Types of atrophy. Why skin atrophy occurs, types, symptoms of atrophy. Principles of therapeutic exercises

The brain regulates the functioning of all organ systems. Any damage to it threatens the normal functioning of the entire body. Brain atrophy is a pathological condition in which there is a progression of neuronal death and a loss of connections between them. This condition requires professional diagnosis and treatment. The types of atrophy and therapy are described in the article.

What it is?

The main organ of humans is the brain, which includes many nerve cells. Atrophic changes in its cortex lead to the gradual death of nerve cells, and mental abilities fade over time. The lifespan of a person depends on the age at which this pathology began to develop.

Changes in behavior are noticeable in almost all older people, but due to their slow development, these signs of decline are not considered pathological. Many older people are unable to respond to environmental changes in the same way as they did at a young age. In the elderly, intelligence decreases, but these changes do not cause neurology, psychopathy and dementia.

With cerebral atrophy of the brain, brain cells gradually die and nerve endings die. This condition is considered a pathology in which changes occur in the structure of the hemispheres. There is also a smoothing of the convolutions, a decrease in the volume and weight of this organ. The frontal lobes are more often destroyed, which causes a decrease in intelligence and behavioral deviations.

Causes

Today in medicine there is no clear answer to the question of why brain atrophy occurs. But it was found that predisposition to the disease can be inherited. It is also formed from birth injuries and intrauterine diseases. Experts identify congenital and acquired causes of the disease.

Congenital

These include:

• genetic factor;
• intrauterine infectious diseases;
• genetic mutations.

One of the genetic diseases that affects the cerebral cortex is Pick's disease. It is usually observed in middle-aged people, which manifests itself in the gradual damage of frontal and temporal neurons. The disease can develop rapidly and after 5-6 years leads to death.

Infection of a child during pregnancy also leads to the destruction of various organs, including the brain. For example, infection with toxoplasmosis in the early stages of gestation leads to damage to the nervous system of the fetus. After this, babies usually do not survive or are born with congenital abnormalities and mental retardation.

Purchased

There are also acquired reasons. Brain atrophy can occur from:

1. Drinking alcohol and smoking. This causes cerebral vascular spasm, resulting in oxygen starvation. Because of this, white matter cells cannot receive enough nutrients, causing them to die.
2. Infectious diseases that affect nerve cells - meningitis, rabies, polio.
3. Injuries, concussions and mechanical damage.
4. Severe form of renal failure. This causes general intoxication of the body, which causes metabolic disorders.
5. Hydrocephalus disorders. This phenomenon manifests itself in an increase in the subarachnoid space and ventricles.
6. Chronic ischemia, which leads to vascular damage and low supply of nutrients to neural connections.
7. Atherosclerosis, which manifests itself in a narrowing of the lumen of veins and arteries, which increases intracranial pressure and creates a risk of stroke.

Atrophy of the cerebral cortex can occur due to insufficient intellectual and physical activity, lack of a balanced diet and poor lifestyle.

Why does the disease develop?

Brain atrophy in adults and children usually develops due to a genetic predisposition to the disease, but acceleration and provocation of neuronal death can occur from various injuries and other factors. Atrophic changes appear in different parts of the cortex and subcortical substance, but with different manifestations of the disease, one clinical picture is observed. Small changes can be stopped and a person’s condition can be improved through medical means and lifestyle changes, but the disease cannot be completely eliminated.

Atrophy of the frontal lobes also develops during intrauterine maturation or prolonged labor due to prolonged oxygen starvation, causing necrotic processes in the cerebral cortex. These children usually die in the womb or are born with noticeable abnormalities. Brain cells are capable of dying due to mutations at the gene level due to the impact of harmful components on the health of a pregnant woman and prolonged intoxication of the fetus. But it could also be a chromosomal malfunction.

Signs

What are the signs of brain atrophy? At the initial stage of the disease, the symptoms are hardly noticeable and can only be detected by close people. The patient develops apathy, lack of desires, aspirations, lethargy and indifference. A lack of moral principles and increased sexual activity are often observed.

As brain cell death progresses, the following signs are observed:

1. The vocabulary decreases, so a person spends a long time looking for words to describe something.
2. Intellectual abilities decrease in a short time.
3. No self-criticism.
4. Control over actions is lost, and deterioration in body motor skills is observed.

