Reception voyachek testimony. Research of sensory systems

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Functional tests that assess the state of the nervous system

Romberg test

They offer to stand with closed feet, a raised head, arms outstretched forward and eyes closed.

The test can be made more difficult by placing the legs one after the other along the same line, or you can test this position while standing on one leg.

Finger-nose test

From the position of the outstretched hand, the subject puts his finger into the tip of the nose with his eyes closed.

Heel-knee test

Get the heel into the knee of the opposite leg and hold along the lower leg in a prone position with your eyes closed.

Voyachek's test

The subject sits in a chair with a head tilt of 90° and eyes closed. Performs 5 rotations in 10 seconds.

After a five-second pause, the subject is asked to raise his head. Before and after rotation, the pulse is counted and blood pressure is measured.

Assessment: three degrees of severity of reaction to rotation:

1 - weak (torso thrust in the direction of rotation);

2 - medium (obvious torso inclination);

3 - strong (tendency to fall).

At the same time, vegetative symptoms are assessed: blanching of the face, cold sweat, nausea, vomiting, increased heart rate, changes in blood pressure.

VNIIFK sample

After measuring blood pressure and pulse, the subject is asked to perform a task for accuracy and coordination, then he tilts his body 90 0 anteriorly, closes his eyes and rotates around his axis with the help of a doctor.

Rotation speed 1 revolution in 2 s. After 5 rotations, the athlete maintains the tilt position for 5 seconds, then straightens up and opens his eyes. After counting the pulse, measuring blood pressure and examining nystagmus, it is again suggested to perform the same set of movements as before rotation. The less the accuracy of the given movements is violated, the pulse and blood pressure values ​​change, the higher the fitness of the vestibular apparatus.

Yarotsky's test

The subject takes the position of the main stand, rotates his head in one direction at a speed of 2 rotations per 1 sec. The time during which the subject maintains balance is recorded.

The norm for untrained people is at least 27 seconds, for athletes it is higher.

Orthostatic test

It is used to study the functional state of the vegetative nervous system, her sympathetic department. After a 5-minute stay in a horizontal position, the subject's pulse is determined at 10-second intervals, blood pressure is measured. Then the subject stands up, and in a standing position, the pulse is counted for 10 seconds and blood pressure is measured. With normal excitability sympathetic department there is an increase in heart rate by 20-25% of the original. Higher numbers indicate increased (unfavorable) excitability of the sympathetic division of the autonomic nervous system. Blood pressure is normal when standing up, compared with the data in a horizontal position, changes little. Systolic pressure fluctuates within ±10 mm Hg. Art., diastolic - ± 5 mm Hg. Art.

clinostatic test

Applicable for research parasympathetic department autonomic nervous system. After 5 minutes of adaptation in a standing position, blood pressure and pulse are measured, then the subject lies down. The pulse and blood pressure are again recorded. Normally, the decrease in heart rate during the transition to a horizontal position is not more than 6-12 beats. per minute, while a slower pulse indicates the predominance parasympathetic influences. BP ±10 mmHg Art. - systolic, ±5 mm Hg. Art. - diastolic.

Ashner test

In the position of the subject lying down, we press on eyeballs 15-20 s. The pulse is normally reduced by 6-12 beats. 1 min from the initial, which indicates the normal excitability of the autonomic nervous system.

Samples to assess the functional state of the respiratory system

Stange test

The subject in a sitting position, after a short rest (3-5 minutes), takes a deep breath and exhale, and then inhales again (but not the maximum) and holds his breath. Using a stopwatch, we record the breath holding time. For men, it is at least 50s, for women - at least 40s. For athletes, this time is from 60 s to several minutes. In children of 6 years: boys - 20s, girls - 15s, 10 years: boys -35s, girls - 20s.

Genchi test

In a sitting position after rest, the subject takes several deep breaths and, on exhalation (not maximum), holds his breath. In healthy untrained individuals, the breath holding time is 25-30 seconds, in athletes - 30-90 seconds.

