Left vagus nerve. Vagus nerve - symptoms and treatment of the problem. Anatomy and physiology

The vagus nerve develops from the 4th and subsequent visceral arches. It is the longest of the cranial nerves. The vagus nerve - mixed” has 3 nuclei: 1) the sensitive nucleus of the solitary tract; 2) motor - double core; 3) parasympathetic - posterior nucleus of the vagus nerve (nucleus dorsalis neri vagi). The parasympathetic nucleus is located in the medulla oblongata between the nucleus of the hypoglossal nerve and the nucleus of the solitary tract, in the triangle of the vagus nerve (trigonum n. vagi), superficial to the double nucleus. The vagus nerve comes out medulla oblongata in its posterior lateral groove (sulcus lateralis posterior), below glossopharyngeal nerve. Its 10-15 roots form a thick nerve trunk, which leaves the cranial cavity together with the glossopharyngeal and accessory nerves through the anterior section of the jugular foramen (foramen jugulare). The internal jugular vein passes through the posterior part of the foramen. In the jugular foramen, the sensitive part of the vagus nerve forms a small superior or jugular node (ganglion superior, PNA; g. jugulare, BNA, VA). Below the jugular foramen there is another spindle-shaped sensory node. This is the lower or nodular node (ganglion inferius, PNA; g. nodosum BNA, JNA).
Initially, in embryos 9-11 mm in length, the vagus nerve is presented as a group of longitudinal bundles of nerve fibers. They can be traced to the level of the trachea bifurcation, then the stomach and further to the small intestine.

Quite early in embryos 12 mm long, bundles of vagus nerve fibers begin to form the esophageal plexus (plexus esophageus). This process quickly ends, already in embryos 14-23 mm in length with the formation of the anterior and posterior vagal trunks (truncus vagalis anterior et truncus vagalis posterior). From the formed food plexus, thin nerve branches are formed that penetrate into the thickness of the wall of the esophagus.
It should be noted that already in the early stages of prenatal ontogenesis, the esophageal plexus is an integral formation and there is an exchange of fibers between both vagus nerves.
After leaving the cranial cavity, the vagus nerve descends down to the neck. IN upper section carotid triangle it is located between the internal carotid artery and the internal jugular vein, and in the middle and lower parts; lah - between the common carotid artery and the internal jugular vein.
This neurovascular bundle is located under the group; dinocleidomastoid muscle. It is surrounded by a vagina formed by the parietal layer of the fourth fascia of the neck. Inside this vagina, fixed to the transverse processes of the cervical vertebrae, there are partitions that form separate chambers for the artery, vein and nerve.
Conductors of general somatic afferent sensitivity arise from neurons of the superior or jugular ganglion of the vagus nerve. They are directed to the skin of the posterior wall of the outer ear canal and to the skin area of ​​the auricle. Conductors of general visceral afferent sensitivity arise from the neurons of the inferior or nodular ganglion and go to the dura mater of the posterior cranial fossa, to the pharynx, larynx, trachea, esophagus, as well as to the organs and vessels of the thoracic and significant parts abdominal cavity.
Conductors of special visceral afferent sensitivity also arise from neurons of the lower

or nodular node. They conduct taste information from taste buds scattered in the epithelium of the epiglottis (epiglottis).
The following branches depart from the head of the vagus nerve between its superior and inferior sensory nodes: 1) the meningeal branch (g. meningeus), which returns through the jugular foramen to innervate the dura mater of the posterior cranial fossa; 2) auricular branch (g. auricular is) - to the posterior wall of the external auditory canal and to the area of ​​​​the skin of the auricle. This is the only cutaneous branch of all the main nerves not related to the system trigeminal nerve. It goes through the mastoid canaliculus temporal bone(canaliculus mastoideus) from the jugular fossa (fossa jugularis) of the temporal bone, crosses the descending segment of the canal facial nerve, goes through tympanic cavity and exits through the tympanomastoid tissue (fissura tymponomastoidea).
In the neck area, the pharyngeal branches of the vagus nerve, together with the branches of the glossopharyngeal nerve and postganglionic fibers of the superior cervical node The sympathetic trunk forms the pharyngeal plexus. From the pharyngeal branches of the vagus Nerve, motor and sensory innervation of the upper and middle pharyngeal constrictors (m. constrictor pharyngis superior et m. constrictor pharyngis medius), muscles of the soft palate, velopharyngeal muscle (m. palatopharyngeus) and palatopharyngeus (m. palatopharyngeus) is carried out. palatoglossus). The pharyngeal plexus also provides sensory fibers to the pharyngeal mucosa. In the carotid triangle, deeper than the internal and external carotid arteries, the superior laryngeal nerve (n. laryngeus superior) departs from the vagus nerve. It passes in an oblique transverse direction and behind the internal and external carotid arteries it gives off an external branch (ramus extemus) to the lower constrictor of the pharynx (m. constrictor pharyngis inferior) and the cricothyroid muscle (m. cricothyreoideus). Next, the nerve called the internal branch (ramus intemus) goes anteriorly along with the superior laryngeal artery (a.

