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636 rrparypu. B CCCP ody6nnxoBas pqA MoHorpaorii, pyKoBoacrB,
Oc1p.i ror '{.rrf 638
639 , r n ) p n u x o B ,y q e 6 r . r H xr a 6 , r H q r o p e o n e K c o r e p a f l y r , r A e c c o B p e M e H -
tlor€pq roroca (aeoHrt)
Ocrpun r xpotslcec(,. PnH{t u2 I r , 1 x f l 0 3 f i q n f i p a c c M a r p ] r B a x r r c r o c H o B H 1 ' 1neo , l o x e H n e p e o n € K c o -
s o c i r a a o r e o x o r o r o c o n u xr a 3 v x ( r a p a s a 3 a i ! H u i ' q H v c u ' ) rrl)an{x, o6cyxAanrcr M € x a H r { 3 M HM e T o A a . n o K a 3 b l B a o r c t e r o
I o . u s o h p y a .r r e L B e . r1 6 ) i . p H N f I r ! _ o v )
645
&8 a € q T e r r , H o c , bo p f a f i o B x c u c T e M o p f a H x 3 M a . e r o 3 { p ,
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i t r t ' t H q e (x o v f l r a H e l { , l a c c H q e c K Hlx. ( o t { l t e n u r t x \ , t e n r u x H b tB o c t o K a .
L Ta6nrra roq€R B Mecrax npucoe/rrHeHne M.p,AuaHosnpv' ( apvrv ' 650
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662
3. Ta6nirra moq€BUx roqrx (qy,lec{dx> MepnaraHoB 6r,rJr ocyuecrBrefi noqra rpxaua,r, rer Ha3aa (B 1959 r.).
662'
4. Ia6rP Ld roqPP uiPqa. rPe 663 N r I f a A a B f l o c r a n a 6 n 6 , r x o r p a O r q e c x o f i p e A l { o c r b r c .B r o N e e p e u a
5. Ta6jrua roqe( ntrfl ,xeM epn adax '
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6 Ta6nu[a rocex nqru 3re
6{i4 , , r i v c I n u n H H B o c r o x a l r c o B p e v e H H o i t .o K a l a n a c 6 H e c o B c e M
Aifa'uried cal.ae raceK atrang4rrltp,l
\ i L i r ! r o i , r a l { K a x 3 T o B b r p a 3 x J r o cbb 3 l l a q f i T e r f , H o My n p o u e H f f c y T
vrrrla De6,rexcoreDanus.

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MO)KHOCTS
r a R o e a 3 , r o x e H r r e M o x e T r l o c ! ' I y x I l r b , l y q r u e M y y c B o e H x r on p a K r I ' , _
c 6 0 , r b u r e i ln o c r o B e p H o c r b l oo r p a 3 x Tb o r H o u i e H n er p e B H e B o c r o q H b l x , r r c l ( o r o M a r e p r a n a . O A H a x o n o A o 6 H a e c x c r e M a T u 3 a u f i qs e c o r , ' I a -
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|,j nporHocrfirrecKtx xpnrepreB, KoTophre He norepq,(a cBoefo 3Haqe_ A , I q o 6 , r e r q e H r r i o n p e A e n e H n qr o q e K a K y n y H K r y p H B u a B a x
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Hse n B coBpeMefifiblx yc.loBfiqx pacnpocrpaHeH_
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x paqeftaoa o6uei peaaKlrneii 3_ re 3arpoMo)(aarb TeKcr x a/rr yrpoueHljg lr3Jloxexus Mareptana,
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o 6nacr, rrpoo XoaHr Bao Tey t h ' r a x c x u e H a 3 B a H B ror n y c K a r o r c H -
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"rlaXyaHr H ena. I l o p u r u H a , l e s a c r o e q e r o n e p e s o A a H e n p e a c , a B n e H ar o n o r p a _
, l ' H , r ' { a c r u s H e M e p u A x a t { H b rrx a y p t l 1 ( y r ' { p OaHaKo Bc€
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OneKcorepanrr. xoropHe tlBrqlorcq HenpexoAerqnMfi B HacTonruee
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.rRaMx: Ta6eeBa n. M. Py(oBoacrBo no tr,lopeo,lexcorepann|,l
craBneHsrM rpaAsuHoHHhrx KoHuenqxi HanplrMep. B Bo'rpoce
( M . : < M e a r r r r t f l a > . 1 9 8 0 ) ; " { y e c a u f . T p a A u u s o H H b r es c o B p e M e B H H e
{ c r p y x r y p a - 0 y u x q t q , B o c r o ' { H 3 qM e a t { q t { H ao c H o B H o eB H x M a H U e
y a c n r e r O l H K u o H a n b H o r lt r e q r e , l b t r o c r H a H e v o p 0 o , r o r H H B H y r ' i , . r e x r b r B o c r o ' { H o i ip € o , r e x c o r e p a n r n ( M . : < H a y x a > , l S 8 6 ) , a r a K
peHHr\ opfaHoB.flpH ,rou x nocneaHrv xpove lpr\'t0 clLrleclB]lo' a o r a 6 n r q a M x : K y 6 e p r e p M . 6 - , K a n y c r n H A . B . < O c H o B b tl , r n o
u x x p e a , ' r b B o c r e i :< n o " 1 u e > x < n " l o T H b l e >o p r a H H . K p o B b , < c o l ( x |e(bneKcorepanrx (M.: Meayvnoco6re, 1980, 1982, 1984).