Stange and Genchi tests allow assessing the body's ability to tolerate hypoxia and are used for medical control in CT, health-improving physical training, and in mass sports. For diseases of cardio-vascular system, respiratory organs, anemia, the time of holding the breath decreases.

Rosenthal test

Five-time measurement of VC with a spirometer at 15-second intervals.

Grade:

• VC increases - good;
• VC does not change from measurement to measurement - satisfactory;
• VC decreases - unsatisfactory.

Combined Serkin test

Consists of 3 phases.

• 1st phase - holding the breath while inhaling (sitting),
• 2nd phase - holding the breath while inhaling immediately after 20 squats for 30 seconds,
• 3rd phase - holding the breath while inhaling after 1 minute of rest.

The results are evaluated according to the table.

Indicators of breath holding time are normal (Serkin's test)

Pirogova L.A., Ulashchik V.S.

This section discusses the indicators for assessing the functional state of the vestibular and visual analyzer.

To the main indicators of functional state assessment vestibular analyzer athletes include the results of rotational tests of Yarotsky, Voyachek, Bryanov, etc.

The simplest and most accessible test is Yarotsky test, the essence of which is as follows: rotational movements of the head are performed at a rate of 2 rotations per second. The evaluation of the sample is carried out by determining the time during which the subject is able to maintain the balance of the body. Fine healthy people maintain balance for an average of 30 s, and athletes - 90 s or more.

Voyachek test. The subject is in a sitting position in Barany's chair, his head is pressed to his chest, his eyes are closed. Rotation is carried out 5 times in 10 s, that is, at a pace of 1 vr. / s. At the end of the rotation, he continues to sit with his eyes closed for 5 s, and then quickly raises his head and opens his eyes. Before the test and immediately after it, the subject's heart rate and blood pressure are measured.

Sample evaluation carried out according to the deviation of the body, vegetative symptoms, which include blanching, sweating, nausea, vomiting, changes in heart rate and blood pressure:

Weak reaction - changes are absent or expressed insignificantly (a slight deviation of the body, ADmax. rises by 8-11 mm Hg. Art.);

Moderate - heart rate does not change, maximum blood pressure rises by 12-23 mm Hg. or decreases by 9 -14 mm Hg. Art.;

Expressed - the pulse slows down, the maximum blood pressure rises by more than 24 mm Hg. Art., or decreases by more than 15 mm Hg. Art., other vegetative reactions appear;

Strong - sudden changes in heart rate, blood pressure, pronounced other vegetative reactions.

Bryanov's test. The subject sits in Barany's chair, the body is tilted forward as much as possible, the eyes are closed. Against the background of uniform rotation at a speed of 1 revolution in 2 s, after the 5th revolution, the subject begins to perform cyclic rocking movements (straighten and tilt the body) at a pace of 1 cycle in 6 s. In order for the rate of inclination and straightening to be controlled by the subject himself, he is asked to pronounce two-digit numbers aloud. In addition to the first 10 s, the rotation accompanied by rocking movements lasts 1 min. Then the chair is stopped. Within 1 min, the severity of vegetative reactions is examined and subjective sensations are clarified. Then, in the absence of pronounced vegetative reactions, the study is continued in the same order, but the chair is rotated in the opposite direction.

Grade Bryanova's tests: high vestibular resistance is characterized by the absence of vegetative reactions and complaints after 2 minutes of rotation.

The main criteria of functionality visual analyzer are visual acuity and visual field boundaries.

For research visual acuity Golovin-Sivtsev tables are used, in which there are 12 rows of characters (a table with letter optotypes and a table consisting of Landolt rings). In these tables, the letters were not chosen by chance, but on the basis of an in-depth study of the degree of their recognition. a large number people with normal vision.

In each row, the sizes of optotypes are the same, but gradually decrease from the first row to the last. The tables are calculated for the study of visual acuity from a distance of 5 m. At this distance, the details of the optotypes of the 10th row are visible at an angle of view of 1°. Consequently, the visual acuity of the eye that distinguishes the optotypes of this row will be equal to 1. If the visual acuity is different, then it is determined in which row of the table the subject distinguishes signs. In this case, visual acuity is calculated by the formula:

where V is visual acuity, where d - the distance from which the study is carried out; D - the distance from which the normal eye distinguishes the signs of this row (marked in each row to the left of the optotypes).