laryngea superior) and a branch of the superior thyroid artery. It pierces the thyrohyoid membrane downward from the large horn of the hyoid bone and innervates with its branches the mucous membrane of the larynx above the glottis, the mucous membrane of the root of the tongue and epiglottis, as well as the thyroid gland. The external branch of the superior laryngeal nerve is also involved in the formation of the so-called depressor cardiac nerve or superior cardiac branches (n. depressor cordis, BNA; rr. cardiaci superiores, PNA). The depressor nerve runs along the wall of the common carotid artery in the thickness of its vagina. It forms connections with branches cervical spine sympathetic trunk and participates in the formation of cardiac nerve plexuses. The superior laryngeal nerve also gives off a connecting branch to the inferior laryngeal nerve (g. communicans cum n. laryngeo interiore). The lower laryngeal nerve (n. laryngeus interior) is a branch of the recurrent laryngeal nerve (n. laryngeus recurrens). It innervates the mucous membrane of the larynx below the glottis, as well as all the internal muscles of the larynx and the thyroid gland.
In the cervical part, a connecting branch departs from the vagus nerve to the IX pair of cranial nerves (r.communicans cum n. glossopharyngeo).

1. Accessory nerve (n. accessorius)

The accessory nerve develops in connection with the last visceral arches. He is a motorist. In phylogeny, the accessory nerve is first identified in turtles. In them, the accessory nerve is formed by the last roots of the vagus nerve. The accessory nerve of mammals is, in principle, no different from a similar nerve in humans. The accessory nerve is closely adjacent to both sensory ganglia of the vagus nerve and to the section of its trunk between them. In embryos 13-14 mm long, nerve fiber cords are detected between the trunks of the X and XI pairs of cranial nerves below the base of the skull. On
The external branch of the accessory nerve in embryos 15 mm long is divided into two branches that reach the anlage of the sternocleidomastoid and trapezius muscles.
The motor nucleus of the accessory nerve is divided into two parts: cerebral and spinal (pars cerebralis et pars spinalis). Pars cerebralis is located in the medulla oblongata dorsolateral to the olivary nucleus and slightly below the nucleus ambiguus. Pars cerebralis directly continues into spinal cord(Cj-Cb). Here the motor nucleus is called its spinal part (pars spinalis). The roots of the medullary part (radices craniales) emerge from the medulla oblongata below the vagus nerve, in the posterolateral groove, behind the olive. The roots from the spinal part (radicis spinales) are formed between the anterior and posterior roots of the spinal nerves (Cx-Sb) and partly between the anterior roots of the three upper cervical segments of the spinal cord.
Then the roots of the spinal part rise upward, enter through the foramen magnum (foramen magnum) into the cranial cavity and join the roots of the medullary part. Together they exit the skull through the anterior jugular foramen along with the glossopharyngeal and vagus nerves. Then the accessory nerve enters the posterior part of the peripharyngeal space and is located inward from the internal jugular vein, lateral from the internal carotid artery and posterior to the glossopharyngeal nerve.
The accessory nerve is divided into internal (g. internus) and external (g. extemus) branches. The sternocleidomastoid muscle is innervated and pierced by the external branch of the accessory nerve. This branch then emerges at the posterior edge of the muscle approximately 1.5 cm above its middle. Located further under the second fascia of the neck on the muscle that lifts the scapula (m.levator scapulae), the external branch of the accessory nerve is directed obliquely downwards, under the anterior edge of the trapezius muscle (m. trapezius) and innervates it. The presence of a single source of innervation for the sternoclavicular

mastomastoid and trapezius muscles indicate
about their common origin. The internal branch of the accessory nerve joins the vagus nerve and is part of its branches. In this case, the fibers from the medullary part of the accessory nerve go as part of the recurrent laryngeal nerve (n. laryngeus recurrens) and then its final branch, the lower laryngeal nerve (n. laryngeus inferion). The laryngeal nerves innervate the muscles of the larynx, while fibers coming from the spinal part of the accessory nerve in the pharyngeal branches (rami pharyngei) innervate the muscles of the pharynx.

