Sensory and motor fibers of the nerve. Sensory nerve fibers

Stimulation EMG includes various methods for studying peripheral nerves, the autonomic nervous system and neuromuscular transmission:

SRV on motor fibers;
NRT for sensitive fibers;
F-wave;
H-reflex;
blink reflex;
bulbocavernosus reflex;
evoked skin-sympathetic potential (VKSP);
decrement test.

Stimulation methods for studying the conductive function of motor fibers, sensory fibers and VCSP make it possible to identify the pathology of each type of nerve fiber in the nerve and determine the localization of the lesion (the distal type of nerve damage is typical for polyneuropathies, local impairment of the conduction function - for tunnel syndromes, etc.) .

The options for the reaction of the peripheral nerve to damage are rather limited.

Any pathological factor that causes dysfunction of the nerve eventually leads to damage to the axons, or the myelin sheath, or both of these formations.

Objectives of the study: to determine the functional state and degree of damage to the motor, sensory and autonomic structures of the nerves; local dysfunctions of myelinated nerves, as well as restoration of motor functions; diagnosis and differential diagnosis of lesions of sensorimotor formations at the segmental, suprasegmental, peripheral and neuromuscular levels; identification and assessment of the degree of neuromuscular transmission disorders in myasthenia gravis and myasthenic syndromes; assessment of the prospects of various methods of treatment and the results of the use of certain drugs, as well as the degree of rehabilitation of patients and restoration of the function of the affected motor and sensory nerves.

INDICATIONS

Suspicion of diseases associated with impaired function of motor and sensory fibers of peripheral nerves or neuromuscular transmission:

various polyneuropathies;
mononeuropathies;
motor, sensory and sensorimotor neuropathies;
multifocal motor neuropathy;
tunnel syndromes;
traumatic nerve damage;
neural amyotrophy, including hereditary forms;
lesions of the roots of the spinal cord, cervical-brachial and lumbosacral plexus;
endocrine disorders (especially hypothyroidism, type 2 diabetes);
sexual dysfunction, sphincter disorders;
myasthenia gravis and myasthenic syndromes;
botulism.

CONTRAINDICATIONS

There are no special contraindications (including the presence of implants, pacemakers, epilepsy) for stimulation EMG. If necessary, the study can be carried out in patients in a coma.

PREPARATION FOR THE STUDY

Special training is not required. Before the start of the study, the patient takes off his watch, bracelets. Usually the patient is in a semi-sitting position in a special chair, the muscles should be as relaxed as possible. The limb under study is immobilized to exclude distortion of the shape of the potentials.

The extremity during the study should be warm (skin temperature 26-32 ° C), since with a decrease in skin temperature by 1 ° C, a decrease in NRV occurs by 1.1-2.1 m/s. If the limb is cold, before examination it is well warmed up with a special lamp or any heat source.

METHODOLOGY AND INTERPRETATION OF THE RESULTS

Stimulation EMG is based on the registration of the total response of a muscle (M-response) or nerve to stimulation with an electric current pulse. The conductive function of motor, sensory and autonomic axons of peripheral nerves or the functional state of neuromuscular transmission are examined.

Dysfunction of the axon (axonal process) leads to the development of the denervation-reinnervation process (DRP) in the muscle, the severity of which is determined using needle EMG. Stimulation EMG reveals a decrease in the amplitude of the M-response.

Dysfunction of the myelin sheath (demyelinating process) is manifested by a decrease in NRV along the nerve, an increase in the threshold for evoking an M-response, and an increase in residual latency.

It should be taken into account that the primary axonal process often causes secondary demyelination, and during the demyelinating process, secondary damage to the axon occurs at a certain stage. The task of EMG is to determine the type of nerve lesion: axonal, demyelinating, or mixed (axonal demyelinating).

Stimulation and recording of the muscle response is carried out using surface electrodes. Standard dermal silver chloride (AgCl) disk or cup electrodes are used as lead electrodes, which are attached with an adhesive plaster. To reduce the impedance, conductive gel or paste is used, the skin is thoroughly wiped with ethyl alcohol.

M-answer

M-response - the total action potential that occurs in the muscle with electrical stimulation of its motor nerve. The M-response has the maximum amplitude and area in the zone of distribution of the end plates (at the motor point). The motor point is the projection onto the skin of the zone of the end plates of the nerve. The motor point is usually located on the most convex section (abdomen) of the muscle.

In the study of the M-response, a bipolar method of assignment is used: one electrode is active, the second is a reference. An active recording electrode is placed in the region of the motor point of the muscle innervated by the nerve under study; reference electrode - in the area of the tendon of this muscle or in the place where the tendon is attached to the bone protrusion (Fig. 8-1).

Figure 8-1. Study of the conductive function of the ulnar nerve. Applying electrodes: an active abducting electrode is located at the motor point of the muscle that abducts the little finger; reference - on the proximal phalanx of the fifth finger; stimulating - at the distal point of stimulation on the wrist; grounding - just above the wrist.

In the study of the conductive function of the nerves, stimuli of supramaximal intensity are used. Usually, the M-response from the nerves of the hands begins to be recorded at a stimulus value of 6-8 mA, from the nerves of the legs - 10-15 mA. As the intensity of the stimulus increases, the amplitude of the M-response increases due to the inclusion of new MUs in the M-response.

A smooth increase in the amplitude of the M-response is associated with different excitability of nerve fibers: first, low-threshold fast-conducting thick fibers are excited, then thin, slow-conducting fibers. When all muscle fibers of the studied muscle are included in the M-response, with a further increase in the intensity of the stimulus, the amplitude of the M-response ceases to increase.

For the reliability of the study, the amplitude of the stimulus is increased by another 20-30%.

This value of the stimulus is called supramaximal.

Stimulation is carried out at several points along the course of the nerve (Fig. 8-2). It is desirable that the distance between the stimulation points be at least 10 cm. The M-response is recorded at each stimulation point. The difference in the latency of M-responses and the distance between the stimulation points make it possible to calculate the NPV for the nerve.

Rice. 8-2. Scheme for studying the conduction function of the ulnar nerve. Schematically shows the location of the outlet electrodes and the stimulation points of the ulnar nerve. At the distal point of stimulation, the M-response has the shortest terminal latency. The difference in latencies between the distal and more proximal points of stimulation determines the SRV.

When examining the conductive function of motor nerves, the following parameters are analyzed:

the amplitude of the M-response;
shape, area, duration of the negative phase of the M-response;
the presence of conduction blocks, the decrement of the amplitude and area of the M-response;
M-response evoking threshold;
NRV for motor (motor) fibers, M-response latency;
residual latency.

The main diagnostically significant parameters are the amplitude of the M-response and CRV. The amplitude, area, shape, and duration of the M-response reflect the amount and timing of muscle fiber contraction in response to nerve stimulation.

M-response amplitude

The amplitude of the M-response is estimated from the negative phase, since its shape is more constant, and is measured in millivolts (mV). A decrease in the amplitude of the M-response is an electrophysiological reflection of a decrease in the number of contracting muscle fibers in a muscle.

Reasons for the decrease in the amplitude of the M-response:

Violation of the excitability of nerve fibers, when part of the nerve fibers does not generate an impulse in response to electrical stimulation (axonal type of nerve damage - axonal polyneuropathies);

Demyelination of nerve fibers, when muscle fibers do not respond to a nerve impulse, which leads to a decrease in the amplitude of the M-response, however, the trophic function of the nerve remains intact;

Various myopathies (PMD, polymyositis, etc.). The M-response is absent in muscle atrophy, nerve rupture, or its complete degeneration.

The neural level of the lesion is characterized by an increase in the threshold for evoking an M-response and a violation of the SRV, an increase in residual latency, and "scattered" F-waves.

For the neuronal level of damage (ALS, spinal amyotrophies, spinal cord tumor, myelopathy, etc.), when the number of motoneurons and, accordingly, axons and muscle fibers decreases, the normal threshold for evoking the M-response, normal SRV, "giant", large and repeated F-waves and their complete loss.

The muscle level of the lesion is characterized by normal SRV and the threshold for inducing an M-response, the absence of F-waves or the presence of low-amplitude F-waves.

Stimulation EMG data do not allow an unambiguous assessment of the level of damage to the peripheral neuromotor apparatus - this requires needle EMG.

Shape, area and duration of the M-response

Normally, the M-response is a negative-positive signal fluctuation. The duration of the M-response is measured by the duration of the negative phase, the area

The M-response is also measured by the area of the negative phase. Indicators of the area and duration of the M-response do not have independent diagnostic value, but in conjunction with the analysis of its amplitude and shape, one can judge the processes of formation of the M-response.

With demyelination of nerve fibers, the M-response is desynchronized with an increase in its duration and a decrease in amplitude, and at the proximal points, desynchronization increases.

Excitation block

The excitation conduction block is the decrement of the amplitude of the M-response during stimulation at two adjacent points of more than 25% (calculated as the ratio of the amplitude A1:A2, expressed as a percentage, where A1 is the amplitude of the M-response at one point of stimulation, A2 is the amplitude of the M-response at the next, more proximal stimulation point). In this case, the increase in the duration of the negative phase of the M-response should not exceed 15%.

At the heart of the pathogenesis of the block of the conduction of excitation is a persistent local focus of demyelination (no more than 1 cm), causing a violation of the conduction of the impulse. Tunnel syndromes are a classic example of blocks in the conduction of excitation.

Two diseases with multiple persistent blocks of excitation conduction are known - motor-sensory multifocal polyneuropathy (Sumner-Lewis) and multifocal motor neuropathy with blocks of excitation conduction.

The correct diagnosis of multifocal motor neuropathy is extremely important, as the disease clinically mimics ALS, which often leads to serious diagnostic errors.

An adequate method for identifying blocks of excitation conduction in multifocal motor neuropathy is the method of stepwise examination of the nerve - "inching", which consists in stimulating the nerve at several points with a step of 1-2 cm. The location of the blocks of excitation conduction in multifocal motor neuropathy should not coincide with places of nerve compression in typical carpal tunnel syndromes.

M-response threshold

The threshold for evoking an M-response is the intensity of the stimulus at which the minimum M-response appears. Usually, the M-response from the nerves of the arms begins to be recorded at a stimulus amplitude of 15 mA and a duration of 200 μs, from the legs - 20 mA and 200 μs, respectively.

For demyelinating polyneuropathies, especially for hereditary forms, in which the initial M-response can appear at a stimulus intensity of 100 mA and 200 μs, an increase in the threshold for evoking M-responses is characteristic. Low stimulation thresholds are observed in children, in thin patients (3-4 mA). Changes in the thresholds for evoking M-responses should not be considered as an independent diagnostic criterion - they must be evaluated in conjunction with other changes.

The speed of propagation of excitation along the motor fibers and the latency of the M-response

CVD is defined as the distance that an impulse travels along a nerve fiber per unit of time and is expressed in meters per second (m/s). The time between the delivery of an electrical stimulus and the onset of the M-response is called the latency of the M-response.

CRV decreases during demyelination (for example, with demyelinating polyneuropathies), since in the areas of destruction of the myelin sheath, the impulse does not propagate in a saltatory manner, but sequentially, as in unmyelinated fibers, which causes an increase in the latency of the M-response.

The latency of the M-response depends on the distance between the stimulating and retracting electrode, therefore, when stimulating at standard points, the latency depends on the patient's height. Calculation of RTS avoids the dependence of the results of the study on the height of the patient.

