Absence Symptom of “a return jerk», speaking also a hypotension and disturbance of an opposing innervation; the patient holds an arm before itself, with force incurvating it in an ulnar joint in what to it there is a resistance; at the sudden termination of order ultram resistance the arm of the patient with force strikes in a breast. At healthy it does not occur, as fast including in action of antagonists (forearm extensors) - «a return jerk» - prevents blow.
Disorder of handwriting is a consequence of disturbance of coordination of thin movements and a tremor; handwriting becomes rough, lines - zigzag, letters - too large (macrography).
Underestimation of gravity of the subject kept by an arm, is the original symptom observed on the party of a lesion.
Маятникообразные, or «пендулярные», reflexes are caused, apparently, by the same hypotension. At research of a knee reflex in position sitting, with anticnemions freely hanging down from a couch, after blow молоточком on lig. patellae, “pumped” movements of an anticnemion are observed some.
Change постуральных reflexes also is one of symptoms of a lesion of a cerebellum. Here it is possible to result manual phenomenon Дойникова; if to the sitting patient to suggest to keep in position of a supination of a brush of arms with sharply divorced fingers, put in a lap, on the party of a cerebellar lesion (we will notice, that the same is observed and at a paresis) quickly there is a flexion of fingers and a brush pronation.
Giddiness is frequent enough symptom of acutely arising lesions of a cerebellum.
At a lesion of communications nucleus dentatus with nucleus ruber there can be extrapyramidal hyperkinesias; at a lesion of the bottom oliva or its communications with nucleus dentatus myoclonias of tongue, a pharynx, a soft palate are sometimes observed.
At a lesion of a worm statics and gait disorders prevail; at a lesion of hemispheres of a cerebellum smoothness and accuracy of movements гомолатеральных extremities (интенционное a tremor) especially suffer.CAUDAL GROUP
Twelve pairs nerves share on purely sensitive 3 pairs, 6 impellent and 3 admixed (having both sensitive and impellent fibers). Strictly speaking, purely impellent cranial nerves does not exist, as in each of them there is a known quantity and sensitive fibers (deep sensitivity).
On the parentage, a structure and function the last 10 cranial nerves (III - XII) essentially do not differ from the spinal. So, sensitive fibers of cranial nerves are not that other, as fibers of the sensory cells located in special ganglions, interconvertible to intervertebral spinal knots; axons of these cells pass in structure of a sensitive root of a corresponding cranial nerve (гомолог a back sensitive spinal root) and enter sensitive kernels of a cerebral trunk (correspond to back horns of a spinal cord), finishing at cells of the last the first (peripheric) sensitive neurone.
Impellent fibers of cranial nerves vpxl begin from cells of impellent kernels (гомологи forward horns of a spinal cord) and leave as a part of an impellent root a cerebral trunk (are interconvertible to a forward root of a spinal cord).
According to the mentioned similarity, and in pictures of a lesion of cranial nerves, their roots and kernels we see familiar lines of a lesion of spinal nerves and grey substance of a spinal cord. So, the lesion of an impellent kernel, a root or the most impellent cranial nerve gives a symptom-complex of a flaccid paralysis of a corresponding musculation. The lesion of a root of a sensitive cranial nerve in a cerebral trunk differs from a lesion of its kernel the same lines which allowed us to differentiate a lesion of a back sensitive spinal root from a back horn: pains, disturbance of all kinds of sensitivity - in the first case, and the split disorders of sensitivity - in the second. We will survey caudal group of nerves (tab. 9).