Then, with atrophy, a deterioration in well-being appears and thought processes decrease. A person does not recognize familiar things and forgets about the rules for their use. Elimination of one's behavioral characteristics causes the appearance of the “mirror” syndrome, in which a person begins to copy other people. Then senile insanity and absolute degradation of personality are observed.

The changes in behavior that have arisen do not allow an accurate diagnosis to be made, so to establish the causes of the changes, a list of studies must be carried out. But thanks to the doctor, it will be possible to determine which part of the brain has undergone destructuring. In case of destruction in the cerebral cortex:

• thought processes decrease;
• the tone of speech and timbre of the voice are distorted;
• the ability to remember changes;
• fine motor skills of the fingers are impaired.

Symptoms of changes in the subcortical substance are determined by the functions that the affected section performs, so limited atrophy has its own characteristics. With necrosis of the tissues of the medulla oblongata, respiratory failure, digestive failure are observed, and the cardiovascular and immune systems suffer.

If damage to the cerebellum is observed, muscle tone is disrupted and coordination of movements is impaired. With the destruction of the midbrain, there is no reaction to external stimuli. When the cells of the intermediate section die, a violation of the body's thermoregulation and a metabolic failure appear.

With damage to the anterior section, all reflexes are lost. When neurons die, the function of independent maintenance of life is lost, which usually leads to death. Often, necrotic changes appear from injury or long-term poisoning by toxins.

Severity

According to the international classification, there are different degrees of brain atrophy and locations of pathology. Each stage of treatment for the disease has its own symptoms:

1. The first degree is called cerebral subatrophy. At this stage, there are minor changes in the person's behavior and rapid progression to the next stage. Early diagnosis is important here, since the disease can be temporarily stopped and a person’s life span depends on the effectiveness of treatment.
2. At stage 2, the patient’s communication skills deteriorate, he becomes irritable and incontinent, and the tone of speech changes.
3. During stage 3, a person becomes uncontrollable, psychosis occurs, and morality is lost.
4. At stage 4, there is a noticeable lack of understanding of reality, the patient does not respond to external stimuli.

With further development, complete destruction occurs and vital systems fail. At this stage, it is better to hospitalize the patient in a psychiatric clinic, since he is difficult to control.

With moderate brain atrophy, changes in personality will be barely noticeable.

In children

Brain atrophy may occur in the child. It can be either congenital or acquired, it all depends on the age at which the disease began to develop. The acquired form appears after 1 year of life. The death of nerve cells in children begins for various reasons, for example, due to a genetic factor, different Rh factors in the mother and baby, infection with neuroinfections in the womb, prolonged fetal hypoxia.

Due to the death of neurons, cystic tumors and atrophic hydrocephalus occur. Based on where the cerebrospinal fluid accumulates, cerebral hydrocele can be internal, external, or mixed. A rapidly developing disease is usually observed in newborns, and this is associated with serious disorders in the brain tissue due to prolonged hypoxia, since the child’s body at this stage needs intensive blood supply, and a lack of nutritional components causes serious consequences.

What disorders affect the brain?

Subatrophic changes are precursors to global neuronal death. At this stage, it is necessary to promptly identify brain disease and prevent the rapid development of atrophic processes.

For example, with hydrocephalus of the brain in adults, the voids free from destruction are filled with the resulting cerebrospinal fluid. This type of disease is difficult to diagnose, but with proper therapy it will be possible to delay the development of the disease.

Changes in the cortex and subcortex are caused by thromophilia and atherosclerosis, which without treatment lead to hypoxia and insufficient blood supply. As a result, neurons die in the back of the head and parietal part, so treatment is necessary to improve blood circulation.

Alcoholic atrophy

Brain neurons are very sensitive to the effects of alcohol. The decay products poison the neurons, the destruction of neural connections occurs, and then gradual cell death is observed. This leads to brain atrophy.

As a result, both cortical-subcortical cells and brain stem fibers suffer. Damage to blood vessels occurs, shrinkage of neurons and displacement of their nuclei. In patients with alcoholism, self-esteem disappears and memory deteriorates. If he continues to drink alcohol, this will lead to severe intoxication of the body. And even if a person comes to his senses, Alzheimer’s disease and dementia will still develop in the future.

Multiple system atrophy

This disease is considered progressive. The occurrence of the disease includes 3 different disorders, combined with each other in different ways. But usually such atrophy manifests itself in the form of:

• parsionism;
• destruction of the cerebellum;
• vegetative disorders.

