Which contain nerve endings. Diseases associated with nerve endings

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The terminal devices of nerve fibers - nerve endings - are different in their functional significance. There are three types of nerve endings: effector, receptor and terminal devices as part of interneuronal synapses.

Effector nerve endings - these include motor nerve endings of striated and smooth muscles and secretory endings of glandular organs.

The motor nerve endings of striated skeletal muscles - motor plaques - are a complex of interconnected structures of nervous and muscle tissue. Motor plaque - effector apparatus of nerve cell axons motor nuclei anterior horns of the spinal cord or motor nuclei of the brain and muscle fibers. Morphologically, it consists of a nerve pole - the terminal part of the neuron axon and a muscle pole, a specialized section of muscle fiber - the base of the motor plaque (Fig. 166).

The motor nerve fiber near the muscle fiber loses the nuclei of glial cells and myelin sheath accompanying the axial cylinder. The axial cylinder, breaking up into several terminal branches, is immersed in a specialized spine of muscle fiber.

The sacrolemma in the area of ​​the nerve ending forms numerous submicroscopic folds that form secondary synaptic clefts of the motor ending.

The muscle fiber in the area of ​​the base of the motor plaque does not have myofibrils and transverse

Rice. 166. Motor nerve ending (motor plaque):

A- profile view ( A And b- myelin endings nerve fiber, c - myelin fiber, d- muscle fiber, e- core of muscle fiber); IN- top view (a - myelin fiber, b- unmyelinated nerve fiber, c - fiber emerging from a motor plaque and ending in another motor plaque, the so-called “ultraterminal fiber”).

Rice. 167. Scheme of the structure of a motor plaque:

1 - lemmocyte cytoplasm; 2 - core; 3 - neurilemma; 4 - axial cylinder; 5 - sarcolemma; 6 - terminal branches of the nerve fiber in longitudinal and cross sections; 7 - mitochondria in neuroplasm (axoplasm); 8 - primary synaptic space; 9 - sarcosomes; 10 - secondary synaptic space; 11 - synaptic vesicles; 12 13 14 - core of the motor plaque (muscular); 15 - myofibril, consisting of myoprotofibrils.

striations. Here the cytoplasm contains a significant number of mitochondria and round or oval nuclei. The combination of these muscle fiber structures in the area of ​​the nerve ending forms its muscle pole.

The terminal branches of the axial cylinder of the nerve fiber are characterized by the presence of mitochondria and numerous synaptic vesicles containing the mediator acetylcholine (Fig. 167). The latter, when depolarizing the axon plasmalemma - the presynaptic membrane - enters synaptic cleft and on the cholinergic receptors of the postsynaptic membrane, which is the sheath of the muscle fiber, which causes excitation (a wave of depolarization of the postsynaptic membrane).

Motor nerve endings of smooth muscle tissue are formed by nerve fibers that spread between muscle cells and form distinct extensions containing cholinergic or adrenergic vesicles.

Sensory nerve endings (receptors)- specialized terminal formations dendrites of sensory neurons. In accordance with their localization and specificity of participation in nervous regulation vital functions of the body there are two large groups receptors: exteroceptors and pteroceptors. Depending on the nature of the perceived irritation, sensitive endings are divided into mechanoreceptors, chemoreceptors, thermoreceptors, etc.

Rice. 168. Lamellar corpuscle (Vater-Pacini corpuscle):

1 - outer flask; 2 - inner flask; 3 - terminal section of the nerve fiber (according to Clara).

Rice. 169. Tactile (Meisierian) corpuscle:

1 - capsule; 2 - special cells.

Sensitive nerve endings are very diverse in their structural organization. They are divided into free nerve endings, consisting only of the terminal branches of the dendrite of the sensitive cell, and non-free ones, containing glial cells. Non-free endings covered with a connective tissue capsule are called encapsulated. An example of free nerve endings is the terminal branching of the dendrites of sensory cells in the epidermis of the skin, where sensory nerve fibers, penetrating into the epithelial tissue, break up into thin terminal branches.

The sensory endings in the connective tissue of animals are very diverse, which are represented by two groups: non-encapsulated and encapsulated nervous apparatus. The former contain a branching axial cylinder of fiber accompanying glia. The latter are characterized by the presence of a connective tissue capsule and the specificity of the morphology and functions of their glial elements. The group of such sensitive endings includes lamellar corpuscles (Vater-Pacini corpuscles), tactile corpuscles (Meissner corpuscles), genital corpuscles, etc. (Fig. 168, 169).

Rice. 170. Scheme of the structure of a lamellar body:

1 - layered capsule; 2 - inner flask; 3 - dendrite of a sensitive nerve cell; 4 - spiral collagen fibers; 5 - fibrocytes; 6 - glial cells with cilia; 7 - synaptic contacts of the axons of secondary sensory cells with the dendrites of the sensitive nerve cell (according to Othelin).

The lamellar body consists of an internal flask and a capsule. The inner flask is formed by specialized lemmocytes. The axial cylinder, the terminal section of the sensitive nerve fiber, is immersed in it. Penetrating into the inner flask, it breaks up into the finest terminal branches.

The capsule of the lamellar body consists of a large number of connective tissue plates formed by fibroblasts and spirally oriented bundles of collagen fibers. At the border of the outer capsule and the inner flask there are cells that are presumably defined as glial. They form synapses with the branches of the axial cylinder (Fig. 170). It is assumed that the nerve impulse is generated under conditions of displacement of the outer capsule in relation to the inner bulb. Lamellar bodies are characteristic of the deep layers of the skin and internal organs.

Tactile corpuscles are also formed by glial cells, which are oriented perpendicular to the long axis of the corpuscle, and spread along their surface with terminal branches of the axon. The surface of the body is covered with a thin connective tissue capsule.

The genital corpuscles of the genital organs are constructed similarly. A distinctive feature of this type of ending is that not one axial cylinder penetrates into the genital body under the capsule, but several. The latter branch between the glial cells of the body. Krause flasks are built according to the same scheme, the function of which is associated with temperature sensitivity. When they are excited, the transmitter enters the synaptic cleft on the cholinergic receptors of the postsynaptic membrane of the muscle fiber and causes an impulse (depolarization wave).

Skeletal muscle receptors - muscle spindles contain several intrafusal muscle fibers covered by a common connective tissue capsule. The spindle usually consists of two thick central muscle fibers and

Rice. 171. Scheme of the structure of the neuromuscular spindle:

A - motor innervation of intrafusal and extrafusal muscle fibers (according to Studitsky); B - spiral afferent nerve endings around the intrafusal muscle fibers in the area of ​​the nuclear bursae (according to Kristich with modification); 1 - motor plaques of extrafusal muscle fibers; 2 - motor plaques of intrafusal muscle fibers; 3 - nuclear bag; 4 - nuclear bag; 5 - sensitive annulospiral nerve endings around the nuclear bursae; 6 - striated muscle fibers; 7 - nerve.

four thin ones (Fig. 171). The equatorial part of the thick fibers is filled with clusters of nuclei - the “nuclear bag”. In thin muscle fibers, the nuclei are arranged in a chain, forming a nuclear chain. Sensitive nerve fibers are presented here in two types. Some form spiral curls surrounding the equatorial, nuclei-containing part of the thick intrafusal muscle fibers - “annular endings”. The endings of the second group of sensory fibers are represented by both annular endings and secondary grape-shaped endings, one on each side of the primary. The endings of the first group react to the degree of muscle stretching and its speed, the secondary ones - only to the degree of stretching. The endings of motor nerve fibers are localized at both poles of the muscle fibers and have a structure typical of a motor plaque.

Interneuronal synapse- specialized contact between two neurons, ensuring unilateral conduction of nervous excitation. Morphologically, the synapse is divided into a presynaptic pole - the terminal section of the first neuron, and a postsynaptic pole - the area of ​​​​contact of the second neuron with the presynaptic pole of the first. There are synapses with chemical and electrical transmission.

At the point of contact of the preganglionic nerve fiber with the second neuron, there are axosomatic synapses (the axon of the first neuron contacts the perikaryon of the second), axodendritic (the axon of the first neuron interacts with the dendrite of the second) and axoaxonal (the axon of one neuron ends on the axon of another) (Fig. 172). It is assumed that the latter does not excite a nerve impulse on the second neuron, but inhibits the excitation received by the neuron through other synapses.

Morphologically, the presynaptic pole of the synapse is characterized by the presence of synaptic vesicles containing a transmitter (acetylcholine or norepinephrine), mitochondria, single cisterns, and sometimes neurotubules. Participation in the transmission of a nerve impulse to the next neuron is determined by the natural release of a transmitter into the synaptic cleft by exocytosis.

Rice. 172. Diagram of the ultramicroscopic structure of various types of synapses:

A - cytotopography of synapses; B- synapse of inhibitory type; IN- synapse of excitatory type; G - electrotonic synapse; 1 - axosomatic synapse; 2 - axodendritic synapses; 3 - axoaxonal synapse; 4 - dendrites; 5 - dendritic spine; 6 - axon; 7 - synaptic vesicles; 8 - presynaptic membrane; 9 - postsynaptic membrane; 10 - synaptic cleft; 11 - postsynaptic structures.

The latter, entering the membrane of the postsynaptic pole, causes a change in its permeability, a wave of depolarization - the generation of a nerve impulse. In addition to those mentioned above, other substances can also play the role of a mediator, namely: adrenaline, serotonin, gamma-aminobutyric acid, etc.

Synaptic vesicles carrying various mediators are morphologically different. At cholinergic synapses they are: small (30 - 40 nm) and transparent. They sometimes also contain several very large and electron-dense bubbles (80 - 150 nm), chemical composition and the meaning of the latter is currently unclear. Presumably they are believed to contain biogenic amines. Synaptic vesicles of adrenergic synapses are larger (50 - 90 nm) and are morphologically characterized by the presence of an electron-dense granule in them. The mediator is released by exocytosis into the synaptic cleft of the contents of synaptic vesicles.

The postsynaptic membrane of cholinergic synapses contains a “cholinergic” protein. When interacting with acetylcholine, conformational changes in its molecules occur, leading to changes in membrane permeability and the generation of a nerve impulse in a neuron (Fig. 173). The mediator of inhibitory synapses - gamma-aminobutyric acid does not increase the permeability of the postsynaptic membrane for ions, but reduces it and, therefore, stabilizes the membrane potential, that is, it inhibits the generation of a nerve impulse.

There are characteristic specializations on synaptic membranes. Under the membranes of both the presynaptic and postsynaptic poles, accumulations of dense material and thin filaments are noted. Clusters are usually thicker by

Rice. 173. Electron micrograph of an axodendritic synapse in the cranial cervical node cat (Kozlov's drug):

1 - Synaptic vesicles; 2 - mitochondria; 3 - neurotubules in the cytoplasm of the dendrite; 4 - thickened postsynaptic membrane.

Rice. 174. Simple reflex arc:

1 - sensitive nerve cell; 2 - receptor in the skin; 3 - dendrite of a sensitive cell; 4 - shell; 6 - lemmocyte nucleus; 6 - myelin sheath; 7 - nerve fiber interception; 8 - axial cylinder; 9 - a notch on the nerve fiber; 10 - neurite of a sensitive cell; 11 - motor cell; 12 - dendrite of the motor cell; 13 - neurite of the motor cell; 14 - myelin fibers; 15 - effector (motor plaque); 16 - spinal node; 17 - dorsal branch of the spinal nerve; 18 - posterior root; 19 - posterior horn; 20 - front horn; 21 - anterior root; 22 - ventral branch of the spinal nerve.

presynaptic membrane. Synaptic vesicles are often associated with presynaptic condensations. Tangential sections of the compaction show that they are not homogeneous, but consist of hexagonal and triangular structures, in the center of which a synaptic vesicle can be distinguished. Clusters of vesicles and compactions together are called the synaptic complex, and since they appear to be the sites of predominant accumulation of vesicles and release of transmitter, they are also called active zones. In the area of ​​synapses, small attachment devices are also identified - attachment points (punctum adherens). They differ from the condensations of synaptic complexes in their greater thickness and symmetry and short linear extent.

