Functions of precentral zivini. Budova frontal part

Lobova part of the loan in the front viddili pivkul. View of this part of the won central furrow, Vіd skronevoї - bichny furrowed. At the frontal part of the chotiri zivini: one is vertical - precentral and three horizontal - the upper, middle and lower lobes of the zivini. Zvivini vіdokremlenі one from one bearded.

On the lower surface frontal part develop direct and orbital zvivini. Straight zivina zalyagє between the inner edge of the drink, the scent furrow and the lasting edge of the drink.

In the glybin of the scent furrow lies the scent cybulin and the scent tract.

Lobova part of the people to become 25-28% of measles; middle mass of frontal part 450g.

The function of the frontal parts is tied to the organization of powerful sleeves, ruddy mechanisms of movement, regulation of folding forms of behavior, and the processes of misdirection. A few functionally important centers are concentrated near the frontal part. The front central zivina is a "representative" of the primary rucous zone and a strictly singing projection of the dilyanok tila. The person “roztashovane” is in the lower third of the zivini, the Hand is in the middle third, the leg is in the upper third. Tulub is presented in the back windows of the upper frontal zivini... In such a rank, the lyudin is projected into the anterior central part of the body burned down with his feet and head down (Div. Fig. 2 B).

The anterior central zvivin together with the adjacent posterior and lateral frontal zvivins is even more important in the functional role. Vona is the center of the great rukhiv. In measles glybin central zivini from the so-called pyramid cells - the central roche neuron and - to repair the main roach path - the first, corticospinal, path. Peripheral outgrowths of the nerve neurons go out from measles, climb into a single straining bundle, pass through the central bulge of the pivot and enter through the inner capsule into the stovbur brain; In the end of the stove, the stink often crosses over (passing from one side to the bottom) and then descends into the spinal cord. The process of growth ends in the system of speech spinal cord... There the stinks come into contact with the peripheral nerve neurons and transmit them impulses from the central nerve neurons. For the pyramidal path, the impulses of the pre-mover are transmitted.

In the back of the upper frontal area, there is also an extrapiracy center for measles, it is anatomically and functionally based on the so-called extrapiracy system. The extrapiracy system is a ruch system, which helps to assist in the health of a rukh. Tse system of "protection" of great rukhiv. Being phylogenetically older, extrapyramid system among people, the automatic regulation of the "zavchenyh" rukhovyh acts, the development of the oval meat tone, the readiness of the peripheral ooze apparatus to the early rucks, re-development of the ooze tone during rucks. Besides, take the fate of the normal position.

Rukhovi zoni measles to be found mainly in the precentral area (fields 4 and 6) and in the paracentral part on the medial surface of the pivot. I see the first and second regions - fields 4 and 6. The motor fields, albeit according to their characteristics, are well known to the Institute of Brain, the stink of development. At the primary engine core(Field 4) roztasvanі neuron and, innervating motoneuron and muses of the face, tuluba and kіntsіvok.

Small. 2. Scheme of self-topical projection of extravagant sensibility and rudimentary functions in the cerebral cortex (according to U. Penfield):

A - the cortex projection of the extravagant sensitivity; B - cork projection roho system... Variety of organisms to represent that area of ​​measles in the brain, where there can be victories of indications and problems

There is a topographic projection of the muses (div. Fig. 2 B). The basic laws of topographic representation are those who regulate the activity of the languages, which will prevent the most accurate and intelligent people (mova, leaf, miracle), in the role of the great people in the area. Field 4 is occupied by the centers of isolated rucks, field 6 is not partly (pidpol 6a).

Preservation of field 4 is necessary for the rejection of rukhiv in case of subdivision of field 4, as well as field 6. In the new-born, field 4 is practically healthy. Improvement of primary motor measles wiklikє fast-moving muscles of the protylny side of the body (for the mouth of the fast-moving head it can be bilateral). When the cortical zone is damaged, the building is absorbed to fine coordinated collapses with the help of the fingers and especially with the fingers.

Vtorinna rukhova bark(Field 6) less functional significance in relation to the introduction to the primordial rukhovoy bark, good rukhovy functions, related to the planning and coordination of dear rukhiv. Here, the most growing negative potential of readiness is re-structured by the greatest world, which is about 1 second before the cob is rolled. The bark of field 6 will take away the main part of the impulses from the basal ganglia and the moss, take care of the part in the re-breathing information about the folding arms.

Reduction of measles fields 6 wiklikє folding coordinated arms, for example, turning the head, eyes and tulub to the opposite side, spіvdruzhnі speedy zginachіv or rozginachіv on the opposite side. At the premotor cortex, the center of the motorized arm, tied with the social functions of the people: the center of the writing movement in the rear view of the middle frontal area (field 6), the center of the motor drive of Broca in the rear area of ​​the lower frontal area musical motor center (field 45), which will preserve the tonality of the movement, the quality of the music. The lower part of the field b (pіdpolі boron), roztasovana in the area of ​​pokrishka, responding to the electrostrum with rhythmic zhuvalny rukhs. Neuron and measles take away afferent enter through the thalamus from the meats, suckling and shkirny receptors, from the basal ganglia and the corns. The main current entry of rukovy measles on stovburovs and spinal motor centers and piracy cells in the V ball.