NRV in the area of the nerve is calculated by dividing the distance between stimulation points by the difference in M-response latencies at these points: V = (D 2 - D 1)/ (L 2 - L 1), where V is the speed of conduction along the motor fibers; D 2 - distance for the second point of stimulation (distance between the cathode of the stimulating electrode and the active discharge electrode); D 1 - distance for the second point of stimulation (distance between the cathode of the stimulating electrode and the active discharge electrode); D 2 - D 1 reflects the distance between stimulation points; L 1 - latency at the first point of stimulation; L 2 - latency at the second point of stimulation.

A decrease in CRV is a marker of the process of complete or segmental demyelination of nerve fibers in neuritis, polyneuropathy, such as acute and chronic demyelinating polyneuropathies, hereditary polyneuropathy (Charcot-Marie-Tooth disease, except for its axonal forms), diabetic polyneuropathy, nerve compression (tunnel syndromes, injuries ) . Determination of SRV makes it possible to find out in which part of the nerve (distal, middle or proximal) pathological changes take place.

Residual latency

Residual latency is the calculated time of passage of an impulse along axon terminals. In the distal segment, the axons of motor fibers branch into terminals. Since the terminal does not have a myelin sheath, the CRF for them is significantly lower than for myelinated fibers. The time between the stimulus and the onset of the M-response upon stimulation at the distal point is the sum of the transit time along the myelinated fibers and the transit time along the axon terminals.

To calculate the time of impulse passage through the terminals, it is necessary to subtract the time of impulse passage through the myelinated part from the distal latency at the first stimulation point. This time can be calculated by assuming that the CRV at the distal site is approximately equal to the CRV at the segment between the first and second stimulation points.

Formula for calculating residual latency: R = L - (D:V l-2), where R - residual latency; L - distal latency (time from stimulus to the beginning of the M-response upon stimulation at the distal point); D - distance (distance between the active discharge electrode and the cathode of the stimulating electrode); V l-2 - SRV on the segment between the first and second points of stimulation.

An isolated increase in residual latency on one of the nerves is considered a sign of tunnel syndromes. The most common carpal tunnel syndrome for the median nerve is carpal tunnel syndrome; for the elbow - Guyon's canal syndrome; for the tibial - tarsal tunnel syndrome; for the peroneal - compression at the level of the rear of the foot.

An increase in residual latencies on all studied nerves is characteristic of demyelinating type neuropathies.

Criteria for normal values

In clinical practice, it is convenient to use the lower limits of the norm for the amplitude of the M-response and SRV and the upper limits of the norm for the residual latency and the threshold for inducing the M-response (Table 8-1).

Table 8-1. Normal values of the parameters of the study of the conduction function of motor nerves

Normally, the amplitude of the M-response is slightly higher at the distal points of stimulation; at the proximal points, the M-response is somewhat stretched and desynchronized, which leads to some increase in its duration and a decrease in amplitude (by no more than 15%). NRV along the nerves is slightly higher at the proximal stimulation points

A decrease in CRV, amplitude and desynchronization (increase in duration) of the M-response indicate nerve damage. The study of NRV on motor fibers allows you to confirm or refute the diagnosis and conduct differential diagnostics in diseases such as tunnel syndromes, axonal and demyelinating polyneuropathies, mononeuropathies, hereditary polyneuropathies.

Electromyographic criteria for demyelinating nerve damage

Classical examples of demyelinating neuropathies are acute and chronic inflammatory demyelinating polyneuropathies (CIDP), dysproteinemic neuropathies, hereditary motor sensory neuropathy (HMSN) type 1.

The main criteria for demyelinating polyneuropathies:

an increase in the duration and polyphasia of the M-response with normal amplitude
decrease in NRV along motor and sensory axons of peripheral nerves;
"loose" character of F-waves;
the presence of excitation blocks.

Electromyographic "clear criteria for nerve damage of an axonal nature. Most toxic (including medicinal) neuropathies are considered classic examples of axonal neuropathies. HMSN type 11 (axonal type of Charcot-Marie-Tous disease).

The main criteria for axonal polyneuropathies:

decrease in the amplitude of the M-response;
normal NRV values for motor and sensory axons of peripheral nerves;

With a combination of demyelinating and axonal signs, an axonal-demyelinating type of lesion is ascertained. The most dramatic decrease in CRV in peripheral nerves is observed in hereditary polyneuropathies.

In Russi-Levi syndrome, CVD can decrease to 7-10 m/s. with Charcot-Marie-Tus disease - up to 15-20 m / s. With acquired polyneuropathies, the degree of decrease in CRV is different depending on the nature of the disease and the degree of pathology of the nerves. The most pronounced decrease in velocities (up to 40 m/s on the nerves of the upper limbs and up to 30 m/s on the nerves lower extremities) are observed in demyelinating polyneuropathies. in which the processes of demyelination of the nerve fiber prevail over the damage to the axon: in chronic demyelinating and acute demyelinating polyneuropathy (GBS, Miller-Fisher syndrome).

Predominantly axonal polyneuropathy (for example, toxic: uremic, alcoholic, diabetic, drug, etc.) is characterized by a normal or slightly reduced CRV with a pronounced decrease in the amplitude of the M-response. To establish the diagnosis of polyneuropathy. at least three nerves must be examined. however, in practice, it is often necessary to examine a larger number (six or more) of nerves.

An increase in the duration of the M-response serves as additional evidence of demyelinating processes in the nerve under study. The presence of blocks of conduction of excitation is characteristic of tunnel syndromes. and also for multifocal motor neuropathy with conduction blocks.

An isolated lesion of one nerve suggests mononeuropathy. including carpal tunnel syndrome. With radiculopathy in the initial stages, the conductive function of the motor nerves often remains intact. In the absence of adequate treatment within 2-3 months, the amplitude of the M-response gradually decreases. the threshold for its evoking may increase with intact SRV.

A decrease in the amplitude of the M-response, with other absolutely normal indicators, requires expanding the diagnostic search and considering the possibility of a muscle disease or a disease of the spinal cord motoneurons. which can be confirmed by needle EMG.

Study of the conductive function of sensory nerves

NRV on sensory fibers is determined by recording the action potential of the afferent (sensory) nerve in response to its transcutaneous electrical stimulation. Methods of registration of SRV on sensory and motor fibers have much in common. at the same time, there is an important pathophysiological difference between them: in the study of motor fibers, the reflex response of the muscle is recorded. and in the study of sensory fibers - the excitation potential of the sensory nerve.

There are two ways to conduct research: orthodromic. in which the distal parts of the nerve are stimulated. and signals are recorded at proximal points. and antidromic. at which registration is carried out distal to the point of stimulation. In clinical practice, the antidromic method is more often used as a simpler one. although less accurate.

Methodology

The position of the patient, the temperature regime, the electrodes used are similar to those in the study of the function of motor fibers. You can also use special finger electrodes for the study of sensory fibers. When registering from the nerves of the hands, the active electrode is applied to the proximal phalanx II or III (for the median nerve) or the fifth finger (for the ulnar nerve), the reference electrode is located on the distal phalanx of the same finger (Fig. 8-3).

The position of the grounding and stimulating electrodes is similar to that in the study of motor fibers. When registering the sensory response of the sural nerve, the active electrode is placed 2 cm below and 1 cm posterior to the lateral malleolus, the reference electrode is 3-5 cm distal, the stimulating electrode is placed along the sural nerve on the posterolateral surface of the leg. With the correct location of the stimulating electrode, the patient feels the irradiation of an electrical impulse along the lateral surface of the foot.

The ground electrode is located on the lower leg distal to the stimulating one. The sensory response is much lower in amplitude (for the ulnar nerve - 6-30 mV, while the motor response is 6-16 mV). The excitation threshold of thick sensory fibers is lower than that of thinner motor fibers; therefore, stimuli of subthreshold (in relation to motor fibers) intensity are used.

The median, ulnar, gastrocnemius, and less commonly, the radial nerve are most often examined.

The most significant parameters for clinical practice:

sensory response amplitude;
NRT on sensory fibers, latency.

Sensory response amplitude

The amplitude of the sensory response is measured by the "peak-peak" method (maximum negative - minimum positive phase). Violation of the axon function is characterized by a decrease in the amplitude of the sensory response or its complete loss.

Speed of propagation of excitation and latency

As with motor fiber testing, latency is measured from stimulus artifact to the onset of response. CRV is calculated in the same way as in the study of motor fibers. A decrease in CRV indicates demyelination.

Normal values

In clinical practice, it is convenient to analyze the results relative to the lower limit of normal values (Table 8-2).

Table 8-2. The lower limits of the normal values of the amplitude and NRV of the sensory response

Clinical significance of the analyzed parameters

As in the study of motor fibers, a decrease in CRF is characteristic of demyelinating processes, and a decrease in amplitude is characteristic of axonal processes. With severe hypesthesia, the sensory response is sometimes not possible to register.

Sensory disorders are detected in tunnel syndromes, mono- and polyneuropathies, radiculopathies, etc. For example, carpal tunnel syndrome is characterized by an isolated decrease in the distal CRV along the median sensory nerve at normal speed at the level of the forearm and along the ulnar nerve. At the same time, in the initial stages of the SRV, it decreases, but the amplitude remains within the normal range. In the absence of adequate treatment, the amplitude of the sensory response also begins to decrease. Compression of the ulnar nerve in the Guyon canal is characterized by an isolated decrease in distal velocity along the sensory fibers of the ulnar nerve. A generalized decrease in CRV along sensory nerves is characteristic of sensory polyneuropathy. Often it is combined with a decrease in the amplitude of the sensory response. A uniform decrease in CRV below 30 m/s is characteristic of hereditary polyneuropathies.

The presence of anesthesia/hypesthesia in the presence of normal conductive function of sensory fibers makes it possible to suspect a higher level of damage (radicular or central genesis). In this case, the level of sensory disturbances can be clarified using somatosensory evoked potentials (SSEPs).

F-wave research

F-wave (F-response) - the total action potential of the DE muscle that occurs during electrical stimulation of a mixed nerve. Most often, F-waves are analyzed in the study of the median, ulnar, peroneal, tibial nerves.

Methodology

In many ways, the registration technique is similar to that in the study of the conductive function of motor fibers. In the process of studying motor fibers, after recording the M-response at the distal stimulation point, the researcher switches to the F-wave recording application, records F-waves with the same stimulus parameters, and then continues to study motor fibers at other stimulation points.

The F-wave has a small amplitude (usually up to 500 µV). When a peripheral nerve is stimulated at a distal point, an M-response with a latency of 3-7 ms appears on the monitor screen, an F-response has a latency of about 26-30 ms for the nerves of the arms and about 48-55 ms for the nerves of the legs (Fig. 8-4) . Standard research includes registration of 20 F-waves.

Diagnostically significant indicators of the F-wave:

latency (minimum, maximum and average);
range of F-wave propagation velocities;
the phenomenon of "scattered" F-waves;
F-wave amplitude (minimum and maximum) ;
the ratio of the average amplitude of the F-wave to the amplitude of the M-response, the phenomenon of "giant F-waves";
blocks (percentage of falling out) of F-waves, that is, the number of stimuli left without an F-response;
repeated F-waves.

Latency, F-wave velocity range, "scattered" F-waves

Latency is measured from stimulus artifact to the onset of the F-wave. since the latency depends on the length of the limb, it is convenient to use the range of F-wave propagation velocities. The expansion of the velocity range towards low values indicates a slowdown in conduction along individual nerve fibers, which may be an early sign of a demyelinating process.

