Wandering nerve, its branches, their anatomy, topography, innervation areas. Wandering nerve - symptoms and treatment. What is a wandering nerve and where is he? Where the nuclei of the wandering nerve is located

Wandering nerve, N.Vagus (x pair) is mixed, as it has sensitive and motor fibers, as well as autonomous (vegetative) fibers, both parasympathetic and sympathetic.

At the wandering nerve distinguish Three nucleiLocated in the oblong brain:

1) the sensitive nucleus of a single path;

2) motor dual core;

3) Vegetative (parasympathetic) rear core of a wandering nerve.

The first two cores are common with a language nerve.

1. Single path core, nucleus Solitarius, It is projected by the rhombid fossa, several laterally border grooves, and it lies significantly more than a dual nucleus.

2. Double kernel, nucleus Ambiguus, It is located in the front sections of the oblong brain, deeper the rear nucleus of the vagus nerve, and is projected on the surface of the rhombid hole, respectively, border furrows.

3. The rear core of the wandering nerve, nucleus Dorsails N. Vagi, Located in the oblong brain laterally, the kernel of the sub-speaking nerve; On the surface of the rhombid fossa is projected in the region of the triangle of the vagus nerve.

Sympathetic fibers come to the wandering nerve and its branches on the connecting branches from the nodes of the sympathetic barrel.

On the bottom surface of the brain, the damping nerve is shown 10-15 roots from the thickness of the oblong brain behind the Oliva. Going to lateral and down, the wandering nerve leaves the skull through the front part of the jugular hole along with the language forces and additional nerves, located between them.

In the area of \u200b\u200bthe yapper, the wandering nerve is thickened due to the top node, Ganglion Rostralis (Superius), and a little lower, after 1.0-1.5 cm, there is another node somewhat large sizes - Lower node, Ganglion Caudalis (Inferius).

In the interior of these nodes to the wandering nerve, the inner branch of the added nerve is suitable. Going below, the wandering nerve in the neck area falls on the rear surface of the inner jugular vein and follows the top aperture of the chest, located in the groove between the specified vein and the internal sleepy at first, and then the overall carotid arteries.

Wandering nerve with internal yarema velana and the total carotid artery is concluded in one common connecting vagina, forming visorily nerve bunch of neck.

In the region of the top aperture of the chest, the wandering nerve is located between the subclavian artery (behind) and the connector vein (ahead).

Having entered B. breast cavity, the left wandering nerve falls on the front surface of the aorta arc, and the right wandering nerve - on the front surface primary department right plug-in artery.

Then, both wandering nerves are rejected by several kice, enhance the rear surface of the bronchi and is suitable for esophagus, where they are crumbled into a number of large and small nerve branches and lose the character of isolated nerve trunks.

The branches of the left and right wandering nerves are directed to the front (mainly from the left nerve) and the rear (mainly from the right nerve) of the esophageal surface and form the esophageal plexus, plexus esophageus.

From the branches of the plexus of the esophageal hole of the diaphragm, respectively, the front and rear wandering trunks are formed, trunci Vagales Anterior. Et. posteriorwhich together with the esophagus penetrate the abdominal cavity. Both front and rear trunk contains fibers of the left and right wandering nerves.

IN abdominal cavity The front and rear trunks send a number of branches to the organs of the abdominal cavity and the waken.

In his go, each wandering nerve is divided into four departments: head, cervical, chest and abdominal.

Head Department of Wandering Nerva the shortest, reaching the lower node. The following branches depart from it:

1. Meningheal branch, r. Meningeus., departs directly from the upper node, headed into the skull cavity and innervates the solid shell of the brain (transverse and occipital venous sinuses).

2. Own branch, r. Auricularis.As a rule, it starts from the upper node or below - from the nerve barrel, the post is sent to the outer surface of the inner jugular vein on the outer surface, it comes to a tier and enters the maternity channel.

In the thickness of the pyramid of the temporal bone, the ear branch is exchanged by fibers with face nerve and leaves the pyramid through the drum-bed-like slot. Then the ear branch is divided into two branches, which appear behind the exterior ear, near the outer end of the bone part of the auditory passage.

One of the branches is connected to the rear ear facial nerve, the other innervates the skin of the rear wall of the external auditory passage.

3. Connecting branch with language petroleum nerve, r. Communicans (Cum Nervo Glossopharyngeo), connects the top node of the wandering nerve and lower knot language nerve.

4. The connecting branch with an additional nerve is represented by the inner branch of the addition nerve, r. INTERNUS N. Accessorius.. This is a rather powerful trunk that comes into the wandering nerve between the upper and lower nodes.

In addition, from the wandering nerve, small branches are sent to an extra nerve. Some authors describe the connecting branch between the top node of the wandering nerve and the upper cervical sympathetic knot.

Cervical it stretches from the lower node until the recovery of the return gentle nerve. At this distance from the wandering nerve, the following branches depart:

1. Supply branches, rR. Pharyngei., often depart from the lower node, but can be left below. Two branches distinguish: the upper - large and lower - smaller. Branches go along the outer surface of the inner sleepy artery Forward and somewhat knutrice, connect with the branches of the language of the petroleum nerve and the branches of the sympathetic barrel, forming a plexus pharmaceutical plexus on the middle plexus Pharyngeus. Branches, separating from this plexus, in-nerve muscles and mucous membranes of the pharynx. In addition, the nerves on the muscle raising the sky curtain go from the upper branch, and to the muscle of the tongue.

2. Upper minor nerve, n. Laryngeus Superior., starts from the lower node, goes down the book along the inner carotid artery, taking branches from the upper cervical sympathetic knot and phael plexus, and is suitable for the side surface of the larynx. Before that, he disintegrates on the branches:

a) Outdoor branch, r. EXTERNUS, innervates the mucous membrane of the pharynx, partially thyroid gland, as well as the bottom assembly of the pharynx and the pisteless muscle; Often this branch connects with outdoor sleeping;

b) the inner branch, r. Internus, walks along with the upper gustrain artery, performs a shield-eyed membrane and its branches innerves the mucous membrane of the larynx (above the voice gap), the epitleant and partially root of the language;

c) connecting branch with lower gentle nerve, r. Communicans (Cum Nervo Laryngeo Inferiori), departs from the inner branch of the upper gentle nerve.

