Hospital pediatrics. Vegetative-vascular dystonia. Arterial hypertension. Clinic, diagnosis, treatment (lecture notes)

Lecture notes, cheat sheets
Free library / Directory / Lecture notes, cheat sheets

Hospital pediatrics. Vegetative-vascular dystonia. Arterial hypertension. Clinic, diagnosis, treatment (lecture notes)

Lecture notes, cheat sheets

Directory / Lecture notes, cheat sheets

Comments on the article

Table of contents (expand)

LECTURE No. 2. Vegetative-vascular dystonia. Arterial hypertension. Clinic, diagnosis, treatment

1. Vegetative-vascular dystonia

The sympathetic division of the autonomic nervous system primarily regulates adaptation and trophic processes in situations requiring intense mental and physical activity. The parasympathetic department of the autonomic nervous system exhibits its main function outside the period of intense activity of the body, mainly during the period of “rest”, and regulates anabolic processes, the insular apparatus, digestive functions, emptying of hollow organs, and helps maintain the constancy of homeostasis. Autonomic reactivity is changes in autonomic reactions to internal and external stimuli. Irritants can be pharmacological drugs (mezaton, adrenaline, etc.), as well as physical influences (cold, heat, pressure on reflexogenic zones, etc.). There are 3 types of vegetative reactivity:

1) normal (sympathicotonic);

2) hypersympathicotonic;

3) sympathicotonic.

Autonomic support is the maintenance of an optimal level of functioning of the autonomic nervous system, ensuring adequate functioning of various organs and systems under stress conditions. Vegetative support in practical work is assessed using the clinoorthostatic test (COT). Autonomic-vascular dysfunction is caused by a violation of the neurohumoral regulation of autonomic functions, which most often can appear with neuroses, physical inactivity, endocrine pathology in the prepubertal period and during menopause. But depending on the etiology and manifestations of VSD, pathogenetic disorders are distinguished at any level: cortical, hypothalamic, with a predominance of the parasympathetic division of the autonomic nervous system or the sympathetic division of the autonomic nervous system.

Determination of the variant of vegetative dystonia depending on the results of assessing the initial vegetative tone and COP. Clinical manifestations in some patients include fatigue, irritability, sleep disturbances, decreased pain sensitivity with various senestopathies. Signs of autonomic dysfunction may include palpitations with a tendency to sinus bradycardia or tachycardia; supraventricular extrasystole, paroxysmal tachycardia. Pathological vasomotor reactions can be manifested by a feeling of hot flashes, cold, decreased or increased blood pressure, pallor of the skin or hyperemia of the skin, general or local sweating, impaired secretory function, motor dysfunction of the gastrointestinal tract, and impaired sexual function. In the presence of neurovegetative imbalance, the activity of the parasympathetic nerves predominates, which is expressed by bradycardia, hyperemia of the skin, increased peristalsis of the stomach and intestines, a positive symptom of persistent red dermographism, and a decrease in pulse.

Treatment. Principles of treatment of vegetative dystonia.

1. Pathogenetic therapy, symptomatic therapy.

2. Long-term treatment to restore balance between parts of the autonomic nervous system; this requires more time than the formation of an imbalance between them.

3. An integrated approach, including various types of effects on the body.

4. Selectivity of therapy depending on the type of vegetative dystonia, both in constant (permanent) and crisis (paroxysmal) course.

The main sedatives in the treatment of vegetative dystopia in children.

1. Herbal products (valerian, motherwort, St. John's wort, viburnum, mint, oregano, sweet clover, lemon balm).

2. Tranquilizers (seduxen, tazepam, elenium, meproman).

3. Antipsychotics (sanopax, teralen, frenolon).

Non-drug therapy includes: proper organization of work and rest; maintaining a daily routine; physical education classes; balanced diet; psychotherapy; hydrotherapy and balneotherapy; physiotherapy; massage; acupuncture (according to indications). Types of sports for vegetative dystonia in children (recreational swimming, cycling, race walking, skiing, skating). Hydrotherapy depending on the type of vegetative dystonia, physiotherapy. Gymnastics, jumping, tennis, boxing, and weightlifting are not recommended. For vagotonia, showers (circular, contrast, needle, jet, Charcot shower), baths (oxygen, pearl, salt-pine) are recommended. For sympathicotonia, showers (fine, rain, circular) and baths (coniferous, sage-green) are recommended.

