which have nerve endings. Diseases associated with nerve endings

The material is taken from the site www.hystology.ru

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

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

Motor nerve endings of striated skeletal muscles - motor plaques - a complex of interconnected structures of nervous and muscle tissues. Motor plaque - effector apparatus of axons of nerve cells 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 axon of the neuron and a muscle pole, a specialized section of the muscle fiber - the sole of the motor plaque (Fig. 166).

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

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

The muscle fiber in the sole 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- the core of the muscle fiber); IN- top view (a - myelin fiber, b- an unmyelinated nerve fiber, c - a fiber emerging from a motor plaque and ending in another motor plaque, the so-called "ultraterminal fiber").

Rice. 167. Scheme of the motor plaque structure:

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 the neuroplasm (axoplasm); 8 - primary synaptic space; 9 - sarcosomes; 10 - secondary synaptic space; 11 - synaptic vesicles; 12 13 14 - motor plaque nucleus (muscular); 15 - myofibril, consisting of myoprotofibrils.

striation. Here, the cytoplasm contains a significant number of mitochondria and round or oval nuclei. The combination of these structures of the muscle fiber in the region 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, during depolarization of the axon plasmolemma - 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 extend between muscle cells and form well-shaped extensions containing cholinergic or adrenergic vesicles.

Sensory nerve endings (receptors)- specialized end formations dendrites of sensory neurons. In accordance with their localization and specificity of participation in nervous regulation the life of an organism there are two large groups receptors: exteroreceptors and pteroreceptors. Depending on the nature of the perceived irritation, sensitive endings are divided into mechanoreceptors, chemoreceptors, thermoreceptors, etc.

Rice. 168. Lamellar body (Vater's body - Pacini):

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

Rice. 169. Tactile (Meisier's) body:

1 - capsule; 2 - special cells.

Sensory 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 sensory cell, and non-free, 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 sensitive endings in the connective tissue of animals are very diverse, which are represented by two groups: non-encapsulated and encapsulated nervous apparatuses. The former contain a branching axial fiber cylinder that accompanies the 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 bodies (Vater-Pacini bodies), tactile bodies (Meissner bodies), genital bodies, etc. (Fig. 168, 169).

Rice. 170. Scheme of the structure of the 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 axons of secondary sensory cells with dendrites of a sensory nerve cell (according to Otelin).

The lamellar body consists of an inner flask and a capsule. The inner flask is formed by specialized lemmocytes. The axial cylinder is immersed in it - the terminal section of the sensitive nerve fiber. 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. On the border of the outer capsule and the inner flask, there are cells that are presumably defined as glial cells. They form synapses with branches of the axial cylinder (Fig. 170). It is assumed that the nerve impulse is generated under conditions of displacement of the outer capsule relative to the inner bulb. Lamellar bodies are characteristic of the deep layers of the skin and internal organs.

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

The genital bodies of the genital organs are similarly constructed. A distinctive feature of this type of endings is that not one axial cylinder, but several, penetrates into the genital body under the capsule. The latter branch between the glial cells of the body. According to the same scheme, Krause flasks are built, with the function of which temperature sensitivity is associated. When they are excited, the mediator enters the synaptic cleft to 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 with 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 region of nuclear bags (according to Kristich with a change); 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 nuclear bags; 6 - striated muscle fibers; 7 - nerve.

four thin ones (Fig. 171). The equatorial part of the thick fibers is filled with accumulations of nuclei - the "nuclear bag". In thin muscle fibers, the nuclei are arranged in a chain, a nuclear chain is formed. Sensory nerve fibers are represented here by two types. Some form spiral curls surrounding the equatorial, containing nuclei, 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-like endings, one on each side of the primary one. The endings of the first group respond to the degree of muscle stretching and its speed, the secondary ones - only to the degree of stretching. At both poles of muscle fibers, the endings of motor nerve fibers are localized and have a structure typical of a motor plaque.

Interneuronal synapse- specialized contact of two neurons, providing unilateral conduction of nervous excitation. Morphologically, in the synapse, a presynaptic pole is distinguished - 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 mediator (acetylcholine or norepinephrine), mitochondria, single cisterns, and sometimes neurotubules. Participation in the transmission of a nerve impulse to the next neuron is determined by a regular release by exocytosis into the synaptic cleft of the mediator.

Rice. 172. Scheme of ultramicroscopic structure of various types of synapses:

A - cytotopography of synapses; B- inhibitory synapse; IN- excitatory type synapse; 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, acting on the membrane of the postsynaptic pole, causes a change in its permeability, a wave of depolarization - the generation of a nerve impulse. The role of a mediator, in addition to those mentioned above, can be played by other substances, namely: adrenaline, serotonin, gamma-aminobutyric acid, etc.

Synaptic vesicles carrying different mediators are morphologically distinct. In cholinergic synapses they are: small (30 - 40 nm) and transparent. Their composition sometimes also contains several very large and electron-dense bubbles (80 - 150 nm), chemical composition and the meaning of the latter is currently unclear. 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 the synaptic vesicles.

The postsynaptic membrane of cholinergic synapses contains a "cholinergic" protein. When interacting with acetylcholine, conformational changes in its molecules occur, leading to a change in the permeability of membranes 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 the axodendrigic synapse in the cranial cervical node cat (Kozlov's drug):

1 - Synaptic vesicles; 2 - mitochondrion; 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 - sensory cell dendrite; 4 - shell; 6 - the nucleus of a lemmocyte; 6 - myelin sheath; 7 - interception of the nerve fiber; 8 - axial cylinder; 9 - notch on the nerve fiber; 10 - neurite of a sensitive cell; 11 - motor cell 12 - motor cell dendrite; 13 - neuritis of the motor cell; 14 - myelin fibers; 15 - effector (motor plaque); 16 - spinal node; 17 - dorsal branch of the spinal nerve; 18 - back spine; 19 - back horn; 20 - front horn; 21 - front spine; 22 - ventral branch of the spinal nerve.

presynaptic membrane. Synaptic vesicles are often associated with presynaptic seals. On the tangential sections of the seal, it can be seen 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 indurations are collectively referred to as the synaptic complex, and since they appear to be sites of predominant vesicle accumulation and neurotransmitter release, they are also called active zones. In the area of ​​synapses, small attachment devices are also detected - attachment points (punctum adherens). They differ from seals of synaptic complexes by greater thickness and symmetry and a small linear extent.

Electrotonic synapses are formed with a dense attachment of plasmolemms, 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).

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

Most a large number of nerve endings in human body located in the oral cavity (in the region of the 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, due to which external stimuli are perceived, and the resulting impulse (signal) is transmitted to the corresponding nerve cell (neuron).

Interesting! There are about 100 times more sensory receptors on the lips than on the fingertips!

A huge number of nerve endings in the region of the tongue and lips is explained by the abundant innervation of the entire oral cavity:

• The lingual, hypoglossal and maxillohyoid 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 membranes and muscles necessary for chewing food.
• The glossopharyngeal nerve leaves thousands of endings in the tongue, the parotid salivary gland, and the muscles of the pharynx.
• The palate is controlled by the vagus nerve.