In this case, a part of the F-waves may have a normal latency.

Calculation of RTS from the F-wave: V = 2 x D: (LF - LM - 1 ms), where V - RTS determined using the F-wave; D is the distance measured from the point under the cathode of the stimulating electrode to the spinous process of the corresponding vertebra; LF - F-wave latency; LM - latency of the M-response; 1 ms - the time of the central delay of the pulse.

With a pronounced demyelinating process, the phenomenon of "scattered" F-waves is often detected (Fig. 8-5), and in the most advanced stages their complete loss is possible. The reason for the "scattered" F-waves is the presence of multiple foci of demyelination along the course of the nerve, which can become a kind of "reflector" of the impulse.

Reaching the focus of demyelination, the impulse does not propagate further antidromic, but is reflected and orthodromic propagates to the muscle, causing contraction of muscle fibers. The phenomenon of "scattered" F-waves is a marker of the neuritic level of damage and practically does not occur in neuronal or primary muscle diseases.

Rice. 8-4. Registration of the F-wave from the ulnar nerve of a healthy person. The M-response was recorded at a gain of 2 mV/D, its amplitude was 10.2 mV, the latency was 2.0 ms; F-waves were recorded at an amplification of 500 μV/d, the average latency is 29.5 ms (28.1 -32.0 ms), the amplitude is 297 μV (67-729 μV), the CRP determined by the F-wave method is 46 .9 m/s, speed range - 42.8-49.4 m/s.

Rice. 8-5. The phenomenon of "scattered" F-waves. Study of the conduction function of the peroneal nerve in a 54-year-old patient with diabetic polyneuropathy. The resolution of the M-response region is 1 mV / D, the F-wave region is 500 μV / d, the sweep is 10 ms / d. It is not possible to determine the range of RTS in this case.

F-wave amplitude, "giant" F-wave phenomenon

Normally, the amplitude of the F-wave is less than 5% of the amplitude of the M-response in this muscle. Typically, the amplitude of the F-wave does not exceed 500 μV. F-wave amplitude is measured "peak to peak". During reinnervation, the F-waves become larger. Diagnostically significant is the ratio of the average amplitude of the F-wave to the amplitude of the M-response. An increase in the amplitude of the F-wave by more than 5% of the amplitude of the M-response (large F-waves) indicates the process of reinnervation in the muscle.

The appearance of the so-called giant F-waves with an amplitude of more than 1000 μV, reflecting the degree of pronounced reinnervation in the muscle, is also of diagnostic significance. "Giant" F-waves are most often observed in diseases of the motor neurons of the spinal cord (Fig. 8-6), although they can also appear in neural pathology that occurs with severe reinnervation.

F-wave dropout

The fallout of the F-wave is called its absence on the registration line. The cause of the loss of the F-wave can be a lesion of both the nerve and the motor neuron. Normally, 5-10% F-waves are acceptable. Complete loss of F-waves indicates the presence of a pronounced pathology (in particular, it is possible in the later stages of diseases with severe muscle atrophy).

Rice. 8-6. "Giant" F-waves. Examination of the ulnar nerve of a patient (48 years old) with ALS. The resolution of the M-response region is 2 mV / d, the F-wave region is 500 μV / d, the sweep is 1 ms / d. The average amplitude of the F-waves is 1084 µV (43-2606 µV). The speed range is normal (71 -77 m/s).

Repeated F-waves

Normally, the probability of a response from the same motor neuron is extremely small. With a decrease in the number of motor neurons and a change in their excitability (some motor neurons become hyperexcitable, others, on the contrary, respond only to strong stimuli), there is a possibility that the same neuron will respond many times, so F-waves of the same latency, shape and amplitude appear, called repeated. The second reason for the appearance of repeated F-waves is an increase in muscle tone.

Normal values

in a healthy person, it is considered acceptable if up to 10% of fallouts, "giant" AND repeated F-waves appear. When determining the speed range, the minimum speed should not be lower than 40 m/s for the nerves of the arms and 30 m/s for the nerves of the legs (Table 8-3). "Scattered" F-waves and complete loss of F-waves are not normally observed.

Table 8-3. Normal values of the amplitude and propagation velocity of F-waves

Normal values of the minimum F-wave latencies depending on the growth are presented in Table. 8-4.

Table 8-4. Normal latency values of F-waves, MS

Clinical relevance

The expansion of the range of erv, determined by the F-wave method, and, accordingly, the lengthening of the latencies of the F-waves, the phenomenon of "scattered" F-waves, suggest the presence of a demyelinating process.

In acute demyelinating polyneuropathy, as a rule, only a violation of the conduction of F-waves is detected, in chronic - F-waves may be absent (blocks of F-waves). Frequent repeated F-waves are observed with damage to the motor neurons of the spinal cord. Especially characteristic of diseases of motor neurons is the combination of "giant" repeated F-waves and their loss.

Another sign of damage to motor neurons is the appearance of a large number of "giant" F-waves. The presence of large F-waves indicates the presence of a reinnervation process in the muscle.

Despite the high sensitivity of F-waves, this method can only be used as an additional method (in conjunction with the data from the study of the conductive function of peripheral nerves and needle EMG).

Study of the H-reflex

H-reflex (H-response) - the total action potential of the DE muscle, which occurs when a weak electric current stimulates the afferent nerve fibers coming from this muscle.

Excitation is transmitted along the afferent fibers of the nerve through the posterior roots of the spinal cord to the intercalary neuron and motor neuron, and then through the anterior roots along the efferent nerve fibers to the muscle.

Analyzed indicators of H-response: trigger threshold, shape, ratio of H-reflex amplitude to M-response, latent period or speed of its reflex response.

Clinical relevance. When pyramidal neurons are damaged, the threshold for evoking an H-response decreases, and the amplitude of the reflex response increases sharply.

The reason for the absence or decrease in the amplitude of the H-response may be pathological changes in the anterior horn structures of the spinal cord, afferent or efferent nerve fibers, posterior or anterior spinal nerve roots.

Study of the blink reflex

Blinking (orbicular, trigeminofacial) reflex - the total action potential that occurs in the examined facial muscle (for example, t. Orbicularis ocu li) with electrical stimulation of the afferent nerve fibers of one of the branches n. trigem eni - I, II or III. As a rule, two evoked reflex responses are recorded: the first with a latent period of about 12 ms (monosynaptic, an analogue of the H-reflex), the second with a latent period of about 34 ms (exteroceptive, with polysynaptic spread of excitation in response to irritation).

In the case of normal SRV along the facial nerve, an increase in the time of the reflex blinking response along one of the branches of the nerve indicates its damage, and its increase along all three branches of the nerve indicates damage to its node or nucleus. With the help of the study, it is possible to conduct a differential diagnosis between damage facial nerve in the bone canal (in this case, there will be no reflex blinking response) and its defeat after leaving the stylomastoid foramen.

Study of the bulbocavernosus reflex

Bulbocavernous reflex - the total action potential that occurs in the examined muscle of the perineum during electrical stimulation of the afferent nerve fibers n. pudendus.

The reflex arc of the bulbocavernosal reflex passes through the sacral segments of the spinal cord at the level of S 1 -S 4 , afferent and efferent fibers are located in the trunk of the pudendal nerve. When examining the function of the reflex arc, one can get an idea of the spinal level of innervation of the sphincters, muscles of the perineum, as well as identify disorders in the regulation of sexual function in men. The bulbocavernosus reflex study is used in patients suffering from sexual dysfunction and pelvic disorders.

The study of evoked cutaneous sympathetic potential

The study of VKSP is carried out from any part of the body where sweat glands are present. As a rule, VKSP registration is carried out from the palmar surface of the hand, the plantar surface of the foot, or the urogenital region. An electrical stimulus is used as a stimulus. Assess the SRV on the vegetative fibers and the amplitude of the VKSP. The study of VKSP allows you to determine the degree of damage to the vegetative fibers. Analyze myelinated and unmyelinated vegetative fibers.

Indications. Autonomic disorders associated with impaired heart rate, sweating, blood pressure as well as sphincter disorders, erectile dysfunction and ejaculation.

Normal indicators of VKSP. Palmar surface: latency - 1.3-1.65 ms; amplitude - 228-900 μV; plantar surface - latency 1.7-2.21 ms; amplitude 60-800 μV.

Interpretation of results. NRV and VCSP amplitude are reduced in sympathetic fiber lesions. Some neuropathies develop symptoms associated with damage to myelinated and unmyelinated autonomic fibers. The basis of these disorders is the defeat of the autonomic ganglia (for example, in diabetic polyneuropathy), the death of unmyelinated axons of peripheral nerves, as well as the fibers of the vagus nerve. Disturbances in sweating, heart rhythm, blood pressure, and the genitourinary system are the most common autonomic disorders in various polyneuropathies.

Study of neuromuscular transmission (decrement test)

Disturbances in synaptic transmission may be due to presynaptic and postsynaptic processes (damage to the mechanisms of mediator synthesis and release, disruption of its action on the postsynaptic membrane, etc.). The decrement test is an electrophysiological method by which the state of neuromuscular transmission is assessed, based on the fact that, in response to rhythmic nerve stimulation, the phenomenon of a decrease in the amplitude of the M-response (its decrement) is revealed.

The study allows you to determine the type of neuromuscular transmission disorder, assess the severity of the lesion and its reversibility in the process of pharmacological tests [test with neostigmine methyl sulfate (prozerin)], as well as the effectiveness of treatment.

Indications: suspicion of myasthenia gravis and myasthenic syndromes.

The variety of clinical forms of myasthenia gravis, its frequent association with thyroiditis, tumors, polymyositis and other autoimmune processes, wide variations in the effectiveness of the same interventions in different patients make this method of examination extremely important in the system of functional diagnostics.

Methodology

The position of the patient, the temperature regime and the principles of applying electrodes are similar to those in the study of the conductive function of the motor nerves.

The study of neuromuscular transmission is carried out in a clinically weaker muscle, since in an intact muscle, a violation of the neuromuscular transmission is either absent or minimally expressed. If necessary, the decrement test can be performed in various muscles of the upper and lower extremities, face and trunk, however, in practice, the study is most often carried out in the deltoid muscle (stimulation of the axillary nerve at Erb's point). If strength in the deltoid muscle is preserved (5 points), but weakness is present mimic muscles, it is necessary to test circular muscle eyes. If necessary, a decrement test is performed in the muscle that removes the little finger of the hand, the triceps muscle of the shoulder, the digastric muscle, etc.

At the beginning of the study, in order to establish the optimal stimulation parameters, the M-response of the selected muscle is recorded in a standard way. Then, indirect electrical low-frequency stimulation of the nerve innervating the studied muscle is performed at a frequency of 3 Hz. Five stimuli are used and subsequently the presence of a decrement in the amplitude of the last M-response relative to the first is assessed.

After performing the standard decrement test, post-activation relief and post-activation exhaustion tests are performed.

Interpretation of results

During an EMG examination in a healthy person, stimulation with a frequency of 3 Hz does not reveal a decrement of the amplitude (area) of the M-response of the muscle due to large stock reliability of neuromuscular transmission, that is, the amplitude of the total potential remains stable throughout the entire period of stimulation.

Rice. 8-7. Decrement test: study of neuromuscular transmission in a patient (27 years old) with myasthenia gravis (generalized form). Rhythmic stimulation of the axillary nerve with a frequency of 3 Hz, registration with deltoid muscle(muscle strength 3 points). Resolution - 1 mV / d, sweep - 1 ms / d. The initial amplitude of the M-response is 6.2 mV (the norm is more than 4.5 mV).