The vagus nerve is an extremely interesting structure. This nerve is not just a passive transmitter of nerve impulses. Its sensory and motor neurons work together to actively regulate a wide variety of processes that link body and brain function, human biology and psychology, health and dysfunction. We, massage therapists and chiropractors, are able to stimulate the vagus nerve with competent touch. How does stimulation of this kind affect the functioning of this nerve?

HANDYMAN

The active influence of the vagus nerve (or X pair cranial nerves) on our well-being is:

-increasing stress resistance and accelerating recovery.

When the vagus nerve is exposed to stress hormones such as cortisol and adrenaline, the motor neurons of its branches (Fig. 1) secrete the neurotransmitter acetylcholine (which was originally called “vagal substance”, “vagustoff” from the Latin nervus vagus - vagus nerve), and such hormone like oxytocin. Thus, it deactivates the sympathetic nervous system, helping to recover faster from stress.

- Control of inflammation and immunity.

The vagus nerve inhibits inflammation by releasing neurotransmitters in response to the detection of inflammatory markers such as cytokines and tumor necrosis markers. If this mechanism is disrupted, autoimmune diseases may develop, such as rheumatoid arthritis, and chronic pain.

- Mood regulation

The vagus nerve is the most important link between the brain and the enteric nervous system, regulating the functioning of smooth muscles internal organs. The gut is home to 100 million neurons, 30 neurotransmitters, and 95 percent of all serotonin found in the human body. The enteric nervous system sends a huge amount of information to the brain through sensory neurons. This information, in simple terms, regulates our mood and the course of mental processes. A measure of vagal tone (i.e., its ability to respond and influence the heart) correlates with the likelihood of developing heart disease and diabetes, as well as with emotional stability and anxiety levels.

ELECTROSTIMULATION OF THE VAGUS NERVE

Electrical vagus nerve stimulation is a procedure that involves implanting an electrical pulse generator in the neck to continuously stimulate the vagus nerve. Despite the scary word “implantation,” EBN therapy is not complete surgery on the brain. Implantation of the device is a simple surgical procedure that will require only a short hospital stay. Electrical stimulation of the vagus nerve is performed with a pulse generator placed under the skin, under the left collarbone or near the armpit. A small incision is made in the neck to attach two thin wires (electrodes) to the left vagus nerve. The wiring is not visible from the outside. They pass under the skin from the impulse generator to the vagus nerve in the neck.

EBN has been successfully used to treat epilepsy, migraine and drug-resistant depression. Research is currently being conducted to study the effect of EBN on the condition of patients with anxiety disorders, Alzheimer's disease, fibromyalgia, obesity and tinitus.

However, EBN therapy is a very risky measure, implying the likelihood of complications (for example, infection). In addition, the long-term effects of EBN on the human body have not yet been studied.

Of course, there are other, less invasive and safer ways to stimulate the vagus nerve. For example, controlled breathing (with prolongation of the exhalation phase), meditation, special movements and relaxation of the tongue, for example, when singing and speaking (stimulation occurs due to the innervation of the larynx and tongue by the vagus nerve), facial gymnastics (facial expressions have a double connection with the function of the vagus nerve, motor and emotional), improvement of intestinal health, physical exercise and getting enough rest and, most importantly, managing stress and anxiety.

However, from the pragmatic point of view of massage therapists and chiropractors The question often arises: “How can I influence this nerve through touch, and what will this lead to?”

THE VAGUS NERVE AND THE HUMAN EAR

The human ear is the only place where the vagus nerve reaches the surface of the body (auricular, auricular branch, Fig. 2). Transcutaneous stimulation of this branch can be used to treat a variety of diseases associated with the vagus nerve. In Europe, this method is used to treat epilepsy, migraine and chronic pain.

The auricular branch of the vagus nerve consists of sensory neurons, therefore, sensory stimulation of the parts of the ear innervated by the vagus nerve (Fig. 3) stimulates the activity of the vagus nerve. In most therapeutic cases, deactivation of the sympathetic nervous system is required. Neat, delicate touches of medium intensity (Fig. 4) demonstrate the greatest effectiveness. A study of the effects of massage on the vagus nerve in infants found that the nerve responded better to moderate-intensity touch than low- or high-intensity touch. For many clients, including ear work in a session may come as a surprise - first ask permission, explain the essence and purpose of your manipulations.

