Yermolaeva Technology Breed Production Equipment. Technology and equipment of production of beer and non-alcoholic beverages - Yermolova G.A.
Download: tehoborudiproizvpiva2000.pdf.
Ministry of Education of the Russian Federation
Institute for the Development of Vocational Education G.A. Ermolaeva, R.A. Kolchev
Technology and equipment of production of beer and non-alcoholic beverages
Textbook
Recommended by the expert advice on primary vocational education for institutions of the initial vocational education
Academa.
Moscow
2000
UDC (075.22) BBK 36.87Я722 + 36.88Я722 E 74
Federal program of the Russian book publishing
Reviewer Chief Specialist of the Ministry of Agriculture Product G. L. Sviridova
E 74.
Yermolaeva G.A., Kolcheva P.A. Technology and equipment production of beer and non-alcoholic beverages: studies. For start. prof. Education. -M.: IRPO; Ed. Center "Academy", 2000. - 416 p. ISBN 5-8222-0118-0 (IRPO) ISBN 5-7695-0631-8 (ed. Center "Academy")
Considered modern technology for the preparation of malt, beer, non-alcoholic and low-alcohol drinks, kvass, mineral waters. The device and the principle of operation of the technological equipment used, as well as methods of chemical and technological control of the quality of raw materials and finished products are described. The requirements for raw materials for the preparation of beverages, technological water, containers and auxiliary materials are presented, as well as resistance and quality of beverages, to industrial sanitation and safe work techniques.
For students of institutions of primary vocational education and engineering and technical workers of enterprises of brewing and non-alcoholic sectors of the food industry.
UDC (075.22) BBK 36.87Я722 + 36.88Я722
© Yermolaeva G.A., Kolcheva P.a., 2000 ISBN 5-8222-0118-0 © Professional Education Institute, 2000
ISBN 5-7695-0631-8 © Registration. Publishing Center "Academy", 2000
Introduction
Beer is a playful, refreshing drink with a characteristic hop aroma and a pleasant bitter taste, saturated with carbon dioxide (carbon dioxide) formed in the process of fermentation. It is not only quenching thirst, but also increases the overall tone of the human body, contributes to the best metabolism.
Brewing is one of the most ancient industries. It is assumed that for another 7 thousand years BC In Babylon, beer was cooked from barley malt and wheat. Then the method of cooking beer spread in ancient Egypt, Persia, among the peoples who inhabited the Caucasus and the South of Europe, and later - throughout Europe.
Beer in Russia. In all Slavic languages \u200b\u200bthere is a word "beer". Previously, this word was called not only beer, but also a drink at all. The words "beer" and "drink" are consonant in Slavic languages. It was the Slavs that were intermediaries who transmitted the practice of using hops to other European peoples.
During the archaeological excavations on the site of ancient Novgorod, the Berchinic diplomas were found, in which the diligeons were mentioned. Digestions are hopic drinks from honey and beer, characterized by a large fortress. How highly appreciated the digestors can be judged by the fact that honey and diligets were tribute to Russia. It should also be noted that beer, malt and hops were part of the horses of the peasants for the use of the Earth.
In Russia, beer and honey of different fortresses (lungs - from 2% to 4% alcohol, medium - from 4.5% to 7%, strong - up to 17% and even 35% or more) were ritual drinks used in peers. Cook beer in monasteries. During the reign of great princes, beer is often mentioned in the royal decrees. The Grand Duke Ivan III during his reign (1462-1505) forbade anyone to cook beer and eat hops, assigning this rule of treasury. Later, the decree was canceled.
Over time, more and more brewing appears in Russia. In 1715, at the direction of Peter I, the Solodovshchiki and brewers were discharged to St. Petersburg, which contributed to the development of brewing. By the same year, the foundation of the current brewery in Lviv. Beer in Russia becomes familiar and popular and even hits the pages of literary works.
At the turn of the XVIII-XIX centuries. He enjoyed fame of the beer of Moscow brewers, the total number of which was 236. Apparently, they were smaller compared to the major Petersburg. Especially famous then Kaluga beer, obtained by riding fermentation.
The history of St. Petersburg brewing is interesting. In 1795, with the highest approval of Catherine II Abraham Friedrich Cro-
3
nom in St. Petersburg was founded by the elder of Russian brewing - the brewery, which was named after Alexander Nevsky. Per year at the factory was produced up to 170 thousand decaliters (1 decalitr or 1 gave 10 l, and 1 hectoliter or I ch - 100 liters) of beer, which was supplied to the imperial table. At the end of the XVIII century. Peter Ka-fallow was based on the production of beer near Kalinkin bridge. Kalinka Pivzavod specialized in the release of the best, elite beer varieties. In 1s48, the crowns and Kazeter united their plants, in the future the brewing was conducted at the Kalinka Brewery, which already in 1848 produced 330 thousand gave. (Since 1923, this plant is named Stepan Razin.) In 1863, the Bavaria's Pivzavod of the Russian-Bavarian Bivarian Society was established at the Petrovsky Island, which became the supplier of the courtyard of his imperial majesty. In 1872, the plant "Vienna * of the Russian-Austrian joint-stock company was founded.
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"A.I. Ermolaeva, G.A. Baranova. Vegetative nervous system and vegetative violations. Study Guide Penza 2015 The textbook describes the structure and functions of the vegetative nervous system, ... "
Ministry of Education and Science of the Russian Federation
Federal State Budgetary Educational
establishment of higher vocational education
"Penza State University" (PSU)
A.I. Ermolaeva, G.A. Baranova.
Vegetative nervous system
And vegetative violations.
Tutorial
The textbook describes the structure and functions of the vegetative nervous system, clinical and paraklinic methods of their research, the main types of vegetative violations.
The textbook is intended for students of 3-6 courses of medical universities, can be used by neurologists, neurosurgeons and doctors of other specialties.
Compilers:
head Department of Neurology and Neurosurgery of the Penza State Medical Institute, Doctor of Medical Sciences A.I. Ermolaeva, Ph.D. Associate Professor of the Department of Neurology and Neurosurgery G.A. Baranova.
Reviewers:
Doctor of Medical Sciences, Professor of the Department of Neurology of the Penza Institute Improving Doctors of the Ministry of Health of the Russian Federation G.I. Martynova Doctor of Medical Sciences, Professor of the Department of Pharmacy and Pharmacology of the Saratov Medical Institute "Reabiis" E.V. Verizhnikov approved and recommended for the publication of the Methodical and editorial-publishing commissions of the Medical Faculty of Penza State University.
1. Vegetative nervous system and vegetative disorders ............ ..4
2. Neurogenic violations of the functions of pelvic organs .... ........................................................................ 29
3. Tests .............................................................................. .33
4. Answers to tests .................................................................. .38
5. Literature ........................................................................ ..39
Vegetative nervous system and vegetative
Violations
The structure and functions of the vegetative (autonomous) nervous system.Functional role VNS:
1. Regulates all internal processes of the organism: the activities of the internal organs, the glands of internal secretion, blood and lymphatic vessels, maintaining the trophics of all tissues of the body:
2. Provides organism homeostasis - the constancy of the internal environment and the stability of its main physiological functions.
3. Carries out the energy provision of all activities.
4. Adaptation-trophic function: regulation of metabolism, in relation to the conditions of the external environment. The essence of this feature is that it should ensure any deviation in the activities of the internal bodies in response to a change in the activities of the body. Such a combination of functions ensures the adaptation of the inner environment of the body to the ever-changing conditions of the external environment.
The structure of the vegetative nervous system.
Like a somatic nervous system, the vegetative nervous system consists of neurons, the main functional unit is the reflex arc.
The vegetative nervous system is divided into central and peripheral departments (oversegment and segmental).
In the segmental level there is a clear unit for the sympathetic and parasympathetic parts.
The sympathetic part is excited by the adrenaline mediator, the parasympathetic part is acetylcholine.
The braking effect on the sympathetic part has an ergotamine mediator; On parasympathetic - atropine.