t s c e K r r T a i c K f i en M e H a .a c r p e q a | o x l t e c s B r e K c r e n e p e B o r a , a a H b l
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n p e l c r a B l r e H a B H e u i H x M xQ a x r o p a M I i , f A e H a p q A y c 3 n n A e M n q M f i
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r pa3BltT!fl MeTOAa{r,royxar'IuBaHr{r x npgxljtaHHa Bo bheTHaMe
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B xHBore, KpoBaBbIa floHoc, TeHe3MbI.BblllaaeHre nPtlMol'l Klllxxlr, frHMy"rr{pyer nocneayloufifi, fi 3Ta cBt3L Mexay nr'rrorHblMl{opra_
- noaaB-
IIOHOCI,l{'IX3anop. 'r"nH xapaxrepaeyerct orHolxeHrtMu runa <nopoxaeHlle
10. MoqeBofi ny3brpb tBlrffercqoptaHoM,rae cxanntl-
BaeTcr Moqa arq [oc{'Ieaybulero BbIBeAeHIrsee Hapyxy, Haxo,Al'lTct reqeHLr <nopoxaaeTt (crlrMynapyeT) cepaqe'
B <noBepxHocrHo-BHyrpeHHeit cBq3q c floqKaMH, PaccrpoiicrBo Mo_ cepaue (nopoxaaer> (crlrMyntpyer) ce,le3eHKy'
'reBoro ny3brpt. o6bl,{Ho ilplrBoanr x aHypI{x. crpaHrypIIl' HoqHoMy ce,reselrxa unopoxaaer, (crrMy,.II,lpyer) n€rKre'
"rerxre unopoiAarcr> (cruMynlrpylor) noqKlt'
selepxaxfirc Mo'{n, npot3BoIbHoMy Moqe cnycxaHvro.
ll. Tpa uacrr rynoBnqa B b l n o r H q l o{ pr y B K t r l r lpoa H c _ noqKt <nopoxAarcr> (cruMynapylor) neq€Hb,
noprnpoBKr, r npeBpaueHl{t coxoB re{'Ia.
