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PARTICULAR SYMPTOMATOLOGY OF SENSITIVITY DISORDERS

Damage to the trunk of the peripheral nerve causes a violation of all types of sensitivity in the area of ​​its innervation, i.e., according to the peripheral mononeuric type. This is because nerve fibers pass through the nerve trunk for various types of sensitivities. The defeat of individual nerve fibers can be more or less deep, which leads to an unequal violation of certain types of sensitivity. Most peripheral nerves contain, in addition to sensory, motor and autonomic fibers, therefore, along with sensitive, other nerve functions also suffer.

The defeat of the nerve plexus (cervical, brachial, lumbar, sacral) causes sensitive, motor and autonomic disorders in the area innervated by the nerves originating from this plexus. These disorders are combined with pain and paresthesias and are peripheral.

The defeat of the posterior roots is accompanied by a violation of all types of sensitivity of the radicular type. In areas of the skin innervated by the affected roots, along with sensory disturbances (hypesthesia, hyperesthesia, anesthesia), acute radicular pain appears.

Damage to the horn of the spinal cord is characterized by an e-fundamental dissociated type of sensitivity disorder. Tendon and periosteal reflexes are lost or reduced, dull, diffuse, poorly localized pain is noted. Damage to the posterior horns is often observed with syringomyelia, therefore this type of sensitivity disorder is also called syringomyelia.

The defeat of the anterior white commissure is similar to that of the horn, but segmental dissociated sensory disturbances in this case are bilateral and symmetrical (“butterfly type”). In contrast to the defeat of the two posterior horns, the defeat of the anterior white commissure is characterized by the persistence of reflexes, which decrease or are lost in the first case.

The defeat of the posterior cord, which consists of nerve fibers of the thin and wedge-shaped bundles, conducting impulses of the articular-muscular feeling and other types of deep, as well as part of the tactile sensitivity, is accompanied by a complete or partial loss of these types of sensitivity according to the conductor type (from the level of the lesion to the bottom down ) As a result of a disorder of muscular-articular sensation, there is a posterior, or sensitive, ataxia;

the patient loses the idea of ​​the position of the parts of his body in space, of the direction and volume of movements, which is manifested by a violation of coordination of movements, for example, with funicular myelosis, spinal cord.

The defeat of the lateral cord causes disorders of pain and temperature sensitivity along the conductor type on the side opposite to the focus, which is explained by the cross of the lateral dorsal-thalamic pathway passing here. In the lateral cord near the lateral dorsal-thalamic pathway, the lateral cortical-spinal pathway passes, the defeat of which is manifested by central paralysis of the limbs on the side of the localization of the pathological process. Isolated damage to the lateral cord is rare, more often the process captures half of the spinal cord.

Transverse lesion of half of the spinal cord is accompanied by Brown-Secard syndrome (. 29) - central paralysis downward from the level of the lesion and violation of the articular-muscular feeling on the affected side, pain and temperature sensitivity disorders on the affected side on a segmental type and on the opposite side (on 1-2 segments below the lesion level) - according to the conductor type.
Violation of tactile sensitivity is insignificant or completely absent both on the side of the lesion and on the opposite side, since it is provided by both the homo- and heterol [oral routes (fibers conducting impulses from the tactile sensitivity recipes pass both in the thin and wedge-shaped bundles, and in lateral dorsal thalamic pathway).

The defeat of the medial loop after fusion within the bridge of the lateral spinal thalamic and bulbothalamic pathways causes pain, temperature and tactile hemianesthesia

sensitivity and sensitive hemataxia on the side opposite to the focus.

The defeat of the thalamus causes the “three gem syndrome” - hemannesthesia of pain, temperature and tactile sensitivity, sensitive hemataxia (loss of joint and muscle feeling on the opposite side) and hemianopsia of opposite fields of view.

In some cases, persistent, excruciating, talma pain in the opposite half of the body is possible, manifested in the form of poorly localized, extremely unpleasant vague sensations (paresthesia, dysesthesia, hyperpathy, etc.), which are sometimes combined with choreoathetoid hyperkinesias, vegetative and trophic disorders.

Damage to the internal capsule also causes hemianesthesia, hemataxia and hemianopsia on the opposite side. If, with the defeat of the thalamus, hemianesthesia of pain and temperature sensitivity is detected strictly along the midline of the body, then such a pattern is not typical for the localization of the focus in the inner capsule - these types of sensitivity disorders are more pronounced in the distal extremities and on the lateral surface of the trunk and weaker on the medial surface.

The defeat of the conductive sensory pathways of the face is characterized by the same patterns as the defeat of the sensitive pathways of the trunk and limbs. So, with damage to the root of the cranial nerve from its node to the brain stem, as well as with damage to the root of the spinal nerve, all kinds of sensitivity fall out. The defeat of the sensitive nucleus of the cranial nerve may be accompanied by a disorder of sensitivity in a dissociated type, as in the case of damage to the posterior horns of the spinal cord. So, damage to the upper, middle or lower spinal tract trigeminal nerve causes dissociated anesthesia or hypesthesia - loss or decrease in pain and temperature sensitivity while maintaining tactile in the segmented ring zones of Zelder (see p. 118).

