Brain bubbles and their derivatives diagram. Ganglinar plate of the embryo. Primary brain vesicles. Embryogenesis of the brain. Posterior brain vesicle, rhombencephalon. Middle cerebral vesicle, mesencephalon

The head section of the neural tube is the rudiment from which the brain develops. In 4-week-old embryos, the brain consists of three brain vesicles, separated from each other by small narrowings of the walls of the neural tube. These are prosencephalon - forebrain, mesencephalon - midbrain and rhombencephalon - rhomboid (hind) brain. By the end of the 4th week, signs of differentiation of the forebrain into the future telencephalon and intermediate brain - diencephalon appear. Soon after this, the rhombencephalon is divided into the hindbrain, metencephalon, and the medulla oblongata, medulla oblongata, s. bulbus.

The common cavity of the rhombencephalon is transformed into the IV ventricle, which in its posterior sections communicates with the central canal spinal cord and with the intershell space.

The walls of the neural tube in the area of ​​the middle cerebral vesicle thicken more evenly. From the ventral sections of the neural tube, the cerebral peduncles, pedunculi cerebri, develop here, and from the dorsal sections - the plate of the roof of the midbrain, lamina tecti mesencephali. The anterior brain vesicle (prosencephalon) undergoes the most complex transformations during development. In the diencephalon (its posterior part), the lateral walls, which form the visual hillocks (thalamus), reach the greatest development. From the side walls of the diencephalon, optic vesicles are formed, each of which subsequently turns into the retina (retina) eyeball and the optic nerve. The thin dorsal wall of the diencephalon fuses with choroid, forming the roof of the third ventricle, containing the choroid plexus, plexus choroideus ventriculi tertii. A blind unpaired process also appears in the dorsal wall, which subsequently turns into the pineal body, or epiphysis, corpus pineale. In the area of ​​the thin lower wall, another unpaired protrusion is formed, which turns into a gray tubercle, tuber cinereum, funnel, infundibulum, and the posterior lobe of the pituitary gland, neurohypophysis.

The cavity of the diencephalon forms the third ventricle of the brain, which communicates with the fourth ventricle through the midbrain aqueduct.

The telencephalon, the telencephalon, subsequently turns into two bubbles - the future hemispheres of the cerebrum.

3. Arteries of the leg: topography, branches and areas supplied by them. Blood supply ankle joint.

Posterior tibial artery, a. tibialis posterior, serves as a continuation of the popliteal artery, passes in the ankle-popliteal canal.

Branches of the posterior tibial artery: 1. Muscular branches, rr. musculares, - to the muscles of the lower leg; 2. The branch that bends around the fibula, the circumflexus fibularis, supplies blood to the adjacent muscles. 3. Peroneal artery, a. regopea, supplies blood to the triceps surae muscle, the long and short peroneus muscles, is divided into its terminal branches: lateral malleolar branches, rr. malleolares laterales, and calcaneal branches, rr. calcanei, involved in the formation of the calcaneal network, rete calcaneum. A perforating branch, the perforans, and a connecting branch, the communicans, also depart from the peroneal artery.

4. Medial plantar artery, a. plantaris medialis, divided into superficial and deep branches, rr. superficidlis et profundus. The superficial branch supplies the abductor muscle thumb foot, and deep - the same muscle and the short flexor of the fingers.

5. Lateral plantar artery, a. plantaris lateralis. forms a plantar arch, arcus plantaris, at the level of the base of the metatarsal bones, giving off branches to the muscles, bones and ligaments of the foot.

The plantar metatarsal arteries, aa, depart from the plantar arch. metatarsales plantares I-IV. The plantar metatarsal arteries, in turn, give off piercing branches, rr. perforantes, to the dorsal metatarsal arteries.

Each plantar metatarsal artery passes into the common plantar digital artery, a. digitalis plantaris communis. At the level of the main phalanges of the fingers, each common plantar digital artery (except the first) is divided into two own plantar digital arteries, aa. digitales plantares propriae. The first common plantar digital artery branches into three own plantar digital arteries: to the two sides of the big toe and to the medial side of the second finger, and the second, third and fourth arteries supply blood to the sides of the second, third, fourth and fifth fingers facing each other. At the level of the heads of the metatarsal bones, perforating branches are separated from the common plantar digital arteries to the dorsal digital arteries.

Anterior tibial artery, a. tibidlis anterior, arises from the popliteal artery in the popliteal.

Branches of the anterior tibial artery:

1. Muscular branches, rr. musculares, to the muscles of the lower leg.

2. Posterior tibial recurrent artery, a. hesi-rens tibialis posterior, departs within the popliteal fossa, participates in the formation of the knee articular network, supplies blood to the knee joint and popliteal muscle.

3. Anterior tibial recurrent artery, a. recurrens tibialis anterior, takes part in the blood supply to the knee and tibiofibular joints, as well as the tibialis anterior muscle and extensor digitorum longus.

4. Lateral anterior malleolar artery, a. malleold-ris anterior lateralis, begins above the lateral malleolus, supplies blood to the lateral malleolus, ankle joint and tarsal bones, takes part in the formation of the lateral malleolar network, rete malleoldre laterale.

5. Medial anterior malleolar artery, a. malleold-ris anterior medialis, sends branches to the ankle joint capsule, participates in the formation of the medial malleolar network.