Does it have a positive effect? manual therapy on the vagus nerve? Of course it is. Of course, the effect will not be as pronounced and rapid as with direct long-term electrical stimulation, but research shows that in this case there is certainly a clinically significant effect on the tone of the vagus nerve. Understanding the function and structure of the vagus nerve stimulates your imagination and creativity as a therapist. Working with the ears is especially useful for headaches and dysfunction of the temporomandibular joint, due to the ability of the vagus nerve to relax both the body and the emotional component of a person.

TECHNIQUES FOR WORKING WITH THE VAGUS NERVE(Illustrations – Fig. 4, Fig. 5)

TARGET

Increasing vagus nerve activity through gentle stimulation to increase sensitivity.

INDICATIONS FOR USE

Headache, migraine

Dysfunction of the temporomandibular joint.

Stress, anxiety, increased excitability of the sympathetic nervous system

Possible positive effect in the treatment of tinnitus, mood disorders, digestive problems, work disorders immune system and autoimmune diseases.

INSTRUCTIONS

Use gentle touch, medium-intensity pressure, or light traction on the pinna to increase sensitivity in the areas of the ear innervated by the vagus nerve.

For migraines and temporomandibular joint dysfunction, find areas hypersensitivity and use active jaw techniques.

VERBAL ASSISTANCE

“Exhale as slowly as possible, pushing all the air out of your lungs.”

"Try to relax your tongue"

“Try humming your favorite song while keeping your neck and jaw relaxed.”

For migraines:

"Rotate eyeballs, alternately looking to the right and left"

For TMJ dysfunction:

“Gently open your mouth, trying to get your lower jaw as far away from your ears as possible.”

Contents of the topic "Cranial nerves.":

1. Facial nerve (VII pair, 7 pair of cranial nerves), n. facialis (n. intermediofacialis).
2. Branches of the facial nerve (n. facialis) in the facial canal. Greater petrosal nerve, n. petrosus major. Drum string, chorda tympani.
3. The remaining branches of the facial nerve after exiting the stylomastoid foramen (foramen stylomastoideum). Intermediate nerve, n. intermedius.
4. Vestibulocochlear nerve (VIII pair, 8 pair of cranial nerves), n. vestibulocochlearis. Parts of the pre-cochlear nerve.
5. Glossopharyngeal nerve (IX pair, 9 pair of cranial nerves), n. glossopharyngeus. Nuclei of the glossopharyngeal nerve.
6. Branches of the vagus nerve in the head and neck parts n. vagus
7. Branches of the vagus nerve in the thoracic and abdominal parts n. vagus Recurrent laryngeal nerve, n. laryngeus recurrens.
8. Accessory nerve (XI pair, 11 pair of cranial nerves), n. accessorius.
9. Oculomotor nerve (III pair, 3 pair, third pair of cranial nerves), n. oculomotorius.
10. Trochlear nerve (IV pair, 4 pair, fourth pair of cranial nerves), n. trochlearis.
11. Abducens nerve (VI pair, 6 pair, sixth pair of cranial nerves), n. abducens.
12. Olfactory nerves (I pair, 1st pair, first pair of cranial nerves), nn. olfactorii.
13. Optic nerve (II pair, 2 pair, second pair of cranial nerves), n. opticus.

N. vagus, vagus nerve, which developed from the 4th and subsequent gill arches, is so called due to the vastness of its distribution. It is the longest of the cranial nerves. The vagus nerve supplies with its branches respiratory organs, a significant part digestive tract (before colon sigmoideum), and also gives branches to the heart, which receives fibers from it that slow down the heartbeat. N. vagus contains three types of fibers:

1. Afferent (sensory) fibers, coming from the receptors of the named viscera and vessels, as well as from some part of the dura mater of the brain and the external auditory canal with the auricle to sensitive nucleus (nucleus solitarius).

2. Efferent (motor) fibers for the voluntary muscles of the pharynx, soft palate and larynx and the efferent (proprioceptive) fibers emanating from the receptors of these muscles. These muscles receive fibers from motor nucleus(nucleus ambiguus).