Electrotonic synapses are formed by the close adhesion of plasma membranes, two neurons, mainly their dendrites, and the perikaryon.

The nervous system of the body is represented by sensitive, associative and motor cells, united by interneuronal synapses into functionally active formations - reflex arcs. A simple reflex arc consists of two neurons - sensitive and motor (Fig. 174).

The overwhelming majority of reflex arcs of higher vertebrates still contain a significant number of associative neurons located between the sensory and motor neurons.

The most large number nerve endings in human body located in the oral cavity (lips and tongue) and in the fingertips. What is a nerve ending (receptor)?

A receptor is a formation at the end of a nerve fiber, thanks to which external stimuli are perceived, and the resulting impulse (signal) is transmitted to the corresponding nerve cell (neuron).

Interesting! There are approximately 100 times more sensory receptors on the lips than on the tips of the fingers!

The huge number of nerve endings in the area of ​​the tongue and lips is explained by the abundant innervation of the entire oral cavity:

• The lingual, hypoglossal and maxillary-hyoid nerves provide sensitivity and motor activity of the floor of the mouth (muscles, mucous membrane, root of the tongue).
• The trigeminal nerve innervates the skin, mucous membrane and muscles necessary for chewing food.
• The glossopharyngeal nerve leaves thousands of endings in the tongue, parotid gland and muscles of the pharynx.
• The palate is controlled by the vagus nerve.

Thus, the endings from many cranial nerves end in various departments the oral cavity, which is why it is so richly saturated with receptors. The lips and tongue are able to sense taste, temperature, pain, pressure, stretching, and touch.

Fingertips

Slightly fewer nerve endings are contained in the thickness of the skin on the tips of the fingers. It is worth noting that tactile analyzers in the fingertips are the most ancient structures of living organisms, so in the process of evolution their number has increased. With our fingers we perceive touch, temperature, pain, pressure, shape, and surface features of objects. This is called touch.

On one square centimeter On the surface of the skin of the fingertips there are about 1.5 thousand tactile receptors (touch), 200 pain receptors, 15-20 baroreceptors and 15 temperature ones.

Why don't we feel pain?

Scattered throughout the human body (skin, mucous membranes, internal organs, blood vessels) are various types of nerve endings that respond to pain, touch, stretching, temperature, and so on. Perceiving receptors, when irritated, send signals to the brain along nerve processes, so a person immediately experiences certain sensations.

Each body is individual and perceives stimuli, such as pain, differently. There is such a thing as pain threshold sensitivity. The higher it is, the less pain the body experiences. At a low threshold, even a minor stimulus can cause a strong impulse and cause pain (this is how a person perceives it).

A rare hereditary disease in which the gene responsible for pain perception is missing. Patients with this pathology absolutely do not feel it under any stimuli. Pain receptors simply transmit signals to the brain incorrectly. Since pain is a defensive reaction, people with Marsili syndrome are deprived of such protection and can easily break the bones of their limbs, constantly hit themselves, get burned, and get other injuries. dangerous injuries. Ultimately, such situations can lead to disability or death.

Where are the fewest nerve endings?

It is believed that a small number of receptors are found on the skin of the back and abdomen. In many internal organs (parenchyma) there are no pain receptors at all (brain, liver, lungs), and there are also no pain receptors in nails and hair.

Pain sensations are ordinary electrical nerve signals, no different from signals caused by sounds, images or smells. The irritating effect is caused by the brain's reaction to received information about danger.

Many people ignore such signals or consider it the height of masculinity to endure such inconveniences when, at first glance, causeless pain, not associated with ailments of internal organs or injuries, are symptoms of various, dangerous diseases of the nervous system.

What's happened

Neuralgia and neuritis are inflammations of the nerves that occur for various reasons; sometimes inflammation occurs not of the nerves themselves, but of their endings or other parts.

Nerve endings are special tiny formations at the ends of neural processes that are responsible for receiving or transmitting information in the form of electrical nerve impulses.

There are several types of endings according to their area of ​​specialization:

• Synapses that transmit impulses between neurons.
• Receptors or afferent endings that transmit information to a nerve cell from the external environment.
• Effectors – transmitting an information impulse from a neuron to tissue cells.

Inflammation of nerve endings is often called neuritis, when in addition to pain, paralysis, paresis, reduction or loss of sensitivity in the area of ​​responsibility of the damaged area of ​​the nervous system may occur.

Neuritis is more dangerous illness than neuralgia, since the symptoms of neuralgia are caused only by the influence of something on the nerve, and not by its breakdown. With severe neuritis, which is a disease of the nerves themselves with a violation of their internal structure, the nerve may not recover, as well as the functions it performed.

It would be more correct to consider that inflammation of the nerve endings is a disease that is part of neuritis and its classification, and not directly by it, since with neuritis other parts of nerve cells or nerves can be affected.

What promotes inflammation

A variety of factors can contribute to inflammation of nerve endings. negative factors influence on the body or the nerve itself:

• Drafts and hypothermia.
• Infection of the body with viruses, bacteria or fungi.
• Inflammation of surrounding tissues.
• Muscle spasms or compression of the nerve area.
• Bruises.
• Local infections in the form of an abscess.
• Circulatory disorders.
• Deficiency of certain substances, vitamins or minerals in the body.
• Malfunctions of the endocrine system.
• Toxic poisoning.
• Heredity or individual structural features of the body.
• Tumor processes and many other factors.

More often, inflammation of the nerves begins with prolonged negative irritating effects on the nerve or with infection.

Symptoms and types

The classification of inflammation of the nerve endings is based on the area of ​​nerve damage, as well as their symptoms. There are the following main types, each of which has its own individual manifestations:

• Inflammation median nerve, also known as ulnar, carpal, radial or ulnar, running along the arm through the wrist. In this case, the work of the hand is disrupted or sensations arise in it in the form of numbness, tingling, pain or restriction of finger movement. The pain can shoot along the entire path of the nerve or be localized only at the site of inflammation.
• Femoral nerve problems, where skin sensitivity or the ability to flex the hip joint are reduced, as well as pain along the surface of the leg, which can shoot down the entire leg.
• Inflammation of the nerve endings of the spine, which is one of the most dangerous species neuritis and manifests itself as severe pain in the back, chest or neck, depending on the affected area, which is called sciatica. Radiculitis also has its own classification, based on symptoms depending on the area of ​​dislocation: radiculitis of the lumbosacral, cervical or thoracic region.
• Inflammation peroneal nerve– pain in the heel or lumbago from it, leading to the inability to fully lean on it.
• Damage to the nerve endings of the facial nerve is represented by disturbances in facial expressions, numbness of parts of the face or unpleasant sensations.
• A disease of the auditory nerve, when in addition to pain, hearing is lost or weakened, and problems with balance or nausea begin due to auditory nerve also responsible for the vestibular apparatus.
• Damage to the intercostal nerve causes more discomfort, since pain can occur not only when moving the body, but when breathing, which makes it difficult or unpleasant. In this case, the pain is truly hellish.

• Inflammation optic nerve accompanied by loss or distortion of vision.
• Damage to the sciatic nerve endings manifests itself in the form of pain in lower limb and impaired sensitivity and ability to move the leg. There are severe cutting groin and lumbar pains.
• Disease of the nerve endings in the occipital region provokes headaches, pain around the back of the head, pain from touching it, “twitching” of the nerve in the head, a negative reaction to light and lumbago in the ear or lower jaw.

In addition to the above, there are many more types of this disease: exactly as many as there are nerves in the body, each of which can become inflamed; other cases are extremely rare.

The concepts of primary inflammation of nerve endings are used - direct, and secondary, which develops against the background of any disease.

Diagnostics

To determine the presence of neuritis, a neurological examination is performed and nerve function is tested using reflexes and motor function testing, if possible.

To determine the extent of damage, use instrumental methods examinations:

• Electroneurography is the study of the speed of impulse transmission through a fiber and its conductivity. Allows you to determine the extent and area of ​​damage.
• Electromyography – examines the boelectric activity of muscles and checks functional state neurons.
• Evoked potentials are a method similar to electroneuronography, but for deep nerves, such as the optic and auditory ones, where they are affected by sound or image and the conductivity is recorded by the activity of the corresponding parts of the brain.
• Ultrasound, X-ray, MRI or CT are diagnostic methods designed to quickly identify physical reason damage to the nerve and its endings, prescribe the necessary treatment than the disorder itself.

If an infectious lesion is suspected, laboratory tests of blood and other tissues are performed, including a biopsy of nervous tissue in extreme cases.

Consequences

Usually, neuritis of any origin is well treated, especially in young people whose regenerative abilities are high. However, if neuritis is not treated, it can lead to a complete loss of the nerve’s functions, the capabilities it performed: vision, hearing, sensitivity, motor activity, secretion of any glands, as well as provoke the cessation of the work of any internal organ etc.

Treatment

Treatment occurs by eliminating the cause of inflammation of the nerve endings, which may require the following procedures:

• Antiviral or antibacterial drug therapy.
• Surgical treatment with compression or physical impact.
• Anti-edematous therapy.
• Stimulation of blood circulation.
• Biogenic stimulation – stimulation recovery processes special drugs.
• Anticholinesterase therapy is treatment with drugs that inhibit nervous activity.
• Fortification and replenishment of deficiencies of minerals and other substances.
• Plastic or surgical suturing of the nerve, when a severely damaged area is removed.
• Local introduction medicines directly next to the nerve.
• Physiotherapy treatment.
• stimulation of the nerve.
• Symptomatic treatment with anesthetics.

Treatment of inflammation of nerve endings is selected individually and depends on the specific type of neuritis and its location. With this disease, traditional methods selected with the help of a doctor are very helpful.

Conclusion

Diseases such as neuralgia or neuritis, which in addition to inflammation of the nerve endings has many other manifestations (radiculitis, funiculitis, plexitis, mononeuritis, polyneuritis) are similar in the method and names of classification, causes of occurrence, symptoms and treatment methods, may well lead the patient into confusion.

These ailments have a common essence and few differences:

• Neuralgia is a disease of the nerve for the same reasons without changing its structure, but only through its excessive excitation.
• Neuritis can be called a late or acute stage of neuralgia, when a disease of the nerve tissue itself occurs with its disorders.
• Varieties of neuritis differ from each other in the disease of specific parts of the nerve: nerve endings, nerve roots, peripheral nerves etc. The causes and methods of treatment for all these diseases are the same. Plexitis can be classified as a separate category - a plexus of nerves or fusion.

It is not necessary for a non-specialist to understand all the terminology, classification of neuralgia and neuritis, the main thing is to remember that what seems from the outside a non-serious disease, which may not cause much suffering, only mild discomfort, can quickly lead to serious problems if the process is left to chance.

Nerve tissues are extremely difficult to restore, while the neurons themselves die forever, and the so-called restoration occurs by taking over the functions of dead cells by others. If you have signs of neuralgia, you should definitely consult a doctor; no one wants to lose, for example, the ability to move a leg because of some stupidity, which could have been solved at one time by simply warming it up or a couple of injections. Neuralgia and neuritis, like all diseases, are treated the faster and more effectively the earlier the necessary procedures are started without triggering the disease.

Human nerve endings

Nerve endings (receptors) are scattered in all tissues and organs and are extremely diverse in their structure.

Human motor nerve endings

Human motor endings or effectors are located in striated and smooth muscles, in the walls of blood vessels and in glands and form final structures that are more uniform in their structure. The main morphological feature of nerve endings is an increase in the surface of the nervous tissue at the periphery due to multiple branching of the axial cylinder and the formation of local thickenings with a neurofibrillary plexus in the terminal structures.

Human sensory nerve endings

Human sensory endings are divided into free nerve endings and nerve endings enclosed in the cytoplasm of special cells (peripheral neuroglia).