If the reliability of neuromuscular transmission decreases, the exclusion of muscle fibers from the total M-response is manifested by a decrease in the amplitude (area) of subsequent M-responses in a series of impulses in relation to the first, that is, the M-response decrement (Fig. 8-7). Myasthenia gravis is characterized by a decrement of the M-response amplitude of more than 10% with its normal initial amplitude. The decrement usually corresponds to the degree of decrease in muscle strength: with a strength of 4 points it is 15-20%, 3 points - 50%, 1 point - up to 90%. If, with a muscle strength of 2 points, the decrement is insignificant (12-15%), the diagnosis of myasthenia gravis should be questioned.

For myasthenia, the reversibility of neuromuscular transmission disorders is also typical: after the administration of neostigmine methyl sulfate (prozerin), an increase in the amplitude of the M-response and / or a decrease in the block of neuromuscular transmission is noted.

A pronounced increase in the amplitude of the M-response during the period of post-activation relief makes it possible to suspect the presynaptic level of the lesion, in this case, a test with tetanization (stimulation with a series of 200 stimuli at a frequency of 40-50 Hz) is performed in the muscle that abducts the little finger of the hand, which reveals an increment in the amplitude of the M-response . The amplitude increment of the M-response of more than +30% is pathognomonic for the presynaptic level of the lesion.

Nufern offers two types of sensor optical fibers: SM(singlemode) and MM(multimode). This type of optical fiber makes it possible to provide acoustic and temperature sensing in extremely harsh environments. Nufern also offers fibers for space applications that meet the most demanding requirements. This section also contains radiation rigid and radiation-sensitive fibers, as well as fiber sensors for real-time measurements and gyroscopic systems.

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INHERITANCE OF THE SIGNS OF SEED PRODUCTIVITY OF CULTURAL FLAX AND THEIR BREEDING USE ABSTRACT DIS. ... CANDIDATE OF AGRICULTURAL SCIENCES

M.: MOSCOW ORDER OF LENIN AND THE ORDER OF LABOR RED BANNER AGRICULTURAL ACADEMY NAMED AFTER K. A. TIMIRYAZEV

Purpose and objectives of research. To study the nature of inheritance and the genetic nature of the signs of seed productivity of cultivated flax

flax-dadguntsy testify to the significant achievements of domestic breeding to increase the fiber content<...>It was revealed that the weight of 1000 seeds, the total height, - ", plants, the fiber content in the offspring are controlled<...>The object of research is service-contrasting in terms of yields and weight ". *. 1000 seeds, ̂ fiber content<...>nor (1000 i seeds (General "Technical;" Cashier "Kept woman height" length.) fiber-j "fiber. 1grow!<...>Genetic control of traits: "total plant height", "fiber mass" and "stem fiber content"

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Technology lessons. Service labor teaching materials for students

Methodical materials are intended for students of the correspondence department of the Faculty of Technology of the State Educational Institution of Higher Professional Education "SHGPU", studying in the specialty 050502.65 Technology and Entrepreneurship while studying the discipline Theory and Methods of Teaching Technology and Entrepreneurship, as well as during the period of teaching practice.

objects of labor, respectful for any work activity, including homework, and develop sensory<...>Fabric is made from yarn, yarn from fiber (or: yarn is made from fiber, fabric is made from yarn).<...>Make a scheme "Natural fibers" from cards (Fig. 2).<...>The thinnest fiber _________________ 2. The shortest fiber _________________ 3.<...>Fibers that exist in nature Natural fibers Plant origin Animal origin

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Utilization of waste of the agro-industrial complex studies. allowance

Pulp and paper production is a source of sulfite liquor, fine cellulose fiber,<...> Alimentary fiber(PV), which are synonymous with indigestible carbohydrates, fiber, dietary fiber<...>Despite a large number of studies, there is no consensus on the term "Dietary fiber".<...>The amount and ratio of biopolymers that define the term "dietary fiber" is different, which significantly<...>Dietary fiber / M. S. Dudkin [and others]. - Kyiv: Harvest, 1988. - 152 p. 52. Zolotareva, A. M.

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The relevance of the problem of diabetic distal polyneuropathy (DDPN) is due to its high prevalence, according to specialized studies, late diagnosis and serious consequences. There is no doubt about the importance of diagnosing DDPN at its early stage: it is during this period that damage to the peripheral nerves is reversible, and the treatment is most effective. However, it is difficult to objectify the diagnosis of DDPN: the data of neurological and electrophysiological tests often do not correspond to clinical symptoms, since these methods assess damage to large nerve fibers, while in DDPN, small fibers are damaged first of all. The use of skin biopsy and corneal confocal microscopy (CMR) for evaluation of small fibers in clinical practice is extremely limited. As an alternative, the possibilities of electroneuromyography (ENMG) are analyzed: parameters with their subjective characteristics, choice of nerves and their number for diagnosing DDPN in the context of topographic neurology and neurophysiology of distal fibers

According to the results of ENMG, the conduction velocity along the motor fibers of the peripheral nerves of the lower extremities<...>The selection of a stimulus in the study of conduction along sensory fibers is carried out individually.<...>RTS along sensory fibers is determined in two ways: using the orthodromic propagation of excitation<...>The motor and sensory responses of the ulnar nerve can also be tested.<...>The result of the nerve impulse conduction along the motor and sensory fibers of the peripheral

Clinical aspects in the expert work of an occupational pathologist: a textbook

The manual presents the clinical aspects of assessing the occupational situation, the lack of awareness of which the primary level of occupational pathology leads either to an erroneous or belated suspicion of an occupational disease; ideas about various levels of professionally determined health disorders are presented; in a compressed form, the clinical features of the main occupational nosological units are presented. In order to assimilate and consolidate the stated provisions, the training manual uses situational tasks in the form of analyzes of 69 clinical cases of consultations or examinations of the most common clinical situations related to the profession. The textbook is intended for occupational pathologists, primary care physicians of occupational pathology, and, first of all, for those taking part in preliminary and periodic medical examinations, for general medical doctors (general practitioners, family doctors, pulmonologists, neurologists) who, to one degree or another, are faced with questions professional determination of health disorders, as well as for students of GBOU DPO and for students of medical universities and academies studying in the specialties "Medicine" and "Medical and preventive care".

? <...> <...> <...>, since the conduction of excitation along sensory fibers was investigated.<...>

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A survey of 14 children with various infectious pathologies, who were in the resuscitation and intensive care unit, was carried out. All underwent electroneuromyography. Polyneuropathy of critical conditions was revealed in 10 children. It is shown that the frequency of severe course of this condition was 40%. The peripheral nerves of the lower extremities were predominantly affected in polyneuropathy. On average, polyneuropathy developed on the 5th–7th day from the moment of stay on mechanical ventilation.

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Clinical aspects in the expert work of an occupational pathologist. allowance

<...>If: 1 SRV along the sensory fibers of the upper extremities; 2 SRV on sensory fibers of the lower extremities<...>SENMG: NRV along the sensory fibers of the nerves of the upper extremities - 40.044.4 m/sec and sensory fibers of the nerves<...>, since the conduction of excitation along sensory fibers was investigated.<...>If: 1 SRV along the sensory fibers of the upper extremities; 2 SRV on sensory fibers of the lower extremities

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The nature of the pain syndrome, the content of lactate, pyruvate, indicators of lipid peroxidation (LPO) were assessed by the level of products that react with thiobarbituric acid, the activity of superoxide dismutase and catalase, the concentration of substance P and norepinephrine in the blood in patients with compressive-ischemic neuropathy of the median nerve in the carpal tunnel. 10 patients in the control group (basic therapy) and 17 patients in the main group (basic therapy + intravenous laser blood irradiation (ILBI) + Phenibut (gamma-amino-beta-phenyl-butyric acid hydrochloride)) at the time of hospitalization and after the course of treatment. At the time of hospitalization, all patients had an increase in the lactate-pyruvate ratio and activation of lipid peroxidation processes. A significant increase in the content of substance P in the blood and a decrease in the concentration of norepinephrine were observed mainly in patients of the main group before treatment. The use of ILBI and Phenibut in the complex therapy contributed to significant positive dynamics according to the results of pain syndrome assessment, improved energy metabolism processes, decreased lipid peroxidation activation and blood levels of the pain neurotransmitter substance P with an increase in the level of norepinephrine. The obtained clinical and pathobiochemical data confirm the pathogenetic validity of the use of ILBI and Phenibut for the treatment of neuropathic pain in patients with carpal tunnel syndrome.

This is due to the fact that there are pathological interactions between nerve fibers.<...>The motor and sensory fibers of the median nerve were examined using surface recording electrodes<...>fibers of the median nerve.<...>Eastern Europe” № 3 (19), 2013 Table 1 ENMG data in the study of motor and sensory fibers<...>fibers Amplitude of PDCH, µV 48.3 ± 16.6 10.7 ± 2.9* SPI, m/s 55.2 ± 5.3 36.4 ± 4.1* Note: * –

No. 2 [Nervous diseases, 2016]

The journal "Nervous Diseases" is published with the support of the Scientific Center of Neurology of the Russian Academy of Medical Sciences. The main objective of the publication is to highlight and popularize among general practitioners modern approaches to the prevention, diagnosis and treatment of nervous diseases. Special attention The pages of the journal are devoted to domestic and international regulatory documents, clinical guidelines and standards in the field of neurology, as well as to the analysis of clinical cases and the exchange of experience.

The passage of impulses along the sensory fibers of peripheral nerves was studied for the median, ulnar<...>After the therapy, the conduction in both motor and sensory fibers increased.<...>The speed of impulse conduction along the motor fibers of peripheral nerves in patients with autonomic-sensory<...>Distal latency along motor fibers of peripheral nerves in patients with autonomic-sensory<...>Cocarnit improves conductivity along the motor and sensory fibers of the peripheral nerves of the upper and lower

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Physiology of sensory systems method. instructions

The section "Physiology of sensory systems" is part of the discipline "Physiology of higher nervous activity and sensory systems". The purpose of teaching the discipline is to introduce students to the structure and functions of all types of sensory organs, the mechanism of regulation of their activity. The knowledge gained by students in the study of this section of physiology can be used by them as a foundation for mastering subsequent special psychological disciplines. Designed for students studying in the specialty 030301 Psychology (discipline "Physiology of higher nervous activity and sensory systems", block EH), correspondence courses.

and sensory systems.<...>Mechanisms of sensory sensitivity.<...>Sound encoding in the fibers of the auditory nerve Hair cells form synaptic contacts with sensory<...> <...>One way: fast myelinated fibers go to the thalamus and then to the sensory and motor areas

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Selected lectures on human physiology (nervous and sensory systems) studies. allowance

Publishing house SibGUFK

In the textbook, from modern scientific positions, the functions of the nervous and sensory systems of the human body are considered, as well as the mechanisms of their regulation, taking into account age-related changes and the effects of physical activity.

