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In the inferior departments of anticnemion it evaded inside together with receptacles and reached the medial side of ankle joint where it are part on the terminating branches: sub item of planters laterals et medial is, which under lig. Laciniatum was referring to sole. On the path of n. tibia is innervated muscles of back surface of antinomian, patellar and talocrural knuckles, tibia bone and yielded responsive branches to skin of antinomian and stack: n. cutaneous sure medial is and rami cutanei mediales. The first began in popliteal space, together with none of branches. Peroneus formed the item of suralis, to-ry innervated outer surface of ankle joint, periphery edge of stack and outside of V toe. Second innervated skin of the interior of heel and the tail of sole. Larger terminating branch of n. tibialis – the item of plantar is medial is, ha reach soles, it are dived into two trailer branches: medial and literal. Still before the separation it yielded branches to muscles: m. abductor halluces and т. flexor digit rum braves. The medial trailer branch innervated skin of the interior of stack and yielded muscular branches to inner head of m. flexor ballucis braves; n. plantar is medial is concluded in skin of the interior of thumb (n. plantar is halluces medial is). The literal trailer branch are dived into three branches – sub item of digitalis planters communes I, II and III of dactyls. At the forward extremity of each interosseous space each of these branches decomposed on two – nn. Digitalis planter’s proprii – for the sides of I-IV dactyls revers to each other. Second terminating branch of n. tibia is – the item of plantar is laterals together with a. plantar is laterals are refer outside and forward, feature arc, lay under m. quadrates Plantae and т. flexor digit rum brevis, baking plate to-rymi also are dived into two terminating branches to muscles – rami superficial is et prefunds. Before the division yielded branches to muscles about who transited. Ramus superficial is are in turn section into two sprigs: n. plantar is laterals digit quite for the outer side of V dactyl and n. digitalis plantar is IV, to-ry innervated the interior of little finger and the outer side of IV dactyl. The first branch innervated also muscles of V dactyl and piece. interossei IV; the second branch innervated mm. lumbricales III-IV. Ramus profundus formed arc camber forward and outside; nerves departed from this camber for the three first mm. interossei and for muscles of thumb; sometimes from it received sprigs and muscles of little finger, and mm. interossei IV of interosseous space.

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A.Ikhtioz’s apricots and Stupor and the Fish-skin disease Pathological anatomy, p.1, with. 41, M., 1953; Pathological physiology, under the editorship of. A.D.Ado and the Fish-skin disease of the River of Petrov, with. 155, M., 1957. and Piontkovsky.

ISCHIADICUS NERVUS (ischiadikos – sciatic) – sciatic nerve, fell into to nerves of the inferior extremity and are the lengthy and large (to 1,5 sm in diameter) from all peripheral nerves. Originated from roots of sacriplex (plexus sacral is, Liv-Siii) as which continuation it as though served. It are shape about major sciatic hole, through cut left lumen of small basin (through foramen infrapiriforme), transit between tuber ischiadicum and trochanter major, behind from the muscles rotate femur outside of (m. quadrates femora’s); it coat by m. gluteus таximus. Further from top to bottom it went on back surface of femur where are located on the centerline on m. adductor Magnus cover behind with muscles, incur vat antinomian (m. biceps femora’s, т. semitendinosus, in. semimembranosus), and such path reached popliteal space where lay behind and outside from a. popliteal and v. роplitea. Over it fascia popliteal ranged. In most cases in upper to angle of popliteal cavity there are it separation into two terminating branches: one, more thick, as though are more its continuation (n. tibialis); another, more fine (item of peroneus communis); sometimes it are separation descended on half of length of femur, or even both branches can be separate one from another at place of yield of the I. the item from plexus. I. the item innervated muscles of lumen of small basin environ it and back surface of femur (otd see. the color table) also yielded sprigs to sheath of hip joint.

Nervus tibia is – tibia nerve, prolonged path of sciatic nerve; in popliteal space lay behind and outside from popliteal receptacles; then it are tap off downwards on back surface of antinomian, located together with and. and v. tibiae’s posteriors between inner and outside heads of Gastrocnemius muscle.