All bodies are under the influence of both the sympathetic and parasympathetic parts of the VNS.
Parasympathetic innervation provides stable states of organs, and sympathetic applies these states in relation to the functions performed. Both parts of the VNS function in close cooperation with each other.
The structure of the sympathetic part of the vegetative nervous system The peripheral department of the sympathetic nervous system begins with the neurons of the side horns of the spinal cord segments C8-L2. The axons of these cells (myelinized pregglicionary fibers) extend from the spinal cord in the composition of the front roots, then separated and ends in the nodes of the border sympathetic barrel. The border sympathetic trunk lies on the side surface of the cervical, infant, lumbays, sacral vertebrae and consists of 3-cervical, 12-chest, 5 lumbar, 4-sacral and alone ganglion. Postgangling (non-moving) fibers go to the internal organs, form a plexus around the blood vessels, are part of the peripheral nerves. Part of the pregganionic fibers in the nodes of the border sympathetic barrel is not interrupted, but it goes to intermediate nodes (prevertubral ganggles), which are located between the borderline sympathetic barrel and internal organs: Ganglium Coeliacum, Ganglium Mesenttericum et al.;
axons of these nodes form vegetative plexuses: solar, mesenter, etc. and innervate the abdominal organs and small pelvis.
Each sympathetic node gives branches on the innervation of the spine, as well as in the spinal nerves and for the innervation of internal organs.
The cervical sympathetic knots innervate the throat, larynx, thyroid gland, give branches to heart. From the cereals of the cilospinal center, located in the lateral horns of the C8-D1 segments of the fiber in the front of the front roots reach the upper cervical sympathetic node, from which the blurred nerve comes from, which forms the plexus of the internal carotid artery (innervates the carotid artery pool). The branches of this nerve along with the eye artery reach the ciliary node, which lies on the visual nerve, the branches go to the next muscles: M.Dilatator Pupillae; M.Tarsalis Superior;
m.ORBitalis. Under the defeat of the cilospinal center, the top cervical node or data of the fibers occurs to the Bernard Gorner-Claude syndrome, which includes the triad of symptoms - ptosis, myiosis, enofalm.
From the third cervical sympathetic assembly (star), branches on the formation of heart aortic plexus, vertebral nerve, forming the plexus of the vertebral artery and accompanying the entire vertebobasilar pool. Also from the third cervical sympathetic node is carried out skin vegetative arm innervation.
Breast sympathetic nodes:
the upper six - innervate the organs of the chest (heart, pericard, trachea, lungs);
the lower six is \u200b\u200binnervating the abdominal organs. Through the lower chest nodes, large and small crank nerves pass, which form solar plexus.
Lumbar sympathetic nodes give branches on the formation of solar plexus (kidney innervation, ureters), and also provide skin vegetative innervation of the leg.
Sleepy sympathetic nodes innervate small pelvis organs. With the defeat of the coccycous knot, Coccigigenia syndrome occurs.
- & nbsp- & nbsp-
The parasympathetic department of the vegetative nervous system is represented by craniobulbar and sacred departments.
The craniobulbar department is represented by parasympathetic cerebral cores:
Yakubovich's core - fibers come out in the composition of the eye nerve, penetrate the cavity of the orbit through the upper eye slit, suitable to Ganglion Ciliarae and innervate the muscle that sinks the pupil.
Pearlo - fiber cores come out as part of the oke-tissue nerve penetrate the cavity of the orbit through the upper eye slit, suitable for Ganglion Ciliarae and innervate accommodation muscle.
The tears of the fiber is the fiber in the face of the face in a bridge corner, from the skull exit via Porus Acusticus, then a large stony nerve reaches a storage unit, reach the lacrimal gland, ensuring its secretion and expansion of the iron vessels.
Taste core - (Nucleus Tractus Solitarius - the core common for the VII and IX pairs of the cranial brain nerves); fibers in the composition of the facial nerve, then in the composition of the drum string, carry out flavors innervation of the front 2/3 of the language; The fibers in the composition of the language nerve innervate the back of the tongue.
Slyunootativative nucleus (it is common to the IX, VII pairs of cranial nerves); The fibers from the upper portion of the kernel go in the composition of the facial nerve, then the drum string and innervate the sublard and lifting gland. From the lower portion of the fiber kernel in the composition of the language inheritance nerve, the ear node reaches and innervate the parole.
Dorsal core of a wandering nerve (located in the bottom of the diamond pits); The fibers go in the composition of a wandering nerve in all organs of the chest, then in the composition of solar plexus innervating the organs of the abdominal cavity.
The sacral department is represented by cells of lateral horns at the SII - SIV segment level.
The fibers go to the lower hyporal plexus on the sides from the rectum, the pelvic nerve comes from this plexus, which innerves the small pelvis organs.
An oversegment (central) department of the vegetative nervous system (structure and function).
Adventure (higher) vegetative centers whose feature is the absence of morpho-functional specificity, are in the core of the hemispheres of the brain, cerebellum, the brain barrel, but mainly represented by the structures united under the title of the hypothalamibico-reticular complex.
The hypothalamus is the main subcortex center for the integration of vegetative functions. Its front limit forms the rear edge of the crossroads of the visual nerves, the rear - the caudal edge of the mummic bodies, the side - subbugs, brain legs and an inner capsule. The hypothalamus forms the base of the brain, representing the bottom of the third ventricle and includes the rear departments of the Hiazma, the gray hill, the funnel of the gray hill, the deputyid bodies.
Allocate:
the ergotropic system, which includes the rear departments of the hypothalamic area, provides physical and mental activities through segmental sympathetic apparatus (increases blood pressure, improves gas exchange, pulmonary ventilation, blood supply to working muscles);
the trophhotropic system, which includes the front departments of the hypothalamic area associated with the recreation period, a slow phase of sleep, mobilizes the vagacyular apparatus (reduces blood pressure, slows down the heart rhythm, narrows bronchi, enhances the intestinal peristalsis).
The hypothalamus is the highest vegetative center, the location of the coordination of the nervous, endocrine, humoral regulation of the body's vital functions. The hypothalamic area has connections with all the departments of the nervous system. The afferent paths go to the hypothalamus from the cortex, from the extrapyramidal system, from the visual basis, the senses.
Efferterent pathways from the hypothalamus go to the auditorium, in the reticular formation of the trunk, and the subcortical EPS kernels, into the parasympathetic core of the brain. Also, the hypothalamus is closely related to the pituitary.
The hypotalamic area is divided into the following departments:
front Division - (including medial and lateral precutic kernels, suprasoptic core, paraventricular kernels and front hypothalamic kernels) ensures control of parasympathetic innervation, water-salt exchange;
the average department - (includes serobugum kernels), provides the regulation of all types of metabolism;
rear Division - (includes medial and lateral mammilated bodies, the rear hypotalamic kernel), ensures control of sympathetic innervation.
The centers of the hypothalamus are neither sympathetic nor parasympathetic, they carry out the integral regulation of the functions of both parts of the vegetative nervous system.
The hypothalamus plays an important role in the regulation of the function of the internal organs. This regulation can be carried out either directly or by means of an internal secretion gland. The cells of the suprasoptic and paraventricular nuclei of the front hypothalamus nuclei are associated with the rear lobes of the pituitary gland and provide vasopressin products (suprasoptic kernel) and oxytocin (paraventricular kernel). Vasopressin regulates water exchange, and oxytocin causes a reduction in a pregnant uterus.
Cells of fine-cell cores of the ventral hypothalamic area are associated with the front fraction of the pituitary gland, adenogipophysome. They produce neurogormons (rillation factors), which come to the portal vascular network of the pituitary leg and reach the front lobe of the pituitary gland.
There are 7 hypothalamic factors that affect the glandular formation of adenogipophies. Of these, 5 factors stimulate the release of a corticotropic, thyrotropic, somatotropic, luteinizing, follicularity hormone, and 2 factors are brakes: one slows down the separation of prolactin, another melanocytomylin.