3. Upper cervical heart branches, RR. Cardiaci Cervicales Superiores., in the amount of 2-3, depart from the trunk of the wandering nerve and are directed along the total carotid artery, and the branches of the right wandering nerve go ahead of the shoulder barrel, left-handed aortic arc. Here, the upper cervical cord branches are connected to heart nerves from the sympathetic barrel and, approaching the heart, is part of the heart plexus, Plexus Cardiacus.

4. Bottom cable heart branches, rR. Cardiaci Cervicales Inferiores. , more numerous and much thicker of the upper, depart slightly below the return Gundy nerve. Going to the heart, the branches are connected to the rest of the heart branches from the wandering nerve and from the sympathetic trunk and also take part in the formation of heart plexus.

5. Returnable guttural nerve, n. Laryngeus Recurrens., departs from the main trunk to the right - at the level of the plug-in artery, and on the left - at the level of the aorta arc. Having reopening the indicated vessels from the front back, the return nerves are heading upwards in the furrow between the trachea and the esophagus, reaching their end branches of the larynx.

At its length, returning the guttural nerv gives a number of branches:

1) trachene branches, rR. tracheales., directed to the front surface of the lower trachea. In his go, they are connected to the sympathetic branches and are suitable for the trachea;

2) esophageal branches, RR. esophagei., innervate the esophagus;

3) lower guttural nerve, n. Laryngeus Inferior.Is the end branch of the return nerve. In his go, it is divided into the front and rear branches:

but) The front branch innervates the lateral pisnopal-shaped, pale-shaped, shield-dynamic, voice and camplonadectural muscles;

b.) Rear, or connective, branch with an inner gust branch, R. Communicans (CUM RAMO LARYNGEOINFERIORI), in its composition has both motor and sensitive fibers. The latter are suitable for the mucous membrane of the larynx below the voice slot. The motor fibers of the back branch innervate the rear perverseacher-like and transverse scarlet muscles.

In addition, there are several more connecting branches in the cervical nerve.

1) with the top cervical sympathetic node;

2) with an approaching nerve;

3) between the returnable gentle nerve and the cervical node of the sympathetic barrel.

Chest wandering nerve department it begins at the place of dying of return nerves and ends at the place of passing the wandering nerve through ecoming hole diaphragms. In the chest cavity, the wandering nerve gives the following branches:

1. Breast heart branches, rR. Cardiaci Thoracici., begins below the return gentle nerve, follow and medially, are connected to the lower heart branches, send branches to the gates of the lungs and enter the heart plexus.

2. Bronchial branches, RR. Bronchiales.are divided into less powerful front branches (4-5) and more powerful and numerous rear branches.

3. Lung plexus, plexus Pulmonalis, It is formed by the front and rear bronchial branches connecting with the branches of the upper three-four breast sympathetic nodes of the sympathetic barrel. The branches departing from this plexus are connected together and enter with bronchins and vessels into the gate of the lungs, branched in the Parenchima of the latter.

4. esophageal plexus plexus esophageus, represented by a variety of different diameters of nerves, which depart from each wandering nerve below the lung root. In his go, these branches are connected to each other and with branches from the upper 4-5 pectoral nodes of sympathetic trunks and form a plexus in the circumference.

The plexus surrounds the entire lower part of the esophagus and sends a part of the branches to its muscle and mucous membranes.

Cure Department of Wandering Nerva posted by front and rear wandering trunks, Trunci Vagales Anterior et Posterior. Both trunks are formed from the esophageal plexus and on the front and rear surfaces of the esophagus enter into the abdominal cavity or single trunks or several branches.

The rear trunk of the wandering nerve in the region of the cardia sends a number of branches - rear gastric branches, rR. Gastrici Posteriores,on the posterior surface of the stomach, and the former rejection itself, forming the curl branches, RR. Celiaci, walking along the left gastric artery to the crank plexus, plexus Celiacus.. The fibers that make up the curb branches pass through the ventilator to the abdominal organs.

The front trunk of the wandering nerve in the area of \u200b\u200bthe stomach is connected to the sympathetic nerves accompanying the left gastric artery, and sends 1-3 branches between the leaflets of the small gland to the liver - hepatic branches, rR. Hepatici.

The rest of the front trunk follows along the front periphery of the small curvature of the stomach and gives here numerous front gastric branches, RR. gastrici Anteriores., To the front surface of the stomach.

The gastric branches from the front and rear trunks in the suberozic layer of the stomach are connected to the nerves suitable here on the left gastric artery, and form the front and rear plexus of the stomach.

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X Couple - wandering nerves

(p. Vagus.), mixed, develops in connection with the fourth-fifth gill arcs, is widely distributed due to which he received its name. Innervates breathing bodies, organs digestive system (to a sigmoid colon), thyroid and parathyroid glands, adrenal glands, kidneys, involved in the innervation of the heart and vessels (Fig. 1).

Fig. one.

1 - dorsal core of the wandering nerve; 2 - the kernel of a single path; 3 - core of the spinal path trigeny nerve; 4 - double core; 5 - Cranial root of the addition nerve; 6 - a wandering nerve; 7 - jugular hole; 8 - upper node of the wandering nerve; 9 - the lower node of the wandering nerve; 10 - pharyngeal branches of a wandering nerve; 11 is the connecting branch of the vagus nerve to the sinus branch of the Language nerve; 12 - pharyngeal plexus; 13 - upper guttural nerve; 14 - the inner branch of the upper gentle nerve; 15 - the outer branch of the upper gentle nerve; 16 - the upper heart branch of the wandering nerve; 17 - lower heart branch of the vagus nerve; 18 - left return guttural nerve; 19 - trachea; 20 - Pisnostechovoid muscle; 21 - lower assembly of the pharynx; 22 - average pharyngeal content; 23 - Cell chill muscle; 24 - Upper pharyngeal consistor; 25 - Labor-sizzet; 26 - Muscle raising a chicken curtain, 27 - hearing tube; 28 - the ear branch of the wandering nerve; 29 - meningeal branch of the wandering nerve; 30 - Language nerve

The wandering nerve contains sensitive, motor and autonomous parasympathetic and sympathetic fibers, as well as intravenous small nervous nodes.

