The trapezium-like body is composed of axons of other auditory sensory neurons and their nuclei. Posterior brain (metencephalon)
Dah
Lower brain window – lacerations between the lower cerebellum, which is a neuroepithelial plate, in a vascular plexus of the IV ductus. May three open: at the bottom in the middle - Mazhandi; lateral to the beast - 2 open Lushtsi. Through them, you can see the emptying of the fourth slug from the subarachnoid space of the brain.
2. Tire I fix the bottom of the IV tube
Nuclei of the cranial nerves:
1. sensory (sensitive) - blurry (X), lingo-pharyngeal (IX), tripartite (V);
2. rukhovi - sublingual (XII), appendage (XI), blurry (X), lingo-pharyngeal (IX);
3. vegetative - parasympathetic blubbering (X) and tongue-pharyngeal (IX).
Nuclear complex olivi to be brought to the extrapyramidal system and to the suburban center of vestibular functions.
Nucleus of a thin beam (Gaulle) - approved by the bodies of associative neurons.
The nucleus of the wedge-shaped bundle (Burdakh) - approved by the bodies of associative neurons.
Kernels of the reticular formation є insertion neurons of the stovbur and form the dichal and vascular-rukhovy center.
Vegetative centers : herbal, wheeze, vomit, cough.
passage ways vulgar sensibility; the stench establishes a medial (sensitive) loop behind the help of axons of other neurons of the nuclei of Gaulle and Burdach, as if to pass to the right side of the dovetail brain and then cross over. The fibers of the spinal loop of the spinal cord are attached to it, which carry tactile, temperature and pain sensitivity.
↓ guideways: rubro-spinal, tecto-spinal, reticulo-spinal.
3. Support- represented by pyramids
↓through the roads - from measles to the biceps and anterior cords of the spinal cord (svіdome control of the hands).
The dorsal brain has two crossings: the ventral rukhovy and the dorsal sensitive.
2. Varoliev city(Mist brain, mist). A white tovsty roller with a length of 25-27 cm. On the cordon between the bridge and the dovgastim brain, there are places for the exits of the extrinsic (VI pair), facial (VII pair), and anterior-rheumatic (VIII pair) nerve. They distinguish: the front part of the bridge, which lies up to the skull of the skull, the back part, as if it is brutalized to the cerebellum. Between the ventral and dorsal parts of the bridge (between the cover and the base), the shackle is 2-3 mm wide. trapezium-like body. There are fibers of the ventral and dorsal auditory nuclei passing through them. On the front part of the bridge there is a basilar sulcus, in which the basilar artery is pierced. From the side of the mist to pass to the right and the left of the middle lower part of the cerebellum. The stinks pass nerve fibers from the pons to the brain. The posterior part of the bridge covers the upper half of the rhomboid fossa. The place of the newborn lies 5 mm higher behind the back of the Turkish saddle. Up to 2-3 rokiv veins fall on the skull of the skull. The fibers of the bridge are mielinizuyutsya up to 8 years.
1. Dah adorned with an upper cerebellar veil, stretched between the upper cerebellar pedicles.
2. Tireє prodovzhennyam dovgastogo mozku
Nuclei
cranial nerves: tripartite (V), which leads (VI) and facial (VII).
Outgrowths of other neurons of the sensitive nucleus of the trigeminal nerve
establish a tripartite (trigeminal) loop.
Nuclei anterior ravine nerve (VIII). The fibers of the neurons of these nuclei form a lateral loop, the fibers of which go to the middle and crotch.
Upper olive core (Parnet).
Nuclei reticular formation.
To lead the paths of wild sensitivity. Growths of other neurons.
↓ Hearing 3. podstava
* ↓ Move through the roads - pyramids.
* ↓ Cork-bridge and bridge-cerebellar paths.
* Power core bridge. Є promizhnoy lankoy zv'yazku measles z
cerebellum. Fibers that go through these nuclei, intersect and go
warehouses of the middle lower cerebellum, after which the skin pivkula of measles is injected into the work of the contralateral half of the cerebellum.
Respect! The fibers of the spinal (exteroceptive sensitivity), medial (proprioceptive sensitivity) and tripartite loops (sensory path in the head) are united in the lemniscus passage, as if they carry sensory information to the perineal brain and far into the cortex.
IV tube to the brain. Roztashovuєtsya in front - mizh dovgastim brain and
bridge, zzadu - mizh dovgastim brain and brain.
The bottom of the shlunochka is a rhomboid fossa, as if it was covered with the posterior part of the bridge and the upper part of the domed brain.
Utvorennya rhomboid fossa in the process of ontogeny: the brain tube at the transition to the pregastric brain curves on the back side and folds into the rhomboid fossa. In this case, the nuclei of the posterior horns of the spinal cord are projected laterally in the fossa, the nuclei of the anterior horns are projected medially, and the vegetative nuclei of the calf horns are projected between them.
Projection of nuclei on a rhomboid fossa:
1. somatically sensitive - laterally;
2. somatic-ruhovі - medially;
3. vegetative - between sensitive and ruddy.
Dakh shlunochka maє the shape of a baton and folded from two plates - the upper and lower brain vitrila. The lower vein of the brain veiled with a leaf of the vessel tunic of the brain, as if with its villus growths it made the vessel gossip of the IV slug. At the posterior inferior duct, the duct is connected to the central canal of the spinal cord, at the anterior superior duct of the veins, it is connected to the III duct for the auxiliary sylvian water supply, and after three open the lower cerebral vitril - from the subarachnoid expanse of the brain.
3. Middle brain. The middle brain is the upper part of the brain stovbur. Vіn є the smallest part of the brain and is formed from the upper dorsal and lower ventral parts. The dorsal part is represented by the dach of the middle brain - the scarf of chotirigorbi. The ventral part is covered with the lower parts of the brain. The empty middle brain is the sylvian water supply - a narrow canal with a length of 1.5-2 cm;
Dah the middle brain - the plate of the quadrigemina - is adorned with two upper humps, which are the podkirk centers of the dawn, and two lower humps, which are the podkirk centers of hearing. Between the upper humps there is a cone-like ridge - epiphysis. From the upper hump, the upper handles enter, yak go to the lateral collinar parts of the body of the crotch. The lower handles go through the lower hump, yak go to the medial columns of the bodies of the crotch. In the middle of the middle brain, two bridles stretch up to the upper cerebral vitrila.
Ventral part - lower brain - walk along the edge of the bridge under the hood and burrow into the tomb of the great brain. The stench may look like tovstih tyazhіv. Mіzh nizhkami є mіzhnіzhkova fossa, the bottom of which is made posterior. perforated speech.
Functions of the middle brain. The middle brain is the primary visual and auditory center, which is responsible for reflex reactions (defensive and orienting). In addition, the red kernels and the black substance are the nuclei, which control the tone of the muscles and the movement.
Inner midbrain. On the transverse section of the middle brain, three lines are seen:
1. Dah- platіvka chotiricholmіya
the first Pidkirkovy center zoru
(upper humps) - wink
the function of reflex centers, which determine the position of the head and
an eye on the eye of the dawn and hearing rozdratuvannya;
the main center for hearing
(lower humps) - stacked from three cores:
two of them transmit information in the medial part of the body, that one
ensures acoustic-ruhovu reaction.
2. Tire- upper vein of the lower brain
Chervone core
- roztashovuetsya between black substance and central
with a gray speech - it is composed of clitin
extrapyramidal system, fibers like measles, thalamus and
cerebellum (Monakiv] way to
cletin of the anterior horns of the spinal cord;
Central syra speech
, roztashovane near the water supply, in the yakoma
perebuvayut below the core;
Nuclei of the parotid nerve
(III pair): rukhove somatic,
vegetatively parasympathetic (Yakubovich), central unpaired
(Perlia);
Core trochlear nerve (IV pair) - rukhove;
Kernels of the reticular formation
: intermediate core (Cajal) - take the fate of
zdіisnennі povіlnyh wrapping and vertical ruhіv ochnіv
apple, nucleus of the posterior commissure of the brain (Darkshevich) - functions themselves;
Core mid-cerebral pathway of the ternary nerve (V pair);
Pass the path of the auditory analyzer (lateral loop) - to be formed
at the bridge, it carried impulses from the auditory nuclei of the opposite side;
The bulbar-thalamic pathway (medial loop) is formed into
dovegasty brain and carry impulses of the same proprioceptive and
tactile sensitivity in the area of the tunic and tips
opposite side;
dorsal-thalamic path (spinal loop) carried pain impulses,
temperature and tactile sensitivity to the opposite side
Tuluba and kіntsіvok;
Nuclear-thalamic (three-part loop) carrying impulses of all types
sensitivity in the area of the head, chastkovo, shii;
Anterior spinocerebellar tract (Govers bundle) - is formed in
spinal cord and carry impulses of unknown proprioceptive
sensibility, partly in their own way, partly - in the same way
sides;
Medial posterior bundle - formed in the nuclei of Cajal and
Darkshevich. Ensures the turn of the head and the eyes and the sound of the tongue
integrative nuclei of the reticular formation and rumen nuclei III, IV, VI
і XI (ochirukhovy, trochlear, extrinsic, appendage) pairs of craniocerebral nerves, as well as vestibular nuclei of VIII pairs of cranial nerves (anterior-rural);
↓ pokryshkovo-spinal path - formed in the upper hump
of the middle brain, making dorsal crossroads of the covering (Meinert) that
ensure safe reactions to non-teasing (zahisnі
reactions);
↓ chervonuclear-spinal tract (Monakova) starts in the middle brain
in the neurons of the red nuclei, establishing the ventral crossroads of the lining
(trout)
pіdtrimannya tone m'yazіv;
↓ the reticulospinal tract begins in the clitin of the reticular formation of the perineum.
Respect! Mіzh pokrishkoy that basis є between the black speech - Semmering's speech, as a way to avenge melanin in their clitins and functionally be brought to the extrapyramidal system.
3. Basis of the lower brain- the cores were spared and made by the lower ones from the measles of the great pіvkul pіvkul pіrіmіdnymi eferentniy provіdnye ways:
↓ frontal bridge path;
↓ tile-skronevo-tim'yano-pavement path;
↓ Kirk-spinal path;
↓ Kirk-nuclear way.
Mist, pons, along the ventral part of the posterior cerebellum, to enter the stovbur storehouse of the cerebellum and is a great white rampart that lies in the center of the base of the cerebellum.
head brain, encephalon, right half; medial surfaces.
Front Vіn sharply vіdmezhovany vіd lower brain, behind- looking at a long brain for help bulbar-bridge furrow, sulcus bulbopontinus.
Lateral cordon respect the bridge later line, carried out through the junction of the exit of the corinth of the tricuspid nerve (V pair of cranial nerves) and facial nerve (VII pair of cranial nerves).
Nazovnі vіd tsієї linії roztashovuєtsya middle cerebellar nizhka, pedunculus cerebellaris medius (pontinus). In this manner, the place of the cerebellum will protect the rights and the lions of the middle cerebellum.
Roztashovuyuchis on the slope of the base of the skull, mist may be slanted straight ahead, the veins of which in the new one are cut two surfaces - anterior and posterior.
front surface lie on pedestal skulls, but rear I take a part in the settled forefront rhomboid fossa, fossa rhomboidea.
Rhomboid fossa.