There are free endings in the epidermis, epithelium of the mucous membranes, along the fibrous structures of the connective tissue. Bundles of thin pulpy fibers penetrate the epithelium, dividing into individual fibers, losing the pulpy membrane. Axons branch, penetrating through the thickness of the layers epithelial cells, and, spreading in horizontal and vertical direction, reach the superficial sections. Direct contact with epithelial cells is carried out in the intercellular spaces through the formation of fibrillar plates or end buttons on the surface of the cells. There are indications of the possibility of terminal branches penetrating into epithelial cells and forming terminal networks and buttons in their protoplasm.

Free human nerve endings in the form of branches and looped plexuses of thin pulpy fibers, ending in bushes of pulpless fibers, plates of fibrillar networks and thin pulpless branches with button-like thickenings, exist in the smooth muscles of internal organs, cardiac muscle, and in the walls of blood vessels. Along the terminal branches of such endings, a protoplasmic syncytium of Schwann cells is detected.

An example of human nerve endings enclosed in the cytoplasm of special cells are Meissner corpuscles, found in the papillae of the skin and located vertically to its surface, mainly on the palm, fingers and toes and in the mucous membranes.

These oval formations reach 160 fi in length and are surrounded by a thick connective tissue capsule, which contains layers of special sensitive cells or discs.

Pulp fibers, penetrating under the capsule of the body, most often lose the pulpy membrane; the pulpless axial cylinder forms spiral bends and branches between the sensory cells, ending in fibrillar branches often in the upper pole of the body.

The largest and most complex nerve endings are Vater-Pacini corpuscles, located in the connective tissue layer of the skin, subcutaneous fat, mesentery, in the walls of blood vessels, joints, periosteum, epineurium of some nerves, and in internal organs. These white oval bodies, 1-4 mm long, consist of connective tissue plates, between which there are fluid-filled slits. Nerve pulp fiber, non-pulp fiber (Timofey's apparatus) and vessels enter the body at one of its poles. The pulp fiber loses the pulp membrane and penetrates into the inner flask of the body, forming there a thickening of the neurofibrillary mass with branching and final swelling. The non-pulpal nerve fiber has a separate terminal network around the thick axon. Nowadays there is a widespread view that the Timofeevsky apparatus is a collateral of the sensory fiber, and not a branch of the vegetative fiber.

Encapsulated endings include the neuromuscular spindles of striated muscles, which are formed by several thin striated muscle fibers enclosed in a spindle-shaped capsule. The pulpy fibers penetrate the capsule, losing the pulpy shell, and wrap around the muscle fibers, forming spirals and ending in places with fibrillar plates. Along all the branches of the nerve fiber there are nuclei of special cells, which many consider to be Schwann cells that have penetrated the sensory endings.

The motor nerve endings of human striated muscles arise after multiple divisions of the muscle branches of the nerves in the connective tissue septa. Individual nerve fibers, having lost their pulpy sheath, adhere closely to the surface of the muscle fiber, the axial cylinder forms a flat branch of the terminal branch with mesh thickenings. This entire formation is surrounded by protoplasm and nuclei of Schwann cells, delimited from the sarcolemma of the muscle fiber and protrudes in the form of a mound on its surface, representing a motor plaque or plate.

In smooth muscles, thin axons, emerging from the plexus, approach the muscle fibers and end on them with terminal buttons, sometimes forming plexuses. A separate axial cylinder can penetrate a muscle cell and end in a button or loop near the nucleus.

In the walls of blood vessels in humans and animals, mainly in the veins, complex plexuses of pulpy and non-pulpate nerve fibers are described, forming extensive reflexogenic fields with various receptors in the form of bushes, branches, dichotomous divisions, end plates, windings around muscle fibers, and encapsulated bodies.

Which organs do not have nerve endings?

NERVE ENDINGS [ terminationes nerve(LNH)] - specialized terminal apparatus of nerve fibers. Depending on the structure and function of H. o. divided into several types: 1) afferent (sensitive), or receptors; 2) efferent; 3) interneuronal (Fig. 1).

Study of various types of N. o. in the peripheral nervous system the works of researchers of the late 19th - first half of the 20th centuries are devoted: A. E. Smirnov, A. S. Dogel, S. E. Mikhailova, N. G. Kolosov, B. A. Dolgo-S Aburova, E . K. Plechkova. B. I. L. Avrentyeva, T. A. Grigorieva, etc.

In c. n. With. interneuronal N. o. studied by Bodian (D. Bodian, 1942), A. D. Zurabashvili (1947). S. A. Sarkisov (1948), S. Ramon-i-K ahal (1954), etc.

Morphology

Afferent (sensory) nerve endings, or receptors, are distributed throughout the body. They represent the terminal branches (terminals) of the dendrites of sensory neurons. In addition, the composition of afferent N. o. may include gliocytes. Receptors (see) are divided into primary sensory ones, when the stimulus directly excites the terminals of the dendrites of the sensitive neuron, and secondary sensory ones, when the stimulus acts on specialized cells, which in turn influence the terminal branches of the dendrites of the sensory neuron.

Primary sensory receptors in vertebrates include all tissue receptors and receptors of the olfactory organ, and secondary sensory receptors include receptors of the organs of taste, vision, hearing, and vestibular apparatus.

According to their structure, sensitive N. o. are divided into free, i.e., consisting of terminal branches of dendrites, and encapsulated, i.e., covered with a connective tissue capsule.

Depending on the tissue in which N. o. is located - epithelial, connective or muscle - they have characteristic structural features. Thus, various types of epithelium (epidermis, epithelium covering the cornea, digestive tract, gland epithelium) are characterized by free

But. In this case, the myelinated nerve fibers approach the epithelial layer, lose their myelin sheath, and the axial cylinders, surrounded only thin layer the cytoplasm of neurolemmocytes - Schwann cells (Fig. 2), penetrates the epithelium and disintegrates between epithelial cells into terminal branches. In the multilayered epithelium of N. o. also free; they include, in addition to terminal nerve branches, specifically modified epithelial cells - tactile menisci (menisci tacti), or Merkel cells. They differ from other epithelial cells in their oval shape, light cytoplasm and dark nucleus.

Terminal nerve branches approach such cells, forming a delicate mesh around them.

In connective tissue (skin, fascia, ligaments, tendons, joint capsules, periosteum, etc.) the majority of N. o. also free and represent dendrite branching in the form of bushes of various shapes.

In addition, encapsulated receptors are found in the connective tissue - lamellar, tactile corpuscles, genital corpuscles (or Grandry, Golgi - Mazzoni corpuscles), terminal flasks, tendon and neuromuscular spindles. All these receptors consist of dendrite branches, covered on the outside with a connective tissue capsule. A typical structural element for N. o. Connective tissue in vertebrates and humans is the lamellar body (corpusculum lamellosum), or Vater-Pacini body, found in the skin, periarticular connective tissue, perineuronal fascia, interosseous membranes, along the vessels. The lamellar body is an ovoid-shaped formation, from 2 mm to several micrometers in length and in diameter. 0.5 mm.

In the center of the lamellar body there is an internal bulb (bulbus internus), surrounded by modified neurolemmocytes. The sensitive myelinated nerve fiber approaches the lamellar body, loses its myelin sheath, plunges into the inner flask and there breaks up into the thinnest terminal branches. On the outside, the lamellar body is covered with a capsule consisting of numerous connective tissue plates.

The tactile or tactile corpuscle (corpusculum tactus), formerly called the Meissner corpuscle, is located under the integumentary epithelium (in the papillae of the skin, under the epithelium covering the lips of the mouth, nipples of the mammary glands). It is a cylindrical or ovoid formation, 40-160 microns long and dia. OK. 30-50 microns. Externally, the tactile body is covered with a connective tissue capsule. Several myelinated nerve fibers penetrate into the lower pole and lateral sections of the body, which lose their myelin sheath and branch abundantly. The terminal branches form extensions that contact transversely lying lamellar gliocytes, forming irregular layers.

A feature of the genital corpuscles (corpuscula genitalia), which lie in the connective tissue of the genital organs, is that not one, but two or three nerve fibers are immersed under their connective tissue capsule.

Terminal flasks (bulbi terminales), or Krause flasks, are found in the skin, conjunctiva, mucous membrane of the lips of the mouth and oral cavity; they consist of terminal branches of the sensitive nerve fiber, forming terminal extensions; inner glial bulb and outer connective tissue capsule. End flask diameter approx. 50 microns.

Sensitive N. o. skeletal muscle tissue and tendons are called neuromuscular (terminatio neuromuscularis fusi) and neurotendinous (terminatio neuroten-dinea fusi) spindles. Neuromuscular and neurotendon spindles are oval-shaped structures surrounded by a connective tissue capsule. Sensitive myelinated nerve fibers, approaching the capsule, lose their myelin sheath; in the cavity of the capsule, the fibers disintegrate into terminal branches, which look like bushes on the tendon fiber bundles. In muscle spindles, these terminals branch and entwine the muscle fibers of the spindles, and the muscle fiber itself loses its cross-striations.

Efferent nerve endings are represented by motor N. o. in skeletal and smooth muscles and secretory N. o. Motor N. o. V skeletal muscles are called motor plaques or end plates, axomuscular or neuromuscular synapses (Fig. 3). Motor N. o. in skeletal muscles it consists of the terminal branches of the myelinated motor nerve fiber (presynaptic zone) and a modified section of the muscle fiber (postsynaptic zone), where the terminal branches of the axon are located. A thick myelin fiber, approaching the motor plaque, loses its myelin sheath and branches into several thin terminal branches, which are located in the folds of the sarcolemma of the muscle fiber (see Muscle tissue). Between the terminal branches and the muscle fiber there is an area limited on one side by the modified cytolemma of the terminal branches, and on the other by the sarcolemma of the muscle fiber. This region is called the primary synaptic space. The sarcolemma of the muscle fiber, which limits the synaptic space, is uneven and forms deep folds. The space located in these folds is called the secondary synaptic space. The areas of terminal branches of nerve fibers, representing the presynaptic zone, contain a large number of synaptic vesicles and mitochondria. The area of ​​the muscle fiber that makes up the postsynaptic zone also contains a large number of mitochondria.

Efferent N. o. on smooth muscles and secretory cells of glands are formed, as a rule, by non-myelinated efferent fibers. n. With. These N. o. are represented by terminal branches of the neurite of great length, along the course of which there are thickenings of diameter. 0.1-2 microns. Towards the periphery, the thickenings gradually decrease. The thickenings contain clusters of synaptic vesicles and mitochondria. The distances between the terminal branches and the innervated smooth muscles or glandular cells are different - from 10 to 1000 nm.

Interneuronal nerve endings are present in the nervous system on the body and dendrite of all neurons, except afferent ones, connected by peripheral processes to receptors. Most of the nerve endings in the c. n. With. formed between the processes of nerve cells; Depending on the nature of the structures involved in their construction, axodendritic, axo-axonal, dendro-dendritic synapses are distinguished. N.s. located on the body of a nerve cell are called axosomatic synapses. Synapses are formed both by terminal branches and along the axon. But. may end on a postsynaptic element in various ways: 1) without expanding or changing its configuration; 2) forming the terminal extension of the presynaptic process; in this case, they usually seem to spread out along the postsynaptic process; 3) partially covering the postsynaptic process or going deeper into it.

Using electron microscopy, it was revealed that the synapses include presynaptic and postsynaptic N. o. Pre-synaptic N. o. (Fig. 4) are characterized by the presence of synaptic vesicles and an increase in the electron density of synaptic membranes. These N. o. They also differ in the shape of synaptic vesicles (round and elongated), their electron density (light and granular) and the width of the synaptic cleft. At synapses, presynaptic N. o. separated from the postsynaptic by a synaptic cleft 25 nm wide. Postsynaptic N. o. often also have certain signs of specialization in the form of a pronounced subsynaptic network, spiny apparatus, subsurface cisterns and stripes of electron-dense substance located parallel to the postsynaptic membrane (see Synapse).

