THE SYNDROMES OF SENSITIVE

THE SYNDROMES OF SENSITIVE DISORDERS ARISING AT THE LESION OF VARIOUS DEPARTMENTS OF SENSITIVE SYSTEM

In the presence of sensitive order ultram 400mg disorders it is necessary to find out: 1) in what limits (in what territory) sensitivity is upset; 2) its what kinds are broken; 3) whether exist, besides disturbances of dermal sensitivity, a pain or paresthesia.



Fig. 4. The scheme of distribution of dermal sensitivity according to nerves and spinal cord segments.

1. The lesion (full) of a trunk of a peripheric nerve is characterised by disturbance of all kinds of sensitivity in the field of a dermal innervation of the given nerve as fibers of all kinds of sensitivity pass in a peripheric nerve together. Zones of a dermal innervation of each nerve are presented on fig. 4. The lesion of the admixed or sensitive nerve is accompanied usually by pains or paresthesias.
II. The Lesion of trunks of plexuses (cervical, humeral, lumbar and крестцового) causes anesthesias or hypesthesias of all kinds of sensitivity of extremities in territory, иннервируемой sensitive fibers of those nerves, which start with the amazed trunk (or trunks) a plexus. Presence of pains is Here too characteristic.
III. The Lesion of a back sensitive root of a spinal cord gives also loss or dropping of all kinds of sensitivity, but zones of sensitive disorders wear fished, namely segmentary character: circular on a trunk and poloskovo-longitudinal on extremities (fig. 4 see). The lesion of roots also is accompanied by pains. At simultaneous involving in process of an intervertebral ganglion (a ganglionitis or a ganglioneuritis) the rash herpes zoster in the field of corresponding segments is possible.
IV. The Lesion of a back horn of a spinal cord causes the same segmentary disorders of sensitivity, as well as a lesion of a back root, but, unlike a root lesion, split, or dissociated, disorders here are observed. It is necessary to recollect, that at an input of a back sensitive root in a spinal cord only fibers painful and a thermoesthesia enter a back horn; fibers of tactile and sustavno-muscular feeling pass it, entering immediately in structure vpxl 400mg of white conductors of a back column (fig. 1 see). Therefore at a lesion of a back horn ways for carrying out from the given segment of painful and temperature feeling are exposed to a break only. As a result there is a painful and temperature anaesthesia at safety in the same territory of tactile sensitivity (dissociation). Was considered, that unlike a lesion of a back root, at a lesion of a back horn of a pain are not so characteristic; However and at a lesion of back horns quite often rather intensive painful sensations are observed.
V. The Lesion of forward grey soldering of a spinal cord where there is a decussation of fibers of painful and temperature feeling, also causes the dissociated disorders (abaissement painful and a thermoesthesia at safety tactile); sites of anesthesias have segmentary character; they двухсторонни also are symmetric (type of "butterfly").
Unlike lesions of back roots, back horns and the forward grey soldering, anesthesias giving segmentary distribution, a lesion of white conductors of the central nervous system gives conduction disorder of sensitivity.
VI. The Lesion of a back column of a spinal cord where there pass Gaulle's fascicles and Бурдаха (fig. 1 see), causes loss of sustavno-muscular and vibratory feeling on the party of a lesion of conduction type, i.e. From lesion level up to the end from top to bottom; can arise as well disorders of tactile feeling. As a result of disturbance of feeling of position comes sensitive атаксия about which it has been told above. Lesions of back columns of a spinal cord are caused quite often by hyperpathia occurrence at drawing painful and temperature a boring.
VII. The Lesion of a lateral column of a spinal cord causes painful and temperature anaesthesia of conduction type at the expense of a lesion passing here tractus spino-thalamicus (fig. 1 see). Abaissement