6. Dorsal artery of the foot, a. dorsdlis pedis, is divided into terminal branches: 1) the first dorsal metatarsal artery, a. metatarsdlis dorsdlis I, from which three dorsal digital arteries arise, aa. digitdles dorsdles, to both sides of the dorsum of the thumb and the medial side of the second finger; 2) deep plantar branch, a. plantdris profunda, which passes through the first intermetatarsal space onto the sole.

The dorsal artery of the foot also gives off the tarsal arteries - lateral and medial, aa. tarsales lateralis et medialis, to the lateral and medial edges of the foot and the arcuate artery, a. ag-cuata, located at the level of the metatarsophalangeal joints. The I-IV dorsal metatarsal arteries, aa, extend from the arcuate artery towards the fingers. metatarsales dorsales I-IV, each of which at the beginning of the interdigital space is divided into two dorsal digital arteries, aa. digitales dorsales, heading towards the backs of adjacent fingers. From each of the dorsal digital arteries, perforating branches extend through the intermetatarsal spaces to the plantar metatarsal arteries.

4. The vagus nerve, its branches, their anatomy, topography, areas of innervation.

The vagus nerve, n. vagus, is a mixed nerve. Its sensory fibers end in the nucleus of the solitary tract, motor fibers begin from the nucleus ambiguus, and autonomic fibers begin from the posterior nucleus of the vagus nerve. Fibers provide parasympathetic innervation organs of the neck, chest and abdominal cavities. The fibers of the vagus nerve carry impulses that slow down the heartbeat, dilate blood vessels, constrict the bronchi, increase peristalsis and relax the intestinal sphincters, causing increased secretion of the glands of the gastrointestinal tract.

Topographically, the vagus nerve can be divided into 4 sections: head, cervical, thoracic and abdominal.

The cephalic portion of the vagus nerve is located between the origin of the nerve and the superior ganglion. The following branches depart from this department:

1. The meningeal branch, g. meningeus, departs from the superior node and goes to the dura mater of the brain in the posterior cranial fossa, including the walls of the transverse and occipital sinuses.

2. The auricular branch, g. auricularis, starts from the lower part of the superior node, penetrates the jugular fossa, where it enters the mastoid canal temporal bone. Innervates the skin of the posterior wall of the outer ear canal and the skin of the outer surface of the auricle.

Cervical region:

1. Pharyngeal branches, rr. pharyngei, go to the wall of the pharynx, where they form the pharyngeal plexus, plexus pharyngeus. The pharyngeal branches innervate the mucous membrane of the pharynx, constrictor muscles, and muscles of the soft palate, with the exception of the muscle that strains the velum palatine.

2. Upper cervical cardiac branches, rr. cardldci cervicales superiores enter the cardiac plexuses.

3. The superior laryngeal nerve, p. laryngeus superior, departs from the lower ganglion of the vagus nerve, runs forward along the lateral surface of the pharynx and at the level of the hyoid bone is divided into external and internal branches. The external branch, g. externus, innervates the cricothyroid muscle of the larynx. The internal branch, g. internus, accompanies the superior laryngeal artery and, together with the latter, pierces the thyrohyoid membrane. Its terminal branches innervate the mucous membrane of the larynx above glottis and part of the mucous membrane of the root of the tongue.

4. Recurrent laryngeal nerve, p. laryngeus recurrens, The final branch of the recurrent laryngeal nerve is the lower laryngeal nerve, p. laryngealis inferior, innervates the mucous membrane of the larynx below the glottis and all the muscles of the larynx, except the cricothyroid. There are also tracheal branches, esophageal branches, and lower cervical cardiac branches that go to the cardiac plexuses.

The thoracic region is the area from the level of origin of the recurrent nerves to the level of the esophageal opening of the diaphragm. Branches of the thoracic vagus nerve:

1. Thoracic cardiac branches, rr. cardiaci thoracici, are directed to the cardiac plexuses.

2. Bronchial branches, rr. bronchidles, go to the root of the lung, where, together with the sympathetic nerves, they form the pulmonary plexus, plexus pulmonalis, which surrounds the bronchi and, together with them, enters the lung.

3. Esophageal plexus, plexus esophageus, is formed by the branches of the right and left vagus nerves (trunks), connecting to each other on the surface of the esophagus. Branches extend from the plexus to the wall of the esophagus.

The abdominal region is represented by the anterior and posterior trunks, which emerge from the esophageal plexus.

1. Anterior vagus trunk, truncus vagalis anterior. From this vagus trunk the anterior gastric branches, gg. gdstrici anteriores, as well as hepatic branches, g. hepatici, running between the leaves of the lesser omentum to the liver.

2. The posterior vagus trunk, truncus vagalis posterior, passes from the esophagus to back wall stomach, runs along its lesser curvature, gives off posterior gastric branches, rr. gdstrici posteriores, as well as celiac branches, rr. coeliaci. The celiac branches go down and back and reach the celiac plexus along the left gastric artery. Fibers go to the liver, spleen, pancreas, kidney, small intestine and colon.

Ticket number 45

1.Diaphragm: position, parts, function, blood supply, innervation.

Diaphragm, diaphragma , - a movable muscle-tendon septum between the thoracic and abdominal cavities. The diaphragm is the main respiratory muscle and the most important abdominal organ. The muscle bundles of the diaphragm are located along the periphery. Converging upward, from the periphery to the middle of the diaphragm, the muscle bundles continue into the tendon center, centrum tendineum. It is necessary to distinguish between the lumbar, costal and sternal parts of the diaphragm.

