level of metabolic activity. This is necessary because the cell body must synthesize the cytoplasmic and mem- brane constituents required to maintain the function of the axon and its terminals. Some of these axons extend for a distance of 1 to 1.5 m and have a volume that is 200 to 500 times greater than the cell body itself. Two axonal transport systems, one slow and one rapid, move molecules from the cell body through the cytoplasm of the axon to its terminals. Replacement proteins and nutrients slowly diffuse from the cell body, where they are transported down the axon, moving at the rate of approximately 1 mm/day. Other molecules, such as neu- rosecretory granules (e.g., neurotransmitters and neuro- hormones) or their precursors, are conveyed by a rapid, energy-dependent active transport system, moving at the rate of approximately 400 mm/day. For example, antidiuretic hormone (ADH) and oxytocin, which are synthesized by neurons in the hypothalamus, are car- ried by rapid axonal transport to the posterior pituitary, where the hormones are released into the bloodstream. A reverse (retrograde) axonal transport is responsible for moving molecules destined for degradation from the axon back to the cell body, where they are broken down. Neuroglial Cells The neuroglial, or supporting cells, which outnumber neurons 10 to 1, provide support and protection for neurons in both CNS and PNS. Although they do not participate directly in the short-term communication of information through the nervous system, the support- ing cells segregate the neurons into isolated metabolic compartments, which are required for normal neural function. The neuroglial cells in the PNS include the Schwann cells and satellite cells. The CNS has four types of glial cells: astrocytes, oligodendrocytes (oligodendroglia), microglia, and ependymal cells. Two of these cell types share a similar function: The Schwann cells of the PNS and the oligodendrocyte of the CNS wrap nerve axons in multiple layers, producing myelin sheaths that serve to increase the velocity of nerve impulse conduction in axons (see Fig. 34-1B, inset). Myelin has a high lipid content, which gives it a whitish color, and hence the name white matter is given to the masses of myelin- ated axons of the spinal cord and brain. Besides its role in increasing conduction velocity, the myelin sheath is essential for the survival of larger neuronal processes, perhaps by secreting neurotrophic compounds. In some pathologic conditions, such as multiple sclero- sis in the CNS and Guillain-Barré syndrome involving the PNS, the myelin may degenerate or be destroyed, leaving a section of the axonal process without myelin while leaving the nearby Schwann or oligodendroglial cells intact. Unless remyelination takes place, the axon eventually dies.

The Schwann cells and satellite cells provide support and protection for the PNS. Schwann cells produce the myelin sheath that isolates nerve axons in the PNS from the sur- rounding extracellular compartment, ensuring rapid con- duction of nerve impulses. They also aid in cleaning up PNS debris and guide the regrowth of PNS nerve fibers. During the process of myelination, the Schwann cell wraps around each nerve fiber several times in a “jelly roll” fash- ion (Fig. 34-2). Successive Schwann cells are separated by short extracellular fluid-filled gaps, called the nodes of Ranvier, where the myelin is missing and voltage-gated sodium channels are concentrated. The nodes of Ranvier increase the speed of nerve conduction by allowing the impulse to jump from node to node through the extracel- lular fluid in a process called saltatory conduction. In this way, the impulse can travel more rapidly than it could if it was required to move systematically along the entire nerve fiber. This increased conduction velocity greatly reduces reaction time, or time between the application of a stimulus and the subsequent motor response. The short reaction time is especially important in peripheral nerves with long distances for conduction between the CNS and distal effector organs.

Epineurium

Perineurium

Endoneurium

Schwann cell

Node of Ranvier

Schwann cell nucleus

Layers of myelin

Axon

FIGURE 34-2. Section of a peripheral nerve containing both afferent (sensory) and efferent (motor) neurons. Schwann cells form a myelin sheath around the larger nerve fibers in the peripheral nervous system. Successive Schwann cells are separated by short extracellular fluid gaps called the nodes of Ranvier, where the myelin is missing and the voltage-gated sodium channels are concentrated.