On the bulging anterior surface of the bridge, along the middle line, there is a lateness. basilar furrow, sulcus basilaris, in which lies the basilar artery. On the offending sides of the furrows, two good turns of the late pyramidal days protrude, in which the pyramidal paths pass.
On this surface of the bridge, there is a clearly marked transverse swarthyness, which is bound to strike straight into it with bundles of nerve fibers.
Dovgy brain, medulla oblongata, place, pons, that lower brain, pedunculi cerebri; looking in front.
On the openings of the bridge, carried out at the frontal plane of the different rivers, it is possible to grind the bundles of nerve fibers and the bundle of gray speech (nerve cells).
Tovshu to bridge on the larger massive front (basilar) part of the bridge, pars ventralis (basilaris) pontis, and more thin rear part (bridge tire), pars dorsalis pontis (tegmentum pontis).
There are more nerve fibers at the anterior part, more nerve fibers at the lower part, at the same time at the posterior part there are more nerve fibers.
IN front part of the bridge in front of the posterior pyramidal bundles, the surface fibers are ruffled, which go transversely, yak in the union upper beam of the bridge. More dorsally between the pyramidal bundles go transverse fibers, which are straight to the posterior branches of the middle cerebellar peduncle; stench satisfies the lower beam of the bridge.
Like the surface, so the deep fibers lie down to the system of transverse fibers of the bridge, fibrae pontis transversae. The stench is made up of superficial balls of fibers - the surface ball and the deep ball of the middle cerebellar pedicles and stow the brain and brain between themselves. Transverse bundles intersect along the middle line. Closer to the lateral surface of the base of the bridge, pass arcuately bulging called the oblique, or middle, bundle of the bridge, the fibers of which are straight up to the exit point of the facial and anterior-rural nerves.
Between the transverse bundles of the bridge, and medially of the oblique bundle, the medial and lower posterior fibers of the bridge are spread, fibrae pontis longitudinales, what lies before the system of pyramidal paths. The stench begins in the clitin of the measles of the great pivculus of the brain, pass at the inner capsule, at the lower brain and through the mist follow to the deep brain at the warehouse of the cortical-nuclear fibers, fibrae corticonucleares, and in the warehouse of cortical-spinal cord fibers, fibrae corticospinales,- To the spinal cord.
Mist, pons.
At the comrade's front part of the bridge there are small piles of gray speech. nuclei to the bridge, nuclei pontis. On the clitins of these nuclei, fibers terminate, which originate from the clitins of the measles pivculus of the great brain and took away the name of the cortical-bridge fibers, fibrae corticopontinae.
Vіd tsikh kіtin take a cob of fiber that intersects with the same fibers of the protilagus side, satisfying the cerebellopontine fibers, fibrae pontocerebellares, to go to the warehouse of the middle cerebellar pedicle to the measles of the cerebellum.
On the level of the cordon between the front and rear parts of the bridge a bunch of transverse fibers is spread out, which is so called trapezium-like body, corpus trapezoideum. Qi fibers, starting from the clitin of the anterior rheumatic nucleus, nucleus cochlearis ventralis (anterior), often reach the clitinum of the anterior nucleus of the trapezoid body, nucleus ventralis (anterior) corporis trapezoidei, yakі rozsіyanі mizh fibers trapezієpodіbіbіbі tіl, and chastkovuyutsya in kіtiny posterior nucleus trapієіbіbіbіbіbіbіb, nucleus dorsalis (posterior) corporis trapezoidei .
Obidvi groups of fibers, switching at the designated nuclei, continue further into the bundle of the lateral loop, lemniscus lateralis, e those sides. Most of the fibers of the trapezium-like body pass to the proliferative bik and reach the cells of the nucleus of the lateral loop, Nucleus lemnisci lateralis .
On the entire stretch of the tire bridge, a reticular formation is prostzhuetsya, formatio reticularis, yak, without a clear boundary, to pass at the reticular formation of the dovegast and middle brain.
The central shearing of the speech of the bridge lining, densities of clusters of reticular neurons and their growths, is signified as bridge seam, raphe pontis.
At the lateral ridge of the reticular formation, the upper olive core, nucleus olivaris rostralis (superioris).
The medial nucleus of the nucleus is found trapezium-like body, lower - complex lower olive kernels.
At the posterior part of the bridge, there are stitches from the middle brain medial and posterior posterior bundles, as well as vishіdnі fibers, which pass from the dovetail brain
Lie down right here nuclei V, VI and VII pairs cranial nerves.
Behind the rear edge of the bridge go more medially facial nerve, and laterally for the new one - anterior ravine nerve. Between them lies a thin trunk of the intermediary nerve.
TRAPEZIUM-SHAPED TILO
(corpus trapezoideum, pna, bna; corpus trapezoides, jna) a flat bundle of fibers of the auditory path, which runs transversely, is spread between the upper and lower parts of the bridge of the brain (varoline bridge).
Medical terms 2012
Marvel at the darkness, synonyms, the meaning of the word that such a TRAPEZIA-VIEW TYLO in Russian language in dictionaries, encyclopedias and docs:
- TILO
Tsibulya - div. - TILO in the Illustrated Encyclopedia
SHUTTER - div. - TILO Slang vocabulary of Sevastopol:
1. A drink for a person 2. A figure skater who takes a sleepy bath on ... - TILO in the Glossary of Analytical Psychology:
(Body; Kava) - material substance of an individual. The body was viewed by Jung as a vision of the "physical materiality of the psychic" (CW 9, par. 392). Those who died... - TILO in the Glossary of Postmodernism:
- the term of traditional aesthetic and socio-humanitarian knowledge (div. also Telesnist), which acquires an immanent categorical status in the conceptual complex of philosophy of postmodernism. At… - TILO in the Glossary of Yoga:
(Body) Div. Deha; Sharira; Upadhi; Physical body; Tonke Tilo; Karana Sharira ... - TILO Glossary of economic terms:
(slang.) - power, which is in the hands of pikluvalnikov, the main sum or ... - TILO in medical terms:
- div. Phone... - TILO in the Encyclopedic Dictionary:
, -A, pl. tіla, tіl, tіlam, povn. 1. An okremy object near the space, as well as a part of the space, filled with matter, somehow. speech ... - TILO
DAM BODY, osn. part of the rowing (without additional attachments - dejection, water breakage, screen and in.), which takes the onslaught. - TILO from the Great Russian Encyclopedic Dictionary:
The BODY is more geometric, whether it is surrounded by a part in space at once from її cordon (for example, a ball, ... - TILO in the new accentuated paradigm of Zaliznyak:
tі"lo, tila", tі"la, tі"l, tі"lu, tila"m, tі"lo, tila", tі"scrap, tila"mі, tі"le, ... - TILO at the Dictionary of Epithets:
Tulub, human body. About size, size, severity; about the strong, the string, or the weak, the good body; about the camp of the body. Athletic, powerless, richer, ... - TILO at the Glossary of the Russian Language of Business Interpretation:
Rostelecom. (Glossary of good names - name ... - TILO at the Popular Tlumach-encyclopedic dictionary of Russian language:
-a, pl. tel "a, tel, tel" am, s. 1) It is material, speech, visible and intelligible, that it occupies space; okremy object in space. … - TILO the dictionary for solving that folding of scanwords:
Hmara in… - TILO at the Glossary of synonyms of Abramov:
|| trim at the black body, dead body, acquire a body, not guilty neither in soul nor body, sleep from the body, soak up to ... - TILO at the vocabulary of Synonyms in Russian:
aloplant, apothecium, bismalite, harpolit, dike, diapir, intrusive, cleistocarp, comet, cone, body, laccolic, lopolit, lofolite, macrothylo, microtylo, organism, remains, perithecium, pycnid, … - TILO at the New Tlumach-Slovovar lexicon of the Russian Efremova:
since. 1) a) An okremic object in space. b) Part of the open space, surrounded by a closed surface. c) Speech, which is characterized by the songfulness of power; chemical … - TILO at the New Spelling Dictionary of Russian Language:
body, -a, pl. tіla, tіl, ... - TILO in the spelling dictionary:
body, -a, pl. tіla, tіl, ... - TILO at the Glossary of Russian language Ozhegov:
! okremy object near the expanse of Solid, rare and gas-like bodies. Geometrically p. tіlo - a small object in space, as well as a part ... - TILO in the Daily Tlumach Dictionary, BSE:
more geometrically, whether a part of the space is surrounded by a cordon at once (for example, a ball, ... - TILO at Tlumach's dictionary of Russian Ushakov:
tila, rich. tіla, tіl, tіlam (por. telesu), por. 1. Obmezheniya prostir, zapovneniy yaki-n matter, speech (physical). Usi tila dilates on… - TILO at Tlumach's vocabulary of Efremova:
body-porn. 1) a) An okremic object in space. b) Part of the open space, surrounded by a closed surface. c) Speech, which is characterized by the songfulness of power; … - TILO at the New vocabulary of Ephraim:
since. 1. An okremy object in space. ott. Part of the space is surrounded by a closed surface. ott. Speech, which is characterized by the songfulness of power; chemical element. … - TILO at the Great Modern Tlumach Dictionary of Russian Language:
I povn. 1. An okremy object in space. ott. switch The main part, the hull of a chogos (ship, aircraft, artillery armor, machine gun that ... - EUCHARISTIC PROPOSITION from the Orthodox Encyclopedia Tree:
Opened Orthodox Encyclopedia "DREVO". If I smell a riddle about the Body of Christ, I will understand what was said in one sense, but the unbelieving - ... - LATERAL LOOP in medical terms:
(lemniscus lateralis, pna, bna, jna; syn. auditory loop) congestion of fibers of other neurons in the auditory pathway, yakі, beginning in the nuclei of the ravic part. - ROD from the Great Encyclopedic Dictionary:
Dovgomirniy metalevy napіvfabrikat - zagotіvlya for otrimannya parts by methods of plastic deformation or processing of cut. The peretin of the rod is round (mostly), six-cut, ...
10.1. MIST BRAIN
Mist brain (pons cerebri, varolievy mist) - a part of the brain stovbur, stashed between dovgastim and the middle brain. The mist of the brain can be seen as a direct continuation of a long brain. If, according to the old age, the insults of the brain stovbur were approximately equal, then the tovshchina of the bridge of the brain is significantly greater, the head rank for the rahunok of the sweating of the yogo foundation.
At the base of the bridge, the pyramidal and cortical-nuclear pathways, there are numerical cortical-bridge fibers that go to the pink bridge between the conductive pathways of the wet cores of the bridge of the brain, which are located right there. The crim tsikh podovzhno roztashovannykh provіdnіv, on pіdstavі bridge of the brain there is a large number of transverse fibers, which are the axons of the cells of the upper nuclei of the bridge. Qi fibers, which form the bridge of the cerebellum, cross the posterior conductors, rozsharovayuchi with this bunch of bundles on the numerical group, move to the protractor bіk and form the middle cerebellar nizhka, so that the bridge of the brain is less than the brain between, to pass through the mіstsya out of the bridge. Cortical-pontine and pontine-cerebellar fibers form cortical-pontine-cerebellar ducts. The presence in the basis of the pons is numerical, which goes near the transverse straight line of the cerebellar pontine fibers, which means the transverse swag of the basal surface.
From the ventral side of the brain, there is a transverse bulbar-bridge furrow, from which the roots of the VIII, VII and VI cranial nerves emerge. The posterior surface of the bridge is covered with the head rank of the upper tricutnik of the rhomboid fossa, which forms the bottom of the IV brain stem.