The field of view is the space that the eye sees when its state is fixed. In the study of the field of view, the peripheral boundaries and the presence of defects in the field of view are determined. Peripheral vision is determined by the field of view. Peripheral vision is carried out mainly with a rod apparatus. It allows a person to navigate well in space, to perceive all kinds of movements. Peripheral vision is also twilight vision, because. rods are highly sensitive to low light. There are several ways to determine the field of view.

Donders control method: the patient and the doctor sit opposite each other at a distance of 1 m and close one opposite eye each, and the open eyes serve as a fixed point of fixation. The doctor begins to slowly move his hand or other object from the periphery of the field of view, moving it gradually to the center of the field of view. The subject must indicate the moment when he notices a moving object in his field of vision. The study is repeated from all sides. If the subject sees the appearance of the hand when the doctor does, then we can say that the boundaries of the patient's field of vision are normal. Necessary condition is the doctor's normal field of vision. This method is indicative and only detects gross changes in the field of view. It is suitable for the study of seriously ill patients, especially those who are bedridden. You can define the boundaries of the field of view using computer perimetry, and most accurately - when projecting them onto a spherical surface. The study in this way is called perimetry and is carried out using devices called perimeters. The most widely used electric projection-registration perimeter (PRP). In many cases, it is not inferior in accuracy Foerster perimeter which is the easiest to handle. On PRP, the study is always carried out under the same conditions, depending on visual acuity and other reasons, the size, color and lightness of objects change.

The data obtained is plotted on a chart. In all cases, it is necessary to examine the field of view in at least 8 meridians. The boundaries of the field of view for colors are narrower than for White color. The normal boundaries of the visual fields are given in Table. eleven.

Table 11

Normal visual field limits (in degrees)

The boundaries of the visual field are normally influenced by numerous factors, such as the depth of the anterior chamber and the width of the pupil, the degree of attention of the subject, his fatigue, the state of adaptation, the size and brightness of the displayed object, the nature of the background illumination, the speed of the object, etc.

Changes in the visual field can manifest themselves either in the form of a narrowing of its boundaries, or in the form of loss of individual sections in it. The narrowing of the boundaries of the visual field can be concentric and can reach such degrees that only a small central area (tubular visual field) remains of the entire visual field.

Narrowing of the visual field occurs with diseases optic nerve, with pigment abiotrophy, with siderosis of the retina, with quinine poisoning, etc. Functional causes may be hysteria, neurasthenia, traumatic neurosis.

Vestibular tests make it possible to determine not only the presence of violations of the analyzer function, but also to give a qualitative and quantitative characteristic of their features. The essence of these tests lies in the excitation of vestibular receptors with the help of adequate or inadequate dosed effects.

So, for ampullar receptors, angular accelerations are an adequate stimulus; this is the basis for a dosed rotational test on a rotating chair. An inadequate stimulus for the same receptors is the impact of a dosed caloric stimulus, when the infusion of water of different temperatures into the external auditory meatus leads to cooling or heating of liquid media inner ear and this causes, according to the law of convection, the movement of the endolymph in the horizontal semicircular canal, which is closest to the middle ear. Also, an inadequate stimulus for vestibular receptors is the effect of galvanic current.

For otolithic receptors, an adequate stimulus is straight-line acceleration in the horizontal and vertical planes when performing a test on a four-bar swing.