In addition, in the hypothalamus there are centers related to the regulation of fatty, salt-salt, carbohydrate metabolism, body temperature, sweating, behavioral reactions (sexual attraction, thirst, appetite), emotions (fear, aggression, euphoria).
The hypothalamic area has greater vascularization (1200 capillaries per 1 mm). Numerous vessels of the hypothalamic region have high permeability for large-molecular weight protein compounds, it contributes not only to high sensitivity, but also the penetration of infectious agents, toxins, hormones. This causes the high sensitivity of the hypothalamic area to various physiological and pathological impacts.
All AGC activities are monitored and regulated by the cortical departments of the nervous system (medobased departments of frontal temporal fractions, parietal shares). The hypothalamus is closely connected to the limbic system.
The limbic system includes the formation of olfactory ways located on the basis of the brain, hippocampus, gear shock, transparent partition, almond-shaped body, the front core of the hypothalamus. The limbic system is of great importance in emotional reactions, the process of attention, memory, adjusts sleep and wakefulness. Therefore, any impact on the structures of the hypothalamus or the limbic system is accompanied by a complex complex of reactions of many organism systems expressed in mental and visceral effects.
Of all the structures of the brain, a substantial role in the regulation of vegetative functions is played by the reticular formation, the kernel of which form an oversegmental regulatory centers of vital functions:
breathing, cardiac activity, exchange, vascular and row of others.
Reticular formation
Anatomically reticular stem formation, as itself shows 1.the name represents a media formation consisting of scattered fibers and cells.
2. The structure of the cells that are part of the Russian Federation is a "mixed", which has simultaneously signs of both the I and Gold type II. These cells are located in various departments of the Russian Federation with different density and differ in their dimensions, which served as the basis for the allocation of significant quantities in it (over 40) nuclei.
3. The length of the Russian Federation barrel in length corresponds to the length of the barrel from the caudal brain to the oral portion of the middle brain.
4. Efferent connection of reticular formation:
a) the downward system is reticulous. Starts in the bridge and goes to the front and side pillars of the spinal cord.
b) Long rising fibers of the Russian Federation are sent to the intermediate and final brain, ends in a visual bug, striped body, the hypothalamic region, a transparent partition and a precient area. They originate mainly in the medial part of the reticular formation.
c) In addition, the efferent fibers of the Russian Federation are sent to the cerebellum, taking the beginning in the lateral and paramedial nuclei, as well as in the core of the bridge of Behterev.
5. Affective communications of the reticular formation:
a) spin-reticular fibers passing in the spinal cord in the front-winding columns. They end in the Russian Federation of the oblong brain and Varoliev Bridge.
b) Cork-reticular fibers occur in various departments of the cerebral cortex. Among them are predominated by fibers arising in the sensorine region of the crust. End of the cellular groups in which the reticulous and reticulous cerebellar paths originate.
c) cerebellar-reticular fibers arise in various cerebellum kernels and ends in different formations of the Russian Federation.
d) Cellular elements of the Russian Federation receive fibers from nuclei of sensitive cranial nerves, sensitive systems passing through the trunk to the brain hemisphere.
e) hypothalamic-reticular fibers arising in different parts of the hypothalamic region and ending in the oral barrel.
6. In the limits of the Russian Federation, semi-specialized entities are also distinguished, closely related to the Russian Federation, formed on the basis of its neurons and carrying out regular blood circulation and respiration:
a) Vasomotor Center. Inside it is distinguished by depressor and press centers. The depressor center, the effect of irritation of which boils down to a decrease in blood pressure, is localized in the lower departments of the giantheaper reticular nucleus and the reticular core of the oblong brain. In these zones there are neurons directly projected on the spinal cord.
The pressure center is located rigorously depressor. Accelerator and inhibitory centers also allocates, the irritation of which leads to a change in heart rate (stimulation of the first is accompanied by tachycardia, and the second - bradycardia).
b) respiratory center. Expruit and inspiratory centers are located in the zone of the giantheaper reticular kernel.
7. The reticular formation, being an important integrative formation (for carrying out mainly somadegentative in the period of wakefulness and sleep interaction) is only part of more global integrative systems, including limbic and non-corrective structures, in collaboration with which the organization of expedient behavior is carried out.
HYPOTHALAMUS.
1. Human hypothalamus consists of a gray substance and nuclei located in it. They are divided into three zones: prevention, tubular and mamille.
2. The main cores of the hypothalamic field are as follows:
a) suprasoptic kernel,
b) three groups of the core of gray boogue,
c) Mamilo-infundibular kernel,
d) Palido-infidibular kernel lying in the middle part of the gray bulb.
e) the introfrunicable kernel lying between the legs of the arch.
e) Paramentaricular core.
g) connecting the kernel lying in the middle commission (ventricle III).
h) paramediable kernel.
and) the kernel of the downtal body.
3. The rest of the hypothalamic region is the resulting elements, smaller than in the coders of the gray substance cells, which are directly continuing the re-formation of the stem.
4. Affective links of the hypothalamus:
a) The hypothalamic region gets a powerful bunch of fibers from the front brain - the medial beam of the front brain.
b) In the hypothalamus, the fibers of the final cavity, by means of which communication with ammonium horn, pear-like fractions and almonds are carried out.
c) a visual afferent system, the fibers of which follow from the visual nerves and the chiasms in the hypothalamus.
d) bundle of fibers, the next from the pale ball in the hypothalamus.
e) In the hypothalamus, the fiber of the arch arising in the hippocampus and ending in the mamillar bodies.
e) The experiment describes the links of the hypothalamus with the middle brain. The fibers of this system arise in the forefront of the middle brain of the Russian Federation and ends in almost all departments of the hypothalamus.
g) In addition, fibers from the spinal cord interrupted in the kernels of the oblongs of the oblong brain are come in the hypothalamus.
5. Efferent contacts of the hypothalamus:
a) a bundle of fibers starting in supraoptic, parasolmentricular and hyperticular nuclei of the hypothalamus and ending in a hypophysies (hypothalamicpofyzar tract),
b) the bunch of Vic D "Azira binds the downtown bodies with the front core of the visual bulb,
c) long descending systems of the hypothalamus bind hypothalamus with the recyclinal formation of the trunk,
d) diffuse rising systems associate the backyard of the hypothalamus with basal-frontal and olfactory structures of the large hemisphey bark,
e) connection of downtown bodies with a cerebellum.
6. Inside the hypothalamus, specific nuclei and nonspecific structures are distinguished.
7. The specifications include the formation of the hypophies, the effect of irritation and the destruction of which is strictly specific, and the distinctive feature of the neurons of these nuclei turns out to be neurocrines. So, in particular, antidiuretic hormone (ADG) is formed in the supraoptic and paraventricular nuclei, descending on the axon of the hypothalamic-pituitary path into the rear stake of the pituitary gland. In other specific nuclei of forming exemption (riliations), the factors that fall into adenogipid regulate the secretion of trop hormones (ACTH, gonadotropic, somatotropic, etc.).
8. The remaining hypothalamus departments (with the exception of specific receptors that perceive shifts in the internal environment of the organism of the OSMO, glyco-, tetmoreceptors) cannot be considered specific. The answers obtained by their irritation depend primarily from the parameters of an irritable agent. They enter, on the one hand, into the limbic system, on the other, are the continuation of the reticular formation of the brain stem, in essence, its most oral department.
9. A feature of the hypothalamus is also the special sensitivity of its neurons to changes in the internal environment, such as a decrease in or increasing blood sugar, hormone concentrations, osmotic equilibrium.
10. Thus, in the hypothalamus presented (with the exception of its specific departments) are not separate functions, but coordination synergies.
The subbozhnaya area is one of the links of integration systems, a relatively specific feature, which is neurogucous coordination, analysis of humoral shifts, the inclusion of a hormonal system into an organization of adaptive behavior.
11. The hypothalamus regulates the metabolism, thermoregulation, is related to the organization of sleep and wakefulness, emotions.
Lymbatic system.
The structure of the limbic system. It includes the following anatomical entities:1. GPIP COBAP.