Sensitive nerve fibers of the wandering nerve occur from afferent pseudo-nipolar nerve cellswhose clusters form 2 sensitive nodes: top (Ganglion Superior)located in the jugular hole and lower (Ganglion Inferior)lying on the opening. Central cell processes go to the oblong brain to the sensitive kernel - core of a single path (nucleus Tractus Solitarii.), and peripherals - in the composition of the nerve to the vessels, heart and internship, where they end in receptor devices.

Motor fiber for melting muscles, soils and laryrs originate from the upper motion cells double kernel.

Parasympathetic fibers come from autonomous dorsal nucleusNUCLEUS DORSALIS NERVI VAGI) and spread as part of the nerve to the muscle of the heart, muscular fabric Shells of vessels and internals. The pulses going on parasympathetic fibers reduce the heart rate, expand the vessels, burn the bronchi, increase the peristaltics of the tubular organs of the gastrointestinal tract.

Autonomous postganglyonic sympathetic fibers enter the wandering nerve according to its connecting branches with a sympathetic barrel from cells of sympathetic nodes and apply to the branches of the wandering nerve to heart, vessels and internals.

As noted, the thickening and additional nerve in the process of development is separated from the wandering nerve, so the wandering nerve retains ties with these nerves, as well as with an approaching nerve and a sympathetic barrel by connecting branches.

The wandering nerve comes out of the oblong brain behind Oliva with numerous roots merging into the common trunk, which leaves the skull through the jugular hole. Next, the wandering nerve goes the book in the composition of the cervical vascular beam, between the inner jugular vein and the inner carotid artery, and below the level of the upper edge of the thyroid cartilage - between the same vein and the total carotid artery. Through the top aperture of the chest, the wandering nerve penetrates into the rear media between the connected vein and the artery on the right and aortic arc ahead is on the left. Here, by branching and ties between the branches, forms ahead of the esophagus (left nerve) and behind it (right nerve) esophageal nervous plexus (Plexus Oesophagealis)which near the esophageal hole of the diaphragm forms 2 wandering trunk: front (Tractus Vagalis Anterior) and tRACTUS Vagalis Posterior)corresponding to the left and right wandering nerves. Both barrels extend from the chest cavity through the esophageal hole, give branches to the stomach and end with a number of final branches in covered plexus. From this plexus on its branches, the fibers of the vagus nerve are distributed. All over the wandering nerve, branches are departed from it.

Branches of the head of the wandering nerve.

1. Meningheal branch (r. Meningeus.) It starts from the upper node and through the jugular hole reaches a solid cerebral shell of the back cranial fossa.

2. Own branch (r. Auricularis.) It comes from the upper node on the front-lane surface of the bulbs of the metering vein to the entrance to the maternity channel and further on it to the rear wall of the external auditory pass and part of the skin own sink. In its path, connecting branches with language petroleum and facial nerves are formed.

Branches of the cervical wandering nerve.

1. Sulfuge branches (rR. Pharyngeales.) Take the beginning from the lower node or immediately under it. Take fine branches from the upper cervical assembly of the sympathetic trunk and between the outer and internal carotid arteries penetrate the side wall of the pharynx, on which, together with the pharyngeal branches of the Language nerve and the sympathetic barrel, form a silent plexus.

2. Upper guttural nerv (rR. Laryngeus Superior.) It is branched off from the lower node and descends down and forward along the side wall of the throat of Knutrice from the inner carotid artery (Fig. 2). In a large horn, the ply bone is divided into two branches: outdoor (r. externus) and inner (r. Internus). The outer branch is connected to the branches from the upper cervical node of the sympathetic barrel and goes along the rear edge of the thyroid cartilage to the pisteless-shaped muscle and the lower constructor of the pharynx, and also properly gives the branches to the sneak-shaped and lateral pisnocher-like muscles. In addition, branches to the mucous membrane of the pharynx and thyroid gland. The inner branch is thicker, sensitive, processes the shield-eyed membrane and branches in the mucous membrane of the larynx above the voice slot, as well as in the mucous membrane of the epiglotter and the front wall of the nasal pharynx. Forms a connecting branch with a lower gentle nerve.

Fig. 2.

a - view of the right: 1 - upper guttural nerve; 2 - internal branch; 3 - outdoor branch; 4 - the bottom assembly of the pharynx; 5 - Pisneglotor part of the bottom of the pharynx; 6 - Returning Guttural Nerve;

b - the plate of the thyroid cartilage removed: 1 - the inner branch of the upper gentle nerve; 2 - sensitive branches to the mucous membrane of the larynx; 3 - front and rear branches of the lower gentle nerve; 4 - Returning Guttural Nerve

3. Top cervical branches (rR. Cardiaci Cervicales Superiors.) - Changeable in thickness and level of branch, usually thin, originate between the upper and returnable gentle nerves and go down to the heno-breast nerve plexus.

4. Lower cervical cord branches (rR. Cardiaci Cervicales Inferiors.) depart from the gentle return nerve and from the trunk of the wandering nerve; Participate in the formation of a shaven-breast nervous plexus.

Branches of the thoracic wandering nerve.

1. Returning guttural nerv (p. Laryngeus Recurrens) Departs from the wandering nerve at its entrance to the chest cavity. Right return guttural nerve goes down and rear connect artery, And the left is the aortic arc. Both nerves rise in the furrow between the esophagus and the trachea, giving the branches to these organs. Ultimate branch - nizhnaya Glutvy Nerv (p. Laryngeus Inferior) Suitable for the larynx and innervates all the muscles of the larynx, with the exception of the pistelessness, and the mucous membrane of the larynx is below the voice ligaments.

A branches to the trachea, esophagus, thyroid and parachitoid glands are departed from the return Gundy Nerva.

2. Breast heart branches (rR. Cardiaci Thoracici.) start from the wandering and left gentle returning nerves; Participate in the formation of shadan plexus.

