Yakі anatomical solutions lie down to the extrapyramidal system. Extrapyramide system, brain
GBOU VPO NizhDMA Ministry of Health of the Russian Federation
Department: normal anatomy
"Extrapyramide system"
Vikonal robot 2nd year student
likuvalny faculty
Sharova Lyudmila Yuriivna
Group: 242
Revised: Bezgroshovykh Andriy V'yacheslavovich
m. Nizhniy Novgorod,
Designation of the "extrapyramidal system"
History of the event
Description
Classification according to topographic and functional criteria
Leading ways
List of references
Extrapyramidna system (lat.: extra - posture, call, guard + pyramis, Greek: πϋραμίς - pyramida) - a combination of pіdkіrkovyh and stovburovy tufts, motor channels, so as not to pass through the pіramіdi of the deep brain. This system, entrusted from the cortical one, takes part in the management of disturbances, moreover, being the most phylogenetically ancient, it plays a significant role in inducing that control of disturbances, which will require activation of respect.
Vyvchennya history.
First, the thought of the one who at the camps of the rukhovy functions pours in like enlightenment, which enters the warehouse of the pyramidal system, according to the English neurologist Z. Wilson in 1908. at the process of getting sick, now known as the ailment of Wilson-Konovalov. As a result, all the structures of the brain, yakі vplyvayut the camp of striated m'yaziv i yakі in safe ruhіv began to be called extrapyramidal.
On the proposal of R. Granit (Granit R., 1973), the structures of the pyramidal paths, which are deposited actively by the body and its parts, were called phasic. Extrapyramidal structures, which are added to the rukhovi acti, the camp, raising the equal body and yoga posture are thin.
N.K. Bogolepov stating that the extrapyramidal system also takes the fate of viconan viraznyh, mimic and emotional reactions.
Have 1973 p. The leading American physiologist P. Milner (Milner P.) summed up how to base okremy extrapyramidal and pyramidal systems. However, at the present moment, after a resolute development of the functions of that other system, their diversity is not transverse.
Description
i.e. the system in povnyannі z pyramidal є phylogenetically more old (especially її palidary part). With the development of the pyramidal system, the extrapyramidal system is being transformed into a sub-priority camp.
The extrapyramidal system consists of the advancing structures of the brain:
basal ganglia (including dark body), nucleus chervone, nucleus interstitial, tectum, black substance, reticular formation of the stovbur of the brain, nuclei of the vestibular complex, brain, inferior olive of the brain.
Nucleus basales - The purchase of a simple speech in a comrade's pivkul of the great brain.
Corpus striatum (smugaste body) consists of n.caudatus and n.lentiformis.
Tail the core -maє Komi shape, ruffled in the sagittal plane. It is made up of three parts: caput, corpus and cauda. The anterior part of the head is enlarged with the white rheum of the frontal part, with its free surfaces (upper and medial) of the body of the caudate nucleus at the skeletal part, filling the bottom of the central part of the temporal duct. Whist of directions near the skronevu part of the pivkul, where it reaches the algae-like body. Take part in the organization of rukhovoї activity, molding mental reflexes and memory mechanisms.
Sochevitsepodіbne core - strikes laterally into the caudate nucleus and the thoracic tubercle and is composed of two parts - lateral, larger beyond the rim and medial, shkaralupi (putamen) and blіdoї kuli (globus pallidus). The function of the acetabular nucleus is the regulation of the m'yazovogo tone.
Subthalamic core (Lewis) - a bunch of gray speech with fibers that permeate yoga. It adheres to the surface of the inner capsule, which is cremated from the bludoї kuli, with which the nucleus is bound by a large number of fibers, which passes at the warehouse of the subthalamic bundle.
Black speech - the core of the ES, which lies at the base of the lower brain, taking part in the development of the m'yazovogo tone, necessary for the restoration of the body in the singing position.
Chervone core - sira speech of the lining of the middle brain - the first integrative center for managing the kіntsіvkami.
Intermediate core (Cajal) - to move in the reticular formation of the middle brain, giving the cob to the medial posterior fascicle, which is an important associative path, which gets different nuclei of the nerves of the eyes of the eye with oneself The function of yoga is also tied with the ruins of the eyes and the head, which is blamed for teasing the apparatus of jealousy.
Chotiripagorbia dress - part of the middle brain, which is the reflex center of various ruhivas, which is blamed, g.o. under the influx of sound and auditory razdratuvan.
lower olive - an oval bearing, which is located on the sides in the skin pyramid of the deep brain. Vіdokremlena in the rest of the anterolateral furrow. It plays an important role in the shlunkovo-rim reflex, to conduct fibers from the medial spinal cerebellar tract.
Cerebellum - part of the posterior cerebellum, which is responsible for the regulation of the position of the m'ulcer tone, sensorimotor coordination of the pelvis and the directing of the hands, the coordination of the direct lines of the hands.
Part of the structures e. Bere fate in formulannі ї ї и відільный, so zvano-ї ї ї poopal_di, Scho warehouses Pallidum (Bіlsh Fіlognenetically Languo Southy, Scho warehouse з Blіdoї kuli, kernels Lujis, Chervonny Kernel, Chorno Rechoven) І STRIATUM (youthful parties, shoe z shkaralupi i
Regardless of the integration of the striatum and palidum into a single system, the functional plan of the structure is divided into one kind of one. The pallidum is the core of the rukhova, as if I hope to activate the day at the Pidkirkov Light. Blind cool otrimu afferent impulses along the fibers that go to the striatum and subthalamic nucleus. Part of the fibers follow to the thalamic nuclei, neurons of the chervo and pokryshkovy nuclei. Blida kulya, being tied efectively to the centers of the middle and posterior brain, regulates the coordination of the work. One of the functions of the palidum is the galvanization of the lower recumbent nuclei, the head rank of the vermiform nucleus of the middle brain, which, with a weak blіdoї kulі, is likely to be strongly increased in the tone of the skeletal muscles - hypertonicity due to the development of the vermiform nucleus, valvular blіvіv
The striatum has a galmuic sound on the piedkirkov structures. The striatum takes away afferent impulses with the head rank of the great pivculi and thalamus and sends afferent impulses with the head rank of the pale ball. Part of the ethers without switching goes to the black substance. The number of fibers is insignificant, straight to the subthalamic and red nucleus, lower olivi, black plyami, raphe nucleus. Smugaste body is seen as an effector core, as if there are no independent rukhovyh functions, but the control of the function of the palidum. Smuhaste tіlo galmuє diyalnіst blіdoї kulі, so it’s on the new one just like the wine itself is on the red core.
Classification
|
(substantia grisea) Nucleus basales (corpus striatum, n, amygdaloideum) |
Activatio-pallidum |
Akinetic-rigid syndrome (hypomymia, bradykinesia) |
|
|
Nucleus subthalamicus |
Balism and hemibalism |
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Substantia grisea, nucleus ruber, n. intersticieles, lamina tecti, |
parkinsonism |
Reactivatio-striatum |
Hypotonic-hyperkinetic syndrome (hyperkinesia, athetosis) |
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Medulla oblongata Oliva inferior, nucleus vestibularis |
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|
Formation reticularis trunci encephali |
The function of e.
The afferent kirkovi ways take their cob from the numerical vіddіlіv kіrkіvі pіvkul, espe- cially from the ruhovy zones of the frontal region (anterior central ring, paracentral chasten). The most important given fiber is galmive. Another system of afferent fibers, yak, may be activated, reaching the swarthy body from the thalamic centromedian nucleus. There is a system of Kirk fibers, which secure bilateral connections between the black substance and the striatum. Dopaminergic (afferent negrositial) fibers - change the galvanic function of the striatum (nearly 80% of dopamine are seen as neuron axons in these pathways, (negrostriatal system, close to 80% of dopamine are seen as neuron axons). neurotransmitter in the endings of axons of peripheral nerves and rich neurons of the CNS. Dopamine is one of the chemical factors of internal reinforcement (EFP) and serves as an important part of the brain’s “wanting system”, oscillating with a little satisfaction (or satisfaction), which contributes to the process of motivation and learning). I give an inhibition effect on dopaminergic neurons.
tractus rubrospinalis, tractus tectospinalis, tractus vestibulospinalis, tractus reticulospinalis, tractus olivispinalis.
Rubro-spinal (Monakov's Way) the tract begins at the red nucleus of the middle medulla, after the exit of which way it crosses again (Forel's crossroads) at the flank cords and ends in the V-VII plates of the spinal cord (intermediate zone). There are no direct connections from motor neurons. Take part in the organization of the movement of all the musculature of the tunic and kinks (walking, running), control the tone of the legs, the stools and the ruhi are plastic, keeping the singing posture alive for a long time.
Vestibulo-spinal tracts (lateral and ventral) activate the motor systems, connected with the equal body and directly the movement. The stench starts at the great vestibular nuclei of the dovetail medulla and the pons, the olive dovetail medulla and ends at the VII - IX plates of the spinal cord (area of the anterior horn). The lateral tract (which passes at the flank canal) terminates in the area of the cervical veins, and the ventral tract (which goes near the anterior duct) in the transverse veins. Control that organization to re-arrange the m'yazovy tone in case of any change in the position of the body and head in the open, control the tone of the growths.