At the flanks of the rhomboid fossa there are auditory fields (areae acustici), yakі vіdpovіdat mіstsyu rastashuvannya nuclei VIII cranial nerve (n. vestibulocochlearis). The auditory field is located on the sticky medulla and the pons, and the nuclei of the VIII cranial nerve often go into the speech of the ovary medulla. In the auditory field, the nucleus of the auditory portion of the VIII cranial nerve is occupied by the lateral ventricles of the rhomboid fossa - this is the name of the biceps vivorit of the IV duct of the brain, between which the so-called hearing aids (striae acustici) pass in a transverse straight line. The medial parts of the auditory fields serve to stimulate the growth of the vestibular nuclei.
On the sides, in the middle furrow, which passes through the upper tricot of the rhomboid fossa, it is ruffled with a vignette (eminentia
medialis). At the lower part of the subdivision, the subdivision divides downward into two ventrals, the outer one of which induces the expansion of the nucleus to the nerve, which is to be injected. Lateral for the middle third eminentia medialis, on the day of the fourth slug, a small burying is visible. fovea Superior, under which the rukhova nucleus of the trichamoidal nerve is roztashovuetsya. In front of this burial, at the upper part of the rhomboid fossa on the sides of the middle line, one can see patches of brain tissue, puffed in gray with a bluish color due to the presence of crowding here of brightly pigmented cells - blakytne mysce (Locus ceruleus).
For a better overview of the future bridge, it is possible to separate yoga into three parts: the lower part, which avenges the nuclei VIII, VII and VI of the cranial nerves, the middle one, in which two of the three nuclei of the V cranial nerve are localized, and the upper part, which is the crossing the bridge near the middle brain and the title of other brain isthmus (Istmus cerebri).
At the same time, that the foundation of the bridge on all equals may be more or less identical to the future and the main reports about it were already published, more respect will be attached to the head rank of the lower equals of the bridge.
Lower part of the bridge. At the lower part of the pons (Fig. 10.1), on the border between the thorax and the base, there is an extension of the medial loop, which is formed from the axons of other neurons, which runs straight to the thalamus.
Rice. 10.1.Zrіz on mezhі dovgastogo mozku that bridge.
1 - medial posterior bundle; 2 - medial loop; 3 - the core of the nerve, what to enter; 4 - vestibular nerves; 5 - lower cerebellar nizhka; 6 - the nucleus of the lower core of the V cranial nerve; 7 - nuclei of the auditory nerve; 8 - the nucleus of the facial nerve; 9 - anterior spinocerebellar pathway; 10 - lower olive; 11 - cortico-spinal (pyramid) path; VI - nerve to enter; VII - facial nerve; VIII - vestibulocochlear nerve; 13 - Kirk-spinal (pyramid) path.
vestments. The medial loop is intertwined with fibers of a trapezoidal body, which runs in a straight line at the transverse one. (corpus trapezoideum), what is brought to the auditory analyzer system. Along the course of these fibers, there are small clusters of gray speech - the so-called hairy nuclei of the trapezoid body (Nuclei corporis trapezoidei). They, as well as the ruffles on the sides of the medial loop, have a bunch of gray speech, leading like the lower olives (olivae inferior), the axons of other neurons of the auditory pathways terminate. The axons, which enter into the body, spread out in the overburdened structures of the third neurons, form a lateral, or auditory, loop, which is called the medial loop, which takes the lateral direct and reaches the sub-auditory centers.
Outwardly and dorsally, in the inferior oliviformation of the fibers of the spinal tract of the trigeminal (V cranial) nerve and the isolated clitinum of the univariate nucleus, also known as the nucleus of the spinal pathway (lower nucleus) of the trichaminal nerve. More than resurfacing, the reticular formation is rotting, that is the central syra of the speech, which lay the bottom of the IV duct. At the bottom of the sides, in the middle line, the stitching nucleus of the VI cranial nerve. Nuclei of the facial (VII) nerve be found at the depth of the reticular formation. The axons of their motor clitins (the roots of the facial nerve) ascend to the top of the head, go around the nucleus of the VI cranial nerve, then, going along the suture to the root of the VI cranial nerve, straight down, to the posterior part of the basal surface of the bridge and fill the stovbur of the brain, passing from furrows that strengthen the basal surface of the pons and dovetail brain.
The upper lateral ridges of the lower part of the tread of the bridge and the upper treads of the tread of the medulla hearing field, in which there are rumors and vestibular nuclei, which lie up to the system of the VIII cranial nerve. The auditory nuclei are located in a part of the auditory field, the rhomboid fossa, which lies down to the lower cerebellar peduncle, which extends on the dorsal surface. One of the auditory nuclei - anterior (dorsal) nucleus, or the nucleus of the auditory hump, spread out on the posterior-lateral surface of the lower cerebellar peduncle, and otherwise - posterior (ventral) nucleus - in the area of the transition of the lower cerebellar foot into the brain. In these nuclei, the axons of the first neurons terminate and the bodies of other neurons of the auditory pathways terminate.
The vestibular nuclei are spread under the bottom of the lateral opening of the IV duct. There are more and more lateral nuclei superior vestibular nucleus (core Bekhterev), in which the viscous part of the vestibular portion of the VIII cranial nerve ends. Posterior of Bechterew's nucleus is localized with great clitinum lateral vestibular nucleus (Vestibular nucleus Deiters), gives the cob to the vestibulospinal tract, and medially - medial, or tricot core (core Schwalbe), which occupies the zone of the auditory field. Inferior vestibular nucleus (core Roller) rostashovane lower in the part of the rhomboid fossa, which extends to the deep brain.
The middle part of the bridge. The middle part of the tire to the bridge (Fig. 10.2) ruhove core (nucl. motorius nervi trigemini) that brukivka(nucl. pontinus nervi trigemini), or the upper sensitive nucleus of the V cranial nerve (the nucleus of the middle brain pathway of the trigeminal nerve), which is composed of other neurons of the pathway in deep and tactile sensitivity. The core of the core is stashed in the depths of the lateral part of the tread, between the upper and middle thirds of the bridge, and the core of the core lies ventral behind the sensitive.
Rice. 10.2.Zrіz on the equal middle third of the bridge.
1 - medial posterior bundle; 2 - medial loop; 3 - rukhove nucleus of the V nerve; 4 - the terminal nucleus of the ternary nerve (the nucleus of deep sensitivity); 5 - lateral (auditory) loop; 6 - corticospinal (pyramid) path; V - tripartite nerve.
On the border between the pokryshkoy and the foundation of the bridge to pass vishіdnі fibers, scho to form the medial and lateral loops. The posterior posterior and pokryshkovo-spinal paths, like on the lower lines of the bridge and the dovetail brain, lie under the bottom of the IV duct, near the middle line.
Reshtu covering the bridge is mainly occupied by the reticular formation, which has increased in obsyazy.
Upper part of the bridge. On the same line IV, the tubes already sound significantly (Fig. 10.3). Dah yoga is stored here the anterior cerebellar vein, in the yakoma, the cream, to pass to the protractile bik of the anterior spinal cerebellar vein of Gowers, to pass through the fibers of the IV cranial nerve, which crosses. The volume of the covering of the bridge changes, and at the same time the foundation reaches the greatest development, in the pyramidal paths, which descend later, they appear to be divided into different bundles by the number of transverse fibers, which do not straighten in the middle cerebellar tsey zrіz, more to go to them fibers zvіdsi dosit abruptly turn back. On the change of the middle cerebellar peduncles on this view, the upper cerebellar pedicles pass, which surround the upper tricot of the rhomboid fossa and straight uphill and medially. Zanuryuyuchis coal of the bridge's roof, the upper cerebellar nizhki on the same level begin to establish a crossroads.
On the cordon between the cover and the foundation of the bridge, yak and on the earlier razglyany rivnyah, raztashovanі medial and lateral loops, yakі here
Rice. 10.3.Zrіz less on the level of the upper third of the bridge.
1 - upper lower cerebellum; 2 - medial posterior bundle; 3 - lateral loop; 4 - medial loop; 5 - Kirk-spinal (pyramid) path; IV - trochlear nerve.
pochayut disperse ubik. At the bottom of the rhomboid fossa, on the same line of the stovbur, there is a pigmented plot. blakitne mіstse (locus ceruleus), zvnі vіd new to know the core of the mid-brain pathway of the triacicular nerve. Reshta covers the bridge reticular formation and in transit, to pass through the city, to lead the way.
10.2. SKULLS NERVE BRIDGE
10.2.1. Anterior door-raw (VIII) nerve (n. vestibulocochlearis)
The anterior-rural nerve is sensitive. Vіn to carry out impulses from receptors, rotting at the folded lining of the natural structure, which is called a labyrinth, as it is located in the stony part of the skeletal cyst. Before the warehouse of the labyrinth enters the ravlik, which avenges the auditory receptors, and the vestibular apparatus, which provides information about the severity of severity and severity, about the collapse of the head, about the orientation in space. The VIII cranial nerve, in this order, is composed of two different parts for the function of either portions: auditory (cochlear, ravic) and vestibular (anterior), as a whole they can be seen
Rice. 10.4.Anterior-doorway (VIII) nerve.
1 - olivi; 2 - trapezium-like body; 3 - vestibular nuclei; 4 - posterior ravlik nucleus; 5 - anterior ravlik nucleus; 6 - front door root; 7 - ravel root; 8 - internal auditory opening; 9 - intermediate nerve; 10 - facial nerve; 11 - vuzol kolina; 12 - ravlik part; 13 - front door part; 14 - front door vuzol; 15 - anterior transverse ampoule; 16 - lateral transverse ampulla; 17 - elliptical small bag; 18 - posterior transverse ampoule; 19 - spherical bag; 20 - ravlik duct.
as a peripheral sensor of independent (auditory and vestibular) systems (Fig. 10.4).
10.2.1.1. hearing system
Together with concentrating (sounding wuho) and sound-transmitting (middle wuho) solutions cochlear part of the internal ear (ravlika) in the process of evolution, she has developed a high sensitivity to sound imitations, which is similar to the sounds. People of the young viku in normal conditions, the auditory analyzer is sensitive to noise in the range of 20 to 20,000 Hz, and the maximum sensitivity is recorded at frequencies close to 2000 Hz. In this way, the ear of a person perceives sounds in a wide range of intensity without saturation or overwhelming. In the middle frequency smoothness, the sound can be more pronounced in the higher case, if the energy exceeds the threshold by 10 12 times. sound intensity, which induces energetic blue infusion of sound waves on the structure of the hearing aid, decibels (dB) are measured. In normal minds, a person can be able to change the intensity of the tone, which sounds continuously, by 1 dB. The frequency of the sound whistle determines the tone of the sound, and the shape of the sound whistle determines yoga timbre. Cream of intensity, height and timbre of sounds, people can signify straight їх dzherel, This function is secure zavdyaki binauralnosti accept sound signals
The sounds of the real world are concentrated by the auricle, to be found in the outer auditory passages, in which there is a membrane - bar-
banna peratinka, vіdokremlyuє vіd zovnіshny expanse emptiness of the middle air. The vice at the middle ear is vrivnovuzhetsya auditory (eustachian) pipe, which is behind the yogo from the posterior part of the pharynx. Tsya trumpet sings in the camp, which falls and opens when forged and pozihannya.
drum retinka, which vibrates under the influx of sounds, lead to to the middle ear, the lances of the small brushes are the malleus, the forefoot and the stirrup. The sound energy can be increased approximately 15 times. Sound intensity regulation (m. tensor timpani), that m'yazi aspire. Rozpovsyuzhuetsya by auditory brushes The energy of sound reaches the oval window of the inner ear, calling out the ringing of the perilymph.