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

Fingertips

A little less nerve endings are contained in the thickness of the skin at the fingertips. It is worth noting that tactile analyzers in the fingertips are the most ancient structures of living organisms, therefore, in the process of evolution, their number has multiplied. With our fingers we perceive touch, temperature, pain, pressure, shape, surface features of objects. This is what is called touch.

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

Why don't we feel pain?

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

Each organism is individual and differently perceives stimuli, for example, pain. 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 there is no gene responsible for the perception of pain. Patients with this pathology absolutely do not feel it under any stimuli. Pain receptors simply don't send signals to the brain correctly. Since pain is a protective reaction, people with Marsili syndrome are deprived of such protection and can easily break the bones of the limbs, constantly hit, burn themselves and receive other injuries. dangerous injuries. Ultimately, these situations can lead to disability or death.

Where are the least number of 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 they are also absent 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 reaction of the brain to the received information about the danger.

Many people ignore such signals or consider it the height of courage to endure such inconveniences when, at first glance, unreasonable pains that are 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 have occurred for various reasons, sometimes inflammation occurs not of the nerves themselves, but of their endings or their 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 the 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 part of the nervous system can occur.

Neuritis is more dangerous disease 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 that 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 other parts of nerve cells or nerves can be affected in neuritis.

What contributes to inflammation

To promote inflammation of the nerve endings can be a variety of negative factors effects 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 area where the nerve passes.
• bruises.
• Local infections in the form of an abscess.
• Circulatory disorders.
• Deficiency of certain substances, vitamins or minerals in the body.
• Disruptions in the endocrine system.
• Toxic poisoning.
• Heredity or individual features of the structure of the body.
• Tumor processes and many other factors.

More often, inflammation of the nerves begins with a long-term negative irritating effect on the nerve or with an infection.

Symptoms and types

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

• Inflammation median nerve, it is also ulnar, carpal, radial or ulnar, passing along the arm through the wrist. In this case, the work of the brush is disrupted or sensations arise in it in the form of numbness, tingling, pain, or restriction of movement with the fingers. Pain can shoot along the entire path of the nerve or be localized only at the site of inflammation.
• Problems of the femoral nerve, where there is decreased sensation in the skin or ability to flex the hip joint, as well as pain along the surface of the leg that can shoot all over the leg.
• Inflammation of the nerve endings of the spine, which is one of the most dangerous species neuritis and manifests itself in the form of severe pain in the back, chest or neck, depending on the area of ​​the lesion, which is called sciatica. Sciatica also has its own classification based on symptoms depending on the area of ​​dislocation: sciatica of the lumbosacral, cervical or thoracic.
• Inflammation peroneal nerve- pain in the heel or backache from it, leading to the inability to fully rely on it.
• Damage to the nerve endings of the facial nerve is represented by facial expression disorders, numbness of parts of the face, or discomfort.
• Acoustic nerve disease, when in addition to pain, hearing is lost or weakened, and problems with balance or nausea begin due to the fact that auditory nerve also responsible for the vestibular apparatus.
• Damage to the intercostal nerve delivers 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 sensory disturbances, the ability to move the leg. There are severe cutting inguinal and lumbar pains.
• A disease of the nerve endings of the occipital region provokes headaches, girdle pains in the back of the head, pain from touching it, “twitching” of the nerve in the head, a negative reaction to light and backache in the ear or lower jaw.

In addition to the above, there are many other types 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, developed against the background of any disease.

Diagnostics

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

Use to determine the extent of damage instrumental methods examinations:

• Electroneurography is a study of the speed of passage of an impulse along a fiber and its conductivity. Allows you to determine the degree and area of ​​damage.
• Electromyography - examines the electrical activity of muscles and checks functional state neurons.
• Evoked potentials - a method similar to electroneuronography, but for deep nerves, such as visual and auditory, where they are affected by sound or image and conduction is recorded according to 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 infection is suspected, laboratory tests of blood and other tissues are performed, up to a biopsy of the nervous tissue in extreme cases.

Consequences

Usually neuritis of any origin is well treated, especially in young people, whose regenerative powers are high. However, if neuritis is not treated, it can lead to a complete loss of nerve functions, the capabilities that it performed: vision, hearing, sensitivity, motor activity, secretion of any glands, and also provoke a stop in the work of any internal organ. and 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-edema therapy.
• Stimulation of blood circulation.
• Biogenic stimulation - stimulation recovery processes special preparations.
• Anticholinesterase therapy - treatment with drugs that inhibit nerve activity.
• Vitaminization and replenishment of deficiencies of minerals and other substances.
• Plastic surgery or suturing of the nerve by surgery, when a severely damaged area is removed.
• Local introduction medicines right next to the nerve.
• Physiotherapy treatment.
• nerve stimulation.
• Symptomatic treatment with the use of anesthetics.

Treatment of inflammation of the nerve endings is selected individually and depends on the specific type of neuritis, the place of its deployment. With this disease, folk methods selected with the help of a doctor help well.

Conclusion

Diseases such as neuralgia or neuritis, which, in addition to inflammation of the nerve endings, has many more manifestations (sciatica, funiculitis, plexitis, mononeuritis, polyneuritis) are similar in the method and names of classification, causes, symptoms and methods of treatment, 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 there is a disease of the nerve tissue itself with its disorders.
• Varieties of neuritis differ from each other by the disease of specific parts of the nerve: nerve endings, nerve roots, peripheral nerves etc. The causes and treatments for all these diseases are the same. In a separate category, plexitis can be distinguished - a plexus of nerves or fusion.

It is not necessary for a non-specialist to understand all the terminology, the classification of neuralgia and neuritis, the main thing to remember is that a seemingly frivolous disease, which may not cause much suffering, only mild discomfort, can quickly lead to serious problems when 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 on the functions of dead cells by others. With signs of neuralgia, it is imperative to consult a doctor, no one wants to lose, for example, the ability to move their legs due to some stupidity that could have been solved at one time by simply warming up or a couple of injections. Neuralgia and neuritis, like all diseases, are treated the faster and more efficiently, the earlier the necessary procedures were 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 the glands and form end structures that are more uniform in structure. The main morphological feature of nerve endings is an increase in the surface of the nervous tissue on the periphery due to the multiple branching of the axial cylinder and the formation of local thickenings with a neurofibrillary plexus in the final structures.

Sensory nerve endings in humans

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, the 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 out, penetrating through the thickness of the layers epithelial cells, and, propagating in the horizontal and vertical direction reach the superficial regions. Direct contact with epithelial cells is carried out in the intercellular spaces by the formation of fibrillar plates or terminal buttons on the surface of the cells. There are indications of the possibility of penetration of terminal branches into epithelial cells and the formation of terminal reticulums and buttons in their protoplasm.