B ax ctrcreve pa3nlrqaloro6bl'{HoTptl qacrH: noqKIt <noaaBnqIoT) cepAue,
a) B€pxHqfl rracrb ryr'IoBfilua - or ypoBxt axoAHoro orBepcrtlt cepaue <noAaBnf,eT> !'lerxter
xeryAKa.4o ypoBHq KopHt t3blKa; 3ra qacTb uMee,r HeIIocpeAcrBeH' JerKrre <noaaBr'ltloT> neqeHb,
HOeOrHOneHIe K CepAUy n nerxljM; IreqeHb <noAaBnter> ce!'le3eHKy'
6) cpeaHqq qacrb ry!'IoBtnra - or ypoBHq BxoAHoro orBepcrl'jfl cene3eHI(a <noaaBJItert noqKlt
3Ta 2 B3aaMocBfl3b Mexay no,1bIML opraHaMn
xe,ryaxa Ao ypoBl{s nplrBpa,HnKa (BblxoAHoro orBepcrljt);
qacTb xMeeT orHoueH[e K cene3eHK€ u xeryaKy; ( )1 oureHHt MexAy nonllMrr opraHaMlr cBfl3aHH c (pyH(qxsMfi
B) HrxHtq qacrb ryr'IoBriqa - or ypoaHt npHBparHxKa Ao rL{i rrpfieMy nrul,l, ee nepepa6orKe, yaareHulo orxoaoB' pacnpe
'nnrar"rsxltx
ypoBHq BLIXOAHOIO OTBepCTt'{MOr{e CnyCKaTeJIbHOrO KaHara L 3aA_ rL",oegnro 3KcTpaxroB' T. e 3TO OTHOtIleHLt runa
HenooxoaHoro oTBepcTllg, xMeeT oTHoulexte K neqeH! g IorIKaM .IDespadleHfie rpaxcnoprHpoBKat
ilor no,reuy npa HaplueHHH rlopMarbHofo (PyxKuxoHupoBaHIt ll.B3aaMocBt3L, MexAy nnorHbIMfi t nor'If'lMI'l
crrcreMti rpex,racrei ry',IoBriua cneAyer qerxo pa3!'Ixqarb' B KaKox ,' l) r a fl a M r{. 6,'laroaaps KaHanaM, coeAliHglolur'tM nrorHHe fi no_
r,r3HHx flporcxoa,{T HapylxeHre. ",r,' ooraxsr. oHn HaxoAttrct ao B3alMoorHo eH|,l'{x <noBepxHocTHo-
Paccrpoicrno repxnefi qacr{ ryr'loBllua cs,laerenbcrByer o 3a6o_ " ' , r r p i n n e r o . T x n a ' 1 x 6 or n a H H b _ 9 H :
JIeBaHrrficeDrqa l,,Ix nerxrx, cpeaHefi - o 6ore3Hl ce"!e3eH(t tl,'Ill J'IETXTE CB'3AXbI C TO''ICTOI{ KITIIIKOH'

xexyaKa, HrxHei -.taule Bcero o 60,re3Hfi neqeHn trl, floqek. cepaue cBq3axo c roHKofi xxllxoi'
i2, f orognoi, cnr Hofi It xocrHLlfi Mo3r' XoltB fleqeHb cBg3aHa c xenqHblM ny3blpeM'
Bocroqfiofi MeafiuxHe fi pa3r'ltqalorctl ronoBHoft, cnrHHofi g xocrH6li c e n e 3 e H X ac B q 3 a H ac x e n y a K o M ,
v o r t . n o n D e A c r a B J e H f i l oa D e B H e B o c r o q H H \ B p a q e f f o H I ' 1 H ! 1 e l o r noqKl cBff3aHbl C MOqeBbIMny3blpeM,
o 6 u r e e r p o t r i x o x a e n a e . f o , 1 a ' B H o f iM o r r n p e a c r a B n t e l c s K a K 6 [ , 1 nepI,lI<apacBq3aH c TpeM'l qacrHMl, rynoBfiua'
.1. uK,rrcqH A,rq noHIrMaHnH) QyHKqlrfi opraHoB:
cBoeo6pa3HHM6acceiiHoM no orHoueHnlo I( cfltHHoMy Il KocrHoMy
nopoxAaerct Mo3r Il3 aHpa6arblBaeMoro a noqKax sKcrpaKTa' K ' r r c q o M , a n r rn o H I { M a H l l gn e q e H ! f l B , r t r c T c qu l a 3 a '
xorbpufi s cgorc oqepeab Bblpa6arblBaerct t3 nfiTare!'lbHblx Be- K,rrcqoM Ar'It noHnMaHxt cepAqa tBr'IqeTct t3blK,
LqecTB. Kr'lroqoManq noBI{MaHxt ce'I€3eHXa tB''Iflrorcq ry6bl,
H€aocra,o'{Hocrb Mo3ra ,rI,,60 Hapy[IeHte ero HopManhHou K,'IrOqoManq noHfiMaHfif r'IerK x qBnteTcq Hoc'
K!'troqoMInt norrfiMaHIt DorIeK flB'' IqIOTCCytult
oyHKurr Bbr3HBaer ror'IoBoKpyxeHre, uyM B yuax. nprrynneHxe
3peHnr. crn6Hylo noMoTy B xocTqx-
KocrH6ri Mo3r o6ecneqxBaer KocrtM Heo6xoaltMble rM nltrarerb- I TII,ITATEJII,HA' CYDCTAIIIIX'. XPOBb, 3AUII'ITllA'I CYBCTAHUXq'
HbIE BEI{ECTBA. o v H K U u O H A J | t ' H O EH A q A { o ( s H E P r x t ) , C O K I { T E J I A ' X t ' l [ X x E
Mo3r recH€filrll,tMo6pasou cansar c noqxaMl'i, O6bI'{Ho B K,'lt{tlll_ JKCTPAKTbI..TIYXOBHOEfl AqAJ|O>
'recKofi npaxrnKe !N'rt yKpenneHlrtl Mo3ra crfiMy,rlrpyror noqKa.
