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PRIVATE SYMPTOMATOLOGY OF SENSITIVITY DISORDERS

The lesion of the peripheral nerve trunk causes a violation of all types of sensitivity in the zone of its innervation, i.e., in the peripheral mononeuritic type. This results from the fact that in a trunk of a nerve pass nerve fibers for various types of sensitivity. The lesion of individual nerve fibers can be more or less deep, which leads to unequal violation of certain types of sensitivity. Most of the peripheral nerves contain besides the sensory motor and vegetative fibers, therefore, along with the sensory nerve, other nerve functions are affected.

Nervous plexus damage (cervical, brachial, lumbar, sacral) causes sensory, motor and autonomic disorders in the area innervated by nerves originating from this plexus. These disorders are combined with pain and paresthesias and belong to the peripheral type.

The defeat of the posterior roots is accompanied by a violation of all types of root-like sensitivity. In the areas of the skin innervated by the affected roots, along with impaired sensitivity (hypoesthesia, hyperesthesia, anesthesia), acute radicular pain appears.

The lesion of the posterior horn of the spinal cord is characterized with an eg -mentary dissociated type of sensitivity disorder. Tendon and periosteal reflexes are lost or reduced, dull, diffuse, poorly localized pain is noted. The defeat of the posterior horns is often observed in syringomyelia, therefore this type of sensitivity disorder is also called syringomyelic.

The defeat of the anterior white commissure is similar to the defeat of the horn, but segmental dissociated sensitivity disorders in this case are bilateral and symmetrical (“butterfly type”). Unlike the lesion of the two posterior horns, the lesion of the anterior white commissure is characterized by the preservation of reflexes, which are reduced or lost in the first case.

The lesion of the posterior cord, consisting of nerve fibers of the thin and wedge-shaped bundles, conducting impulses of the articular-muscular sense 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 by conductive type (from the level of the lesion to the end downward ). As a result of a muscular-articular disorder, a zadiac head, or sensitive, ataxia occurs;

the patient loses an idea about the position of parts of his body in space, about the direction and volume of movements, which is manifested as a violation of coordination of movements, for example, with funicular myelosis, dorsal tabes.

The defeat of the lateral cord causes frustration of pain and temperature sensitivity on the conductor type on the side opposite to the hearth, which is explained by the intersection of the lateral spinal-thalamic path passing here. In the lateral cord near the lateral spinal-thalamic path passes the lateral cortical-cerebrospinal path, the defeat of which is manifested by the central paralysis of the limbs on the side of the localization of the pathological process. An isolated lesion of the lateral cord is rare, often the process involves half of the spinal cord.

The transverse lesion of half of the spinal cord is accompanied by Brown-Sekar syndrome (.29) - central paralysis downward from the level of the lesion and a violation of the musculoskeletal feeling on the affected side, pain and temperature sensitivity disorders on the affected side by the segmental type and on the opposite side (on 1–2 segments below the lesion level) - by conductor type.
The violation of tactile sensitivity is insignificant or completely absent both on the affected side and on the opposite side, since it is ensured by both homo and heterol [oral routes (fibers that conduct impulses from tactile sensitivity receptors pass through both thin and wedge beams and lateral dorsal-talamic pathway).

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

sensitivity and sensitive hemitaxia on the opposite side of the hearth.

The defeat of the thalamus causes “three heme syndrome” - henanesthesia of pain, temperature and tactile sensitivity, sensitive hemiataxy (loss of joint-muscular feeling on the opposite side) and hemianopsia of opposite visual fields.

In some cases, persistent, excruciating, painful and tantalic pain in the opposite half of the body is possible, manifested as poorly localized, extremely unpleasant vague sensations (paresthesias, dysesthesies, hyperpathies, etc.), which are sometimes combined with choreoathetoid hyperkinesia, autonomic and trophic disorders.

The lesion of the inner capsule also causes hemianesthesia, hemiaxia and hemianopia on the opposite side. If hemianesthesia is affected by thalamus, pain and temperature sensitivity is found strictly along the midline of the body, then this pattern is not typical for 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 body and weaker on the medial surface.

The same regularities as the defeat of the sensitive ways of the trunk and extremities are characteristic of the defeat of the conductive sensory facial paths. So, with the defeat of the cranial nerve root from its node to the brain stem, as well as with the defeat of the spinal nerve root, all kinds of sensitivity fall out. The lesion of the sensory nucleus of the cranial nerve may be accompanied by a disorder of sensitivity of the dissociated type, as well as with the defeat of the posterior horns of the spinal cord. Thus, the defeat of the upper, middle or lower part of the trigeminal spinal cord causes dissociated anesthesia or hypoesthesia - loss or reduction of pain and temperature sensitivity while maintaining tactile in Zelder’s segmental ring zones (see p. 118).