Ravlikis a tube curled up into a spiral, divided down into 3 channels or go: go down before the day і drumming go, what to avenge the perilymph and ravliki, which are located in the pose with a frequent part, that middle go (Ravlik's Vlasny Canal), avenge the endolymph and є part of a retinal labyrinth, ruffled into a ravlika. Qi descend (channels) are subdivided one by one with a basal scarf and a front door membrane (Reisener's membrane).
The receptors of the auditory analyzer are located in the inner ear, more precisely in the labyrinth that is pierced there, in order to avenge the spiral organ (organum spirale), or cortical organ, what is found on the basilar plate and the anterior ridges of the middle descents filled with endolymph. Vlasne receptor apparatuses - hair cells of the spiral organ, yaki fight with vibration of the basilar plate (lamina basilaris).
Encircled by a sound stimulus, the sounding through the oval vein is transmitted to the perilymph of the ravic labyrinth. Expanding along the curls of the ravine, the stinks reach the її round vein, are transmitted to the endolymph of the perineal labyrinth, vibrating the basilar plate (the main membrane) and teasing the receptors, in which there is a transformation of the mechanical pulmonary electrical coliving.
Varto designate what, Crimea described, so called improved conductivity of sound coliving, possible and їx transmission through the bones of the skull. cystic conductivity; the butt of this can be the transmission of sound, called by the vibration of a tuning fork, the lower part of which is installed on the crown of the head, or a scopal-like bud of the crown brush.
Nerve impulses, which are blamed on the auditory receptors, collapse in the pre-central direction along the dendrites of the first neurons in the auditory pathway to the spiral node (ganglion spirale), or the aboreal node, in which their bodies are folded. These impulses move behind the axons of these neurons, which form a cochlear portion of a single stovbur of the VIII cranial nerve, which consists of approximately 25,000 fibers. The stovbur of the VIII cranial nerve exits the skeletal cyst through the internal auditory passageway, passes the cistern of the pons (mostocerebral expanse) and penetrates into the stovbur of the brain in the lateral part of the bulbar-pontine sulcus, what is known on yoga, and what is the sight of a deep brain.
At Stovburi's brain cochlear dose VIII cranial nerve is cremated in the vestibular and ends in two auditory nuclei: posterior (ventral) and anterior (dorsal) (Fig. 10.5). In these nuclei, impulses pass through synaptic connections from the first neuron to another. Axon clitin of the posterior (vent-
Rice. 10.5.To conduct paths of impulses of auditory sensitivity.
1 - fibers that go through the receptor apparatus; 2 - ravlic (spiral) vuzol;
3 - posterior ravlik nucleus;
4 - anterior ravlik nucleus;
5 – upper olive core; 6 - trapezium-like body; 7 - brain husks; 8 - lower cerebellar nizhka; 9 - upper cerebellar inferior; 10 - middle cerebellar nizhka;
11 - needles to the worm of the cerebellum; 12 - reticular formation; 13 - lateral loop; 14 - lower shaft; 15 - pineal body; 16 - virnіshe dvoolmіє; 17 - medial kolіnchaste body; 18 - cochlear path, which goes to the cortical center of hearing at the upper skeletal ring.
ral) core to take part in the molding of a trapezoidal body, what to know on the cordon between the foundation and the cover of the bridge. The axons of the anterior (dorsal) auditory nucleus are straight to the middle line of the cerebellar (auditory) males of the ovary IV (striae medullares ventriculi quarti). Most of the axons of other neurons of the auditory pathways terminate in the nuclei of the trapezoid body or at the upper olives of the protylogenous side of the brain stem. In addition, a smaller part of the axons of other neurons do not cross over and end at the upper olive side.
In the upper olives and nuclei of the trapezoid body, the third neurons of the auditory pathways are ruffled. Axons їх form a lateral, or auditory, loop, what is formed from the intersection and non-intersection of the auditory fibers, as they rise uphill and reach the podkirkovyh auditory centers - medial kolіnchastih tіl, what is located at the warehouse of the intermedullar brain, more precisely, the yogo metathalamic vіddіlu, and lower pagorbs of Chotiricholmiya, that can be seen up to the middle brain.
In these subarachnoid auditory centers, the bodies of the remaining neurons of the auditory pathway lie down to the subprojective auricular fields. Behind the axons of these neurons, the impulses are directed through the sublenticular part (pars sublenticularis) internal capsule and promenistium crown to the end of the auditory analyzer, which is found in bark of transverse zvivins of Geschl, rotting on the lower lip of the biceps (sylvian) furrow, made up of the upper skeletal ridge (cytoarchitectonic fields 41 and 42).
Damage to the auditory analyzer may be different in nature of hearing loss. When the function of the sound-conducting structures is damaged and the receptor apparatus of the auditory analyzer begins to sound hearing loss (hypacusis, deafness) or deafness (anacusis, surditas), often accompanied by noise at the ears.
Injury to the trunk of the VIII cranial nerve, and navit nuclei їх near the pons can also lead to hearing loss due to pathological fossa and blamed for lateralized noise.
If the hearing paths appear as lesions from one side of the mist of their impenetrable intersection in the bridge, then deafness does not set in, but it is possible that there is a decrease in hearing from both sides, more importantly on the side, which is protilezhnіy pathological middle, in such fluctuations it is possible to die, unstable noise.
As a pathological cavity, the crucible of the auditory analyzer is folded, it is possible for auditory hallucinations, which in such situations may represent an auditory aura of an epileptic attack.
When I become an auditory analyzer, it is necessary to pay attention to the scare of the ailing: what is absent in that number of reports, as if it would indicate a decrease in hearing, twisting of sounds, noise in the ears, auditory hallucinations.
Reversing the hearing, following the memory, that with normal hearing, a person can smell a whisper with a wind of 5-6 m. Whether it is a hearing loss (hypacusia) or an external one (anacusia), it is necessary to specify the cause of this discord.
Slid vrakhovuvaty Hearing in a sick person may have a decrease in the ear as a sound-perceiving and sound-transmitting apparatus of the middle ear. In the first breath, there is a deafness of the inner ear, or about neural deafness, in another - about the deafness of the middle ear, or about conductive form of hearing loss. The cause of the conductive form of hearing loss may be a form of damage to the middle (rarely - ovnishny) ear - otosclerosis, otitis media, swelling and other, with which hearing loss is possible, the noise in the ear. Neural form of hearing loss - showing impaired function of the internal ear (spiral or cortical, organ), cochlear portion of the VIII cranial nerve or brain structures, which lies before the auditory analyzer.
With conductive hearing loss, there is no more deafness and ailments, you can feel the sounds that are transmitted by the spiral organ through the brush; with decreased hearing of the neural type, the patient suffers from hearing until the sound is transmitted, which is transmitted both through the wind and through the brush.
For differentiation of hearing loss for conductive and neural types, such additional investigations can be made.
1. Doslіdzhennya hearing for the help of tuning forks іz raznoy kolivani frequency. Ring out the tuning fork S-128 and S-2048. When the sound of the middle ear is damaged, it is destroyed by the head rank of low-frequency sounds, just as when the function of the sound-receiving apparatus is damaged, the damage is caused by the sound, whether it be tonality, or if it means hearing on the temple sounds.
2. Doslіdzhennya povіtryanoї and kіstkovої conductivity. In case of damage to the sound-conducting apparatus, the conduction is damaged, but the same way the stone is saved. When the sound-receiving apparatus is damaged,
It's like a proverb, so is the stone's conduct. For re-verification, I will check and check the bone conductivity, but I can also beat the offensive samples with a tuning fork (often cory with a tuning fork C-128).
Dosvid Weber of foundations on the possibility of lateralization of trivality to transmit sound through the brush. At the end of the test, the tuning fork will sound in the middle of the darkness of the sick. At the time of the damage of the sound-carrying apparatus, the sound of the tuning fork on the affected side of the patient was more sensitive to ailment, tobto. lateralization of the sound in a sick ear is significant. When the sound-perceiving apparatus is damaged, the sound is lateralized in a healthy ear.
Dosvіd Rennes foundations on povnyannі trivalnosti povіtryany and kіstkovogo zvukopriyattya. It is overwhelmed by the way of s'yasuvannya, how long does it take for ailments to feel a tuning fork, how low it is to stand on a scopal-like bud of a skeletal cyst, and a tuning fork, bringing it to the ear on the wall 1-2 cm. . At such a time, it seems that Rennes has + (positive). How much more trivaly sound is received through the brush, Renne's note - (negative). Negative opinion of Rennes indicates the possibility of a sound transmission device (middle device)
wow).
Dosvіd Shvabbach's foundations on vimіrі trivalnosti zvukopriynyattya ailing the tuning fork through the brush and porіvnyannі yogo with normal kіstkovy zvukoprovіdnіstyu. The test is carried out in an offensive manner: a lower tuning fork, what to sound, to be placed on a sap-like bud of the skeletal cyst of an ailing person. After that, like an ailment, you stop sounding a little to the tuning fork, you continue to lower the tuning fork to your nipple-like bud. What should be shortened in a sickly cystic conduction, that is. disruption of the function of the sound-receiving apparatus (the apparatus of the internal ear), which still lasts for an hour while listening to vibration, with which it is important that a normal hearing is obstezhuyuchiy.
3. Audiometric follow-up. The exact information about the station of the examined and the cystic conductivity can be taken by means of an audiometric study, as it allows you to take that graphical image of the threshold of the sensitivity of the sound in different frequencies through the repetition of such a brush. To clarify the diagnosis, audiometry is performed in a wide range of frequencies, including high-frequency and low-frequency spectra, as well as various above-threshold tests. Audiometry is carried out with the help of a special apparatus of an audiometer for the minds of an otoneurological cabinet.
10.2.1.2. vestibular system
The term is similar to understand labyrinthine vestibule- Ahead of the maze; in front of the (part of the inner ear) the piping canals of the ravlik are closed. Three pivkola to the channel of rotting in three mutually perpendicular planes and interlocking with each other, the skin channel near the front ends with an ampoule. Empty cystic ducts, anterior and slimatic ducts, which are behind them, roztashovani in the pyramid of the skeletal cyst. The stench filled with perilymph - ultrafiltrate of the cerebrospinal nerve. In the cystic canals there are formations of membrane tissue. retinal labyrinth (labyrinthus membranaceus), what is made up of three membrane
pіvkruzhny duct (ductus semicirculares), and three warehouses otolithic apparatus elliptical and spherical little bags (Sacculus et utriculus). Retinal parts of the labyrinth of exudates with perilymph and filling with endolymph, imaginatively, secreted by the clitins of the labyrinth itself.
The receptors of the vestibular (statocinetic) analyzer are spread in the pilar ducts and in the otolith apparatus of the internal ear. All three ducts terminate in ampullae to avenge receptor hair cells, to form ampullar ridges. The rows of combs go into the dredge-like speech, which makes the dome. The receptor hair cells of the combs are sensitive to the movement of the endolimph in the circumferential ducts of the canals and react to the change in the swidkost ruhu - accelerated and galvanized, to stinks are called kinetic receptors.