Free human nerve endings in the form of ramifications and looped plexuses of thin fleshy fibers, ending in bushes of non-fleshy fibers, plates of fibrillar networks and thin, non-fleshy branches with button-like thickenings, exist in the smooth muscles of the internal organs, the heart muscle, and in the walls of blood vessels. Along the terminal branching of such endings, protoplasmic syncytium of Schwann cells is found.

An example of human nerve endings enclosed in the cytoplasm of special cells is Meissner's bodies, 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 connective tissue capsule containing layers of special sensitive cells or disks.

The pulpy fibers, penetrating under the capsule of the body, most often lose the pulpy membrane; a fleshless axial cylinder forms spiral bends and ramifications between sensitive cells, ending in fibrillar branches often in the upper pole of the body.

The largest and most complex nerve endings are the bodies of Vater-Pacini, 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 pulpy fiber, non-pulmonic fiber (Timofey apparatus) and vessels enter the body at one of its poles. The pulpy fiber loses its pulpy membrane and penetrates into the inner flask of the body, forming there a thickening of the neurofibrillary mass with branching and a terminal swelling. An amyopia nerve fiber has a separate terminal network around a thick axon. It is now widely believed that the Timofeevsky apparatus is a collateral of the sensory fiber, and not a branch of the vegetative fiber.

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

The human motor nerve endings of the striated muscles arise after multiple division of the muscle branches of the nerves in the connective tissue septa. Separate nerve fibers, having lost the pulpy membrane, closely adhere to the surface of the muscle fiber, the axial cylinder forms a flat branching of the terminal branch with mesh thickenings. All this 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, standing out from the plexus, approach the muscle fibers and terminate on them with terminal buttons, sometimes forming plexuses. A separate axial cylinder can penetrate the muscle cell and end with a button or loop near the nucleus.

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

Which organs do not have nerve endings?

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

To studying of various types N. about. in the peripheral nervous system are devoted to the work of researchers of the late 19th - first half of the 20th century: A. E. Smirnova, A. S. Dogel, S. E. Mikhailov, N. G. Kolosov, B. A. Dolgo-S aburova, E K. Plechkova. B. I. L avrent’eva, T. A. Grigorieva and others.

In c. n. With. interneuronal N. o. studied Bodian (D. Bodian, 1942), A. D. Zurabashvili (1947). S. A. Sarkisov (1948), S. Ramon-i-Kakhal (1954) and others.

Morphology

Afferent (sensory) nerve endings, or receptors, are distributed throughout the body. They are terminal branches (terminals) of the dendrites of sensitive neurons. Besides, in structure of afferent N. about. may include gliocytes. Receptors (see) are subdivided into primary ones, when the stimulus excites directly the terminals of the dendrite of the sensitive neuron, and secondarily, when the stimulus affects specialized cells, to-rye, in turn, affect the terminal branching of the dendrites of the sensitive neuron.

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

On the structure sensitive N. about. 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. is located - epithelial, connective or muscular - they have characteristic structural features. So, for various types of epithelium (epidermis, epithelium covering the cornea, digestive tract, epithelium of the glands), free

But. In this case, myelinated nerve fibers approach the epithelial layer, lose their myelin sheath, and the axial cylinders, surrounded only by thin layer cytoplasm of neurolemmocytes - Schwann cells (Fig. 2), penetrate into the epithelium and disintegrate between epitheliocytes into terminal branches. In a multilayered epithelium of N. the lake. also free; they include, in addition to terminal nerve branches, specifically altered epitheliocytes - 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 the connective tissue (skin, fascia, ligaments, tendons, articular bags, periosteum, etc.), the majority of N. o. also free and represent a branching of the dendrite in the form of bushes of various shapes.

In addition, encapsulated receptors are found in the connective tissue - lamellar, tactile bodies, genital bodies (or Grandri bodies, Golgi - Mazzoni bodies), 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 are the lamellar body (corpusculum lamellosum), or body of Vater - Pacini, found in the skin, periarticular connective tissue, perineural fascia, interosseous membranes, along the vessels. The lamellar body is an ovoid-shaped formation, from 2 mm to several micrometers in length and dia. 0.5 mm.

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

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

A feature of the genital bodies (corpuscula genitalia), to-rye 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.

End 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 veto-checks of a sensitive nerve fiber, forming terminal extensions; internal glial flask and external connective tissue capsule. End cap diameter approx. 50 µm.

Sensitive N. o. skeletal muscle tissue and tendons are called neuromuscular (terminatio neuromuscularis fusi) and neurotendinous (terminatio neurotendinea fusi) spindles. Neuromuscular and neurotendinous spindles are oval-shaped formations 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 break up into terminal branches, which look like bushes on tendon fiber bundles. In muscle spindles, these terminals branch and braid the muscle fibers of the spindles, and the muscle fiber itself loses its transverse striation.

Efferent nerve endings are represented by motor N. o. in skeletal and smooth muscles and secretory N. of the lake. Motor N. o. V skeletal muscles called motor plaques or end plates, axo-muscular or neuromuscular synapses (Fig. 3). Motor N. o. in skeletal muscles, it consists of terminal branches of the myelin 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-new 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 bounded on one side by the modified cytolemma of the terminal branches, and on the other, by the sarcolemma of the muscle fiber. This area 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, 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 the glands, they are formed, as a rule, by non-myelinated efferent fibers c. n. With. These N. about. are represented by terminal branches of neurite of great length, along the course of which there are thickenings to dia. 0.1-2 microns. Toward the periphery, the thickening gradually decreases. The thickenings contain accumulations of synaptic vesicles and mitochondria. The distances between the terminal branches and 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 for afferent ones, which are connected with receptors by peripheral processes. Most nerve endings in 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. o., located on the body of a nerve cell, are called axosomatic synapses. Synapses are formed both by terminal branches and along the course of the axon. But. may terminate on a postsynaptic element in various ways: 1) without expanding and without changing its configuration; 2) forming a terminal extension of the presynaptic process; at the same time, they usually seem to spread out along the postsynaptic process; 3) partially covering the postsynaptic process or deepening into it.

With the help of an electron microscopic study, it was revealed that the composition of the synapses includes presynaptic and postsynaptic N. o. Presynaptic N. o. (Fig. 4) are characterized by the presence of synaptic vesicles, an increase in the electron density of synaptic membranes. These N. about. 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. In synapses, presynaptic N. o. separated from the postsynaptic synaptic cleft 25 nm wide. Postsynaptic N. o. quite often they also have certain signs of specialization in the form of a pronounced subsynaptic network, spiny apparatus, subsurface cisterns and bands 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 the nervous tissue, muscle and glandular cells.

Afferent N. of the lake, located in various tissues of the body, are receptors. Efferent neurons that form synapses on muscle elements regulate the activity of skeletal and smooth muscles. The N. of the lake, forming contacts with other nervous cells, participate in mechanisms of interaction of neurons, providing transfer of excitement in c. n. With. from afferent nerve cells to efferent ones.

