Peripheral nervous system histology

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Questions

USMLE® Step 1 style questions USMLE

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A segment of a peripheral nerve is taken and examined under the microscope. In the segment, the axons, nerve fascicles, endoneurium, perineurium, and epineurium were identified. Which of the following is true regarding these structures?  

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The peripheral nervous system or PNS consists of all the nerves and ganglia outside of the central nervous system.

The central nervous system consists of the cerebellumcerebrumbrainstem, and spinal cord.

The peripheral nerves consist of at least one bundle of nerve fibers called a fascicle, which has a surrounding layer of connective tissue called the perineurium.

This cross-section of a larger peripheral nerve was stained with Masson’s trichrome.

If we zoom in to look at just one fascicle, we can see that the thin layer of perineurium surrounding the fascicle is stained a darker blue.

At 40x magnification, we can see the individual nerve fibers, but the structures are not as easy to identify compared to a similar image stained with H&E instead.

The very thin and delicate layer of connective tissue surrounding each nerve fiber is called the endoneurium.

The endoneurium stains a slightly darker pink compared to its contents, which include the individual nerve axons at the center, as well as the Schwann cells or neurolemmocytes that form the myelin sheath around larger nerve fibers.

The myelin sheath can be seen as a thick pink outer ring that surrounds many of the nerve fibers.

The basophilic or purple round nuclei found along the outer edge of the nerves are the nuclei of schwann cells.

Alright, if we take a look at the outer edge of the peripheral nerve, we can see the outermost layer of dense irregular connective tissue called the epineurium.

The epineurium surrounds the entire nerve and also fills the space between fascicles in order to hold the fascicles together along with the blood vessels and loose connective tissue within the nerve.

Now, if we take a look at a longitudinal section of a large peripheral nerve, the nerve fibers have a wavy or zigzag pattern.

This arrangement of the nerve fibers helps to protect the nerves from damage when they’re stretched due to normal movement or if the nerve is connected to flexible tissue.

At 40x magnification, we can faintly see myelin sheaths surrounding their nerve axons.

With an H&E stain, the myelin sheaths have pink and red stripes or striae along the upper and lower portions of each nerve fiber.

The nuclei of Schwann cells can be identified by their round or oval appearance, while the nuclei of fibroblasts typically have more elongated nuclei.

In this image, a node of Ranvier can be seen as a purple line that’s perpendicular to the nerve fiber.

The nodes of Ranvier are the small gaps or junctions between neighboring Schwann cells.

We can even see how the myelin sheaths become more narrow right before they reach the node.

Summary

The peripheral nervous system (PNS) consists of all the nerves and ganglia outside the brain and spinal cord. The peripheral nerves consist of at least one bundle of nerve fibers called a fascicle, surrounded by an outer layer called epineurium. Fascicles within nerves are in turn surrounded by the perineurium, whereas individual nerve fibers are surrounded by the endoneurium. Ganglia are clusters of nerve cells found along the length of peripheral nerves, serving as relay stations for the transmission of nerve impulses.

Elsevier

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