2. MILLINAL BODY.
3. Washing shock.
4. Transparent partition.
5. Front core of the visual bulb.
6. Amipdalar complex (almond-shaped body and fence).
7. Pear-like convolution.
8. Self-adequate bumps.
9. Obllary paths.
Lymbic system links:
Afferent - impulsation follows in LS mainly and from the reticular formation of the barrel, hypothalamus, a visual boogue and from various bark departments.
Efferent ties - with bark (all its departments), with subcortical formations, visual hill, hypothalamus and the reticular formation of the trunk.
Neural circles within the limb system:
Large circle of papits - hippocaip - arch - core transparent 1.
partitions - Mamillar Body - the front of the Talamus kernel - the belt clench.
The small circle of the pair is the amigdalar complex - the hypothalamus.
The segmental circle of Naouth is partition - supraclese 3.
plates - Hippocampus - arch - partition.
Functions of the limbic system:
1. Regulation of the constancy of the inner environment of the body by creating the corresponding neurovistee management complexes.
2. Participation in the implementation of emotions.
3. Organization of everyday acts or motivations
4. Memory organization.
5. Takes part in the regulation of sleep and wakefulness.
6. Takes part in the regulation of general-selling activity.
Signs of lesions of the limbic system:
Violation of visceral reactions - expansion in the course of the gastrointestinal tract, arterial hypertension, anginal cardiovascular paroxysms.
Emotional disorders - the state of false rage and 2.
aggressiveness, symptoms of lack of fear and aggressiveness (shown in the experiment). In tumors of the temporal share, symptoms can be observed - the lack of fear, aggressiveness, good, expressed hypersexuality, strengthening oral research automatics.
Violation of motivations - disorder of complex behavioral acts 3.
(Anatomoto-ambuls syndromes, lack of initiative).
Memory disorders - difficulty playback of traces, 4.
the difficulty of memorization may be manifestations of Corsakov syndrome.
Psychomotor epileptic seizures are characteristic of 5.
psychosensory, visceral and other sensory auras.
Akinetic Mutism syndrome ("awesome coma") - absence of 6.
intelligence to motor acts, including speech products (with the eyes of open eyes and preserving the tracking movements of the eyeballs).
Emotions and motivation.
When considering the problem of physiology and pathology of emotions andMotivations need to keep in mind the following:
1. In Russia, the biological theory of emotions PK received the greatest distribution. Anokhina.
2. The specified theory was created by P.K. Anochene based on its own original generalization of functional systems.
The functional system, according to anocyne, is a branched, self-regulating central peripheral organization that provides one or another adaptive result based on a constant return affaentation.
3. PK Anokhin comes from the fact that life is a chain of events consisting of two stages: a) the emergence of needs and deposits and b) their satisfaction.
4. Emotions are nothing but to define the needs of the body and the likelihood of its satisfaction at the moment.
5. Human emotions always carry certain adaptive effects (adaptation to an external situation or internal motivation).
6. At the time of any need for a person, a negative emotion appears at first (since at the time of the emergence of the need for satisfaction it is not yet).
7. The body has an appropriate mechanism that provides the necessary reaction to ensure the need.
8. If the need or attraction is satisfied - the emotion is positive.
9. Part of emotions and motivations are laid genotypically as a certain form of response. These forms are stored in memory.
10. The action program (to meet the need) is made on the basis of afferent synthesis and analysis of memory traces.
11. The appropriate process of afferent synthesis includes: a) multi-touch type of convergence on neurons, b) Multibiological type - perception of complex biological shipments (hunger, pain, orientation, etc.), c) Sensorobiological type - a combination of some receptor and biological neurons stimuli, d) axonral-sensorobiological type - compound of previous and efferent neuron.
All this occurs at the level of cortical-subcortical structures relating to the system of implementation of afferent synthesis.
12.The emotion implementation includes complex types of synthesis. After the decision is made, a model of action determining human behaviors is generated.
13.After the implementation of the action there is an inverse affamentation into an action acceptor, the program and the result, a comparison of the need and the degree of its satisfaction occurs. The more complete the coincidence, the more positive emotion.
14. In the inconsistency of the need and the result of the action arises negative emotion, a new program is adopted - a new action, etc. Before the emergence of coincidence (positive emotion).
15.In the present opinion is dominated by the absence of cruel localization of emotional centers. It is believed that the corresponding functional systems that may vary in the process of individual life are to be created and interconnected in accordance with the specific situation and the living conditions of the individual. Under the emotions of a person means the experience of attitudes towards the surrounding reality and internal state.
16. A person has two main emotion design mechanism: a) an internal experience (sphere of mood), b) external expression of emotions - Mimic, gestures, game of vasomotors.
Emotion is very closely connected with motivations (motivation and attraction)
1. Motivation characterizes those actions that are due to the internal needs of a person.
2. In the hypothalamus there are a number of specialized cells that can finely catch changes in the parameters of the internal environment. Here there is a transformation of chemical irritation (arising in response to changing parameters) into a nervous impulse.
3. The distribution of pulses from the hypothalamus cells into the reticular formation, the limbic system and the boron leads to the organization of a peculiar behavior of a person and an animal aimed at searching in the external environment of the relevant stimulus required to eliminate excess or inflammation of the lack of relevant substances in the body.
4. Assessment of the result of the action leads to a certain emotional state, depending on the degree of satisfaction.
5. After comparison in the action acceptor, with the coincidence of the program and the action, an emotional fixation of motivation occurs and this is fixed in memory. Following the repetition of a similar situation, this emotional memory is a kind of guide by motivation (a kind of appetite to this type of action).
6. Motivations are divided into a) empty (primary), which are fixed by hereditary mechanisms (hunger, sexual attraction, fear, etc.) and is based on unconditional reflexive reinforcement and b) higher, which are based on conditionedoreflexive reinforcement and are associated with training and upbringing .
There is even a higher level of motivation (purely human type) associated with the social factor (patriotism, heroism, etc.).
7. In the most motivation, there are three stages: a) the attraction (formed at the level of afferent synthesis) - it turns out that now it is necessary for the body, b) targeted action. The attraction occurs a lot, but at each stage the most important functional system is selected - the dominant (more often or hereditaryly programmed or established on the basis of individual experience), c) reinforcement - the external incentive, which is wanted by the body (to make changes in the latter).
Clinical methods of examination of the vegetative nervous system.
A complex of studies of the vegetative nervous system includes two groups of methods: the first allows you to estimate the state of the oversegmental department, the second - allows you to assess the state of the segmental department. The study of the oversegmental department includes the definition of vegetative tone, reactivity and activities. The state of the segmental department is estimated at the level of the functioning of internal organs and physiological systems of the body. It is determined which department of the autonomic nervous system (sympathetic or parasympathetic) suffers and which parts (afferent or efferent) are amazed.
The study of vegetative status consists of three groups of indicators:
1. Investigation of the original vegetative tone.
Vegetative tone is the degree of voltage (basal level of activity) in the functioning of a particular organ (heart, lungs, etc.) or physiological system (cardiovascular, respiratory, etc.) in the state of relative rest. It is determined by a pulsation administering from postganglyonary sympathetic and parasympathetic fibers. The vegetative tone is influenced by segmental and oversegmental vegetative centers. The influence of segmental vegetative centers determines the tone inside the system, and the apprental - in the body as a whole. To determine the authentative tone of the body, you need to evaluate the tone in each of its system.
The methods of study of the vegetative tone include special questionnaires, tables and objective research data. In the process of targeted questioning patients, attention is drawn to the tendency to chills, allergic reactions, dizziness, nausea, heartbeat.
The duration and depth of night sleep, emotional background, efficiency is evaluated. With objective inspection, such signs are recorded as the magnitude of the pupils and the eye slit, the color and temperature of the skin, the mass of the body, arterial systolic and diastolic pressure, the frequency of the pulse.
The function of the thyroid gland, adrenal glands, blood glucose content using load samples is carried out.
ECG indicators are estimated.