Stimulating and tonic herbal products (ginseng, lemongrass, eleutherococcus, green tea, licorice root). Nootropic drugs used in the complex treatment of autonomic disorders in children (piracetam, pyriditol, aminalon, glycine, glutamic acid, acepheren).

2. Arterial hypertension

Arterial hypertension is an increase in blood pressure from the mouth of the aorta to the arterioles inclusive.

Classifications of arterial hypertension: primary arterial hypertension and secondary arterial hypertension.

Etiology, pathogenesis. Etiopathogenesis of arterial hypertension.

1. Etiological factors: psycho-emotional effects, brain hypoxia, age-related neuroendocrine changes, perinatal disorders, salt overload.

2. First-line predisposing factors: hyperreactivity of nerve centers regulating blood pressure; dysfunction of norepinephrine deposympathetic structures. Borderline arterial hypertension develops.

3. Second-line predisposing factors: weakening of hypertensive renal function, disturbances of the renin-angiotensin-2-aldosterone pressor system, changes in cell membranes.

The development of hypertension in various forms

Before prepubertal age, an increase in blood pressure is observed more often with kidney diseases, endocrine pathology, coarctation of the aorta, pheochromocytoma, etc.

Classification. Classification of blood pressure levels and severity of arterial hypertension

1st degree. Systolic - 140-159 mm Hg. Art., diastolic - 90-99 mm Hg. Art.

Borderline degree: systolic - 140-149 mm Hg. Art., diastolic - 90-94 mm Hg. Art.

2st degree. Systolic - 160-179 mm Hg. Art., diastolic - 100-109 mm Hg. Art.

3rd degree. Systolic - more than 180 mm Hg. Art., diastolic - more than 110 mm Hg. Art.

Classification according to M. Ya. Studennikov.

1. Vascular vegetative dystonia of the hypertonic type.

2. Hypertension.

3. Symptomatic (secondary) hypertension.

Clinical manifestations. Often detected by chance, with diseases of the urinary system, the numbers of both maximum and minimum pressure usually increase. Hypertension with coarctation of the aorta is diagnosed by low pressure in the lower extremities and the presence of systolic murmur. Pheochromocytoma is characterized by high blood pressure crises and painful headaches; the diagnosis is established when an increased content of catecholamines is detected in the urine and blood. In prepubertal and pubertal age, hypertensive conditions occur with vegetative-vascular dystonia. Hypertension is unstable, pressure fluctuates throughout the day, and a close connection with emotional factors can be noted. There are complaints of poor health, irritability, easy fatigue, pain in the heart, feeling of heat, etc. An objective examination revealed tachycardia, inadequate response to physical activity, and autonomic lability.

Treatment. Treatment of arterial hypertension in vegetative-vascular dystonia: sedative therapy is indicated - bromine with valerian, seduxen, normalization of the daily routine, mandatory stay in the fresh air, children are shown moderate physical activity and sports with gradually increasing loads. For arterial hypertension, according to indications, diuretics, ACE inhibitors, β2-blockers, L-blockers, adrenergic blockers, and calcium channel blockers can be used.

Prevention: correct daily routine, nutrition, exercise and sports, sufficiently long sleep.

Author: Pavlova N.V.

<< Back: Immunodeficiency states in children. Clinic, diagnosis, treatment (Primary immunodeficiencies. Secondary immunodeficiency conditions. Principles of treatment of immunopathological syndromes)

>> Forward: Cardiomyopathy in children. Clinic, diagnosis, treatment (Dilated cardiomyopathy. Hypertrophic cardiomyopathy. Restrictive cardiomyopathy)

We recommend interesting articles Section Lecture notes, cheat sheets:

▪ Conflictology. Crib

▪ Advertising and promotional activities. Lecture notes

▪ Russian literature of the XNUMXth century in brief. Crib

See other articles Section Lecture notes, cheat sheets.

Read and write useful comments on this article.