Reticulo-spinal tracts are represented by axons of neurons in the reticular formation, the pons and the medulla. The stinks pass at the anterior canaliculi, satisfying two paths: medial and lateral, and end in the region of the motor nuclei of the IX plate, and also in the region of the VI-VIII plates. The importance of this tract in the mechanism of improvement and rozpodіl mucosal tone and regulation of postures, participation in diffuse galvanization of all muscles is necessary in certain behavioral acts, for example, when the body is overheated. This way is in the middle an active infusion of the dichal and vessel-ruhic centers.
Tecto-spinal the tract takes the ear at the deep balls of the humpback of the chotiricholmia of the middle brain, passes at the warehouse of the ventral funiculus and ends on the interneurons of the VII-VIII plates of the spinal cord (anterior horn area). Functionally, the tecto-spinal paths are connected with the coordination of the head and the tuluba at dawn and the sound signal that ensures the development of the sentinel reflex in humans.
Olive dorsal the tract takes the cob in the lower nucleus of the olive-double moss, it has no middle links with the bark of the frontal part of the pivkul (crust-olive tract), with the chervonim core (chervo-olive-olive tract) and the bark of the cerebellum (olive-cerebellar tract). The axons of the clitin of the lower nucleus are taken into a bundle, which protrudes from the anterior-medial ventral cord of the biceps funiculus and terminates at the rudaceous nuclei of the anterior horns of the spinal cord. Safeguarding the insanely reflexive tone of the mind, the head and the ruddy act, directed to the preservation of the equal body.
Impulses from the extrapyramidal system, as well as from the cerebellum and from the pyramidal system, are added, later, to the clitinum of the anterior horn, de and end all the overridden conductors. The residual path to the m'yaz passes through the peripheral rukhovy neuron.
Associative (links of neurons in the extrapyramidal system among themselves)
Extrapyramidal disorders can be divided into two clinical syndromes: akinetic-rigid and hyperkinetic-hypotensive
Variants of decrease in rukhovoї activity є: akinesia - the absence of rukhіv, bradykinesia - the increase of rukhіv, oligokinesia - the inability of rukhovіv, hypokinesia - lack of rukhovo activity.
Rigidness - constant change of m'yaziv at the station of tonic tension, as powerful as m'yazamagonists, so it is m'yazam-antagonists, in connection with which the plastic nature of the increase in m'yazovogo tone is manifested.
In case of akinetic-rigid syndrome in the cob stage of yogo development, m'yazovan rigidity in Parkinson's disease sounds asymmetric, may appear in either one part of the body, prote nadal, progression of illness in the world, it becomes more and more common.
The hypotonic-hyperkinetic syndrome develops with damage to the caudate nucleus and skaralupi (in these cases, there is an excess of mediators of awakening - dopamine and in.). Separate:
athetosis - in the form of a strangely tonic character of the turn, it is important in the distal joints of the kinks, sometimes and in the musculature of the guise (vipination of the lips and іn)
choreic hyperkinesia (the widest form) - swiddy non-rhythmical ruhi in the distal and proximal edges of the kinks, appearances, tubules.
Also, functionally, it is more closely related to the more phylogenetically young, pyramidal. Ale, at the same time, plays a significant role, which plays a role in 1. Regulation of the mucosal tone in the complex with other structures.
2. Regulation of the tempo, rhythm and plasticity of any kind of sufficient movement.
3. Safety of the rukhovy component in the regulation of insane reflexes (state, defensive, start-reflex, etc.).
4. Safeguarding the sequence of the rukhovy act.
5. Care of the motor component of the emotional sphere.
6. Regulation of highly specialized human movements, which have reached the level of automatisms
List of literature:
Burd, Gusev, Konovalov - Neurology and neurosurgery
Zagalna neurology A.S. Nikiforov, E.I. Gusev - 2007 - 720 s
Pnevmapsychasomatology of people, Trifonov E.V. Russian-English Encyclopedia 2013
Human anatomy is normal Gayvoronsky I.V. 2001
"Topical diagnosis of diseases of the nervous system", A.V. Triumfov
Topical diagnosis in neurology, Petter Duus
Extrapyramide system- another efferent mechanism for the implementation of certain disruptions that
diy. The extrapyramidal system is called all the ruhovі ways, yakі do not pass through
pyramids of the dovetail brain (Fig. 32; colored gluing).
As already mentioned above, the pyramid system is not a single mechanism, for help
of which there are quite a lot of ruhov acts. Extrapyramidal system older, lower
pyramid. Vaughn is already folding behind the warehouse. doteper
it’s time to talk about those who are the very structure of bringing to the extrapyramidal system i, smut,
like functions of these structures.
In the extrapyramidal system, there are distinctions between kyrkovy and subkirkovy vіddіli. To Kirk's Viddilu
extrapyramidal system, the same fields can be seen, as they enter at the kirkove core of the rue
analyzer. Tse 6th and 8th, as well as 1st and 2nd fields, tobto. sensorimotor area of measles. Vinyatok
to become the 4th field, like a Kirk Lanka, less than a pyramidal system. 6th and 8th fields
budovi lie down to the watering of the motor type, in III and V
motor clitins, ale of lesser rosemary, lower clitins of Betz.
Budov pіdkirkovogo vіddіl ekstrapіramіdnoї system є dosit foldable. Wine is stacked in a row
womb. Nasampered tse striopalidar system - central group
extrapyramidal system, where to enter caudate core, shellі blida cool(or palidum).
The system of basal nuclei is spread in the middle of the white speech (at the depth of the premotor zone of the brain) and
characterized by folding rukhovy functions (Fig. 33).
It should be noted that, behind the current tribute, the striopalidar system takes the fate of the
only motor and other folding functions (div. ch. 22).
The extrapyramidal system includes the following: belt bark, black substance, Lewisow
body, anteroventral, intralaminar nuclei of the thalamus, subthalamic nuclei, chervone nucleus,
the brain, different types of reticular formation, reticular structures of the spinal cord.
Kіntsevoj іnstanciе ekstrapіramіdnyh vplivіvі є і і є і єє motoneuroni spinal cord, to yakіh
the impulses of the pyramidal system are addressed (Fig. 34).
Anatomical reading between the pyramidal and extrapyramidal systems during the day (Fig. 35).
The stench of the Kremlin is anatomically less on the distance of the pyramids, near the deep brain. Prote functional
to compare the difference between these systems. І especially clearly the stinks appear at the clinic
local lesions of the brain.
Damage to the rukhovy functions, which can be blamed for various local lesions of the brain, can
podіlit on vіdnosno elementary, related to the wounds of vikonavchi, efferent
mechanisms of failure, and more foldable, which expand on quite a lot of ruhi that diїі
it is important to affect the afferent mechanisms of rukhovyh aktiv.
Khomska Y. D. X = Neuropsychology: 4 studies. - St. Petersburg: Peter, 2005. - 496 s: il. 103
Rice. 33. Striopalidum and yoga afferent links, basal aspect.
Tail the core ( from. caudatus), scale lens ( putamen) and blue ball pallidum), warehousing a single system ( striapallidum), closely associated with deep structures: the horn tubercle, the hypothalamic region, the vermiform nucleus, the black substance and the cortex of the brain (according to O. Krigu)
shodo elementary fluffy discord blamed for damage to the subcutaneous lanoks of the pyramidal and extrapyramidal systems. When the Kirk lanka of the pyramidal system (4th field) is damaged, it is ruffled in the precentral space paresis or paralysis singing group of m'yazіv: arms, legs, or tulubi on the side, protilezhnіy to the wound. For damage to the 4th field, there is a characteristic malignant paralysis (if the m'yazi does not suffer from a passive rush), which results in a decrease in the m'yazovogo tone on aphids. Ale with fires, rotting before the front of the 4th field (in the 6th and 8th fields of measles), the pattern of spastic paralysis is blamed, so that there is a fall of ruptures on aphids, an increase in m'yazovogo tone. The manifestations of pari-
Khomska Y. D. X = Neuropsychology: 4 studies. - St. Petersburg: Peter, 2005. - 496 s: il. 104
Rice. 34. Organization of motor functions on the spinal line:
BUT - lateral and ventromedial pathways;
B- termination of the lateral and ventral pathways on the motoneurons of the anterior branches of the spinal cord and on the proximal
neurons of the proximal zone;
IN - projection of proximal neurons on motoneurons and projection of motoneurons on body musculature.
The lateral system is projected onto the distal musculature, and the ventro-medial system is projected onto the proximal one. one -
lateral cortico-spinal tract; 2 - rubro-spinal tract; 3 - medial tract; 4 - lateral reticulo-
spinal tract; 5 - vestibulo-spinal tract; 6 - medial reticulo-spinal tract; 7 - tecto-spinal
tract; 8 - ventral cortico-spinal tract; 9 - crotch zone; 10 - ventral zone; 11 - industrial
(insert) neurons; 12 - motor neurons; 13 - fingers; 14 - hands; 15 - body (according to L. Laurenceі D. Coopersu)
A call at once from sensitive discords is characteristic of post-central measles lesions. The number of damage to the rukhovyh functions is reported to neurology. A number of neurological symptoms of damage to the Kirk's lanka of the extrapyramidal system give also damage to the folded prevіlnyh ruhіv, about which it will be mentioned below.