At the rear end of the middle frontal area there is a frontal okorukhovy center, which is good control over spids, one-hour turn of the head and eyes (the center of the turn of the head and eyes to the opposite side). Raising the center of the wiklikє turning the head and eyes to the opposite side. The function of the center is of greater importance in the so-called organic reflexes (or reflexes "how are you?") more important for the preservation of the life of the creatures.

Lobovy viddil measles great pіvkul I will also take an active part in the formulation of the mission, the organization of the goal of direct action, and the promising plan.

Central parallel and paresis occur with localization of pathological signs in the precentral region. The somatic representation of the rok's functions is approximately similar to that for the sensitiveness in post-central development. 3 - for the great length of the precentral zivini, the focus of pathological processes (sudinni, puffy, traumatic) will lead you to enmity, not all, but in part. Localization of the pathological disease on the outer surface of the wicker, but also the paresis of the upper skin, mimic musculature and movi (linguistic abnormal paresis), and on the medial surface of the central rubber foot - the severing

2. Neurological symptoms of osteochondrosis: myazov, dystrophic, humeral-scapular periarthrosis, cortical artery syndrome

In a large number of vypadkіv accelerated є a lot of infusion of one or two osteophytes or soft eruptions of the disc.

Regularly from the ethiological official, localization of the pathological process and the stage of becoming ill, the onset of the onset of clinical manifestations of osteochondrosis:

More in the area of ​​shia there is a change in the ridge apparatus of the ridge (including the mid-ridgelike disc).

Shiino-shoulder pain of a nice character.

Korintseviy syndrome with symptoms of baking, pulling any type of severe radicular pains in the back of the neck, in the sub-mental and mid-pathogen areas, in front of the palpitations of the palms of the palms.

Neurodystrophic damage (periarthritis shoulder joint, Syndrome of the anterior gingival ointment, neurovascular dystrophy of the upper part).

Cardiac syndrome (pain in the area of ​​the heart).

Syndrome urazhennya hrebetnoї arterії i її nice plexus (zadnіy Shiin cuter syndrome i rozladi, SSMSC Je naslіdkom nedostatnostі krovopostachannya stovburovih vіddіlіv mozk) scho viyavlyaєtsya zapamorochennyam, noise i dzenkotom at vuhah, mozochkovimi torn down, slabkіstyu in kіntsіvkah, SSMSC chastіshe vinikayut at zaklyuchnih position gіperekstezіі і to know at the middle position of the shia.

Shiina mylopathy of discogenic etiology, which manifests itself in the progression of spastic-atonic upper paraparesis and spastic lower paraparesis.

3. Spinal ataxia (Friedreich's ailment).

Spadkovi attacks.

The coordination of the ruch is developing, the trick is to walk.

Lesions of the corns.

Cutting the rear corners.

Stripping of the peripheral nerves.

Clinical syndromes: Geni pleiotropic, to genius with no effect. Romberg described tardus dorsalis for the first time. Duchenne describing the motor ataxia. Tse syphilithic lesion of the spinal cord.

Spinal attacks:

Khvorob Friedreich,

Hvoroba Strompel (dorsal - cerebellar).

Mendel's ailment (predominantly cerebellar).

Ataxia P. Mari.

Khvorob Friedreich.

To repair in a child - in 10 - 15 years, or even in a mature camp. The cunning of the walk is determined.

5 syndromes:

Loss of coordination syndrome. The reason is the back ropes. Appear in a grimace, ataxia.

Rukhovikh syndrome. Atrophy of m'yaz_v homilka, other m''yaz_ of the foot. Wager III and VI cranially - cerebral nerves And also often - XII and II bet.

Syndrome of cystic deformities: - kyphosis, - scoliosis, - Friedreich's foot (high star, extension of the main phalanges of the toes and flexion of the finger phalanges).

Sensitivity disorder syndrome. Sensitivity breaks down. Guard the I and VIII cranial nerves bet.

Psychic disorder syndrome.

RECISSIVNY USPADKUVANIA. Rizik ailments 25% are not covered by stati. When Friedreich's ailment breaks down 2 enzymes: lipolydehydehydrogenase. Enzyme deficiency is produced to accumulate glutamate. Destruction of the CoA. The synthesis of acetylcholine will break down.

Pathogenetic lykuvannya: coenzyme Q - thiotropin - releasing - hormone, riboflavin, cornitin, ascorbic acid. symptomatic therapy, (For the liking of ataxia): obzidan, carbomozepin, amantadine. Physical culture, massage.

1. Internal capsule: symptoms of urozhennya.

Clinical picture of hemiplegia

The internal capsule is a ball of white speech between the commensal-shaped nucleus, from one side, and the head of the caudate nucleus and the thalamus - from the other. In the inner capsule, the front and rear legs and number are expanded. Fold the front nіzhku axoni kіtin, in the main frontal part, go to the nuclei of the bridge to the brain and to the corns (fronto - bridge - to the corns). With these victories, the coordination of ruffs and positions is promoted, ailments cannot stand and walk - lobova ataxia. The front two thirds of the rear lower leg of the inner capsule are fixed by the pyramid tract, in the colony pass the Corvo - nuclear path. Ruynuvannya cich guides should be brought up to the central parallel of the protagonists, the lower mimic muscles and half of the mov (hemiplegia).

The posterior third of the posterior lower leg of the inner capsule is stored in the axons of the thalamic clin, as it conducts impulses of all types of sensitivity to the brain and senses. When the guides are turned on, sensitivity is involved on the other side (hemianesthesia).