Damage to the sensitive area of ​​the cerebral cortex (postcentral gyrus) leads to loss of all types of hemithip sensitivity on the opposite side. In fact, loss of sensitivity in monotype (on the arm, leg, face, etc.) is more common than in hemitype, since not all postcentral gyrus is usually affected, but only its individual sections. So, with the defeat of its upper portion, anesthesia or hypesthesia of the foot (less often the entire leg) is detected, the lower portion — the face, the tongue on the side opposite to the outbreak.

In addition to the effects of prolapse (anesthesia), there may be phenomena of irritation (paresthesia) appearing in the appropriate localization of the pathological focus parts of the body (arm, leg, torso, face) on the side opposite to the focus (for example, epilepsia partialis S. epilepsy). manifested partial ptupup 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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PRIVATE SYMPTOMATOLOGY OF SENSITIVITY DISORDERS

  1. PRIVATE SYMPTOMATOLOGY OF SENSITIVITY DISORDERS
    The lesion of the peripheral nerve trunk causes a violation of all types of sensitivity in the zone of its innervation, i.e., in the peripheral mononeuritic type. The damage to the plexus (cervical, brachial, lumbar, sacral) causes sensory, motor and autonomic disorders in the area innervated by the nerves, combined with pain and paresthesia and belong to
  2. Cortical 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 set 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 is subject to reception is felt. For example:
  3. TYPES OF DISTURBANCE OF SENSITIVITY

  4. TYPES OF DISTURBANCE OF SENSITIVITY

  5. Sensitivity and types of sensitivity disorders
    Sensitivity - the body's ability to perceive irritation emanating from the environment or from its own tissues and organs. The analyzer consists of three sections: the receptor, the conductor part and the cortical department. Receptors are the terminal formations of sensory nerve fibers that perceive changes in the body or outside of it and transmit it in the form of impulses.
  6. Symptomatology of skin rashes
    Roseola - a speck of pink, red, purple-red or purple in size up to 5 mm. Roseola shape is round or irregular; edges are clear or blurry; above the skin does not protrude, disappears when pressed on the skin, when released, reappears. Multiple roseola 1-2 mm in size - petechial rash. Stain - the color is the same as that of roseola, but the size is from 5 to 20 mm, not
  7. MENTAL DISORDERS (PR) AND DISORDERS OF BEHAVIOR (RP), THEIR MEDICAL AND SOCIAL SIGNIFICANCE
    Class V (ICD-10), encrypted - F 00 - F 99. Mental health (mental health) is a dynamic process of mental activity characterized by the determination of mental phenomena, the harmonic relationship between the reflection of reality circumstances and the attitude of the individual 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 set 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 is subject to reception is felt. For example: afferent to
  9. SENSITIVITY RESTORATION
    When reading this section, one should take into account the fact that we are talking about the possibility of restoring sensitivity, and not its normalization. With anatomical damage to the spinal cord, recovery of sensitivity proceeds in a certain sequence. The surface skin sensitivity is restored first. Gradually emerging foci of skin sensitivity expand and
  10. Sensitivity
    The primary perception of all the stimuli in the human body is carried out by receptors - specific cells that perceive the effects of external and changes in the internal environment of the body. Exteroreceptor Receptors Proprioceptors Interoreceptors General features of three-neural pathways of superficial and deep sensitivity • The first neuron is located in the intervertebral node.
  11. RESEARCH SENSITIVITY
    In the study of sensitivity based on the testimony of patients in response to certain stimuli. However, the study of sensitivity in children presents great difficulties, since the child cannot always clearly differentiate the stimulation, correctly analyze his feelings and adequately describe them. In young children, it is often necessary to confine ourselves to researching only
  12. RESEARCH SENSITIVITY
    In the study of sensitivity based on the testimony of patients in response to certain stimuli. However, the study of sensitivity in children presents great difficulties, since the child cannot always clearly differentiate the stimulation, correctly analyze his feelings and adequately describe them. In young children, it is often necessary to confine ourselves to researching only
  13. SENSITIVITY DISORDER
    In the clinic, it is customary to distinguish between types and types of sensitive disorders. There are the following types of sensitivity disorders, which are allocated depending on the qualitative or quantitative changes in sensations. Anesthesia - the complete loss of any kind of sensitivity - is due to the fact that, due to some obstacles, the impulses do not reach the corresponding cortical
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