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In 14 events feature by Kushingom, illness beginning: in 5 events till 20 years, in 5 events from 20 to 30 years, in 2 events after 30 years, and in 2 events the age of patients in the beginning of disease c not be precisely position. Among 73 patients who observe by Ionas, there 55 women and 18 men. Almost at 50 % patients disease beginning aged till 20 years. According to Oppengeymera and Fishberga (Fischberg), the earliest age of the diseased – 6 years and the most serotonin – 42 years. On observations of Rutiskhauzera (Rutishauser), the earliest age of the diseased were 2 years, the most serotonin – 65 years.
The death came from complications (hematencephalon, attack of stenocardia, myocardial infarction, failure of cardiac activity, acute infectious diseases). The mortality averaged nearly 76 %.

Presence of those or other symptoms are cause by expression of the clinical shape and duration of disease. So, according to series of authors, obesity met in 88-97,6 % all events the Fish-skin disease, hypertonia – in 76,8-84,5 %, so-called pre-trial detention centers – crimson cicatricle strips in 60-73,6 %, osteoporosis – at 50-83 %, dynamic – in 27,7-66,5, %, the carbohydrate curve the position sugar Diabetes – in 9,6-15 % all events. Basel metabolism in some cases is normal, is in certain cases raise or depress. In pathogenesis the Fish-skin disease larger role played change of functions of hemadens; so, signs of intensifying of function of thyroid gland, adrenals and dropping of function of sex glands become perceptible.

In some cases the Fish-skin disease the mental shears, characterize was feature by disturbance of higher nervous activity. Some features of mental state of patients were spot by hypertonia, endocrinal-metabolic disturbances. The injury factor is the appreciable disfiguration of the person.
At the syndrome feature for the first time by N.M.Itsenko, symptoms predominated from interstitial brain, at the disease feature by Kushingom, in rare instances are hypnosetherapier it are possible to ascertain dilating of lumen of Turkish saddle and in exclusively rare occurrences – pressure of gr basophilic adenoma crosswise optic nerves with the subsequent temporal hemianopia. Normally basophilic adenomas were small and dilating of lumen of Turkish saddle thus isn’t available.

Disease chronic. Disease lasted some years (on the average 5) and eventually symptoms become more express. Sometimes the beginning of disease happened stormy, all symptoms educed almost simultaneously, sometimes disease began sluggishly, and the one symptom, then and others at first are tap. In single instances development of disease process went very sluggishly.

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In 1925 the syndrome was carefully stud and feature by the Soviet neuropathology’s N.M.Itsenko. In 1946 Н. The m. of Itsenko publishing the express monography devote to studying of this syndrome in who analyzed 17 case histories (15 women and 2 men) from the practice. In two events on section changes in interstitial to brain and f in one event adenoma of forward lobe of hypothesis. Н. The m. of Itsenko figuring that the pathogen etic cause of this disease are the primary lesion of interstitial brain.

Harvey Kushing’s American neurosurgeon (Н. Cushing), feature this syndrome in 1932, considering that the leading cause are the adenoma of forward lobe of pituitary body, and terming this disease «pituitary basophilismus». Without negate value of lesion of interstitial brain, he coming to a conclusion that the basophilic adenoma of pituitary body donated the secret not only in blood, but also at means labialized centers of gray hillock (hypothalamus); and, according to Kushinga, it caused not only obesity, but also hypertension, saccharuria, polyuria and changes in receptacles.

Etiology. Diencephalic changes could reduce owing to neuroinfections, traumas, and diseases of receptacles of brain. The causes of originating of basophilic adenomas were obscure. The guess was c out that at the Fish-skin disease disease of cortex of adrenals, and basophilic adenoma in forward lobe of hypothesis – the phenomenon the secondary is primary.

Y.Bauer (J. Bauer) guessing for the first time (1935) that the pathogenesis of syndrome are reduce to activation of function of cortex of adrenals by the corticotrophin which is exuberantly enter from basophilic adenoma of pituitary body.

In the literature some hundreds events of this syndrome was feature, many events was stud section. So, Ionas (Jonas) at histological studying of pituitary bodies of 35 corpses of the patients who have d from the Fish-skin disease, basophilic adenoma finding in 21 events (60 %), hyperplasia basophilic device in 11,4 %, adenoma in 5,7 %, acidophilic adenoma in 2,8 %, acritical tumor of pituitary body in 5,7 %, willows 14,4 % events of any changes in pituitary body weren’t f. In most cases
Found so-called hyaline dystrophic of basophilic devices of forward lobe of pituitary body.
On the average disease began at the age of 17-25 years more often.