Muscle-tendon bundles lumbar part, pars lumbalis, the diaphragm starts from the anterior surface of the lumbar vertebrae with the right and left legs, crus dextrum et crus sinistrum, and from the medial and lateral arcuate ligaments. Right and left leg the diaphragms below are woven into the anterior longitudinal ligament, and at the top their muscle bundles intersect in front of the body I lumbar vertebra, limiting the aortic opening, hiatus aorticus. Above and to the left aortic orifice the muscle bundles of the right and left legs of the diaphragm cross again, and then diverge again, forming the esophageal opening, hiatus esophageus.

On each side between the lumbar and costal parts The diaphragm has a triangular-shaped area devoid of muscle fibers - the so-called lumbocostal triangle. Here the abdominal cavity is separated from chest cavity only thin plates of the intra-abdominal and intrathoracic fascia and serous membranes (peritoneum and pleura). Diaphragmatic hernias can form within this triangle.

Rib part, pars costalis, The diaphragm starts from the inner surface of the six to seven lower ribs with separate muscle bundles that are wedged between the teeth of the transverse abdominal muscle.

Sternal part,pars sternalis starts from the posterior surface of the sternum.

Function: when contracting, the diaphragm moves away from the walls of the chest cavity, its dome flattens, which leads to an increase in the chest cavity and a decrease in the abdominal cavity. When contracted simultaneously with the abdominal muscles, the diaphragm helps to increase intra-abdominal pressure.

Innervation: n. phrenicus.

Blood supply: a. pericardiacophrenica, a. phrenica superior, a. phrenica inferior, a. musculophrenica, aa. intercostales posteriores.

2.Spleen: development, topography, structure, function, blood supply, innervation.

Spleen, lien, performs the functions of immune control of blood. It is located in the path of blood flow from the main vessel great circle blood circulation - the aorta into the portal vein system, which branches in the liver. The spleen is located in abdominal cavity, in the area of ​​the left hypochondrium, at the level from the IX to the XI rib.

The spleen has two surfaces: diaphragmatic and visceral. Smooth convex diaphragmatic surface,fades diaphragmatica, facing laterally and upward towards the diaphragm. Anteromedial visceral surface,faces visceralis, uneven. On the visceral surface there is gate of the spleen,hilum splenicum and areas to which neighboring organs are adjacent. Gastric surface, faces gdstrica, comes into contact with the fundus of the stomach. Renal surface, faces rendlis, adjacent to the upper end of the left kidney and to the left adrenal gland. Colonic surface, fades colica, located below the gate of the spleen, closer to its anterior end.

The spleen has two edges: upper and lower, and two ends (poles): posterior and anterior.

The spleen is covered on all sides by peritoneum. Only in the area of ​​the gate, where the tail of the pancreas faces, is there a small area free of peritoneum.

From fibrous membrane,tunica fibrosa, located under the serous cover, connective tissue crossbars extend into the organ - trabeculae of the spleen,trabeculae splenicae. Between the trabeculae there is parenchyma, pulp(pulp) spleen,pulpa splenica. Red pulp is isolated pulpa rubra, located between venous sinuses, sinus venularis, and white pulp pulpa alba.

Development and age characteristics spleen. The spleen anlage appears at the 5-6th week of intrauterine development in the form of a small accumulation of mesenchymal cells in the thickness of the dorsal mesentery. At the 2-4th month of development, venous sinuses and other blood vessels. In a newborn, the spleen is round and has a lobular structure.

Vessels and nerves of the spleen. The splenic artery of the same name approaches the spleen, which is divided into several branches that enter the organ through its gate. The splenic branches form 4-5 segmental arteries, and the latter branch into trabecular arteries. Pulp arteries with a diameter of 0.2 mm are directed into the parenchyma of the spleen, around which lymphoid periarterial couplings and the periarterial zone of splenic lymphoid nodules are located. Each pulp artery is ultimately divided into brushes - arteries with a diameter of about 50 microns, surrounded by macrophage-lymphoid couplings (ellipsoids). The capillaries formed during the branching of the arteries flow into the wide splenic venular sinuses, located in the red pulp.

Venous blood from the splenic parenchyma flows through the pulpal and then trabecular veins. The splenic vein formed at the portal of the organ flows into the portal vein.

Innervation of the spleen is carried out through sympathetic fibers approaching the spleen as part of the plexus of the same name. Afferent fibers are processes of sensory neurons located in the spinal ganglia.

3.Organs immune system: classification, general patterns of the anatomical organization of immune organs.

The immune system unites organs and tissues that provide protection for the body from genetically foreign cells or substances coming from outside or formed in the body.

The immune system consists of all organs that participate in the formation of lymphoid cells, carry out the body's defense reactions, and create immunity - immunity to substances that have foreign antigenic properties. The parenchyma of these organs is formed by lymphoid tissue, which is a morphofunctional complex of lymphocytes, plasma cells, macrophages and other cells located in the loops of reticular tissue. The organs of the immune system include the bone marrow, in which lymphoid tissue is closely related to the hematopoietic tissue, the thymus (thymus gland), The lymph nodes, spleen, accumulations of lymphoid tissue in the walls of the hollow digestive organs, respiratory systems And urinary tract(tonsils, lymphoid - Peyer's patches, single lymphoid nodules).