Rice. 35. Different systems of afferentation of sensitive (kinesthetic) and rukhovy (kinetic) measles effects (for D.I. Peipetsu)
When struck Pyramid Ways in brain(for example, near the zone of the internal capsule) vinikaє outside the fall of the ruin ( paralysis) on the opposite side. Seemingly one-sided
Khomska Y. D. X = Neuropsychology: 4 studies. - St. Petersburg: Peter, 2005. - 496 s: il. 105
vipadannya ruhіv arms and legs ( hemiplegia) appears at rough midpoints. Most often, in the clinic of local lesions of the brain, there are manifestations of a partial decrease in rukhovy functions from one side ( hemiparesis).
When the pyramidal path is overturned in the pyramid zone - the single zone, the depyramid and extrapyramidal paths are anatomically water-reinforced, - more ruhi are realized only for the help of the extrapyramidal system. In the 40s of the 20th century, experiments on the cross-section of pyramids were carried out by the English physiologist S. Tower on mawps. It turned out that the mavpa zdatna vykonuvati low folding ruhіv (burrowing, manipulation with objects and so on.). However, in similar moods, the ruhi becomes less discrete (that is, rude). In buried objects, more m'yazivs begin to take the fate. Moreover, in Russian
yakh, where the fate of all m'yaziv (type of haircut) is necessary, which is attached to the motility of the mawp, the accuracy and coordination are known. Similar damage to the rukhіv leaks and the anatomy increases the m'yazovogo tone.
Qi data to tell about those who the pyramidal system takes part in the organization of more importantly precise, discrete, space-oriented disruptions and suffocated m'yazovogo tone. Porazka kіrkovyh and pіdkirkovyh lanoks of the extrapyramidal system to produce until the appearance of different rukhovih rozladіv. You can share dynamic(tobto ruined by the vlasne ruhіv) that static(That's a broken position). In case of damage to the cortical line of the extrapyramidal system (6th and 8th fields of premotor measles), which is tied to the ventrolateral nucleus of the thalamus, the pelvis and the cerebellum, spastic ruptures are blamed on the contralateral kinks. On the 6th or 8th half of the day, turn your head, eyes and a coat in the opposite side (adversity), as well as folding the arms of the contralateral arm or leg. Porazka pіdkirkovoї strіopalіdarnoї system, viklikana with various illnesses (parkinsonism, Alzheimer's disease, Peak, puffiness, hemorrhages in the region of the basal nuclei and in), are characterized by severe unruliness, adynamia, and difficulties in overdressing. Appear one hour rape contralateral arms, legs, heads - hyperkinesia. Such ailments are afraid and broken tone(for looking spasticity, rigidity or hypotension), to become the basis of the position, that damage to rukhovyh assets(The tremor seems to be getting worse - hyperkinesis). The ailments lose the ability to serve themselves and become disabled.
In this hour, surgical (stereotaxic) and conservative (pharmacological) methods for treating parkinsonism have been developed. The essence of the first fields in the collapse of one of the "ailments" of extrapyramidal structures (for example, the ventrolateral nucleus of the thalamus) is that pathological arousal that circulates along closed extrapyramidal pathways. Fallow in the form of parkinsonism, it also destroys either the palidum zone, or the striatum zone (in the region of the caudate nucleus or shkaralupi). Zone palidum(blood cool) may be extended to regulation more smooth flow and tone up(posey), at that hour yak zone striatum(shkaralupa and caudate core) big world
tied with physiological tremor, pass with pathology of hyperkinesia.
A choice of damage to the palidum zone (older part, lower striatum) can be brought up to athetosis
or choreoathetosis(pathologically stunted hand and foot, smirking kіntsіvok toshcho.
d.). Illness is good and is described by neurological helpers.
Striopalidar infections are accompanied by another type of dry symptoms.
damaged mimicsі pantomimes, so mimic motor components of emotions. Qi damage
can act either in the form of amіmії (mask-like person)
fleeting rushes of the whole body with different emotions), or in the form of violent laughter, crying
or violent walking, running (propulsion). Often, these ailments suffer and are subjective
"experiencing emotions.
Zreshtoy, such ailments break down and physiological synergy - normal
other rukhovy organs (for example, waving hands for an hour of walking), what to bring to
non-naturalness of their dry assets.
The results of the destruction of other structures of the extrapyramidal system by the lesser world,
vinyatko, zvichano, brain. cerebellum is the most important center for coordinating various
rukhovyh aktіv, "organ of brіvnova", scho zabezpechuє a number of insane motor aktіv,
connected with the oral, auditory, skin-kinesthetic, vestibular afferentation. Porazka
the cerebellum is accompanied by various rheumatic disorders (we are in front of the disorders
coordination of rukhovyh aktіv). Їх description to become one of the good razroblenikh razdіlіv
contemporary neurology.
Damage to pyramidal and extrapyramidal structures spinal cord lead to the destruction of functions
motoneurons, in the aftermath of which fall (or break) keratinized by them. Fallow view
equal damage to the spinal cord disrupts the impaired functions of the upper and lower ends (on
(or on both sides), moreover, all mіstsevі ruhovі reflexi zdіysnyuyutsya, as a rule,
Khomska Y. D. X = Neuropsychology: 4 studies. - St. Petersburg: Peter, 2005. - 496 s: il. 106
normal or navit posilyuyutsya after the adoption of cortical control. All these damages are also reported in the course of neurology.
Clinical care for ailments, as if they could damage that other equal pyramidal or extrapyramidal system,
allowed to clarify the functions of these systems. Pyramid system is capable of regulating discrete, precise fluctuations, subordinating to sufficient control and good afferentation by “evil” afferentation (zoral, auditory). Vaughn manages the complex space-organizational movements, from which they take the fate of the body. Pyramid system of regulation is important phase type ruhiv, i.e., rush, as if dosed at the hour and at the open space.
The extrapyramidal system is most importantly mimic components of prevalent ruhiv; before him krіm regulation tonus (of that background of rukhovoї activity, on which phases of short-hour rukhovі acts are played) can be seen:
♦ pіdtrimannya position;
♦ regulation of physiological tremor;
♦ physiological synergy;
♦ coordination of activities;
♦ the general use of rukhovyh aktiv;
♦ future integration;
♦ body plasticity;
♦ pantomime;
♦ mime is too thin.
The extrapyramidal system is also known to be different rukhovy novichki, automatisms. In general, none of the extrapyramidal systems are less corticolized, the lower pyramidal, and the regulation of the rukhova by it is less peaceful, the lower ruhi, the regulation of the pyramidal system. Slid, however, remember that the pyramid and extrapyramid systems are single efferent mechanism, different equals to beat different stages of evolution. The pyramidal system, as if evolutionarily young, is a singing world “over the bud” over more old extrapyramidal structures, and її viniknennya in people is wised up before the development of quite a few ruins and diy.
Neurology and neurosurgery Evgeniy Ivanovich Gusev
3.2. Extrapyramide system
3.2. Extrapyramide system
The term "extrapyramidna system" means pidkirkovi and stovburov postapiramidni utvochennya and motor paths, so as not to pass through the pyramids of the dovegasy brain. Part of the system's є ti bundles, like pove'azuyut the cortex of the great brain with extrapyramidal structures: swarthy body, chervonim core, black speech, cerebellum, reticular formation and cores of stovbur lining. In these structures, the impulses are transmitted to the interstitial nerve cells and then descend as pokrishkovo-, chervonuclear-spinal cord, reticular- and anterior-spinal cord and other pathways to the motor neurons of the anterior horns of the spinal cord. Through qi pathways, the extrapyramidal system is injected into the spinal cord activity. The extrapyramidal system, which is composed of projective afferent nerve pathways, which originates in the cortex of the great brain, which includes the nuclei of the swarthy body, the nuclei of the stovbur of the brain and the brain, regulates the regulation of the rukhіv and m'yazovogo tone. We will supplement the cortical system of more rukhіv, we will prepare more ruh, we will subtly nail it to vikonnannya.
The pyramidal path (through the insertion of neurons) and the fibers of the extrapyramidal system in the terminal pouch are attached to the motoneurons of the anterior horn, on the alpha- and gamma-clitins, and are injected into them as an activation, as well as a galvanization.
The extrapyramidal system is phylogenetically old (especially the palidary part) is similar to the pyramidal system. With the development of the pyramidal system, the extrapyramidal system is being transformed into a sub-priority camp.
The extrapyramidal system consists of the following main structures: the caudate nucleus, the scale of the ovarian nucleus, the proximal coulis, the subthalamic nucleus, the black speech and the red nucleus. The lower order of the system is the reticular formation of the cap of the stovbur of the brain and the spinal cord. With a further development of the creaturely world of paleostriatum (blood of the kul), becoming panuvati over these structures. Let's play the role of the neostriatum in the greater savants (the tail of the nucleus and the scarralupe). As a rule, phylogenetically late centers dominate over early ones. Tse means that in the lower creatures, the innervation of the ruhiv lies up to the extrapyramidal system. The classic butt of the "palidary" istot є ribi. The birds are trying to bring the neostriatum to reproach. In greater creatures, the role of the extrapyramidal system is no longer important, regardless of those who in the world form the measles of the great brain phylogenetically older rukhovi centers (paleostriatum and neostriatum) daedals are more controlled by the new rukhovo system - the pyramidal system.
Smugaste body- a conducting center of the middle structures that establishes an extrapyramidal system. Vіn I take impulses in different areas of the measles of the great brain, especially in the frontal rukhovo region of measles, which includes fields 4 and 6. The swarthy body reaches that other system of afferent fibers that go to the thalamus. From the caudate nucleus and the scale of the lenticular nucleus of the main afferent fiber straight up to the lateral and medial segments in the proximal coulis, yak vodokremleny one in one of the internal medullary plate. Іsnuyut links that go from the ipsilateral measles of the great brain to the black speech, the red nucleus, the subthalamic nucleus, the reticular formation.