3. Fucking branches Go to the thoracic trachea.

4. Bronchial branches Head to bronchoms.

5. Esophageal branches Suitable for the thoracic departure of the esophagus.

6. Pericardial branchesinnervate pericardium.

With the limits of the cavities of the neck and chest, the branches of wandering, return and sympathetic trunks form a cerhy and thoracic nervous plexus, in the composition of which organized plexuses are distinguished: shield, tracheal, esophageal, loney, cardiac:

Branches of the trunks (abdominal part).

1) front gastric branches start from the front trunk and form front gastric plexuses on the front surface;

2) rear gastric branches depart from the rear trunk and form rear gastric plexus;

3) Clasp branches We depart mainly from the rear trunk and take part in the formation of the ventilation;

4) hepatic branches included in the hepatic plexus;

5) renal branches Form renal plexus.

XI Couple - Additional nerve

(p. Accessories) Mostly a motor, separated during the development process from a wandering nerve. It begins two parts - wandering and spinal from the corresponding motor nuclei in the oblong and spinal cord, the afferent fibers are suitable in the barrel through the cerebrospinal part of the cells of sensitive nodes (Fig. 3).

Fig. 3.

1 - double core; 2 - a wandering nerve; 3 - Crane root of the addition nerve; 4 - the spinal root of the addition nerve; 5 - a large hole; 6 - jugular hole; 7 - the upper node of the wandering nerve; 8 - additional nerve; 9 - the lower node of the wandering nerve; 10 - the first cerebrospinal nerve; 11 - breast-curable-cottage muscle; 12 - second spinal nerve; 13 - the branches of the addition nerve to the trapezoidal and sternum-curable-bed-like muscles; 14 - Trapezoid muscle

The wandering part comes out cranial root RADIX CRANIALIS from the oblong brain below the yield of the wandering nerve, the spinal volume is formed spinal root (Radix Spinalis), leaving out spinal cord Between the rear and front roots.

The spinal from the nerve rises to the large hole, enters it into the cavity of the skull, where it is connected to the wandering part and forms a common nerve barrel.

In the skull cavity, the addition nerve is divided into two branches: internaland outdoor.

1. Internal branch (r. Internus.) Suitable for a wandering nerve. Through this branch, motor nerve fibers are included in the brewing nerve, which leave it through the gentle nerves. It can be assumed that sensitive fibers also pass to the wandering and further into the guttural nerve.

2. Outdoor branch (r. externus) It comes out of the cavity of the skull through the jugular hole on the neck and first comes first behind the rear abdomen of the two-dimensional muscle, and then from the inside of the breast-curable-cottage muscle. The last, the outer branch is heading down and ends in the trapezoidal muscle. Communications are formed between additional and cervical nerves. Innervates the breast-curable and large and trapezoid muscles.

XII Couple - Podium Nerve

(p. Hypoglossus) Muscular mainly, it is formed as a result of the merger of several primary spinal segmental nerves, innervating subwaytone muscles.

Nervous fibers, components of the sublard nerve, depart from its cells motor kernel located in the oblong brain. The nerve comes out of it between the pyramid and olive several roots. The formed nerve barrel passes through the channel of the sub-speaking nerve on the neck, where it is located first between the outer (outside) and the internal carotid arteries, and then descends under the rear abdrunk (tongue triangle) (Fig. 4); branches to the final page branches (RR. Linguales), innervating muscles of the language.

Fig. four.

1 - Podium-free nerve in the channel of the same name; 2 - the core of the sublingual nerve; 3 - the lower node of the wandering nerve; 4 - the front branches of the 1-3 cervical spinal nerves (form a cervical loop); 5 - Upper cervical sympathetic trunk; 6 - the upper root roof root; 7 - internal carotid artery; 8 - the lower roof root; 9 - cervical loop; 10 - internal jugular vein; 11- total carotid artery; 12- lower abdomen of the explosive-lift muscle; 13 - sternum-thyroid muscle; 14 - Breast-but-subwind muscles; 15 - upper abdominal muscular muscle; 16 - shield-subwitting muscle; 17 - Podium-language muscle; 18 - suburban-related muscle; 19- chore-tongue muscle; 20- Own muscles of the language; 21 - Shiliant Muscle

From the middle of the nerve arc down along the overall carotid artery goes top Radix Superior AnSae Cervicaliswhich connects to her lower root (Radix Inferior) from the cervical plexus, resulting in neza Cervicalis. From the neck loop, several branches go to the muscles of the neck, located below the sub-bandy bone.

The position of the approximate nerve on the neck may be different. People with the long neck arc, formed by the nerve, lies relatively low, and people with a short neck are high. This is important to consider when operations on the nerve.

Other types of fibers also pass in the sublard nerve. Sensitive nerve fibers come from the cells of the lower node of the wandering nerve and, possibly, from the cells of the spinal assemblies along the connecting branches between the sub-band, wandering and cervical nerves. Sympathetic fibers are included in the sub-speaking nerve along its connecting branch with the upper node of the sympathetic barrel.

The innervation areas, the fiber composition and the names of the cranial nerve nuclei are presented in Table. one.