In N. about. processes of accumulation and allocation of mediators are carried out (see). The process of excitation spreading in N. of the lake causes depolarization of the presynaptic membrane and the release of one or another mediator. In addition to mediators in N. about. found in significant amount macromolecules coming from the body of a nerve cell due to the movement of axoplasm (axotok) in nerve fibers (see): neurophysins, chromogranins. These macromolecules influence processes of accumulation and storage of mediators in N. about.

With axotok in N. o. enzymes arrive. So, in N. o. the cerebral cortex found up to 30-40 different enzymes. In N. about. a system of contractile proteins, possibly also involved in the secretion of mediators, has been identified. The ability of local synthesis in N. o. some biologically active substances(e.g., proteins and RNA), to-rye enter the body of the nerve cell with the reverse axotok (movement of the axoplasm from N. to the body of the nerve cell).

But. not only participate in the release of mediators into the synaptic space, but also remove excess mediators and their decay products. Through N. o. trophic influences of nerve cells on executive bodies(see Trofika). Especially clearly the trophic role of N. o. it is shown in the conditions of denervation (see), as a result a cut bodies and fabrics get hypersensitivity to the action of chem. substances.

Pathomorphology

Patomorphol, N.'s changes about. 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.

At a light-optical research of pathologically changed N. about. of all types (sensitive, motor and interneuronal), the following most common patterns are noted: an increase in their tinctorial properties (argyrophilia and osmiophilia), N. edema and swelling of the lake, their deformation and fragmentation. Less common are axo-plasma streaks and spherical formations arising from dystrophically changed N. o. Electron microscopic study of N. about. allowed to establish nek-ry features inherent in pathologically changed N. of the lake. each of the specified types. However, the degree of knowledge of these changes in N. o. different types is different, the least studied patol. changes in sensory and motor N. o.

Patol, sensitive N.'s changes of the lake. V most associated with changes in nerve fibers in various patol processes (eg, in a number of skin diseases - ichthyosis, leprosy, pemphigus) and are caused by damage to nerve fibers. In the early stages 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, membrane inclusions. At this stage of N.'s change of the lake. still reversible. In case of progression patol, process membrane inclusions become larger, vesicular and tubular components swell, the quantity of vacuoles increases, neurofilaments collapse and disappear, accumulations of fine granular substance appear, considerable osmiophilia of N.'s cytoplasm of the lake is noted. Finally, nerve fibers and N. o. wrinkled and filled with fine-grained substance. These stages precede their disintegration and phagocytosis by neuroglial cells.

Early stages patol, changes of motive N. about. 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. With the progression of patol, the width of the synaptic cleft becomes uneven, the osmiophilic substance in it is also unevenly distributed. Deformation of contours motive N. about. is the beginning of their collapse. Changes in motor N. o. most studied in various forms of myasthenia gravis and myopathy, while significant deviations are 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-granular matter in them and an increase in the electron density of N. o.

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

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

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

Dark dystrophy is studied by hl. arr. on the example of Waller rebirth (see). A characteristic sign of N.'s damages of the lake. when the axon is cut, their dystrophy with an increase in osmiophilia develops on the 5-11th day after the cut. The constancy of the occurrence of an increase in osmiophilia during experimental damage to certain systems of nerve fibers serves comfortable model to study various aspects of synapsoarchitectonics. Dark dystrophy of N. about. observed with brain injury, encephalitis, as well as a number of other diseases of c. n. With.

Another form of dystrophy of presynaptic N. of the lake is swelling of presynaptic terminals (Fig. 7), which is accompanied by enlightenment of the cytoplasm (light dystrophy), a decrease in the number of synaptic vesicles, to-rye at the same time form small groups, as well as destruction of mitochondria. At this form of dystrophy of presynaptic N. about. a small amount of fine-granular substance and neurofilaments appear in them, to-rye, however, do not change the general 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 a slight severity of the damaging effect, the described changes can be reversed.

Light dystrophy is a typical form patol, N.'s changes of the lake. with hypoxia and ischemia of the brain, occasionally observed with brain injury. According to a number of researchers, swelling of presynaptic N. about. it was observed at section of their axons, however this reaction of N. of the lake. occurs, apparently, only in certain types of nerve fibers. At a number hron, intoxications in presynaptic N. the lake. large lysosomes and phagosomes appear, which, combined with a decrease in the number of synaptic vesicles, indicates degenerative changes in these N. o. light type.

Bibliography: Bogolepov H. N. Ultrastructure of synapses in norm and pathology, M., 1975; Histology, ed. V. G. Eliseeva. Moscow, 1972. Glebov R.N. and K ryzh and N about in with to and y G. N. Functional biochemistry of synapses, M., 1978, bibliogr.; Grigoryeva T. A. Innervation of blood vessels, M., 1954; To l go-Sab at ditch B. A. Innervation of veins, M., 1958; Kolosov N. G. Innervation of internal organs and the cardiovascular system, M. - JI., 1954; Kupriyanov VV Nervous apparatus of the vessels of the pulmonary circulation, L., 1959; JI a b o r i G. Metabolic and pharmacological bases neurophysiology, trans. from French, Moscow, 1974; About to with S. Fundamentals of neurophysiology, trans. from English, M., 1969; Portugalov VV 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, Moscow, 1960; Chernigovsky V. N., Interoceptors, M., 1960; McLennan H. Synaptic transmission, Philadelphia, 1970; Tobecis A. K. Transmitters and identified neurons in the mammalian central nervous system, Bristol, 1974.

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

Why are there no nerves in the liver?

Recently learned a subject. It turns out that the liver, if it hurts, is only with an increase, because it puts pressure on the surrounding space.

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

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

It turns out that the liver, if it hurts, is only with an increase, because it puts pressure on the surrounding space.

As in a joke, I will remove the right lung so that it does not interfere and continue to drink. 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

The intestines, more precisely 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 occur, so there is no need to be afraid. But you will not feel pain, because there are no nerve endings in the rectum. Blood can only be seen, and then of course it is better to stop this business. You experience pain during anal sex only from the expansion and microcracks of the sphincter, therefore, you do not need to spare lubrication and you need to prepare your partner for a long time, especially the first time, starting literally from the diameter of the little finger.

Anatomy of human 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 anatomy of a person's internal organs, one can think about some kind of disease, thereby drawing the doctor's attention to the problem. We will try to describe the most common problems and complaints in diseases of the internal organs.

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

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

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

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

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

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

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

The liver is one of the most insidious internal organs. The liver itself is unique, taking only one small piece from a donor and transplanting it to a patient, it can almost completely recover. But there are no nerve endings in the liver, and it cannot produce pain. Pain often comes from the gallbladder or other organs.

Human anatomy provides for many factors, such an observation that the heart is behind the ribs means that mother nature understands the importance of this organ. But do not think that the heart can hurt, in 70% of cases it is 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 diseases, if the pain occurs sharply, does not allow you to move, and intensifies on exhalation or inhalation - this is Intercostal neuralgia. Especially, neuralgia likes to be periodically repeated by attacks. The cause of neuralgia is quite often in the spine.