In case of capsular hemiplegia, all signs of a lesion of the central corneal neuron: muscle spasticity, advanced reflexes, surface reflexes, developing foot and hand pathological reflexes. The posture of Vernike is characteristic - Manna Nizhnyakіntsіvku is straightened and when walking, we move around the movement).

In case of a stately period of internal control, Psulum myazovy tone and gliboki reflexes appear in a decrease. Tse vikorystovuєtsya in diagnostics for the development of hemiplegia in ailments in a coma. Yakshcho at a lying on the back of a sick person, bend the top of the lіktyovyh slopesі immediately lower їх, then let us descend beforehand on the side of hemiplegia (h - for a greater low meat tone). The reasons on the side of the parallel to the lower stakes have been largely rotated.

2. Discogenous transverse cryovy ​​radiculitis and radiculomyeloeshemia, pathogenesis, clinical course. Recent findings about the pathogenesis of parallels in the mucous membranes and the impairment of the pelvic organ function in disc discs

Radikulit - fired in the nervous system. Become 1 - 5% of the ignition processes of the nervous system. Previously, they respected the spirochete as a witch.

1/4 make sure you get the middle discs. The first among the people of old are the support - ruddy apparatus and the nervous system.

Disc prolapse is a part of the fibrous ring. If the back nucleus is zsuv - bichny, then it can be the pressure of the roots.

Causes of pain syndrome.

Structural or physical problems.

Metabolic damage.

New Satisfaction.

Imagine pain.

Structural damage.

prolapse mid-row disc, Spondylosis, spondylomestosis, fractures of the ridge (ridge ridge), osteochondrosis = kyphosis of working fatigue = Shaerman's ailment - May, spinal stenosis. Gryza of the disc - where the nucleus pulposus moves forward or backward. With the replacement of grids in the middle of the ridge, with the partial ruinuvannyam - Schmorl's gryzh. Spondylosis - changes in appearance between ridges, edges of growth, changes in decay in the boundaries of the segment. Spinal stenosis is an ulceration of the space, in which the spinal cord passes through and to liven up the spinal cord. Myeloischemia may develop. Spondylolistosis is the replacement of the ridge - the whole orthopedic problem. At the same time, it is necessary to interconnect the physical installation. Winikє of the incidence of bolovy syndrome. With a great magnitude of spondylolistosis, a single vykhid for a sick person is an operation. Ankylosing spondylitis - fibrosing spondylitis. Symptom of the thread - when there is a disease, it is not possible to break the thread on the breast plate. Elderly Kyphosis. Everything is degenerative - structurally ill, which can lead to pain syndrome and damage to the central nervous system.

Klinika transverse kryzhovy radiculitis.

1. Pain syndrome - the best yaskraviy. The stage can not be found in all ailments. I will see a change in my mind, lumbago - shot across, sharp bile in the spin when rozginnі. Vinikak ryzhuchy or prickly bill. Lyudin has received the position. continued

Suggestions for nutritional replacement

It is held from December to December. Nadal lumbodynia.

Mechanism for pain diagnosis:

a) dysphixation - in non-manual position vinikak bil (often with spondylolistosis).

b) meaty-dystonic beetle through an increase in meaty tone, c) dyshemic beele - winery in calmness, often during sleep.

G) igniter: Pulsing, changing the reception of the anti-firing devices.

Syndrome of sensitive disagreements.

Defective reflexes: colline reflex on the level of L2-L4 of the spinal cord, the Achilles reflex changes on the level of C].

Syndrome of trophic breakdowns: change in the temperature of the skin, as confirmed by thermography, dryness of the skin, change in temperature of the children, hyperpigmentation, peeling, hair loss.

Loss of statics and dynamics of the ridge: spine of the spine of the spine, the function of the collapse of the ridge, the Show-Bera test for decay (in the norm, it grows by 4 or more cm).

Symptoms.

Jlacera - there is a bile in dilyantsi nirok when lying straight legs. Positive symptom with lesions of the lower roots L 5 - Ci, L4. Niri - namagayutsya head to the breasts. A cough symptom is an increase in coughs. They also suffer from Lj and L2, to be differentiated from surgical and gynecological pathology, as well as to the groin area. When the disc is flattened, the ailments have more bends of the rods. For a rakhunok pressurization of a citizen's foot - clapping a foot. Damage at level L4. General rule: with the appearance of a persistent, trivial symptom, prior to surgery, the need for direction, as well as the pain syndrome, may last more than 4 months. With irradiation, reflexion and muscular tone are inhibited. In case of shinny radiculitis, they are radiated into the scapula, brachioacromial slope. Virazheni neurodistrophic snakes.

In case of transverse draining (L1-S2 at the level of 10 - 12 chest and 1 transverse ridges), peripheral parallax of the lower symptoms, anesthesia of the perineum and nig (to the bottom of the pulparotomy. With important exercises, the syndrome develops stubborn belly, Paralitic intestinal obstruction, vasomotor - trophic hematuria.

3. Moses ataxia (P. Mari's ailment, olive-ponto-cerebellar degeneration).

Klinika, diagnostics, treatment, genetics

Mozochkova ataxia P. Mari - a decline in degenerative disease with over-lesions of the cerebellum and the second provincial paths. The type of sedation is autosomal - dominant. Vinikak is ill at the age of 20 years and older.