3. Efferent (parasympathetic) fibers emanating from vegetative nucleus (nucleus dorsalis n. vagi). They go to the myocardium of the heart (slow down the heartbeat) and the muscular lining of the blood vessels (dilate the blood vessels). In addition, the cardiac branches of the vagus nerve include the so-called n. depressor, which serves as a sensory nerve for the heart itself and the initial part of the aorta and is in charge of the reflex regulation of blood pressure. Parasympathetic fibers also innervate the trachea and lungs (narrow the bronchi), esophagus, stomach and intestines to colon sigmoideum(strengthen peristalsis) located in the named organs of the glands and glands of the abdominal cavity - liver, pancreas (secretory fibers), kidneys.

Parasympathetic part of the vagus nerve is very large, as a result of which it is primarily an autonomic nerve, important for the vital functions of the body. The vagus nerve is a complex system consisting not only of nerve conductors of heterogeneous origin, but also containing intra-trunk nerve nodes.

Fibers of all types associated with three main nuclei of the vagus nerve, exit from the medulla oblongata in its sulcus lateralis posterior, below the lingual tray nerve, with 10-15 roots, which form a thick nerve trunk, leaving the cranial cavity together with the lingual tray and accessory nerves through the foramen jugulare. In the jugular foramen, the sensitive part of the nerve forms a small node - ganglion superius, and at the exit from the hole - another ganglionic thickening of a fusiform shape - ganglion inferius. Both nodes contain pseudounipolar cells, the peripheral processes of which are part of the sensory branches going to the named nodes or receptors of the viscera and blood vessels ( ganglion inferius) and external auditory canal ( ganglion superius), and the central ones are grouped into a single bundle, which ends in sensitive nucleus, nucleus solitarius.

Upon exiting the cranial cavity vagus nerve trunk goes down to the neck behind the vessels in the groove, first between v. jugularis interna and a. carotis interna, and below - between the same vein and a. carotis communis, and it lies in the same vagina with the named vessels. The vagus nerve then enters through the superior aperture chest V chest cavity, where its right trunk is located in front of a. subclavia, and the left one is on the anterior side of the aortic arch. Going down, both vagus nerves go around the root of the lung from behind on both sides and accompany the esophagus, forming plexuses on its walls, with the left nerve passing along the front side, and the right one along the back. Together with the esophagus, both vagus nerves penetrate through the hiatus esophageus of the diaphragm into the abdominal cavity, where they form plexuses on the walls of the stomach. Vagus nerve trunks in the uterine period they are located symmetrically on the sides of the esophagus. After the stomach rotates from left to right, the left vagus moves forward, and the right one moves back, as a result of which it branches on the anterior surface left vagus, and on the back - right.

Nervus vagus(n. vagus) innervates the membranes of the brain, organs of the neck, chest cavity, and most of the abdominal organs. The fibers of the vagus nerve carry impulses that slow down the heartbeat, narrow the bronchi, increase peristalsis and relax the intestinal sphincters, increase the secretion of glands, etc. The vagus nerve contains sensory, motor and secretory fibers. Sensory fibers are the central processes of pseudounipolar neurons of the superior and inferior ganglia of the vagus nerve. The superior ganglion superius of the vagus nerve is located at the level of the jugular foramen, the inferior ganglion inferius is slightly lower. The motor fibers of the vagus nerve begin from the double nucleus located in the tegmentum of the medulla oblongata. Autonomic preganglionic parasympathetic fibers originate from the posterior nucleus of the vagus nerve. In addition, the vagus nerve contains sympathetic fibers that approach it as part of the connecting branches from the sympathetic trunk.

The vagus nerve leaves the medulla oblongata with 10-18 roots behind the olive, next to the glossopharyngeal and accessory nerves. The roots of the vagus nerve unite into one trunk, running through the anterior part of the jugular foramen. After emerging from the foramen, the vagus nerve is initially located behind the glossopharyngeal nerve and anterior to the accessory nerve and internal jugular vein, lateral and anterior to the hypoglossal nerve. In the neck, the vagus nerve passes between the internal jugular vein and the internal carotid artery, and below - between the same vein and the common carotid artery. The common carotid artery, vagus nerve and internal jugular vein form a neurovascular bundle in the neck, surrounded by a common connective tissue sheath. The vagus nerve then enters the chest cavity, posterior mediastinum. The right vagus nerve passes in front of the right subclavian artery, the left vagus nerve passes in front of the aortic arch. Below, the vagus nerve runs along the posterior surface of the root of the lung on its side. Further, both nerves are adjacent to the outer surface of the esophagus. The left vagus nerve gradually shifts to the anterior surface of the esophagus, the right - to its posterior surface. The vagus nerves, together with the esophagus, pass through the diaphragm into the abdominal cavity. The left vagus nerve is located on the anterior wall of the stomach, the right - on the back.