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

Human anatomy has provided for another internal organ, which 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, accumulating urine in the bladder. Kidney problems show up as swelling in the morning, bad urine color, and some other symptoms.

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

Far from always knowing the anatomy of a person's internal organs, one can accurately diagnose and symptoms are often not enough either. If you have any doubts about the competence of a doctor, choose another for consultation.

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

Modern doctors use the nokia c8 phone because the 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 the nokia c8 phone, but 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 apparent, 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 just the liver. 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 the constraint of nearby organs, that is, a diseased liver affects the work of neighboring organs, which causes pain.

To understand how a person's liver hurts, it is not necessary to listen only to the signals physical pain in the right hypochondrium. Liver diseases manifest themselves according to such signs: causeless nausea, feelings of heaviness in the right side of the body, a bitter taste in the mouth. The pain from the liver capsule - the membrane - has a aching character, with sudden movements the pain intensifies.

However, it is not so easy to identify liver diseases immediately, it is advisable to undergo a liver examination once a year. At a young age, the liver practically does not bother, but closer to old age, liver problems begin to appear, caused by malnutrition, bad habits: fast food, fat, alcohol, nicotine, excessive sweets (or rather, trans fats found 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 may experience only indirect consequences of liver diseases: causeless nausea and vomiting, problems with appetite; bitter taste in the mouth; dark urine; yellow-gray skin color; diarrhea; chronic ailment, 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 entire volume of the liver remains, 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 decline in strength, the white of his eyes turns yellow, his skin color changes, bruises appear due to low blood clotting - this is a reason to go to a gastoenterologist or hepatologist for a diagnosis. 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, due to a fast run or just a step, it starts to prick in the right side. The reason for this phenomenon is the filling of the liver with venous (waste) blood. The main thing during physical stress is to breathe correctly and deeply, and such colic disappears on its own after a while of rest. In this case, it hurts and colitis is the shell of the liver, but not the liver.

Except physical activity combined with the use of a fatty lunch or breakfast, a drug overdose can also disturb the liver. In general, the liver removes toxins from the outside of the body through bile. But in case of overdose - the liver is not able to quickly remove toxins and causes such symptoms: yellowness of the face, itchy skin, dizziness, weakness, discomfort in the gastrointestinal tract - this indicates drug-induced hepatitis. It looks like drug-induced hepatitis and an overdose of alcohol. 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 with ascites disease: through 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, a large stomach. Also, a diseased liver causes twitching of the eyelids, twitching in sleep, night sweats, bad dream, strong heartbeat, the immune and hormonal systems fail, the 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 particular organ. Nersesov Alexander Vitalievich, Doctor of Medical Sciences, Professor, Head of the Gastroenterology and Hepatology Department of the Research Institute of Cardiology and Internal Diseases of the Ministry of Health of the Republic of Kazakhstan, Chairman of the Kazakhstan Association for the Study of the Liver, told the Expert Health newspaper how the liver works.

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

Zavorotnyuk Alexander, Almaty

Don't overeat to the point where you need medical attention.

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

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

Alekseeva Tamara, Astana

Not certainly in that way. 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 capsule of the liver. 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, they are associated with impaired motor skills, inflammation of the gallbladder or biliary tract.

EZ: How to determine if there are stones and sand in the gallbladder?

Ultrasound diagnostics is the most acceptable method in terms of accuracy, safety and economy. 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 gallbladder, is it necessary to have surgery or are there any therapeutic methods of treatment?

Baydauletova Nurgul, Karaganda

According to existing standards, the presence of stones in the gallbladder is an indication for its removal - a cholecystectomy operation, which is now performed in most cases by laparoscopic method. It is dangerous to postpone the operation, especially when the 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 to which manufacturers indicate the possibility of dissolving small calculi by them, we are talking 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 are dealing 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.), then they should not be used categorically. 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 an emergency complex operation

When is it necessary to do a liver cleanse? How?

Dauletkireeva Galima, Almaty

The liver is not a sewer, and no cleansing is needed. I want to emphasize that if a patient has diseases of the liver itself (for example, hepatitis), then it is impossible to overload the organ and stimulate bile secretion in any case. At the same time, any choleretic herbal preparations are also contraindicated. As for the blind probing procedure called tubage, we used to recommend it to patients with acalculous cholecystitis or gallbladder dysfunction that is accompanied by bile stasis. Now, when there is a large list of choleretic drugs in the arsenal, tubage is not so popular.

EZ: Is it true that there can be nervous disorders in liver diseases? In what way do they appear? And what is the reason for this connection?

Combination neurological disorders with liver pathology occurs with some congenital diseases, for example, Konovalov-Wilson's disease. More often, we, gastroenterologists, are dealing with hepatic encephalopathy. But it's not neurological, but mental disorder that occurs 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 sick liver is not able to neutralize it.

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

Lukinykh Alla, Kostanay

The difference is that they are caused by different viruses that are transmitted through different mechanisms. Hepatitis A is transmitted by the enteral (fecal-oral) route, occurs only in an 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 the blood or other body fluids of an infected patient enter the body of a healthy person. At the same time, in 90-95% of cases, hepatitis B occurs in an acute form and only in 5-10% of cases becomes chronic. The use of approved antiviral therapy regimens allows you to achieve control over the hepatitis B virus (i.e. reduce its concentration in the blood to a safe level or turn the virus into an “inactive” form). Hepatitis C much more often - in about 80 percent of cases - passes into chronic form, and the effectiveness of its antiviral therapy is higher. With proper treatment by a trained specialist, the 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.

Which food puts the most stress on the liver? What food is good for the liver?

Karimova Evgenia, Pavlodar

Alcohol, fatty foods, and especially their combination give the greatest load on the liver. Therefore, the first recommendation for liver diseases is the exclusion of alcoholic beverages and foods containing animal fat.

Dietary fiber, pectin contained in vegetables and fruits are useful for the liver. Do not forget about sufficient fluid intake. IN last years abroad, large population studies have been conducted that have proven the antifibrotic and antitumor effect of coffee, confirmed by 43% of healthy and hepatitis patients who consumed 2 cups of this drink per day.

How much alcohol destroys the liver? Is it possible to somehow 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 a 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 mug of beer. For patients with liver disease, there is no safe dose of alcohol, it must be completely abandoned.

EZ: Is liver cirrhosis reversible and at what stage?

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

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

Zakurdaeva Svetlana, Karaganda

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

EZ: What is the risk? What does this ultimately lead to?

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

Can the liver hurt?

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

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 when, with the loss of 70% of liver tissues, a person retained all chances 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 arise only when the liver capsule is stretched, in which there are just a lot of nerve fibers. 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 malaise and do not see a 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 make you 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 you to make a correct and timely diagnosis. Therefore, you need to be more attentive to your health, to know where the liver hurts in a person, what signs its pathological conditions manifest, and what causes damage to the most important gland of the body.

Why does the liver hurt?