Tail the nucleus and scale of the ovarian nucleus to make two "channels" zv'yazkіv іz black speech. From one side, afferent nigrostriatal fibers describe how dopaminergic and change the inhibitory function of the swarthy body. On the other side, the strionigral path is GABAergic and may inhibit the action on dopaminergic nigrostriatal neurons. Tse close the ring of the zvorotny link. GABAergic neurons control mucosal tone through the gamma neuron of the spinal cord.
All other afferent fibers of the swarthy body pass through the medial segment bіdoї kuli. The stench is made to dosit tovstі bundles of fibers. One of these bundles is called a lenticular loop. The fibers start at the ventral part of the medial segment of the pallid nucleus and go ventromedially towards the posterior leg of the internal capsule to the thalamus and hypothalamus, and also reciprocally to the subthalamic nucleus. After crossing, the stench radiates behind the reticular formation of the middle brain, as a lance of neurons forms the reticular-spinal pathway (lowered reticular system), which ends in the clitinae of the anterior horns of the spinal cord.
The main part of the afferent fibers extends from the back of the chest to the thalamus. Cepalidothalamic bundle, or Trout field H1. Most of the fibers terminate in the anterior nuclei of the thalamus, projecting onto the cortical field 6. Fibers originating in the dentate nucleus of the cerebellum terminate in the posterior nucleus of the thalamus, projecting onto the cortical field 4. All thalamocortical regions transmit to both sides. In the cortex, thalamocortical tracts establish synapse with corticostriate neurons and form the ring of the involuted ligament. Reciprocal (obtained) thalamocortical streaks are relieved, or the activity of cortical ruxic fields is reduced.
The fibers of the basal nuclei, which descend to the spinal cord, are innumerable in number and reach the spinal cord only through the lance of neurons. This nature of the day allows us to admit that the main function of the basal ganglia is the control and regulation of the activity of motor and premotor cortical fields, which is enough to move smoothly, without interruption.
The pyramidal path originates from the sensorimotor division of measles (fields 4, 1,2, 3). At the same time, the fields, in which the extrapyramidal rukhovi pathways begin, include corticostriar, corticorubral, corticonigral and corticoreticular fibers, which go to the rukhovaya nuclei of the cranial nerves and to the spinal rukhovoi nerve cells through the lower lances of the neurons.
More zv'yazkіv measles pass through the internal capsule. Also, the inner capsule breaks like fibers of the pyramidal path, and the extrapyramidal fibers. Tsya interruption is the cause of m'yazovoi spasticity.
Semiotics of extrapyramidal disorders. The main signs of extrapyramidal disorders are the disorder of the m'ulcer tone (dystonia) and the mimic disorders (hyperkinesia, hypokinesia, akinesis), daily sleep. You can see two clinical syndromes. One of them is characterized by hyperkinesias (automatic violent ruptures in the aftermath of miraculously soon m'yaziv) and m'yazovoy hypotonia and evoke neostriatum lesions. The latter is the case for hypokinesis and m'yazovoi hypertonia, or rigidity and fear in case of damage to the medial part of the bludo kuli and black speech.
Akinetic-rigid syndrome(syn.: amiostatic, hypokinetic-hypertensive, palidonigral). This syndrome in the classic form is manifested in tremulous paralysis, or Parkinson's disease. Pathological process in this disease is degenerative, leading to the loss of melanin neurons in black speech. The lesion in Parkinson's disease is bilateral. In case of unilateral colitis, clinical signs are observed on the protileous side of the body. With Parkinson's disease, degenerative recession. Similar loss of neurons in black speech may be caused by other reasons. In such cases, trembling paralysis can be attributed to Parkinson's syndrome or parkinsonism. As a result of lethargic encephalitis, it is also called postencephalitic parkinsonism. Other conditions (cerebral atherosclerosis, typhoid, cerebral syphilis, primary or secondary radiation to the process of the middle brain with swelling or trauma, carbon monoxide intoxication, manganese and other speeches, trivalium with phenotyazine or reserpation)
Clinical manifestations of the akinetic-rigid syndrome are characterized by three main signs: hypokinesia (akinesis), rigidity and tremor. At hypokinesia the sluggishness of the ailing is gradually decreasing. All the mimics and expressive movements fall off step by step or sharply spoof. An ear of ruhu, for example, walking, even more difficulties. Ailments on the back to rob a sprat of short krokiv. Having started the ruh, the vines cannot grow like a ripple and rob a sprat of zayvih krokiv. This continued activity is called propulsion. Viraz appearance becomes mask-like (hypomymiya, amimiya). Mova becomes monotonous and dysarthric, which often vibrates the rigidity and tremor of movement. The body is known to the fixed sginal position of anteflexion, all the ruhi, including the right ones and the unfinished ones. Hands do not take part in the act of walking (acheirokinesis). Mustache mimichnі and spіvdruzhnі ekspresivnі ruhi, typical for the individual, daily.
Against the spastic rise in the tone of the mind rigidity it is possible to see in extensors as a “wax” opir usim passive movement. M'yazi cannot be relaxed. With passive movements, it can be seen that the tone of the m'yaziv-antagonists decreases step by step, inconsequently (a symptom of a gear wheel). The head of the ailing person is raised to lie down, do not fall, as if to let it in, and step by step fall back onto the pillow (head drop test). In contrast to the spastic state, proprioceptive reflexes are not advanced, but pathological reflexes and paresis are daily. It is important to call the reflex and it is impossible to strengthen the knee reflex with the Jendrashik's technique.
Most ailments show passive tremor, which can have a low frequency (4-8 ruhіv per second). Passive tremor is rhythmic and is the result of the interaction of agonists and antagonists (antagonistic tremor). In contrast to the intentional antagonistic tremor, the hour of purposeful disruption is attached. Rolling pigulok or rahunok coins are signs characteristic of parkinson's tremor.
Mekhanizm, scho umovlyuє the appearance of three transferred signs, z'yasovaniya in full obsyazy. Acinesis, perhaps, is associated with an increase in dopaminergic transmission of impulses in a swarthy body. Acinesis can be explained by the coming rank: damage to neurons in black speech causes the inflow of inhibitory lower nigroreticulospinal impulses on the Renshaw clitinum. Clitini Renshaw, who can communicate with the great motor neurons, lowers her inhibiting activity of the rest, so that the cob of a pretty rush is more important.
Rigidity can also be explained by the second neurons in black speech. In normi qi, neurons give a hawk sound to the impulses of a swarthy body, as if in their line they call down a kul. This loss means that the afferent palatal impulses do not tumble. A similar path to the bludoї kulі establishes synapse with reticulospinal neurons; to facilitate the development of intercalated neurons in the lancet tonic reflex to stretching. In addition, out of the medial part of the proximal coulis, the impulses reach through the thalamic nuclei of area 6a and behind the help of the corticospinal fibers, it also facilitates the injection on the inserts of the neurons in the lanceuzis of the tonic reflex to stretching. There is a violation of the m'yazovogo tone, as it is called rigidity.
As a result, the afferent clitin fibers of the proximal spleen were ruined by a stereotaxic operation in the medial part or in the area of the lenticular loop, or in the thalamic nucleus, the rigidity changes.
Stereotaxic operations of coagulation of the medial part of the proximal coulis, palidothalamic fibers of the abodentatothalamic fibers and the terminal thalamic nucleus are shown in part of the disease.
Hyperkinetic-hypotension syndrome. Develops with damage to a swarthy body. Hyperkinesia calls out to ear-inhibiting neurons in the neostriatum, the fibers of which go to the pale coulis and black speech. In other words, it is the destruction of the neuronal systems of the highest order, which leads to the overworld awakening of the neurons of the lower systems. As a result, hyperkinesia of various types is blamed: athetosis, chorea, spastic torticollis, torsion dystonia, balism and others.
Athetosis call out to the perinatal ears of a swarthy body. It is characterized by mimic and worm-like ruhi with a tendency to re-arrangement of the distal parts of the tips. In addition, there is an irregular, spastic increase in the m'yazovoi tension in agonists and antagonists. In the wake of this position, the ruhi is eccentric. Pretty much ruhi is significantly damaged due to spontaneous vindication of hyperkinetic ruhivi, yakі can mourn a person, language and, in such a rank, make a grimace with abnormal language ruhi. Can spastic vibes laugh and cry. Athetosis may subside with contralateral paresis. Vin can be double-sided.
Facial paraspasm- tonic symmetrical shortness of mouth, cheek, shi, tongue, eyes. Some people are afraid of blepharospasm - isolating the rapidity of circular eye ulcers, which can be combined with clonic convulsions of m'yazyv tongue, company. Paraspasm vinikaє іnоdі іnіnі іdі podіdі hour rozmovi, їzhі, chuckles. Help with hvilyuvanni, yaskravomu vysvitlennі. Knowing about the dream.
Choreic hyperkinesis characterized by short, swishy, fleeting smirks, which grow up without a beat, in m'yazakh and call out various kinds of ruhi, which sometimes predict quite well. On the back, the distal parts of the tips radiate, then the proximal ones. Mimovilni smirks of the facial musculature call out grimaces. Crim hyperkinesis, characterized by a decrease in the tone of m'yaziv. Choreic ruhi with a full development can be in case of Huntington's chorea and small chorea pathognomonic sign, secondary to other ailments of the brain (encephalitis, carbon monoxide attack, sudine ailment). The swarthy body is afraid.