Signs of predominance of the activity of the sympathetic department are: Tachycardia, an increase in blood pressure, mydriasis, pallor and dry skin, pink or white dermographism, a decrease in body weight, periodically occurring chill-like hypercines, surface alarm sleep, increase the content of catecholamines and ketosteroids, increasing the pulse rate, detection on ECG shortening of the intervals RR, PQ, increasing the teeth R and the formulation of the T. T.
The predominance of the tone of the parasympathetic department of the vegetative nervous system is manifested by bradycardia, hyperemia of skin cover, hyperhydrosis, hypotension, red rising dermographic, increased drowsiness, a tendency to allergic reactions, decrease in blood glucose, relative decrease in the thyroid function. Sine bradycardia is detected on the ECG, an increase in the RR, P-Q intervals, the extension of the QRS complex, the shift of the ST segment is above the insulance, an increase in the tongue T and a decrease in R.
For the quantitative ratio of sympathetic and parasympathetic manifestations, a number of calculated indicators are offered, for example, a vegetative Kerdo index:
Hell diast.
Vi \u003d 1 pulse
- & nbsp- & nbsp-
Symptoms and parasympathetic sympathetic reactions reaction indicators skin color pallor leaning to hyperemia vascular pattern not expressed strengthened, cyanosis rolling normal increased dryness increased normal sweating reduced (if sweat is viscous, then enhanced (sweat fluid) increased) dermographing pink, white intense red, towering Leather temperature reduced raised pigmentation Strengthened Body Temperature Increased Reduced Hod Portability Satisfactory Bad Poor Tapability Bad, Impairment Heat Satisfactory Mass Thickness Leaving Again The Appetite Employed Low Pupils Expanded Normal Eye Scrolls Expanded Normal Pulse Labyl Tachycardia Bradycardia Health (Systolic normal diastolic) ECG sinus tachycardia sinus bradycardia dizziness uncharacterically frequency of breathing normal or rapid slow, deep salivation reduced strengthened composition Yuna thick liquid gastric acidity Normal or lowered increased intestinal motility juice atonic constipation, weak drive, spastic peristalistic constipation, diarrhea urination polyuria, light urine imperative urge Pilvor reflex reinforced normal allergic reactions No tendency (swelling, itching) Temperament Sleepness Little, poor drowsiness physical increased reduced performance mental scope dispersion, inability to focus on any satisfactory, one, activity higher in the evening Activity In the first half of the day, the number of erythrocytes increased decreased by the number of leukocytes increased decreased blood glucose levels increased, the norm is reduced (hypoglycemia ) Hunger tolerance normal bad response to UVO normal, reduced strengthened orthostatic pulse test relatively accelerated pulse relatively slowed clinostatic pulse sample relatively slowed down bullet With relatively accelerated Ashner Trial rate, paradoxical acceleration Significant deceleration of pulse pulse
2. Study of vegetative reactivity.
Vegetative reactivity is determined by the speed and duration of changes in vegetative indicators in response to irritation from the external or internal environment. Research methods include pharmacological samples using adrenaline and insulin and physical exertion.
The following samples are used in clinical practice:
The eyes of the eye reflex (Danyini Ashner) is pressed on the eyeballs, as a result of which healthy people have a heart abbreviation to 6-12 per minute. If the number of abbreviations is slowed down by 12-16, it is regarded as a sharp increase in the tone of the parasympathetic part. The lack of a slowdown or acceleration of cardiac abbreviations by 2-4 per minute indicates an increase in the excitability of the sympathetic part.
Solar reflex - a patient lying on his back, the surveyer produces pressure with hand to the upper part of the abdomen before the sensation of the abdominal aorta pulsation. After 20-30 seconds, the number of heart abbreviations slows down in healthy persons by 4-12 per minute. Cancer changes are evaluated as with an eye reflex.
Cold sample - in the patient's position lying counting the heart rate and measured blood pressure. After that, the brush of the other hand is lowered by 1 minute into cold water of 4 °, then removed from the water from the water and the blood pressure and the pulse frequency register each minute to return to the initial level. Normally, this happens in 2-3 minutes. With an increase in blood pressure, more than 20 mm.rt.st. The reaction is estimated as pronounced sympathetic, less than 10 mm.rt.st. As a moderate sympathetic, and with a decrease in pressure, as parasympathetic.
The orthoclinostatic reflex - the study is carried out in two receptions.
In the patient lying on the back, count the number of heart abbreviations, and then propose to quickly stand (orthostatic sample).
When moving from a horizontal position to the vertical frequency of heart abbreviations increases by 12 per minute with an increase in blood pressure by 20 mm. When the patient moves to the horizontal position, the pulse and pressure indicators are returned to the original for 3 minutes (clinostatic sample). The degree of acceleration of the pulse with an orthostatic sample is an indicator of excitability of the sympathetic part of the autonomic nervous system. A significant slowdown in the pulse with a clinnotatic sample indicates an increase in the excitability of the parasympathetic part.
Pilot reflex - reflex "goose skin" is caused by a pinch or using a cold item applying (test tube with cold water) or coolant (vet, moistened with ether) on the skin of the adapter or nape. At the eponymous half of the chest, "goose leather" occurs as a result of a reduction in smooth hair muscles. The reflex arc closes in the side horns of the spinal cord, passes through the front roots and sympathetic trunk.
Sample with acetylsalicylic acid - with a glass of hot tea, 1 g of acetylsalicylic acid is given. Diffuse sweating appears. With the defeat of the hypothalamic field, its asymmetry can be observed. Under the defeat of the side horns or the front roots of the spinal cord, the sweating is disturbed in the innervation zone of affected segments. Under damage to the spinal cord variation, the reception of acetylsalicylic acid sweating is only above the place of lesion.
Sample with a pilocarpine - the patient is subcutaneously introduced with 1 ml of 1% solution of hydrochloride pilocarpine. As a result of irritation of postganglyonic fibers, which goes to feather glands, sweating is intensified. It should be borne in mind that the pylocarpine excites peripheral mholinoreceptors, which cause strengthening the secretion of digestive and bronchial glands, the narrowing of the pupils, an increase in the tone of the smooth muscles of the bronchi, intestines, a gall and bladder, uterus.
However, the strongest action of the pilocarpine has for sweating. Under the defeat of the side horns of the spinal cord or its front roots in the corresponding skin section after taking acetylsalicylic acid, the sweating does not occur, and the introduction of the pilocarpine causes a sweating, since postgangle fibers that react to this preparation remain the preserved.
Light bath - the warming of the patient causes sweating. Reflex is a spinal, similar to a sawctural one. The lesion of the sympathetic trunk completely eliminates the sweating on the pilocarpine, acetylsalicylic acid and warming the body.
3. Vegetative security activities are made using modeling of various activities:
Physical - dosage physical activity, bicycle ergometry, dosage walking, dosage squat;
Mental - account in mind;
Emotional - modeling of negative or positive emotions.
Evaluation of vegetative reactions is made under the change in pulse, respiration, blood pressure, ECG indicators, reophiecephalogram.
Since the hypothalamic region regulates all types of metabolism, investigate indicators characterizing the water-salt, carbohydrate, fat, protein, mineral exchange, study the function of the domestic secretion glands, thyroid gland, the function of the ovaries, and explore the level of trop hormones of the pituitary gland.
- & nbsp- & nbsp-
Syndromes lesions of the segmental department of the VNS.
Under the defeat of the segmental department, the VNS often arises sympatalia for which it is characteristic:
1) pain burning, cutting, gulp;
2) is associated with the temperature, increases from heat and decreases from cooling;
3) the parlor, strengthens with the change of weather, emotional voltage;
4) the localization of pain does not correspond to the innervation zones of peripheral nerves;
5) It is combined with a change in the pain sensitivity of a vegetative nature: hyperalgesia, hypalgesia with hyperpathy, fuzzy boundaries of sensitivity disorders;
6) the soreness of the blood vessels during palpation;
7) The presence of vasomotor disorders: skin hyperemia, pallor, pastosity.