Rotational test. The subject is seated in Barany's chair in such a way that his back fits snugly against the back of the chair, his legs are placed on a stand, and his hands are on the armrests. The patient's head is tilted forward and down by 30°, the eyes should be closed. Rotation is carried out uniformly at a rate of 1/2 revolution (or 180 °) per second, a total of 10 revolutions in 20 seconds. At the beginning of rotation, the human body experiences a positive acceleration, at the end - a negative one. When rotated clockwise after stopping, the endolymph flow in the horizontal semicircular canals will continue to the right; therefore, the slow component of the nystagmus will also be to the right, and the direction of the nystagmus (the fast component) will be to the left. When moving to the right at the moment the chair stops in the right ear, the movement of the endolymph will be ampulofugal, i.e. from the ampulla, and in the left - ampulopetal. Therefore, post-rotational nystagmus and other vestibular reactions (sensory and vegetative) will be due to irritation of the left labyrinth, and the post-rotational reaction from the right ear will be observed when rotating counterclockwise, i.e. to the left. After the chair stops, the countdown begins. The subject fixes his gaze on the doctor's finger, while determining the degree of nystagmus, then determining the nature of the amplitude and vivacity of nystagmus, its duration when the eyes are positioned towards the fast component.

If the functional state of the receptors of the anterior (frontal) semicircular canals is being studied, then the subject sits in the Barani chair with his head thrown back by 60 °; if the function of the posterior (sagittal) canals is studied, the head tilts 90 ° to the opposite shoulder.

Normally, the duration of nystagmus in the study of the lateral (horizontal) semicircular canals is 25-35 s, in the study of the posterior and anterior canals - 10-15 s. The nature of nystagmus during stimulation of the lateral canals is horizontal, the anterior canals are rotatory, and the posterior canals are vertical; in amplitude, it is small or medium-sized, I-II degree, lively, quickly fading.

Caloric test. During this test, a weaker artificial irritation of the labyrinth, mainly the receptors of the lateral semicircular canal, is achieved than during rotation. An important advantage of the caloric test is the ability to irritate the ampullar receptors of one side in isolation.

Before performing a water caloric test, you should make sure that there is no dry perforation in eardrum of the ear being examined, since the ingress of water into tympanic cavity may exacerbate chronic inflammatory process. In this case, air calorization can be carried out.

The caloric test is performed as follows. The doctor draws 100 ml into Janet's syringe. water at a temperature of 20 ° C (with a thermal caloric test, the water temperature is +42 X). The subject sits with the head tilted back by 60°; while the lateral semicircular canal is located vertically. Pour into the external auditory canal 100 ml. of water in 10 s, directing a jet of water along its posterior upper wall. The time from the end of the infusion of water into the ear to the appearance of nystagmus is determined - this is the latent period normally equal to 25-30 s, then the duration of the nystagmus reaction is recorded, which is normally 50-70 s. The characterization of nystagmus after calorization is given according to the same parameters as after a rotational test. Under cold exposure, nystagmus (its fast component) is directed in the direction opposite to the ear being tested, with thermal calorization - in the direction of the irritated ear

Pressor (pneumatic, fistula) test. It is carried out to detect a fistula in the area of ​​the labyrinth wall (most often in the area of ​​the ampulla of the lateral semicircular canal) in patients with chronic suppurative otitis media. The test is performed by thickening and rarefying the air in the external auditory canal, either by pressure on the tragus, or with the help of a rubber pear. If nystagmus and other vestibular reactions occur in response to air thickening, then the pressor test is assessed as positive. This indicates the presence of a fistula. It should be noted, however, that a negative test does not allow us to completely deny the presence of a fistula. With extensive perforation in the tympanic membrane, direct pressure can be applied with a probe with cotton wool wrapped around it on sections of the labyrinth wall that are suspicious of a fistula.

Study of the function of the otolithic apparatus. It is carried out mainly in professional selection; in clinical practice, the methods of direct and indirect otolithometry are not widely used. Taking into account the interdependence and mutual influence of the otolithic and cupular parts of the analyzer, V.I. Woyachek proposed a technique that he called "double rotation experiment" and known in the literature as the "Otolith reaction according to Woyachek".

Otolith reaction (OR). The subject sits in Barani's chair and tilts his head along with his torso 90° forward and down. In this position, it is rotated 5 times for 10 seconds, then the chair is stopped and waited for 5 seconds, after which it is suggested to open your eyes and straighten up. At this moment, a reaction occurs in the form of a tilt of the torso and head to the side. Functional state of the otolithic apparatus is estimated by the degrees of deviation of the head and trunk from the midline towards the last rotation. The severity of vegetative reactions is also taken into account.

