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Chapter 3 / Body Systems
101
myofilaments remain the same length, but that the overall length of the sarcomere shortens because the myofila­ments slide together. Calcium molecules first uncover sites on the actin where the myosin can attach. Once those sites are exposed, the myosin’s cross bridges latch onto the actin filaments like Velcro. Temporarily connected, the actin fila­ments are pulled closer together, overlapping the myosin filaments. Figure 3-38 illustrates the sliding filament mecha­nism. The overlapped filaments create a shorter sarcomere,
resulting in a shorter fibril. When many fibrils shorten, the whole muscle cell shortens. Clearly, calcium is necessary for muscle contraction, which is one of the reasons calcium should be included in a balanced diet.
Muscular Control Mechanism
The sliding together of the myofilaments begins with a nerve impulse from the CNS via a somatic motor neuron. One somatic motor neuron can stimulate hundreds of
Tendon
Bone
Muscle
Single myofibril
H zone
I band I band
Sarcomere unit
M line
H zone
H zone
A bandA band
A band
A band
Z lineZ line
I band
I bandI band
Myofibrils
Myosin (thick filament)
Actin (thin filament)
Troponin complex
Bundle of muscle fibers (facide)
Single muscle fiber
Mitochondrion
Myosin tail
Tropomyosin
Nucleus
Sarcoplasmic reticulum
Sarcolemma (plasma membrane)
Myosin head
Myosin binding site
Cross section of filaments
Figure 3-38. Sliding filament mechanism. (Reprinted with permission from McArdle WD, Katch FI, Katch VL. Exercise Physiology:
Energy, Nutrition, and Human Performance. 5th ed. Baltimore: Lippincott Williams & Wilkins, 2001.)
102 INTRODUCTION TO MASSAGE THERAPY
Posterior
Ventral root
Mixed spinal nerve
Motor neuron
Figure 3-39. Motor unit. (Reprinted with permission from Bear
MF, Connors BW, Paradiso MA. Neuroscience: Exploring the Brain. 2nd ed. Baltimore: Lippincott Williams & Wilkins, 2001.)
Lower motor neurons
Muscle cells
Anterior
Axonal terminals at neuromuscular junction
Ventral horn
muscle cells, but each muscle cell is controlled by only one somatic motor neuron. The more muscle fibers one nerve must supply, the less precise the movements. One motor neuron and all of the muscle cells it stimulates is called a motor unit (Fig. 3-39). The extension of this neuron that communicates to the fibril is called an axon (AK-sahn) and
branches out with axonal terminals, like tree branches, as it nears the muscle cells. Each axonal terminal meets the motor end plate, the place on the muscle cell membrane that receives the nerve impulse, at a synaptic cleft, which is the space between the axon and muscle cell. This collection of structures, including the axonal terminal, the synaptic cleft, and the motor end plate, is called the neuromuscular junction. Figure 3-40 illustrates the neuromuscular junction.
The axonal terminal releases a chemical neurotrans­mitter called acetylcholine (ah-SEE-tuhl-KOH-leen) that is received by the motor end plate and triggers muscle contrac­tion. (The series of events that occurs at the neuromuscular junction is described in detail below in the nervous system section.) As soon as the acetylcholine causes the muscle fiber to contract, it is broken down by a chemical in the syn­aptic cleft to prevent an unwanted sustained contraction. If more nerve impulses are conducted to the same muscle cell, it can sustain a prolonged contraction.
A minimal amount of current, called the threshold stimulus, is necessary to stimulate the contraction of a muscle cell. When the threshold is reached, the muscle cell reacts with complete contraction. All the muscle cells in a motor unit respond as one when stimulated. This response is commonly called the “all-or-none” principle, meaning the muscle cells contract completely or not at all. The all-or­none principle may seem counterintuitive, since we know muscle contractions can be precise or forceful. Remember, there are thousands of muscle cells in a whole muscle. The strength of the whole muscle contraction is determined by the number of muscle cells that have been stimulated to contract. In other words, a whole muscle contraction does not require every muscle cell to contract. The precision of a movement is determined by the number of muscle cells that are controlled by a single nerve cell. A motor unit that
Figure 3-40. Neuromuscular
junction.