Receptors of the otolithic apparatus are concentrated on plots called flames (maculae). In one of the bears, such a flame occupies a horizontal position, in the other - a vertical position. Receptor hair cells of the skin are injected into the precious tissue, in order to avenge crystals on sodium carbonate - otolitis, changing the position of some and calling out the teasing of the receptor cells, when nerve impulses are blamed on them, which signal pulse about the position of the head in space (statistically).
In the peripheral receptor apparatus of the vestibular system, impulses follow the dendrites of the first neurons in the vestibular pathways to the vestibular node (gangl. vestibularis), or in a scarp knot, ruffled at the internal auditory canal. The bodies of the first neurons are rotting in a new one. Sound impulses squeal behind the axons of the nerve cells themselves, which pass at the warehouse of the vestibular portion of the upper stovbur of the VIII cranial nerve. As it has already been planned, the VIII cranial nerve engulfs the skeletal cyst through the internal auditory passageway, passes through the lateral cistern of the pons and penetrates into the stovbur of the brain in the lateral part of the bulbar-pontine furrow, which runs through the basal surface of the pons and douglas medulla. Extending into the brain stovbur, the vestibular portion of the VIII cranial nerve divides into the upper and lower parts (Fig. 10.6). The visible part ends at the clitinum of the vestibular nucleus of Bechterew (nucl. superior). Deyakі vyskhіdnі fiber, passing Bekhterev's nucleus, through the lower cerebellar nizhka are taken from the worms of the cerebellum and terminate in the yogo nuclei. The descending fibers of the vestibular portion of the VIII cranial nerve terminate in the tricate vestibular nucleus of Schwalbe (Nucl. Medialis) and in the core of Deiters (Nucl. lateralis), as well as in the expanded lower vestibular nuclei - the lower nucleus of the Roller (Nucl. inferior). In the vestibular nuclei, the bodies of other neurons of the vestibular analyser, axons of some distance to go at different straight lines, without the need to form numerical vestibular links.
The axons of the clitin of the lateral nucleus of Deiters go down, penetrate at the outer vertebrae of the anterior cords of the spinal cord, decontaminate the descending anterior-spinal cord (Leventhal's bundle), which ends at the clitin of the anterior horns of the same side of the spinal cord. The axons of the lower nucleus of the Roller reach the clitins of the anterior horns of the adjacent side of the cervical cord of the spinal cord. The axons of the vestibular nuclei of Bekhterev (upper), Schwalbe (medial) and Roller (lower) may have connections with the medial posterior bundle. Having taken a direct route to the new sky and often switching to the protracted bіk, the stench ends at the clitin
Rice. 10.6.Conduct paths of impulses of vestibular sensitivity. 1 - anterior-spinal path; 2 - pіvkruzhnі ducts; 3 - front door vuzol; 4 - front door root; 5 - lower vestibular nucleus; 6 - medial vestibular nucleus; 7 - lateral vestibular nucleus; 8 - upper vestibular nucleus; 9 - core of the cerebellum; 10 - tooth of the nucleus of the cerebellum; 11 - medial posterior bundle; 12 - the core of the nerve, what to enter; 13 - reticular formation; 14 - upper cerebellar inferior; 15 - red core; 16 - nucleus of the bark nerve; 17 - the nucleus of Darkshevich; 18 - coevice-like core; 19 - thalamus; 20 - bark of the thyme part; 21 - bark of the skronevy part of the great pіvkuі mozku.
the nuclei of the cranial nerves, which protect the ruhi of the ophthalmic apples (III, IV and VI cranial nerves). The presence of anterior-oculomotor connections and care for the support of the medial posterior bundle of connections between the nerve structures, which coordinate the function of the transverse membranes of the ophthalmic apples, indicate the friendliness of the rupture of the ophthalmic apples and save the position of the head Damage to the conduction of nerve impulses due to the designation of nerve connections can be the cause vestibular nystagmus.
Part of the axons of other neurons, bodies of such deposits in the vestibular nuclei, enter into contact with vegetative structures, zokrema from the posterior nucleus of the bulging nerve i h nuclei of the hypothalamic region intermediary brain. The presence of these connections explains the appearance in pathology of the vestibular analyzer, zocrema in cases of over-excitement, pronounced vegetative, parasympathetically important reactions in the appearance of nausea, vomiting, deterioration of the curved tissues, fluidity, increased intestinal peristalsis, arterial decrease.
The vestibular system may bilateral connections with the cerebellum, what, perhaps, is explained by the close proximity of the functions of these organs of the nervous system. Fibers, which go from the vestibular nuclei to the cerebellum, are the head rank of axon clitin, the body of which is spread in the upper and medial nuclei (in the nuclei of Bekhterev and Schwalbi). Numerous links pass at the warehouse of the lower cerebellum and end mainly in the nuclei of the thoracic worm.
In addition, the vestibular apparatus of the Stovbur brain may connection with the reticular formation, with the established extrapyramidal system, zocrema with chervonim nuclei and with podkirkovy nodes, as well as with bark of the great pіvkul brain. Links of the vestibular nuclei from the bark are more prosteghenian. The cortical end of the vestibular analyzer is located in the skeletal part of the brain, here near the cortical end of the auditory analyzer. Possibly, cells of measles, as they take away information from the vestibular analyzer, are located near the skronevy part of the brain and in the thymus and frontal chasms adjacent to it.
Razdratuvannya receptors in the navel channels can be provoked by wrappings or infusions in the external auditory passages of hot and cold water. As a result, the confusion of the vestibular nystagmus in the area of the nape canal is blamed, in which the maximum movement of the endolymph occurs.
Numerical links of the vestibular apparatus explain the large number of pathological symptoms that are caused by this injury. Among the vestibular symptoms, there are sensory (confusion), oculomotor (nystagmus), tonicity (decreased mucosal tone, retraction of the tousled arms and toe), statocinetic (disturbance of the leg, walking, trembling of the head and other).
The most informative results of learning hearing and vestibular functions can be taken away from the process of neurothiatric obstruction of a sick person, if it is carried out by viable facsimiles.
10.2.2. Facial (VII) nerve (n. facialis)
The facial nerve is more importantly ruhovim, but at the warehouse it is also sensitive to pass (Relish and impassioned views of sensibility) i secretor-
nі (parasympathetic) fibers that satisfy so titles intermediary nerve (nervus intermedius), or Wrisberg nerve, vodomy so well XIII cranial nerve, I mean part of the way to pass at once from the VII cranial nerve (Fig. 10.7). In connection with the cym, the facial nerve together with the intermediary nerve is sometimes called the interfacial nerve. (Nervus intermedio-facialis).
Vlasna The (Rukhova) part of the facial nerve in the brain stem is represented by the motor nucleus, which is spread at the lower part of the pons. The core is composed of a number of clitin groups, the skin of some of them provides the innervation of the singing mimic m'yazyv. in the new it is accepted to separate the upper part, so that there is a connection with the bark of both pivkul of the brain, so like cortical-nuclear fibers that go to it, create a non-permanent supranuclear intersection, and the lower part, for example, only a connection with the bark of the proliferative . The upper and lower parts of the nucleus of the facial nerve provide the innervation of the mimic membranes in the same way as the upper and lower parts of the face.
The nuclei of the intermediary nerve are located mainly in the douglas medulla and є overhead with the nuclei of the IX cranial nerve. The upper parts of the primordial nucleus of the solitary tract and the parasympathetic sloughing nucleus (nucleus salvatorius). The parasympathetic cells are also diffusely spread near the rux nucleus of the seventh cranial nerve to the intermediate nerve, which ensure the function of the mucosal duct.
The main, rukhovy, root of the VII nerve emerge from the stovbur of the brain in the transverse bulbar-bridge furrow between the brain and the bridge. The lateral nerve of the furrow exits the median nerve. Nezabar stench rush into the scorching stovbur (VII and XIII nerves), which is to pass through the bіchnu cistern of the bridge (mostomozochkovy expanse). Nadali VII cranial nerve at once from the VIII cranial nerve penetrates into the canal of the internal auditory canal, and then water-creaming enter vlasny channel - canal of the facial nerve, or the fallopian canal. Passing through the cim canal, the facial nerve robs the vigin (outer ring of the facial nerve); at the mister's vigin vuzol kolіna (ganglion geniculi, extends to the system of the intermediary nerve), which avenges pseudo-unipolar sensitive clitinis, which is the first neurons of the responsive smoky path and the paths of deep views of sensitivity, care for the outer ear of sensitivity on the outer surface of the tympanic membrane and the area of the outer ear canal. The axons of the first neuron of the gustatory sensibility, passing in the precentral direction directly at the storehouse of the intermediary nerve, transmit impulses to the upper part of the primate nucleus (the nucleus of a solitary bundle), which is splayed into the brain in the cranial stovbur. The axons of pseudo-unipolar clitins of the upper part are sensitive, which go to the node of the knee, extending into the stovbur of the brain, completing their path in the nuclei of the trigeminal nerve.
Causes in the warehouse of the head stovbur of VII and XIII cranial nerve structures, which protect sensitivity, explain the possible pain syndrome in case of neuropathy of the VII cranial nerve, as well as the presence of herpetic hanging in Head's syndrome, which is based on ganglioneuritis with lesions of the knee node, joints. herpes zoster.
Passing through the skronevu cyst, the stovbur of the facial nerve and the intermediary (XIII) cranial nerve, which enters to the th warehouse, passes 3 needles. (Fig. 9.8). The first type of new entry is parasympathetic fibers to avenge. great stone nerve (n. petrosus major). Preganglionic fibers, which enter to the th warehouse, are axons of the clitin of the mucosal nucleus, stowed in Stovbur
10.7. Facial (VII) nerve.
1 - the core of a single beam; 2 - upper clinoid nucleus; 3 - the nucleus of the facial nerve; 4 - ring (internal) of the facial nerve; 5 - intermediate nerve; 6 - vuzol kolina; 7 - deep stony nerve; 8 - internal carotid artery; 9 - krylopidnebіnny vuzol; 10 - external vuzol; 11 - lingual nerve; 12 - drum string; 13 - stapedial nerve i stapedial m'yaz; 14 - drum gossip; 15 - ring-shaped nerve; 16 - number (sound) of the facial nerve; 17 - skronevy hilts; 18 - frontal cuticle of the tiling-frontal m'yaz; 19 - m'yaz, which wrinkle the eyebrow; 20 - circular m'yaz eyes; 21 - m'yaz proud; 22 - great vilicious m'yaz; 23 - maliy vilichny m'yaz, 24 - m'yaz, which lifts the upper lip; 25 - m'yaz, which raises the upper lip and the wing of the nose; 26, 27 - nasal m'yaz; 28 - m'yaz, what does the company say; 29 - m'yaz, which lowers the nasal septum; 30 - upper masonry; 31 - circular m'yaz company; 32 - lower rіztsevy m'yaz; 33 - buccal m'yaz; 34 - m'yaz, which lowers the lower lip; 35 - pіdboriddya; 36 - m'yaz, what lowers the kut company; 37 - m'yaz smіhu; 38 - pіdshkіrny m'yaz shiї; 39 - forked chicks; 40 - sublingual fold; 41 - neckline; 42 - lower slit vuzol; 43 - posterior external nerve; 44 - shilopid'yazichny m'yaz; 45 - posterior side of the double-meat; 46 - styloscopal opening; 47 - potilichne cherevets polichno-frontal m'yaz. Rukhovi nerves are marked with a red color, blue - sensitive, green - parasympathetic.