13, Marxa < o r B e q a e r ) 3 a M e H c , p y a n h H H eI r x K r b I l { 3 a c o c - l. Ilrrarenl'fiat cyccraHqxs. npofiAr B nfiqeBap|Tel'IbHoM rpaKTe
TorHre 3apoahlEa. oyH(ulroHa'lbHat aettrer'rbHocrb MarKx onpeae ' ' . . r h e r . t B l r o u l l | i r I t p o u e c c o 6 p a 6 o l x l t . n f i u a n p e B p a L r r a e ' c f lB n I r _
qfoobl
rreTcr cocTotHn€M nepeaxecpeaxHHoro r 3aaHecpeaHHHoro MepI{_ ',r'(,rbH)rc cy6craHu rc, Koropae HanpaBnterct h 11erKfiM.
nonacrs s paa'ruuxue Blyrpetlte opraHu a''Irr ooec_
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qac-
B. Ocrosale rnAu a:an ocBc3x MexAy Blyrpexxxntr opraxaMn' r( LrcHrs Ex n[TaHIteM, yxa3aHHat cy6craHll|lt cocror'rr ll3 AByx
q a c r r ' xa3blBaercq n f i T a r e ' r b H o t , M y r H a t q a c r b
L B3aIMocBt3b Mex!y nrorHtIMI'I oprasaMl't' r,ii: noo3DaqHat
2l
20
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x Ar{ocrL B Te!'reqe"'roBeKa,Koropar o6pasyercq B p€ynbrare
MHOTITX CIIOXHbTXnpeBpaUleHUt n!naTe,lbHLIX 9XCTpaXTOB'3aXJIK)- L OCItoBHHE nOJIOXEII]lt
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ynpaBnneMoll cepAqeM, (poBt tlB!'tqeTcq Icxr'I6qnre,Ibso BaxHoH (l ap€BHefirxux BpeMeH BocroqHat Meaulrnua paccMarpllBa'I4
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B. 3aq[Trar cy6craxrlrr. OrHocurenr,Ho nponcxoxAeHufl AaH- pyKoBoAtnuM nptlHqnnoM fipu oflpeaenexri{ Hop-
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MA,lbHOrO COCTOtilllf,
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ropanrlj r.r flpoQnral(TuKe 6o,Ie3Heri
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BeutecTBa, HeBsarMHe r,1a3y, - Bo3ayx, ras, Br'lary (Bo3ayxa) lepa3pHBHas, opraHrqecxaq cBcab, BocroqHat MeAl'lqllua acqH-
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B cBoeii auarHocrnq€cxofi u '1eqe6Hofi npaxr!(e Bpaq o6caaH
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ToB: flfirare,,rLHblfi sKcrpaKr, Bbrpa6arblBaeMbri opraHn3MoM x3 uirnnirsxe sa cocroqxle neqeH!. Hepea(o AocraroqHo flpfiMeHeHfiq
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f i, B , 1 r . 1 q H r r qpM
23
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27
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2. COAEPXAIUE PvKOBOAflILtXX
t u o p x o i o q a x t o p a n o c p i s n e x a r c c O a h r o p o M . B b l 3 u B a l o u l t ' t v< 6 0 -
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Manl'fioe I| na,o,lortqecKoe JHaqeHue 3rtx AByx nptHlrnnos pac_
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creil), cyxofi Kaulerb. '
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43
42
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f . [ I a n 6 n a qr I n y a r i o i a n A l a r H d c r x K al - n a t b D a u x e ' nvsbloql roqxa <TXoH>- COCTOtTHfie CepAIla u loHxott KHlxKIj'