Axon terminal
Muscle cell nucleus
Axon to motor neuron
Motor end plate
Muscle cell
Mitochondrion
Synaptic vesicle
Sarcolemma
Synaptic cleft
Neurotransmitter (acetylcholine)
Chapter 3 / Body Systems
has a few muscle cells will be able to control the contrac­tion more precisely than a motor unit that has hundreds of muscle cells.
103
Bone
Structures of a Whole Skeletal Muscle
A skeletal muscle is made up of bundles of muscle cells held together with connective tissue. This fibrous connective tis­sue, called fascia, carries blood vessels and nerves into the muscle and mechanically transmits the force of the contrac­tion from one end of the muscle to the other. The basic component of the muscle tissue bundle is the muscle cell, or muscle fiber. The cells are very fragile, but each one is wrapped in a connective tissue covering called endomysium (EN-doh-MAHY-see-um). Several cells and the nerve cells that supply them are bundled together to create a fascicle (FAS-sih-kul), which is wrapped with connective tissue called the perimysium. The fascicles, along with blood vessels, nerves, and muscle spindles (special sensory receptors of muscles that are discussed below in the nervous system sec­tion), are then bundled together by the epimysium, which is the connective tissue covering of the whole muscle. The epimysium blends into the tendons or aponeuroses, which attach the muscles to bones, cartilage, or other connective tissue coverings. The thickest part of a muscle that is pri­marily made of muscle cells and has a pinkish appearance is sometimes called the belly of the muscle. Tendons are very strong and thin and can easily anchor at transverse bony projections and joints to provide durability and save space. Once the small, delicate cells are wrapped in connec­tive tissue and bundled together, a very strong and resilient structure is created. Figure 3-41 illustrates the structures that form a skeletal muscle.
Functions of the Muscles
The primary function of the muscular system is to create movement, but muscles also produce heat, support the skel­eton, maintain posture, and provide some protection from external forces.
Movement
All muscle cells have the ability to contract, bringing the ends of the cell closer together. On a cellular scale, this movement is amplified by the many bundles of muscle cells to create movement of entire muscles. Cardiac and smooth muscles in the walls of organs squeeze contents out or push contents through organs or, in the case of blood vessels, change the diameter of the tube.
The main function of skeletal muscles is to move bones and sometimes to move connective tissue structures such as the lips. Most muscles attach indirectly to bone, mean­ing that their connective tissue covering continues past the muscle and blends into a tendon or aponeurosis, which then
Tendon
Muscle
belly
Epimysium (deep fascia)
Perimysium
Endomysium (between fibers)
Capillary
Single muscle cell (muscle fiber)
Figure 3-41. Structures of a skeletal muscle. (Reprinted with
permission from McArdle WD, Katch FI, Katch VL. Exercise Physiology: Energy, Nutrition, and Human Performance. 5th ed. Baltimore: Lippincott Williams & Wilkins, 2001.)
Muscle fascicle
Endomysium
Sarcoplasm
Nuclei
Sarcolemma
attaches to the bone. If muscles attach directly to a bone, their connective tissue covering fuses with the connective tissue that covers the bone.
Each skeletal muscle has two kinds of attachments:
origin and insertion. The origin of a muscle is the attachment
on the bone or connective tissue structure that is more station­ary during muscle contraction. The insertion of a muscle is the point of attachment that moves most during contraction, often at the distal end.
All muscles have at least one of each of these two attachments. If muscle inserts into a bone, the bone will be pulled toward the origin of the contracting muscle. If a muscle inserts into a connective tissue structure, such as the lips, the lips will be pulled toward the origin of the contract­ing muscle (Fig. 3-42).
In addition to moving the skeleton and connective tis­sue structures, muscles also help move blood and lymph. Muscles become shorter and wider when they contract, which you see in a bodybuilder who strikes a pose. As the muscles contract, they constrict the blood and lymph ves­sels, squeezing the fluids out.