To date, the causes of this disease have not been identified. Diagnosis is made using MRI and clinical examination. Treatment includes supportive care and reduction of symptoms of the disease.

Cortical atrophy

Usually this type of disease is observed in older people and appears due to senile changes. It affects the frontal lobes, but the disease can spread to other parts. Signs of the disease do not appear immediately, but the result is a decrease in intelligence and memory, and dementia. An example of the impact of such a disease is Alzheimer's disease. Usually diagnosed using MRI.

With the diffuse spread of the disease, blood flow is disrupted, tissue restoration is suffocated and mental performance is reduced. A disorder of fine motor skills of the hands and coordination of movements also appears; the development of the disease changes the lifestyle and leads to absolute incapacity.

Cerebellar atrophy

With this disease, the cells of the “small brain” are affected and die. The first symptoms of the disease appear in the form of incoordination of movements, paralysis and speech impairment. With changes in the cerebellar cortex, vascular atherosclerosis and brain stem tumors, infectious diseases, vitamin deficiency and metabolic disorders usually develop.

Cerebellar atrophy manifests itself as:

• speech and fine motor impairments;
• headache;
• nausea, vomiting;
• decreased hearing acuity;
• visual disorders;
• reduction in the mass and volume of the cerebellum.

Treatment involves blocking the signs of the disease with antipsychotics, restoring metabolism, and using cytostatics for tumors. It is possible to eliminate the formations using a surgical method.

Diagnostics

The disease is diagnosed by instrumental analysis methods. Using magnetic resonance imaging (MRI), it will be possible to examine in detail changes in the cortical and subcortical substance. Based on the completed images, an accurate diagnosis is made in the early stages of the disease.

Thanks to computed tomography, it is possible to examine vascular lesions after a stroke and establish the causes of hemorrhage, determine the area of ​​cystic formations, which disrupts the normal blood supply to tissues. Multislice tomography is considered a new method of research, with the help of which it will be possible to detect the disease at the initial stage.

Treatment and prevention

By following simple rules, it is possible to alleviate symptoms and prolong a person’s life. Once the diagnosis is made, it is advisable for the patient to remain in a familiar environment, since stress aggravates the condition. A person needs feasible mental and physical activity.

A balanced diet is important, you need to restore a clear daily routine. It is necessary to give up bad habits. You also need physical activity and mental exercises. A diet for atrophy involves avoiding heavy, unhealthy foods, you should not eat fast food, and drinking alcohol is strictly prohibited. The menu should include nuts, seafood and greens.

Treatment of brain atrophy involves the use of neurostimulants, tranquilizers, antidepressants and sedatives. This disease cannot be completely cured; therapy can only alleviate the symptoms. The choice of remedy depends on the type of atrophy and the type of impaired functions.

With damage to the cerebellar cortex, treatment is required to restore movement. You also need to use drugs that reduce tremor. Sometimes surgery is needed. Sometimes medications are used that improve metabolism and cerebral circulation, ensuring good blood circulation and protection against oxygen starvation.

(atrophia) is a pathological condition accompanied by a decrease in the size, volume and weight of both the organ as a whole and its individual sections with a gradual decrease and cessation of functioning. In addition to organs, atrophy can affect certain tissues, nerves, mucous membranes, glands, and so on.

Atrophy is an acquired lifetime process, that is, the drying out of elements that previously developed normally in accordance with the age and physiological characteristics of the body occurs. This is its fundamental difference from hypoplasia, characterized by intrauterine underdevelopment of an organ or other part of the body, for example, bone. Also, atrophy must be clearly distinguished from aplasia, in which the organ retains the appearance of early conception, or from agenesis, the complete absence of an organ that occurs as a result of disturbances during ontogenesis.

The simple atrophic process is based on a decrease in tissue volume due to cell atrophy. Moreover, in most cases, a qualitative change in their structural elements is not observed at first, only later can their complete disappearance be observed. More precisely, the main constituent elements - the cytoplasm and the nucleus - remain unchanged in the cell. There are no deep cellular metabolic disorders. In the future, atrophy can lead to a decrease in the number of cells.

Degenerative atrophy is a combination of atrophy and degenerative cell degeneration. A typical example is brown atrophy, characterized by the accumulation of lipofuscin in the organ tissue.