Physiology

But. participate in the transmission of impulses from one nerve cell to another, as well as in ensuring the regulatory influence of nerve cells on the activity of other elements of nervous tissue, muscle and glandular cells.

Afferent N. o., located in various tissues of the body, are receptors. Efferent N. o., forming synapses on muscle elements, regulate the activity of skeletal and smooth muscles. N. o., forming contacts with other nerve cells, participate in the mechanisms of interaction of neurons, ensuring the transmission of excitation to the c. n. With. from afferent nerve cells to efferent ones.

In N. o. processes of accumulation and release of mediators are carried out (see). The process of excitation, spreading into the N. region, causes depolarization of the presynaptic membrane and the release of one or another mediator. In addition to mediators in N. o. found in significant amount macromolecules coming from the body of a nerve cell due to the movement of axoplasm (axocurrent) in nerve fibers (see): neurophysins, chromogranins. These macromolecules influence the processes of accumulation and storage of mediators in the NO.

With axotoc in N. o. enzymes arrive. So, in N. o. In the cerebral cortex, up to 30-40 different enzymes were discovered. In N. o. A system of contractile proteins has been identified, possibly also involved in the secretion of mediators. The ability of local synthesis in N. o. has been demonstrated. some biologically active substances(for example, proteins and RNA), which enter the body of the nerve cell with reverse axocurrent (movement of axoplasm from the N. region to the body of the nerve cell).

But. not only participate in the process of releasing mediators into the synaptic space, but also remove excess mediators and their decay products. Through N. o. provides trophic influences of nerve cells on executive bodies(see Trophics). The trophic role of N. o. is especially clear. manifests itself in conditions of denervation (see), as a result, the cut organs and tissues acquire increased sensitivity to the action of chemicals. substances.

Pathomorphology

Pathomorphol, changes in N. o. largely resemble similar changes in nerve fibers, but are less diverse. In the vast majority of cases, these changes in N. o. wear dystrophic character and are associated with damage to the bodies of nerve cells and their processes - axons and dendrites.

During a light-optical examination of pathologically altered N. o. of all types (sensitive, motor and interneuronal), the following most general patterns are noted: an increase in their tinctorial properties (argyrophilia and osmiophilia), edema and swelling of the nodal region, their deformation and fragmentation. Leaks of axoplasma and spherical formations arising from dystrophically altered N. o. are less common. Electron microscopic study of N. o. made it possible to establish certain features characteristic of pathologically altered N. o. each of the specified types. However, the degree of knowledge of these changes in N. o. different types are different, the least studied patol. changes in sensory and motor N. o.

Patol, changes in sensitive N. o. V to the greatest extent are associated with changes in nerve fibers in various pathol processes (for example, in a number of skin diseases - ichthyosis, leprosy, pemphigus) and are caused by damage to nerve fibers. In the early stages of patol, the process of change in N. o. may be characterized by the appearance of vesicular and tubular components or an increase in their number, the appearance of small vacuoles, and membrane inclusions. At this stage of change in N. o. still reversible. In the case of progression of patol, the process, membrane inclusions become larger, vesicular and tubular components swell, the number of vacuoles increases, neurofilaments are destroyed and disappear, accumulations of fine-granular substances appear, significant osmiophilia of the cytoplasm of the N. o. is noted. Finally, nerve fibers and N. o. shrink and fill with fine granular substance. These stages precede their breakdown and phagocytosis by neuroglial cells.

Early stages patol, changes in motor N. o. are characterized varying degrees swelling of mitochondria, an increase in their size, a decrease in the number and change in the shape of synaptic vesicles, the appearance of vacuoles, myelinated bodies and phagosomes (Fig. 5). There is a significant increase in osmiophilia. As patol progresses, the width of the synaptic cleft becomes uneven, and the osmiophilic substance in it is also unevenly distributed. Deformation of the contours of motor N. o. is the beginning of their disintegration. Changes in motor N. o. most studied in various forms of myasthenia gravis and myopathy, with significant deviations detected in mitochondria and lysosomes (changes in their number and shape). In case of injury motor nerves the main sign of damage to motor N. o. is the accumulation of fine-grained substances in them and an increase in the electron density of the nitrogen lake.

The most studied are pathomorphol, changes in interneuronal N. o. in the central nervous system. They are expressed in ch. arr. in the so-called dark and light degeneration, or dark and light dystrophy.

With dark dystrophy, the early stages of changes in presynaptic interneuronal N. o. characterized by deformation and increase in the size of synaptic vesicles, then the number of synaptic vesicles decreases, mitochondria swell, and lose cristae. Along with this, in the presynaptic N. o. a fine-grained substance appears, the amount of which quickly increases with the development of patol, the process. At the stage of maximum severity of the process, the cytoplasm of the presynaptic N. o. becomes osmiophilic, acquires a dark, homogeneous appearance (dark dystrophy), most of the synaptic vesicles are destroyed (Fig. 6). In the terminal stages of degeneration of presynaptic N. o. deformation of the cytolemma of the terminal structures occurs, then N. o. phagocytosed by neuroglial cells (see Neuroglia).

A variant of dark dystrophy of presynaptic N. o. is the presence in them in the early stages of patol, a process of bundles of neurofilaments forming a ring shape.

Dark dystrophy has been studied in Chapter. arr. on the example of Waller's rebirth (see). A characteristic sign of damage to N. o. when an axon is cut, their degeneration occurs with an increase in osmiophilia, which develops on the 5-11th day after the cut. The persistence of increased osmiophilia during experimental damage to certain nerve fiber systems serves as a convenient model to study various aspects of synapsoarchitecture. Dark dystrophy N. o. observed with brain injury, encephalitis, as well as a number of other diseases of c. n. With.

Another form of dystrophy of presynaptic N. o. is swelling of presynaptic terminals (Fig. 7), which is accompanied by clearing of the cytoplasm (light dystrophy), a decrease in the number of synaptic vesicles, which form small groups, as well as destruction of mitochondria. With this form of dystrophy of presynaptic N. o. a small amount of fine-granular substance and neurofilaments appears in them, which, however, do not change the overall light background of the presynaptic process. Swelling of presynaptic processes with clearing of their matrix may be a stage preceding their disintegration and phagocytosis. However, in a number of cases, with insignificant severity of the damaging effect, the described changes may undergo reverse development.

Light dystrophy is a typical form of patol, changes in N. o. with hypoxia and cerebral ischemia, occasionally observed with brain injury. According to a number of researchers, swelling of presynaptic N. o. was observed when their axons were cut, but this reaction of N. o. appears, apparently, only in certain types of nerve fibers. At a number of hron, intoxications in presynaptic N. about. large lysosomes and phagosomes appear, which, in combination with a decrease in the number of synaptic vesicles, indicates dystrophic changes in these N. o. according to the light type.

Bibliography: Bogolepov N. N. Ultrastructure of synapses in normal and pathological conditions, M., 1975; Histology, ed. V. G. Eliseeva, M., 1972; Glebov R.N. and K r y z h a n o v s k i y G. N. Functional biochemistry of synapses, M., 1978, bibliogr.; Grigorieva T. A. Innervation of blood vessels, M., 1954; Do l go-Sab u ditch B. A. Innervation of veins, M., 1958; Kolosov N. G. Innervation of internal organs and the cardiovascular system, M.-JI., 1954; Kupriyanov V.V. Nervous apparatus of the vessels of the pulmonary circulation, L., 1959; JI a b o r and G. Metabolic and pharmacological basis neurophysiology, trans. from French, M., 1974; About to with S. Fundamentals of neurophysiology, trans. from English, M., 1969; Portugalov V.V. Essays on the histophysiology of nerve endings, M., 1955; Structure and reactive properties of afferent systems of internal organs, ed. E.K. Plechkova, p. 5, M., 1960; Chernigovsky V.N., Interoceptors, M., 1960; McL ennan H.. Synaptic transmission, Philadelphia, 1970; Tobecis A. K. Transmitters and identified neurons in the mammalian central nervous system, Bristol, 1974.

N. N. Bogolepov, V. P. Tumanov (anatomy and pathomorphology); S. A. Osipovsky (physiol.).

Why are there no nerves in the liver?

I recently learned the subject. It turns out that if the liver hurts, it is only when it enlarges, because it puts pressure on the surrounding space.

I wonder why nature deprived the liver of nerve endings? What is the point of this, from the point of view of evolution, survival, and in general?

PS, it would also be interesting to know if there are still organs, tissues, etc., without nerves?

It turns out that if the liver hurts, it is only when it enlarges, because it puts pressure on the surrounding space.

As in the joke, I’ll remove the right lung so it doesn’t interfere and I’ll continue drinking. My liver is enlarged from Coca-Cola, I drink two liters every day, and I’m no better than an alcoholic, in principle.

Are there any other organs, tissues, etc., without nerves?

Intestines, or rather the rectum. When engaging in anal sex, it can be damaged by friction, resulting in there will be blood, - there is nothing terrible, it will heal, infection with feces will not happen, so there is no need to be afraid. But you won’t feel pain, because there are no nerve endings in the rectum. You can only see the blood, and then of course it’s better to stop this matter. You experience pain during anal sex only from the expansion and microcracks of the sphincter, therefore there is no need to skimp on lubricant and you need to prepare your partner for a long time, especially for the first time, starting literally from the diameter of the little finger.

Human anatomy internal organs, internal organs

Often, having health problems, you have to self-diagnose yourself, because even the most experienced doctor may miss some disease.

Knowing the human anatomy of internal organs, you can think about some disease, thereby drawing the doctor’s attention to the problem. We will try to describe the most common problems and complaints in diseases of internal organs.

Human internal organs are divided into two cavities (compartments). The upper compartment is the chest cavity, the lower is the abdominal cavity.

The chest cavity is located behind the ribs and above the diaphragm and contains the heart and lungs.

In the abdominal cavity it is somewhat more complicated, there you can find: Intestines, Kidneys, Liver, Pancreas, Bladder, Spleen, Gallbladder, Stomach and others.

Quite often it is not enough to know human anatomy; it is necessary to know the complaints.

If the problem is with the pancreas, then patients complain of diarrhea, pain in the pancreas after drinking milk. Sometimes teeth marks remain on the tongue.

A sick intestine is reflected in flatulence, unpleasant smell, diarrhea, etc. Anatomically, the intestine occupies almost the entire abdominal cavity.

If there are problems with the gallbladder, the patient will feel bitterness in the mouth, the skin and pupils will be yellowish, and in extreme cases itching may appear.

The liver is one of the most insidious internal organs. The liver itself is unique; by taking just one small piece from a donor and transplanting it into a patient, it can be almost completely restored. But the liver has no nerve endings and cannot produce pain. The pain most often comes from the gallbladder or other organs.

Human anatomy has many factors, such an observation that the heart is located behind the ribs means that mother nature understands the importance of this organ. But you shouldn’t think that the heart can hurt; in 70% of cases it’s not the heart that hurts. A disease such as Intercostal neuralgia is hidden under the mask of the heart. It is very easy to distinguish between diseases; if the pain occurs suddenly, does not allow you to move, and intensifies on exhalation or inhalation - this is intercostal neuralgia. Especially, neuralgia likes to periodically repeat attacks. The cause of neuralgia is quite often in the spine.

Heart problems are accompanied by changes in pressure, pain often radiates to the shoulder blade, stomach or shoulder, there may be dizziness, and most importantly, they occur on average after 45 years.

Human anatomy provides another internal organ that is quite important - the kidneys. And there are 2 of them, they produce urine and remove harmful substances from it. The kidneys, like the heart, work continuously, storing urine in the bladder. Kidney problems are reflected in swelling in the morning, bad color of urine and some other symptoms.

The spleen and bladder are rarely disturbed; the problem can be diagnosed only by blood, urine or ultrasound tests.

Not always knowing the human anatomy of internal organs can accurately make a diagnosis, and symptoms are often not enough either. If you have any doubts about the competence of a doctor, choose another one for consultation.