Heat Production
The core temperature of the body is maintained in a safe range of 96.8° to 98.6°F. Skeletal muscles release heat in the
104 INTRODUCTION TO MASSAGE THERAPY
Tendons
Biceps brachii
Insertion
Radius
Ulna
Figure 3-42. Muscle attachments: origin and insertion.
process of contraction, and the heat generated helps main­tain the body’s core temperature. Shivering, for example, involves the body making small, involuntary muscle con­tractions to release chemical energy or heat.
Humerus
Tendon
Origins
Scapula
Skeletal Support
Skeletal muscles support and maintain posture by holding the body upright against gravity and by stabilizing joints. The skeleton is only a collection of bones, joints, cartilage, and ligaments. Even standing still, our muscles work contin­uously to hold the skeleton up in a balanced, stable position.
Protection
Physical exertion is often followed by muscular fatigue, and massage is one of the most practical, beneficial treat­ments for muscular fatigue. By increasing nutrient delivery and waste removal from the muscles, massage minimizes the accumulation of chemicals that cause symptoms of muscular fatigue, such as lactic acid. Massage also maximizes healing.
Alert
Massage techniques that are too aggressive may
create fatigue-like symptoms or initiate a protective
reflex contraction in the muscles.
Manipulation of the muscles also produces heat, part­ly as a result of the increased circulation, partly because of increased chemical activity in muscle cells, and partly because of the heat generated when fascia is subjected to pressure. Muscle contractions produce heat as a byproduct of chemical reactions, and manipulation of the muscles increases these chemical reactions. Recall the thixotrop­ic property of deep fascia, discussed earlier in the chap­ter. Without movement, fascia can thicken, contract, and become less pliable, restricting muscle movement and cir­culation within the muscles. Manipulation of the muscles deforms the fascia, which creates heat, similar to how bending a paperclip back and forth heats up the area being deformed. Because fascia and muscles are so intertwined, softened fascia can also restore muscular movement.
The muscles protect the structures underneath them. Our organs and bones would be much more vulnerable to trau­ma without the muscles surrounding them.
Effects of Massage on the Muscular System
Massage increases the nourishment and development of smooth, cardiac, and skeletal muscles by enhancing the delivery of oxygenated blood and removal of cellular waste.
The skeletal muscles and the surrounding soft tissue, which make up about half of our body weight, are the pri­mary focus of massage therapy. In fact, sometimes massage is the best treatment for muscles, tendons, and fascia. It has been proven that massage can reduce tension by lengthening shortened muscles. It is highly effective at breaking the pain cycle by relieving muscular tension and increasing circula­tion. Inactive and paralyzed skeletal muscles benefit greatly from massage because it delivers oxygen and nutrients to muscle cells to keep them healthy.
Massage increases the excitability of muscles, mak­ing them more sensitive to nerve impulses. Faster reaction times, more effective movements, and better coordination can all result from massage.

Nervous System

The nervous system serves as the body’s communication and control center. The nervous system regulates bodily pro-
cesses to maintain homeostasis, keeping everything in the body in balance.
cesses the information, and directs the body to respond to it. A stimulus is an irritant or something that can cause a response, and it can come from the inside of our bodies as well as the external environment. The nervous system is constantly monitoring these stimuli, integrating the input, and controlling the body to respond appropriate­ly. When the nervous system is not functioning properly, the communication can break down or become inhibited, and the body’s ability to carry out its normal functions is diminished. Simply, the body then cannot maintain homeostasis.
The nervous system is integral to muscle and soft tis­sue function, which is why massage therapists should understand its structures and functions. The tissues of the nervous system are organized into two separate divisions, called the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS consists of the brain and
The nervous system receives stimuli, pro-
Chapter 3 / Body Systems
105
spinal cord. The PNS is made up of all the nerve tissue out­side the brain and spinal cord, including the cranial and spi­nal nerves.