Characteristically, the deterioration of the functions of the cornsus and the first link. Ataxia is promoted in case of viconious co-ordinator tests, deranged walk, scandalous mova, intentional tremor, nistagmus. Mozochkovy symptoms coexist with altogether abnormal signs of secondary deficiencies (malformations of tendon and periostal reflexes, cloning of the feet), and some of the healthy and perioral deformities (obliqueness, fever, malformations) A characteristic acquaintance є in of a risky step turn over the decrease to the intellect.

Diagnostics.

Differential diagnosis is made from Friedreich's attack. Diagnostics priming on the basis of the disease.

Symptomatic.

Olive-ponto-cerebral degeneration.

A group of recessive disorders of the nervous system, characterized by degenerative changes in the neurons of the cornsus, the nuclei of the lower olives and the bridge of the brain, in the row of vipads - the nuclei of the cranial nerves of the caudal group. Indigestion is a type of sedation and rapid development of clinical symptoms. 5 types:

Mendel's olivopontocerebellar degeneration. To settle down in an autosomal dominant manner. Клініка: symptoms lesion of the corns(Ataxia, myazova hypotonia, scandalous mova with dysarthria, intentional tremor) of the nuclei of the caudal cranial nerves (dysarthria, dysphagia), pidky ganglia (hyperkinesia).

Olivopontocerebellar degeneration of Fikler-Winclair. To settle down in an autosomal recessive manner. Klіnіka: symptoms of a lesion of the corns, which are more important in the symptoms. Sensitivity and tendon reflexes do not change. Pareziv is dumb.

Olivopontocerebellar degeneration with retinal degeneration. To settle down in an autosomal dominant manner. Vinikaє among young people. At the same time with cerebellar and extrapiracy symptoms - a decrease in the state of health.

4. Olivopontocerebellar degeneration of the Jester - Haykman. To settle down in an autosomal dominant manner. It is early to arrive. Moses and striations of nuclei of VII, IX, X and XII pairs of cranial nerves (parallax of the facial nerve, bulbar symptoms). І posterior cords in the spinal cord (strand of the myazovo - slope view and vibrating sensitivity).

5. olivopontocerebellar degeneration with dementia, ophthalmoplegia and extrapiracytic disorders. The decline is autosomal - dominant. Characterized by dementia, progressive ophthalmoplegia, extrapiracy and cerebral symptoms.

Symptomatic. Courses of nonspecific zagalnozmіtsnyuyuchiy lіkuvannya, massage, lіkuvalnuyu physical culture.

1. Boulevard and pseudobulbar parallel

A characteristic feature of the stovbur to the brain is that it is bought in a small space of the nuclei of the cranial nerves, especially to be carried to the nuclei of pairs V, IX, X, and XII in the large brain. The nucleus cytoplasm is urazhayutsya at occasionally small sizes of pathological vognische, to produce up to the development of a parallel peripheral type 9, 10, and 12 pairs of nerves (parallel mov, pharynx, larynx). Clinically, it is necessary to rotate through the distribution of kovtannya (dysphagia), the second sonority of the voice (aphony), the nasal vidtinkom move (nasolalia), the damaged articulate vimov and sounds (dysarthria). Denmark has a complex of pathological signs otrimav the name of the bulbar paralysis.

Inodi guard half diameter dovzhastogo brain... As a result of the smashing of the nuclei of the cranial nerves on the sides of the head, the interruption of the paramedal bundle, the development of hemiplegia on the prototype bots (alternating hemiplegia) is achieved. Bilateral alternating parallich 9, 10 and 12 pairs of cranial nerves inappropriate for life.

Rozladi kovtannya, the lanterns or articulations are in the middle in both cerebral infusions, the central neurons are injected to the lactopharyngeal, bloody and lazy pairs of cranial nerves. Such parallels are called pseudobulbaric. There is a stench when the functions of the cortical - nuclear parts of the pyramidal system are damaged.

Bilateral dissection of cortical - nuclear beams is supervised by the appearance of pathological reflexes of oral automatism. Stimulate a positive proboscis reflex. In the case of the proboscis vipinennya of the lips, it is not possible to move forward from the blow, but from the direction of the hammer to the mouth of the sick person - there is a distant oral reflex. stroking

nerves ailments

shkiri doloni over the days of the great finger (reflex of Marinescu - Radovic) supervise on the way of shkiri pidboriddya.

Dot with a cotton swab to the corneous membrane of the wicker, fast-moving mucus pidboriddya or the lower slit to the opposite side.

One of the early signs of bilateral lesion of the central or peripheral motor neurons of the articulatory musculature is dysarthria, which can be found in the presence of an onset of afferent and eferent systems. Serious skargi are ailments for the duration of the movement, the visibility of the readiness, growth and the inviolability of the movement.

At the syndrome of a paralysis to enter, in addition to dysarthria, as well as a problem of communication and phonation. At the same time, symptoms of oral automatism appear.

2. Focal epilepsy, the cause of the blame.

Manifest focal attacks in case of degradation of the epileptogenic presence

Intoxication, autointoxication, abscesses to the brain, igneous granulomas, meningitis, encephalitis, arachnoiditis, arachnoidal bristles, bladder problems. Peredv_sniki symptomatic epilepsy.