It is obvious that what better health parents, the more healthy their child can be born. There are many ways to check your health status. We offer you right now, with the help of two simple tests, to see state your posture and ability nervous system to the perception of increased stress (any - physical, educational, mental, etc.). The tests take no more than 5 minutes to complete, and you can immediately evaluate the result.

The technique is universal and suitable for men, women and children of any age.

The course of childbirth, as well as the course of pregnancy, is greatly influenced by maternal nervous system. One of simple methods his score is the Woyachek test. We invite you right now (to break away from the computer) to perform this simple test.

Initial position:

Get up. Set your feet in a straight line one in front of the other (do not move your legs!), keep your head straight, eyes open, stretch your arms forward parallel to the floor.

Perform head movement(nodding "Yes" with a large amplitude), throwing your head back to the position "face up parallel to the ceiling" and lowering your head forward, face down (see photo on the right).

Records the number of "nods" you can make, without moving(8 times is enough).

If you do not fall or stumble in this position after 8 nods, then you have enough "strong" brain with well controlled excitation and inhibition processes. That is, your nervous system is ready to perceive increased loads.

If the number of nods performed without moving from the spot is less than 8, performing gymnastics, as well as performing all sections of the ecological one, will help you normalize this indicator.

This test shows state of the nervous system at the time of verification. If the day was hard, then tomorrow, perhaps, the test will show a different result. By doing this test regularly, you will be able to track the dynamics resistance of your nervous system to overload. With a wellness program, you will soon notice that this indicator will become consistently high, regardless of whether you are tired and how much stress the day brought. And this means that you will be less worried about trifles and better control your emotions.

Pelvis standing level

For the second test, you will need a measuring tape and someone help with measurements. This test not only shows the state of your posture, its results have great importance during pregnancy and childbirth.

Lie down on a flat, straight surface (floor, bed). Relax. Now perform the following movements one by one:

a) bend your knees;

b) rest your feet on the floor;

c) lift the pelvis;

d) lower it back;

e) stretch and relax straight legs.

Now the pelvis is located as evenly and symmetrically as possible and you can start measuring.

What will we measure?

Find two symmetrical points- the most protruding parts of the wings of the pelvic bones on the right and left. To do this, without getting up, place your palms on top of your thighs on both sides and feel for the highest points from two sides. When found, place your index fingers on them, marking them for the assistant.

Your assistant measures with a centimeter tape the distance from the jugular cavity (fossa under the neck) to the points you indicated on the right and left. Estimated difference left and right measurements. For example, the measurement on the left is 50 cm, on the right is 51 cm. In this case, the difference will be 1 cm. Record the difference.

The second indicator of the correctness of the location of the pelvis, complementing the first indicator, is the difference in the length of the legs. You continue to lie, indicating the same points. The assistant measures the distance between these points and the upper limit of the ankles. We write down the difference in the measurements of the right and left legs. For example, on the left - 87 cm, on the right - 87.5 cm. We write down - 0.5 cm.

We evaluate the result

If the pelvic bones are even and symmetrical with respect to the spine, measurements on the right and left almost equal, a difference of up to 0.5 cm is acceptable (data from the city medical and sports dispensary of St. Petersburg). If the pelvis is "twisted", then this difference increases. If the difference exceeds 1 cm, then for the expectant mother is high the risk of injury to the child during childbirth, and for the future father - the possibility of male hormonal problems with age.

For self-monitoring of the effectiveness of classes, try to conduct measurements before and after performing exercises. So you can evaluate the result of your own efforts in healing.

How does the posture of future parents affect the health of the unborn baby?