Table 1.Innervation areas, fiber composition and names of cervical nerve nuclei

Couple	Nerve	Fiber composition (preferential)	Names of nuclei located in the brain trunk	Innervored organs
	Nervus Terminalis	Sympathetic (?)		Blood vessels and glands of the mucous membrane of the nasal cavity
	Nervi Olfactorii.	Sensitive		Regio Olfactoria Nasal Poland Mussel
		Sensitive		Retina eyeball
		Motor	Nucleus p. Oculomotorii	M. Levator Palpebrae Superioris, T. Rectus Medialis, T. Rectus Superior, T. Rectus Inferior, m. Obliquus Inferior.
		Parasympathetic	Nucleus p. Oculomotorius Accessorius	M. Ciliaris, m. SphIncterpupillae.
	Nervus trochlearis	Motor	Nucleus p. Trochlearis	M. Obliquus Superior.
	Nervus trigeminus	Motor	Nucleus Motorius n. Trigemini.	MM. Masticatorii, m. Tensoris Veli Palatini, m. TENSOR TYMPANI, VENTER ANTERIOR M. Digastrici.
		Sensitive	Nucleus Mesence-Phalicus N. Trigemini.	The skin of the frontal and temporal parts of the head, the skin of the face. Mucous membranes of the nasal and oral cavities, front 2/3 languages, teeth, salivary glands, Organs of the Elets, solid cerebral shell in the field of front and medium cranial pits
		Sensitive	Nucleus Pontinus N. Trigemini.
		Sensitive	Nucleus Spinalis N. Trigemini.
		Motor	Nucleus n. abducentis	M. RECTUS LATERALIS.
		Motor	Nucleus p. Facialis	Mm.Faciales, T. Platysma, Venter Posterior T. Digastrici, m. Styloideus, m. Stapedius.
	Nervus NterMedius.	Sensitive	Nucleus Solitarius.	Delicious front 2/3 language sensitivity
	Nervus NterMedius.	Parasympathetic	Nucleus Salivatorius Superior.	Glandula Lacrimalis, Tunica Mucosa Oris, Tunica Mucosa Nasi (glands), GL. Sublingualis, GL. SubmandiBularis, Glandulae Salivatoria Minores
	Nervus vestibulo-cochlearis	Sensitive	Nervus Cochlearis: NUCL. Cochlearis Anterior, NUCL. Cochlearis Posterior.	Organon Spirale, Spiral Organ
	Nervus vestibulo-cochlearis	Sensitive	Nervus Vestibularis: NUCL. Vestibularis Medialis, NUCL. Vestibularis Superior, NUCL. Inferior.	Crista Ampullares. Macula Urticuli, Macula Sacculi, Mebirint inner ear
	Nervus Glossopharingeus.	Motor	Nucleus Ambiguus	M. Stylopharingeus, Pot Muscles
		Sensitive	Nucleus Solitarius.	Cavum Tympani, Tuba Auditiva, Tunica Mucosa Radicis Linguae, Pharingis, Tonsilla Palatina, Glomus Caroticus, Hearing Pipe
		Parasympathetic	Nucleus Salivatorius Inferior.	Glandula parotidea.
		Motor	Nucleus Ambiquus.	Tunica Muscutarispharingis, m. Levator Velipalatini, m. Uvulae, m. Palatoglossus, m. Palatopharyngeus, mm. Laryngis
		Sensitive	Nucleus Solitarius.	DURA MATER ENCEPHALI in the area of \u200b\u200bthe rear cranial fossa, the skin of the outer auditory passage. Organs of the neck, chest and abdomen (with the exception of the left part of the colon)
		Parasympathetic	Nucleus Dorsalis N. Vagi.	Smooth muscles and glands of breast and abdominal organs (with the exception of the left part of the colon)
	Nervus Accessorius.	Motor	Nuclei Nervi Accessorii (NUCL. Accessorius)	M. SternocleIdomastoideus, t. Trapezius
	Nervus hypoglossus	Motor	Nucleus n. Hypoglossi.	Language Muscles, Musculi Infrahyoids

Anatomy of man S.S. Mikhailov, A.V. Chukbar, A.G. Tsybulkin

Nervus vagus (X.)

Wandering nerve, p. vagus. , is mixed nerves. Its sensitive fibers end in the core of a single path, the motor starts from the double kernel (both nuclei are common with the language "nerve), and vegetative - from the rear nucleus of the wandering nerve. Wandering nerve innervates an extensive territory. Fibers emerging from the vegetative kernel make up most of The nerve of the nerve and provide parasympathetic innervation of the organs of the neck, chest and abdominal cavities. The fibers of the wandering nerve are impulses that slow down the rhythm of the heartbeat, expand the vessels (ref-lecturer regulate blood pressure in the vessels), sneak bronchi, enhance the peristaltics and relax the intestine sphincters, cause Enhanced secretion of the gastrointestinal lights.

The wandering nerve comes out of the oblong brain in the rear side of the furrow by several roots, which, compound, form a single barrel heading for the jugular hole. In the hole itself and at the exit of it, the nerve has two thickening: upper and lower nodes, ganglion. supe- rius. et. ganglion. inferius.. These nodes are formed by sensitive neurons. The peripheral processes of neurons of these nodes go to the internal organs, the solid shell of the brain, the skin of the external auditory passage. In the jugular hole to the trunk of the wandering nerve, the inner branch of the addition nerve is connected.

Coming out of the jugular hole, the nerve is heading down, located on the pre-plane plate of the cervical fascia behind and between the inner jugular vein and the inner carotid artery. In the thoracic cavity, the wandering nerve passes through the upper aperture of the chest. The right nerve is located between the connectible artery of the rear and the connector vein in front. The left nerve goes between the total sleepy and plug-in arteries, continuing to the front surface of the aortic arc (Fig. 178). Next, the right and left nerves are located behind the roots of the lungs. Then the right wandering nerve goes to the back, and the left is on the front surface of the esophagus, sharing several branches connecting among themselves. So the esophageal plexus is formed, from which the front and rear wandering trunks are formed. The latter along with the esophagus pass into the abdominal cavity and there are given their end branches.

Thopographically, the wandering nerve can highlight 4 departments: head, cervical, chest and abdominal.

Head Departmentthe wandering nerve is between the beginning of the nerve and the top node. The following branches depart in this department:

1Minengual branch g.meningeus., it departs from the upper node and goes to a solid shell of the brain in the area of \u200b\u200bthe rear cranial fossa, including the walls of the transverse and occipital sinuses.

2 suite branch g.auricularis., it starts from the lower part of the upper node, penetrates the jugular hole, where it is included in the marshite canal holder. Coming out of the latter through the drum-bed-like slit, the ear branch innerves the skin of the rear wall of the external auditory passage and the skin of the outer surface of the ears of the sink.

TO cervical departmentthe wandering nerve includes that part of it, which is located between the lower node and the exhaustion of the returnable Gundy Nerva. Branches of the cervical vagus nerve:

1Hlotch branches, rR. pharyngei. [ pharianedlis], go to the wall of the throat, where, connecting with the branches of the tongue nerve and the sympathetic barrel, form sulfuge plexusple xus pharyngeus. [ pharyngedLis]. Sulfuge branches innervate the mucous membrane of the pharynx, muscle-connectors, the muscles of the soft sky, with the exception of the muscle, straining the sky curtain.