In case of symptomatic epilepsy, headache attacks are often repaired from focal aura. Prior to the sensory aura, there is a developmental breakdown on the side of the organs of the senses. Zorova aura, which is a worm in the affected areas of the city, you start to show up in those areas of yasks, shining sacks, lines, yaskravo is a worm-name for farbivans of navkolishnіh objects (simple healthy hallucinations are around the warehouses) and in the case of ). Change the size of objects. Inodi vipadayut fields zoru (hemianopsia), it is possible to vrata zoru (slapota). In case of a scent aura (skroneva epilepsy), ailments carry a "rotten smell", often in conjunction with savory hallucinations (relish blood, girkot metal). Hearing aura is characterized by the appearance of different sounds: noise, triviality, rustling, music, screams. For the psychic auri (in the case of the affected temporal area), there are types of experiences of fear, zhahu, or bliss, joy. The vegetative aura is manifested by the changes of the functional stance of the internal organs: sertsebitam, pain behind the sternum, increased peristalsis of the intestine, poses for severity and defecation, pain in the stomach, nudity, dullness. The motor aura (when the sensorimotor area is affected) rotates in a kind of rocking automatisms: turning the head and eyes to the side, smoktalny and zhuvalny rukhs. Focal cortical seizures tend to occur frequently with unconditional testimony

and, as a rule, they are one-sided. It is not often spontaneous at once, both focal and court attacks.

3. Principles of treatment of persistent ataxias

Pathogenetic lykuvannya, for example in case of spastic paraplegia of Strumpel: coenzyme Q thyotropin - releasing - hormone, riboflavin, cor-Nitin, ascorbic acid.

Symptomatic therapy (for the treatment of ataxia): obzidan, carbomozepin, amantadine.

Zagalnozmіtsnyuchі drugs, scho to redden the bloodstream, vitamins, physiotherapy, massage.

Hirurgical treatment (correction of deformity of Friedreich's foot).

1. Features of the innervations of the muscle muscles by the central and peripheral corneal neurons. Peripheral parallich of minutiae

A special nerve є a shifting nerve. At its warehouse there are parasympathetic and sensitive fibers, the remaining two types of fibers are seen as an intermediate nerve.

Rukhov's part of the facial nerve will provide the innervation of all the miniscule muses of exposure, muses shell, Skull, hind cherevts of the two-abdominal ointment, court muzzle and pediatric ointment of the shia. The qi system is composed of two neurons. The central neuron of measles cells of the lower third of the precentral zivini, axons of which near the cortical - nuclear pathway are sent to the brain to the nucleus of the facial nerve of the prototypal side. A part of the axons goes to the nucleus of its side, it ends up on the peripheral neurons, which innervate the muzzles of the upper part of the face.

Peripheral neurons are represented by cells of the nucleus of the facial nerve, which are removed in the 4th day of the brain. The axons of peripheral neurons form the root of the facial nerve, which goes from the bridge to the brain spirally from the root of the intermediate nerve between the posterior edge of the bridge and the olive to the large brain. Dal the offense of the nerve go into the facial canal in the colony, to become the colony - gangl.geniculi. Out of the canal, it enters the parotid saline vines.

In a special channel from the facial nerve, enter the great kamian nerve, the court nerve and the drum string.

With the lesion of the facial nerve, the peripheral paralysis of the facial muscles develops - this is the name of prosoplegia.

Vinikak asymmetry of an individual. Urazhena Polovnev is a non-ruhoma specimen, mask-like, the folds of the forehead and nasolabial folds are smoothed out, the line widens, the eye does not close, the mouth of the company goes down. Slosotecha. Decreased horn and brow reflex.

When the crust-nuclear path is defeated, the parallels of the face muses are deprived of the lower half of the face on the opposite side of the face of the defeated sides. It is not often on the side of the winery and hemiplegia (aka hemiparesis). The peculiarities of the parallels are explained by the fact that the part of the nucleus of the facial nerve, which can lead to the innervation of the muscles upper half individuals, I will reject a two-sided cortical innervation, and іnsha - one-sided.

2. Polyemielitis, epidemiology, prophylaxis, treatment.

Poliomyulit (childish-paralich) - a state of infection, infected with a virus with a tropism to the anterior horns of the spinal cord and the rudny nuclei of the stovbur to the brain, the destruction of some cyclones of parallax atrophy.

Epidemiology.

Most often, sporadic illnesses occur, but in the past, epidemias were recognized. The number of healthy noses and abortive diseases, if the disease came before the development of parallels, significantly surpasses the number of ailments in the paralitic stage. The most healthy nose and abortive diseases are the main problems in all cases of illness, if it is possible to become infected as a sick person in a paralytic stage. The main ways of transmission of infection are special contact and fecal obstruction. We will explain the seasonality with the maximum ailment in summer and early autumn. At the age of 5, the steadiness is very low. The incubation period is 7-14 days, or even up to 5 days.

There are 4 types of reactions to the virus poliomyelite:

Development of immunity when there are symptoms of illness (subclinical or implicit infection);

Symptoms in the stage of viremia, which have the character of an external infection without a diagnosis to the process of the nervous system (abortive symptoms);

The presence of fever, headache, ill health (up to 75% in the period of the Epidemic) in bagatokhs; There may be a meningeal manifestation, pleocytosis in the liquid. Parallels do not develop;

Parallel development (in okremikh vypadkakh).

Prevention.