Classification

Physiological atrophy. This is a normal process that accompanies a person throughout his life. As an example, obliteration and atrophy of the ductus arteriosus and umbilical arteries in newborn infants, atrophy of the thymus gland after puberty in adolescents. Old age is characterized by atrophy of the gonads, and old age - of bones, intervertebral and articular cartilage, and skin. Cortical atrophy with characteristic damage to the frontal lobes, accompanied by destruction of cerebral cortex tissue, leads to the appearance of senile insanity and dementia.

Pathological atrophy. In turn, it is divided into general And local.

General pathological atrophy develops due to insufficient supply of nutrients to the body, or when the absorption of certain elements is disrupted or stopped due to cancer, infectious diseases, and diseases of the nervous system.
With the initial degree of cachexia, accumulated fat from fat depots is consumed, then atrophy spreads to skeletal muscles, significantly reducing muscle mass. The lack of nutrients then affects the liver, heart, brain and other vital organs, impairing their functioning. General muscular atrophy (cachexia) is manifested by such changes.

Local atrophy according to the causes and mechanism of development is divided into the following types:

Dysfunctional. This type of atrophy develops due to decreased function of an organ or limb. In this case, forced bed rest or physical inactivity leads to atrophy of the thigh and calf muscles. It is observed in case of bone fractures, when the patient is temporarily unable to give full load to the fractured limb. Loss of function from inactivity may include optic nerve atrophy that occurs after enucleation of the eyeball. Bone atrophy manifests itself as osteoporosis with a decrease in the size of the trabeculae.

compression(from pressure). Complete atrophy of an organ or some part of it can occur from prolonged compression, for example, by a large tumor. Kidney atrophy is provoked by compression of the ureter with impaired urine outflow and the occurrence of hydronephrosis.

Discirculatory atrophy (ischemic). It begins after a narrowing of the lumens of the arteries that supply an organ, tissue or mucous membrane. Insufficient blood circulation in the tissue leads to nutritional deficiency, oxygen starvation and metabolic disorders, ending in atrophic processes in cells with their gradual death. Hypoxia of cerebral cortex cells contributes to the development of sclerosis and dementia. Generalized cerebral atrophy of the brain of varying degrees of severity can be observed in newborns due to fetal hypoxia.

Neurotic or neurogenic atrophy. Occurs due to disruption or blockage of nerve conduction (impulses) to the organ. This condition is caused by damage to neurons, destruction of nerve fibers that appear after injuries, malignant neoplasms, and hemorrhages. Lesions of bone tissue, skeletal muscles or skin are most typical for this type of atrophy. It is innervation that is a common cause of atrophy of the epithelium of the mucous membranes of one or both extremities. When the trigeminal nerve is damaged, atrophy of the corresponding part of the face is observed.

Atrophy provoked by various chemical, physical or toxic factors. Long-term infections with severe intoxication of the body, radiation exposure, chemical poisoning, long-term use of corticosteroids are the causes of the development of this type of atrophy. Radiation energy, related to physical factors, most often causes atrophy in the hematopoietic and reproductive organs. The gonads, bone marrow cells, and areas of the spleen atrophy. Long-term use of exogenous glucocorticoids can result in atrophy of the adrenal glands, and steroids – in testicular atrophy.

Dishormonal atrophy caused by a lack of trophic hormones. Hypofunction or functional insufficiency of the thyroid gland, pituitary gland or ovaries leads to a decrease in the size of the uterus and mammary glands. Excess iodine results in thyroid atrophy, and decreased estrogen production leads to atrophy of the vaginal muscles.

brown. With it, the organ acquires a brown tint due to the appearance of a brown pigment - lipofuscin - in the protoplasm of the cells. This appearance is typical for the heart, striated muscles or liver.

By external manifestations:

lumpy. The uneven distribution of the process is expressed in the unevenness and small bumpiness of the surface of the area with atrophy.

Smooth. With this form of atrophy, the physiological folds of the organ are smoothed out, its surface becomes smooth and glossy. Or the organ retains its original smoothness, which indicates an even distribution of the atrophic process. This mainly applies to the kidneys and liver.

By the nature of the lesion:

Focal. It does not affect the entire surface of the mucous membrane or other tissue, but only its individual areas (foci). This type of atrophy is characteristic of the epithelium of the gastric and intestinal mucosa, manifesting itself in multiple focal lesions.

Diffuse. It spreads over the entire surface of the organ, often completely involving it in the process. The configuration of the organ does not change, but its complete drying out (reduction in size) is observed.

Partial. The organ or tissue area is not completely affected. There is a reduction in the volume and size of part of the organ.