Nervous System Tissue
The tissues of the nervous system include neurons, or nerve cells, and supportive cells called neuroglia. Individual neu­rons are organized in bundles with protective connective tissue wrappings. These bundles are called tracts, nerves, ganglia, and plexuses. Nerve tissue can be classified func­tionally by the direction of the nerve impulse, either toward or away from the CNS.
Neuron
The neuron, or nerve cell, is the basic unit of the nervous system (Fig. 3-43). The neuron has three main parts: the body, dendrites, and an axon. The body is the main portion of the neuron and contains the nucleus and other organelles
Figure 3-43. Structure of a neuron
(nerve cell).
that drive its functions. Dendrites are highly branched, tree­like fibers that start the communication path by receiving impulses from the external and internal environments and conducting that information toward the cell body along their plasma membranes. The axon is a long single fiber with branched ends that conducts impulses away from the cell body and takes the information to another structure, such as a muscle. Nerve cells are sometimes called nerve fibers because of their long axons and dendrites.
Some neurons have specialized Schwann cells strung along their axons and dendrites. These cells form a multilay­ered membrane of insulative tissue for the nerve cell called the myelin (MAHY-uh-lin) sheath. It protects and insulates nerves and allows nerve impulses to be transmitted very effi­ciently. The nuclei and cytoplasm of the Schwann cells are located on the outer surface of the myelin sheath, the neu­rilemma (NOO-rih-LEH-muh). Between the Schwann cells, along the neuron, are gaps called nodes of Ranvier (rahn­vee-AY), which are the active areas during nerve impulse transmission.
Dendrites
Nucleus
Nucleolus
Cell body (soma)
Schwann cell nucleus
Axon terminal
Axon
Neurilemma
Axon
Unmyelinated region
Myelinated region
Myelin sheath
Neurilemma
Node of Ranvier
Schwann cell
Schwann cell nucleus
Axon
Muscle fiber
Neuromuscular junction
Unmyelinated fiber Myelinated fiber
106 INTRODUCTION TO MASSAGE THERAPY
The neurilemma produces a chemical growth factor involved in a cellular repair mechanism for nervous tissues. Nerve cells are not regenerated on a regular basis, nor are
Nerve cell
they replaced upon damage. However, the axons and den­drites of injured nerve cells can regenerate from within the layers of neurilemma. This is a very slow process, and the tissue is not always functional once regenerated, but it gives
Astrocyte
hope to those with nerve injuries. The brain and spinal cord contain no Schwann cells, and repair of the brain or spinal cord is nearly impossible.
Blood capillary
Neuroglia
The nerves are supported and connected with accessory cells called neuroglia. They come in five different forms (Fig.3-44):
• Astrocytes—support and anchor nerve cells to blood capillaries
• Ependymal cells—line the cavities of the brain and spinal cord to help circulate the fluid that bathes and cushions the organs in those cavities
• Microglia—phagocytes that consume cellular debris
• Oligodendrocytes—fatty cells that wrap around nerves in the CNS to create the myelin sheath for insulation
• Schwann cells—form the myelin along a nerve cell in the PNS
Nerve Tissue Organization
In the CNS, neurons are collected together into bundles called nerve tracts. In the PNS, neuronal cell bodies are grouped together to form ganglia, and axons are grouped together to form a nerve.
The nerve has a structure similar to that of a muscle, with bundles of axons wrapped in connective tissue that are then bundled together with blood vessels in more connec­tive tissue. Each neuron is wrapped with a connective tis­sue covering called an endoneurium (EN-doh-nur-ee-um). The neurons are grouped together in fascicles and wrapped in a perineurium (PAIR-ih-nur-ee-um). Several fascicles are grouped together, along with blood vessels, to form a nerve. The entire nerve is wrapped with a fibrous connective tissue covering called the epineurium (Fig. 3-45).
Nerve plexuses are large networks of intertwined nerves. The four main plexuses are the cervical, brachial, lumbar, and sacral, each serving a different region of the body (Fig. 3-46). These plexuses are important in massage therapy because they must be dealt with carefully to avoid damaging the nerve structures.