Sensory areas of the cortex include fields into which fibers come from the projection nuclei of the thalamus.<...>these are highly specialized epithelial cells that are in contact with the nerve ( sensory) fiber of the sensory<...>to the fiber (Fig. 22).<...>Intrafusal fibers are classified into two types.<...>; 2 - the end of the same fiberattached to the tendon; 3 - the so-called nuclear bag of fibers with spiral

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CLINICAL AND ELECTROPHYSIOLOGICAL CHARACTERISTICS OF NEUROLOGICAL COMPLICATIONS OF TYPE 2 DIABETES IN ELDERLY PATIENTS AND THEIR TREATMENT [Electronic resource] / Chistova, Aleksandrov, Vinogradova // Advances in Gerontology .- 2013 .- №2 .- P. 14 4- 149 .- Access mode: https://website/efd/547677

The analysis of subjective and objective symptoms, electroneuromyographic parameters, analysis of the state of autonomic balance in 120 patients with type 2 diabetes mellitus was carried out. The dynamics of indicators depending on the duration of the disease was studied. The results obtained indicate an increase in the severity of polyneuropathy, including cardiac autonomic neuropathy, depending on the duration of the disease.

Here and in Table. 4: SRVm - SRV along the motor fibers of the peroneal nerve, SRVl - SRV along the motor fibers<...>ulnar nerve, SRVi - SRV along the calf (sensory) nerve, SRVlch - SRV along the sensory fibers of the ulnar<...>At the time of diagnosis according to ENMG data, patients with type 2 diabetes have signs of damage to sensory<...>With a disease duration of 1–10 years, there is a tendency to improve the conduction of motor and sensory<...>fibers, which is associated with better compensation for diabetes.

X-linked dominant hereditary motor sensory neuropathy (HMSN, subtype IX) is the second most common variant of type I demyelinating polyneuropathy, caused by mutations in the GJB1 gene encoding the connexin-32 transmembrane protein. HMCHIX manifests with progressive muscle weakness, loss of reflexes, and sensory disturbance in the extremities of the distal type with more pronounced clinical manifestations in men. The study group included 20 patients with an established genetic defect (7 male probands, 13 relatives). The spectrum of mutations in the GJB1 gene, the clinical characteristics of patients, and the diagnostic algorithm used in Belarus are presented. Mutation identification makes it possible to establish a diagnosis, determine a genetic prognosis, and conduct prenatal DNA diagnostics of HMSN in high-risk families.

X-linked dominant hereditary motor-sensory<...>Hereditary motor sensory neuropathy, subtype IX (HMCHIX), is a form of peripheral<...>The disease is characterized by a pronounced clinical manifestation of hereditary motor-sensory neuropathy IX:<...>fibers) is a highly informative method for diagnosing HMSN, and is also indispensable for differential<...>In hereditary polyneuropathies, a decrease in SPI indicators for motor and sensory fibers of peripheral

The aim of the work was to study the informational value of dynamic electroneuromyography using the motosensory coefficient and the tacheodispersion index in patients with diabetic and alcoholic forms of sensorimotor distal polyneuropathies. Some features of the polyneuropathy clinic are described by means of questionnaires and scales. The necessity of examining patients in dynamics by conducting stimulation electromyography was emphasized, which clarifies the course of the disease in question.

electroneuromyography, M-response amplitude, motor sensory coefficient, polyneuropathy, craniopathy, motor fibers<...>, sensory fibers , tacheodispersion.<...>damage to sensory and motor fibers.<...>The indicators of the sensory response of the muscle and the action potential of the nerve were studied - the sensory response of the speed of conduction<...>, orthodromic sensory response amplitude, and sensory response latency.

Clinical, functional and metabolic disorders and the possibility of their correction in patients with chronic inflammatory demyelinating polyneuropathy [Electronic resource] / Nechipurenko [et al.] // Neurology and Neurosurgery. Eastern Europe.- 2014 .- №2 .- S. 65-79 .- Access mode: https://site/efd/495023

The severity of pain syndrome and neurological status were assessed, electroneuromyographic testing of axonal and conductive nerve function, speckloptic study of skin microcirculation of the lower extremities, determination of the content of substance P and norepinephrine in blood plasma in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) accompanied by neuropathic pain syndrome (NPS). ) It has been established that the inclusion of intravenous laser blood irradiation (ILBI) and α1-adrenergic blocker - nicergoline in the complex therapy contributes to significant positive dynamics according to the results of the pain syndrome score, improvement of the speckloptic parameters of the proximal-distal gradient of the skin microcirculation of the lower extremities and improvement of venous outflow. In patients with CIDP and NBS with an increased content of the main pain neurotransmitter, substance P, in the blood, there were no significant changes in the content of the antinociceptive neurotransmitter, norepinephrine. The obtained clinical and functional data indicate the possibility of using ILBI and nicergoline in the complex therapy of patients with CIDP and LBP.

In demyelinating PNP, thick myelinated fibers are predominantly affected, i.e. motor<...>and sensory fibers that conduct deep sensitivity but remain relatively intact<...>Eastern Europe" No. 2 (22), 2014 vegetative fibers, as well as sensory fibers that conduct surface<...>The motor fibers of the median, peroneal and tibial nerves were examined using superficial<...>C-fibers activated during NBS secrete from their peripheral endings into the tissues of neurokinins, in

A critical state is an extreme degree of any pathology, including iatrogenic, in which artificial replacement or support of vital functions is required. The most frequent and formidable complication of the peripheral nervous system that occurs in critically ill patients is polyneuropathy. Critical polyneuropathy is an acute axonal sensorimotor polyneuropathy, a syndrome of neuromuscular disorders, manifested by muscle weakness, that occurs in patients who are in critical condition for a long time (more than 7 days) in intensive care units on mechanical ventilation. The incidence of this disorder is 33.1–52 cases per 100,000 population. Polyneuropathy in critically ill patients is most often associated with sepsis and multiple organ failure. Its development was also observed after acute respiratory distress syndrome, acute episodes of arterial hypotension and trauma without signs of sepsis and multiple organ failure, the use of aminoglycosides (gentamicin), corticosteroids, the use of drugs that block neuromuscular transmission, which are widely used in intensive care. This review devoted to the etiology, diagnosis, prevention and treatment of polyneuropathy in critically ill patients.

Polyneuropathy of critical conditions is an acute axonal sensory-motor polyneuropathy, a syndrome<...>In most polyneuropathies, the longest nerve fibers are the first to suffer, therefore, in<...>This condition is an acute axonal sensorimotor polyneuropathy with muscle weakness<...>According to ENMG, there was a decrease in the M-response in motor, sensory fibers.<...>ENMG was performed, which revealed a violation of the conduction of excitation both in motor and sensory fibers

Physiology of sensory systems, central nervous system and higher nervous activity studies. allowance

The manual outlines modern ideas about the structure and functions of the nervous and sensory systems, the doctrine of GNI as the basis of the body's behavior. An attempt was made to describe the functioning of the central nervous structures at the system level. It is intended for students studying in the specialty 030301 Psychology (discipline "Physiology of Higher Nervous Activity and Sensory Systems", block EH), full-time and part-time forms of education, as well as graduate students and teachers of psychological departments of universities.

Sensor systems 1.<...>Hair cells form synaptic contacts with sensory fibers of the YIII pair (n. cochlearis), body<...>In response to low-frequency sounds, sensory nerve fibers discharge synchronously with receptor potentials.<...>One way: fast myelinated Aδ fibers (12 - 14 m/s) go to the thalamus, and then to sensory and motor<...>Ascending fibers transmit sensory stimulation to subcortical and cortical centers.

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Physiology of sensory systems and higher nervous activity studies. allowance

The manual outlines modern concepts and ideas about the processes and mechanisms for ensuring the behavior of humans and animals. Designed for students studying in the specialty 020201 Biology (discipline "Higher nervous activity", block of general education), full-time and part-time forms of education.

(sense organs, or sensory organs); - nerve fibers extending from them (conducting pathways); – cells<...>impulses in sensory fibers, features of impulses in nerve centers, chemical processes<...>Physiology of sensory systems 50 sympathetic fibers, others are afferents ending in<...>One way - fast myelinated fibers Aδ (12 14m / s) go to the thalamus, and then to sensory and motor<...>The efferent fibers of the associative nuclei are sent to the associative areas of the cortex, where these fibers, giving

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Theoretical and practical foundations of organoleptic analysis of food products. allowance

St. Petersburg: GIORD

The book discusses modern information about the structure and functions of human sensory systems, the psychophysical foundations of sensory analysis, the methodology of organoleptic analysis, the basics of training testers and organizing their work. The main methods for assessing the organoleptic indicators of food products and processing the results are briefly given.

(sensory organs, or sense organs), nerve fibers extending from them (pathways) and cells of the central<...>nuclei is usually carried out in a pulsed form (pulse code). an impulse in the sensory fiber occurs<...>Between the action of a physical stimulus on receptors and a pulsed discharge in a sensory nerve fiber<...>The maximum number of impulses in the nerve fibers of sensory systems is about 2000 per second.<...>These fibers form thick bundles under the sensory epithelium ( olfactory fibers), which go to the olfactory

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Sensory ecology studies. allowance

The ecological features of the development and structural and functional organization of the most important sensory systems of organisms (visual, auditory, olfactory, gustatory and tactile) are considered, as well as the mechanism of participation of these systems in solving a number of environmental problems: biological isolation of the species, ensuring sexual, parental and other forms of behavior, regulation of aggression and social communication. The book presents the original data of the authors and the work of domestic and foreign physiologists, ethologists and biochemists on the study of the role of chemoreception in the perception of pheromones. Particular attention is paid to the sensory assessment of the ecological well-being of the artificially formed human habitat and the problems of sensory communication and ecological methods for controlling the behavior of organisms. For students and graduate students of ecological, biological and medical faculties of higher educational institutions, teachers and researchers specializing in the field of analyzer physiology and physiological ecology. There are considered ecological peculiarity of development and structural and functional organization of the most important sensory systems of organisms (visual, hearing, olfaction and taste) and mechanism of these systems participation in the decision a series of ecological tasks (the biological isolation of species, providing of the sexual, parental and other forms of behavior, the regulation of aggression and social communication). In the book the original data obtained by the authors and the general survey of russian and foreign physiological, ethological and biochemical works concerning the role of chemoreception in chemocommunication are presented. The special attention is devoted to sensory estimation of ecological prosperity of artificially made environment and sensory communication problems and ecological methods of managing the organisms behavior. The manual is intended for students, post-graduate students of ecological, biological and medical departments, and scientists, specializing in physiological ecology.

Nevertheless, even with the destruction of sensory structures, the remaining nerve fibers retain, albeit in a rough<...>Sensory ecology 54 The melting anterior two-thirds of the tongue is innervated by fibers that go as part of the lingual<...>Sensory Ecology 78 receive fibers from the primary and accessory olfactory bulbs; part of the entorhinal<...>Sensory ecology 264 of the refractory period of the fiber (6 ms.), however, leads to the appearance<...>Sensory ecology 356 because true temperature sensitive fibers are characterized by

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A short course of lectures on physiology with the basics of anatomy studies. allowance

Buryat State University

The textbook in a simple and accessible form outlines modern ideas about the structure and mechanisms of functioning of the main systems of the human body. Recommended for use in educational process students of medical specialties, as well as other biological areas.

In the spinal cord, sensory fibers are part of the dorsal roots. 3.<...>Functions of the medulla oblongata and pons - analysis of sensory stimuli.<...>The most important sensory area is the postcentral gyrus.<...>The sense organ is the peripheral part of the sensory system; conductive.<...>Sensory cell hairs are attached to the integumentary membrane.

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Neurolinguistic foundations of speech disorders textbook. allowance

M.: FLINTA

This paper presents the main theoretical provisions of the neurolinguistic, psycholinguistic and neurological foundations of speech therapy, the general patterns of impaired psycho-speech development, discusses the etiology and pathogenesis of speech disorders (dysarthria, apraxia), describes the methods of neurological, psycholinguistic and neuropsychological diagnostics.