Damage to the sensitive area of ​​the cerebral cortex (postcentral gyrus) leads to the loss of all types of sensitivity according to the hemitype on the opposite side. Sensitivity loss occurs more often by the monotype (on the arm, leg, face, etc.) than by the hematotype, since usually not all of the postcentral gyrus is affected, but only its individual sections. So, with the defeat of its upper section, anesthesia or hypesthesia of the foot (less often than the entire leg) is detected, the lower section - the face, tongue on the side opposite to the focus.

In addition to prolapses (anesthesia), there may be irritations (paresthesias) that appear in the parts of the body (arm, leg, trunk, face) corresponding to the localization of the pathological focus (on the side opposite to the focus (for example, when a Jackson epilepsy seizure is epilepsia partialis s. Corticalis— manifested by partial ptupa of paresthesia or pain spreading in parts of the body in accordance with the sequential inclusion of centers in the postcentral gyrus).
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PARTICULAR SYMPTOMATOLOGY OF SENSITIVITY DISORDERS

  1. PARTICULAR SYMPTOMATOLOGY OF SENSITIVITY DISORDERS
    Damage to the trunk of the peripheral nerve causes a violation of all types of sensitivity in the area of ​​its innervation, i.e., according to the peripheral mononeuric type. The defeat of the nerve plexus (cervical, brachial, lumbar, sacral) causes sensitive, motor and autonomic disorders in the area innervated by the nerves, combined with pain and paresthesia and relate to
  2. Cortical Type Disorder
    (Internet) Sensitivity - the body's ability to perceive irritation emanating from the environment or from its own organs and tissues. In physiology, the entire totality of afferent systems is united by the concept of reception. Sensitivity is a special case of reception, when afferent impulses lead to the formation of sensations. Not everything that undergoes reception is felt. For example:
  3. SENSITIVITY DISORDERS TYPES

  4. SENSITIVITY DISORDERS TYPES

  5. Sensitivity and types of sensory impairment
    Sensitivity is the body's ability to perceive irritations emanating from the environment or from its own tissues and organs. The analyzer consists of three departments: the receptor, the conductor, and the cortical. Receptors are the terminal formations of sensitive nerve fibers that perceive changes in the body or outside it and transmit it in the form of impulses.
  6. Symptomatology of skin rashes
    Roseola - a speck of pink, red, purplish-red or purple in size up to 5 mm. The shape of roseola is round or irregular; the edges are clear or blurry; does not protrude above the skin, disappears with pressure on the skin, and when released again appears. Multiple roseola 1-2 mm in size - a small-point rash. Spot - the color is the same as roseola, but the size is from 5 to 20 mm, not
  7. MENTAL DISORDERS (OL) AND BEHAVIORAL DISORDERS (RP), THEIR MEDICAL-SOCIAL SIGNIFICANCE
    Class V (ICD-10), encrypted - F 00 - F 99. Mental health (mental health) - a dynamic process of mental activity, which is characterized by the determinism of mental phenomena, the harmonious relationship between the reflection of circumstances of reality and the individual's attitude to it, the adequacy of the body's response to social, psychological and physical (including biological)
  8. Sensitivity
    Sensitivity - the body's ability to perceive irritation emanating from the environment or from its own organs and tissues. In physiology, the entire totality of afferent systems is united by the concept of reception. Sensitivity is a special case of reception, when afferent impulses lead to the formation of sensations. Not everything that undergoes reception is felt. For example: afferent to
  9. RESTORE SENSITIVITY
    When reading this section, one should take into account the fact that we are talking about the possibility of restoration of sensitivity, and not about its normalization. With anatomical damage to the spinal cord, restoration of sensitivity proceeds in a certain sequence. The first to restore surface skin sensitivity. The gradually appearing foci of skin sensitivity expand and
  10. Sensitivity
    The primary perception of all stimuli in the human body is carried out by receptors - specific cells that perceive the effects of the external and changes in the internal environment of the body. Receptors-Exteroreceptors Proprioreceptors Interoreceptors General features of the three-neuronal paths of surface and deep sensitivity • The first neuron is located in the intervertebral node.
  11. SENSITIVITY STUDY
    In the study of sensitivity, they are based on the testimony of patients in response to certain stimuli. However, the study of sensitivity in children presents great difficulties, since a child cannot always clearly differentiate irritation, correctly analyze his feelings and adequately describe them. In young children, often have to be limited to research only
  12. SENSITIVITY STUDY
    In the study of sensitivity, they are based on the testimony of patients in response to certain stimuli. However, the study of sensitivity in children presents great difficulties, since a child cannot always clearly differentiate irritation, correctly analyze his feelings and adequately describe them. In young children, often have to be limited to research only
  13. SENSITIVITY VIOLATION
    In the clinic, it is customary to distinguish between types and types of sensitive disorders. The following types of sensory impairment exist, which are distinguished depending on a qualitative or quantitative change in sensations. Anesthesia - the complete loss of any kind of sensitivity - is due to the fact that, due to some obstacles, the pulses do not reach the corresponding cortical paths
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