So as a secret, slaughter, feces can take vengeance against viruses, it is ailing recommended for isolation not less than 6 times. In feces, viruses appear after 3 months in 50% of ailments and in 5-6 weeks - in 25%. Children in booths, de ailments go to insoluvati from іnіh children for 3 tіzhni іsolatsіy sick. Modern immunization is a greater success in the world of intercourse in the expansion of epidemics. VaccinaSeibina (1-2 drops for a small piece of tsukru) expands the immunity for 3 rocks and more.

3. Significance of electro-neuromyography and new non-invasive methods of pre-diagnosis in diagnostics of nervous diseases

electromyography- the method of reconstructing the bioelectric activity of the muscular system, which allows for the significance of the nervous system. The method is stagnant in ailments with small ruffles for the purpose of making a step and a wider battle.

electroneuromyography- a comprehensive method, based on the basis of the stasis of electrical stimulation of the peripheral nerve with the onset of injections of the vicious potential of the innervated mucosa (stimulation of the electromyography) and the nerve (stimulation of the electroneurography)

Viklikanі potentiality of myazi.

М - ідповідь - summarized synchronous discharge of rokovyh odnits of m'yazi at її electrical subdivision. H - type - monosynaptic reflex response of the mucous membrane in case of electric subdivision of sensitive nerve fibers of the greatest diameter from the subdivision of the subliminal stimulus for rud axons. The setting of the maximum amplitudes of H and M - indications characterizes the level of reflexiveness of alpha - motoneurons of the given muzzle, and in the norm it ranges from 0.25 to 0.75. With an increased pathway, the amplitude of the H - reflex and the target of the H / M will get better. H - reflex can be found in other muscles of the hands and feet. When peripheral motoneurons and spikes are severe, the amplitude of the H - reflex and the impairment of the H / M decrease, with a severe denervation of the H - the reflex of the mind.

Rhythmic stimulation of the peripheral nerve to be carried out to detect the deterioration of the nerve - myazovoy providnost, mіasthenіchny reaction.

Shown to the end of the day and diagnostic value. Electromyography allows you to establish a change in meat tone and deterioration of ruff. Vona can be used for characterization of meat activity and early diagnostics of the lesion of the nervous and meat systems, if clinical symptoms do not bend. EMG - until it is allowed to activate the manifestation of pain syndrome, the dynamics of the process.

1. Symptoms of the lesion of the facial nerve in the fallopian canals

Cutting the nerve in a special canal until the last line of sight of the great stone nerve should be brought up in one hour from the tiny parallels to dryness of the eyes, the taste and hypercauses will be spread. As long as the nerve is to fight for the inspiration of the great stone and court nerves, for the inspiration of the drum string, then there will be a miraculous parallich, there will be a flow of relish. If there are 7 bets in the key channel, lower than the input of the drum string, or if you go out from the slotted opening, open the winniggly parallich from the drip-j ime. Most often, there is a lesion of the facial nerve at the entrance to the facial canal and from the skull. The facial nerve can be doubled and relapsed.

2. subarachnoid hemorrhage, causes of blame, clink, lykuvannya.

Terms of post-regime for ailments

It is not common to be susceptible to craniocerebral injuries as a result of the tearing of the vesicles, the pulp - the cerebral membrane, veins, which fall into the sinuses, intracortical vessels, especially when the brain is struck, before - in the ligament of the membrane of the dura mater and sinus ...

The early period is characterized by symptoms of measles in the brain (epileptic seizures, psychomotor disturbances), meningitis of the other and radicular symptoms. Клініка growing up gostro or step by step. Here it is a problem to skarry on head b_l, back pain. Lo "calysis pain to lie down in the topics of fighting saplings: often the pain predominates in the country, but in those regions, from the radiosity in the eyes. pe3Kai headache, early meningeal symptoms, psychomotor disturbed 1 nya, madder, disorder of anxiety, euphoria. Destroyed zmіnyuєte] stunned. Reactions in a sick person in an unreported state ! call for changes, a house of blood appears in them. The prognosis is good!

Suck up, how to move the throat of blood: chloride Ca (10%, 3-5 tablespoons or 10 ml i.v.), Ca gluconate (0.5 g 3-4 times a day, or 10 ml 10% v / v) abo i / m), vikasol (1 ml of 1% solution i / m), as well as drugs that induce fibrinolytic blood activity, for example aminocaproic acid (10-15 g daily). In case of damaged diazepam, aminazine. Indicated repeated lumbar puncture, saluretics and glucerin.

3. Chorea Huntington.

Clinic, diagnostics, pathogenesis, treatment, genetics

Chronically progressive decline - degenerative illness, characterized by an overgrowing choreic hypertension and dementia.

Genetics.

Zahvoryuvannya spadkove. The type of sedation is autosomal - dominant with high penetrance (80 - 85%). The mutant gene is localized in 4 chromosomes.

Pathomorphology.

Atrophy of the brain appears. In pedigree ganglia, especially in the scale and caudate nucleus, gross degenerative changes of other and great cells begin, the change in number, the growth of major elements.

Hvor_yut in 30 years. There can be a lot of intellectual property, and dementia is developing in a frivolous way. One hour there are choreic hyperkinesi: shvidki, unrhythmic, happy hands in different groups of music. Difficulty making it difficult and supervising a number of unnecessary ruins. A small part of ailments can be easily stifled hyperkinesis. Mova is complicated. Hypotonicity of myaziv. Pareziv is dumb. Zahvoryuvannya progressє.