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

Conditions that provoke pain syndrome:

• Intense sports training with improper breathing technique or heavy physical work after a tight 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 overflows with blood and presses on the capsule shell, causing pain.
• A sedentary lifestyle (physical inactivity) causes congestion in the gallbladder and leads to a violation of the outflow of bile, which threatens the formation of stones and provokes hepatic colic. Therefore, if it hurts 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 most adversely affects the state of the liver and provokes pain in the right hypochondrium.

Diseases that lead to pain in the liver:

Any of these causes disruption of the liver 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 occur in advanced cases.

Symptoms

In the early stages of liver problems, it is difficult to identify, since they are manifested by non-specific ailments that an ordinary person can write off as 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 of well-being is due to the fact that the gland does not 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 the brain primarily suffer from disruption of the liver, which causes the above ailments.

As the pathology progresses, more severe symptoms 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). It is believed that this is the main symptom that indicates problems with the liver. At this stage, there are more pronounced signs of the disease:

• pains of a different nature (pulling, aching) in the right hypochondrium;
• an increase in the size of the liver;
• yellowness of the skin and sclera of the eyes;
• indigestion, a feeling of discomfort and heaviness in the abdomen;
• nausea, bitterness in the mouth;
• the appearance of spider veins;
• increased allergic reactions;
• feverish conditions (chills, fever);
• changes in the color of urine (it becomes darker);
• discoloration of feces.

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 how the liver hurts in women is practically no different from the symptoms of the course of the disease in men. But in the representatives of the stronger sex, the course of the disease may be accompanied by sexual dysfunctions, a decrease in the number of spermatozoa and impotence. In addition, many men suffer from alcohol dependence, which most often causes cirrhosis.

How the liver hurts - the symptoms in men and women are generally the same. But the fair sex is more likely to pay attention to the deterioration of appearance. With the progression of the pathology, the complexion changes, the skin acquires a grayish or yellowish tint, bags under the eyes appear, the hair falls out, becomes thin, dry and lifeless. Appears pruritus rashes, nails break off, dysfunctions of the menstrual cycle develop.

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 representatives of the stronger sex who are more prone to bad habits. But alcoholism is an insidious disease that develops much faster and more actively in women. Women become addicted to alcohol faster than men, and this addiction is accompanied by rapidly developing pathologies from the liver and other internal organs. Wherein female alcoholism practically untreated, and the daily intake of ethanol in the body leads to fatty degeneration and cirrhosis of the liver.

With the constant use of alcohol, liver cells die and connective tissue forms in their place. The inflammatory process progresses, the liver increases in size, presses on the capsule shell and provokes pain. Even taking into account the amazing ability to regenerate, long months of treatment will be required to restore the liver, during which it will be necessary to completely abandon alcohol.

How does liver disease affect health?

Pathological changes occurring in the liver are immediately reflected in the appearance. Since the gland cannot fully perform its cleansing functions, toxins 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 (acne, pimples) appear, hair falls out, nail plates exfoliate and break off.

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

Doctors note that almost all patients with excess weight or obese, 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 and do not take analgesics before consulting a doctor! Taking painkillers can blur the picture of the disease, make it difficult to diagnose and have an additional toxic effect on the liver.

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

Which doctor should I contact?

If anxiety symptoms appear, it is recommended to consult a therapist. After an external examination and history taking, the doctor will refer the patient to narrow 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 pain in the liver include a number of laboratory, invasive and non-invasive research methods.

• Laboratory methods include general and biochemical blood tests, hepatitis and cancer cells, immunological and genetic tests(if necessary).
• Non-invasive diagnostic methods are examination of the patient using computer technology (CT, MRI), ultrasound. Modern and informative diagnostic methods allow you to get an idea of ​​the state of the organ, the degree of its damage, determine the size of the liver, the structure of its tissues.
• Investigations 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. Painkillers and antispasmodics are most often used to relieve pain. They should be prescribed by a doctor, since the treatment of this the most important body requires a competent approach and a properly selected scheme of complex treatment.

The main role in the treatment of the liver is assigned to drugs - hepatoprotectors, the action of which is aimed at the regeneration and restoration of liver cells. You need to take them 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 means, which not only stop the pain syndrome, 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 with such severe liver damage as cirrhosis or chronic hepatitis. If the appearance of pain syndrome is accompanied by chronic cholecystitis or cholelithiasis, the treatment regimen includes drugs:

To eliminate spasms, No-shpu, Drotaverine are prescribed. Hepatic colic relieves Trimedat, Buscopan, Duspatalin well. dock acute attack pain will help Riabal, and to normalize intestinal motility and eliminate biliary dyskinesia - Cerucal or Domperidone.

Medicines for pain in the liver should be taken after consulting 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 drugs, it is necessary to call emergency medical care and go to the hospital. acute viral or bacterial hepatitis, liver toxicity, acute cholecystitis treated only in a hospital setting. In other cases, liver pathologies require long-term and regular treatment, constant medication and strict adherence to the doctor's recommendations.

Very good reviews are received by an innovative drug for liver restoration - Leviron duo.

Diet for pain in the liver

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

• fat free dairy products(kefir, curdled milk, 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;
• cereals (buckwheat, pearl barley, oatmeal, millet);
• steam omelets;
• vegetable salads with vegetable oil;
• fresh fruits, vegetables, herbs.

The use of white bread should be limited to 2-3 slices per day, it is best to use it not fresh, but slightly dried, stale. You can make crackers from white bread and serve them with first courses. All products are recommended to be steamed, boiled or baked. Fried foods should be completely excluded from the diet. Of the drinks, green and herbal teas, kissels, compotes, fruit drinks are useful.

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 caused a general intoxication of the body.

It is possible to learn about diseases associated with this organ if you can imagine why it is needed.

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

The liver accumulates the elements necessary for the life 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 body is hematopoiesis. When it is broken, the blood stops clotting.

A person has only one liver, and its removal or destruction leads to death within 1-3 days. You won't be able to survive without this organ. Therefore, when symptoms appear that indicate a violation of functions, measures must be taken immediately to restore working capacity.

Signs of functional disorders

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

Failures are indicated by:

• bitterness in the mouth, which at first appears only in the morning, and then is felt during the day;
• change in color of the tongue - it becomes greenish;
• yellowing of the whites of the eyes and integuments of the skin - the sclera react 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 a large amount of fatty, rich or spicy foods - or a large amount of alcohol, you can not strain. But if they are constantly present, it is advisable to start the examination.

The 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 an increase in 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 a bitter taste is constantly felt in the mouth, a gastroscopy and an ultrasound examination are performed.

Changes and violations of hepatic functions can be guessed by the following signs:

• periodically there is a sensation of hot waves passing along the spine;
• there are spasms of a girdle character, as from an electric shock;
• the spleen is constantly enlarged - in case of violations of the liver, it has to work for wear and tear, performing hematopoietic functions;
• numbness of the fingertips and feet;
• frequent muscle spasms in the limbs;
• thickening and yellowing of the nails.

