Notes

Peripheral Nerve Anatomy

Sections

Peripheral Nerve Histology

Summary

Nerve vs Nerve fibers (axons)

  • A peripheral nerve encompasses bundles of nerve fibers (axons) and has various connective tissue coverings (superficial epineurium, perineurium, and endoneurium).

Nerve Coverings

Outside to Inside:

Superficial epineurium

  • Superficial epineurium is the outer covering of the nerve.
  • It is a supporting coat: a cylindrical, dense connective tissue sheath.

Perineurium

  • Perineurium encases separate nerve fascicles.
  • It is a mechanically strong sheath that is dense and forms a protective barrier around the nerve fascicle: a blood-nerve barrier.
  • Perineurium comprises a flattened form of epithelial cells that are joined by special junctions, which helps it withstand tremendous pressure.

Endoneurium

  • Endoneurium is a loose connective tissue; it comprises collagenous fibers.

Additional, less often addressed terminology:

Deep epineurium

  • Deep epineurium accounts for the connective tissue sandwiched between the nerve fascicles.
  • We find vasculature in this region.

Perineurial septa

  • Perineurial septa pass through the nerve fascicles and carry vasculature to the nerve fibers.

Nerve fibers (Axons)

  • The nerve fiber is the nerve cell axon.
  • Myelin sheath surrounds myelinated axons.
  • Schwann cells: each myelinates at most one axon internode.

Myelin

Unmyelinated cell

In an unmyelinated cell, we see:

  • The Schwann cell nucleus intermixed with axons within Schwann cell cytoplasm.
  • The mesaxon is the zone of apposition for the Schwann cell membrane and the axon.
  • Multiple axons can pass through a Schwann cell, when the nerve fiber is unmyelinated.

Myelinated cell

In a myelinated cell, we see:

  • The Schwann cell nucleus lies off to the side of the axon, which is enveloped in concentric circles of myelin: a myelinated sheath.

Schwann cells vs oligodendrocytes

  • Unlike oligodendrocytes, which can myelinate up to 50 individual axons, a Schwann cell only myelinates one axon, as shown here (specifically only one peripheral nervous system internode).

Dorsal root ganglion

We highlight the following:

  • Ganglion cell
  • Cell nucleus
  • Surrounding satellite cells (which support the ganglionic neurons).
    • Satellite cells are derived from neural crest cells in the same way that Schwann cells are.

Peripheral nerve in longitudinal view

We highlight the following:

  • Schwann cells
  • Myelin sheath
    • The myelin sheath is vacuolated because its high lipid content creates this artifact upon paraffin embedding.
  • Deep stained nerve fibers (axons).

Clinical Correlation