a. flanbnaq{t l<oxt. JIerKrlMnflpfixocHoBeijacMri na'rbqeB Mox- '
cTenelL B,IaxHocTt h,IIn cyxocrg Kox[ t TaKIIM Ilpaaaa pyxa: <cllrb, orpaxaer cocroquueflepuKapaan rpel
HO OnpeaentTb qacre_liry,roinura; roqxa <xyaa, orpaxa€r cocrotune ce"te3etxn L
o6pa:ov c,le,rarr 3aK'lloqeHl'Ieo HaJlfiqt! firl'I orcyrcrBrH norrtl- x","vaxr; roqxu (TxoHt - cocroqltre rer(rx Ii roncroi KljulKu
s. BpeMs vc.reao"un{s ny,ibca.,qyquleeBpevn a'']t onpenere
6. fla,'rbnaq t Koreqsocrefi. Ten,lble KoteqHocrl npt c,rHAPoM€
qnvcToTbir B coqeTaHr c .xc{loaov, yKa3HBarcT Ha rtxe"'l6lH xa- rna nyauca yrpo, r{ornanauxeHl o6blqHoc[o(oeH. a nyJbc no!'I'
ga6o,resaxua,XoronH6le KoHeqHocrH y 6o'lbHbll 4ereff a co_ nee riero orpaiaer cocroflHue opraHI{3Ma, IIpfi &ccneaoBaHrs
oa'xreo nvrbca rDeOvtorcg rlruxHa x cnoxofiHato6craHoBRa
qetaniti c gucorofi reu[eparypoi cBrAerenbcrByloro Iracryna]ou(eM "
BtlloB Dalo?'lu'
yne Kor{Bynbcr,rt. r. Xapar.ieprcrlxa Hafi6oneepacnpocrpaHeHHHx
aprcf
' r uqecxor6nvorca, BcTpeqaloL[rxcf, B Krlr,HHqecxon flpaKrrxe
g,'fla,rrnarifir rpyAH ll xlloora: ecnn B 3nfitacrpanhHofi 06_ - Ooeeixnocrxuft ny'rbc {Qyl: xposeHocHblfi coc}A Bo 6peMe
racrt{ HveercflB3aylMex naJlbnaurt abIJHBaet6o''lb.To 9To cafi- rry,rrcoaofi io.nan exaquie'rrxo BuAaeict HaA (oxHbIM noKpoBoM;
;;;";;"y;i " "n"'apo"".nor"oro, Mirxocrb tr orcyrcrs,e 6onr
|lvooc npo,uyn"uaercclaxe np rletxoM HaaaB'lIBaHHrHa COCyII
nDfi nanhiauH troi o6'1acrfi- floKaraIeJI6 cYHAPova'flycrorhl)
xloaxreien npu 6one3g[ B HapyxHoi ee cra,axtl
naJlr,fla{us r B3Ayrle xnBora '
Eo,re3nesHbleouyqeHnt npu - f,ry6oinfr nynbc lqaM): nyrbcoBofi ynap 'florplxaercfl'
.floJlHOrH' trx orcytcrB e - o cHHApove
foBoDtT O CxHApOMe qyBcIByer'(ap' er,ry6s, novrr ao cBt3oK, Ao Kocru; qro6bl no'IyBcrBoBarb ero'
tnyciorsrt. Ecrr, flpxroxl{BraIIoHbK xnBoly. Bpaq ro"6vercc sHaurjre'ronoeHaaaBntBaHltena,rbuauI'l; cBraereltbcrByer
yc rrBaercq ro rMeer {ecro <noiHorar oore3-
xoiopui nocreneuuo n nairyrpeuxer'r, xapaxrePe 6o,1e3sl, o ee KoHlrexrpauxti Bo aHyr_
gr.. ic,rr *aD nocreneuso yMegbll'aerct' Han]iqo c]rHApoM-(nox_ oenneii "ucra reia, o cliMIIToMa\(flycroru! x c'la6ocrl'
'
"o.o xaorr, fcnx ananxaa-o6paryeruarot HaxarHt B o6"lacrH - MeaneHfi6lfinynEc (tlH): xapaxrepHbl3aMe4rleHHHe yaapbl'
,(xBora. Hcqe3aer6Hcrpo voxHo roBoPtrb 06 orexa\' ecrll 3a BpeMc oAHoro aHxare,'IbHoro qxKna o6blqHo IlporqynhlBaercq
BflatqHa ocraelctt a qBer Kox, He !3Mefiferct, To lMe€T Mecro
t(oxHat 9M(Pt3eMa
4
48
Tpl n\JhcoBHeBonHu:)xarLIBaet Ha HHb(fir.jH
crHApov. cHHApov
(xoJoaa) BHyrpeHHr.ix opraHoB,
EblcrpHfi nynhc (cax): xapaxrepr3yercq floBbrmeHHofiqac-
Toroft 5 6 !aapoB ra onl,|HnblxarerbHbrfiury,,rl caHteTe,lL,cl-
Bye,ro cxHApoMe <xapbrr.