The fibers of the former are sent to the skeletal muscles, and the fibers of the latter are switched in the autonomic ganglia<...>Sensory zones are distinguished in the cortex, to the cells of which the main sensory systems are projected (gustatory,<...>The aura can be motor, sensory, mental, visceral, secretory.<...>From the latter, the fibers reach the cortex (function - smell).<...>Sensory fibers carry general sensitivity from the vocal folds and larynx below the level of the vocal folds

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No. 3 [Neurological Journal, 2017]

The speed of propagation of excitation (SRV) along the motor fibers was estimated, the amplitude of M-responses<...>with stimulation nn. tibialis, peroneus, medianus, ulnaris; RTS on sensory fibers and potential amplitude<...>for nn. tibialis, peroneus, medianus, ulnaris; along sensory fibers and action potential amplitude<...>Compared with the control and OMAN groups, in the ARDP group in sensory fibers, the<...>nerve ≤ 0.4 mV with the preservation of normal values of NRV for motor fibers indicates the presence

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Professional multidisciplinary journal for practicing physicians. Articles in the journal combine practical information, clinical lectures and scientific reviews with medical news. Each issue presents the main thematic sections on specialties: therapy, pediatrics, allergology, bronchopulmonary, gastroenterology, gynecology, dermatovenereology, cardiology, psychoneurology, rheumatology, urology; information on professional development from the best medical universities in the country; news, interviews and a page for the publication of dissertation works.

Sensory positive symptoms are divided into non-painful and painful.<...>Ultra-late components selectively test unmyelinated C-fibers - pain pathways.<...>The method of stimulation electromyography (EMG) was used to study the motor and sensory fibers of the nerves of the lower<...>fibers of the sural nerve, amplitudes of motor and sensory responses.<...>responses and the rate of propagation of excitation along the sensory fibers of the nerves of the legs.

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Neuropathology. Natural science foundations of special pedagogy [proc. allowance]

Moscow: VLADOS

This textbook highlights the structure of the nervous system, its formation in different periods of child development, as well as the causes, mechanisms of the course and residual manifestations of neurological diseases. Particular attention is paid to those diseases that can lead to violations of the psychophysical development of the child.

Sensory fibers (from muscle and tendon receptors) Vestibulospinal tract Rubrospinal tract Olivospinal<...>Sensory areas of the cortex highest level sensory analysis.<...>Sensory afferentation entering the cortex has multiple representation: each of the sensory<...>Sensory systems 143 characterizes general function analyzer (sensor system), adapted to<...>There are three forms of alalia: lower frontal - motor; lower parietal - sensory; superior temporal - sensory

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Fibromyalgia (FM) is a common pain syndrome in soft tissues typical for patients of any gender and age. FM is often associated with diseases gastrointestinal tract. 200 patients with celiac disease and 100 patients with reflux esophagitis without celiac disease were examined. Conducted clinical and instrumental examination, filling out questionnaires on FM, restless legs syndrome, migraine, polyneuropathy of thick and thin fibers, depression, anxiety. It was found that FM occurred 3 times more often in the group of patients with celiac disease (22%, p=0.001). The most characteristic prognostic signs of the development of FM were the typical form of celiac disease and the age of patients 40–59 years. Polyneuropathy of thin fibers occurred significantly more often in the group of patients with celiac disease than in the comparison group (p=0.005). Women with celiac disease and FM had more sensitive points than men of the same group (p=0.003), but the average duration of FM was much shorter: 34.5 months for women and 145 months for men (p=0.002). A correlation was found between FM and fine fiber polyneuropathy, restless legs syndrome, depression, and anxiety in the group of patients with celiac disease (p≤0.05).

M-response, M-response latency, impulse conduction velocity (SPI), residual latency (RL), as well as sensory<...>(distal application of lead electrodes and stimulation similar to the study of SPI on motor fibers<...>action potential (AP) amplitude, AP shape, AP duration, AP area, AP latency, SPI by sensory<...>fibers.<...>mm above the lateral malleolus) followed by immunohistochemical examination of skin biopsy specimens for C-fibers

№2 [Neurology, neuropsychiatry, psychosomatics, 2015]

The objective of the journal is to inform specialists of various profiles about the achievements of neuropsychiatry and neurosomatic medicine, to form on this basis a modern integrated interdisciplinary approach to various neuropsychiatric and somatic diseases, which will contribute to the development of scientific research.

Sensory variants of chronic inflammatory demyelinating polyneuropathy.<...>Patients with stage 1 WB showed a decrease in PWV in sensory and motor fibers of the median and ulnar<...>,m/s PWV along sensory fibers , m/s TL, ms ENMG of the ulnar nerve: PWV along motor fibers ,m/s PWV along<...>sensory fibers, m/s TL, ms 6.0±0.5 56.4±0.55* 54.7±0.9* 2.8±0.2* 62.2±0.17* 56, 5±0.63* 2.38±0.21*<...>to a lesser extent - type I fibers (slow with an aerobic type of metabolism).

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No. 3 [Neurological Journal, 2018]

Covers topical issues of practical neurology. Along with original articles, lectures and literature reviews, clinical reviews of diagnostically difficult cases are published. Much attention is paid to neurological complications of somatic diseases, borderline neuropsychiatric conditions, pediatric neurology, and neurogeriatrics. New methods of instrumental and laboratory diagnostics are covered. "Neurological Journal" informs about upcoming and past congresses, conferences, symposiums in Russia and abroad and highlights the organization of neurological care. Abstracts of the most significant reports published in other journals and reviews of out-of-print monographs are published. The main purpose of the journal is to give the practitioner the new information necessary in his daily work on the diagnosis and treatment of diseases of the nervous system. Designed for neurologists and doctors of related specialties.

Considering the increased tropism of the Zika virus described in vitro for sensory nerve fibers, trigeminal<...>on the upper/lower extremities Presence of muscle pain syndrome Velocity of impulse conduction along the fibers<...>of the median nerve 21 m/s The speed of the impulse along the motor fibers of the median nerve 38 m/s Blocks<...>fibers (pulse conduction velocity 38 m/s and 21 m/s, respectively).<...>The study included the analysis of NRV on the motor and sensory fibers of the nerves of the arms and legs in compliance with the temperature

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Physiology of Higher Nervous Activity and Sensory Systems: Guidelines Guidelines

The work is intended for students studying in the specialty 020400 Psychology (discipline "Physiology of higher nervous activity and sensory systems", block EH), correspondence courses.

Physiology of sensory systems TOPIC № 1. Sensory systems 1. The concept of a sensory system. 2.<...>In addition, their afferent fibers do not form special nerves, but are distributed over numerous nerves.<...>to non-temperature stimuli; small receptive fields of the order of 1 sq. mm, with each afferent fiber<...>cranial nerves, while in the afferent fiber there is a certain pattern of impulses,<...>called the fiber flavor profile.

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Pathophysiology of pain

Medicine DV

The textbook was prepared in accordance with the requirements of the Federal State Educational Standard and modern programs in pathophysiology, clinical pathophysiology in strict accordance with the recommended competencies. The manual highlights the pathophysiology of pain of varying intensity, which is a constant companion of most pathological processes and interventions in the oral cavity, which is determined by the mixed (somatic and autonomic) innervation of this area, and the doctor's task is to prevent the development of pain syndrome. The textbook presents the modern pathophysiological characteristics of pain, dental pain syndromes, including infectious diseases. The manual is intended for students majoring in Dentistry.

<...>"SENSORY PAIN UNIT" IS ASSOCIATED 1) with the peripheral part of the afferent fiber 2) with the peripheral<...>The pain receptor itself and the peripheral part of the afferent fiber associated with it are called "sensory".<...>along A-δ and C-fibers.<...>The primary sensory zone forms a sensory-discriminative system that determines the qualities, spatial

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Motor rehabilitation of a patient with the consequences of a spinal cord injury using non-invasive electrical stimulation of the spinal cord in combination with mechanotherapy [Electronic resource] / Vissarionov [et al.] // Spinal Surgery.- 2016 .- No. 1 .- P. 3-7 .- Regime access: https://website/efd/418966

A clinical observation of the treatment of a patient with the consequences of spinal cord injury using non-invasive electrical spinal cord stimulation in combination with mechanotherapy is presented.

channel electroneuromyograph by the method of assessing the speed of conduction and determining the amplitude indicators of sensory<...>potentials in the study of sensory fibers of the left lower limb, which indicated damage to motor neurons<...>spinal cord at the S1–S2 level on the left and peripheral sensory fibers of the left lower limb.<...>Signs of damage to peripheral sensory and motor fibers of the right lower limb, motor neurons<...>fibers at the peripheral level (Fig. 3).

No. 2 [Anesthesiology and resuscitation, 2016]

Founded in 1956 (under the name "Experimental Surgery and Anesthesiology", since 1977 - "Anesthesiology and Resuscitation"). Chief Editor journal - Bunyatyan Armen Artavazdovich - Academician of the Russian Academy of Medical Sciences, Professor, Head of the Department of Anesthesiology and Resuscitation of the Federal State Budgetary Institution Russian Scientific Center for Surgery named after A.I. Academician B.V. Petrovsky RAMS, head of the department of anesthesiology and resuscitation FPPOV SBEE HPE First Moscow State Medical University. THEM. Sechenov. journal of clinical direction. The journal focuses on the problems of general anesthesia in surgery, intensive care and resuscitation. A significant place on the pages of the journal is occupied by the promotion of advanced methods of anesthesiology and resuscitation in obstetrics, gynecology and pediatrics (including micropediatrics), dentistry, otorhinolaryngology, outpatient practice and much more. , poisoning, infectious diseases). The journal publishes reviews and lectures on topical issues of anesthesiology and resuscitation, discussion articles, (acquaints readers with the methodology and practice of teaching general anesthesiology, intensive care and resuscitation). Related issues of physiology, pharmacology and hematology are covered. The journal widely covers the issues of using new anesthetic equipment, means of monitoring monitoring and express diagnostics, and introduces new drugs for anesthesia. Publishes minutes of meetings of the societies of anesthesiologists and resuscitators of Moscow, reports on world congresses, congresses and plenums of the board of the Scientific Society of Anesthesiologists and Resuscitators, information materials and reviews of various publications. For practical anesthesiologists and resuscitators, a special section has been introduced, dedicated to rare or instructive practical observations, errors and complications with their analysis and comments by leading experts.

and sensory fibers of the sural nerve on one or both sides.<...>responses in sensory fibers and the number of reduced responses in motor fibers of nerves, asymmetry<...>Thus, it has been established that sensory fibers of the nerves of the upper and lower extremities suffer during CS.<...>In children with polyneuropathy of critical conditions, sensory and motor fibers are predominantly affected.<...>peripheral nerves of the upper and lower extremities Index Motor fibers Sensory fibers of the ulna

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Neuropsychology textbook for universities

Moscow: VLADOS

The textbook of a new generation discusses the development of the science of the brain and the formation of neuropsychology as an independent branch of psychological knowledge, the anatomical and physiological principles of the brain, syndromes of damage to the cortical regions of the cerebral cortex, damage to deep structures, the corpus callosum, the principles of syndromic analysis of violations of higher mental functions approach to their rehabilitation and recovery. The appendices provide practical advice on conducting neuropsychological examinations of patients with various pathologies.