According to the topographic principle, the vagus nerve is divided into head, cervical, thoracic and abdominal sections.

The meningeal and auricular branches depart from the cephalic section of the vagus nerve (to the level of the jugular foramen):

1. the meningeal branch (r. meningeus) from the superior ganglion of the vagus nerve goes to the dura mater of the brain in the posterior cranial fossa, and then to the occipital and transverse sinuses;
2. the auricular branch (r. auricularis) from the superior ganglion of the vagus nerve passes through the mastoid canal of the temporal bone, innervates the skin of the posterior wall of the external auditory canal and outer surface auricle.

Several branches arise from the cervical spine:

1. pharyngeal branches (rr. pharyngei, s. pharyngealis), two or three in number, go to the walls of the pharynx, where, together with the branches of the pharyngeal nerve and the superior sympathetic ganglion, they form the pharyngeal plexus (plexus pharyngeus). The pharyngeal constrictor muscles are innervated from the pharyngeal plexus; levator muscle soft sky; uvula (palatine) muscle, palatoglossus and velopharyngeal muscles. Sensitive branches of the pharyngeal plexus innervate the mucous membrane of the pharynx and root of the tongue, as well as the thyroid and parathyroid glands;
2. the upper cervical cardiac branches (rr. cardiaci cervicales superiors) depart one to three from the vagus nerve or from the superior laryngeal nerve and descend down along the common carotid artery. These branches run along the back surface thyroid gland, then the left branches - along the anterior surface of the aortic arch and are part of the cardiac plexuses. The left upper cervical cardiac branches participate in the formation of the superficial extraorgan cardiac plexus, the right ones enter the deep cardiac plexus. The superior cervical cardiac branches also innervate the thymus and thyroid gland;
3. The superior laryngeal nerve (n. laryngeus superior) departs from the lower ganglion of the vagus nerve, runs forward along the lateral surface of the pharynx, posterior to the internal and external carotid arteries. At the level of the hyoid bone, the superior laryngeal nerve is divided into external and internal branches. The external branch (r. externus) innervates the lower constrictor of the pharynx, the cricothyroid muscle, and sends fibers to the thyroid gland. The internal branch (r. internus), sensitive in composition, together with the superior laryngeal artery pierces the thyrohyoid membrane and innervates the mucous membrane of the larynx above the glottis and the mucous membrane of the root of the tongue.
4. the recurrent laryngeal nerve (n. laryngeus reccurens) has a different origin on the right and left. The right recurrent laryngeal nerve departs from the vagus nerve at the level of the subclavian artery, bends around it from below and behind, and rises along the lateral surface of the trachea. The left recurrent laryngeal nerve begins at the level of the aortic arch, bends around it from below in the anteroposterior direction, and goes up in the groove between the esophagus and trachea. Tracheal branches arise from the recurrent laryngeal nerves. The final branch recurrent nerve on each side is the lower laryngeal nerve (n. laryngeus inferior), which innervates the mucous membrane of the larynx below the glottis and all the muscles of the larynx, except the cricothyroid.

IN thoracic region branches extend from the vagus nerve to the internal organs:

1. thoracic cardiac branches (rr. cardiaci thoracici) are directed to the extraorgan superficial and deep cardiac plexuses;
2. bronchial branches (rr. bronchiales) go to root of the lung, where together with sympathetic nerves form the pulmonary plexus (plexus pulmonalis), which surrounds the bronchi, entering the lung with them;
3. esophageal branches (rr. esophageales) participate in the formation of the esophageal plexus (plexus esophageus) located on the surface of the esophagus, the branches of which go to its walls, muscles and mucous membrane.

The abdominal part of the vagus nerve is represented by the anterior and posterior vagus trunks emerging from the esophageal plexus and their branches:

1. the anterior vagus trunk (truncus vagalis anterior) passes from the anterior surface of the esophagus to the anterior wall of the stomach, located along its lesser curvature. From the anterior vagus trunk, the anterior gastric branches (rr. gastricianteriores) and hepatic branches (rr. hepatici) extend to the stomach, which go between the leaves of the lesser omentum to the liver;
2. the posterior vagus trunk (truncus vagalis posterior) passes to back wall stomach, located mainly along its lesser curvature. The posterior vagus trunk gives off the posterior gastric branches (rr. gastrici posteriores) and celiac branches (rr. coeliaci), which go along the left gastric artery to the celiac plexus.