<nycroi) ny,16c(xbt): KaK flplj nerKoM,TaK fi npfi cpeAHeMtl
clLlbHoMHanaBr'lHBaHrH AO BpeMqnaJlbnaUl{lt y nyJhcoBo[ BoJI]tbl
He vyBcTByercq <cxrbr> 3ro roBopr,rTo <nycToTe> 9Heprln t
hpoBH:e.,1Hnyr1b.onHoBpeMeHHo .nycrofir l, (noBep\HocTHbri..
1o
3ro y(a3blBaerHa 6o"re3HbnpocryAHoroxapaxTepa,oT neperpeBaHa
- <no,rHbrfi) nynbc (TXHX): flporrBonoroxeH no cBoeMy xa-
paKrepy<nycroMy),npfi fiaaaBruBanfiu nrc6oi creneHrouryuraerct
clrna ny!'lLcoBot Bor'lHbl;cBIrAereJrrbCTByeTo cxHApoMe<no,IHoTbIr;
xapaKrepeHrrrr 3a6oneBaHrfi , conpoBoxAarcurnxcqBHco(ofi TeMne-
parypoii u 3a.qepxxoi Ae(peKaunx.
- Cxo,163rulnii fly,Ibc (xoa,): KpoBb cBo6oAHo,nerKo rlripKy-
nrrpyerrlo cocyaaM;yxa3hrBaer Ha crHApoM<B?]axHocrr,tr, Har'lrqne
MoKpo'rbr, Ha cKonneHrerrfiruu B rrruleBapfiTelbHoMTpaxTe;y xeH-
lrlltx 9To Moxe, 6HTb noKa3are,reM6epeMeHHocrlr,
HepoBHbri (<uepoxoBarbrfi)) ny,16c (can): KpoBb npoxoAlrr
no cocyaaMc rpyAoM,xax 6H <npnrunaq>K creHKaM;no cBoeMy
xapaKTepynpoTxBono!'LoxeH c(onL3rr{eMy nyr6cy; roBopsT o Mano-
KpoBrrj, o 3acToeKpoBD,
- 6o,1burofiny,rbc (xoHr): xapa(repr.r3yercqcH,rbHblMl.r, orqer-
JxBbrMr{nynhcoBr{Mr{yAapaMn, HanoMr alouuMrj BolrH6rBo BpeMt
npu6os, yaapH oulylqarorcr cpa3y aaxe npfl JrerxoM nprKocgoBe-
Hfix na,'rbqeB;Ha6,'[oAaercr nprj sucoroi TeMneparype.conpoBox-
ra'oUleica xaxaofi r o6rn6H6rMnorooraeneHreM.
- ToHKr.tfirryrbc (rs): He6onbfiofi, c,ra66lfi, flo xapaoepy npo-
TrBononoxeH 6onhuoMy; cBHAerenbc, Byer o cnxApoMe<nycrorhl),
HanprxeHH6tt ny,rbc (xrcex): nps nanbnawlfi co3Aaerct
ouyqeHfie, qro ny,,IscoaHeylapbr Hanprxexxbre, fiaK BaTflHyrat
crpyHa: Ha6nroAaercsnpfi 3xartljTerbEbrx6ontx,,rfixopaA(e, <B,rax-
Cxarufi ny,rrc (KxaH): xapaxrep[3yercq noB6rueuHofiqac-
'roToH,IIpI,l3xarrfiTerlhHoMHaAaEJIrBaHI|lloulyulaeTct SaJuqlle (cq.