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

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

Factors that increase the risk of pathologies

Violation of the liver functions cause the following reasons:

• poor quality products;
• bad ecology;
• contaminated water;
• frequent alcoholic libations;
• obesity;
• viral infections;
• genetic factors;
• worm infestations.

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

This destroys the functions of the whole organism - due to the lack of bile in the intestine, favorable conditions are created for the activation of opportunistic flora, immunity decreases - altered cells can no longer differentiate "their" and "foreign" structures, there is a risk of autoimmune diseases.

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

Particularly sensitive to them react brain cells - neurons - 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 to detect changes in liver functions at an early stage.

What to do if the liver hurts?

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

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

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

Medications do not need to be prescribed to oneself on their own - they will be taken after an accurate diagnosis has been established. For some diseases, treatment with other means may be required - antibiotics, drugs for worms or others.

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

Only a doctor can decide which drug 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", "Rezalyut" ..

For the treatment of the liver, drugs from other groups are also used:

• "Ademetionin";
• "Methyluracil";
• ursodeoxycholic and lipoic acids ...

At home, you can try to help the liver, but this is done only after the examination. Cholagogue drugs or dubazh can be used only in cases where there is no cholelithiasis. Otherwise, the cleansing can end badly - the stones will begin to move and get stuck in the bile duct. It is possible to remove them only during the operation.

If the liver hurts a lot, what can be done at home?

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

Probing is carried out according to the following algorithm:

• in the evening make a cleansing enema;
• on an empty stomach they drink water with a diubage agent dissolved in it;
• do a few exercise- squats, bends, twists;
• then they lie on their right side, placing a heating pad under the right hypochondrium and lie for half an hour.

Sorbitol, vegetable oils, egg yolks, vegetable raw materials of choleretic action are used as means for dubazh.

If probing is risky, you can prepare the mixture yourself.

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

Treatment of the liver at home is carried out only after a medical consultation. Self-medication can aggravate the condition. Properly selected therapy will be able to 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 learn about problems with it too late. But they can be prevented.

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

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

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

Pleasant, of course, is not enough, but you should not be upset. The liver is capable of self-healing and is ready to forgive you for decades of inattention to it. You just have to be her friend from now on.

Step one. Ask your doctor if your liver is enlarged. If not, good, then the changes in the structure of the organ are minimal. If yes, it’s also okay: 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, you can not do without severe restrictions and a course of treatment.

Are you taking oral hormonal contraceptives?

You will need to start taking cholesterol-lowering medications.

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

Step two. Find out if liver function is affected. Most often, fatty hepatosis does not disrupt its work. The liver is able to properly perform its functions, even if only 20% of its cells remain “in shape”. To be sure of this, it is necessary 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 results of analyzes and ultrasound images to the gastroenterologist. Even if the size of the organ is enlarged 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 you just have to find a balance in food and drink, together with the doctor, find the line at which you can practically not deny yourself anything, without loading the offended organ. And for control - every three months to 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 a diet and giving up alcohol. “The main thing is that the thought does not get fixed in the head: “I’ll take the medicine - and it’s in the bag, you can eat and drink anything and as much as you like,” doctors say.

But it is possible to supplement the course of "liver rehabilitation" with hepatoprotectors. There is confirmed evidence that against the background of their intake, the liver recovers faster.

How much can you drink so as not to harm the liver? Here doctors agree that this issue is purely individual.

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

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

Max-777 08-07-2014 20:02

Hello everyone!


I’ll make a reservation right away that we don’t take into account the genitals

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

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

silent_hunter 08-07-2014 22:54

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

but in general, the solar plexus is a very weak spot, a strong blow, and you can’t breathe already, but 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?
A couple of times I missed a blow to the sternum, it was very bad!

comrade Beria 09-07-2014 08:37

quote: Originally posted by mihalich1978:

samurai were advised to bite off their tongue in a hopeless situation ...

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

noteA 09-07-2014 17:44

There are no nerve endings in the liver itself. Only the capsule is innervated...

The most sensitive organ is the eye. More specifically, the cornea.

Max-777 09-07-2014 18:05

Tell me, what determines the degree of sensitivity of a particular organ/tissue?
Probably from the number of nerve endings and the "accuracy" of their location?

PRINCIP 09-07-2014 18:12

Officer 1996 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 it?

Officer 1996 09-07-2014 18:50

What is it?

So you ask yourself.

PRINCIP 09-07-2014 19:34

quote: Originally posted by Uryadnik1996:

So you ask yourself.

Shut up, bitch...

Officer 1996 09-07-2014 19:47

quote: Originally posted by PRINCIP:

Shut up, bitch...

Max-777 09-07-2014 20:28

I read how an appendectomy is done under novocaine. So, they write that the mesentery cannot be strongly pulled and pulled,
because the patient becomes very ill from this.

Officer 1996 09-07-2014 20:36

And all sorts of different mesentery of the intestines and the roots of the mesentery, these are also pain zones, right?
I read how an appendectomy is done under novocaine. So, they write that the mesentery cannot be strongly pulled and pulled, because the patient becomes very ill from this.

What is the interest in internal organs?

Max-777 10-07-2014 10:50

Well, it's interesting to know why a blow in one place "folds", and in another place - does not add up.
and which organs are injured

ahin 10-07-2014 11:40

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

PRINCIP 10-07-2014 17:08

quote: Originally posted by ahin:

In general, some suspicious topic.

No... well, what?
Maybe someone needs it for "laboratory work" ... or immediately pass the exam in the torture room.

ahin 10-07-2014 18:40

quote: Originally posted by PRINCIP:

No... well, what?
Maybe someone needs it for "laboratory work" ... or immediately pass the exam in the 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 with your eyes))))

Bajonet 10-07-2014 22:35

Eggs. From the blow on which it is easy to turn off. From a blow to the teeth, eyes and other organs, no one has yet passed out. Moreover, in the battle with wounds to the face, the fighters also fought. An example is Kutuzov. The Turks gouged out his eye, but he still continued the assault.

dimon8-5 10-07-2014 22:45

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

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

Good Monster 11-07-2014 12:46

I have never experienced more pain than in the kidneys.

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 location of the nerve endings.

Wrong common misconception...

Despite great 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 should they, if the destruction of the brain leads to the death of the body? Here the pain is not needed at all, nature has decided correctly. True, pain is felt by the shell in which our brain is enclosed. That 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 written 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 major nerve plexus. Shoulder, cervical, lumbosacral, etc.

hellfire hellfire 12-07-2014 18:58

quote: Originally written by Max-777:
depends on the accuracy of the location of the nerve endings

but according to this indicator, the dental pulp is in the first place.

Samrat 12-07-2014 20:09

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

Shukher 12-07-2014 23:41

The pain is different, it 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

Shukher: I think it's about sharp.

Shukher 13-07-2014 12:00

The piercing pain of a gum tooth or something ... It happens not sourly.
A leg with a crunch in kneecap at 180` so that the tendons would crack ... Also somehow ...
Internal organs only inflammation when it is too late to prevent.
The limit of sensitivity is individual for everyone. For example, at least get tired of hammering one hell in my kidneys, I don’t feel anything, while others are bent.