With regard to the function of immunogenesis, the listed organs are divided into central and peripheral. To the central organs of the immune system include bone marrow and thymus. In the bone marrow, B-lymphocytes (bursa-dependent) are formed from its stem cells, independent in their differentiation from the thymus. Bone marrow in the human immunogenesis system is currently considered as an analogue of the bursa (bursa) Fabricius is a cell accumulation in the wall of the cloacal intestine in birds.

TO peripheral organs of the immune system include tonsils, lymphoid nodules located in the walls of the hollow organs of the digestive and respiratory systems, urinary tract, lymph nodes and spleen. The functions of the peripheral organs of the immune system are influenced central authorities immunogenesis.

4.Third branch trigeminal nerve and the area of ​​its innervation.

Trigeminal nerve, n. trigeminus, mixed nerve. The motor fibers of the trigeminal nerve begin from its motor nucleus, which lies in the pons. The sensory fibers of this nerve approach the pontine nucleus, as well as the nuclei of the midbrain and spinal tract of the trigeminal nerve. This nerve innervates the skin of the face, frontal and temporal regions, the mucous membrane of the nasal cavity and paranasal sinuses, mouth, tongue, teeth, conjunctiva of the eye, muscles of mastication, muscles of the floor of the mouth (mylohyoid muscle and anterior belly of the digastric muscle), as well as muscles , straining the velum and eardrum. In the area of ​​all three branches of the trigeminal nerve there are vegetative (autonomous) nodes, which were formed from cells that moved out of the rhombencephalon during embryogenesis. These nodes are identical in structure to the intraorgan nodes of the parasympathetic part of the autonomic nervous system.

The trigeminal nerve exits the base of the brain with two roots (sensory and motor) at the place where the pons passes into the middle cerebellar peduncle. Sensitive root radix sensoria, significantly thicker than the motor root, radix motoria. Next, the nerve goes forward and somewhat laterally, entering into the splitting of the dura mater of the brain - trigeminal cavity, cavum trigeminale, lying in the area of ​​the trigeminal depression on the anterior surface of the pyramid of the temporal bone. In this cavity there is a thickening of the trigeminal nerve - the trigeminal ganglion, ganglion trigeminale(Gasser knot). The trigeminal ganglion is crescent-shaped and is a cluster of pseudounipolar sensory nerve cells, the central processes of which form a sensory root and go to its sensory nuclei. The peripheral processes of these cells are sent as part of the branches of the trigeminal nerve and end with receptors in the skin, mucous membranes and other organs of the head. The motor root of the trigeminal nerve is adjacent to the trigeminal ganglion from below, and its fibers participate in the formation of the third branch of this nerve.

Three branches of the trigeminal nerve depart from the trigeminal ganglion: 1) optic nerve(first branch); 2) maxillary nerve (second branch); 3) mandibular nerve (third branch). The ophthalmic and maxillary nerves are sensory, and the mandibular nerve is mixed, containing sensory and motor fibers. Each of the branches of the trigeminal nerve at its beginning gives off a sensitive branch to the dura mater of the brain.

optic nerve,n. ophthalmicus, departs from the trigeminal nerve in the area of ​​its ganglion, is located in the thickness of the lateral wall of the cavernous sinus, and penetrates the orbit through the superior orbital fissure. Before entering the orbit, the optic nerve gives off tentorial (shell) branch, g. tentorii (meningeus). This branch goes posteriorly and branches in the tentorium of the cerebellum. In the orbit, the optic nerve is divided into the lacrimal, frontal and nasociliary nerves.

maxillary nerve,n. maxillaris, departs from the trigeminal ganglion, goes forward, exits the cranial cavity through the round foramen into the pterygopalatine fossa.

Even in the cranial cavity, they extend from the maxillary nerve meningeal (middle) branch, meningeus (medius), which accompanies the anterior branch of the middle meningeal artery and innervates the dura mater of the brain in the region of the middle cranial fossa. In the pterygopalatine fossa, the infraorbital and zygomatic nerves and nodal branches to the pterygopalatine ganglion depart from the maxillary nerve.

mandibular nerve,n. mandibuldris, exits the cranial cavity through the foramen ovale. It contains motor and sensory nerve fibers. When leaving the foramen ovale, motor branches depart from the mandibular nerve to the chewing muscles of the same name.

Ticket number 51

1.Muscles and fascia of the leg, their topography, function, blood circulation, innervation. Anterior tibial, m. tibialis anterior. Beginning: lateral surface of the tibiae, interosseous membrane. Insertion: medial cuneiform and 1st metatarsal bones. Function: extends the foot, raises its medial edge. Innervation: n. fibularis profundus. Blood supply: a. tibialis anterior.

Extensor digitorum longus, m. extensor digitirum longus. Origin: lateral condyle femur, fibula, interosseous membrane. Attachment: foot. Function: extends the toes and foot, raises the lateral edge of the foot. Innervation: n. fibularis profundus. Blood supply: a. tibialis anterior.

Extensor hallucis longus, m. extensor hallucis longus. Beginning: interosseous membrane, fibula. Attachment: nail phalanx of the 1st finger. Function: breaks the foot and big toe. Innervation: n. fibularis profundus. Blood supply: a. tibialis anterior.

Triceps surae muscle, m. triceps surae: Calf muscle, m. gastrocnemius: lateral head (1), medial head (2), Soleus muscle, (3) m. soleus. Origin: above the lateral condyle of the femur (1), above the medial condyle of the femur (2), head and upper third of the posterior surface of the fibula (3). Attachment: tendo calcaneus (calcaneal, Achilles tendon), calcaneal tubercle. Function: flexes the leg and foot and supinates it - 1,2, flexes and supinates the foot - 3. Innervation: n. tibialis. Blood supply: a. tibialis posterior.