,rr,r, B ny,'rbcoBo! aor',rHe; o crlHApoMe<xolroaa,;
cBrAeTe?'rbcTByeT
Ha6,'rroaaercrnp 3Haqxre,lbxbrx6o,'rflx,
noBepxHocrHbri oqeHb Ma,rbrii nynbc (HIo): He6o,'Ihrxoi,
MqrKltfi, nprl ierKoM HaAaBrIHBaHtuHa cocyA nyr'lLcoBbleyAapl,l
npoqyflbrBarcrcq,np{ 3Haq[Ter'rbl{oM - r]cqe3arcT:cBfiaeTe.IbcTByer
o c,HApoMax(B,'IaxHocrx) x <nycrorbl>, 06 orexax.
* fny6oKHit ri oqeHb Ma,'rbriiny,rbc (Hljox): r,ry6oxxfi, Marblfi,
Mrrxxfi ; cBuere"'rbcrByer06 ocna6ne[rn oprafix3Ma, HeaocraroqHo-
crr 9Heorrgfi KDoBtt,
- AByy,(apHbrii(AnKporrqecl{ri1)nyr6c ( ay): cocyrbr Bhlr,'lt-
rqr Ha6yxrxriMn,Ho BHyrpfi oHx nycrbre, roqHo nepbrr 3enelioro
,ryxa; yKa3blBaerHa 6o,1l,uryrcnoreplo xpoBx.
50
CKopHft ny,qbc (rar): 6o,ree qacrHfi, qeM 6brcrp6li ny'rbc,
ra oa|rH nHxarer'IbHblti qrKn MoxHo Hacqrrar6 Ao 6 7 0 6onee
nynhcoBhrxyaapos; roBopar o cxnbHoM, flary6HoM Bo3AeicrBul'{
6oJrdHerBopHoro Oa(Topa (xapbr), 06 oc.la6reHfilJ lHbcKoi 9HeP
JanararrsalourHfi n\,1bc (\odfi): HecKoflbxo faMen'lerrHbri.
paBfioMepHhrii; cBHAere"lbcrByer o Har'lrqI,{!{3Heprrr xe'rryaKa] 8c)c)6-
|rle no cBoeMy xapaKTepy H€ tlBrqeTct naTolorHqec(HM, xort ll
Ha6,'rnaa€Tcs np', 6o,,re3Htx, BH3BaHHbrx<B,1axHoc161o).
Ma,r6ri nyrbc (Bn): oq€Hb c,1a6hlfi, He,{er(ti, MqrK{ji, ro
npoqynbrBaerct, To t{cqe3aer, KaK 6yITo flponaAaer coBceM; cst
aereJlbcTByer ()6 IlcTolueErIl flH. o 3Haqtre,16HoM ocna6,leHI'lq 3Bep-
rna r KpoBri €cnfi 6onbHoMy He oKa3arb excrpeHHyto noMolub. cnac-
rn ero se yaacrca,
-- CKpbrrbri ny,lbc (QyK): rlyr'lbcoBbleyaapH cKpblrbl B ."Iyor{qe,
aaxe np, cfi!'rbHoMHaaaBirBaHl,tl,t (<ao KocTHr) flyrbc He oqyua-
eTcr: cBnaererbcTByer o npoHxKHoBeHrt 6o,'re3HeTBopHoroQa(Topa
B H y T p bo p r a H l r 3 M a .
BHUe M6l nepeqficrx,l, 19 Har{6o,1ee qacro Bcrpeqao4lxct 3
K"lxHxqecKofi npa(TriKe BuaoB ny,I6ca fi3 Tex 28. xoropbre npxBoarr_
cr B Klaccr,{ecKofi MeALrufiHct{ofi nlrreparype.
flovrno erxx 28 BLrAos, cyrqecrByer eure l0 <Heo6br,{ailHblx)
g f i n o B n y r b c a . K o l o p b l e .K a K n p a a r r o . c B l { , I l e T e r ' l b c r B } l 0o 6l l c u e } H o
Bel rx 3Heprx xe{'ryrlKa fl 06 onacHoti, repMt{Ha,lbHoi cTaafifi
pa3BHrrrq 6o,te3sI,r,
IIy,rbcoBar Ararxocruxa rBJ'rflercq oaHofi H3 c"loxHeilnfix npo6_
, r e \ r a r a r H U c r ] K r x r p e 6 y e r o c o 6 e H H o r , l y 6 0 K o r o f i J y q e H H 9 ., [ l ' r t
oBr'raAeHfig rlcKyccrBoM flynbcoBoi AfigrHocrnxt Heo6xoAltMo rIo
c T o q x H o er r 3 y q e H f i eI c o B e p u e H c T B o B a H l lB e K J H H q q e c K o tn p a K T t K e .
