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Physiology · Nerve physiology: fibre susceptibility
Sample itemAfter a long period of pressure on the upper arm during deep sleep, a man wakes with wrist drop and loss of position sense in the hand, but pain sensation is relatively preserved. Which property of nerve fibres explains this pattern?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Large myelinated A fibres are more susceptible to pressure than small C fibres
Compression affects fibres in a size-dependent manner: large-diameter, fast A fibres carrying motor and proprioceptive impulses are blocked first, while small C fibres carrying slow pain are blocked last. With local anaesthetics the order is reversed, because small fibres are blocked first. This is why neuropraxia from pressure affects motor power and joint position before pain.
Option by option
A. Large myelinated A fibres are more susceptible to pressure than small C fibres (correct)
Large A fibres are the most pressure-sensitive, so motor and proprioceptive loss appear first.
B. C fibres are more susceptible to pressure and so are blocked first
C fibres are the least sensitive to pressure; they are the most sensitive to local anaesthetics.
C. Motor fibres are unmyelinated and so are damaged by mechanical stress
Motor fibres to skeletal muscle are large and myelinated, not unmyelinated.
D. Pain fibres conduct fastest and recover first after compression
Pain fibres conduct slowly, being thin; the fastest are large A-alpha fibres.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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