Full. Characteristic of optic nerve atrophy. The fibers are completely destroyed and replaced by connective tissue cells. There may be damage to the optic nerves of both eyes, or maybe only one.

Separated into a separate category multisystem atrophy (MSA) is a neurodegenerative disease of a progressive nature with damage to the neural subcortical nodes of the white matter of the hemispheres, brainstem, spinal cord and cerebellum.

Statistics:
According to statistics, multiple system atrophy is detected in 4.6 cases out of 100 thousand people, and 55% of them occur in mature men (from 50 to 65 years old).
Optic nerve atrophy leads to irreversible blindness in 21% of cases, and partial blindness in 68%, leading to disability.

1. Striatonigral degeneration. Symptoms of parkinsonism predominate.

olivopontocerebellar. Clinic of cerebellar ataxia.

3. Shy-Drager syndrome. Clinical picture of orthostatic hypotension and other manifestations of progressive autonomic failure.

In young children, spinal Kugelberg-Welander amyotrophy. This is a hereditary disease characterized by connective tissue hyperplasia, fascicular atrophy and hypertrophy of muscle fibers.

Causes

1. Lack of nutrients;
2. Oncological diseases;
3. Lesions of the hypothalamus (cerebral cachexia);
4. Endocrine disorders (spinal cachexia);
5. Long-term infectious diseases.

List of reasons for the appearance of local atrophy:

1. Pressure on an organ or part of it;
2. Limitation of physical activity and muscle load;
3. Poor circulation due to ischemic lesions of the veins and arteries;
4. Innervation;
5. Severe intoxication of the body due to serious infections;
6. Hereditary predisposition;
7. Radiation exposure;
8. Long-term use of hormonal drugs;
9. Dishormonal disorders.

As an example, foci of atrophy of the left ventricle can form from blockage of the lumen of the artery that supplies this part of the heart, and the optic nerve - from diseases of the retina, brain, its vessels, and so on. Loss of a tooth can lead to atrophy of the jaw bone.

Clinical manifestations

With cachexia, the patient experiences a general loss of muscle mass, he is emaciated and thin. Progression leads to atrophy of internal organs and brain cells.

Partial atrophy of the optic nerve is expressed in decreased vision, severe limitation or absence of lateral vision, and the appearance of spots on objects when viewing them. The progression of the process can result in complete loss of vision (complete atrophy of the optic nerves), which cannot be corrected.

Symptoms of retinal atrophy – loss of clarity and ability to distinguish colors. The gradual deterioration of vision causes optical illusions. One of the results of the disease is complete blindness.

Signs of skin atrophy are dryness, thinning, loss of elasticity. Foci of skin thickening may be observed due to the formation of connective tissue and dystrophy during colloid cutaneous degeneration, or idiopathic atrophy.

Patients with Kugelberg-Welander disease first complain of difficulty walking, then atrophy spreads to the arms, reducing muscle tone and impairing their motor activity. Tendon reflexes fade, various deformities form: feet, legs, chest and others.

Atrophy of the nasal mucosa leads to the shutdown of all its functions, and complete atrophy leads to a decrease in bones, absence of cartilage and nasal turbinates.

The process can affect the mucous membranes of the trachea and bronchi, which affects the lungs and the entire respiratory system as a whole. Thinning of the mucosa with expansion of the lumen and scar formation is an incomplete list of problems due to this pathology.
A decrease in ovarian function with a reduction in estrogen secretion during menopause threatens the atrophic process of the cervical epithelium.

Diagnostic methods

The first and general step for any type of atrophy is a physical examination, consisting of anamnesis, visual examination, palpation, and so on. Laboratory testing is also necessary in all cases. Further diagnosis varies.

To detect atrophy of any organ, ultrasound diagnostics, computed tomography or magnetic resonance imaging, scintigraphy, fibrogastroduodenoscopy, radiography, and so on are performed.

For example, the main diagnostics for muscle atrophy are electromyography and muscle biopsy. The laboratory method consists of determining certain indicators in a general and biochemical blood test.

The diagnosis of optic nerve atrophy is made after analyzing the results of ophthalmoscopy, tonometry, fluorescein angiography and other studies.

Treatment

The choice of treatment is influenced by: the form, severity and duration of the disease, individual intolerance to medications, and the patient’s age. If atrophy is a consequence of an underlying disease, then it is treated first. Other treatment methods are selected strictly individually. Symptomatic and physiotherapeutic treatment is usually long-term. In some cases, a positive effect is achieved, for example, they stop the decline in vision due to retinal atrophy, but treatment of another process may be ineffective.