We sincerely hope that this short article about human anatomy will not only allow you to know where the internal organs are, but will also allow you to get sick less!

Modern doctors use the Nokia C8 phone because of its characteristics this phone exceed any expectations. A color display with a resolution of 720×405 pixels and a backlit keyboard on the screen will not only delight the owner of a Nokia c8 phone, but will also make others jealous of your purchase.

Are there nerve endings in the liver?

The liver, like the brain, does not have nerve endings, so all liver problems do not immediately become obvious, because the liver simply does not hurt. But what then causes such discomfort in the right side, if the largest organ in that part of the body is the liver. The pain can come from the lining of the liver; it already has nerve endings and receptors. The second cause of pain in the right side may be constriction of nearby organs, that is, a diseased liver affects the functioning of neighboring organs, which causes pain.

To understand how a person’s liver hurts, you don’t necessarily need to listen only to signals physical pain in the right hypochondrium. Liver diseases manifest themselves by the following symptoms: causeless nausea, a feeling of heaviness in the right side of the body, a bitter taste in the mouth. The pain from the liver capsule - the membrane - is aching in nature, and with sudden movements the pain intensifies.

However, it is not so easy to identify liver diseases right away; it is advisable to undergo a liver examination once a year. At a young age, the liver is practically not bothered, but closer to old age, liver problems begin to appear, caused by poor nutrition, bad habits: fast food, fat, alcohol, nicotine, excessive sweets (or rather trans fats contained in them), numerous E- additives and other preservatives in food.

How to understand how a person’s liver hurts

Symptoms of liver problems manifest themselves in such a way that a person can experience only indirect consequences of liver disease: causeless nausea and vomiting, problems with appetite; bitter taste in the mouth; dark urine; yellow-gray skin color; diarrhea; chronic malaise, dull pain under the right rib.

The liver is an amazing organ that has the ability to regenerate, that is, self-healing. Even if only 20% of the total liver volume remains functioning, it will work as if nothing had happened. The most terrible problems with the liver are diseases - cirrhosis and hepatitis. If a person notices an acute loss of strength, the whites of his eyes turn yellow, his skin color changes, and bruising appears due to low blood clotting - this is a reason to go for a diagnosis to a gastoenterologist or hepatologist. To help the liver recover, you can eat a decoction of oats for the liver.

The most common situation occurs, in almost all people, when, as a result of fast running or just walking, a stabbing sensation begins in the right side. The reason for this phenomenon is the filling of the liver with venous (waste) blood. The main thing is to breathe correctly and deeply during physical stress, and such colic goes away on its own after some time of rest. In this case, the lining of the liver hurts and colitis, but not the liver.

Except physical activity, combined with eating a fatty lunch or breakfast, a drug overdose can also cause liver problems. In general, the liver removes toxins from outside the body through bile. But in case of overdose, the liver is not able to quickly remove toxins and causes the following symptoms: yellowishness of the face, itchy skin, dizziness, weakness, discomfort in the gastrointestinal tract - this indicates drug-induced hepatitis. Similar to drug-induced hepatitis and alcohol overdose. In this case, detoxification and taking hepatoprotective drugs that restore the liver can help.

You should also pay attention to how a person’s liver can hurt due to ascites: due to improper functioning of the liver, it releases blood that is not completely purified, fluid begins to accumulate in the body - this is reflected in edema and a large abdomen. Also, a diseased liver causes twitching of the eyelids, twitching in sleep, night sweats, bad dream, palpitations, the immune and hormonal systems malfunction, and metabolism changes.

The liver is traditionally called the biochemical laboratory of our body. It performs many functions. Suffice it to say that all harmful substances that enter the body are neutralized by this organ. Doctor of Medical Sciences, Professor, Head of the Department of Gastroenterology and Hepatology of the Research Institute of Cardiology and Internal Diseases of the Ministry of Healthcare, Chairman of the Kazakhstan Association for the Study of the Liver Alexander Vitalievich Nersesov told the newspaper “Health Expert” how the liver works.

After celebrating the anniversary, a feeling of heaviness appeared in the right hypochondrium. How can you deal with this?

Zavorotnyuk Alexander, Almaty

You don't want to overeat to the point where you need medical attention.

Well, if this does happen, sometimes it’s enough to eat a slice of lemon, and if that doesn’t help, then you can take an enzyme preparation.

Is it true that the liver has no nerve endings, and if it hurts, is it the gallbladder?

Alekseeva Tamara, Astana

Not really. There really are no nerve endings in the liver tissue itself. Therefore, when a liver biopsy is performed and the needle is advanced into the organ, it is painless for a person. But there are nerve endings in the liver capsule. If the liver is greatly enlarged and the capsule is stretched, then the pain may be associated with this. But most often, when a person points to the right hypochondrium and says that pain occurs there, as a rule, it is associated with impaired motor skills, inflammation of the gallbladder or biliary tract.

E.Z.: How to determine whether there are stones and sand in the gallbladder?

Ultrasound diagnostics is the most acceptable method in terms of accuracy, safety and cost-effectiveness. There are ultrasound signs, indirect and direct, by which you can determine the presence of stones or sand in the gallbladder

If there are stones in the gall bladder, is it necessary to undergo surgery or are there any therapeutic methods of treatment?

Baidauletova Nurgul, Karaganda

According to existing standards, the presence of stones in the gallbladder is an indication for its removal - cholecystectomy, which is now in most cases performed laparoscopically. It is dangerous to postpone the operation, especially when stones make themselves felt in the form of attacks of biliary colic. It is almost impossible to dissolve stones. And although there are preparations of ursordeoxycholic acid, in the annotations of which the manufacturers indicate the possibility of dissolving small stones with them, we're talking about only about the so-called cholesterol stones. They are soft, you can even knead them in your hand, but in clinical practice such stones are extremely rare. More often we deal with pigmented or mixed types of gallstones that cannot be dissolved. As for the use of folk methods based on choleretic procedures (taking lemon juice, olive oil, etc.), they are strictly forbidden. The diameter of the common bile duct does not exceed 3-4 millimeters, so larger stones simply will not pass, and smaller ones can block the duct and cause obstructive jaundice- an acute surgical condition fraught with serious complications and requiring emergency complex surgery

In what cases is it necessary to cleanse the liver? How?

Dauletkireeva Galima, Almaty

The liver is not a sewer, and no cleansing is necessary. I would like to especially emphasize that if the patient has diseases of the liver itself (for example, hepatitis), then under no circumstances should the organ be overloaded and bile secretion stimulated. At the same time, any choleretic herbal preparations are also contraindicated. As for the blind probing procedure, called tubage, we previously recommended it to patients with acalculous cholecystitis or gallbladder dysfunction, which is accompanied by bile stagnation. Now that there is a large list of choleretic drugs in the arsenal, performing tubage is not so popular.

E.Z.: Is it true that liver diseases can cause nervous disorders? How do they manifest themselves? And what is the reason for this connection?

Combination neurological disorders with liver pathology occurs in some congenital diseases, for example, Konovalov-Wilson disease. More often, we, gastroenterologists, deal with hepatic encephalopathy. But this is not neurological, but mental disorder, occurring in patients with advanced stages of liver cirrhosis or liver failure.

The mechanism is associated with the accumulation of urea in the blood serum. Urea is one of the end products of protein breakdown. A diseased liver is unable to neutralize it.

What is the difference between hepatitis A and hepatitis B and C?

Lukins Alla, Kostanay

The difference is that they are caused by different viruses, which are transmitted through different mechanisms. Hepatitis A is transmitted by the enteral (fecal-oral) route, occurs only in acute form and in most cases does not require any treatment other than diet and plenty of fluids. Hepatitis B and C viruses have a parenteral transmission mechanism, i.e. infection occurs when blood or other biological fluids of an infected patient enter the body of a healthy person. At the same time, in 90-95% of hepatitis B occurs in an acute form and only in 5-10% of cases it becomes chronic. The use of approved antiviral therapy regimens makes it possible to achieve control over the hepatitis B virus (i.e., reduce its concentration in the blood to a safe level or transfer the virus to an “inactive” form). Hepatitis C is much more likely - in about 80 percent of cases - to develop into chronic form, and the effectiveness of its antiviral therapy is higher. With proper treatment by a trained specialist, persistent disappearance of the hepatitis C virus is observed in 60-90% of cases, depending on the type (genotype) of the virus. Timely treatment viral hepatitis prevents the progression of the disease, i.e. development of cirrhosis and liver cancer.

What foods put more strain on the liver? What foods are good for liver function?

Karimova Evgenia, Pavlodar

The greatest load on the liver comes from alcohol, fatty foods, and especially their combination. Therefore, the first recommendation for liver diseases is the exclusion of alcoholic beverages and dishes containing animal fat.

Dietary fiber and pectin contained in vegetables and fruits are beneficial for liver function. Don't forget about drinking enough fluids. IN recent years Large population studies have been conducted abroad that have proven the antifibrotic and antitumor effect of coffee, confirmed by 43% of healthy people and people with hepatitis who drank 2 cups of this drink per day.

How much alcohol damages the liver? Is there any way to recover after taking a dose?

A lot of different works have been published on this issue. The expected risk of developing liver disease in a healthy person occurs when the weekly dose of 40 grams of ethanol for men and 20 grams for women is exceeded. 40 grams is a glass of strong drink, a glass of wine, one cocktail or an average glass of beer. For patients with liver disease, there is no safe dose of alcohol; it should be completely avoided.

E.Z.: Is liver cirrhosis reversible and at what stage?

Until recently it was thought not. Cirrhosis is the final stage of fibrosis, a process in which liver tissue is replaced by scar. It has now been proven that this process is initial stages reversible if the cause of the disease is affected. For example, if we treat a patient with viral hepatitis with antiviral drugs, the stage of liver fibrosis decreases with repeated biopsies. The same thing is observed up to a certain time with alcoholic hepatitis, when the patient refuses to drink alcohol.

The doctor diagnosed toxic hepatosis. Where did I get it from? Can this be cured?

Zakurdaeva Svetlana, Karaganda

There is no such diagnosis. There is a diagnosis of fatty hepatosis. It can be caused by alcohol or metabolic disorders. The reason for the latter may be obesity, diabetes, taking certain medications and, oddly enough, sudden weight loss. The fact is that with metabolic disorders, fat is deposited not only in subcutaneous fatty tissue, but also in internal organs, including the liver parenchyma.

E.Z.: What does this mean? What does this ultimately lead to?

Hepatosis is a potentially reversible condition. If a fat person loses weight, then fat leaves the liver. The same thing happens with proper treatment diabetes mellitus, giving up alcohol. But if the underlying cause is not eliminated, then over time fatty hepatosis can develop into alcoholic or non-alcoholic steatohepatitis and further into cirrhosis and primary liver cancer. So it is important not to waste time.

Can your liver hurt?

The liver is the most important internal organ that acts as a filter, purifying the blood of toxic substances, poisons and other harmful substances. This is the largest gland in the human body, which is directly involved in the production of protein, fat and carbohydrate metabolism, is responsible for detoxification, processes of hematopoiesis, digestion and excretion.

Without this organ, the human body cannot function. Therefore, nature took care of its protection and endowed it with truly unique abilities for regeneration and self-healing. There are cases where, with the loss of 70% of liver tissue, a person still had every chance of survival, since over time the organ recovered and continued to function.

At the same time, this gland has a serious drawback - namely the absence of nerve endings. That's why severe pain occur only when the liver capsule, which contains many nerve fibers, is stretched. But such symptoms occur only with severe lesions (hepatitis, cirrhosis, tumors), when the pathological process has already gone too far and the swollen liver begins to put pressure on the membrane. In other cases, the pain syndrome is mild and many simply do not pay attention to the usual ailment and see no reason to see a doctor.

The liver is a very “quiet” organ that rarely manifests itself with pain in the early stages of the disease. But still, there are some characteristic signs that indicate trouble and force you to seek medical help. Often, liver pathologies are directly related to diseases of neighboring organs (pancreas, gallbladder).