Spastic torticollisі torsion dystonia– the most important dystonic syndromes. With both ailments, the scapula and the centromedian nucleus of the thalamus, as well as other extrapyramidal nuclei (blood stool, black speech and other) are affected. Spastic torticollis is a tonic discord that manifests itself in spastic contractions of the neck area, which leads to complete, fleeting turns and sickness of the head. Ailments often vikoristovuyut compensatory priyomi and change of hyperkinesia, with a hand to raise the head with a hand. Krіm іnshih m'yazyv shiї, espe- cially often involved in the process of sternocleidomastoid and trapezium-like m'yazi.
Spastic torticollis can be an abortive form of torsion dystonia or an early symptom of other extrapyramidal disease (encephalitis, Huntington's chorea, hepatocerebral dystrophy).
Torsion dystonia is characterized by passive overwrap of the torso and proximal segments of the ends. The stench can be on the floor turns, so without a support of ailments you can’t stand, don’t walk. Ailments can be symptomatic or idiopathic. In the first case, mild injuries, zhovtyanitsa, encephalitis, early chorea of Gentington, Hallervorden-Spatz ailment, hepatocerebral dystrophy (Wilson-Westphal-Strumpel ailment) are possible.
Ballistic syndrome sound like hemibalism. Viyavlyaєtsya fast paced proximal m'yazyv kіntsіkov steep character. With hemibalism, the ruch is tight, strong (“kidkovy”, dispersed), the shards rush like a great m'yazi. Blame it on the damage of the subthalamic nucleus of Lewis and its connections from the lateral segment of the proximal coulis. Hemibalism develops on the sides, contralateral lesions.
Mioklonichni smikuvannya sound to indicate the damage to the region of the tricutnik Gillen - Mollare: the red nucleus, the lower olive, the dentate nucleus of the cerebellum. Tse shvidki, ring out the bezladnі fastness of various groups of m'yaziv.
Tiki- Shvidkі mimovilnі skorochennya m'yazіv (mostly circular m'yazi eye and other m'yazіv guise).
Hyperkinesias develop spontaneously as a result of the use of an ingrown-bodied swarthy body on neuron systems (cool blemishes, black speech).
Pathological impulses go to the thalamus, the ruch area of the measles and then along the afferent cortical neurons.
In sick people of a frail age with cerebral atherosclerosis, signs of parkinson-like disorders or hyperkinesia can often be seen, especially tremor, a tendency to repeat words and phrases, kіntsevyh folds of words (logoclonia) and ruhіv (polykinesia). You can have schilnist to pseudo-spontaneous breaks, but right choreic or athetoid breaks are equally rare. In most cases of depression, symptoms are associated with miliary and sometimes larger necrotic patches of swarthy body and bludo kuli, which appear in the appearance of scars and even small cysts. Tsei became a vidomy as a lacunar status. The tendency to repetition of that logoclone is considered to be swayed by similar lesions of the caudate nucleus, and the tremor is shkaralupi.
Automated activities- Folding ruhovі acts and іnshі sledovnі ії, scho prokіkayut without control svіdomostі. They blame it on pivkulnih follicles, which destroy the measles ligaments with the basal nuclei while saving their ligaments with the brain stem; appear in the same and the middle kіntsіvkah.
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From Su Jok books for everyone by Park Jae-wooSection IV. Suspension system of head visibility. "Komahi" system. Minisystem Subway system of head visibility There are two systems of head visibility on the fingers and feet: the system "to the type of a person" and the system "to the type of creature". System "like a person".
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The EU includes the basal nuclei of the great brain and the cerebral stovbur, the reticular formation, the cerebellum with its morphological and functional links. The cortical part of the extrapyramidal system is the premotor area, as well as the decimal areas of the skeletal and politic chasms.
Functions of the EC system:
A) improve and reshape the normal mucosal tone
B) adjust mimoly automated movements (posture, facial expressions, gestures), support the end of movements
C) ensuring the readiness of the m'yazovogo device to vykonannya prevіlnyh rukhovyh aktіv, sledovnistnіnіnі before them singing m'yazovyh groups, regrouping m'yazovogo tone, vykonannya additional ruhіv, shvidkіst, rhythm, fluency, gnuchkіst that іn.
Pretty ruhi - the final result of the split and subtly narrowed diyality of the pyramidal and extrapyramidal nerves of the nervous system, as well as the cerebellum. The inclusion of the extrapyramidal system to the system of dolnyh ruhіv zdіysnyuєtsya behind the help of the thoracic tubercle, for which there may be a number of connections.
Anatomy. Main parts of the EU:
BUT) Basal nuclei- roztashovanі at the clay vіddіlakh of the great brain:
1. Tail the core
2. Sochevitsepodіbne core
but. the outer core (shkaralup)
b. internal nuclei (lateral and medial flanks of the sump)
The tailed core and the scale are formed from the small and great cells and merge into one system - a smugaste body
B) Nuclei of the middle cerebellum(black speech, red kernels)
IN) Hypothalamus
Between these nuclei there are numerical links.
Blida cool, black speech, red kernels, the body of Luis, which are composed of great cells, unite the palear system (phylogenetically old).
The basal nuclei are numerically straight and cross-linked with the cortex of the great brain.
Cortical-striar fibers go through the inner capsule to a swarthy body and a bludo kuli. In the view of the lateral nucleus, the pale kustina part of the fibers is straight up to the red nucleus of the tareticular formation. Another part of the fibers from the swarthy body ends in black speech.
Nerve fibers begin in the clitins of the black speech, which go to the reticular formation. In the form of nuclei, a network-spinal pathway begins, which passes at the anterior cords of the spinal cord and terminates on the inserted and small alpha-neurons of the anterior horns of the spinal cord. Through this path there is a lighter (clinically manifested by an increase in the lingual tone) and halmuic (manifested by a decrease in the ulcer tone) inflow of the reticular formation onto the spinal cord. From the cells of the red nuclei, a red-spinal path begins, which is sleepy for the extrapyramidal system of the cerebellum. The red kernels are also connected from the reticular formation behind the help of the red-nuclear-communal bundles. The heart of the luis is tied with a pale sack, we will smug the body with the bark of the great brain. Vіd ny go fibers to the red core of that black speech.
Anterior-spinal tract begins at the front of the anterior nuclei, which descends into the SM, passes between the anterior and posterior cords and ends at the anterior horns of the SM. Vіn pov'yazuє brain and nucleus of the front door root with m'yazami both halves of the body, zdіysnyuyuchi conduction іpulsіv, directing to the preservation of equal body and regulation m'yazovogo tone.
Pokrishkovo-spinal tract begins in the Syrian speech dahu of the middle brain, crosses and descends in the anterior cord of the spinal cord, ending at the anterior horns of the cervical segments. Vіn regulates the work of m'yazіv, po'yazanih z reflex ruhami head and coat at the sound of the morning teasing.
In this order, the nerves to the numerical links of the basal nucleus acquire impulses from the reticular formation of the stovbur, the nuclei of the dahu of the middle brain, and the posterior posterior fasciculus. At the same time, through the sitcho-, pokrishkovo-, chervo-nuclear - that anterior-spinal pathway, the extrapyramidal system was tied to the spinal cord. So, as on different lines of the brain stovbur, there are crossroads, then the basal nuclei appear to be connected by the head rank from the opposite halves of the body.
Syndrome of the morning. Damage to the palidary extrapyramidal system is manifested by the development of hypertensive-hypokinetic, or rigid-amiostatic, syndrome (parkinsonism):
1. Extrapiramidna rigidity (plastic hypertension of m'yaziv) - increase of m'yazovy tone, with passive movements of kintsivok (springing or swelling in loamy areas), even re-rendering of opir m'yaziv (phenomenon of "gear wheel") is shown.
2. Violence (oligokinesia) and upovіlnenіst (bradykinesia) ruhіv.
3. Difficulties during the transition, I will become calm in ruh and navpaki; schilnіst to catch at the nadanіy pose (pose of "wax cradle").
4. Weakening or development of joint limbs (synkinesia): when walking, ailments do not wave hands (acheirokinesis).
5. A peculiar posture of a sick person: stooped, trochs of heeled forward toulub, poked up arms and legs.
6. Move with dribbling croques, “shuffling”.
7. Mimovіlnі poshtovkhopodіbnі ruhi forward (propulsіya), bіk lateropulsіya аbо back (retropulsіya).
8. Mova is monotonous, quiet, graceful to the point of fading; repetition of silent words themselves (perseveration).
9. The handwriting is different, from uneven lines (micrography).
10. Mimicry is wretched (gіpomіmіya) or during the day (animіya).
11. Tremor of the distal tips, especially of the hands (guessing the hands for a fluff of coins, a symptom of "rolling pins"), the head, the lower slit; change with the rukhs and know uvі snі.
12. Paradoxical kinesias - the possibility of a Swedish vikonnannya being like ruhіv on the aphids of the wild slope (bіgannya going uphill, waltzing).
13. The salinity of the skin of the face, the worsening of the slumber (hypersalivation), the increased sweatiness (hyperhidrosis).
14. Changes in character: lack of initiative, silliness, stubbornness, shyness until the repetition of one and the same food and sip thinly.