Complications and consequences of atrophy

therefore increases in volume.-A. can be local, i.e., concern only one organ or part of it or some tissue, or be general, covering the entire organism or at least most of its organs and tissues; in the latter kind of cases, this state of the body is called cachexia or marasmus. The conditions for the development and causes of A. are varied; in general, it is customary to consider seven types of A.-1 according to the main causal point. Physiological A., which is the prototype of the patent. A., there is a decrease in the volume of certain organs, which occurs in the order of physiological survival; This includes A. the thymus gland in adults, A. the ovaries in menopause, as well as senile A. (senile insanity), which concerns the entire body and is expressed in the decrease in the volume of most organs and tissues, which is observed in old age.-2. A. from lack of nutrition can be local or general. The first of them is observed in cases where one organ or part of it suffers from lack of nutrition, which most often occurs from a narrowing of the lumen of the adductor artery and weakening of blood flow (for example, A. kidney tissue with arteriosclerosis of the renal artery). General A. from lack of nutrition is that state of exhaustion and weight loss (cachexia, marasmus), which is a consequence of starvation and severe long-term illness; In such cases, fatty tissue and muscles are exposed to the most severe degree A. -3. A. from pressure is observed in cases where some tissue is under pressure for a long time; A. under such conditions occurs depending on the decrease in blood flow to the tissue due to compression of its vessels, and also due to the fact that the assimilatory ability of the compressed cells weakens. Examples: cord or corset groove of the liver in women, tightening the waist tightly, small legs of Chinese women from artificial compression with a bandage, A. bone tissue of the sternum and vertebrae from pressure aneurysm(see) aorta, A. kidneys with hydronephrosis(see), depressions on the inner surface of the skull from the so-called. Pachyonic granulations. - 4. A. due to toxic influences, occurs in various long-term diseases accompanied by intoxication, and is of a general nature; This includes general cachexia of patients with advanced syphilis, tuberculosis patients, cachexia with

Drawing 1. Atrophy of the left hemisphere of the brain: A-right hemisphere (normal); L-atrophic left hemisphere, shrinking so much that the cerebellum opened; c - free space formed between the skull and the brain due to its atrophy; d-consecutive thickening of the skull bones. malignancies tumors, with chronic malaria, etc., and it must be borne in mind that in most of these cases A. is the result of not only direct toxicity. influence on tissues, but also disturbances in general nutrition and metabolism. Close to the category A. from toxic influences is A., which is a consequence of the action of radiant energy, for example, A. testicles from X-rays.-5. A. from inactivity is a decrease in the volume of tissue and its cells, observed during the inactive state of this tissue. Activity is an important factor in maintaining sufficient blood flow to the tissue and metabolism in it; when the function ceases, these processes decline and tissue atrophy occurs. An example would be A. of the muscles of a limb that has been immobile for a long time, for example, with paralysis or in a plaster cast due to a bone fracture. - 6. Neurotic A. is that atrophic state of tissue (for example, muscles, bones, skin), which develops when the connection of this tissue with the central nervous system is disrupted. In the past, it was assumed that there were special trophic fibers in the nerves that regulated the nutrition of the tissue, the elimination of the influence of which caused this type of A.; In the crust, the existence of such special nerves is not recognized by everyone, and neurotic atrophy is explained by a combination of various factors (circulatory disorders, metabolic disorders, inactivity, etc.). Examples of neurotic A. can serve as A. muscles with damage to the anterior horns of the spinal cord or peripheral nerves related to these muscles, A. half of the face with damage to the trigeminal nerve on the corresponding side. - 7. A. from a violation of hormonal correlations implies an atrophic process that develops due to any improper influences or loss of influences hormones(see), i.e. products of glands with internal secretion. Examples: general cachexia with damage to the cerebral appendage (cachexia hypophysaria) or with insufficiency of the thyroid gland (cachexia hypothyreotica), A. prostate gland during castration or destruction of the testicles by a pathological process. Pat.-anatomically, A. is expressed in a decrease in the volume of an organ or tissue, and if A. captures the organ evenly, the usual configuration does not change; if A. affects only some parts of the organ, leaving others untouched, a change in the shape of the organ or only its surface occurs (for example, granular A. of the kidney in arteriosclerosis). Along with a decrease in volume, compaction of the organ is often noticed, depending on the relative or even absolute increase in the connective tissue in it. Sometimes this proliferation of interstitial tissue is so significant that the total volume of tissue is not reduced and even increased; this is observed in A. muscles, often accompanied by significant growth of interstitial fatty tissue [false hypertrophy(see) muscles]. The color of organs in A. is somewhat paler than normal due to anemia of the tissue. In the liver, heart, and sympathetic ganglia, a brown color is usually observed due to the fact that these organs are characterized by “brown atrophy.” Microscopically, in an atrophied organ, a decrease in the size of its parenchymal elements is found, and this decrease occurs at first entirely due to the loss of protoplasm, while the nucleus retains its volume; Only with a strong degree of A. does a decrease in the size of cell nuclei occur. In some A., along with a decrease in the volume of protoplasmic