2-top cervical heart branches, rR. cardiaci. cervicdles. superiores., in the amount of 1-3, they depart from the wandering nerve, descending along the overall carotid artery, and together with the branches of the sympathetic barrel enter the heart plexuses.

3 Top Horland Nerve, p.laryngeus. [ laryngea.- lIS] superior., departs from the lower node of the wandering nerve, go ahead along the lateral surface of the pharynx and at the level of the sub-speaking bone is divided into outdoor and inner branches. Outdoor branch, G.externus, innervates the Pisnostechoid Muscle Large. Inner branch, G.internus., accompanies the upper gentle artery and, together with the latter, processes the shield-eyed membrane. Its finite branches innervate the mucous membrane of the larynx above the voice slot and part of the dust root mucosa.

4Arpente harvested nerve, p.laryngeus. [ lA- ryngealis] recurrens., it has different starts on the right and left. The left return mountain nerve starts at the level of the aortic arc and, having encouraged it from the bottom in the anterior seat, rises vertically up in the furrow between the esophagus and the trachea. The right return mountain nerve departs from a wandering nerve at the level of the right plug-in artery, envelopes it from below and also in the back direction and rises up the lateral surface of the trachea. The ultimate branch of the return gentle nerve - nizhny guttural nerve, p.larynGealis. infe riOR., innervates the mucous membrane of the larynx below the voice slot and all the muscles of the larynx, except for Pisnostechoidovoid. From the rotary gentle nerve is also departed trachean branchesrR. trachenles., esophageal branches,rR. esophagei. [ oesophagealis] and loweruieuhbie. Cardiac branchesrR. cardiaci. cervicdles. infe- riores., who go to heart plexuses. From the lower gentle nerve, it is also connecting branch(with the inner gentle branch of the upper gentle nerve), g.communicans. (cUM r.. laryngeo. interno.).

Chest department- This is a portion of a wandering nerve from the level of revering of return nerves to the level of the esophageal hole of the diaphragm. Branches of the chest wandering nerve department:

1Good heart branches, rR. cardiaci. thordcici., direction to heart plexuses.

2Bronchial "branches, / t. bronchidles., go to the root of the lung, where together with the sympathetic nerves form pulmonary plexusplexus. pulmondlis, which surrounds bronchi and together with them enters the easy.

3pish maker plexus, plexus. esophageus. [ oeso. phagealis] , formed by branches of the right and left wandering nerves (stems), connecting between themselves on the surface of the esophagus. The branches to the wall of the esophagus move away from the plexus.

Abdominal departmentthe vagus nerve is represented by the front and rear trunks, which come out of the esophageal plexus.

1 pre-wandering trunk, truncus. vagdlis anterior., it moves from the front surface of the esophagus to the front surface of the stomach near his small curvature. From this wandering trunk front gastric branches, GG.gdstrici. anteriores., as well as hepatic branches, G.hepdtici., going between a small gland leaflets to the liver.

2-way wandering trunk, truncus. vagdlis pOS. terior., from the esophagus goes to the rear wall of the stomach, goes along his small curvature, gives rear gastric branches,rR. gdstrici. posteriores., as well as custody branchesrR. coeliaci.. Clasp branches go down and back and on the left gastric artery reach an enzyme plexus. Fibers of wandering nerves along with, sympathetic fibers of the ventilating plexus go to the liver, spleen, pancreas, kidney, a small intestine and a colon to a descending colon.

It often happens that a person who leads a healthy lifestyle suddenly detects unpleasant symptoms: the stomach hurts, the heart is stuck ... And this is despite the fact that he does not drink, does not smoke, engaged in sports. The cause of concern can be a wandering nerve. Where it is, what it is, as functions and what problems with well-being can create - try to figure it out!

What is a wandering nerve?

Medicine has 12 pairs of nerves emanating from the base of the skull. Each of them has its own functions and transmits signals to certain organs. The tenth pair was named a wandering nerve, because it is transmitted to all the signals from the brain almost to all vital important organs. The wandering nerve begins at the base of the skull and passes through the neck, chest and peritoneum.

First of all, the wandering nerve adjusts the functions:

swallowing;
vomiting;
cough;
stomach work;
breathing;
heartbeat.

If the work of the wandering nerve is broken, it is even possible to stop the heart and a fatal outcome.

Causes of disease

In diseases of the wandering nerve, symptoms and treatment are interrelated. And the main reasons for the development of pathology can be:

injuries that put pressure on the nerve;
surgical operations during which there was damage or pinching the nerve;
diabetes mellitus (the increased level of sugar adversely affects the work of the wandering nerve);
viral diseases of the respiratory organs;
chronic diseases (HIV infection, Parkinson's disease);
alcoholism.

Symptoms

Depending on which the wandering nerve department is amazed, the doctor defines symptoms and treatment for each specific case:

head Department (strong headaches and discomfort in the ear);
the cervical department (the swallowing function is disturbed due to the paralysis of the sinking muscles, a change in voice, suffocation);
the chest department (violation of the functions of cardiovascular and respiratory systems, which is expressed in difficulty breathing, sensation of air shortness, chest pain; weakening cough reflex and, as a result, pneumonia);
abdominal department (disorder of the stomach and intestines, pain in the peritoneum, vomit reflex).

If the nerve is damaged, the cardiovascular system is particularly suffering especially. This is expressed in the following states:

reduced pulse;
pressure drops;
dyspnea appears;
feel pain in the heart area;
few air shortages;
it seems that "com in the throat is worth".

With damage to the nucleus of the wandering nerve rises or the tone of the vegetative system is reduced. Vegetative disorders make themselves felt by the lethargy of the body, apathy in the behavior of a person with an increased tone and irritability, quick-tempered - with reduced.

Learn also about the causes of Ikota in newborns and why there is a whole day IKOT.

Diseases of a wandering nerve

When pinning a wandering nerve, the following groups of diseases are developing:

angiogenesis (diseases of the vegetative system, in which the work of blood vessels is disturbed);
neurasthenia (the disorder of the vegetative system, in which the excitability increases and exhaustion occurs).