<< Back

Latest news of science and technology, new electronics:

The existence of an entropy rule for quantum entanglement has been proven 09.05.2024

Quantum mechanics continues to amaze us with its mysterious phenomena and unexpected discoveries. Recently, Bartosz Regula from the RIKEN Center for Quantum Computing and Ludovico Lamy from the University of Amsterdam presented a new discovery that concerns quantum entanglement and its relation to entropy. Quantum entanglement plays an important role in modern quantum information science and technology. However, the complexity of its structure makes understanding and managing it challenging. Regulus and Lamy's discovery shows that quantum entanglement follows an entropy rule similar to that for classical systems. This discovery opens new perspectives in the field of quantum information science and technology, deepening our understanding of quantum entanglement and its connection to thermodynamics. The results of the study indicate the possibility of reversibility of entanglement transformations, which could greatly simplify their use in various quantum technologies. Opening a new rule ... >>

Mini air conditioner Sony Reon Pocket 5 09.05.2024

Summer is a time for relaxation and travel, but often the heat can turn this time into an unbearable torment. Meet a new product from Sony - the Reon Pocket 5 mini-air conditioner, which promises to make summer more comfortable for its users. Sony has introduced a unique device - the Reon Pocket 5 mini-conditioner, which provides body cooling on hot days. With it, users can enjoy coolness anytime, anywhere by simply wearing it around their neck. This mini air conditioner is equipped with automatic adjustment of operating modes, as well as temperature and humidity sensors. Thanks to innovative technologies, Reon Pocket 5 adjusts its operation depending on the user's activity and environmental conditions. Users can easily adjust the temperature using a dedicated mobile app connected via Bluetooth. Additionally, specially designed T-shirts and shorts are available for convenience, to which a mini air conditioner can be attached. The device can oh ... >>

Energy from space for Starship 08.05.2024

Producing solar energy in space is becoming more feasible with the advent of new technologies and the development of space programs. The head of the startup Virtus Solis shared his vision of using SpaceX's Starship to create orbital power plants capable of powering the Earth. Startup Virtus Solis has unveiled an ambitious project to create orbital power plants using SpaceX's Starship. This idea could significantly change the field of solar energy production, making it more accessible and cheaper. The core of the startup's plan is to reduce the cost of launching satellites into space using Starship. This technological breakthrough is expected to make solar energy production in space more competitive with traditional energy sources. Virtual Solis plans to build large photovoltaic panels in orbit, using Starship to deliver the necessary equipment. However, one of the key challenges ... >>

Random news from the Archive

Artificial leather for touch emulation 15.04.2024

In a modern technology world where distance is becoming increasingly commonplace, maintaining connection and a sense of closeness is important. Recent developments in artificial skin by German scientists from Saarland University represent a new era in virtual interactions.

German researchers from Saarland University have developed ultra-thin films that can transmit the sensation of touch over a distance. This cutting-edge technology provides new opportunities for virtual communication, especially for those who find themselves far from their loved ones.

The ultra-thin films developed by the researchers, just 50 micrometers thick, can be integrated into textiles and worn like a second skin. These films act as sensors that recognize tactile signals from mom or dad, and as actuators that transmit these movements to the baby.

Parents' touch to the fabric activates sensors that react to pressure and deform the ultra-thin film. This deformation is precisely reproduced in the second tissue that comes into contact with the baby's skin, allowing him to feel physical closeness, even at a distance.

Electrodes on both sides of the film react to deformation by changing its electrical capacitance. Intelligent algorithms predict and programmatically control the sequence of movements, controlling the deformation of the elastomeric film and emulating the parent's touch.

Artificial skin technology for virtual hugs opens new horizons in the field of virtual communication and intimacy. This development could be a valuable tool for those who are away from their loved ones, especially children quarantined in hospitals. Emulating touch from parents can bring solace and comfort to children during difficult times, as well as strengthen the bond between parents and children over a distance.

Other interesting news:

▪ Family crossover Nissan Pathfinder

▪ 48-layer 3D NAND flash

▪ Cocoa - protection against hypertension

▪ Solar energy will save bees from extinction

▪ Digital apocalypse

News feed of science and technology, new electronics

Interesting materials of the Free Technical Library:

▪ section of the site Personal transport: land, water, air. Article selection

▪ article Architecture - frozen music. Popular expression

▪ article Why does the sky turn red in the morning and evening dawn? Detailed answer

▪ article Polar and northern plants. Travel Tips

▪ article Generators on the timer KR1006VI1. Encyclopedia of radio electronics and electrical engineering

▪ article Self-untying rope. Focus secret

Leave your comment on this article:

All languages of this page

Home page | Library | Articles | Website map | Site Reviews