Rice. 10.8.Facial nerve and 1st nerve fibers, variants of their lesions in case of sepsis on different levels. a - in the region of the cerebellopontine junction; b, c, d – equal indentation in the canal of the facial nerve; d - squeezing of the facial nerve after exit from the stylomastoid opening; 1 - internal auditory canal; 2, 3 - ravlic that anterior part of the anterior ravic (VIII) nerve; 4 - intermediate (XIII) cranial nerve, or posterior root of the facial nerve; 5 - secretory fibers to long ridges; 6 - secretory fibers to long ridges; 7 - great stony nerve; 8 - stapedial nerve; 9 - drum string; 10 - styloscopal opening.
the brain near the main, rukhovy, nucleus of the VII cranial nerve, emerge from the pyramid of the skeletal cyst through the gorge of the canal of the great petrosal nerve and pass along the same furrow to the torn opening. Through this, the great stony nerve enters the base of the skull, where it connects with the deep stony nerve (n. petrosus profundus).Їhnє anger leads to the closure of the nerve of the krylopodіbny canal (n. canalis pterygoidei), pass through the wing-like canal to the wing-shaped node (Ganglion pterygopalatinum).
Postganglionic fibers, which enter the neurons of the krylonal node, innervate the mucosa and mucosa of the nasal and oral stools. In case of damage to the facial nerve, the great petrosal nerve emerges, which takes part in the formation of the nerve of the wing-like canal, causing dryness of the eye. xerophthalmia, what can be the cause of keratitis, episcleritis, ophthalmitis; there may also be insufficient swelling of the homolateral part of the empty nose.
A nail is stepped on, which enters the trunk of the facial nerve, on a distance, which passes through the yogic upper canal, - stapedial nerve (n. stapedius),іn- nerve-wracking one-man m'yaz (m. stapedius), pull the drum retina. The impaired function of the first nerve leads to the development of the timbre of sounds that are received by the sickly side. Sounds of an incomprehensible, sharp character - a phenomenon, in the house under the name hyperacusis.
The third needle, which enters the stovbur of the facial nerve, - drum string (chorda timpani), representing a direct continuation of the intermediary nerve. At the її warehouse pass smack fibers, which are the dendrites of clitin, the body of some kind of arborization at the nodes of the column, and the secretory vegetative fibers (axons of vegetative neurons, the body of which is rebuffed at the nucleus of a single bundle). Through the same channel, the drum string penetrates into the empty drum, passes through it under the mucous membrane between the forefoot and the handle of the malleus. After that, the drum string through the stone-drum slot (glazer's slot) enters the outer side of the base of the skull, after which it reaches the lingual nerve, which extends to the system of the V cranial nerve. As a result, the smack fibers reach the two anterior thirds of the tongue, and the secretory fibers reach the sublingual and sublingual vegetative nodes (Fig. 10.9). Postganglionic fibers, which enter from these nodes, innervate the sublingual and sublingual sinus folds. When the function of the drum string is damaged, the taste is broken on the front 2/3 of the tongue, with which the head rank saps sour and licorice. Calling on those that the drum string takes part in the innervation of the slings, the shock can lead to a change in the secretion of the sling, which can be reduced to a special level, to finish the folded lining. E thought (Nomura S., Mizino N., 1983),
Rice. 10.9.The system of smoky sensitivity. 1 - kolіnchast vuzol; 2 - intermediate (XIII) nerve; 3 - lower vuzol of the IX nerve; 4 - lower node of the X nerve; 5 - smakove nucleus (nucleus of a single bundle);
6 - bulbo-laminar tract;
7 - nuclei of the thalamus; 8 - hippocampus zvivina; 9 - pіvmіsyachny vuzol; 10 - epiglottis.
that the tympanic string anastomoses with the system of the tongue-pharyngeal and upper laryngeal nerves.
After the exit of the VII cranial nerve, the tympanic string, the nerve emerges from the one-dimensional cystic canal through the styloscopal opening (foramen stylomostoideum) to the outer side of the base of the skull.
The presence of three hilums of the facial nerve makes it possible to pinpoint the exact location of the lesion. As soon as the nerve breaks out more than the exit of the great stony nerve, then due to paresis of the mimic muscles, the functions of all three of the functions of the facial nerve needles are disrupted. As the pathological process is observed over the outlet of the main nerve stovbur of the other nerve - the stapedial nerve, the function of the mucosal fold will be saved, hyperacusis and discord will be prevented. As well as the nerve of the nerves between the joint of the stapedial nerve and the node of the knee, then the paresis of the mimic muscles will rise only with a disorder of relish and, possibly, damaged superficial sensitivity in the zone of the external auditory canal. In times of damage to the stovbur of the facial nerve, below the entry of the tympanic string, in the clinical picture, only peripheral paresis or paralysis of the muscles, which are nerved by them, will appear on the pathological process.
After the exit of the VII cranial nerve from the skeletal cyst through the styloscopal opening into the new entrance posterior external nerve (n. auriculus posterior), Innervious m'yazi of the auricle and potilichny m'yaz. Descho distal to the face of the facial nerve, there is a two-headed neck. (ramus digastricus), what is the innervation of the posterior side of the bifurcated m'yaza and the shilopid' lingual m'yaz. In addition, from the stovbur of the facial nerve, there are adjoining needles - anastomoses to the tongue-pharyngeal and pharyngeal nerves.
Then the stovbur of the facial nerve passes through the pharynx and in front of the outer auditory meatus divides into hilts, thus calling great goose paw (pes anserinus major) and shaping gossip (Plexus parotideus). Sounds come out of the chicks, as if they protect the innervation of the mimetic m'yazyv. Most of them are: skronev (rr. temporales), shchichni (rr. buccales), vilitsevir (rr. zygommatici) and marginal gorge of the lower slit (R. marginalis mandibulae). In addition, the collar descends on the neck. (ramus colli) for innervation of subshkirnogo shii.
Injury of the facial nerve (kernel or be-like a stovbur) leading to peripheral paralysis or paresis of the m'yaziv, which are innervated by the facial nerve, under which the asymmetry of the individual develops, it is noted in the calm and sharply rises in mimic movements. In case of paralysis of the mimic m'yaziv on the side of the defence, the face is unruhoma, the eye is wide, during the day, or rіdkіsmi migodіvі ruhi appear (Blink test). When you try to wrinkle your forehead, skin folds on your bots do not settle ("Polishing" the forehead). The ailing one does not dare to flatten the eye: when you try, close your eyes, the apple on the side of the wound turns burnt out (Bell sign) and through the eyes of the eye, under the iris, when I go uphill, you can see the sclera ("hare's eye", lagophthalmos) (Figure 10.10). If it’s not paralysis, but paresis of the circular area of the eye, then when you try to close the eyes, the eyes blink slightly, if on the side of the wound you don’t drown in the folds of the neck (symptom viy). In times of paresis of the circular mass, the eyes of ailments can close the eyes from both sides, but it is not possible to close them only on the side of the wound, closing the eyes with others (dyskinesia povik, or sim-
Rice. 10.10.Signs of damage to the left facial nerve, which are seen when trying to flatten the eyes and teeth (schematically).
Reviyo). When rozdmuhuvanni schіk again go out of the hood of the company on the side of the battle, with respiratory shock on the same shoes "Sail". Passively raise the mouth of an ailing person, obstezhuyuchy it means that with identical yoga susilla from both sides on the side of the injury, there is a decrease in the m'ulcer tone, at the zv'yazku z tsim the company rises higher, lower on health (Symptom of Rusetsky). When teeth are rocked on the side of the circular m'yaza, the company's stench is less bare, lower on a healthy side, and the mouth gap becomes similar to a tennis racket, the handle of which shows the beak of the injury. (racket symptom). The ailment sounds like it’s difficult to receive it, the shards are falling out of the way under the paretic shock and її іnоdі you have to win the sound of the help of the language. Rіka їzha that slina can wind up from the insufficiently covered hood of the company on the side of the battle. In my yard, with paresis of the circular m'yaz, the company of ailments cannot take away the wife of paper. (test circular m'yaz rota), you can’t, otherwise you should hang down importantly, blow out the candle.
With the localization of the pathological process in the pit of measles otherwise, along the course of the cortical-nuclear path, on the side of the sick person, protilezhnіy pathological process, sound blame brachiofacial syndrome and hemiparesis, central paresis of the mimic muscles develops. At the junction with a practically complete intersection of the cortical-nuclear pathways, which approach the lower part of the nucleus of the facial nerve, show paresis of mimic m'yaziv blame the lower part of the guise, If there is a decrease in the strength of the mimic m'yaziv, a weakened zmikannya povik, it can be seen in the upper part of the individual.
In the case of a circumscribed pathological center in the lower part of the anterior central line, on the protractile pathological center of the side, paresis can be blamed on the central type of m'yaziv of that tongue. faciolingual syndrome. When developing in the same epileptogenic zone
fires can be local jacksonian judicial paroxysms, manifested on the contralateral pathological process as clonic sudomas in tongues and tongues, sometimes with paresthesia. J. Jackson (1835-1911), a local judicial attack, which originates from the court of the facial muscles, often transforms into second-generalized tonic-clonic epileptic attack.
10.2.3. External (VI) nerve (n. abducens)
The visible nerve is ruhovim. The veins are formed from axons of peripheral motor neurons, the bodies of which are rebuyed at the rumen nucleus, studded in the pons. The dendrites of these clitins, through the system of the medial posterior fascicle, are located at the ligament with the other clitinous structures of the stovbur of the brain, including the nuclei of the parotid nerve of its own protigella side. The VI cranial nerve pierces the entire torso of the pons and emerges from the transverse furrow on the ventral surface of the brain stem, between the pons and the medulla of the pons, medial roots of the VII cranial nerve, above the pyramids of the medulla. After this, the VIth cranial nerve, creeping from the base of the skull, reaches the cavernous venous sinus and passes at the lateral wall. Viyshovshi from the empty skull through the upper slit of the eyes, vin penetrates into the eyes.
The VI cranial nerve innervates only one transverse muzzle - the direct outer m'yaz of the eye (m. Rectus lateralis oculi). Injury of the VI cranial nerve leads to the friability of the internal apple of the name (Fig. 10.11), there may be a trend to turn it in the middle (strabismus convergens) at the link with it, that the direct internal m'yaz of the eye, being the antagonist of the paralyzed m'yaz, pulls the apple of its own beak. In case of damage to the VI cranial nerve, the diplopia (Double vision), especially pronounced when trying to turn a glance at the pathological process. Apparently, in such situations, the images of objects split in two in a horizontal plane, with which the manifestation of the double is greater in the world, increasing the intensity of the turn I look into the beak of the paralyzed m'yaz. Diplopia can be accompanied by confusion, unpreparedness, and a broken orientation in space. It is not uncommon for ailments to hide one eye (diplopia in one’s own, ring out, know).
Lack of function of the VI cranial nerve is often associated with other neurological symptoms
Rice. 10.11.Having shown paralysis of the left ovnіshny direct m'yaza of the eye, when trying to turn, I will look at the beak of the affected m'yaz (schematically depicted).
matics and may be manifesting polyneuropathy, meningitis, thrombosis of the cavernous sinus, fracture and tufts of the base of the skull and other. skulls.