Plantar, m. plantaris Origin: above the lateral condyle of the femur. Insertion: calcaneal tendon. Function: tightens the capsule knee joint, bends the lower leg and foot. Innervation: n. tibialis. Blood supply: a. poplitea.

Hamstring muscle, m. popliteus. Origin: outer surface of the lateral femoral condyle. Insertion: posterior surface of the tibia. Function: bends the lower leg, turning it outward, stretches the capsule of the knee joint. Innervation: n. tibialis. Blood supply: a. poplitea.

Flexor digitorum longus, m. flexor digitorum longus. Origin: tibia. Attachment: distal phalanges of 2-5 fingers. Function: flexes and supinates the foot, bends the toes. Innervation: n. tibialis. Blood supply: a. tibialis posterior.

Flexor hallucis longus, m. flexor hallucis longus. Origin: fibula. Insertion: distal phalanx of the thumb. Function: flexes and supinates the foot, flexes the big toe. Innervation: n. tibialis. Blood supply: a. tibialis posterior, a. fibularis.

Tibialis posterior muscle, m. tibialis posterior. Beginning: tibia, fibia, interosseous membrane. Attachment: foot. Function: flexes and supinates the foot. Innervation: n. tibialis. Blood supply: a. tibialis posterior.

Peroneus longus muscle, m. fibularis longus. Beginning: fibula. Attachment: foot. Function: flexes and pronates the foot. Innervation: n. fibularis superfacialis. Blood supply: a. inferior lateralis genus, a. fibularis.

Peroneus brevis muscle, m. fibularis brevis. Beginning: distal 2/3 fibulae. Insertion: tuberosity of the 5th metacarpal bone. Function: flexes and pronates the foot. Innervation: n. peroneus superfacialis. Blood supply: a. peronea.

Fascia of the leg, fascia cruris, fuses with the periosteum of the anterior edge and medial surface of the tibia, covers the outside of the anterior, lateral and posterior muscle groups of the legs in the form of a dense case, from which intermuscular septa extend.

2.Oral cavity, oral diaphragm, palate, pharynx, vestibule and, accordingly, oral cavity. Lips, cheeks, gums.

Oral cavity,cavitas oris, located at the bottom of the head, is the beginning of the digestive system. This space is limited below by the muscles of the upper neck, which form the diaphragm (bottom) of the mouth, diaphragma oris; above is the sky; which separates the oral cavity from the nasal cavity. The oral cavity is limited on the sides by the cheeks, in the front by the lips, and at the back through a wide opening - pharynx,fauces, the oral cavity communicates with the pharynx. The oral cavity contains the teeth and tongue, and the ducts of the major and minor salivary glands open into it.

The alveolar processes of the jaws and teeth divide the oral cavity into vestibule of the mouth,vestibulum oris, And the oral cavity itself,cavitas oris rgbrpa. The vestibule of the mouth is limited externally by the lips and cheeks, and internally by the gums - the mucous membrane covering the alveolar processes of the upper and alveolar parts of the lower jaws, and teeth. Posterior to the vestibule of the mouth is the oral cavity itself. The vestibule and the oral cavity itself communicate with each other through the gap between the upper and lower teeth. The entrance to the oral cavity, or rather to its vestibule, is mouth slit,rima dris, limited to lips.

Upper lip and lower lip,labium superius et labium inferius, They are skin-muscle folds. The base of the lips is formed by fibers orbicularis muscle mouth The outer surface of the lips is covered with skin, the inner surface with mucous membrane. At the edge of the lips, the skin passes into the mucous membrane (transition zone, intermediate part). The mucous membrane of the lips on the threshold of the mouth passes onto the alveolar processes and the alveolar part of the jaws and forms well-defined folds along the midline - the frenulum of the upper lip and the frenulum of the lower lip, frenulum labli superioris et frenulum labii inferioris. The lips, upper and lower, limiting the oral fissure, on each side pass one into the other in the corners of the mouth through the labial commissure - lip commissures,Commissura labiorum.

Solid sky, palatum durum, occupies the anterior two-thirds of the palate; its basis is formed by the palatine processes of the maxillary bones and the horizontal plates of the palatine bones. In the midline on the mucous membrane covering the hard palate, there is a palatal suture, raphe palati, from which 1-6 transverse palatal folds extend to the sides.

Soft sky,palatum molle, makes up one third of the entire palate and is located posterior to the hard palate. It is formed by a connective tissue plate (palatal aponeurosis), attached to the posterior edge of the horizontal plates of the palatine bones, muscles that are woven into this plate, and the mucous membrane covering the soft palate above and below. The anterior section of the soft palate is located horizontally, and the posterior section, hanging freely, forms the velum, velum palatinum. The posterior section of the soft palate ends with a free edge with a small rounded process in the middle - the uvula, uvula palatina.

The composition of the soft palate includes the following striated muscles: tensor velum palatini muscle, levator velum palatini muscle, uvula muscle, palatoglossus muscle, and velopharyngeal muscle.

3.Lymphatic bed and regional lymph nodes of the uterus and rectum.