The syndrome of parkinsonism is associated with manifesting the chronic stage of epidemic encephalitis, with Parkinson's disease, cerebral atherosclerosis, manganese poisoning, fumes, and after closed injuries of the skull. Vin can be blamed for treatment of ailments on high doses of neuroleptics (chlorpromazine).
In case of damage to the striatal vein Hypotonic-hyperkinetic syndrome, which is characterized by mild hypotonia (dystonia) and the appearance of various mimic changes (hyperkinesis):
1. Chorea: non-rhythmical, shvidki, bezpalnі ruhi in the proximal vіddіlakh kіntsіvok, tulubі, oblichі, movі that soft sky. Great amplitudes can make quite a mess, gestures, grimaces. Ailments grimace, smack. A tongue hangs out from the company, which they cannot overcome ailments. In important cases of choreic hyperkinesis, there is a “ruh storm” that helps the ailing ability to move around, serve oneself, make the movement easier. Hyperkinesia posilyuyutsya pіd hvilyuvan hvilyuvan and znikayut vі snі. When the knee reflex is overwhelmed after the tonic shortness of the chotirigolous meat of the stehna homilka, for the next hour, it is stuck in the folded position - a tonic symptom of Gordon. Through the manifestation of m'yazovu hypotonia, the symptom of "flying overtones" is often suspected: when you try to pick up an ailing person for bending in the elbows of the hand, the head goes deep into the overhead.
2. Athetosis: common, chimeric, worm-like ruhi is more important in the distal openings of the ends, more - in the m'yazah, the appearance of that tuluba. With athetosis of m'yazov, hypotension is marked with hypertension. This hyperkinesia will increase under the hour of zavorushen and active ruhіv, znikaє uvі snі.
3. Torsion dystonia: tonic shortness of the m'yaziv, which appear at the hands, walking and familiar with the calm. In different tonic groups, we can speak about a local form of torsion dystonia.
4. Hemibalism: large-scale hyperkinesia, which manifests itself in non-rhythmic obertal and kink movements in kinks, often from one side, in the case of m'yazovaya hypotension.
5. Myoclonus: shvidki, bliskavichni smikuvannya okremikh m'yazovyh groups or okremih m'yazyv (localized myoclonia), which swell with ruhah and znikayut uvі snі.
6. Myorhythms: stereotyped short rhythmic shortness of speech, which is blamed independently on the disruption (myorhythm of the tongue, diaphragm, soft breath).
7. Tiki- short-hour, one-man, rapist, clonic spoofing of other meat groups. The teak of an individual is accompanied by swishing frowns of the chola, blinking, raising the brows, hanging the tongue.
8. Facial paraspasm- Periodic tonic-clonic convulsions of the facial musculature due to overexertion of the tonic phase (spasms of circular ulcers of the eye, mouth, forehead ulcers). Facial hemispasm is characterized by sudomas of m'yaziv, which sound like a chin, which sounds like a mouth from one side.
follow-up methods: I will develop a m'yazovogo tone, the nature of hyperkinesis (rhythm, stereotype, amplitude of movement, frequency), the originality of active, friendly movements, mimics, letters, walk.
Pretty much vykonuyuchi that chi іnsu dіyu, a person does not think about it, which m'yaz needs to be turned on at the right moment, not treading in his memory the following working scheme of the movement act. The main movements vibrate mechanically, indefinitely respect, the change of some m'yazovyh is soon mimic and automated. Motor automatism guarantees the most economical extraction of m'yazovoї energy from the process of recovery. A new, unknown movement act energetically zavzhd marnotratnіshiy, nіzh zvichny, automation. The dance of the ballet dancer is the grace of the musician's fingers and the most rational automated movements. Improved developments - in step-by-step economics, automation, which ensures the operation of the extrapyramidal nervous system.
The extrapyramidal nervous system takes part in the regulation of the postural movement by the pyramidal system, being more anciently related to the pyramidal system in the phylogenetic plan. The striopalidar system was given to us at the bottom of the valleys, where it was easier to stand at the evolutionary gatherings - reptiles and birds. In deyakі vіkovі periodі іtіnі іt саn commemorate the robot of the palіdаї system: in prematurity and full-term babies of the first months of life - the axis of the ruhi of the touluba and pozannya (infusing the palіdar system), and the reaction of the support of the hands, superfluous ruhi do not suffice for the other half of the life of such an older (infl.) .
The process of starting a movement, directing to the automation of a movement act, may have three phases. Under the hour of the I (palidary) phase of the rush, uplifting, zdiyasnyuyutsya іz trіvaly fast m'yazіv. Phase II (strіarna) is characterized by supermundane strength, handless hands. Phase III (rationalization of rux) is based on stepwise selection of the energy-rational, most efficient (with minimal energy exertion) method of rox under control of measles, which is optimal for this individual.
Rice. 4.1.Extrapyramide system (scheme):
1 - ruhova area of the great brain (fields 4 and 6) zliva; 2 - cortical fibers; 3 - frontal region of the measles of the great brain; 4 - striopalidar fibers; 5 - scale lens; 6 - blue ball; 7 - caudate nucleus; 8 - thalamus; 9 - subthalamic nucleus; 10 - frontal bridge path; 11 - red nuclear thalamic path; 12 - middle brain; 13 - red core; 14 - black speech; 15 - toothed-thalamic path; 16 - toothed-chervo-nuclear path; 17 - upper cerebellar inferior; 18 - brain; 19 - jagged core; 20 - middle cerebellar nizhka; 21 - lower cerebellar nizhka; 22 - olives; 23 - proprioceptive and vestibular information; 24 - pokrishkovo-spinal cerebrospinal, reticular-spinal and chervonuclear-spinal paths
Extrapyramide system
includes the following structures (Fig. 4.1):
Cortex of the pivculus of the great brain (prefrontal ridge of the frontal chasm, hippocampus);
Basal nuclei (caudate nucleus, scapularis, bluda cula, subthalamic nucleus of Lewis);
Stovbur brain (black speech, red kernels, scarf to the middle brain, nuclei of the posterior posterior fascicle of Darkshevich, black plama, reticular formation);
Mozochkov system;
Gamma motor neurons of the spinal cord;
Skhіdnі and vіshіdnі ways.
Afferent pathways from motor measles terminate in the nuclei of the basal nuclei: caudate nucleus, swarthy body, red nucleus, black speech and reticular formation. They cross on the inserts of neurons and through the system of afferent pathways (tecto-rubrospinal, vestibulospinal reticulum) reach the anterior horns of the spinal cord and terminate in alpha-malic and gamma-motoneurons. A part of the afferent pathways reverberate in the thalamus, and through the system of rich canal annular links, the afferent pathways also touch the anterior horns of the spinal cord.
4.1. Budova and functions of striopalidar system
Striopalidar system podіlyaetsya for functional values and morphological features on striatum і palidum (Table 3).
Table 3Functional and morphological features of striatum and palidum
Any other system does not respond to the outer modeling influx of hormones and neurotransmitters, as it is extrapyramidal, since it is functionally not included in the structure of the limbic system. To the very same energetic mood of the people
to lie in the face of emotions, and in case of damage to the pidkirkovykh ganglions, affective disorders appear (violent laughter and crying). Functions of the extrapyramidal system.
1. Regulation of mucosal tone in the complex depends on other structures.
2. Regulation of the tempo, rhythm and plasticity of any kind of sufficient movement.
3. Safety of the rukhovy component in the regulation of insane reflexes (state, defensive, start-reflex, etc.).
4. Safeguarding the sequence of the rukhovy act.
5. Provision of the motor component of the emotional sphere.
6. Regulation of highly specialized human movements, which have reached the level of automatism.
4.2. Syndromes of damage to the striopalidary system
Palidum lesion: palidary syndrome
Symptomocomplex of the disease of bludoї kuli and black speech is called parkinsonism, akinetic-rigid syndrome, amiostatic syndrome, hypertensive-hypokinetic syndrome. Due to the effects of a functional deficiency of dopamine, a change in the infusion of the palidonigral system on the reticular formation and impaired impulses in the cortical-subkirk-Stovburian neuronal colae. The reticular formation is Stovbur's "controller-regulator" for the flow of high and low impulses. When the sound is damaged from the black speech, the passage to the m'yaz of superfluous tonic signals does not pass, due to which the m'yazova rigidity develops, which is supported by an uninterrupted flow of afferent impulses to the striopalidar system. Blame it on a vicious circle: the pallet system was damaged, sending uncontrolled tonic signals that increase the m'azovy tone and strengthen the flow of impulses of the convulsive aferentation.