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Pathogenesis. G – disease progress, not intercept in the development if the cause it originating aren’t eliminate, the Ischuria in pelvis caused gradual the dilating propagate on calyxes are more it, differences between pelvis and calyxes Gradually smoothed out, and the general lumen are form. The parenchyma of nephros with development of process will atrophy and turned to fine connective tissue coating more and more. The arrest of development of parenchyma of nephros depended as on positive pressure in the extend lumens of nephros, and from circulatory disturbance, mainly arterial anemia. Disorder in renal circulation led to destruction of the function elements of nephros, glomerular and canalicular systems and replacement of plots of parenchyma by cicatrical tissue.

Speed of development of arrest of development is influence also by anatomical features of nephros. At inside renal pelvis this process are accelerate. Extra renal pelvis, extend even till the larger dimensions, could not cause long time of atrophic changes of parenchyma.

In the urine, nephritic nephros evolve hydras, gradually, with development of process, the salt content and urea fell and, hence, specific gravity of urine decreased. The stages the Hydronephrosis are define not by the dimensions of pelvis, and degree of change of parenchyma and are more its functional capacity.
Pathological anatomy. In early stages the Hydronephrosis choronomicly the nephros differed neither magnitude, nor kind, because only renal pelvis is exposed to dilating; thus the parenchyma of nephros isn’t variants.

In case of frolic Hydronephrosis the nephros are routinely enlarge in volume, the surface it are hilly, the pelvis are extend. On slit the thinning of renal parenchyma became perceptible. Calyxes was am plate, part among themselves by fine septum’s, was report with the extend thin-walled pelvis (see the separate color table). Papilla’s of pyramids was flattening and obsolete. In events extensive the Hydronephrosis to delimit pelvis from obsolete parenchyma of nephros it are not possible. The nephros represented the larger unilocular cyst with sleek surface.

V.I.Braude at path morphologic research hydra are more nephrotic than nephroses noticed that in incipient states the Hydronephrosis educed sharply express hypertrophy of all evenly – muscle bundles in walls of expanded renal calyxes and pelvis in process of advance of hydras of nephrotic process untreated muscles of calyxes and pelvis was gradually substitute by fibrous fibers. In far c stages the Hydronephrosis it are possible to note full replacement hypertrophy evenly – muscular tissue fibrous connective tissue. The hypertrophy muscles of calyxes, and then pelvis was exposed to process of hardening at first.

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One of the frequent causes the Hydronephrosis are the “extension” receptacle (the receptacle to the inferior pole of nephros at loose phylum are more it’s than leg) are more so-called, the cross ureter at place of discharge are more it’s from pelvis. The role of this receptacle remained till now disputable. One authors denied causative role of «extension receptacle» in development the Hydronephrosis, others supposed that it could cause the Hydronephrosis, but under certain conditions, as, e.g., nephroptosis. The majority of authors recognized that «the extension receptacle» in itself could cause the Hydronephrosis. Action of «extension receptacle» on development of the Hydronephrosis could be expressing both in mechanical prelum of ureter, and in influence on nerve-muscular apparatus of ureter. As a result of inflammatory reaction round so-called extension receptacle the perivascular cicatrical commissures fram fix excesses or squeezing ureterovenosus of anastomosis was form (And. Item Frumkin).

The hurdles in lumen of ureter and in lumen of pelvis, valves and operons on mucosa in the field of ureteric anastomosis, narrowing of ureter, tumor of pelvis and ureter, stones, diverticulum’s was. And, at last, last bunch of the causes of development of pyeloectasis and the Hydronephrosis are connected with the function disorders of pelvis and ureter. One – and double-ended atonies of ureterovenosuses was the etiological factor of development of the Hydronephrosis.

Value of the function disorders of ureter proved to be true a lot of researches.
Traumatic Hydronephroses was section on true and false. Clumps of urine and blood concerned the last in perirenal tissue at traumatic tearing up of nephros.

True traumatic the Hydronephrosis arisen because of prelum of ureter hematoma with the subsequent formation of commissures, because of stricture of ureter as a result of it of damage, and also because of damage of the excitatory ganglions of renal plexus. The Hydronephroses result damages of ureterovenosuses concerned the traumatic (gunshot wounds, damages at gynecologic operations).
Traumatic the Hydronephrosis educed sluggishly, but in the literature events was known and very fast formation is more there.