Then the pain syndrome becomes more pronounced, and the examination allows for a correct and timely diagnosis. Therefore, you need to be more attentive to your health, know where a person’s liver hurts, what signs of its pathological conditions appear and what causes damage to the most important gland of the body.

Why does my liver hurt?

There are many factors that can lead to liver dysfunction. They can be divided into two groups:

Conditions that provoke pain syndrome:

• Intense sports training with improper breathing technique or performing heavy physical work after a heavy snack, they may be accompanied by the appearance of a dull, aching pain in the right side. This is due to the fact that increased loads accelerate blood circulation, as a result of which the gland becomes filled with blood and puts pressure on the capsule shell, causing pain.
• A sedentary lifestyle (hypodynamia) causes congestion in the gallbladder and leads to disruption of the outflow of bile, which threatens the formation of stones and provokes hepatic colic. Therefore, if there is pain in the liver area, you should undergo an examination as soon as possible and determine the cause of this condition.
• Improper diet with a predominance of fatty or spicy food, compliance strict diets, abuse alcoholic drinks- all this has the most unfavorable effect on the condition of the liver and provokes pain in the right hypochondrium.

Diseases that lead to pain in the liver:

Any of these reasons causes liver dysfunction and can lead to the development of serious diseases such as kidney failure, hepatitis, cirrhosis or cancer. Therefore, it is very important to know how the symptoms of liver pathologies manifest themselves in order to seek medical help in time and avoid the serious consequences that arise in advanced cases.

Symptoms

In the early stages, liver problems are difficult to identify, since they manifest themselves as nonspecific ailments, which an ordinary person can attribute to signs of completely different diseases. What should you pay attention to, and what symptoms should alert you and make you see a doctor?

These symptoms indicate the development of a pathological process in the liver. The deterioration in well-being is due to the fact that the gland cannot cope with its functions and cannot fully neutralize and remove incoming toxins, which leads to poisoning of the body with decay products. The nervous system and brain primarily suffer from liver dysfunction, which causes the above ailments.

As the pathology further progresses, more pronounced symptoms appear associated with the accumulation of bilirubin in the blood, which leads to a change in the color of the skin and sclera of the eyes (they become yellowish). This is considered to be the main sign indicating liver problems. At this stage, more pronounced signs of the disease appear:

• pain of various types (pulling, aching) in the area of ​​the right hypochondrium;
• increase in liver size;
• yellowness of the skin and sclera of the eyes;
• indigestion, feeling of discomfort and heaviness in the abdomen;
• nausea, bitterness in the mouth;
• the appearance of spider veins;
• increased frequency of allergic reactions;
• feverish conditions (chills, fever);
• changes in urine color (it becomes darker);
• discoloration of stool.

The pain that occurs in the right hypochondrium can be different: dull, pulling, aching, sharp. It all depends on the nature and severity of the pathological process. At the same time, the clinical picture of liver pain in women is practically no different from the symptoms of the disease in men. But in representatives of the stronger sex, the course of the disease may be accompanied by sexual dysfunction, a decrease in sperm count and impotence. In addition, many men suffer from alcohol addiction, which most often causes cirrhosis.

How the liver hurts - the symptoms in men and women are generally the same. But representatives of the fair sex more often pay attention to the deterioration of appearance. As the pathology progresses, the complexion changes, the skin acquires a grayish or yellowish tint, bags appear under the eyes, hair falls out, becomes thin, dry and lifeless. Appears itchy skin rashes, nails break off, menstrual dysfunction develops.

How does alcohol affect the liver?

Everyone knows that alcohol destroys liver cells and leads to the development of cirrhosis, fatty degeneration or alcoholic hepatitis. The risk of severe liver damage caused by alcohol abuse is much higher in men, since it is the stronger sex who are more often susceptible to bad habits. But alcoholism is an insidious disease that develops much faster and more actively in women. Women fall into alcohol addiction faster than men, and this addiction is accompanied by rapidly developing pathologies of the liver and other internal organs. At the same time female alcoholism There is practically no treatment, and the daily intake of ethanol in the body leads to fatty degeneration and cirrhosis of the liver.

With constant alcohol consumption, liver cells die and connective tissue forms in their place. The inflammatory process progresses, the liver increases in size, puts pressure on the capsule shell and provokes pain. Even taking into account the amazing ability to regenerate, restoring the liver will require many months of treatment, during which you will have to completely give up alcohol.

How does liver disease affect your health?

Pathological changes occurring in the liver are immediately reflected in the appearance. Since the gland cannot fully perform its cleansing functions, waste and toxins accumulate in the body and worsen the condition of the skin, hair and nails. The skin on the face becomes dull and excessively dry, rashes appear (acne, pimples), hair sheds, nail plates flake and break off.

In patients with liver pathologies, the risk of developing cataracts and glaucoma increases, and visual acuity decreases. “Twilight” vision decreases, lacrimation appears, a painful reaction to bright sunlight. Since the liver cannot cope with the load, the level of “bad” cholesterol in the blood increases, which triggers the development of heart disease. vascular diseases and leads to a persistent increase in blood pressure. Arterial hypertension in turn, increases the risk of developing a heart attack or stroke.

Doctors note that almost all patients with overweight or those who are obese or have liver problems. Most often, fatty degeneration of the liver (hepatosis) is observed, in which liver cells are replaced by adipose tissue.

Important! If you have characteristic symptoms (heaviness in the right side, acute or persistent aching pain), do not self-medicate or take analgesics before consulting a doctor! Taking painkillers can blur the picture of the disease, complicate diagnosis and have additional toxic effect to the liver.

If the liver hurts severely and there is at least a few characteristic symptoms listed above, consult a doctor immediately! This condition may indicate the development serious problems with health and requires immediate qualified assistance.

Which doctor should I contact?

If alarming symptoms appear, it is recommended to consult a therapist. After an external examination and medical history, the doctor will refer the patient to specialists. For liver problems qualified assistance will be provided by a hepatologist or gastroenterologist who specializes in diseases of this organ. If necessary, after clarifying the diagnosis, the patient will be referred to an oncologist (if there is a suspicion of the development of an oncological process) or a surgeon.

Diagnostics

Diagnostic measures for liver pain include a number of laboratory, invasive and non-invasive research methods.

• Laboratory methods include general and biochemical blood tests, studies for hepatitis and cancer cells, immunological and genetic tests(if necessary).
• Non-invasive diagnostic methods are examination of the patient using computer technologies (CT, MRI), ultrasound. Modern and informative diagnostic methods make it possible to get an idea of ​​the condition of the organ, the degree of its damage, determine the size of the liver, and the structure of its tissues.
• Studies such as biopsy, laparoscopy or percutaneous puncture (invasive methods) are necessary to clarify the diagnosis in doubtful cases.

Treatment methods

Medicines for liver pain are prescribed taking into account the severity of symptoms, the clinical picture of the disease and general condition patient. To relieve pain, painkillers and antispasmodics are most often used. They should be prescribed by a doctor, since the treatment of this the most important body requires a competent approach and a correctly selected complex treatment regimen.

The main role in the treatment of the liver is given to drugs - hepatoprotectors, the action of which is aimed at the regeneration and restoration of liver cells. They need to be taken for a long time. Taking into account concomitant diseases(cholecystitis, pancreatitis), the doctor may prescribe medications with anti-inflammatory and antispasmodic properties.

Well proven combined agents, which not only relieve pain, but also work to eliminate the inflammatory process and normalize the functions of the most important organ. Among them are the following drugs:

These drugs are used even for severe liver damage such as cirrhosis or chronic hepatitis. If the appearance of pain is accompanied by chronic cholecystitis or cholelithiasis, the treatment regimen includes the following drugs:

To eliminate spasms, No-shpa, Drotaverine are prescribed. Hepatic colic is well relieved by Trimedat, Buscopan, Duspatalin. Buy acute attack Riabal will help relieve pain, and Cerucal or Domperidone will help normalize intestinal motility and eliminate biliary dyskinesia.

You should take medications for pain in the liver after consultation with a doctor, who will select the optimal treatment regimen taking into account your individual characteristics, the severity of the condition, possible contraindications and other nuances. If acute pain is not relieved by medications, you must call emergency medical care and go to the hospital. Acute viral or bacterial hepatitis, toxic liver damage, acute cholecystitis treated only in a hospital setting. In other cases, liver pathologies require long-term and regular treatment, constant use of medications and strict adherence to doctor’s recommendations.

An innovative drug for liver restoration - Leviron duo - receives very good reviews.

Diet for liver pain

For liver diseases, following a certain diet is necessary. This will reduce the load on the diseased organ, normalize liver function, bile secretion and digestion processes. The basis of the diet in this case is proteins and carbohydrates, and the fat content should be reduced to a minimum. For liver pain, nutritionists recommend building a diet based on the following products:

• low fat fermented milk products(kefir, yogurt, cottage cheese, yogurt);
• vegetable, cereal, milk soups;
• borscht or cabbage soup (vegetarian option);
• dietary lean meat (chicken, rabbit, veal);
• low-fat varieties of fish;
• pasta;
• porridge (buckwheat, pearl barley, oatmeal, millet);
• steam omelettes;
• vegetable salads with vegetable oil;
• fresh fruits, vegetables, herbs.

The consumption of white bread should be limited to 2-3 pieces per day; it is best to eat it not fresh, but in a slightly dried, stale form. You can make crackers from white bread and serve them with first courses. It is recommended to steam, boil or bake all products. Fried foods should be completely excluded from the diet. Healthy drinks include green and herbal teas, jelly, compotes, and fruit drinks.

Liver functions

It is possible to tell how the liver hurts only at the stage when this organ has collapsed almost completely - normal cells have already been replaced by fibrous tissue, which has caused general intoxication of the body.

It is possible to learn about diseases associated with this organ if you have an idea of ​​why it is needed.

The most important function of the organ is filtration. It cleanses the blood, filters out harmful substances that enter the body, and neutralizes the effects of poisons. All toxins entering the bloodstream remain in the liver, and subsequently leave the body naturally - with feces.

The liver accumulates elements necessary for the functioning of the body, and one of them, the most important, is glycogen. If excess glycogen is stored, blood sugar levels decrease, which prevents the development of diabetes.

Also accumulate in the liver:

• iron – hemoglobin is subsequently produced from it;
• folic acid – necessary for brain function;
• vitamin B12 – growth and immunity stimulator;
• and many other useful compounds - about 500 in total.

Another very important function of the organ is hematopoiesis. If it is disrupted, the blood stops clotting.

A person has only one liver, and its removal or destruction leads to death within 1-3 days. It is impossible to survive without this organ. Therefore, when symptoms appear that indicate dysfunction, you need to immediately take measures to restore functionality.

Signs of functional impairment

Why does the liver hurt, and by what signs can one guess about problems associated with it?

Problems are indicated by:

• bitterness in the mouth, which first appears only in the morning, and then is felt throughout the day;
• change in the color of the tongue - it becomes greenish;
• yellowing of the whites of the eyes and skin - the sclera reacts most sensitively;
• the appearance of dark urine and light feces;
• periodic pain under the ribs on the right side.

If these symptoms are observed only after a violation of the diet - eating large amounts of fatty, rich or spicy foods - or large amounts of alcohol, you can not stress. But if they are constantly present, it is advisable to start an examination.

Yellowness of the sclera and skin appears when the filtering function is impaired: bilirubin, which accumulates in the liver, is normally excreted in the bile. At inflammatory processes it remains and causes general intoxication.

Dull pain under the ribs on the right side and constant heaviness occur with enlargement of the organ. During inflammatory processes, it swells, and the capsule - the shell - which has pain receptors, stretches. Clinical picture can be detected during an ultrasound examination.

To understand why there is a constant bitter taste in the mouth, gastroscopy and ultrasound examination are performed.

Changes and disturbances in liver function can be guessed by the following signs:

• periodically there is a sensation of hot waves passing along the spine;
• girdling spasms occur, as if from an electric shock;
• the spleen is constantly enlarged - in case of liver dysfunction, it has to work hard, performing hematopoietic functions;
• numbness of the tips of the fingers and toes;
• frequent muscle spasms in the limbs;
• thickening and yellowing of nails.