The entire complex of vegetative manifestations arising from the damage to the segmental (peripheral) department of the VNS is called peripheral vegetative insufficiency (PVN).
Primary peripheral vegetative failure is chronic, slowly progressive diseases. They are based on the degeneration of segmental vegetative apparatus, often in combination with the degenerative process in other structures of the nervous system (Parkinsonism, cerebellar disorders, damage to the peripheral nervous system). For example, Shea-Drajer's syndrome, Riley Aky, Bradberigglston. The main symptom is the loss of peripheral vascular resistance, which is manifested by an orthostatic hypotension.
Secondary peripheral vegetative failure is formed against the background of the current somatic or neurological disease.
Manifests itself in the form of the following clinical forms:
1. The defeat of the side horns of the spinal cord (vegetative violations are combined with the defeat of other structures);
2. The defeat of sympathetic gangliopathy units, reflex sympathetic dystrophy;
3. The defeat of postganglyonary vegetative fibers: vegetative neuropathy, vegetative polyneuropathy, perivascular plexopathy;
4. The defeat of the segmental, department with violation of the innervation of vessels:
reino disease and syndrome, Eritrolealgia, Erytrosis, Sweet, angioedeurosis;
5. The defeat of vegetative plexuses: vegetative plexopathy;
6. The defeat of the segmental department with the involvement of the oversegmental departments: Kauzalgia, phantom pain, reflex paralysis, contracture, hypercines, reflex sympathetic dystrophy.
Clinical characteristics of the main forms of lesion
1. The defeat of the side horns of the spinal cord may be in siringomyelia, vertebrogenic myelopathy, tumors of the spinal cord, inflammatory lesions of the spinal cord. It is manifested by vascular, trophic, sensitive, secretory, visceral disorders, respectively, the level of lesion is combined with signs of lesion of sensitive, moving paths.
2. The defeat of sympathetic nodes occurs with inflammatory adhesions in the chest and abdominal cavities, traumatic injuries, infectious diseases.
Accordingly, the level of innervation in patients occur skin symptoms in the form of vascular disorders (redness or pallor of the skin, cooling, warming), sawmother disorders, skin atrophy and subcutaneous tissue, disrupting sweating.
Visceral violations are observed: the defeat of the abdominal cavity organs, small pelvis, pain in the heart of the heart unchanged on the ECG (not removed by coronaryarolitics), pain in the field of small pelvis, muscle symptoms in the form of atrophy and muscle hypotension, pain (sympathetale) of vegetative nature, sensitivity disorders . Characterized mental disorders in the form of longing, anxiety, fear. With the damage to the cervical sympathetic nodes there is a horn syndrome or PH syndrome.
3. The defeat of vegetative plexuses.
More often there is a damage to solar plexus - solarpathy.
Ethiology: chronic traumatization of plexus with enteroptosis, external mechanical injuries, extension of aortic, neoplasms, infections (malaria, syphilis, flu, types), inflammatory diseases of internal organs (cholecystitis, duodenites, ulcerative disease of the stomach and duodenum), intoxication (alcoholic, diabetic , lead), melting invasions.
Clinic: non-food pains, in the epigastric area with irradiation in a chest, encircling, accompanied by fear of death, anxiety. Outside the attack, depression is observed, a hypochondriac. The pain can be constant and in the form of crises, is accompanied by an increase or decrease in blood pressure, constipation or diarrhea, vomiting. Such symptoms can be with the defeat of other plexuses.
4. Defeating postganglyonary vegetative fibers.
It is observed in the damage to the peripheral nerves containing a large number of vegetative fibers (this is a sedable, tibial, median, trianque nerves). If the vegetative symptoms acts on the fore, then the vegetative form of neuritis is diagnosed. For example, when neuruting a seeded nerve, burning pain occurs in the innervation zone with hyperpathy phenomena, raising or decreased skin temperature, pale the foot, fingers, dry skin, may be trophic ulcers.
If there is a multiple symmetrical lesion of peripheral nerves in the distal limbs and pain, vascular, trophic disorders are dominated, the vegetative polyneuropathy is diagnosed. More than 100 etiological factors can be caused, more often occurs during alcohol, diabetic polyneuropathy.
With the defeat of the vascular plexuses of individual arteries, perivascular plexopathy arises. For example, a vertebral artery syndrome with cervical osteochondrosis.
5. The defeat of the segmental department of VNS with violation of the innervation of vessels.
Angiotroid elementary group of diseases arising from the disorders of vasomotor and trophic innervation of organs and tissues.
The disease and Reino syndrome there is a damage to the vegetative centers regulating vascular tone, (vasomotor centers), resulting in a vascular spasm. Women suffer more often.
Symptom complex Reyny can manifest itself as an independent disease and as syndrome under various diseases: collaplanosis, especially sclerodermia, lesions of the cervical spine, systemic diseases of vessels, vibration disease, inxication of the ardines.
The disease is manifested by triad signs:
1) the bugs of vegetative-vascular disorders;
2) the symmetry of vegetative disorders;
3) the presence of trophic disorders.
The attack consists of 3 phases:
1) Lone pale fingers (lasts 5-20 minutes) - there is a spasm of capillaries, characterized by paresthesia, burning.
2) The formation of fingers of the hands (lasts up to 1 hour) - arises spasm arteriole, the expansion of capillaries.
3) Redness of the fingers of the hands - arises of the arteriole and capillaries.
First, hands are amazed, then the area of \u200b\u200bthe nasolabial triangle, legs.
Differential diagnosis between the disease and Reino syndrome:
Sygnosis disease
1. The appearance of symptoms under the influence of 1. The spontaneity of the occurrence.
supercooling, psycho-emotional arousal.
2. The symmetry of the lesion. 2. Asymmetry of the defeat.
3. Relatively favorable flow at 3. Early appearance complications.
for several years, a long lack of gangrene.
Erythrolealgia.
Vair Mitchell's disease. It may occur as syndrome after malaria, injuries, frostbines, with multiple sclerosis, myxedema, mercury poisoning. More often develops over the age of 40 years.
In the pathogenesis, the irritation of the parasympathetic part of the VNS is important. It is clinically characterized by the emergence of the parole pain in the evening and at night in the footsteps, especially in 1 finger, swelling in the distal legs, a feeling of heat, redness of the skin, the expansion of veins, an increase in the pulsation of the arteries, an increase in skin temperature in the edema by 2-4 °. In the future, trophic violations appear in the form of vesicles, empty, spreads the process to hands, nose, ears. Pain sensations are sharply enhanced during the warming of the limb, standing, walking and, on the contrary, significantly decrease in the cold, in the lying position. The attack lasts from a few minutes to several hours.
Erytrosis - redness of the distal limbs with light trophic disorders, without pain.
Sweet Qincke - arises as a reaction to external specific stimuli, allergens. The persistent paralytic changes in the vessels are characterized, accompanied by an increase in vessel permeability.
The swelling of tissues, subcutaneous fiber on a small surface, most often it is a throat, larynx, face.
6. The defeat of the segmental department with the involvement of oversegment structures (reflex sympathetic dystrophy).
Kauzalgia occurs when the finiteness is injured with damage to the nerves rich in vegetative fibers: median, tibial.
The damage to the nervous trunk causes irritation of afferent vegetative fibers, the impulses are transmitted to the cells of the side horns, the rear horns, then in the composition of the beams of the surface, deep sensitivity reach the visual beam and the parietal area.
Therefore, during Kauzalgia, there is a peripheral focus of irritation in the nerve and the focus of irritation at the level of the optic bulb. Kauzalgia occurs two weeks after injury and can proceed until 14 years.
Clinic:
1. Intensive burning pains with localization in the skin, dried sensations of skin dryness (characterized by a "wet rag" symptom).
2. Mind of the localization of pain innervation zone of affected nerve.
3. Reducing pain when cooling and enhancing during warming.
4. The presence of vasomotor, secretory, trophic violations in the damage zone.
When generalizing the process, the following symptoms are characterized:
1. Strengthening pain with loud sounds, excitement, light stimuli;
2. Changing the behavior and psyche of the patient;
3. Formation of pain contractures;
4. Senestagia - the spread of pain on the secondary causalgic fields (for example: the spread of pain with the left hand on the right hand).