10.2.4. Tripart (V) nerve (n. trigeminus)
Tripartite nerve (Figure 10.12) є zmіshanim. It is basic, sensitive, a portion that cares for all the sensitivity of the skin of the scalp and the hairy part of the head to the crown suture, horn, conjunctiva, mucous membranes of the nose and yogo adnexal emptyings, oral emptying, teeth, dura mater. Dviguna portion of innervation of chewing m'yazi. In addition, the tripartite nerve can have sympathetic and pair-sympathetic fibers in its warehouse.
The bodies of the first neurons (pseudo-unipolar cells) of the sensitive portion of the V cranial nerve are located in the tripartite (drinking or gasser) node (gangl. trigeminale), roztashovanomu in mycelium hole - buried in hard mucosal tunic on the upper front surface of the pyramid of the skeletal brush. Aksoni clitin, which is located in this node, is formed sensitive root of the V cranial nerve, which is straight through the cistern of the bridge to the surface. Uviyshovshi in the city, sensitive root yogo divide into two parts. One of them is to avenge the fibers of deep sensitivity and part of the fibers of tactile sensitivity, it ends in the pontine nucleus of the trigeminal nerve, which is spread out at the cover of the bridge. (nucl. pontinus nervi trigemini), or to the superior sensitive nucleus of the fifth cranial nerve (nucl. sensorius superior nervi trigemini) - nuclei of proprioceptive sensitivity. The other part, which is made up of fibers of pain and temperature sensitivity, as well as fibers of tactile sensitivity, which accompany them, satisfies the lower root of the V cranial nerve, which is straight down, pass through the dorsal brain and descends to the II cervical segment of the spinal cord. The lateral root of the ternary nerve has cells that form the nucleus of the spinal cord of the ternary nerve (nucleus spinalis nervi trigemini), in the same way as the lower sensitive nucleus of the trifrequent nerve (Nucleus sensorius inferior nervi trigemini). Nuclei of the nucleus of the spinal tract of the trigeminal nerve and the body of other neurons of the tract in the superficial, head rank of pain and temperature, as well as tactile sensitivity. Axons of these clitins, like and axons of other neurons, spread at the pontine nucleus of the tripartite nerve, adjoin to the medial sensitive loop and, when this happens, move to the protractile bik, following at once from the fibers of the spinothalamic pathway. Give stinks rise uphill at the warehouse of the stovbur tires reach the bodies of the third neurons, spreading in the ventrolateral nuclei of the thalamus. Sounds along the axons of the third neurons of the impulse, which carry information about the state of sensitivity to the face, are taken to the lower branches of the post-central line (the area of the projection of the head) more importantly than the protilazhny pivkul.
The dendrites of the clitin of the nasal node go to the periphery, forming three main branches of the V cranial nerve: I - ophthalmic nerve (n. ophtalmicus), II - superior
Rice. 10.12.Tripartite (V) nerve.
1 - the nucleus of the spinal tract of the triacicular nerve; 2 - rukhove nucleus of the ternary nerve; 3 - the pontine nucleus of the trichaminal nerve; 4 - the core of the middle cerebrospinal tract of the trichasal nerve; 5 - tripartite nerve; 6 - eye socket; 7 - frontal head; 8 - nasociliary nerve; 9 - posterior lattice nerve; 10 - anterior lattice nerve; 11 - slіzna zloza; 12 - supra-foveal nerve (lateral nail); 13 - supra-fossil nerve (medial neck); 14 - supratrochlear nerve; 15 - subblock nerve; 16 - internal nasal hilars; 17 - ovnishnya nasal nail; 18 - vіyny vuzol; 19 - mucus nerve; 20 - upper slit nerve; 21 - podochkovy nerve; 22 - nasal and upper labial gills of the subfossil nerve; 23 - anterior upper alveolar ridges; 24 - krylopidnebіnny vuzol; 25 - lower jaw nerve; 26 - buccal nerve; 27 - lingual nerve; 28 - lower slit vuzol; 29 - podschelepna and pod'yazychna runes; 30 - lower alveolar nerve; 31 - pinched nerve; 32 - front chervets of double-meat; 33 - splintered-pod'yazikovy m'yaz; 34 - cleft-sublingual nerve; 35 - chewing m'yaz; 36 - medial wing-like m'yaz; 37 - drum strings; 38 - lateral wing-like m'yaz; 39 - ear-skronevy nerve; 40 - external vuzol; 41 - deep skeletal nerves; 42 - skronevy m'yaz; 43 - m'yaz, which energizes the bottom of the firanka; 44 - m'yaz, which energizes the tympanum; 45 - vulva. Sensitive nerves are marked with blue color, rukhovi with chervonim, and parasympathetic with green.
schlepny nerve (n. maxillaris) and III - lower jaw nerve (n. mandibularis). Before the depot of the lower slit, the ruh portion of the V cranial nerve enters, which is formed from the axons of the clitin, splayed near the ruh nucleus (nucl. motorius n. trigemini) at the bridge of the bridge. Branches in the nucleus of the nerve fibers go out of the bridge at the warehouse of the ruhic root, which pass along the ventral node, adjoin to the III branch of the trifoliate nerve, following in the warehouse, reach the masticatory membranes and take care of their innervation.
In the cob part of the skin, from the three main hilums of the trigeminal nerve, a hilus enters the empty skull to the dura mater (r. meningeus).
ophthalmic nerve - sensitive, pass at the lateral wall of the cavernous sinus, and then through the upper glaucoma penetrates into the occipital cavity, dedividing into 3 parts: slіzny nerve (n. lacrimalis), frontal nerve (n. frontalis)і but-ciliary nerve (n. nasociliaris). These nerves provide the innervation of the upper part of the skin and the anterior hairy part of the head from the level of the ophthalmic fissures to the region of the crown suture, as well as the horns, conjunctivitis of the sclera and povik, the main and frontal sinuses, and the upper sinuses. When the ophthalmic nerve is damaged, the corneal reflex is reduced.
superior scapular nerve - sensitive, to come out of the empty skull through a round opening and through the feet: great nerve (n. zygomaticus), foveal nerve (n. infraorbitalis), gіlkami є, zokrema, upper alveolar nerves (nn. alveolares superiores). The stench innervates the skin of the middle part of the appearance, the mucous membrane of the lower part of the empty nose, the upper slit (maxillary) sinus, the hard bottom, is clear, as well as oxidizes the teeth of the upper slit.
Inferior jaw nerve - Zm_shany behind the warehouse, filling the empty skull, moving through the oval opening, and dividing into the necks: chewing nerve (n. masstericus), mainly rukhovy, but to avenge and a sensitive portion, which ensures the innervation of the lower cleft loam, deep skronevі nerves (nn. temporales profundi)- rukhovi, external and internal krylopodibnі nerve (nn. pterygoidei lateralis et medialis)- Mostly ruhovі, buccal nerve (n. buccalis)- sensitive ear-skronevy nerve (n. auriculotemporalis)- sensitive lingual nerve (n. lingualis)- sensitive inferior alveolar nerve (n. alveolaris inferior)- zmіshany, pass through the lower slit canal, passing through the numerical needles to the tissues of the lower slit, the distal part of the th part exits the th canal through the chin. (Foramen mentalis).
The lower jaw nerve provides sensitive innervation of the skin in front of the auricle and in the lower third of the appearance, mucous membrane of the cheek. Yogo rukhova portion of the innervation of the chewing m'yazi (m. temporalis, m. masseter, mm. pterigoidei lateralis et medialis), as well as the anterior cuticle of the bifid m'yaz, m'yazi of the diaphragm mouth, tensor veli palat tympanum (m. tensor tympani).
In case of damage to the tripartite nerve characteristic of us is damage to sensitiveness (Fig. 10.13). It is possible paroxysmal pain in a particular person on the neuralgia of the trigeminal nerve (div. division 28) or permanent pain in this other area, which is innervated by the hilts.
If the conduction of the triceps nerve is damaged, then the zone of innervation is under anesthesia and hypoesthesia. There it appears as a ruined yak
Rice. 10.13.Innervation of the skin of the face of that head.
a - peripheral innervation: I, II, III - zones of innervation in the I, II and III nerves of the trigeminal (V) nerve; 1 - great potilichny nerve; 2 - great external nerve; 3 - malium potilidny nerve; 4 - neck nerve; 6 - segmental innervation: 1-5 - Zelder zones; C2 and C3 - zones of the upper cervical segments of the spinal cord; 6 - stovbur to the brain, the nucleus of the spinal tract of the triacous nerve.
superficial, and deeply sensitive. Such vipadkas go about damaged sensitivity to appearances behind the peripheral type (Fig. 10.13a).
It should be noted that between the zones of innervation of the hilok of the trigeminal nerve, one on one, and to that, when one of them is damaged, there is damage to the sensitivity, which may be less for the zone of innervation.
Derangement of sensitivity can be blamed for damage to the sensitive nuclei of the trifoliate nerve, rotting at the brain stem. When one of the two sensitive nuclei of the fifth cranial nerve is damaged, damage to sensitivity is blamed on dissociated type (Fig. 10.13b).
The most frequent damage to pain and temperature sensitivity in case of sparing proprioceptive in depressions of damage to the nucleus of the spinal tract (low coryne) of the trigeminal nerve. If the fragments of the core can be very long, then the function of this part is often destroyed. If only the upper part of the body is affected, then the discordance of sensitivity appears on the side of the damage in the oral part of the half of the individual (the area of the nose and lips), as the pathological process expands along the core, then the sensitive discord is progressively indicated on the daedals of the larger territory of the individual half. If the lower part is damaged, the sensitivity will be damaged in the lateral ventricles of the upper half of the individual. In such a rank, the skin "on top" of the nucleus on the face of the visible zone, which forms the shape of the arch, I will name the Zelder zone, or the cibulin zone. In case of damage to the nucleus of the spinal tract of the trigeminal nerve in the singing zones of Zelder, there is only pain and temperature sensitivity, even so, that tactile sensitivity is lost in savings. In such vapadas go about the discord of sensitivity for the segmental type.
The defeat of the rukhovy nucleus, the rukhovy root or the III hilum of the trichamoidal nerve is accompanied by the development of peripheral paralysis or paresis of the chewing mucosa. In the aftermath of the atrophy on the side of the lesion, the asymmetry of these lesions can sometimes be blamed. Hypotrophy of the skeletal meat (m. temporalis). With paralysis m. masseter blame the asymmetry of the oval face.
The pressure of chewing m'yazіv with chewing ruhs appears to be weakened. You can do it by placing your hands on the chewing area on both sides and exerting pressure on them. With unilateral damage to chewing m'yazіv, it is also possible to show asymmetry or bite force. As a result of paralysis, or paresis of the ovary and internal wing-like m'yazyv, then the lower slit is slightly lowered to the middle line of the pathological process. In case of bilateral lesions of the chewing gums, a bilateral weakened bite may occur, unless the lower fissure hangs. It is also characteristic of a decrease or decrease in the lower jaw reflex.
10.3. SYNDROMES OF BRIDGE AND YOGO CRANIAL NERVE INJURIES
Localization of the pathological process in half of the pons of the brain can lead to the development of offensive alternating syndromes.