The last symptom may appear already at the stage of constant intoxication.

These symptoms are not necessarily associated with liver disease, but if they appear, it is worth starting an examination - if the disease is detected at an early stage, its development can be slowed down.

Factors that increase the risk of pathologies

Liver dysfunction is caused by the following reasons:

• low-quality products;
• poor environment;
• contaminated water;
• frequent alcoholic libations;
• obesity;
• viral infections;
• genetic factors;
• helminthic infestations.

Alcohol is especially dangerous. Under its influence, the bile ducts narrow, bile stagnates, beginning to destroy liver cells - hepatocytes.

This destroys the functions of the entire body - due to a lack of bile in the intestine, favorable conditions are created for the activation of opportunistic flora, immunity decreases - the altered cells can no longer differentiate “their” and “foreign” structures, and the risk of autoimmune diseases appears.

In addition, since filtration is impaired, free radicals move freely throughout the body.

Brain cells - neurons - react especially sensitively to them - they die.

Non-hepatic manifestations - weakness, signs of kidney pathology, joint pain, skin reactions. With these symptoms and the absence of pain in the liver, completely different diseases begin to be treated, medications are prescribed that further increase the general malaise.

To prevent this from happening, do not neglect the general examination. Blood biochemistry and ultrasound examination will help identify changes in liver function at an early stage.

What to do if your liver hurts?

First of all - as already indicated - it is necessary to undergo an examination, and then analyze when the characteristic symptoms manifest themselves most strongly.

If this happens after drinking alcohol, then it’s even ridiculous to ask what to do when your liver hurts. It is enough to give up alcohol-containing drinks.

When pain in the right hypochondrium and nausea appear after consumption fatty foods, then you should reconsider your diet. You should not completely give up fat and go on a lean diet - vegetable oils are necessary to maintain the functioning of the body.

You do not need to prescribe medications yourself; you will start taking them after an accurate diagnosis has been established. Some diseases may require treatment with other means - antibiotics, deworming medications, or others.

To restore liver functions, not only hepaprotocters are used, but also essential phospholipids.

Only a doctor can decide which medication should be included in the therapeutic course.

• Hepaprotective agents include: preparations containing milk thistle, “Liv-52”, “Sirepar”, “Gepadif” and the like;
• Essential phospholipids are “Essentiale-forte”, “Essliver-forte”, “Rezalut”..

Drugs from other groups are also used to treat the liver:

• "Ademetionine";
• "Methyluracil";
• Ursodeoxycholic and lipoic acids...

You can try to help the liver at home, but this can only be done after an examination. Choleretic drugs or dubage can be used only in cases where there is no gallstone disease. Otherwise, the cleansing may end in failure - the stones will begin to move and get stuck in the bile duct. They can only be removed during surgery.

If your liver hurts badly, what can you do at home?

Blind probing is a procedure that helps get rid of bile stagnation and reduce swelling of the liver capsule.

Probing is carried out according to the following algorithm:

• in the evening they do a cleansing enema;
• on an empty stomach, drink water with a dubage solution dissolved in it;
• make several physical exercise– squats, bends, twists;
• then lie down on the right side, placing a heating pad under the right hypochondrium and lie there for half an hour.

Sorbitol, vegetable oils, egg yolks, and plant materials with choleretic action are used as dubage products.

If probing is risky, you can prepare your own mixture.

Effectively restores liver function tea from corn silk, a mixture of honey and cinnamon - for a glass of honey, 1 tablespoon of cinnamon.

Liver treatment at home is carried out only after medical consultation. Self-medication can worsen the condition. Properly selected therapy can stop the development of the degenerative process and restore liver function.

It's bad when something hurts. But sometimes it would be better if it hurt! For example, there are almost no nerve endings in the liver, so we find out about problems with it too late. But they can be prevented.

It is perhaps difficult to find another such martyr organ in our body. The liver takes a beating day after day and withstands everything we eat and drink. Filters blood, produces bile, without which fats would not be broken down, neutralizes toxins. And even when she feels bad, she practically does not give SOS signals. Therefore, for every second person, the diagnosis of “fatty hepatosis” literally sounds like a bolt from the blue.

Fat is deposited in liver cells. Over time, these islets become more and more numerous, they partially replace normal liver cells (hepatocytes). As a result, the risk of atherosclerosis, diabetes mellitus, and liver cirrhosis increases.

This diagnosis is heard by almost every second person over 40 who comes for a routine ultrasound.

Of course, it’s not very pleasant, but you shouldn’t be upset. The liver is capable of self-repair and is ready to forgive you for decades of inattention to it. You just need to become her friend from now on.

Step one. Ask your doctor if your liver is enlarged. If not, good, it means that changes in the structure of the organ are minimal. If yes, that’s okay too: with the right lifestyle, everything will quickly return to normal. The worst option is if the spleen is enlarged along with the liver. In this case, one cannot do without strict restrictions and a course of treatment.

Are you taking oral hormonal contraceptives?

You are about to start taking medications to lower your cholesterol levels.

You have a chronic disease for which you are taking medication.

Step two. Find out if your liver function is affected. Most often, fatty hepatosis does not interfere with its function. The liver is able to properly perform its functions, even if only 20% of its cells remain “in shape”. To be sure of this, you need to take a blood test for liver enzymes (AST, ALT, GGTP) and bilirubin (direct and indirect), and at the same time for viral hepatitis.

Step three. We show the test results and ultrasound images to the gastroenterologist. Even if the size of the organ is increased and the function is impaired, most likely, the main treatment will be diet and avoidance of alcohol. Not forever: in a few months the liver will recover, and all you have to do is find a balance in food and drink, together with your doctor, find the line at which you can deny yourself practically nothing, without loading the already offended organ. And for control - once every three months, do an ultrasound and take tests.

Many gastroenterologists are wary of hepatoprotectors. In any case, the effect of taking these drugs is not comparable to the effectiveness of dieting and giving up alcohol. “The main thing is not to get the thought in your head: “I take the medicine and it’s done, you can eat and drink whatever and as much as you want,” doctors say.

But you can supplement the course of “liver rehabilitation” with hepatoprotectors. There is confirmed evidence that the liver recovers faster when taking them.

How much can you drink without harming your liver? Here doctors agree that this issue is purely individual.

In old medical textbooks you can find a categorical statement: daily use 40 g pure alcohol after 5 years it will lead to the development of cirrhosis. In practice, this is not entirely true: everything depends on a confluence of many factors. The disease develops faster with a hereditary predisposition, the presence of viral hepatitis and, of course, with the consumption of low-quality alcohol.

In any case, periodic visits to a gastroenterologist, ultrasound of the abdominal organs and blood tests for liver enzymes will help you not to miss the changes that have begun in the liver and take timely measures.

Max-777 08-07-2014 20:02

Hello everyone!


Let me make a reservation right away that we do not take into account the genitals

Based on my own little experience of beating, I will suggest that the most painful organs are the LIVER and SOLAR PLEXUS.

Maybe there is something else somewhere? All sorts of different mesenteries, ligaments, membranes, large neurovascular bundles?

silent___hunter 08-07-2014 22:54

The phalanges of the fingers with nails on the hands are extremely painful, they say there were cases where people died after a strong blow to them (a car from a jack, etc.)

but in general, the solar plexus is a very weak point - a strong blow, and you can no longer breathe, and by the way, is it possible to die from this?

mihalich1978 09-07-2014 12:17

Max-777 09-07-2014 08:05

Are there such places in the chest cavity?
Pulmonary pleura, heart, pericardium, diaphragm?
I missed a blow to the sternum a couple of times, it was very bad!

Comrade Beria 09-07-2014 08:37

quote: Originally posted by mihalich1978:

samurai were recommended to bite off their tongue in a desperate situation...

There, death seemed to be expected from blood loss. If you believe Akunin and his creation about the Japanese “liquidators” (“shinobi”, they are also “ninjas”).
And they, ninjas, allegedly also “cut off their faces” - they removed the skin from their faces so that they would not be identified.

nota 09-07-2014 17:44

The liver itself has no nerve endings. Only the capsule is innervated...

The most sensitive organ is the eye. Or rather the cornea.

Max-777 09-07-2014 18:05

Tell me, what determines the degree of sensitivity of a particular organ/tissue?
Probably on the number of nerve endings and the “accuracy” of their arrangement?

PRINCIP 09-07-2014 18:12

Uryadnik1996 09-07-2014 18:12

The most painful organ in a person is the “soul”.

PRINCIP 09-07-2014 18:21

quote: Originally posted by Uryadnik1996:
The most painful organ in a person is the “soul”.

What is this?

Uryadnik1996 09-07-2014 18:50

What is this?

So you ask yourself.

PRINCIP 09-07-2014 19:34

quote: Originally posted by Uryadnik1996:

So you ask yourself.

Silent, stupid...

Uryadnik1996 09-07-2014 19:47

quote: Originally posted by PRINCIP:

Silent, stupid...

Max-777 09-07-2014 20:28

I read how an appendectomy is done under Novocaine. So, they write that the mesentery should not be pulled or tugged too hard,
because the patient becomes very ill from this.

Uryadnik1996 09-07-2014 20:36

And all sorts of different intestinal mesenteries and roots of the mesenteries, these are also pain zones?
I read how an appendectomy is done under Novocaine. So, they write that the mesentery should not be pulled or tugged too hard, because this makes the patient very ill.

What kind of interest in internal organs?

Max-777 10-07-2014 10:50

Well, it’s interesting to know why a hit in one place “adds up”, but in another place does not add up.
and which organs are injured?

ahin 10-07-2014 11:40

quote: Originally posted by Max-777:
...I’ll make a reservation right away that we don’t take the genitals into account
...

PRINCIP 10-07-2014 17:08

quote: Originally posted by ahin:

In general, some kind of suspicious topic.

No... but what?
Maybe someone needs it for “laboratory work”... or to immediately pass an exam in a torture room.

ahin 10-07-2014 18:40

quote: Originally posted by PRINCIP:

No... but what?
Maybe someone needs it for “laboratory work”... or to immediately pass an exam in a torture room.

dimon8-5 10-07-2014 21:39

PRINCIP 10-07-2014 21:59

quote: Originally posted by dimon8-5:

tooth

You entropy nuts with your teeth... try it with your eyes))))

Bajonet 10-07-2014 22:35

Eggs. It's easy to switch off when hit. No one has ever passed out from a blow to the teeth, eyes or other organs. Moreover, in battle, when the face was wounded, the fighters also fought. Example - Kutuzov. The Turks put out his eye, but he still continued the assault.

dimon8-5 10-07-2014 22:45

quote: You entropy nuts with your teeth... try it with your eyes))))

Drill an eye like HZ, but try a tooth... with an army tooth drill, it’s easier, the evil ones caught you and... (no, I won’t write, and the forum will be extinguished for describing torture..))) whoever wants, PM

Good Monster 11-07-2014 12:46

I haven’t experienced more pain than kidney pain.

Max-777 11-07-2014 11:26

PRINCIP 11-07-2014 12:56

quote: Originally posted by Max-777:

Presumably, the degree of sensitivity depends on the accuracy of the arrangement of nerve endings

Wrong common misconception...

Despite huge amount nerve endings (in fact, the whole brain is one big nerve ending), our brain is not able to feel pain. The thing is that there are no pain receptors in the brain at all: why would they be if the destruction of the brain leads to the death of the body? There is no need for pain here, nature decided correctly. True, pain is felt by the membrane in which our brain is enclosed. This is why we so often feel different types of headaches - it all depends on the nature of the membrane and on physiological characteristics our body.

hellfire hellfire 12-07-2014 11:55

quote: Originally posted by Max-777:
Hello everyone!
It became interesting, which internal organ is the most sensitive in terms of various traumatic effects (blows, bruises, wounds)?