There are collections of individual nerve cell bodies in the PNS called ganglia (GAYNG-lee-uh). Even though they are part of the PNS, ganglia are located very close to the spinal cord, within the vertebral canal.
Nerve cell
Microglia
Cerebrospinal fluid
Ependymal cells
Brain or spinal cord tissue
Nerve fiber
Oligodendrocyte
Myelin
Body of nerve cell
Satellite cells
Schwann cells
(form myelin sheath)
Dendrites of the nerve cell
Figure 3-44. Forms of neuroglia.
Chapter 3 / Body Systems
107
Epineurium
Perineurium
Endoneurium
Peripheral nerve
Blood vessels
Fascicle
Neurilemma
Axon of a nerve cell
Figure 3-45. Structures of a nerve. (Reprinted with permission
from Stedman’s Medical Dictionary, 27th ed. Baltimore: Lippincott Williams & Wilkins, 2000.)
Classification by Function
There are many types of nerves that monitor, integrate, and respond to external and internal stimuli and changes occur­ring within the body. Functional classification of nerve cells separates them into two separate groups. Sensory (afferent)
neurons receive sensory input and transmit that information
to the CNS. Motor (efferent) neurons carry messages from the CNS to the muscle or organs that must react. Groups of sensory neurons form sensory nerves, and groups of motor neurons are called motor nerves. Most nerves, however, are mixed nerves, which have both sensory and motor neurons that carry information to and from the CNS.
Sensory Neurons
Sensory neurons are classified by their location, sensitivity, or structure. They send signals to the CNS in response to external or internal stimuli. Proprioceptors (PROH-pree- oh-SEP-torz) are sensory nerve cells sensitive to body posi­tion, muscle tone, and equilibrium. They are located in the muscles, tendons, joints, and inner ear. Exteroceptors respond to stimuli from the external environment, such as touch, pressure, temperature, smell, sight, and hearing. These are mostly found in the skin and near the surface of the body. Interoceptors, also called visceroceptors, detect stimuli such as pressure within the organs and blood vessels.
For a massage therapist, the proprioceptors and extero­ceptors are the most important of all the sensory receptors. In the muscle, the muscle spindles are complex propriocep­tors that are sensitive to the length of the muscle fibers and respond to changes in that length. Between the collagen fibers in tendons are Golgi (GOHL-jee) tendon organs that respond to tension within the tendon that results from mus­cle contraction (Fig. 3-47). Both muscle spindles and Golgi tendon organs provide information to the CNS regard­ing the length and tension of a muscle and its tendon(s).
1st cervical nerve
1st cervical vertebra (C1)
Cervical plexus
7th cervical vertebra (C7)
8th cervical nerve
1st thoracic vertebra (T1)
1st thoracic nerve
Brachial plexus
Dura mater
Cervical enlargement
Conus medullaris
12th thoracic vertebra (T12)
12th thoracic nerve
1st lumbar vertebra (L1)
1st lumbar nerve
Cauda equina
Lumbar plexus
5th lumbar vertebra (L5)
5th lumbar nerve
1st sacral vertebra (S1)
1st sacral nerve
Sacral plexus
Figure 3-46. Nerve plexuses. (Reprinted with permission from
Bear MF, Connors BW, Paradiso MA. Neuroscience: Exploring the Brain. 2nd ed. Baltimore: Lippincott Williams & Wilkins, 2001.)
108 INTRODUCTION TO MASSAGE THERAPY
Spinal cord
Sensory nerve
Motor nerve
Figure 3-47. Muscle spindles and Golgi tendon organs.
Within a joint capsule are Ruffini end organs and Pacinian corpuscles. Both respond to pressure within a joint, essen­tially sensing the position of the joint by sensing different amounts of pressure at different places.