Miyar-Gubler syndrome - blamed for a unilateral pathological middle in the lower part of the pons of the brain and damage to the nucleus of the facial nerve or the cortical-spinal cord. On the side of the lesion, there is peripheral paresis or paralysis of the mimic malignancies, on the protractile side - central hemiparesis and hemiplegia. Described in 1856. French doctor A. Millard (1830-1915) and born in 1896 German doctor A. Gubler (1821-1897).
Fauville syndrome- blame for unilateral pathological swelling in the lower part of the pons of the brain, zooming in on the lesions of the nuclei and coronets of the facial and external nerves, as well as the pyramidal path and inode - the medial loop. On the side of the injury, it is manifested by peripheral paresis or paralysis of the mimic membranes and the direct oval mass of the eye; on the protractile leg - central hemiparesis or hemiplegia and, possibly, discord in the hemitype of pain and temperature sensitivity. Describing 1858 p. French neuropathologist A. Foville (1799-1879).
Raymond-Sestanu Syndrome - blamed for a unilateral pathological middle in the bridge due to the damage to the bridge center at a glance, the middle cerebellar pedicle, the medial loop and the pyramidal path. Paresis is indicated at a glance for the pathological fossa, for the follicles - hemiataxia; on the protile leg - central hemiparesis or hemiplegia, discord according to the hemitype of pain and temperature sensitivity. Described in 1903. French neuropathologists F. Raymond (1844-1910) and E. Cestan (1873-1932).
Gasperin's syndrome - blamed for the pathological pit near the bridge. There are signs of dysfunction of the auditory, facial, visual and tripartite nerves on the side of the lesion and a disorder of pain and temperature sensitivity according to the hemitype on the protractile leg. Describing the Italian neuropathologist M. Gasperini.
With extracerebral localization of a pathological pit in an empty skull, offensive syndromes are possible.
syndrome - a sign of damage to the auditory, facial and tripartite nerves that pass through the cistern of the bridge. It develops for the formation of a pathological process in them, often with acoustic neuroma.
Syndrome Gradenigo - muffledness, caused by damage to the sound-transmitting and sound-perceiving apparatus of the auditory nerve, in the impairment of the functions of the facial, visual and tripartite nerves. It shows paresis of the mimic and chewing muscles, similar to a squint, diplopia and pain in the individual. Sounds like a case of purulent otitis media, when the infection penetrates through the top of the pyramid of the skeletal cyst into the empty skull, which leads to the formation of a scaly leptomeningitis with radiation in the process of assigning the cranial nerves. Describing in 1904 p. Italian otolaryngologist G. Gradenigo (1859-1925).
With a one-sided lesion of the so-called bridge center, which is ripped in the bus, the center of the bridge develops paresis at a glance in the pathological process.
With bilateral damage to the pons of the brain, there may be onset syndromes.
Syndrome of pontine myelinolysis - bilateral demієlinіnіzatsіya by the head rank of the afferent ducts on the pons of the brain: corticospinal (pyramid), frontopontocerebellar and cortico-nuclear. Shows central tetraparesis, signs of pseudobulbar syndrome and cerebrovascular insufficiency. Characterized by ophthalmoparesis, sinus, tremor, tonic seizures, decreased activity of mental processes. Forgiveness is a development of sopor, Komi. It is blamed on disorders of metabolism in starvation, chronic intoxication (with alcoholism, infectious diseases, severe somatic pathology). Іsnuє Thought about those scho Pontin mієlіnolіz Mauger Buti sprovokovany nadmіrnoyu gіdratatsієyu scho Veda to tyazhkoї gіponatrієmії of nabryakom mozkovoї tkanini scho chastіshe vinikaє from ailing to alkogolіzm, that scho they utrimannya od habits Veda to zbіlshennya vmіstu in krovі antidіuretichnogo hormone that ymovіrnіst rozvitku hyponatremia. infusions of rіdin and liquor by diuretics are especially great. On CT and MRI, the middle of the reduced width in the central part of the pons and near the adjoining vertebrae of the stovbur brain is revealed. The vibrancy of the damage to the foundation of the bridge is explained by the peculiarities of myeloarchitectonics.
Syndrome of "dancing eyes" (myoclonus full-time) - Hyperkinesia of ophthalmic apples in the form of spontaneous, irregular, uneven in terms of amplitude of their movements, which develop in the horizontal plane and are especially pronounced at the cob stage of fixation to look at the subject. Mozhlivy with damage to the splint of the bridge or the middle brain.
Roth-Bilshovsky syndrome (pseudoophthalmoplegia Bilshovsky) - the cost of building up to quite a few ruins of apples on the side with saving their reactions to the teasing of the labyrinth, with which convergence of eyes and saving the ruins of them at the vertical plane is possible. It is blamed on the growth of the swelling or the damage to the blood circulation in the lining of the stovbur, which may be a manifestation of pink sclerosis. Described 1901 p. Vytchisnyany neuropathologist V.K. Roth (1848-1916), born 1903 German neuropathologist M. Bielschowsky (1869-1940).
Mist,pons (varolієv mist), between the middle brain (with the lower brain), and below (behind) - with the second brain.
The dorsal surface of the pons is wound at the bottom of the fourth stubby and takes part in the illumination of the bottom of the rhomboid fossa. At the lateral straight line, the mist should pass at middle cerebellar nizhku,pedunculus cere- belldris medius. The cordon between the middle cerebellar inferior and the bridge is the exit point of the trigeminal nerve. At the deep transverse furrow, which is the cremation point in the pyramids of the deep brain, the roots of the right and left nerves emerge, which lead. At the lateral part of the ciliary furrow, one can see the root of the facial (VII pair) and the anterior-rural (VIII pair) nerves.
On the ventral surface of the bridge, where the empty skull lies up to schila,clivus, remember basilar (main) furrow,sulcus basilaris. This furrow has a single artery.
At the central windows of the bridge, there is a dense bundle of fibers that can be seen to the wire path of the auditory analyzer. trapezium-like body,corpus trapezoideum. Tse permission to divide the mist on the back part, or the cover of the bridge, pars dorsalis, that anterior (basilar) part, pars ventralis. Mіzh fibers trapezієpodіbіbіbіbіbіbіbіbіbіbіbіb tіla raztashovuetsya anteriorі posterior nucleus of the trapezoid body,Nuclei corporis trapezoidei ventralis et dorsalis. At the anterior (basilar) part of the pons (on the base) one can see the later transverse fibers. Lateral fibers of the bridge,librae pontis longitudindles, lie on the pyramid path (cortical-nuclear fibers,fibrae corticonucleares). Right here Kirk-bridge fibers,fibrae corticopontinae, yaki will end in nuclei(Vlasnih) bridge,Nuclei pontis. The growths of the nerve clitin nuclei of the pons bundles of transverse fibers of the bridge,fibrae pontis transversae. Rest of the middle cerebellar peduncles.
At the posterior (dorsal) part (pond pons) there is a cluster of gray speech - nuclei, V, VI, VII, VIII pairs of cranial nerves. Fibers lie above the trapezium-like body medial loops,lemniscus medidlis, and laterally in them - spinal loop,lemniscus spinalis. Above the trapezium-like body there is a reticular formation, and more - posterior inferior bundle,fasciculus longitundindlis dorsdlis. On the side and above the medial loop lie the fibers of the lateral loop.
Nutrition 135 Anatomy and topography of the middle brain: 1st part, inner bud, links with other medulla. The position of the nuclei and ducts in the middle brain. Empty middle brain.
middle brain mesencephalon , vlashtovany mensh is difficult. At the new one they see daha and nizhki. The empty middle brain is the water of the brain. The upper (anterior) boundary of the middle cerebellum on the ventral surface is served by the optic tracts of the body, and on the posterior - anterior edge of the bridge. On the dorsal surface, the upper (anterior) boundary of the middle cerebellum passes to the posterior margins (superficial) of the thalamus, the posterior (lower) is equal to the exit of the trochlear nerve roots.
Dah of the middle brain,tectum mesencephalicum, roztashovana over the water supply to the brain. Dah of the middle brain is composed of a few days - humpbacks. The rest of the vіdokremlіnі one vіd one borozenki. The late furrow is ripped to make a bed for the pineal body. A transverse furrow for the top of the hillock, colliculi superiores, in the lower humps, colliculi inferiores. From the skin side of the hump, at the lateral straight line, there is sweating at the visible roller - the handle of the hump. The upper pagorbi of the dahu of the middle brain (four colliculi) and the lateral collinar parts of the body mark the function of the suborbital centers. The lower hump and medial columns of the body are the suburban auditory centers.
The legs of the brain,pedunculi cerebri, come out of the bridge. The destruction of the brain between the right and left lower legs was given the name of the femoral fossa, fossa interpeduncularis. The bottom of the fossa is a mass, where blood-bearing vessels penetrate into the tissue of the brain. On the medial surface of the skin of the lower brain, there is a late okorukhov furrow, sulcus oculomotorus (medial sulcus of the lower leg of the brain), where to go root of the parotid nerve, n.oculomotorius (3rd pair).
You can see the brain at the bottom black speech,substantia Nigra. Black speech divide the lower medulla into two vertices: posterior (dorsal) - the lining of the middle medulla, tegmentum mesencephali, and anterior (ventral) vіddіl - the basis of the lower brain, basis pedunculi cerebri. At the top of the middle medulla, the nuclei of the middle medulla lie and pass through the airways. The basis of the lower brain is made up of white speech, and low passageways pass here.
Water pipeline of the middle brain(Silvі vodoprovіd), aqueductus mesencephali (cerebri), get an empty III slug from IV and avenge the spinal cord. For his journey, the water of the brain is empty of the middle cerebral michur.
Near the aqueduct of the middle brain, the central sira speech is stouted, substantia grisea centrallis, in some area of the bottom of the water supply, the nuclei of two pairs of cranial nerves are perforated. On the rivers of the upper hump there is a guy parietal nerve nucleus,Nucleus nervous oculomotorii. Vono takes a part in the innervation of the eyes. The nucleus of the autonomic nervous system is localized ventrally in a parasympathetic way. adnexal nucleus of the paroxysmal nerve, Nucleus oculo- motorius accessorius. . In front and somewhere else the core of III bet is found intermediate core,Nucleus interstitialis. The growths of the clitin nucleus take part in the established reticulospinal tract and the posterior posterior bundle.
On the rivers of the lower humps near the ventral vіddіlakhs of the central syroї speech lie trochlear nucleus,Nucleus n. trochlearis. At the lateral ventricles of the central syria of the speech, the nucleus of the middle cerebellar duct of the trichaminal nerve (V pair) is extended to the tendon of the middle cerebellum.
In the case of the largest and most marked on the transverse view of the middle brain red core,Nucleus ruber. The base of the lower part of the brain is covered with low conducting paths. The inner and outer parts of the bases of the lower brain are formed by the fibers of the cortical-bridge path, and the medial part of the base itself is occupied by the frontal-bridge path, the lateral part - by the skronev-tim'yano-potilichno-bridge path. The middle part of the base of the lower brain is occupied by pyramids.
Cortical-nuclear fibers pass medially, laterally - cortical-spinal tracts.
In the middle brain, the center of hearing is thoracic, which ensures the innervation of certain mimic apples of the apple of the eye, as well as the middle brain nucleus of the fifth bet.
Through the middle brain pass viskhіdnі (sensitive) and nіzkhіdnі (ruhovі) conducting ways. Empty middle brain.