Diversion drugs uterus go in 2 directions: 1) from the fundus of the uterus along the tubes to the ovaries and further to the lumbar nodes, 2) from the body and cervix in the thickness of the broad ligament to the internal and external lumbar nodes. Also flows into lnn. Sacrales and into the inguinal nodes along the round uterine ligament.

Regional lymph nodes of the uterus are located from the iliac arteries (common, external and internal) to the origin of the upper mesenteric artery from the aorta. The nodes are located along the common and internal iliac vessels and under the place of division of the common iliac artery into external and internal. The uterus also has common iliac lymph nodes and nodes in the area of ​​the aortic bifurcation.

On both sides, the lymph nodes lie in the form of chains from the level of the beginning of the uterine to the place where the inferior mesenteric artery originates from the aorta.

Nodes rectum, accompanying in the form of a chain the superior rectal artery - nodi lymphoidei rectales superiores. Lymphatic vessels and lymph nodes of the rectum are located mainly in the direction of the rectal arteries. From the upper part of the intestine, lymph flows into the nodes located along the superior rectal artery, from the part of the intestine corresponding to the hemorrhoidal zone - into the hypogastric lymph nodes, from the area anus-in inguinal lymph nodes. The efferent lymphatic vessels of the rectum anastomose with lymphatic vessels other pelvic organs.

4.Autonomic plexuses of the thoracic and abdominal cavities.

Autonomic plexuses of the abdominal cavity

Abdominal aortic plexus located in the abdominal cavity on the anterior and lateral surfaces of the abdominal aorta. It is formed by several prevertebral sympathetic ganglia, branches of the greater and lesser splanchnic nerves approaching them, nerve trunks, as well as fibers of the posterior trunk of the vagus nerve and sensory branches of the right phrenic nerve. This plexus has only 3-5 large nodes. The main ones:

1. Paired celiac nodes, ganglia coeliaca semilunar in shape, located to the right and left of the celiac trunk.

2. Unpaired superior mesenteric ganglion, gan mesentericum sur - at the place of origin of the artery of the same name from the aorta.

3. Paired aortorenal nodes, gan aortorenalia - at the point of origin of the renal arteries from the aorta.

Numerous branches arise from the nodes of the abdominal aortic plexus - the “solar plexus” ».

Distinguish secondary autonomic plexuses of the abdominal organs:

1. The celiac plexus is unpaired, represented by numerous nerve trunks entwining the celiac trunk and continuing on its branches.

2. Diaphragmatic plexuses, plexus phrenici, paired, located along the way ah. phrenicae inferiores.

3. Gastric plexuses along the way left gastric artery the superior gastric plexus is formed along the right- lower.

4. Splenic plexus

5. Hepatic plexus along the course a. hepatica propria.

6. Adrenal plexus

7. Renal plexus,

8. Testicular plexus, in women - ovarian plexus .

9. Superior mesenteric plexus.

10. Intermesenteric plexus,

11. Inferior mesenteric plexus.

At the next stage of brain development in embryogenesis at the anterior (rostral) at the end of the tube, three specialized swellings appear: primary brain vesicles - forebrain, midbrain, hindbrain (Fig. 27).

Rice. 27.

From each bladder, one of the three main areas of the brain develops - the forebrain, midbrain and hindbrain. The cavities of each bladder develop into the ventricles of the brain.

Caudal part of the neural tube becomes the spinal cord. The cavity of the caudal part of the neural tube forms the spinal canal.

Differentiation of brain vesicles

At the next stage, differentiation of the primary brain vesicles occurs.

The anterior cerebral vesicle is divided into three secondary vesicles: 1) left and right terminal vesicle; 2) left and right optic bladder; 3) unpaired intermediate vesicle (Fig. 28).

Rice. 28.

The terminal vesicle undergoes the most complex changes during brain development. It develops in four directions.

The left and right bubbles begin to grow back and sideways (completely covering the intermediate bubble). The ventral-medial section of the terminal bladder closes with the lateral (lateral) surface of the intermediate bladder.

The olfactory bulbs and the olfactory nerve are formed from the anterior sections of the left and right bladder.

Cells in the walls of the terminal vesicle divide and differentiate into cortical structures (cerebral cortex) and subcortical structures (basal ganglia).

The neurons of the terminal vesicle form axons, with the help of which they establish connections with other parts of the nervous system. These axons gather into bundles that form three major white matter systems: white matter of the cerebral cortex, corpus callosum (corpus callosum), external capsule.

White matter of the cerebral cortex contains axons that connect neurons located within the cerebral cortex of one hemisphere. Corpus callosum contains axons that connect cortical neurons located in different hemispheres. Outer capsule contains axons connecting the cerebral cortex with the brain stem, in particular with the thalamus.

The internal space of the terminal bladder forms the lateral ventricles of the brain.

Thus, from the telencephalon, the cerebral hemispheres (telencephalon) develop, which include the cerebral cortex, subcortical nuclei, olfactory brain, white matter and lateral ventricles of the brain.

From intermediate bubble are developing thalamus And hypothalamus. The internal space of the intermediate vesicle forms the third ventricle of the brain.

From optic bladder The optic nerve and retina develop. Thus, the retina and optic nerve are part of the brain and not the peripheral nervous system.

Medium bubble undergoes minor changes compared to the anterior bladder. The dorsal side of the middle bladder develops into a hectum or quadrigemina. The ventral side of the middle vesicle develops into the tegmentum (Fig. 29). The narrow internal space filled with cerebrospinal fluid turns into cerebral aqueduct, which connects the third and fourth cerebral ventricles.

