题目
After sitting with one leg crossed under the other for several hours while working on a document at her computer terminal, a 52-year-old woman tries to stand up, but is unable to walk on the crossed leg, and feels tingling and pain. Which of the following explains the loss of motor function without the loss of pain sensation in the peripheral nerves?A. C fibers have higher conduction velocities than A fibersB. A fibers are more susceptible to local anesthetics than C fibers
After sitting with one leg crossed under the other for several hours while working on a document at her computer terminal, a 52-year-old woman tries to stand up, but is unable to walk on the crossed leg, and feels tingling and pain. Which of the following explains the loss of motor function without the loss of pain sensation in the peripheral nerves?
A. C fibers have higher conduction velocities than A fibers
B. A fibers are more susceptible to local anesthetics than C fibers
题目解答
答案
B. A fibers are more susceptible to local anesthetics than C fibers
解析
本题考查周围神经纤维的分类及其功能特点,关键在于理解不同神经纤维对压迫或损伤的敏感性差异。
- A纤维(有髓鞘,传导速度快)负责运动和快痛信号的传递,对缺血、压迫更敏感;
- C纤维(无髓鞘,传导速度慢)负责慢痛和温度觉,耐受性较强。
题目中“运动功能丧失但疼痛感觉保留”说明A纤维受损而C纤维未完全受损,对应选项需体现这一特性。
神经纤维分类与功能
-
A纤维(有髓鞘):
- Aα纤维:控制骨骼肌运动(如行走),传导速度最快。
- Aδ纤维:传递快痛(锐痛)。
- 易受局部麻醉或物理压迫影响,因髓鞘较薄,对缺血敏感。
-
C纤维(无髓鞘):
- 传递慢痛(钝痛)、温度觉,传导速度最慢。
- 无髓鞘保护,但对局部麻醉和短暂压迫的耐受性更高。
题干现象分析
- 无法行走:Aα纤维受损,运动指令无法传递到肌肉。
- 刺痛和疼痛:C纤维未完全受损,仍能传递疼痛信号。
选项解析
- A. C纤维的传导速度比A纤维快
错误。A纤维有髓鞘,传导速度远快于无髓鞘的C纤维。 - B. A纤维比C纤维更容易受到局部麻醉剂的影响
正确。A纤维因有髓鞘,局部麻醉剂(如利多卡因)更易穿透髓鞘阻断信号;C纤维无髓鞘,耐受性更高。同理,物理压迫(如长时间坐姿)更易损伤A纤维。