The main symptoms of infection with coli are:
change of mucosal tone behind the plastic type, the phenomenon of "gear wheel"(opir, which is considered to maintain the tone, growth to the end of the turn), plastic rigidity;
pose of a wax cradle, mannequin - the phenomenon of catalepsy(during the transition, I will become calm at the camp, ailments often catch at an unhanded position);
pose "prohacha" - typical ill-looking look: the coat is slightly bent, the head is heeled forward (Fig. 4.2), the arms are bent
brought to the coat, looking straight ahead, unruly;
oligokinesia- bіdnіst і malovіraznіst ruhіv; hands under an hour of walking are not disturbed, during the day normal physiological synkinesis;
bradykinesia - upovіlnenіst ruhіv; maladies, low-grade, inert, scaly;
parkinsonichne stomping on the mist - the cob of the rukhovogo act is difficult, to the cob of the skin ruh of ailments, the sprat of repeated rukhiv, for example, is rozgoduetsya abo krokuє at home;
Innertial move forward - propulsion, to the side - lateropulsion, back - retropulsion; visions I will become jealous of ailments not
you can disable yoga automatically;
bradilalia - monotonous, calm, quiet language;
bradypsychia- upovіlnennya the pace of thought;
micrography- handwriting is dry, fuzzy;
akairiya- "viscosity" in splintering, whimsicality;
"paradoxical kinesia"- sickness, scho for days to sit at the armchair, at the moment of affective spalah, that emotional strain can vibrate gatherings, stribati, dance;
restful parkinson's tremor: often localized at the fingers of the hand - a phenomenon "rolling piglets", "rahunki coins", head tremor - a phenomenon “so-so, nі-nі, nі-so”; tremtinnya is afraid of the calm and changes when there is enough change;
Positive postural reflexes: Westphal foot phenomenon(with a passive tiled bending of the foot vinikaє tonicne
Rice. 4.2.Pose for parkinsonism
Rice. 4.3.Athetosis of the hand (а-е)
the tension of the rupture of the foot - it catches in the position of the tiled bend) and homolka phenomenon(in a sick person, who lies on his stomach with his legs bent at the knees under a straight kutom, with a distant passive bend, the hominy catches him in the bending position);
Destroyed by the rhythm of sleep-non-sleeping;
Vegetative discord (salne veneer, peeling skins, hypersalivation).
Damage to the swarthy body: striatal syndrome
In case of damage to the striatal system, vinica dystonic-hyperkinetic syndrome, confusion with a deficiency of galmive inflow to the striatum on the lower rukhovy center, after which m'yazova hypotonia and superfluous mimic ruhi (hyperkinesia) develop.
Hyperkinesia- automatic, transcendental movements, in which they take the fate of other parts of the body and kіntsіvki. The stench blames in passing, they know more and more dreams, they grow stronger when there are enough changes and hvilyuvanni.
Athetosis- common, worm-like, chimeric ruhi in the distal tips of the tips (at the hands and feet) [Fig. 4.3]. Athetosis in m'yazah is accompanied by vipinannie lips, twisted mouth, grimacing, clattering tongue. Sound athetosis due to the defeat of the great cells of the striar system. A characteristic sign of yoga is the elimination of minor contractures (spasmus mobilis), like pushing the brushes and fingers is their own position.
Balizm, hemibalism - Great, dispersed, "kidkovi" ruhi kіntsivok. Most often, the balism sticks out in the m'yazіv hands, calling out the roc at the sight of the wave of a bird's wing. Violent ruhi with hemibalism viroblyayutsya with great strength, it is important to pin them down. The blame for hemibalism is attributed to the defeat of the Lewis body, ruffled under the golden mound.
Chorea - shvidkі skorochennya raznyh groups m'yazіv disguise, tuluba and kіntsivok. Hyperkinesia is non-rhythmic, non-coordinated, expands on large areas of distal and proximal fibres. You can make more changes, so that synergies get to the process. The frowning of the brows, the chola, the hanging tongue, the hands, the frowning of the kіntsіvok are pronounced. Hyperkinesis, which suffocates half of the body, is called hemichorrhea. Chorea is blamed for damage to neostriatum and is associated with subcutaneous degeneration, rheumatic brain injury, and Huntington's disease.
In some cases, choreic hyperkinesia is associated with athetosis. (choreoathetosis). Choreoathetosis can be suspected in ailments like a constant, so in those who look attacked - paroxysmal choreoathetosis. A few variants of the family form of paroxysmal choreoathetosis are described.
Distonia - forcible shortening of m'yaziv, which leads to "twisting", bending a part of the body. see spastic torticollis (local dystonia of m'yazіv shiї), when yakіy, the head is turned, and it is healed up to the shoulder (Fig. 4.4). Possibly mimovilni cocked their heads forward or backward. On the cob of illness, the stress of m'yazіv becomes the past, the protege of the year becomes fast, after which the head rests all the time in an unnatural position. Spastic torticollis is often blamed in the cob stages of torsion dystonia as a local manifestation. Torsion dystonia є
4.4. Krivoshia
generalized variant of hyperkinesis. Tulub ruhi has an wrap-around, corkscrew-like character, accompanied by hyperlordosis, scoliosis, and chimerical postures. Torsion dystonia can be caused by various compensatory techniques, for example, when clasping hands around the neck, with a strong turn of the shoulder, etc. See also dystonia of others group m'yazіv.
Letter spasm (graphospasm) - judging by the shortness of the fingers of the brush, which is announced under the hour of the sheet.
Professional judiciary - spasm of m'yazіv, scho in singing professional ruhs. They hang out at the violinists, pianists, guitarists, drukarok just a little.
Facial hemispasm - judge m'yazіv half of the individual, which are periodically repeated, innervated by the facial nerve. Sudomi are accompanied by the appearance of a wrinkle on the forehead, the company is called up in the hill, platysma is strained.
Meige's facial paraspasm - symmetrical judgments of facial m'yaziv, which are periodically repeated. Paraspasm is often blamed for the hour of moving, laughing.
Blepharospasm - the judgment of the speed of the circular m'yaza eye. Clinically, blepharospasm is manifested by frequent migotinny, paroxysmal.
hiccup - clone judgments and diaphragms. Manifested as swarthy thick inhalation, slurred by a pathological process in the shells or speech of the brain, intoxication.
Myoclonus - Shvidky hyperkinesia, which looks like a wince. You can see local myoclonus (for example, kіntsіvki) and generalizations. It is also possible to distinguish non-epileptic myoclonus (hyperkinesis) from epileptic myoclonus.
Tiki - Swedish clonic imitation of a fouled group of m'yaziv, as a rule, of a stereotypical character that imitates quite a lot of ruhi. Most often, they are localized in m'yazakh disguise and appear as swollen wrinkling of the chola, lifting of the brows, blinking, hanging of the tongue. The tick of the deepest m'yazіv is accompanied by a turn of the head, killing, nodding. In children, ticks often develop as if manifesting neurosis as a result of a pathological mental reflex, which is established as inherited by individuals who suffer from hyperkinesias. The tic of the facial musculature can be blamed for trigeminal neuralgia. Tiki can get m'yazi kіntsіvok, tuluba, diaphragms. Particularly occupied by generalizations of impulses
blue tic - de la Tourette's syndrome, with which there are impulses to streak, squat, grimace, vocal phenomena at the sight of grunting, wiggling, wiggling of lily words (coprolalia).
Tremtinnya (tremor) - stereotyped clonal rhythmic hyperkinesia, which is important in the hands, feet; may also be a three-ton coat, a head. Tremtynnya - the oval manifestation of the often invisible shortness of m'yaziv after the damage of segmental and suprasegmental rukhovy structures, ahead of the striopalidary system of the cerebellum. The fluctuation amplitude and frequency, the fluctuation of the other phases can be different depending on the mechanism of vinification. There is a large-scaled, “rubral” tremor, which is due to damage to the vermiform nucleus and suffocates the protractile half of the body. The tremor may be mild, or it may be a sign of a collapse. Intentional tremor sharply increases, or it is blamed for vikonannі tsіlesprjamovavanih ruhіv, zokrema with vikonannі coordinating tests - finger-nose and paw-knee. A static tremor is observed in calm, does not improve with ruptures (navpaki, it can change), it affects parkinsonism.
4.3. The cerebellum and the disorder of the coordination of the hands
The most important rices of the rotational act are the accuracy and the purposefulness of the rotation. The coordinating apparatus for controlling the balance of the body, stabilizing the center of gravity, regulating the activity of m'yaziv-antagonists, which ensures the death, the destruction of that in. trajectory of the turn.
The center of coordination of the ruhіv is the brain, which is made up of two pivkul, a worm and three pairs of lower ones, made up of afferent and afferent cerebellar paths. Also, the coordination of the circulation is ensured by the activity of the cortical centers, the entire extrapyramidal system, the afferent and afferent pathways.
The afferent pathways are direct at the brain to the proprioceptors of the mucous membranes, the vestibular apparatus, the reticular formation and some other organs. Signals of sensitive proprioception are found
into the brain from the nuclei of Gaulle (thin) and Burdakh (wedge-shaped) through the lower cerebellum to the nucleus I will mark my side. All the impulses that come to the brain along the re-opened afferent canals, complete the nuclei of the plaque. Otrimavshi razrіznenu іnformatsiyu z raznyh dzherel, stink її silayut її to kіtin Purkіnє for processing, rozpodіlyayuchi vіdpovidno to somatotopіchnії proektії. In the cortex of the cerebellum, the hands are presented in the anterior cuffs, the legs are in the posterior ones; the bark of the hrobak has a head, a neck (at the front ridges), a trunk (at the back ridges).
Clitini Purkinya translate all the "different voices" signals, which come from the cores of the name, into a single "cerebral tonality". The information that entered the cerebellar cortex is reshaped, encoded in a single "cerebellar" cipher, then it is transmitted to the dentate nuclei, goiter and rozodiliti її і rozіslati in the need for afferent equipment.