All sensory fibers, passing through the brainstem, give collaterals to the oblong, middle and intermediate<...>Its fibers lie in the center of the brainstem, look like a network and are surrounded on the outside by a layer of sensory pathways.<...>fibers Cerebral cortex Specific sensory pathway<...>The presence of parallel channels for processing and transmitting sensory information provides the sensory system<...>All fibers enter the dorsal horns of the spinal cord.

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Physiology of sensory systems

Medicine DV

The study of the physiology of sensory systems is necessary for the formation of professional competencies of future clinical psychologists. The textbook is compiled on the discipline “Neurophysiology. Workshop on Neurophysiology" in accordance with the requirements of the Federal State Educational Standard and is intended for students in higher education programs - specialist's programs, specializing in Clinical Psychology. Modern data on the physiology of sensory systems and their features in human ontogenesis are considered. The guide is well illustrated. A clear rubrication of fragments of the material ensures its easy assimilation.

sensory system (Chapter 2), auditory sensory system (Chapter 3), vestibular sensory system<...>Even in silence, spontaneous impulses with a frequency of up to 100 Hz follow the fibers of the auditory nerve.<...>type A-delta, and from tickle receptors along C-fibers.<...>“Kniga-Service Agency” also comes with fibers from the accessory olfactory bulb.<...>PAIN IMPULSE IS CONDUCTED BY NERVE FIBERS 1) A type alpha 2) A type delta 3) C fibers 4) B fibers 9

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The essence of biomedical foundations of life safety. At 2 o'clock. Part II studies. allowance

Publishing house of NSTU

This training manual characterizes the basics of legislation on human life safety, analyzes the state of public health and provides ways to improve it. Issues related to man and the environment are considered; human adaptation to environmental conditions; brief characteristics of the nervous system, brain activity, sensory systems, analyzers, etc. are given.

This role is performed by sensory relays - intermediate nodal structures of sensory systems.<...>Sensory areas of the cortex.<...>The ascending pathways to the sensory cortex come mainly from the relay sensory nuclei of the thalamus.<...>Localization of sensory zones.<...>Efferent nerve fibers related to gamma fibers end on the intrafusal muscle fiber

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Module "Musculoskeletal system" [method. allowance]

M.: Man

Excitation time of the sensory neuron. 3.<...>Sensory elements are combined into special sensory fields.<...>The central sulcus separates the primary sensory and motor cortex; 7. Sensory primary cortex; 8.<...>Appearance of an action potential in a sensory organ (receptor) 5% 2.<...>Physiology of sensory systems and higher nervous activity. 2 v. T.1.

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Human anatomy. Textbook; Human anatomy. Atlas [set] textbook for universities complete with electronic application “Human Anatomy. Atlas"

Moscow: VLADOS

The textbook is based on the textbook "Human Anatomy" by M.M. Kurepina and G.G. Wokken (1979). The most significant changes and additions were made to the chapters "Nervous system" and "Internal organs". Most sections of the textbook contain material on the microscopic structure of organs, their intrauterine development and changes during a person's life. The textbook is accompanied by the Atlas of Human Anatomy, which has also been significantly revised. It includes new schemes, color drawings and microphotographs.

Depending on which fibers predominate in the nerve, it is called sensitive (sensory<...>SENSOR SYSTEMS 3.6.1.<...>The structure of the auditory sensory system.<...>The neurons of the motor cortex receive signals from sensory areas along the associative fibers, transmitting<...>Sensory fibers (from muscle and tendon receptors) Vestibulospinal tract Rubrospinal tract Olivospinal

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No. 1 [Neurological Journal, 2018]

One of the types of operational quality control of products is the so-called control "by technical condition", which consists in continuous monitoring of product quality indicators using sensors built into it. In the case of fibrous polymer composite materials (FPCM), such sensors can be fibers with special properties embedded in the structure of unidirectional or woven reinforcing fillers at the stage of their textile production.

In the case of fibrous polymer composite materials (FPCM), fibers can serve as such sensors.<...>two completed projects in the cities of Dresden and Rudolstadt pave the way for the use of fiber sensor<...>More expensive carbon fibers, which, however, have higher elastic-strength properties<...>Dresden presented a system for continuous sensor control of the state of wind turbine rotors.<...>The unit automatically inserts two-dimensional carbon sensor elements at almost any lay-out angle

Human physiology with the basics of pathophysiology. In 2 vols. Vol. 1 [textbook], Physiologie des menschen mit Pathophysiologie

Moscow: Laboratory of Knowledge

Why does thirst arise? Why should we sleep? Why can't we live five minutes without breathing? In this book, which has become a desktop for many, you will learn how "works" human body. It covers many topics, including the physiology of cellular respiration, the functioning of the brain, heart, and kidneys. Students will find here everything they need for their studies. The authors, world-famous experts, know and are able to explain their subject like no one else. Key concepts are briefly presented in special information blocks, more than 1100 illustrations help to reinforce knowledge visually, and a discussion of over 200 clinical cases will provide invaluable support to future doctors in their daily clinical practice. The new edition will serve as an ideal guide for studying and reviewing material before the exam.

When this happens in the sensory nerve fibers, abnormal perception begins, which causes<...>Sensory innervation of muscle spindles Both nuclear bag fibers and nuclear chain fibers<...>The motor cortex sends: cortico-cortical fibers to the sensory and secondary motor areas of the cortex;<...>Primary afferent nerve fibers terminate in secondary sensory neurons after entering the<...>The electromyogram is normal, but the sensory neurogram (Aβ fibers) is absent.

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Clinical physiology: textbook. Part 1. Specialization: 060601.65 (30.05.01) - Medical biochemistry, 060301.65 (33.05.01) - Pharmacy. Direction of training 020400.62 (06.03.01) - Biology. Undergraduate

NCFU publishing house

The manual (Part I) was developed in accordance with the Federal State Standard of Higher Education. It includes four sections, which consider the links of physiological processes in terms of the occurrence of damage and the pathogenetic mechanisms that cause them. An analysis is made of the nature and severity of violations of the functions of vital human organs at each stage of the disease, the relationship between the pathogenesis of the disease and its clinical manifestations. From the position of choosing an adequate algorithm of diagnostic methods, a clinical interpretation of changes in the functional state of organs is given, taking into account the pathogenesis and restoration of the natural autoregulation of processes in the body. Intended for students studying in the areas of training and specialization: 060601.65 (30.05.01) - Medical Biochemistry, 060301.65 (33.05.01) - Pharmacy, 020400.62 (06.03.01) - Biology. In addition, the manual can be used in teaching magistracy students when studying the course "Human and Animal Physiology" in the module "Pathological Physiology"

Fine fiber polyneuropathy (PTV) is a disease in which Aδ and C fibers are selectively affected. The article provides information on the pathogenesis, clinical picture and diagnosis of PTV. Skin biopsy, quantitative sensory testing, corneal confocal microscopy, nociceptive evoked potentials, microneurography, and autonomic testing in PTT are described in detail. New diagnostic criteria for PTV are presented. The management of PTV includes the treatment of systemic diseases that cause PTV and the treatment of neuropathic pain.

or both fibers, resulting in sensory disturbances and/or autonomic dysfunction<...>), thin (Aδ and C-fibers).<...>PTV is a disease in which Aδ- fiber system 130 8.4.<...>Vestibular sensory system 133 8.5. Motor sensory system 136 8.6.<...>visual sensory system.<...>vestibular sensory system.<...>motor sensory system.

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No. 3 [Russian Pediatric Journal, 2018]

Founded in 1998. Editor-in-chief of the journal - Baranov Alexander Alexandrovich - Academician of the Russian Academy of Sciences and the Russian Academy of Medical Sciences, Vice-President of the Russian Academy of Medical Sciences, Doctor of Medical Sciences, Professor, Chairman of the Executive Committee of the Union of Pediatricians of Russia, Director of the Federal State budget institution "Science Center of Children's Health of the Russian Academy of Medical Sciences, Head of the Department of Pediatrics and Pediatric Rheumatology, Faculty of Pediatrics, First Moscow State medical university them. THEM. Sechenov. The Russian Pediatric Journal is the leading scientific and practical publication for a wide range of pediatricians. The pages of the journal cover priority areas of child health and social pediatrics, issues of pathogenesis, clinic, diagnosis, treatment and prevention of various forms of pathology in children, original research, clinical and clinical-experimental work on topical issues of pediatrics, bioethics, teaching methods and the history of Russian pediatrics, the results of international scientific conferences and symposiums, anniversaries are discussed. The journal provides operational support to applicants for scientific degrees in the publication of the main scientific results of dissertations for the degree of doctor and candidate of science in the specialties - pediatrics, pediatric surgery, public health and healthcare. The editorial board of the journal includes well-known pediatric scientists representing all areas of pediatrics. The Russian pediatric journal is registered in the information and reference publication: Ulrich's International Periodical Directory. The five-year impact factor is 0.345. The submitted articles are subject to mandatory review by leading experts, accompanied by a summary in Russian and English and a list of keywords.

Human Physiology course of lectures

The textbook contains the main content of 19 lectures, with a total volume of 38 hours, reflecting the main sections curriculum on human physiology. The course of lectures introduces the basic laws of the body's activity, the physiological mechanisms of muscle activity, modern scientific ideas about the development of motor skills and physical qualities, physiological features body activity depending on age, gender, as well as special environmental conditions, ensuring the successful development of general cultural and professional competencies OK-1, OK-8, OK-13, PC-2, PC-4, PC-6, PC-8 , PK-10, PK-11, PK-13, PK-16, PK-17, PK-18, PK-19, PK-25, PK-26, PK-28, PK-31, PK-38.

Classification of sensory systems 10.5. Activity value

M.: FLINTA

This tutorial supplements information about the physiological and hygienic basics physical education early childhood and preschool age. The manual discusses modern ideas about health, various approaches to identifying the typological characteristics of children, reveals the patterns of building skills and muscle development, and features of the development of movements in children at different age periods.

Sensory corrections are a set of impulses coming to the CNS from various sensory systems, which<...>Booth) Fast red fibers Fast white fibers Slow red fibers High intensity<...>fibers "Giant" tonic fibers

Receptor neurons are called sensory or sensitive.<...>from specific sensory inputs.<...>specific sensory system (first type).<...>The thalamus is considered as a subcortical link of the sensory and motor systems of the brain.<...>sensory nuclei.

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Fund of evaluative means of current control / intermediate certification on the module of the structural and functional organization of biological objects [proc. allowance]

Rostov

The textbook "Fund of Assessment Means of Current Control/Intermediate Certification" is based on a competency-based approach and is aimed at a level assessment of knowledge, skills and possessions of the principles of the structural and functional organization of biological objects and the main physiological methods of analysis and assessment of the state of living systems.

Olfactory sensory system. 2. Taste sensory system. 3. Visual sensory system. 4.<...>descending fibres. 2. Ascending fibers. 3. Association fibers. 4. Callosal fibers. 33.<...>Sensory systems. The concept of a sensory system. Methods for the study of sensory systems.<...> General principles structures of sensory systems. Functions of sensory systems.<...>Encoding of sensory information. 9. Visual sensory system.

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11648 0

Upper limb has an innervation from roots C5-C8 with small additions Th1 and C4. These roots form three bundles: lateral, posterior and medial. They go together in the plexus to the shoulder joint and are divided into two main trunks - the supraclavicular and subclavian parts.

Supraclavicular part of the brachial plexus

Supraclavicular part brachial plexus contains the following nerve branches: muscular branches, long thoracic nerve, thoracic nerves, dorsal scapular nerve, suprascapular nerve, thoracic nerve, subclavian nerve, and subscapular nerve.