Diagnostics.

On the EKG diffuse changes in the bioelectrical activity of the brain. Pneumoencephalography is the expansion of the lingering and so called the depression of the thalamus, as well as the disease is associated with the lesions of other cells. At CT - signs of atrophy of measles in the brain. In diagnostics, there is a significant decline in the nature of the ailment, the appearance of the disease in the brain, the nature of the change in the disease, the change of the cerebrospinal birth.

For stifling hyperkinesis - antagonizing dopamine - phenothiazine preparations - triftazin (75-10 mg / dob) in combination with tranquilizers, dopegita, reserpin.

1. Three-part nerve. Peripheral and segmental type of sensitiveness deterioration on the face

The tripartite nerve is the cephalic sensitive nerve of the individual and the mouthwash, and in its warehouse it is also the fibers for the mucous membranes. The sensitive part is set by a lance of three neurons. Clients of the first neurons roztashovani in the first university tripartite nerve Roztasvanny on the front surface of the pancreatic membrane between the sheets of the dura mater. The dendrites of the cych clitin go up to the shkiri of the disclosure and to the areas innervated by the pins of the tripartite nerve. Clines of other neurons pass through the mesto-cerebral, pre-gasteal cerebral and two upper spinal segments of the spinal cord. In the core is a somatotopic representation. At the oral part of the nucleus, the region of the individual is represented, which is the most distant until the middle line, and navpaki, in the caudal part - the most distant region. That is, when the nucleus is defeated on the lower ravines of the bridge, the deep brain is in the middle of the zone, and the sensitivity is not caused by the growth in the ganglia of the tricycle nerve, but is of a segmental nature. Also, caudal parts of the nucleus are affected, anesthesia is performed in the form of swamp on the surface of an individual from the chola to the second and the last.

Fibers of other neurons go to the opposite side and go to the thalamus. From the cells of the thalamus, the third neurons of the tricycle nerve system are repaired, the axons of which are sent to the cells of the brain and end in the lower sections of the postcentral and precentral cells.

The striking of the nucleus of the spinal path of the tripartite nerve is manifested by sensitivities of the segmental type.

With a peripheral type of impairment of sensitivity, an increase in the throat of the tripartite nerve (intramuscular nerve, maxillary nerve, inferior slit nerve) is observed, and in the presence of a nerve, the nerve of the attacks and the zone of the innervation will be characteristic of the fever.

2. Coma with cerebral strokes.

Yak viznachiti hemiplegia, іnshі signs of battle

brain in ailments in a coma.

Advanced methods

Stroke - tse gostre damage to cerebral blood circulation. Win can be hemorrhagic and hemorrhagic. Before the hemorrhagic hemorrhage is carried into the cerebral cord and under the shell, before the hemorrhagic - thrombotic, embolic and non-thrombotic education.

Coma is the most glimpse of the onset of evidence, when both mind and reflexes are extinguished (at the expense of the mind and heart). Pathological reflexes (Babinsky's reflex) are not often seen. Mitigation of cerebrovascular accidents in case of impaired function of the reticular formation of the brain (activation of systems), in case of brain injury, cerebral strokes, important intoxications.

In case of a gross period of time, the internal capsule is reduced in tone and reflexes. Tse vikorystovuєtsya in diagnostics for the development of hemiplegia in ailments in a coma. If, lying on the back of a sick person, bend the upper edges in the lactic slopes and immediately lower them, then first descend before the surface on the side of the hemiplegia (h - for more low meat tone). The reasons on the side of the parallel to the lower stakes have been largely rotated.

3.hepatolenticular degeneration (Konovalov's disease - Wilson's). Clinic, diagnostics, pathogenesis, treatment, genetics

Hepatolenticular degeneration (hepatocerebral dystrophy, Wilson-Konovalov's ailment) - chronically progressive decline-degenerative illness, characterized by some lesions pіdkіrkovyh universities Central nervous system and liver.

Zakvoryuvannya spadkov, sedation autosomal recessive. The leading pathogenetic sign is a genetically impaired synthesis of cerulloplasmin bilca, which can enter the store of alpha 2 globulins, which is used for transport.

Pathomorphology.

pid internal organs In the eyes, degenerative changes begin, the most rotations in the pyocytic nuclei. Dystrophy of nerve cells with vognischevny razm'yakshennya, education of microcrystals and growths of the glia. Liver cirrhosis.

Symptoms of CNS and internal organs damage. In ailments, growths of myazova rigidity, malignant hyperkeys, pseudobulbar symptoms, progressive decrease in intellect, wrinkles from the side of the liver and the arch of the shell. Leading - the syndrome of extravagant destructions - rigidity of the tulubs, kintzivok, accusation, pharynx, collapse of walking, kovtannya and movi. Hyperkinesi: tremor, athetosis, torsion dystonia. Along with the turn and the next major manifestations, in the ear of the ear and the stage of the battle, there are 4 forms:

early developmental form;

tremtlivy - rigid і tremtlivy form;

Extrapіramіdni - cork form;

abdominal form.

Diagnostics.

On the basis of the class. In syrovatz blood, there is a decrease in the place of cerulloplasm, hypoproteinemia, hypertension in the blood, changes in liver tests, anemia, thrombocytopenia. The horns of the Kaiser - Fleischer are added to the pigment from the middy along the periphery of the cornea.