Phantom pain - intense diverse sensations in amputated limb.
The syndromes of damage to the central department of VNS Hypotalamic syndromes arise as a result of violation of the production of railing factors and neurotiator exchange.
The etiological factors of the lesion of the hypothalamus:
infections (flu, rheumatism, tonsilogenic intoxication);
1) allergic factors;
2) Card-brain injury;
3) intoxication - drug, production;
4) inflammatory diseases of the internal organs by type 5) of the reformation;
psychogenic (due to connections with a limbic system);
6) Vascular diseases of the brain (hypertensive 7) disease, atherosclerosis, vasculitis).
Often to identify the brain defeat fails, in this case there is a constitutional-conditioned biochemical defect of hypothalamic regulation, which can decompan aside at various critical periods: puberty, pregnancy, climax.
Also on the formation of a brain affects the presence of diseases from parents, the nature of childbirth, the degree of domesticity, and professional harm.
Hypotalamic syndromes are a combination of vegetative, endocrine, trophic disorders caused by the defeat of the hypothalamus. Mandatory for the diagnosis of hypothalamic syndrome is the presence of neuroendocrine disorders.
Clinical classification of hypothalamic syndromes.
1. Neuro-endocrine-based syndrome: unacceptable diabetes, hypothalamic obesity, Incenko-Cushing disease, Babbabinelich syndrome, acromegaly, syndrome of persistent galathelie-amenorrhea, Morgani-Stewarta Syndrome.
2. Violation of thermoregulation: hyperthermia (permanent, paroxysmal), hypothermia, chill-like hyperkinesis, Zhlving syndrome.
3. Nervous muscular syndrome Miasten-like;
myopathic;
miaton-like;
myoplegic.
4. Nervous trophic syndrome, including malignant exophthalm, change in hair growth, osteoporosis, atropathic, ulcers of the gastrointestinal tract.
5. Sleeping and wakefulness impairment: hypersmal states, narcolepsy, piquet syndrome, periodic hook syndrome, hypothalamic insomnia.
6. Psychopathological syndrome: depressive, hypochondriac, neurasthenic.
7. Vegetative-vascular visceral syndrome is characterized by the occurrence of crises (sympathy-adrenal, vaginswall, mixed vegetative-viscerals).
8. Hypotalamic epilepsy: the stereotype of the structure of the vegetative-vascular visceral crisis, the disorder of consciousness of varying degrees, tonic convulsions.
The general principles of therapy of lesions of the segmental department of VNS etiotropic therapy is shown if the vegetative syndrome develops against the background of an acute period of any disease. For example, an acute period of infectious disease.
The main type of therapy is pathogenetic.
When prescribing pathogenetic therapy, an analysis of the clinical picture of the disease is important: identifying signs of lesion or oppression of this or that department of VNS.
In the presence of symptoms of irritation of sympathetic formations, it is advisable to assign:
To reduce sympathoadrenal activity, central sympatholites (reserpine 0.1 3 times a day),
Neuroleptics (Aminazine 0.025 1 time per day, Sonapaks, Speed \u200b\u200b0.25 3 times a day), -Adrenoblays (fantolamine, pyrroxyan, dihydroergotamine, niccolin), -Adrenoblays (anaprilin, wickey).
2) gangliplockers: benzohexonium, pentamine (to avoid orthostatic complications used in small doses, Per OS).
3) vasodinating means (spasmolitics papaverine, nicotine acid, but-shp);
4) Tranquilizers: relaignation, phenazepam, elenium, mespam;
5) sedatives: bromine, dyeing, valerian root;
6) in pronounced sympmets apply Finlepsin, Tegretol;
7) at causalgias are prescribed neuroleptics, analgesics, carbamazepine preparations, but not drugs!;
8) Preparations of mixed action - Belloid, Bellappon, Bellataminal;
9) Means of general impact: soft marine climate, carbonate, radon, hydrogen sulfide baths;
10) Physiotherapy processes when defeated by the segmental unit of the vegetative nervous system are carried out on the affected limb and segmental in the projection of the affected sympathetic nodes (for example, during the disease Rhine - on the hands and the cerium department, paravertebrally appointed UFO, DDT, electroforming with calcium, novocaine, phonophoresis of hydrocortisone, mud Appliques not high temperatures (37 °), electrophoresis with novocaine to the epigastric area during solarpathy);
11) IRT (brake method);
12) Novocaine blockades (perivascular, perineral blocks, blockade of sympathetic ganglia, solar plexus);
13) surgical treatment methods (desimalization, preggliance and sympathectomy);
14) X-ray therapy for sympathetic nodes during Rhino disease.
To reduce parasympathetic tone:
Monoaminoxidase inhibitors (ephedrine);
Tranquilizers;
Cholinolities (cyclodol, tropacine, belladonna preparations);
Antihistamines (Dimedrol, Tuequil, Betaderk, Pipolfen);
Malokalorian diet;
Coniferous baths;
IRT (exciting method).
In case of lack of sympathetic tone:
Adrenomimetics: Adrenaline, Ephedrine.
Preparations that stimulate the nervous system: caffeine, fenamine, 2.
calcium preparations, ascorbic acid, glutamic acid, ginseng extract, Chinese lemongrass.
Diet with lots of proteins.
Mountain climate, cool shower, salt, radon baths.
Symptomatic therapy: analgesics, tranquilizers.
Psychotherapy.
Treatment of rain disease.
Vasoactive antispasmodics (but-shpa, complemin, nicotinic acid).
Neuroleptics (aminazine).
Gangliplays (novocaine 0.5% intravenous).
Sympatholites, -Adrenoblocators (fantolamine, tropuff, reserpine, 4.
surifing, Sermion); The adrenoblays do not apply, as they cause the spasm of peripheral vessels).
ACE inhibitors (captopril, enalapril).
Tools Improving the rheological properties of blood (Trental, Kuraltil, 6.
verapamil, Corinthar, Cordafen).
7. To normalize the synthesis of prostaglandins and reduce the aggregation of erythrocytes, use NSAIDs (methindol, pyroxics).
8. Novocaine blockades of the star node.
9. Electrophoresis with novocaine on cervical sympathetic nodes, endonazal electrophoresis with aminazine, currents of D "Arsonvala on the affected limb.
10. X-ray therapy for affected sympathetic ganglia.
11. Surgical treatment Preggling sympathectomy.
Treatment of erythrolealgia.
Impact on parasympatic tone:
Holinolitics (Belladonny preparations, atropine).
Ganglioblocators.
Antihistamines.
Preparations that improve microcirculation: Trental, Cavinton.
Tools that strengthen the vascular wall (ascorbic acid, 5.
rutin, calcium preparations).
Novocaine blockades of lumbar ganglia.
Cool foot baths.
Electrophoresis with calcium on lumbar sympathetic nodes, currents 8.
Darsonval on the affected limb, general electrophoresis with calcium by vermel.
During the attack, the locally cold is used, the introduction of subcutaneously 9.
atropine.
Features of therapy of hypothalamic disorders.
Ethiotropic therapy is carried out depending on Genesis 1.
hypotalamic syndrome.
Pathogenetic therapy is prescribed depending on character 2.
vegetative violations.
The presence of neuroendocrine exchange disorders often requires 3.
replacement hormone therapy in conjunction with the endocrinologist.
Symptomatic therapy.
Psychotherapy.
Innervation of the bladder and disorder
Urination
In the neurological clinic, the violation of the function of pelvic authorities (urination disorders, defecation and genital organs) is quite often found.Urination is carried out by the agreed activity of two muscular groups: m. Detrusor Urinae and m. Sphincter urinae. The reduction in muscle fibers of the first group leads to the compression of the wall of the bladder, to the extrusion of its contents, which becomes possible while relaxing the second muscle. This occurs as a result of the interaction of the somatic and vegetative nervous system.