The muscle spindles and Golgi tendon organs respond as muscles move a joint through its range of motion, but joint proprioceptors are active when a joint is at the ends of its range. All of the proprioceptors act as a group to provide a sense of joint position, body position, effort, heaviness, and timing of movement. Input from the proprioceptors, along with input from other sensory organs such as the eyes and equilibrium sensors, is sometimes called a kinesthetic sense. Manipulating the muscle spindles and Golgi tendon
Sensory nerve
Muscle spindle
Golgi tendon organ
Tendon organ capsule (connective tissue)
organs with advanced massage techniques can encourage
muscles to shorten or lengthen. One of these techniques,
appropriately called proprioceptive neuromuscular facilita-
tion, is discussed in the Therapeutic Applications chapter.
The integument contains several different exteroceptors
that constantly monitor our surroundings (Fig. 3-48). The
closer these exteroceptors are to the surface of our skin, the
more sensitive they are:
• Free nerve endings, also called nociceptors, located
in the lower layer of the epidermis, detect pain and
temperature.
Figure 3-48. Sensory receptors of the
integument. (Reprinted with permission from Bear MF, Connors BW, Paradiso MA. Neuroscience: Exploring the Brain. 2nd ed. Baltimore: Lippincott Williams & Wilkins,2001.)
Merkel’s disc
Epidermal­dermal border
Free nerve ending
Meissner’s corpuscle
Hair follicle receptor
Pacinian corpuscle
Ruffini’s ending
Hairy skin
Glabrous
(hairless) skin
Epidermis
Dermis
Chapter 3 / Body Systems
109
• Merkel cells, found in the lower layer of the epider­mis, detect very light touch.
• Meissner’s corpuscles, found in the upper part of the dermis in the lips, hands, feet, and genital organs, detect very light touch.
• Ruffini end organs, located in the dermis, detect heat and strong or continuous pressure.
• Pacinian corpuscles, found in the deep dermis, sense vibrations and deep pressure.
Motor Neurons
Motor neurons carry signals from the CNS to the muscles, creating a response that involves muscle contraction. The skeletal muscles can be effectors, or endpoints, for nervous signals, under voluntary control. The motor neurons can also control involuntary activity of the organs, glands, and smooth and cardiac muscle.
Mixed Nerves
Most of the nerves of the body are mixed nerves that con­tain both sensory and motor nerve cells. They can monitor for input, integrate the information received, and stimulate the body to respond to the input. The sciatic (sahy-AT-ik) nerve in the leg is an example of a mixed nerve that can receive and send information via individual neurons that run alongside each other.
Nerve Impulses
rushing from the high sodium concentration outside the cell to the lower sodium concentration inside. With the extra supply of sodium ions inside, the membrane becomes depolarized; that is, the negative and positive charges on either side of the membrane are balanced.
4. Repolarization—Almost as soon as the sodium has rushed in, the permeability of the membrane reverts, preventing any more sodium from entering. The cell membrane becomes more permeable to potassium, which quickly rushes out of the cell, restoring the positive charge outside the cell and the negative charge inside. The sodium–potassium pump uses ATP to move sodium ions out and potassium ions in to maintain sodi­um–potassium gradients necessary for the resting state.
This process is called the action potential, also known as the nerve impulse (Fig. 3-49). There is a threshold stimu­lus that acts as a switch for the impulse. If a stimulus is not strong enough and does not reach the threshold stimulus, the nerve impulse will not occur at all. Stimuli above the threshold stimulus will trigger the nerve impulse over the entire nerve cell. The permeability of the entire membrane spreads down the neuron, carrying the signal. This all-or­none response of whether there is an action potential or not means that either the whole nerve cell responds to the stimulus or it does not.
The PNS is equipped with Schwann cells that are strung like beads along the nerve cell. The Schwann cells insulate
Nerve cells have two primary functions: irritability and con­ductivity. A neuron’s irritability allows it to respond to a stimulus and translate that perception into a nerve impulse. Its conductivity allows the neuron to communicate that nerve impulse to another neuron, a muscle, or a gland.