Vagal fibers conduct impulses to organs in the head (innervate the larynx, palate and middle ear), as well as the chest and abdominal cavities.

The main functions of the vagus nerve are related to the functioning of the parasympathetic nervous system. What does it mean? - IN nervous system Human beings have a pair of opposites – the sympathetic and parasympathetic nervous systems.

Sympathetic– associated with the activation of the body, vigorous activity, aimed at increasing the speed of reactions, intensive production of hormones, prepares for running, for fighting.

Parasympathetic nervous system - prepares the body for relaxation, recuperation, digestion of food, sleep, sex and other activities related to pleasure. Thus, the vagus nerve partly regulates a person’s mood and sleep.

With chronic overexcitation of the nervous system, muscle hypertonicity And similar conditions Vagus nerve dysfunction may be suspected.

Where is the vagus nerve located? – You can feel it yourself directly in the hole under the earlobe.

Coming from the jugular foramen of the brain, the vagus descends along the side of the neck as part of the neurovascular bundle along with the carotid artery and internal jugular vein. Passes near the trachea and pharynx, innervating them. Next, the vagus passes into the chest cavity, its right branch runs next to the right subclavian artery, and the left one is in front of the aortic arch. Both branches approach the lower part of the esophagus, passing from it in front and behind, and regulate its functions. Next, through the opening of the diaphragm, both nerve fibers enter the abdominal cavity. They innervate the stomach. Then some of the fibers go to the liver, some to the celiac (or solar) plexus. From the celiac plexus, fibers approach all organs of the abdominal cavity, except lower sections colon and pelvic organs.

The vagus nerve contains fibers responsible for motor skills and sensory skills (mixed type), but all its activities are still connected with the autonomic nervous system - from the word “vegetable” - “vegetable” (that which cannot be controlled by consciousness) - in contrast somatic nervous system - from the word “soma” - “body” (we can consciously control muscle movement).

Symptoms of dysfunction

Since the vagus nerve innervates the larynx, damage to it leads to problems with speech and uncomfortable swallowing, and loss of the gag reflex. Disruption gastrointestinal tract– also one of the manifestations of vagal dysfunction, manifested in loss of appetite, a feeling of satiety may occur after taking small quantity food.

Causes of defeat

One of the causes of damage to the vagus nerve is diabetes. A mechanism that destroys nerve fibers, has not been fully studied. Damage and irritation of the vagus nerve can also be caused by injuries to the body, for example, during car accident and others when a pinched nerve occurs. Surgery can also affect the functioning of the nerve.

Exercises to stimulate the vagus nerve

Preparation:

• Sit upright on a chair with your hands on your knees
• Place both feet on the floor and take a deep breath

Neck area

• Stretch your head as far as possible with the top of your head up and turn it left and right. Repeat this movement several times.

Lower jaw area

• Move lower jaw, slowly opening and closing your mouth, moving it from side to side, back and forth. Feel the muscles in your jaw, which may be causing tension. painful sensations. Do this exercise until you feel slight fatigue in your jaw.

Eyes

• Open and close your eyes. Look in different sides without moving your head - left and right, up and down. Alternately open your eyes wide and squint.

Facial muscles

• Think back to your childhood and spend a few minutes “making faces”, trying to use as many facial muscles as possible.

Middle ear

• Listen. Hear background sounds environment, for example, the creaking of chairs, the sound of tires of a car passing on the street, the chirping of birds, the sound of an elevator, the noise of a running computer, the rustle of an air conditioner or fan.

Throat

• First, make a few “coughing” movements (as if something has entered the trachea), and then swallow the saliva.

Larynx

• Start developing your voice, for example, you can hiss like a snake, or roar like a lion. The main thing is that these sounds lead to tension in the muscles of the larynx.
• Feel the vibration in the larynx; the vibration sound should reach the diaphragm and spread throughout the abdomen.

Listen to how you feel, especially the sensation in your chest. Pay attention to every positive change, no matter how small. By performing this complex daily, you will increase the tone of the vagus nerve and the entire body, and revitalize your internal energy!