The muscles constituting the inner sphincter of the bladder and m. Detrusor Vesicae, consist of smooth muscle fibers receiving vegetative innervation. The outer sphincter of the urethra is formed by cross-striped muscle fibers and is innervated by somatic nerves.
Other cross-striped muscles, in particular the muscles of the anterior abdominal wall, the aperture of the pelvis, take part in the act of arbitrary urination. The muscles of the abdominal wall and the diaphragm at their voltage cause a sharp increase in intra-abdominal pressure, which complements the function M. Detrusor vesicae.
The mechanism for regulating the activities of individual muscle formations that ensure the function of urination is quite complicated. On the one hand, at the level of the segmental apparatus of the spinal cord there is vegetative innervation of smooth fibers of these muscles; On the other hand, in an adult, a segmental apparatus obeys the cerebral cortical zone and this is carried out by an arbitrary component of the regulation of urination.
In the act of urination, you can select two components:
involuntarily reflex and arbitrary.
The segmental reflex arc consists of the following neurons (cm. Fig.): The afferent part is the cells of the intervertebral node Si-Siii, the dendrite ends in the proprigatory of the bladder wall, are part of the pelvic internal nerves (NN. Splanchnici Pelvini), pelvic nerve - NN. Pelvici, axons go in the rear roots and the spinal cord, contact with the cells of the front-point part of the gray substance of the spinal cord segments Si-Siii (the spinal center of the parasympathetic innervation of the bladder).
The fibers of these neurons together with the front roots come from the spine channel and in the composition of the pelvic nerve (n. Pelvicus) reached the walls of the bladder, where they are interrupted in PL cells. vesicalis.
Postsynaptic fibers of these intramural parasympathetic nodes innervate smooth muscles N. Detrusor Vesicae and partially internal sphincter. The pulses along this reflex arc lead to a reduction in m. Detrusor Vesicae and relaxing internal sphincter.
Schematically, the innervation of the bladder can be depicted as follows (see Fig.1).
Fig. 1. Innervation of the bladder and its sphincter:
1 - a pyramidal cell of the cortex of a paraventional lobby; 2 - coder cell of a thin beam; 3 is the sympathetic cell of the LI-II side horns; 4 - cell of the spinal assembly; 5 is a parasympathetic cell of the SI-III, 6 - peripheral motnelone; 7 - sex nerve; 8 - bubble plexus; 9 - outer bladder sphincter; 10-internal urinary bubble sphincter; 11 - profry nerve; 12 - DestroNing of the bladder; 13 - Lower mesenger knot; 14 - sympathetic barrel; 15 - a cell of the visual bulb; 16 is a sensitive cell of a paraventional loss Sympathetic cells carrying the innervation of the bladder are at the level of the Li-II spinal cord segments. The fibers of these sympathetic neurons together with the front roots leave the vertebral channel, then separated in the form of a white connective branch and pass, without interrupting, through the lumbar nodes of the sympathetic barrel, in the composition of mesenter nerves reach the lower mesenteric node, where they switch to the next neuron. Postsynaptic fibers in N. Hypogastricus is suitable for smooth muscles of the bladder.
The automatic emptying of the bladder provides two segmental reflex arcs (parasympathetic and somatic). Irritation from stretching its walls according to the afferent fibers of the pelvic nerve is transmitted in the spinal cord to the parasympathetic cells of the sacral segments of the spinal cord, pulses over effeminative fibers lead to a reduction in m.detrusor vesicae and relaxing the internal sphincter. The disclosure of the internal sphincter and the arrival of urine into the initial departments of the urethra include another reflex arc for the outer (cross-striped) sphincter, while the water is released. So functions the bladder in newborns. In the future, due to the ripening of the oversegment apparatus, conventional reflexes are also produced, a feeling of urge to urination is formed. Usually, such a call appears with an increase in intravenous pressure by 5 mm Hg. Art. The arbitrary component of the urination act includes the control of the outer sphincter of the urethra and the auxiliary muscles (abdominal muscles, aperture, pelvis diaphragm, etc.).
Sensitive neurons are laid in intervertebral nodes Si-Siii.
The dendrites are held as part of an intense nerve and ends with receptors both in the wall of the bubble and in the sphincters. Axons, along with the rear roots, reach the spinal cord and as part of the rear cakes rise to the oblong brain. Further, these paths are followed by Gyrus Fornicatus (Touch region of urination). According to associative fibers, the pulses from this zone are transmitted to the central motor neurons located in the core of the paracantral lobe (the motorb bladder motor zone is located near the foot zone). The axons of these cells in the composition of the pyramidal tract reach the cells of the front horns of sacral segments (Sii-Siv). The fibers of peripheral motor neurons together with the front roots leave the vertebral channel, in the cavity of the small pelvis form a sexual plexusion and in the composition N. Pudendus; Suitable for outdoor sphincter. When reducing this sphincter, it is possible to arbitrarily withhold urine in the bladder.
With a bilateral violation of the bonds of cerebral (cortical) zones of the bladder with spinal centers (this happens with a cross-lesion of the spinal cord at the level of breast and cervical segments) there is a violation of the urination function. Such a patient does not feel a call, neither the passage of urine (or catheter) in the urethra and cannot arbitrarily control urination. With a sharp impaired impairment, urine delay arrives at first (Retentio Urinae); The bubble is overwhelmed with urine and stretches to large sizes (the bottom of it can reach the navel and above);
it is possible to empty it only with the help of a catheter. In the future, due to the increase in the reflex excitability of segmental apparatuses of the spinal cord, the urine delay is replaced by periodic incontinence (Incontinentio Intermittens).
In easier cases, imperative urge on urination are observed.
In disruption of the segmental vegetative innervation of the bladder and sphincters, various urination disorders arise.
The urine delay occurs with impaired parasympathetic innervation m. Detrusor vesicae bubble (spinal cord segments Si-Siv, N. Pelvicus).
The denervation of internal and external sphincters leads to the true incontinence of urine (Incontinentia Vera). It occurs with the defeat of the lumbar spinal cord segments and the roots of the horse-tail, n. Hypogastricus and n. Pudendus. In such cases, the patient cannot keep urine, it stands out involuntarily or periodically or continuously.
Another type of urination disorder is found:
paradoxantic incontinence of urine (Ischuria Paradoxa) when there are elements of urine delay (bubble constantly overflowing, it does not empty) and incontinence (urine all the time leaks due to mechanical sphincter releasing).
- & nbsp- & nbsp-
5. Abe 55. A
50.G List of the Literature of the Nervous System Disease: Guide for Doctors: at 2 tons / sub. N.N. Xino, 1.
D.R.Stulman. - 3rd ed., Pererab. and add. - M.: Medicine, 2005. - T.1. - 744 p. - T.2. - 744 p.
Vegetative disorders: clinic, diagnosis, treatment / ed. A.M.Veun. - 2.
M.: LLC Medical Information Agency, 2003. - 752 p.
Gusev, E.I. Neurology and neurosurgery: studies. / E.I. Gusev, A.N. Konovalov, G.S.
Bourge. - M.: Medicine, 2007. - 611 p.
Zenkov, L.R. Functional diagnostics of nerve diseases: manual for 4.
doctors / L.R. Zenkov, M.A.ronkin. 5th ed.- M.: Medpress-Inform, 2013. - 488 p.
A brief reference book of a neurologist / under. ed. Acad. Ramna, prof. A.A.
Skirt. - M.: Medpress-Inform, 2008. - 576 p.
Skirt, A.A. Topic diagnosis of diseases of the nervous system:
Guide for doctors / A.A. Skirt, TA Skirt. - 4th ed., Stereotype. - St. Petersburg. : Polytechnic, 2007. - 399 p.
Topic diagnosis of diseases and injuries of the nervous system / under. Ed. MM
Same. - St. Petersburg. : Dean, 2010. - 232 p.
Topic diagnosis of diseases of the nervous system / A.V. Triumphs. - 18th 8.
ed.- M.: Medpress-Inform, 2014. - 264 p.
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