Muscular branches supply the scalenus muscles and the longus colli muscle of the neck.

Subclavian nerve (C5, C6), a very delicate nerve, innervates the subclavian muscle.

Long thoracic nerve (C5-C7) Supplies a front gear muscle. Failure of the function is detected in the position (installation) of the scapula, when its medial edge lags behind chest. In this case, one speaks of "pterygoid blades".

Thoracic nerves (C5-Th1) Supply pectoralis major and minor muscles.

Dorsal nerve of the scapula (C5) innervates both rhomboid muscles and partly the muscle that lifts the scapula. This muscle also has branches from the cervical plexus. A movement disorder is detected by checking the action of the muscle.

Suprascapular nerve (C4-C6).

It supplies the supraspinatus, cavitary, and partially teres minor muscles. Isolated damage is very rare. Because of this, the resultant force in case of violation of movements decreases slightly. The supraspinatus muscle abducts the arm and supports the abduction of the deltoid muscle as a fixation muscle. The abdominal and small round muscles are involved in external rotation.

supplies latissimus dorsi back and a large round muscle. It is best to determine their slight weakness in the position of the patient lying on his stomach. He simultaneously raises both arms in internal rotation and resists the backs of his shoulders.

Supplies a subscapularis muscle and a big round muscle. They show their weakness clinically only in internal rotation.

Subclavian part of the brachial plexus

Forms a knot from which the nerves of the arm and hand emerge. These are the musculocutaneous nerve, axillary nerve, median nerve, ulnar nerve, radial nerve, and sensory medial cutaneous nerve of the forearm and medial cutaneous nerve of the shoulder.

Musculocutaneous nerve (C4-C6) innervates together with the motor bundle biceps shoulder, coracobrachial muscle and brachialis muscle. Function failure shoulder muscle and the biceps brachii are usually easy to identify.

Damage to the coracobrachialis muscle, which is involved in adduction (adduction) and flexion in shoulder joint, difficult to fix. The nerve, after it has transmitted the motor branch, runs as the lateral cutaneous nerve of the forearm in the region of the forearm and supplies its radial region.

Axillary nerve (C5, C6) short and strong, supplying two motor muscles, namely the deltoid muscle and the small round muscle. It is necessary to be able to determine mainly the failure of the deltoid muscle, while the failure of the small round muscle does not play a big role.

Its sensitive branch is considered as the lateral cutaneous nerve. It innervates the lateral (lateral) side of the shoulder girdle and arm.

Median nerve (C6-Th1, sometimes also C5) is a very long nerve, its branch goes to the forearm and to the hand.

As a result (see Table 1.7), the median nerve innervates all the muscles of the inner surface of the forearm, with the exception of the ulnar flexor of the wrist and the ulnar part of the deep flexor of the fingers, in the future, all the tenar muscles, with the exception of the adductor thumb muscle, and the internal, deep horizontal head short flexor thumb brushes. It also innervates the first worm-like muscles.

So, the median nerve innervates the following muscles: round pronator, radial flexor wrist, long palmar muscle, superficial flexor of the fingers, deep flexor of the fingers (lateral head), long flexor of the thumb, quadrate pronator, short muscle that abducts the thumb, muscle that opposes the thumb of the hand, short flexor of the thumb (superficial head) and, finally, the 1st and 2nd vermiform muscles.

Violation of movements in case of damage to the median nerve occurs necessarily, a number of other movements will depend on the radial and ulnar nerves innervating the balancing muscles. Functional failure at first glance seems to be less significant based on the extensive area of innervation of these nerves.

Table 1.7. Median nerve (innervation of roots C6

The entire median nerve can be examined in clinical examination. Based on the signs and symptoms, a decision is made about his condition.

1. Position of the hand: thanks to the intact long extensor and adductor (adductor muscle), it is possible to approach the 1st finger to the rest of the fingers. In this case, they say about the "monkey's paw".

2. Test of isolated flexion of the terminal phalanx of the index finger: the middle link is fixed in extension. With violations of the median nerve, flexion of the terminal phalanx is impossible due to paralysis of the deep flexor of the fingers.

3. Test of the 1st finger: the fingers of the hands move one to the other, that is, the 1st finger to the rest. On the side of the paresis, there is no movement of the 1st finger.

4. Circular test: the tip of the 1st finger moves along the bodies of the metacarpal (metacarpal) bones. On the side of the lesion, movement is not possible in full (up to the 5th metacarpal), but only for the first half, if the adductor thumb muscle is preserved, movement is possible. The second part of the movement (opposition) is impossible to perform with the 1st finger.

5. Symptom of folded hands: the patient squeezes the hands into a fist. On the side of the violation, it is impossible to bend the first three fingers, they remain unbent.

6. Opposition and abduction of the 1st finger are impossible.

7. Sign of the bottle: when grasping the bottle on the weaker side of the paresis, slight pressure is exerted on it. A skin fold forms between the 1st and forefinger due to weak abduction and opposition of the 1st finger, i.e. the bottle is not held tightly.

8. Cam test: on the side of paralysis, the patient cannot clench his fist, since the flexion of the first three fingers is defective.

9. If the median nerve is damaged above the branching of a certain branch, it is impossible for the round pronator, in addition, to perform pronation (inward rotation).

Sensitivity: in the thenar area and the flexor surface of the 1st finger, in the middle part of the palm, in the 2nd, 3rd and partially 4th fingers and, finally, on the dorsal side of the distal phalanges of the 2nd and 3rd fingers. In general, not a very extensive zone of sensitivity. Significant and frequent autonomic disturbances and causalgia are observed.

Table 1.8. Ulnar nerve (innervation of roots C5-Th1). Branch height for individual muscles

The ulnar nerve is a long and powerful nerve that receives fibers from the C5-Th1 roots. It gives the first branch in the forearm, the main branching occurs only in the palm. Sensitive cutaneous branches supply the dorsal region and the palmar side of the ulnar edge of the hand, the 5th finger and the ulnar half of the 4th finger. Inconstantly the entire 4th and ulnar side of the 3rd finger.

motor fibers the ulnar nerve supplies mainly the small muscles of the hand, with the exception of the opposing muscles, the short flexor of the thumb, the muscle that abducts the thumb, and the 1st and 2nd worm-like muscles.

And so it innervates the following muscles: in the forearm, the ulnar flexor of the wrist and the internal (medial) head of the deep flexor of the fingers, in the hand, the adductor thumb muscle, the interosseous muscles (palmar and dorsal), the 3rd and 4th worm-like muscles, from the short flexor of the thumb, the inner, deep horizontal head, further the short palmar muscle, the muscle that removes the little finger, the muscle that opposes the little finger and the short flexor of the little finger.

A number of clinical symptoms during the test of disorders of the ulnar nerve, thanks to which a conclusion can be drawn.

1. The position of the hand: the 1st finger is bent at the interphalangeal joint, the 4th and 5th fingers are extended at the metacarpophalangeal joints, in the remaining joints they are bent. The 2nd and 3rd fingers are less involved due to the well-preserved 2nd and 3rd lumbrical muscles. The little finger is fixed with struts due to the predominance of the activity of the extensor muscle of the fingers. In this case, they talk about the claw-like position of the fingers.

2. Study of isolated adduction (adduction) and abduction (abduction) of the little finger. On the interested side, the patient cannot make these movements with the little finger.

3. Paper test (for the adductor of the 1st finger): the patient holds a sheet of paper compressed with the 1st and forefinger and tries to stretch it in different directions. On the side of the lesion, flexion in the distal phalanges of the fingers is impossible, so the paper will only be clamped in the healthy hand.

4. Drawing a circle: when testing isolated flexion, the main joints will maintain extension of the 2nd and 3rd fingers, and the 4th and 5th fingers will be bent (paralysis of the 3rd and 4th lumbrical muscles)

5. When examining the mobility of the middle finger: on the side of the lesion, a lateral tilt of the middle finger is impossible.

Sensitivity is manifested in the ulnar half of the back of the hand, also in the hypotener, in the little finger and the ulnar side of the 4th finger.

Radial nerve (C5-C6).

It gives two sensory branches in the shoulder: the posterior cutaneous nerve of the shoulder and further distally the posterior cutaneous nerve of the forearm. After branching, the motor branch goes to the skin of the rear of the hand.

The radial nerve thus supplies the skin of the hand with sensory branches in a large area, namely the posterior cutaneous nerve of the arm, the dorsal region of the shoulder, the posterior cutaneous nerve of the forearm, the dorsal region of the forearm. Two branches of nerves supply the radial half of the rear of the hand.

Table 1.9. Radial nerve (innervation of roots C5-C8). Branch height for individual muscles

It supplies the entire motor musculature of the dorsal side of the shoulder and the dorsal and radial sides of the forearm. This triceps shoulder, ulnar muscle, brachioradialis muscle, long and short radial extensors of the wrist, arch support, extensor of the fingers, extensor of the little finger, ulnar extensor of the wrist, longus muscle abductor thumb, long and short extensors of the thumb, extensor of the index finger.

Symptoms of damage to the radial nerve.

1. Hand position: forearm pronated, bent in wrist joint and proximal joints of the fingers, the 1st finger is lowered down. In clinical observation, they talk about a fallen hand.

2. Finger fold test: The patient is unable to fold the extended fingers because the hand is in palmar flexion.

3. Extensor test: extension of the arm and major finger joints is not possible. When tested, the fingers come to extension only in the interphalangeal joints due to the worm-like muscles.

4. For injuries above the center of the shoulder ( humerus) the brachioradialis muscle is also involved, flexion and supination suffer, in addition, the triceps muscle of the shoulder and the ulnar muscle, extension at the elbow is impaired.

Sensitivity is broken from the place of damage.

Medial cutaneous nerve of the forearm is a long, thin nerve. From it, the skin of the palmar and ulnar areas of the forearm is supplied with sensitive branches.

Medial cutaneous nerve of the shoulder- thin nerve, innervates the skin of the ulnar side of the shoulder.

We are all used to such a fairly new input device as a touch screen. It would seem that the next step should be the creation of devices that understand our thoughts. However, scientists and inventors are already working on such. But researchers at the University of North Carolina decided to take a slightly different route. They proposed a completely new variation of the same touch display - touch fibers.

The new technology involves the use of soft, elastic and touch-sensitive microscopic fibers, the operation of which is similar to that of a touch screen. Their new development, according to the scientists themselves, will lead to the creation of completely new electronic wearable devices in the future, as well as help create more advanced sensors and sensing devices used in all areas of science, medicine and everyday activities.

The new sensory fibers are made of very thin filaments with a tubular structure. The outer part of the thread consists of a polymer, and inside, as a filler, the composition of liquid metals (eutectic): gallium and indium (EGaIn) is used. Such a thread has a diameter of several microns, which is slightly larger than the thickness of a human hair.

The final sensory fiber is made from a strand of three threads twisted together, and is a fairly strong spiral. The principle of operation of the sensor fiber, as noted earlier, is similar to the principle of operation of a capacitive sensor.

A strand of three threads is a classic system in which conductors and dielectrics are intertwined. The conductor in this case is the liquid metal inside the thread, and the dielectric is the polymer shell. It turns out a kind of sandwich system that reacts to a change in electrical capacitance.

The developers note that triple twisting of the threads is not at all necessary. For example, to create a rotation or torsion sensor, it is enough to use only two threads twisted in a “pigtail”. Advantage new technology also in the fact that sensory devices, and especially sensors, are made of very flexible components, so they are not afraid of repeated deformation.