Rice. 29.

Posterior bladder develops into three structures: 1) cerebellum; 2) Varoliev Bridge; 3) medulla oblongata (Fig. 30). The cerebellum and pons are formed from the rostral portion of the posterior bladder. The cerebellum is formed from the rhomboid lips, which are located on the dorsal side of the posterior bladder. The lips grow dorsally and medially, then join together into a single unit. The ventral wall of the posterior bladder forms the pons. The medulla oblongata is formed from the caudal part of the posterior bladder. The ventral and lateral sides of the bladder grow, and the dorsal side turns into a thin roof consisting of ependymal cells. On the ventral side medulla oblongata white matter is formed (pyramids of the medulla oblongata).

Rice. 30. Differentiation of the posterior bladder: A - development of the rostral portion of the posterior bladder; b- development of the caudal portion of the posterior bladder

In Fig. Figure 30 shows the development of the posterior bladder. The internal space of the posterior bladder, filled with cerebrospinal fluid, turns into the fourth cerebral ventricle (Fig. 31).

Rice. 31.

In Fig. 31 shows the development of the spinal cord.

Development of the cerebral hemispheres

The surface of the cerebral cortex grows greatly during ontogenesis, forming numerous folds (furrows and convolutions). The main stages in the development of the cerebral cortex are presented in Fig. 32-33.

Rice. 32.

Rice. 33.

development

The cerebral cortex is differentiated into four large lobes: 1) frontal; 2) parietal; 3) temporal; 4) occipital (see Fig. 33).

Embryogenesis of the brain. Posterior brain vesicle, rhombencephalon. Middle cerebral vesicle, mesencephalon.

Neural tube very early it is divided into two sections corresponding to the brain and spinal cord. Its anterior, expanded section, representing the rudiment of the brain, as noted, is divided by constrictions into three primary brain vesicles lying one behind the other: anterior, prosencephalon, middle, mesencephalon, And posterior, rhombencephalon. The anterior brain vesicle closes in front of the so-called end plate, lamina terminalis. This stage of three vesicles, upon subsequent differentiation, passes into the stage of five vesicles, giving rise to the five main parts of the brain. At the same time, the brain tube bends in the sagittal direction. First of all, in the region of the middle bladder, a dorsally convex cephalic curve develops, and then, at the border with the spinal cord rudiment, a dorsally convex cervical curve also develops. Between them, a third bend is formed in the region of the posterior bladder, convex to the ventral side - the pontine bend.

Through this last bend posterior medullary vesicle, rhombencephalon, divided by two departments. Of them posterior, myelencephalon, turns into the medulla oblongata during final development, and from the anterior section, called metencephalon, the pons develops on the ventral side and the cerebellum on the dorsal side. Metencephalon separates from the midbrain vesicle lying in front of it narrow constriction, isthmus rhombencephali. Common cavity rhombencephalon, which has the shape of a rhombus in a horizontal section, forms the IV ventricle, communicating with the central canal of the spinal cord. Its ventral and lateral walls become greatly thickened due to the development of the cranial nerve nuclei in them, while the dorsal wall remains thin. In the region of the medulla oblongata, most of it consists of only one epithelial layer, fused with the soft membrane ( tela choroidea inferior). Walls mesencephalon, mesencephalon, thicken with the development of brain matter in them more evenly. The cerebral peduncles arise from them ventrally, and the roof of the midbrain arises from them dorsally. The cavity of the middle bubble turns into narrow channel - water supply, connecting to the IV ventricle.

Due to the fact that this group cells arising from paired primordia and soon again divided into right and left components, it can be considered a paired structure, although due to its temporary median position dorsal to the neural tube it was called the ganglion plate.

Ganglion plate grows in the anteroposterior direction. During further development its cells migrate ventrolaterally on both sides of the spinal cord and at the same time segments begin to form. Metamerically located groups of cells arising from the ganglion plate give rise to the ganglia of the dorsal roots of the spinal nerves, and in the head region they form the ganglia of the cranial nerves, which have sensory components.

Primary brain vesicles

It was noted above noticeable expansion of the anterior part of the neural plate. When the neural tube is formed from the neural plate, its anterior part in the area of ​​​​the future brain has a larger diameter. The spinal cord is formed from the thinner part of the neural tube, located caudal to the expanded cephalic region.

Already with your emergence the brain shows some signs of differentiation into sections. In four-week-old human embryos, three regions of the brain can be distinguished. These are the so-called forebrain, midbrain and hindbrain. The forebrain (prosencephalon) is the widest due to the presence of optic vesicles, which arise in the form of outgrowths from its lateral walls.

In the very front parts of the forebrain complete closure of the neural folds slows down somewhat. An opening known as neuroporus anterior remains there for some time.

Midbrain(mesencephalon) is separated from the anterior and somewhat less clearly from the posterior by small narrowings of the walls of the neural tube. In early embryos, the mesencephalon exhibits minor local specialization prior to the formation of specific structures.

Its roof increases in thickness and differentiates into the corpora quadrigemina (centers associated with vision and hearing), and along its bottom large fibrous tracts crurae cerebri are formed, which connect the higher cerebral suits with the spinal cord.

Caudal end The hindbrain, or rhombencephalon, gradually passes into the thinner part of the neural tube, which later turns into the spinal cord. The most interesting feature of the latter in its early stages is the clear signs it exhibits of neuromeric extensions, indicating that the brain also has a fundamentally metameric organization.

