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MYOGENIC AND NEUROGENIC PARALYSIS OF THE LARYNX

The function of the muscles of the larynx can suffer with various infections, injuries, overexertion of the voice, congenital weakness (Fig. 4.16).

In the first place among myogenic paralysis is paralysis of the internal vocal muscle, the folds do not close during phonation, an oval gap remains between them, which often happens with acute laryngitis. In case of damage to the lateral cricoid-scyphoid muscle, the anterior two-thirds of the glottis do not close, it looks like an irregular rhombus, and with paralysis of the intercranial muscles they do not close in the back third of the glottis in the form of a triangle. In case of damage to the posterior vocal muscle, which is the only expander of the glottis, the vocal fold is stationary in the middle, the glottis expands only due to the opposite muscle. Aspirated, the glottis looks like a rectangular triangle. Voice formation and breathing, however, are not disturbed. Another thing is with bilateral paralysis of these muscles, when a tracheotomy is required with the threat of asphyxiation. However, myogenic paralysis of these muscles - the dilators of the glottis - is very rare, usually due to damage to the recurrent nerve, the only one that innervates this muscle, in contrast to muscles - constrictors that have cross-innervation.


The main causes of lesions of the recurrent (lower throat) nerve are aortic pathology, cardiac muscle hypertrophy, mediastinal tumors. More often, the left recurrent nerve is affected, passing along the mediastinum much lower than the right, to the level of the aortic arch. Finally, 2.5-3% of stumectomies performed by surgeons is accompanied by a unilateral, less often bilateral lesion of the recurrent nerve. In case of unilateral lesion of the nerve, the fold is first located in the midline, then there is compensation of the respiratory function due to the restructuring of the tone of the constrictors and the lateral shift of the affected fold by one third of the lumen (the so-called cadaveric position). A healthy fold goes away during phonation beyond the middle (sagittal) line, the arytenoid cartilage lies behind the paralyzed.

Unilateral damage does not require treatment. With a bilateral lesion, a tracheostomy is usually applied, and then a larynx operation is performed with the removal of one or two folds to eliminate stenosis (chorectomy).
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MYOGENIC AND NEUROGENIC PARALYSIS OF THE LARYNX

  1. Laryngeal palsy
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  2. Neurogenic regulation
    In understanding the regulatory mechanisms of the general adaptation syndrome as an organism's response to extreme changes in the environment, a special role belongs to the management of not so much somatic as visceral functions. It (this direction) refers to the most complex reflex acts, in which all departments of the autonomic (vegetative) nervous system participate in interaction with
  3. Neurogenic Amyotrophy
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  4. Neurogenic airway regulation
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  5. VIRAL PARALYSIS
    Viral paralysis (Latin - Paralysis apium; English - Honey bee paralysis) - a group of diseases (chronic, acute and slow paralysis) of adult honey bees, accompanied by paralysis of the extremities of the insect. Historical background, distribution, hazard and damage. Descriptions of some signs of paralysis of adult bees are found in the works of ancient authors (Aristotle,
  6. Paresis and paralysis
    This is a complete or incomplete termination of the functions of nerves or muscles. Cessation of nerve function can occur in various ways, depending on where the conduction of the nerve trunk is impaired. If the initial location of the outcome of the motor impulse is affected, i.e. cerebral cortex, cerebral palsy occurs; if nerve conduction is disturbed throughout the spinal cord - spinal;
  7. Periodic paralysis
    Periodic paralysis (paroxysmal myoplegia) is a variant of metabolic myopathy, manifested by transient episodes of sudden muscle weakness. As a rule, it is associated with a decrease in potassium (hypokalemic paralysis) or an increase in its content in the blood (hyperkalemia paralysis). The primary forms of dyskalemia paralysis are inherited in an autosomal dominant manner, therefore
  8. Paralysis
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  9. EXTREMITAL PARALYSIS
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  10. Myopathic paresis of the larynx
    Occupational diseases of the voice that disrupt long-term disability include myopathic paresis of the larynx (Figure 3). With myopathic paresis of the larynx, pathological changes are localized in the muscles themselves. They are observed in acute and chronic laryngitis, when microbes or their toxins penetrate into the interfibrillar tissue and cause small cell infiltration of the latter. These
  11. PARESIS AND PARALYSIS
    Paresis is incomplete, and paralysis is the complete inhibition of the motor function of one or another organ, caused by damage to various parts of the nervous system. The causes of paresis and paralysis can be diseases of the nervous system, infections, poisoning, vitamin deficiencies and metabolic disorders, as well as injuries, bruises and other injuries accompanied by mechanical compression of nerve fibers. Symptoms: function
  12. Peripheral paralysis
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  13. SLOW VIRAL PARALYSIS
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