Cerebral proprioception is carried out according to posterior and anterior cerebrospinal tracts (Flexiga and Goversa). Impulses from proprioceptors, which signal the position of the body in space, go to spinal nodes, de lie first neurons, the axons of which come through the posterior cortex at the spinal cord. At the base of the posterior horns of the spinal cord and in the middle part of the thyroid gland lie other neurons, in such cases, the dorsal-cerebellar pathways begin. Posterior cerebrospinal tract (Flexiga) pass, without crossing, at the back of the biceps funiculus to the deep brain and at the warehouse lower legs reach the worm's brain. Anterior spinocerebral tract (Goversa) after the transition to the protractile bik, it is roztashovuetsya in the flank cords, ventrally through the bundle of Flexiga, pass the dorsal, middle brain, at the ventral part of the bridge of the brain, it crosses again at the warehouse upper lower straight into the worm of the cerebellum. In this order, the way of Gowers double crosses: at the spinal cord and at the anterior cerebral vitrila.
Ways in the medial vestibular nucleus (Bekhterev's nucleus), nuclei of the reticular formation go up to their side of the lower legs. Inferior olives of the cerebellum are functionally most closely connected with the cerebellum, so the olive-cerebellar pathways, which pass at the lower legs, go directly into the cortex of the cerebellum, passing through the nucleus of the skull.
In this manner:
The main afferent paths go up to the cerebellum, not crossing or crossing the two (way to Govers), zavdyaki
why does the skin pіvkulya cerebellum take information from its half of the body;
The main channel for the supply of afferent signals is the lower cerebellar peduncles (to make the Gowers way to enter the cerebellum along the upper cerebellums);
The main "point of reception" of a bundle of afferent signals is the core of the name.
Special afferent pathways descend to the cerebellum from the measles pivculus of the great cerebellum and are interrupted at the upper nuclei of the pons: in the frontal part - frontopontocerebellar, in the politic and scrone - occipitetemporopontocerebellar. For the help of these passages, the cortex of the great brain, to contribute, scho korigu, to the coordination of changes on the presentation of information, which was in the cortical centrifuge, to the hearing and other organs of the senses. The cortico-cerebellar paths enter at the brain at the warehouse of the middle lower legs, end in the cortex of the cerebellum, passing the nucleus of the skull.
Cortico-cerebellar paths
The six-neuronal path covers the cortex of the great pivculi from the nuclei of the anterior horns of the spinal cord.
First neuronsfrontal path is located at the upper and middle frontal zvivins. The yogo axon passes through the navicular center, the anterior inferior inner capsule, the inner ventral base of the inferior cerebellum and terminates at wet cores bridge your side. First neuron The tiling-covered path is located in the back doors of the folded ridges and the tiled areas of measles. The yogo axon passes through the posterior part of the posterior inferior part of the internal capsule at the outer part of the base of the inferior cerebellum and terminates in wet cores bridge your side.
Other neurons (pontocerebellar pathway) bridle at its nuclei, like axons, crossed forward on the pedestal of the bridge, go at the middle legs to the cerebral cortex. Clitini Purkinje are the third neurons. in such a manner, pivculi of the great cerebellum are connected with the protilegian pivculi of the cerebellum. Dali in the third neuron of the efferent in the measles of the cerebellum impulses to go to the fourth neuron in the jagged nucleus, and then before the fifth neuron in the red nucleus, after some other crossing. Then the axons go down, ending at alpha-malic motor neurons in the anterior horns of the spinal cord (spinal neuron).
Like the dentorubral, so the rubrospinal paths create crossovers (Verneking and Trout), to that, with the damage of the callus of the cerebellum, coordination is blamed on the sides of the fire.
The red kernels give fibers not only to the spinal cord, but even to the thoracic hump, the stars of the impulse come from the striopalidum and the cortex of the great brain. The reverse afferent signals from the striopallidar system pass to the m'ulcers through the rubrospinal, vestibulospinal, tectospinal, reticulospinal pathways, and also through the posterior lateral fasciculus to the m'ulus of the eye.
The cerebellum is connected with the vestibular system and the reticular formation. Ways to the lateral vestibular nucleus (Deiters) and the nucleus of the reticular formation go through the nucleus of the tent of the worm of the cerebellum along the lower legs. Immediately pass the lower path through the cerebellum to the lower olive (div. fig. 1.6 and 4.1).
4.4. Syndromes of damage to the cerebellum and yoga zv'yazkіv
Neurons of the cerebellum of the brain react negatively to the change of the plant or the navkolishny middle. When the cerebellum is weak, it becomes more difficult for new rukhovy novice to learn, and when the known rukhivs are older, the coordination in the kіntsіvkah is only one and the same toluba. Zreshtoy develops ataxia.
The triad of symptoms of cerebrovascular injury includes:
Mozochkovu ataxia (static and dynamic);
M'yazovu atony;
Asinergy.
Also, in case of damage to the cerebellum, it is indicated:
Hypermetry;
miss;
adiadochokinesis;
Intentional tremor;
nystagmus, opsoclonus;
Cool down the movie.
When struck worm'yaka cerebellum synergies are being used to stabilize the center of gravity. As a result of this, a static ataxia on aphids, diffuse malignant hypotonia, is used. Illness to walk, legs wide apart, hitayuchi, which is especially pronounced when turning. Eye control
I do not change ataxia. In case of damage to the anterior part of the worm of the cerebellum, ailments fall forward when standing, when the posterior part of the worm is damaged, backwards, rotten head (Fig. 4.5).
When struck pіvkul cerebellum override the dynamic ataxia of the kinks, the atactic course of the breath in the beat of the affected pivkul, the intentional tremtinnya, miss, hypermetry (Fig. 4.6), nystagmus, adiadochokinesis, asynergy, hypotonia on the sides of the throat, "scanded mova".
Ataxia - tse lack of coordination and pіd hour dovіlnyh ruhіv. Vaughn can appear at the sight of unpretentiousness, inaccuracy and inconsistency. Rukhs are not smooth and are given not to be bound by each other. Ataxia can torment, whether it be parts of the body.
Hand ataxia: when vikonannі ruhіv, shcho vymagayut osobliї retelnostі, tremor appears; miss the target (missing); the accuracy of the repetition of repeated collapses (for example, clapping) is damaged - dysdiadochokinesis.
Ataxia nig calling out the instability of the coat with a tendency to fall. Compensatory develops its own move, which predicts the move of the “p'yany”, with a yakіy stop, it should be placed wider for a step between the quilts.
Ruined jealousy they appear as spontaneous falls: otherwise, for changing the flow directly, you call the mail.
Rice. 4.5.Romberg's position showing static ataxia
Rice. 4.6.Finger-nose test for the detection of dynamic ataxia
Ataxia of the moving apparatus manifested by "my chanting". With this, the voice becomes monotonous, often accompanied by the sounds of sighing, at an infinite pace with pauses between warehouses.
Ataxia of the eyes characterized by the presence of swedish rukhivs with a stiffness behind the singing object - nystagmus. With respect, you can mark the “missing eye”, if the object is used on the eye, and then “fuck”.
Damage to the river when standing and walking is called static locomotor ataxia, disrupted coordination of rukhovyh aktiv - dynamic ataxia.
You can see a sprat of ataxia fallow in the topography of the cavity.
Sensitive ataxia. Blame in case of damage to the posterior cords of the spinal cord and other branches, where to pass the paths of deep sensitivity. A great compensating role is played by the control of the dawn over the position of the body: like only ailments, they flatten their eyes, they start to hit and can fall. Stamping move.
At vestibular ataxia damaged jealousy is accompanied by confusion, boredom, vomiting.
At damage to the cerebellum (especially hrobak) blame the gross damage to statics. In most cases of ailment, it is impossible to sit or stand with wide-set legs, move forward or backward. In case of damage, the cornea of the cerebellum ventilates more in the area of the follicle of the wound. On the view of spinal ataxia in case of cerebellar ataxia help control the gap. A ailing jealous man breaks down like when he is crying, so when his eyes are closed.
At measles infection pivkul the great brain(forehead, skronevyh, potilichnyh chasms) also develop static damage. When measles is attacked, the disease in Romberg's position is not stable, with a tendency to fall in the middle of the middle of the bed. Cortical ataxia obov'yazkovo accompanied by peculiarities of behavior, for example, "frontal psyche". The extreme stage of Kirk's ataxia is called astasia-abasia- ailments not able to take a vertical pose through the introversion of the navvychki to empathize in space.
Cerebral discords are accompanied m'yazovaya hypotension: m'yazi v'yali, mlyavi, obsyag ruhіv in the swamps zbіlsheno.
The disrupted coordination of the activity of other peoples or groups that take the fate of this Russia is called asynergy. For example, an ailment cannot lift the crustaceans through the impossibility to clearly coordinate the movements of the contralateral arms and legs;
Mova ailments spend smoothness, become uplifted, scanned, torn in warehouses, ailments speak with visible noises, loudly in skin warehouses (damaged coordination of the disruption of the speech motor apparatus - cerebrodysarthria).
nystagmus (rhythmical smirking of ophthalmic apples) in case of damage to the cerebellum of large-scaled, shvidka, the phase of yogo is straightened at the back of the fossa. The nystagmus increases when looking at the beak of the fire, and it changes when the eyes are flattened, more often it becomes horizontal; It is seen when the cerebellum is injured as an intentional tremor of the ophthalmic apples.
Opsoclonus - ruhovy discord, which is characterized by chaotic ruhs of the eyes, often accompanied by frizzy breeches.
It is also characteristic handwriting disorder. As a result, the broken coordination of thin fluctuations in the handwriting becomes uneven, the letters become too great (Megalography).