XI pair, n. accessorius Willisii - a motor nerve. N. accessorius (eleventh cranial nerve) by right can be considered still as a spinal nerve. The cells which are giving rise to its fibers, are located in the long kernel which is in grey substance of a spinal cord at level I - V (partly and VI - VII) cervical segments in the basis of a forward horn (fig. 23, 24 and 47). Its thin roots buy cipro (number 6 - 7) leave on a lateral surface of a spinal cord between forward and its back roots at level CI - СVI - CVII segments and merge in one general стволик a nerve, following inside позвоночного the channel along a lateral surface of a spinal cord up. Further the nerve enters into a skull cavity through foramen occipitale magnum, passes in a direction to foramen jugulare, whence again leaves a skull (fig. 27 see). Иннервирует m. stemo-deido-mastoideus and m. trapezius (cucullaris). Function of the given nerve is head turn in an opposite side (m. sterno-cleido-mastoideus), приподнимание brachiums, a scapula and an acromial part of a clavicle up («пожимание shoulders»), shoulder girdle procrastination кзади and scapula reduction to a backbone, and also поднимание brachiums above a horizontal (m. trapezius). At a lesion of a kernel, a root or a nerve the peripheric or atrophic paralysis иннервируемых muscles develops. Thus m. Sterno - cleido-mastoideus and top department m. trapezii атрофированы, head turn in the healthy party is complicated, the shoulder on the sick party is lowered, the scapula the bottom angle departs from a backbone кнаружи and upwards. At the patient it is complicated пожимание by a shoulder, it is limited поднимание arms above a horizontal line.
Cramps of muscles, иннервируемых XI nerve, are observed in the isolated kind seldom; often they happen unilateral and grow out cortical or subcortical a boring. The tonic cramp gives a picture «кривошеи» (torticollis spasti-cus); clonic - head twitchings in an opposite side, sometimes with simultaneous подниманием brachiums.
The bilaterial clonic cramp leads кивательным to head movements (салаамова a cramp, spasmus nutans).
Fig. 25. The geometrical scheme of a rhomboidal fossa (on L.V.Blumenau).
abed - all rhomboidal fossa; abc - the bottom triangle belonging to an oblong brain; Ьа and be - веревчатые bodies; ае and cd - striae medullares; beh - trigonum hypoglossi: bhg - trigonum vagi; aghf - area acustica.
XII pair, n. hypoglossus - a motor nerve. A kernel n. hypoglossi is in a bottom of a rhomboidal fossa, it is located dorsally in depth trigonum hypoglossi (fig. 25); caudal department it reaches from top to bottom to I - II cervical segment (fig. 23 and 24 see). Roots (number 10 - 15) leave between pyramids and olivas of an oblong brain (fig. 22 see) and merge in the general стволик which leaves a skull through canalis hypoglossi (see fig. 27).
N. hypoglossus is a tongue motor nerve. At (its lesion the flaccid paralysis or a paresis of a corresponding half of tongue with an atrophy and a thinning of buy rimonabant muscles (develops at a kernel lesion are observed as well fibrillar twitchings). At высовывании tongue from a mouth it deviates the extremity towards the amazed muscle. It occurs because m. genio-glossus the healthy party, pushing tongue forward is stronger, shifts tongue in a direction of a weak half (fig. 26). Unilateral a tongue lesion (hemiglossoplegia) does not cause appreciable disturbances of functions that speaks an appreciable interlacing of both muscular fibers gоловин, i.e. Call of the last for an average line on other party. The bilaterial lesion of tongue (glossoplegia) is conducted to disturbance of speech which becomes vague, insufficiently clear, braided by) (dysarthtia); In easy cases it manages to be found out only at pronouncing of difficultly articulated words (for example «Serum from under curdled milk»).
At a full bilaterial lesion of tongue speech becomes impossible (anarthria); tongue is motionless, cannot be will put out from a mouth. It is clear, that meal process is thus sharply complicated also: the alimentary lump cannot be moved in a mouth for chewing, will move to a pharynx for проглатывания.
At identical basically the picture of the flaccid paralysis resulting a lesion of a kernel, a root or a nerve, lesion level manages to be established usually more precisely. For chronic progressing processes in the kernel are characteristic, as it has already been told, fibrillar twitchings. Besides, at a nuclear lesion of XII nerve simultaneously with tongue it is amazed, separately from all other facial musculation, m. orbicularis oris (a thinning, складчатость labiums, impossibility of whistle). The specified circumstance presumably can be explained that impellent fibers for a circular muscle of a mouth, going on periphery as a part of a facial nerve