If the mother has a violation of posture, then in childbirth the child is forced to undergo through a twisted birth canal which could injure him. According to osteopathic doctors, because of this, especially in violation of the level of standing of the pelvic bones (“twisting the pelvis” or the presence of a violation of the tone of the muscles of the pelvic floor), the summing vector of the mother’s expelling forces does not enter the birth canal. Therefore, when passing through the birth canal, the baby's head experiences stronger pressure from one side of the maternal pelvis and baby skull bones overlap each other asymmetrically.

Further, these bones mechanically clamp the hard meninges and nerve centers, which leads to the appearance neurological symptoms, which, as a rule, is indicated by diagnoses: encephalopathy, minimal brain dysfunction (MMD), children's cerebral paralysis, impaired muscle tone, delayed psychomotor development, etc. The first common manifestations her are frequent regurgitation, constant crying and screaming of the child, weak sucking, impaired muscle tone, etc.

According to English osteopaths, 80% of children require osteopathic intervention from the first day. In children with minimal brain dysfunction reduced concentration, memory, they are impatient, excitable, it is very difficult for them to learn. It is surprising how important the level of standing of the pelvis is for the favorable course of labor and the future health of the newborn.

Be healthy!

To better understand the state of all body systems, you can undergo a comprehensive medical examination. The better you prepare for pregnancy and childbirth, the more easily and harmoniously you will live this difficult but joyful period of your life.

To assess the state of the vestibular analyzer, simple coordination and rotational tests are used, where there is an increased irritation of the vestibular receptors. Among the rotational tests, the simplest is the Yarotsky test.

Yarotsky's test: the athlete performs rotational movements of the head in one direction at a speed of 2 rotations per 1 second. According to the time during which the subject is able to perform this test, while maintaining balance, they judge the stability of the vestibular analyzer. Untrained people maintain their balance for an average of 28 seconds, athletes - up to 90 seconds or more.

The threshold level of sensitivity of the vestibular analyzer mainly depends on heredity, but under the influence of training it can be increased.

Voyachek's test

Voyachek's test allows you to assess the stability of the vestibular apparatus using rotation in the Barani chair. Irritation of the semicircular canals of the device is caused by rotation at a speed of 5 times per 10 seconds. The subject sits in a chair with his eyes closed and his head tilted 90 degrees. At the end of the rotation, after a 5 second pause, he raises his head and opens his eyes. The response is assessed by torso tilt and autonomic symptoms. A weak inclination of the torso characterizes a good condition, a pronounced deviation - medium, a tendency to fall and a slope with a fall - weak. At the same time, vegetative reactions are evaluated - pronounced nystagmus, blanching of the face, cold sweat, nausea, vomiting, changes in the pulse, increased blood pressure. With a good functional state of the vestibular apparatus, these symptoms are expressed slightly, with a satisfactory - clearly, with a reduced - strongly.

The principles for evaluating the results of the Voyachek test are presented in table 2.

Table 2 - Principles for evaluating the results of the Voyachek test (K.L. Khilov's scheme, modified by P.I. Gotovtsev, 1972)

Degree of reaction	Changes in heart rate and blood pressure
	Pulse and arterial pressure do not change
	The pulse does not change, the maximum blood pressure rises by 8-11 mm Hg. Art.
	The pulse does not change, the maximum blood pressure rises by 12-23 mm Hg. Art. or decreases by 9-14 mm Hg. Art.
	The pulse slows down, the maximum blood pressure rises by more than 24 mm Hg. Art. or decreased by more than 15 mm Hg. Art., vegetative reactions appear
	Abrupt changes in heart rate, blood pressure, pronounced vegetative reactions

Minkowski's samples

Used to assess the functional state of the vestibular apparatus. There are two versions of this test.

Minkowski test -1: the subject for one minute with closed eyes performs 20 head tilts to the right and left alternately. Then, with his head tilted to the side, he quickly walks forward without opening his eyes. A push to the side is a sign of a violation of the functional state of the vestibular apparatus.

Minkowski test -2: the subject performs 20 forward and backward tilts of the head for one minute with closed eyes. Then, with his head tilted forward, he quickly walks forward without opening his eyes. A wobbly gait is a sign of a violation of the functional state of the vestibular apparatus.