Figure 2. Muscle atrophy (cross section). On the left and below, bundles of normal muscle fibers are visible; in the rest of the visual field there is severe atrophy of muscle fibers.

Parts of cells sometimes undergo a very pronounced proliferation and increase in the number of their nuclei, which is called atrophic proliferation of nuclei; this phenomenon is considered as a manifestation of an automatic regenerative reaction. With brown atrophy (in the liver, heart muscle, sympathetic ganglia) there is atrophic in the protoplasm. cells, an accumulation of grains of brown pigment located near the nuclei is visible. Atrophying parenchymal elements are usually moved apart from each other by overgrown interstitial tissue. The outcome of A. can be expressed in a progressive increase in the process, and such A. leads cells to death and disappearance; on the other hand, when the conditions causing atrophy are eliminated, mildly changed cells can acquire their previous appearance. The meaning of A. is that the function of the atrophied tissue or organ is reduced. This loss of function of an atrophied organ can be the basis of a serious general disease; so, with A. the thyroid gland develops myxedema(see) or cachexia (cachexia hypothyreotica), a consequence of A. pancreas is often diabetes mellitus. A. Abrikosov.

Health - The state of the human body when the functions of all its organs and systems are balanced with the external environment, and there are no painful changes. Complete physical, mental and spiritual well-being.

Disease - This is the vital activity of the body, expressed in a change in function, as well as in a violation of the structure of organs and tissues, and arising under the influence of stimuli from the external and internal environment of the body that are extraordinary for a given organism.

Etiology – the causes of the disease. Pathogenesis is a mechanism, changes that occur during illness in the body.

Atrophy– reduction in the volume of the organ and decrease in its functions. Congenital underdevelopment of an organ is hypoplasia, congenital absence is aplasia (lobulated kidney, lobated spleen or bicornuate uterus).

Types of atrophy

· Physiological: accompanies normal human life (atrophy of the umbilical arteries after birth, the thymus upon reaching puberty, muscles and gonads in old age).

· Pathological: associated with diseases. It can be general and local. General atrophy (exhaustion) is the result of starvation or a malignant tumor of the digestive tract - cachexia - an extreme degree of exhaustion. At autopsy, the organs are atrophied, brown in color, and there is no adipose tissue.

Local atrophy is the result of impaired blood circulation or innervation of the organ

Necrosis. This is the death of individual cells, tissues or organs in the body. Necrosis is preceded by periods of weakening and cessation of cell and tissue functions.

The main sign of necrosis is irreversible changes in the nuclei and cytoplasm of cells

Dystrophy is a pathological process reflecting a metabolic disorder in the body. Dystrophy is always based on a violation of trophism (nutrition). The meaning of dystrophy is that in the cells or intercellular substance an excess or insufficient amount of substances characteristic of this tissue or not characteristic of it is formed. There are reversible and irreversible (leading to necrosis)

Parenchymatous: under the influence of a pathological factor, cell proteins either become denser or become liquid, oncotic pressure in the cell increases and water rushes into it (hypoxia, infections and intoxications). Grainy.

Mesenchymal: occur when there is a metabolic disorder in the interstitial connective tissue, which consists of collagen, elastic and reticular fibers, as well as the ground substance. The fibers are made up of the proteins collagen and elastin. Mucoid swelling.

Pathology of fat metabolism manifests itself in a change in the accumulation of neutral fat in the body. Increased – obesity (neuroendocrine disorders, excess, unhealthy diet, sedentary lifestyle). Neutral fat accumulates in large quantities in the subcutaneous fatty tissue, in the greater and lesser omentum, as well as around and inside organs. Obesity of the heart manifests itself in the deposition of fat in the epicardium, between muscle fibers.