Vivedennya to the body of an excess of medi - thiol preparation (unithiol 5 ml 5% i / m school for 25 ін'єкцій 2 course for rіk, D - penіcylamіn 0.45 - 2 g / day). The drug will take all life. Preparations that polishuyut the function of the liver. Diet with office products, rich food, food fats and food. Vitamin and carbohydrate in excess.

1. Providniki and segmental problems of pain and temperature sensitivity in cases of lesions of the spinal cord

Pathological processes (trauma, burning, puffiness) often lead to a transverse lesion of the spinal cord. Affected guides in such a fall may be interrupted. All kinds of sensitiveness below the level of anxiety appear to be tormented (spinal type Provincial discord of sensitiveness). Such an increase in sensitivity is called paraanesthesia in clinics. At the same time, the sick person suffers from an eferent system, a spastic bunch, a parallel lower symptoms develop - a lower spastic paraplegia.

When carried out topical diagnostics, it was remembered about the particularity of the transition of the dorsal-thalamic fibers in the spinal cord from one side to the bottom. At the link with the cymbals, the upper interface must be shifted by 1 - 2 segments up the hill, and in this case, it must be located at the level Td or Tg.

The value of the border is less important in the localization of the chubby, if you see food about the operation. As soon as the surroundings become loose, the spinal cord segments and ridges become loose in the lower thoracic and transverse ridges as much as 3-4 ridges.

With a lesion of one half of the transverse spinal cord vision on the side of the head, the joint wakes up - the back cord is visible (the posterior cord is visible), there is a spastic parallel of the lower end (interruption of the crossed bundle). On the side, opposed to the fire, there is a visualization of pain and temperature sensitivity according to the conductive type (the dorsal - thalamic tract is connected to the cord). Such a key picture is called the Brown-Séquard parallel.

Provincial disasters of sensitiveness are susceptible to pathological signs in the back cords. At the same time, the joint is involved - the muscle and the vibrations are slightly on the sides of the head (the inclusion of the bundles of the thin and wedge-shaped). Inodi vipada and tactile sensitivity. Disruption of the posterior cords is more susceptible to tachycardia of the spinal cord, or lack of vitamins B12, or in case of myelochemia, which manifests itself as sensitive ataxia and parasthesia.

Segmental type of sensitiveness.

It is observed when the posterior horn and anterior spinal cord adhesions are obstructed. In the posterior rose, only other neurons in the pathway, which conduct an impulse of greater and temperature sensitivity from all types of dermatomes. yaksho rear rig To run through the stretching of decilkoh segments, in the form of dermatomes on its side, there is a sense of pain and temperature sensitivity. It is tactile and sensitive to the senses, and the guides appear in the posture zone of the head, and, having moved to the edge of the Lisauer zone, the stench will immediately be straightened into the rear rope. This kind of sensitiveness is called dissociated anesthesia. In case of severe anterior adhesions of the spinal cord, dissociative anesthesia can also develop, falling into decile dermatomes on both sides.

When localization of the head in the anterior adhesion of the spinal cord on the lower and thoracic segments of the razor of sensitiveness develops in the viglyad "jacket" - spinal, segmental type. Tsestrіchaєtsya at sіrіnshmіelіі, at judgments, With intramedular puffins.

2. Operative lichen.

Klіnіka, diagnostics, lіkuvannya

The price of free hanging on shkiri or mucous membranes at viglyadi bulbs on the erythematous - edematous infestation, expanding in the zone of segmental innervations. Operative versicolor (herpes) Most of the winners are among the lithians, or else you can be seen in any occasion. It is possible to achieve one or more instructions of the spinal-cerebral ganglia and posterior corners. The first place is to trace the thoracic region, on the other - the internal head of the tripartite nerve. In addition to the universities, before the process begins, the back corners, the shells to the brain, and the speech itself to the brain are formed.

Chvoroba to be repaired in rapt, gostro, without provisions. Characteristic general infectious symptoms: nezduzhannya, headache, slightly increased temperature, shlunkovo ​​- intestinal dislocation, ale buvay and little symptoms. The time period is usually 2-3 days. We will help to diagnose severe neural pain in the zone of innervascular diseases of the universities and in the cores. Bіl is sharply twisted, hectic, slow in character, can be sverbіzh. Possibility to develop hyperemia of shkiri and in 1-2 days a group of papules appears, which are characterized by a common worm. Papules become serous. After 3-4 days, the puffy crusts melt with ginger-brown colorah. When you see it, you will get pigmented scars, which will allow you to see it. In case of a severe institute of the threefold nerve of the bulb, it is localized on the face in the zone of innervation of the bulb, in the main one. Zakvoryuvannya trivaє 3-6 tizhnіv and do not leave behind. Ale in lіtnіkh nerіdko vinikє postherpetic neuralgia. As long as the bulbs are on the horns, keratitis can develop with further slough.

Stagnate deoxyribonucleosis, analgesics, aspirin, and, if necessary, drugs in conjunction with neuroleptics, antihistamines, barbiturates. For the control of erosions from secondary infections, ointments with antibiotics. When accelerated - GCS. When developing, neuralgia is postherpetic - roentgenotherapy. At the hospital stage and with neuralgia - tranquilizers, carbamazepin, antidepressants (amitriptylin) in conjunction with analgesics.

Suggestions for nutritional replacement