Any large nerve plexus. Shoulder, cervical, lumbosacral, etc.

hellfire hellfire 12-07-2014 18:58

quote: Originally posted by Max-777:
depends on the distribution of nerve endings

But in terms of this indicator, dental pulp comes first.

samrat 12-07-2014 20:09

I agree with the opinion of doctors: pain in the kidneys is the most severe pain a person can feel. Everything else is in descending order.

Nice 12-07-2014 23:41

The pain can be acute, dull, aching or even all three four five at the same time.
What are we talking about?

samrat 13-07-2014 10:51

Nice: I think it’s about spicy.

Nice 13-07-2014 12:00

A piercing pain in the tooth, gums or whatever... It happens quite a bit.
Leg with a crunch kneecap 180` so that the tendons would crack... Also somehow...
Internal organs only become inflamed when it is too late to prevent.
The sensitivity limit is individual for everyone. For example, at least I get tired of hitting one horseradish in the kidneys; I don’t feel anything, but the others are dying.

TEq 13-07-2014 14:56

The pulp is most likely, especially when it is inflamed. Because many endings and an almost closed cavity

Bajonet 13-07-2014 18:51

I witnessed the following scene:

The dentists are treating a peasant, he sits calm, like a cliff above the Volga. The doctor asks him: “Aren’t you in pain?” The man, as if waking up, said, “No, honey, the other day I had kidney stones removed... But with you, it DOESN’T HURT!”

bad_brazza 20-07-2014 16:53

trigeminal nerve. as well as the sciatic nerve

bad_brazza 20-07-2014 16:56

in general, any major nerve

Sivutya 21-07-2014 16:58

I raked him in the balls and liver and in the sun.

I can't say which is more painful. Almost identical.
The effect, in fact, is also the same - he twisted and fell helplessly to the floor.

I won't say anything about the kidneys. They are located in the back, surrounded by a powerful framework of muscles, so I couldn’t pierce them, and the stones in them are unknown to us - beer alcoholics)))

zhogl 21-07-2014 20:40

Well, I had two knockouts.
1 time during training we drove an old glove right into open eye. Didn't even blink, because... I didn't see the impact at all. It hurts a lot. And the blow was not strong, a bruise eyeball it wasn't even close. And there wasn’t even any settling of the sclera; everything went away on its own, quickly and without a trace. But it hurt, for about 1-2 minutes - a lot.
2 times - at school during recess, they dealt with me. In sunny. It twisted, but didn’t fall to the floor at all, because the wall didn’t give way.
If you ask which is more painful, it’s about the same.
And seizures urolithiasis suffered, repeatedly. It hurts more in the sun and the eyes. But teeth are easier.

Den_black 22-07-2014 16:59

quote: Topic: What is the most painful organ in a person? Where greatest number nerve endings?

Maybe the root of the mesentery of the small intestine?

zhogl 22-07-2014 18:02

quote: root of the mesentery of the small intestine?

Only surgeons will get there. The idea is purely theoretical.

hellfire hellfire 22-07-2014 19:11

quote: root of the mesentery of the small intestine

extremely shockogenic zone.
It happens that it comes off in athletes in those sports where excessive turns and bending of the body back are possible, for example. among wrestlers, among gymnasts, and especially among female gymnasts.

Nahum 22-07-2014 19:26

In the east they knew a lot about torture; it was common there to hit people on the heels with sticks, as they say the procedure was very painful.

Bajonet 22-07-2014 19:33

Yes, the West was not particularly far behind. Read about the execution of the murderer of the Prince of Orange. There is no smell of humanism there at all. However, as in all of Europe until the 17th-18th century...

federal 23-07-2014 19:55

Once there was such a depression in the front of the knee, a piece of iron flew in, I almost threw up from the pain, on the same knee, when the leg shifted a little to the left, I walked normally for several hours, and when I went to bed I realized that climbing the wall is not a metaphor, I got a Soviet glass syringe, inserted two ampoules of novocaine, I realized that it wasn’t helping, I drank two bottles of vodka, and only then was I able to sleep.

hellfire hellfire 02-08-2014 19:01

and the “painfulness” of a particular organ greatly depends on its condition.
inflamed and swollen tissues, as well as ischemic tissues, hurt much more

vasill 05-08-2014 04:45

of course it's a penis

Mr. Gray 11-08-2014 18:31

quote: Originally posted by federal:
Once there was such a depression in the front of the knee, a piece of iron flew in, I almost threw up from the pain, on the same knee, when the leg shifted a little to the left, I walked normally for several hours, and when I went to bed I realized that climbing the wall is not a metaphor, I got a Soviet glass syringe, inserted two ampoules of novocaine, I realized that it wasn’t helping, I drank two bottles of vodka, and only then was I able to sleep.

1 per knee.

When I injured my knee (ACL+meniscus tear), my leg did not want to bend (painful contracture). This is about 40 minutes after the injury.
Let me, I think I’ll move my leg a little more in terms of bending - FUCK!!! The pain was such that blows to the balls were a light massage!
My vision darkened, my leg relaxed and bent, making it even more painful.
It feels like you are about to lose consciousness and die.

hellfire hellfire 11-08-2014 18:45

and I would give a thumbs up for the liver...

Mr. Gray 16-08-2014 12:36

Soreness and shockogenicity are somewhat different things...

zhogl 16-08-2014 17:41

But still strongly connected...

Mr. Gray 16-08-2014 19:28

It all depends on the purpose of inducing pain - if it is neutralized, then shockogenicity is a plus.
And if you force someone to tell you something, it’s a minus.

hellfire hellfire 16-08-2014 21:29

What determines the “shockogenicity” of a particular area, and how does “shockogenicity” differ from simple soreness? Interesting...

(on my own behalf: I would venture to suggest that “shockogenicity” appears in those places where there are a large number of n. vagus endings)

zhogl 17-08-2014 10:10

quote: And if you force someone to tell you something, it’s a minus.

We are not special forces, we are purely self-defenseists.

quote: (on my own behalf: I would venture to suggest that “shockogenicity” appears in those places where there are a large number of n. vagus endings)

Probably, more precisely, where the vagal reaction is more easily evoked.
For example, the pain from the fingers is very strong, but the vagal functions are triggered rather weakly, the client can still run away. But when you hit the ribs, the pain is relatively nothing, but it’s crippling; obvious vagal effects and clearly stronger than from the fingers.

Rusich 18-09-2014 12:23

I wouldn't wish it on anyone...

Sashok025 14-10-2014 14:51

quote: Originally posted by Max-777:
Hello everyone!
It became interesting, which internal organ is the most sensitive in terms of various traumatic effects (blows, bruises, wounds)?
Which internal organ contains the largest number of nerve endings?

Theoretically, the most sensitive should be internal serous membranes the chest and abdominal cavities, as having the maximum surface area.
Plus, they have a high density of receptors per 1 square meter. see surfaces.
Well, as a rule, irritation of one small area in these membranes quickly spreads over a significant area,
as, for example, occurs with pleurisy and peritonitis.

PP-PV 14-10-2014 23:12

in case of damage to the spine or its processes...
In general, until you crawl to the syringe with Tramal, you won’t even be able to breathe or scream.
I wouldn't wish it on anyone...
#64 But it doesn’t help me at all.

VLderbyshov 04-12-2014 18:30

quote: Originally posted by Max-777:

Which internal organ contains the largest number of nerve endings?

Maybe the liver? More precisely, her capsule.
By the way, how to measure the sensitivity of a particular organ?
Put a piece of an organ under a microscope and count the number of nerve endings per 1 sq. mm?
I think it is unlikely that such studies were specifically carried out anywhere.

Nerve fibers end in terminal apparatus - nerve endings. There are 3 groups of nerve endings:

effector endings(effectors) transmitting nerve impulses to the tissues of the working organ,

receptor(affective, or sensitive, sensory),

end devices, forming interneuronal synapses and communicating between neurons.

Effector nerve endings

Effector nerve endings are of two types:

motor,

secretory.

Motor nerve endings

These are the terminal devices of the axons of the motor cells of the somatic, or autonomic, nervous system. With their participation, the nerve impulse is transmitted to the tissues of the working organs. The motor endings in striated muscles are called neuromuscular endings or motor plaques. Neuromuscular ending consists of the terminal branching of the axial cylinder of the nerve fiber and a specialized section of the muscle fiber - the axo-muscular sinus.

The myelinated nerve fiber, approaching the muscle fiber, loses the myelin layer and plunges into it, involving its plasmalemma and basement membrane.

Neurolemmocytes covering nerve terminals, except for their surface in direct contact with the muscle fiber, turn into specialized flattened bodies of glial cells. Their basement membrane continues into the basement membrane of the muscle fiber. The connective tissue elements then pass into the outer layer of the muscle fiber sheath. The plasmalemmas of the terminal branches of the axon and muscle fiber are separated by a synoptic cleft about 50 nm wide. Synaptic cleft filled with an amorphous substance rich in glycoproteins.

Sarcoplasm with mitochondria and nuclei together forms postsynaptic part of the synapse.

Secretory nerve endings ( neuroglandular)

They are terminal thickenings of terminals or thickenings along the nerve fiber, containing presynaptic vesicles, mainly cholinergic (contain acetylcholine).

Receptor (sensory) nerve endings

These nerve endings - receptors, terminal devices of the dendrites of sensitive neurons - are scattered throughout the body and perceive various irritations both from the external environment and from internal organs.

Accordingly, two large groups of receptors are distinguished: exteroreceptors and interoreceptors.

Depending on the perception of irritation: mechanoreceptors, chemoreceptors, baroreceptors, thermoreceptors.

Based on structural features, sensitive endings are divided into

free nerve endings, i.e. consisting only of the terminal branches of the axial cylinder,

unfree, containing in their composition all the components of the nerve fiber, namely the branches of the axial cylinder and glial cells.

Non-free endings, in addition, can be covered with a connective tissue capsule, and then they are called encapsulated.

Non-free nerve endings that do not have a connective tissue capsule are called unencapsulated.

Encapsulated connective tissue receptors, with all their diversity, always consist of branching axial cylinders and glial cells. On the outside, such receptors are covered with a connective tissue capsule. An example of such endings is the very common lamellar corpuscles in humans (Vater-Pacini corpuscles). In the center of such a body there is an internal bulb, or flask (bulbus interims), formed by modified lemmocytes (Fig. 150). The myelinated sensory nerve fiber loses its myelin layer near the lamellar body, penetrates the inner bulb and branches. Outside, the body is surrounded by a layered capsule consisting of s/t plates connected by collagen fibers. Lamellar bodies perceive pressure and vibration. They are present in the deep layers of the dermis (especially in the skin of the fingers), in the mesentery and internal organs.

Sensitive encapsulated endings include tactile corpuscles - Meissner's corpuscles. These structures are ovoid in shape. They are located at the tops of the connective tissue papillae of the skin. Tactile corpuscles consist of modified neurolemmocytes (oligodendrocytes) - tactile cells located perpendicular to the long axis of the corpuscle. The body is surrounded by a thin capsule. Collagen microfibrils and fibers connect the tactile cells to the capsule, and the capsule to the basal layer of the epidermis, so that any displacement of the epidermis is transmitted to the tactile body.

Encapsulated endings include genital corpuscles (in the genitals) and terminal Krause flasks.

Encapsulated nerve endings also include muscle and tendon receptors: neuromuscular spindles and neurotendon spindles. Neuromuscular spindles are sensory organs in skeletal muscle that function as a stretch receptor. The spindle consists of several striated muscle fibers enclosed in a tensile connective tissue capsule - intrafusal fibers. The remaining muscle fibers lying outside the capsule are called extrafusal.

Intrafusal fibers have actin and myosin myofilaments only at the ends, which contract. The receptor part of the intrafusal muscle fiber is the central, non-contractile part. There are two types of intrafusal fibers: fibers with nuclear bag(the central extended part contains many nuclei) and nuclear chain fibers(the nuclei in them are located in a chain throughout the receptor region).