Exact homology characteristic enlargements of the brain with specific neuromeres of precancerous forms has not yet been established. Controversy surrounds the issue of fusion of neuromeres in the anterior part of the brain. At least 11 extensions can be seen in the embryonic brain, but only the more posterior ones have a characteristic appearance. Some of the anterior extensions undoubtedly represent several neuromeres. It is quite possible that there are at least 15 neuromeres in the vertebrate brain.

The brain is formed from the anterior section of the neural tube, which already in the earliest stages of development differs from the trunk section in its width. The uneven growth of different sections of the wall of this section leads to the formation of three protrusions located one after another - the primary brain vesicles: anterior, prosencephalon, middle, mesencephalon, and posterior, rhombencephalon. Next, the anterior and posterior cerebral vesicles are divided into two secondary cerebral vesicles, resulting in five interconnected cerebral vesicles, from which all parts of the brain develop: terminal, telencephalon, intermediate, diencephalon, middle, mesencephalon, posterior metencephalon, and accessory, myelencephalon. The process of formation of five brain vesicles occurs simultaneously with the appearance of bends of the brain tube in the sagittal direction. First, the dorsal parietal flexure appears in the mesencephalon area, then in the same direction - the occipital flexure between the myelencephalon and the spinal cord, and finally the third ventral pontine flexure in the metencephalon area. This process is accompanied increased growth lateral sections of the head end of the neural tube and a lag in the growth of the dorsal and ventral walls (integumentary and bottom plates). The thickened lateral sections are divided by a boundary groove into the main and wing plates, of which the neuroblasts of the main plate form motor centers, and the neuroblasts of the wing plate form sensory centers. Between both plates in the intermediate zone there are important autonomous centers. The border groove can be traced throughout the trunk and head sections of the neural tube to the diencephalon. The main plate ends here, and therefore the nerve cells of the telencephalon are derived only from the alar plate. The most significant differentiation and changes in shape are observed during the development of the forebrain derivatives telencephalon and diencephalon.

Figure: Brain development (according to R. D. Sinelnikov).
a - five brain vesicles; 1 - first bubble - telencephalon; 2 - second bubble - diencephalon; 3 - third bubble - midbrain; 4 - fourth bubble - the hindbrain itself; 5 - fifth vesicle - medulla oblongata; between the third and fourth bladders there is an isthmus; b - model of a developing brain at the five-vesicle stage.

The telencephalon, the telencephalon, is formed from a paired protrusion forward and outward of the wall of the primary forebrain bladder, from which the right and left hemisphere brain The stacks of these protrusions quickly increase in volume, significantly outstripping other parts of the brain in growth, and cover the derivatives of other brain vesicles, first from the sides, and then from the front and top. The uneven growth of the medulla determines the appearance of grooves and convolutions on the surface of the formed hemispheres, among which those that appear the earliest (sulcus cerebri lateralis, sulcus centralis, etc.) are more consistent. As the hemispheres grow, the longitudinal gap between them deepens and the configuration of their cavities—the lateral ventricles—changes sharply. The interventricular foramen, connecting the lateral ventricles with the third, narrows. Clusters develop at the base of the hemispheres gray matter- basal or subcortical nuclei. The rudiment of the olfactory brain also belongs to the derivatives of the telencephalon.
The diencephalon, the diencephalon, is formed from the posterior part of the forebrain. During development, a sharp thickening of the lateral walls of this section occurs, where large accumulations of gray matter are formed - the visual tuberosities. Moreover, in very early stage development, when the division of the anterior cerebral vesicle is just beginning, the lateral walls give off external protrusions - two optic vesicles, from which the retina eyes and optic nerves. The strong development of the visual thalamus sharply narrows the cavity of the diencephalon and turns it into a narrow longitudinal fissure - the third ventricle. The pineal body develops from the dorsal wall of the diencephalon, and the gray tubercle, infundibulum and posterior lobe of the pituitary gland are formed from the protrusion of the ventral wall. Posterior to the gray tubercle, the rudiments of the mamillary bodies are identified.
The middle cerebral vesicle, mesencephalon, is characterized by a fairly uniform thickening of the walls, which turns its cavity into a narrow canal - the cerebral aqueduct connecting the third and fourth ventricles of the brain. The quadrigeminal plate develops from the dorsal wall of the bladder, first the lower and then the upper tubercles. The ventral wall of the bladder, in connection with the development of cells and fibers of other parts of the brain, turns into massive fibrous bundles - the cerebral peduncles.
The hindbrain, rhombencephalon, is divided into the hindbrain, metencephalon, and the medulla oblongata, myelencephalon, as well as into a narrow constriction - the isthmus of the rhombencephalon, isthmus rhombencephali, which separates the hindbrain from the midbrain. The superior cerebellar peduncles and the anterior medullary velum develop from the isthmus. On the ventral side, a bridge is formed, and on the dorsal side, first the vermis, and then the cerebellar hemispheres. The development of myelencephalon leads to the formation of the medulla oblongata.
The cavities of the metencephalon and myelencephalon merge and form the fourth ventricle of the brain, which communicates with the central canal of the spinal cord and the cerebral aqueduct. The ventral and lateral walls of the ventricle sharply thicken during development, but the dorsal wall remains thin and in the region of the medulla oblongata consists only of an epithelial layer, which fuses with the choroid of the brain, forming tela chorioidea inferior.