Carbohydrate metabolism disorder underlies the development of diabetes mellitus (impaired functioning of the β-cells of the islets of Langerhars of the pancreas. Causes: sclerosis of the gland with age, metabolic disorders, mental trauma. Risk factors: heredity, increased consumption of carbohydrate foods.

Atrophy is a pathological condition that is accompanied by a decrease in the size, weight and volume of an entire organ or its individual sections with a gradual cessation of functioning. Atrophy can also affect tissues, mucous membranes, nerves, and glands.

Causes

Atrophy is an acquired process. Drying of organs, tissues or other elements that previously developed normally occurs.

• General atrophy is provoked by the following factors:
• Nutrient deficiencies
• Oncological diseases
• Hypothalamic lesions
• Endocrine disorders
• Infectious diseases that occur over a long period of time

The causes of local atrophy include:

• Pressure on an organ or part of it
• Limitation of physical activity, muscle load
• Innervation
• Circulatory disorders resulting from ischemic lesions of veins and arteries
• Severe intoxication due to serious infections
• Radiation exposure

Long-term use of hormonal drugs

• Dishormonal disorders
• Heredity

Symptoms of atrophy

Symptoms of atrophy depend on the location, nature of the lesion, extent and severity.
For example, general muscle atrophy is characterized by a general loss of muscle mass, exhaustion, and thinness. The progression of the pathology leads to atrophy of internal organs and brain cells.

Symptoms of retinal atrophy include loss of clarity of vision and the ability to distinguish colors. As vision deteriorates, the patient experiences optical illusions and complete blindness develops.

Skin atrophy is manifested by dryness, thinning of the skin, and loss of elasticity. Foci of thickening of the skin may form.

Diagnostics

Diagnostic measures differ in each specific case of suspected atrophy.
For any type of atrophy, at the initial stage, a physical examination is prescribed, which includes taking an anamnesis, visual examination, palpation and other procedures. In all cases, laboratory testing is also necessary. Further diagnosis varies.

For example, to detect organ atrophy, ultrasound diagnostics, CT or MRI, scintigraphy, radiography, fibrogastroduodenoscopy, etc. are performed.

The basis for diagnosing muscle atrophy is electromyography and muscle biopsy. Laboratory diagnostics includes the assessment of certain indicators in a general and biochemical blood test.

Types of disease

There are many types of atrophy. The main ones are physiological and pathological.
Physiological atrophy is a normal process that occurs to a person throughout life. Example: atrophy of the thymus gland after puberty in adolescents, atrophy of bones, intervertebral and articular cartilage, and skin in old age.

Pathological atrophy develops for the reasons mentioned above and is divided into general and local.

In addition, local atrophy is divided according to the following characteristics:

• According to the reasons and mechanism of development (dysfunctional, compression, dyscirculatory, neurotic, provoked by chemical, physical or toxic factors, dishormonal, brown)
• According to external manifestations (lumpy, smooth)
• By the nature of the lesion (focal, diffuse, partial, complete)

Multisystem atrophy is a separate category - a neurodegenerative progressive disease with damage to the neural subcortical nodes of the white matter of the hemispheres, brainstem, spinal cord and cerebellum. Depending on the clinical picture, multisystem atrophy is divided into striatonigral degeneration, olivopontocerebellar atrophy, and Shy-Drager syndrome.

Patient Actions

If changes are detected in organs or tissues characteristic of atrophy, as well as a decrease in their functioning, the patient must promptly consult a doctor and undergo an examination.

Treatment of atrophy

Treatment begins with eliminating the underlying disease that provoked the appearance of the atrophic process. If atrophy and sclerotic lesions are not very advanced, it is possible to partially or completely restore the structures and functions of the affected organ or part of an organ.

Deep atrophic lesions cannot be corrected or treated.

The choice of treatment depends on the form, severity, duration of the disease, the patient's age and drug tolerance.
Treatment methods are selected individually. Long-term medication, symptomatic and physiotherapeutic treatment is usually necessary. In some cases it is possible to achieve a positive effect, while in others the treatment is unsuccessful.

Complications

Complications can arise from various systems and organs, from minor changes in structure to complete drying out of the organ. This is manifested by partial or complete blindness, deterioration of organ function, immobility, myxedema, infertility, dementia and other complications including death.

Prevention

Prevention consists of preventing the causes of the atrophic process.