Among these groups are most common:

migraines - bouts of headaches wearing episodic character;
meniera's disease is affected by the peripherals of the nervous system and the brain, as a result of which the head is spinning, the rumor is reduced;
reino disease is affected by the nervous system, as a result of which the limbs and sections of the face are pale and become cold, emotional irritability appears.

Treatment

The wandering nerve is almost not treatable. In this regard, you should always be careful and at the first symptoms nervous disorder Contact a doctor.

Traditional medicine offers the following funds as treatment:

hormonal preparations (prednisone);
multivitamin complexes with group vitamins B;
anticholinesterase medicines (drugs that hinder the activity of the enzyme, which transmits an excitation signal to the nervous system);
antihistamines.

In particularly severe cases, it can be applied:

electrostimulation;
surgical methods;
plasmapheresis (blood purification at the cellular level).

Traditional treatment should be held exclusively under the supervision of the doctor. With incorrect or late therapy, death may occur due to the termination of the work of some body bodies.

ethnoscience

With defeats of the wandering nerve, traditional medicine is ineffective. It allows us only to mitigate some symptoms, but in no case treats the disease. As prevention and to enhance the effect of methods traditional medicine You can offer some of the grasses.

1 tbsp. l. Dried grass chassis pour 50 ml of boiling water and insist for 15 minutes. Drink out during the day, breaking a portion for 4 reception.
Mint is mixed with Melissa, pour the glass of boiling water and insist for 20 minutes. Drink out during the day for 2 receptions.
1 tbsp. l. Clover pour 200 ml of boiling water and insist for 20 minutes. Strain and drink in 2 reception.
Of medical herbs and fruits can be done tincture for the treatment of a wandering nerve:
50 g of vocabulary pour 1.5 liters of white wine. Insist during the week in a darkened place. Consume 10 drops by adding them to milk 4 times a day.
50 grams of shank root pour 0.5 liters of vodka. Soaking 7 days and take 15 drops 3 times a day.

It should be remembered that it is almost impossible to cure a wandering nerve. Need carefully to the health of the nervous system. If there are suspicions of the disease of the wandering nerve, the symptoms and treatment will define only the doctor. Self-treatment and untimely treatment for medical help can lead to a fatal outcome.

The human body has a complex structure and branched nervous system. This article will talk about wandering (Vagus) Nerve. The wandering nerve, what it is, what violations can arise in it and how to treat them?

The wandering nerve is the main nerve in the parasympathetic system of man and is the longest of all nerves in the human body. He does not know how to wander around the body, and it began to be called this way thanks to the vastness of the functions assigned to him with the brain.

The parasympathetic system is a system that has the name "relax and digest".

Where is the wandering nerve? It comes out of the skull, it penetrates into the chest plane through the cervical department and falls below, to the abdominal cavity. Thanks to this long way, nerve performs a large number of Functions in the body, including:

Responsible for the innervation of the mucous membrane and the larynx, the outer hearing channel, the cranial fossa.
Innervates the lungs, intestines, esophagus, stomach and heart.
Responsible for the movement of neba, pharynx, larynx and esophagus.
It affects the production of gastric juice and secretion of the pancreas.

As a result of such extensive functions, it can be bolder to state that the wandering nerve is responsible in the body, for:

breath;
cough;
speech;
sweating;
the process of saturation;
heart work;
swallowing process;
romatic reflexes;
digestion.

Even minor lesions can lead to stopping the work of a significant part of the body and lead to death.

The structure and function of the nerve

Structure

The vagus nerve is x pair of cranial nerves (in total in the human body XII pairs of cranial nerves) and originates in the cranial box. Thus, it refers to the central nervous system.

Anatomy The nerve wandering is not so simple, as it seems, at first glance. Vagus himself consists of four departments:

The head - nerve barrel comes out of the cranial box and goes to the cervical department.
The cervical is located directly in the neck.
Breast - proceeds from the base of the neck until the end of the chest plane.
Abdominal - located in the area of \u200b\u200bthe stomach.

Each of the specified departments has its own branches. These branches consist of fibers, which are also divided into:

Sensitive (located in the auditory canal and brain shell).
Motor (located in the muscles of larynx, pharynx and esophagus).
Vegetative (bear responsibility for functioning internal organs, endocrine glands, blood and lymphatic system).

What does nerv look like

Topography of a wandering nerve, as follows:

the left and right wandering nerve (pass in parallel to each other and respond to each of their easy, after which the esophageal plexus is formed below);
meningeal branch (transmits signals to the back of the external auditory channel and is responsible for the innervation of a solid cerebral shell);
pharyngeal branch (innervates pharyngeal muscles, mucous and packed);
upper hydrogen nerve (innervates voice ligament mucosa, claroid ligaments, upper esophageal sphincter and subglot);
returnable guttural nerve (innervates the muscles of the larynx, the esophagus, smooth muscles);
upper heart nerve (has 2-3 branches, which are communicated with sympathetic fibers);
lower heart branch (innervates heart muscles);
front I. rear branch esophagus (must be directly near the esophagus and innervates the rear surface of the pericardium);
gastric branches (innervation stomach, pancreas, spleen, intestines, kidneys and adrenal glands);
hepatic branches (innervate liver).

Causes of defeat

The reasons that can serve pinched or inflammation of the wandering nerve are different. So, the most often violations in the work of Vagus cause diseases of the brain, including:

meningitis;
tumor neoplasms (malignant and benign tumors, aneurysms, cyst, etc.);
CMT brain, which cause hematoma or other damage;
circulation disorders, which affects the thrombosis.

In addition, irritation of the wandering nerve causes the following agers:

diabetes;
chronic diseases (tuberculosis, sinusitis);
hIV infection;
parkinson's disease;
multiple sclerosis;
heavy metals poisoning.

In addition, it is impossible to exclude the effects of alcohol, the increased content of which adversely affects the vagus nerve. Along with the abuse of alcoholic beverages, which developed in this background, alcoholic neuralgia often causes nerve irritation.