Irritability
The neuron’s irritability is the result of a chemical process of depolarization. There are several steps to creating a nerve impulse from a stimulus. Following is the series of events that takes place in response to a stimulus, such as a sharp thorn poking your finger:
1. Resting state—A nerve membrane at rest is in a polar­ized state, meaning that the positive and negative charges on either side of the membrane are not bal­anced. There are more sodium ions outside the neuron than there are potassium ions inside, creating an overall negative charge inside the membrane.
2. Excitation—When the thorn is perceived by a pain receptor, a neurotransmitter chemical is usually released to alter the permeability of the membrane.
3. Depolarization—The membrane becomes more per­meable to sodium ions, and they diffuse into the cell,
Stimulus
++
++ + + + + + + + +
Depolarization
+++++
+++++ ++++
Repolarization
+
+
+
+++
+
Figure 3-49. Action potential (nerve impulse).
+++++++
++++
+
+
+
+
+
+
+
+
+
++
++
110 INTRODUCTION TO MASSAGE THERAPY
the nerve membrane and in between the Schwann cells are gaps called nodes of Ranvier. The myelin provides insulation to the axon, like the plastic coating around electrical wires, preventing the nerve impulse from spreading out and short­circuiting. The nerve impulse is forced to jump from node to node instead of traveling along the entire surface of the membrane. By jumping over the Schwann cells, the impulse can travel much faster and transmission speed increases. The CNS does not have any Schwann cells, but it is equipped with oligodendrocytes that form the myelin sheath on some of the neurons that need insulation. The myelin insulation is especially helpful when there are hundreds of neurons trans­mitting hundreds of nerve impulses through one nerve.
Once the impulse reaches the end of the axon, it will send a signal to the next cell. There, the action potential may contin­ue along the next cell or stimulate activity of a gland or organ.
Alcohol, cold temperature, continuous pressure, and anesthetics are some factors that can reduce the speed of the action potential. These factors either reduce the mem­brane’s permeability to sodium or prevent oxygen and other nutrients from reaching the nerve. Without oxygen, cells suffer and eventually die.
Synaptic Transmission (Conductivity)
If the electrical impulse at the end of the axon is strong enough, the impulse will be conducted from one neuron to
another neuron or an effector (muscle, organ, or gland). The impulses are conducted in a tiny but active gap called the synapse (SIHN-aps). The nerve cell that needs to transmit the impulse is called the presynaptic cell, and the cell that will receive the impulse is called the postsynaptic cell.
The electrical nerve impulse on the presynaptic cell triggers the axonal terminal to release a neurotransmitter chemical into the synapse. Approximately 30 different neu­rotransmitters are made in the brain and stored in vesicles at the axonal terminals all over the body. Some of the neu­rotransmitters are epinephrine (adrenaline), norepinephrine (noradrenaline), dopamine, serotonin, and acetylcholine. Acetylcholine, discussed in the muscular system section, is the neurotransmitter released at the neuromuscular junc­tion. Once the vesicles release the neurotransmitter into the synapse, special receptor sites on the postsynaptic cell receive the neurotransmitters. The receptor site is activated and starts the action potential along the postsynaptic cell.
The synapse is designed such that the axon produces the neurotransmitters and the dendrites have specific recep­tor sites. In other words, a specific neurotransmitter must be received by the dendrite to complete the conduction. This design ensures a specific, one-way communication along the path (Fig. 3-50). Although most synapses are chemical (neu­rotransmitters and receptors), electrical synapses occur in cardiac or smooth muscle tissue where rhythmic, sequential muscle contractions are required.
Figure 3-50. Synapse. (Reprinted
with permission from Bear MF, Connors BW, Paradiso MA. Neuroscience: Exploring the Brain. 2nd ed. Baltimore: Lippincott Williams & Wilkins, 2001.)
Synaptic cleft
Secretory granules
Axon terminal (presynaptic element)
Synaptic vesicles
Receptors
Mitochondria
P
o
s
t
s
y
n
c
a
i
t
p
e
t
i
r
d
n
e
d
Fusion and exocytosis (Neurotransmitter released)