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:

Dentists treat a peasant, he sits calm, like a cliff over the Volga. The doctor asks him: "Are you in pain?" The little man, as if waking up, - "No, dear, the other day stones were removed from my kidneys .. And you don't HURRY!"

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

He raked both in the eggs and in the liver and in the sun.

I can't say which hurts more. Pretty much the same.
The effect, in fact, is also the same - twisted and helplessly fell to the floor.

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

zhogl 21-07-2014 20:40

Well, I had two knockouts.
1 time we stopped in training with an old glove right in open eye. Didn't even blink, because I didn't see the impact at all. Very painful. And the blow was not strong, a bruise eyeball and it wasn't even close. And there was not even a settling of the sclera, everything went by itself, quickly and without a trace. But it hurt, for about 1-2 minutes - very much.
2 times - at school at recess, they sorted it out with me. Sunny. Twisted, did not fall completely to the floor, because the wall did not give.
If you ask what is more painful - about the same.
And seizures urolithiasis endured, repeatedly. In the sun and the eye - more painful. But teeth are lighter.

Den_black 22-07-2014 16:59

quote: Topic: What is the most painful organ in humans? Where the largest 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 breaks away from athletes in those sports where excessive turns and deflections of the body back are possible, for example. wrestlers, gymnasts, and especially gymnasts.

Nahum 22-07-2014 19:26

In the East, they knew a lot about torture, it is common to beat them on the heels with sticks, as they say, the procedure is very painful.

Bajonet 22-07-2014 19:33

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

federal 23-07-2014 19:55

Once there was such a recess in the knee in front, the piece of iron flew in, I almost vomited from pain, on the same knee when the leg shifted slightly to the left for several hours I walked normally, and when I went to bed I realized that climbing the wall was not a metaphor, I got a Soviet glass syringe, planted two ampoules of novocaine, I realized that it was not helping, I drank two bottles of vodka, and only then could I fall asleep.

hellfire hellfire 02-08-2014 19:01

and also "painfulness" of this or that organ strongly depends on its condition.
inflamed and edematous tissues, as well as ischemic ones, hurt much more

vasillll 05-08-2014 04:45

of course it's a penis

Mr. Gray 11-08-2014 18:31

quote: Originally written by federal:
Once there was such a recess in the knee in front, the piece of iron flew in, I almost vomited from pain, on the same knee when the leg shifted slightly to the left for several hours I walked normally, and when I went to bed I realized that climbing the wall was not a metaphor, I got a Soviet glass syringe, planted two ampoules of novocaine, I realized that it was not helping, I drank two bottles of vodka, and only then could I fall asleep.

1 per knee.

When he injured his knee (torn ACL + meniscus), the leg did not want to bend (pain contracture). This is about 40 minutes after the injury.
Give me, I think I'll move my leg a little stronger in terms of bending - PI * DEC !!! The pain was such that blows to the balls - a light massage!
His eyes darkened, his leg relaxed and bent, making it even more painful.
It feels like you're about to lose consciousness and die.

hellfire hellfire 11-08-2014 18:45

and I would upvote for the liver ...

Mr. Gray 16-08-2014 12:36

Pain and shock are two different things...

zhogl 16-08-2014 17:41

But still strongly related...

Mr. Gray 16-08-2014 19:28

It all depends on the goal of birding pain - if it is neutralized, then shockogenicity is a plus.
And if you force something to tell - in the minus.

hellfire hellfire 16-08-2014 21:29

What is the reason for the "shockogenicity" of this or that area, and how does "shockogenicity" differ from simple morbidity? Interesting...

(from myself: I would venture to suggest that "shockogenicity" appears in those places where there are a large number of endings n. vagus-a)

zhogl 17-08-2014 10:10

quote: And if you force something to tell - in the minus.

We are not special officers, we are purely self-defenders.

quote: (from myself: I would venture to suggest that "shockogenicity" appears in those places where there are a large number of endings n. vagus-a)

Probably, more precisely - where the vagal reaction is more easily caused.
For example, the pain from the fingers is very strong, but the vagal affairs start rather weakly, the client can still run away. But when you hit the ribs, the pain is relatively nothing, but it fetters; obvious vagal affairs and clearly stronger than with fingers.

Rusich 18-09-2014 12:23

I don't wish anyone...

Sashok025 14-10-2014 14:51

quote: Originally written 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 thoracic and abdominal cavities as having the maximum surface area.
Plus, having a high density of receptors per 1 sq. see surfaces.
Well, as a rule, irritation of one small area in these shells quickly spreads over a large area,
as, for example, occurs in 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 and yell.
I don't wish anyone...
#64 He doesn't help me at all.

VLderbyshov 04-12-2014 18:30

quote: Originally written 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 don't think it's possible that such research has been carried out anywhere.

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

effector endings(effectors) that transmit a nerve impulse to the tissues of the working organ,

receptor(affectoral, or sensitive, sensory),

end devices, which form interneuronal synapses and carry out the connection of neurons with each other.

Effector nerve endings

There are two types of effector nerve endings:

motor,

secretory.

motor nerve endings

These are the end 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. 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 sinks into it, involving its plasmolemma and basement membrane.

Neurolemmocytes covering the nerve terminals, in addition to their surface, which is 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. Connective tissue elements at the same time pass into the outer layer of the shell of the muscle fiber. The plasmalemma of the terminal branches of the axon and muscle fiber are separated by a synoptic slit 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 the terminal or thickening 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 stimuli 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.

According to the structural features, sensitive endings are divided into

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

not free, containing in its composition all the components of the nerve fiber, namely the branching 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 of the axial cylinder and glial cells. Outside, such receptors are covered with a connective tissue capsule. An example of such endings is the lamellar bodies that are very common in humans (Vater-Pacini bodies). In the center of such a body is an internal bulb, or flask (bulbus interims), formed by modified lemmocytes (Fig. 150). The myelinated sensitive nerve fiber loses its myelin layer near the lamellar body, penetrates into 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 bodies - Meissner's bodies. These structures are ovoid in shape. They are located in the tops of the connective tissue papillae of the skin. Tactile bodies consist of modified neurolemmocytes (oligodendrocytes) - tactile cells located perpendicular to the long axis of the body. The body is surrounded by a thin capsule. Collagen microfibrils and fibers connect tactile cells with the capsule, and the capsule with the basal layer of the epidermis, so that any displacement of the epidermis is transmitted to the tactile body.

Encapsulated endings include genital bodies (in the genitals) and Krause end flasks.

Encapsulated nerve endings also include muscle and tendon receptors: neuromuscular spindles and neurotendinous 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 an extensible connective tissue capsule - intrafusal fibers. The rest of the 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-contracting part. There are two types of intrafusal fibers: nuclear bag fibers(the central extended part they contain many nuclei) and nuclear chain fibers(the nuclei in them are located in a chain throughout the receptor area).