Symptoms of defeat

The wandering nerve of his symptoms and treatment differ in contrast to which department is amazed. So, the symptoms may be as follows:

Violations of speech - as a rule, a patient begins with everything from a little chic during a conversation. Further, problems with pronunciation are possible and a loss of votes.
Problems with swallowing are pinching or inflammation of a part of a wandering nerve that is responsible for swallowing may cause difficulties with solid food, and as progression and liquid. Gradually, it is possible to develop vomit urges when trying to swallow ordinary water And even saliva. In particularly severe cases, sufforations of suffocation.
Disorders of the digestive system and the gastrointestinal tract - the increased tone of the muscles of the esophagus or its absence can lead to a stop of the digestive system or its slowdown. This leads to constipation, diarrhea, the emergence of heartburn, etc.
Problems with a cardiovascular system - a violation in the work of the heart is not so easy to detect, if you do not pay attention to the signals that the organism sends us (unfortunately, most people do this. The main symptoms of violation - arrhythmia, tachycardia, bradycardia dizziness, respiration difficulties uncontrolled urination (appears as a result of a long period of absence of treatment), deafness.
Problems of the nervous system - headache, problems with ears, lethargy, excessive irritability, apathy, extension.

Stimulation

Vagus plays an important role in the human body. So, if it is normal, he:

improves blood sugar regulation;
reduces the risk of stroke and heart disease;
stabilizes pressure;
improves digestion;
reduces the intensity and number of attacks of head and migraine pain;
raises the mood;
reduces stress and alarming state.

In order to maintain a good tone of a wandering nerve, it is recommended to regularly activate it (this procedure is called stimulation of the wandering nerve).

Stimulation contributes:

reducing the risk of the occurrence of panic attacks, fears, heart disease;
preventing Alzheimer's disease;
fighting headaches, overweight and obesity;
encourage the body to fight bulimia, anorexia, autoimmune diseases, cancer, hemorrhoids;
eliminating problems with alcoholism.

It is necessary to understand that the usual activation of Vagus is not enough, in order to defeat one or another ailment, but in a complex with drug treatment shows quite good results.

Variant stimulation

Activation is possible in the following ways:

slow and rhythmic stomach breathing (10-15 minutes);
meditation (15-20 minutes);
washing with cold water (in the morning and evening);
reception of probiotics;
rinse throat (repeated several times a day after meals);
singing (loudly and with pleasure, and this positively affects the parasympathetic system);
reception of fish oil (Omega 3 is an excellent stimulant).

Diagnostics

The disease diagnosis is carried out in a medical institution and begins with a patient's survey and refinement that it bothers.
For example, in case of problems with swallowing, the doctor makes an inspection of a soft nose (the tongue saves the opposite damage) and the throat. In addition, the doctor appreciates the voice of the voice and the level of greed during pronunciation.

To check the swallowing function, it is enough to ask for a patient to drink a glass of water, a cough should begin during swallowing (the natural reaction of the body when the wandering nerve is notching with complications of a swallowing function).

In addition, the neuropathologist additionally appoints:

laryngoscopy;
magnetic resonance tomography (MRI);
radiography;

Treatment

Act in case of violations associated with the Vagus must be necessary, since the absence of treatment may lead to sad consequences.

Treatment is divided into conservative and surgical. In addition, a separate category can be taken out folk treatments.

Conservative treatment implies the reception of hormonal drugs (prednisone, hydrocortisone), which contribute to the elimination of symptoms.

In addition, in order to calm down painfulnessSuppose the admission of painkillers.

Treat inflammation of the vagus nerve is permissible to antihistamine, which remove the swelling formed around the vagus nerve.

Naturally, a vitamin feeding for the affected nerve and a weakened organism is necessary. Suitable for this vitamin - vitamin group B, as well as drugs containing magnesium.

As in most cases, after a course of drug therapy, physiotherapeutic procedures are needed, which include:

Dyadynamic currents (have a stimulating effect on the muscles).
Plasmorosis.
Electrostimulation.

As a rule, the effect of physical processes at the minimum treatment phase, therefore, this type of therapy is used as a rehabilitation procedure.

Additionally, you can resort to recipes folk Medicine. Cereal illness using only home treatment methods is hard, and it is not recommended to replace drug therapy for folk. The complex may have quite good results.

As the main options home Treatment Showing:

Baths.
Tincture.
Decorations.
Monolay.

Baths based on herbs - mix in the same proportion of 20 g of Aira, souls, kidney pine and yarrow and pour the resulting mixture 5 l hot water. Before pouring the resulting mixture into the bath, it insists for up to 5 hours. Take a bath must not more than 20 minutes. It is believed that such manipulations relax and contribute to the calm of the nerve.

Various varieties are quite a lot, as an alternative, you can try to use the valerian root and sage are also mixed in equal proportions and infused on boiling water.

As a means, sedatives are used for intake. So, for the preparation of the sedative, it is necessary to mix 10 g of mint and melissa in an equal proportion and pour their 300 ml of hot boiled water. It must be praised for at least an hour. Use the tool every day one cup.

For removal nervous tension It is enough to boil in 50 ml of water st. Spoon of flowers of the chastard. Take such a decoction better every day 50 ml.

The patient can make a pillow of soothing herbs. Such a tool is called an aromatic pillow. To herbs that can be used:

thyme;
mint;
melissa;
hop cones;
chamomile;
bay leaf;
oregano;
lavender.

Consumerities include honey, which must be regularly taken instead of the same sugar. Honey has a tousing and soothing effect at regular reception. Good results showing homeopathy.

To surgical interference resorts in the most extreme case when conservative treatment Does not bring visible results. In addition, surgical intervention is shown for persons having tumor processes, the tumor removal is in some cases a prerequisite for recovery. The surgeon must make sure that the operation will bring more benefits than harm.

Prevention

For preventing diseases of the wandering nerve there is no need to adhere to some kind of complex diet or bleed with cold water. All recommendations are quite adequate and will not cause difficulties ordinary person. So, recommendations include:

Maintenance healthy image Life.
Daily moderate physical exertion.
Daily healthy sleep.
Admission in the evening of a contrasting soul.
Rejection of bad habits.
Avoiding stressful situations at work.

So why it is so important to take care of your emotional state? Because a calm and balanced person is much less likely to suffer from diseases, including from ailments related to inflammation of a wandering nerve. Take care of your nerves, it will be much harder to treat them than to protect them.