|JIABHbIE TEPANEBT]IqECKhE MEPOTIP14'T]t'
1 . O C H O B H b T nEo r o x E H t l t
llpfiMeHr.rB ,rerbrpe afiarHocrnqec(fix MeroAa ll BoceMb pyKoBonr-
u"x npfifiqrooB arrt aHa,I 3a 3a6oreBaHfit, Bpaq onpeaenqer MeToa
,,reqeHfiq. MHoroBeKoBat npaKTt|<a flo3Bo!'II,t!Ia ApeBHeBoc,|oqHblM
MeAIiXaM BbIAer'Il'lTt)BOCeM6rrlaBHHx TepaneBT[LIeCKIrl M€ToAOB I'l
HecKoJbKo loIIoJlHr{Te"l6H6rXCnOCO6OB "leqeHlr'l 6O,Ie3Heil,
2. AOCEMb ulAaHblx IEPATEBTtt'lEc|(l' lx mEroAoB
BoceMb r,,IaBHbIxrepafleBTllqecxfix MeroaoB BK,'Ircqalor B ce6q: npfi-
M e s e H r e a o r o r o H H H x c p e n c T a , p B o r H H x c p e A c T B ,o r { t l q e H r e o p r s _
Hrr3Ma,ero peryr''Itqrlo, oxnaxaeHre L corpeBafiI,le opraIlx3Ma, .4,'lx_
Bxaaufio pa3nrqfiHx cKon,'IeHnt Ii MoI(poTbI,yKpenr'leHfieoprasI,l3Ma
A. IIpx efi€Ht€ aocbll, rraaflH)( Tepaflearlqec(fix xeroAoa
L n o r o r o H H o e r e q e H r e. 3TfiM MeroaoM o6l,qHo,1eqar
6 o n e l H l r s r o i l x \ c r a a r f i . K U r t a 6 o , l e r H e r B o p H H eO a k r o p H e u e H e
vrnv6xnHcbBHvrpEopraHr3Ma,B xaqecrae nororoHHHxcpencrB Heo6xoAr.rMHe npr 9ToMnexapcrBa raKxe AeJInr Ha (nPoxnaA-
no,risuorcg Peiifla ocyrnoidesL.. ceM. Labiatae.Mtroi, xopHuefi [bre> (peBenb) ,i <renrH€> (Croton iiglium L. ceM. Euforbiaceae).
x r. a. -[,rn neqeHut 6G1eJHeflB cnoBepxHocrHofi)craafil,t Bo3refi' flpexae ,{eM Ha3Baqrrh JIeqeHUeorlruleHfleM, c"Ieryer o6partrh
crBvror raKxe Ita roqKli xon'l(ol( (x3_ry, 4CI) t QoHr-MoH (oeH- EHtMaHfieHa coclotHte 6o,'Ibliofo c qenblo onpelenuTb cTene8h
ugrir, l2 V). uTeHCHBHOCTT{ O,rfiqeu{t (SHeprrqHoe nt nocTeneHHoe).
B gasrlcfiuoct]i or xapa(Tepa nororoHHblxlte(apcrB ,x MoxHo flo,rb3yflcr, yKa3aHnErMMeroroM, cJleAyer noMHtrb, qro ecn
pa3aeJrHTb 8a lBe KaTeroPnu. 6onBHr, erqe fie flepeuJa c <noBepxfiocrlroff>craAlrfi Ha (BEyr'
JlexaDcrsa, BbI3bIBaloulHe <Te[/rory>t crrMyntpyloulre noro_ DeHH|otot xJ|}' ecnr, nepetaq lra <aflyTpe[Hloo, cTaal{lo, oHa
orae,rexre.ll:r npxMeHtornpx cxHApoMe .noBepxHocrHHixonoa'' re ycnera raM <yxopeHtTbct>,ro Mstoa oqfiueHst nptMefiqrb
(orAa y "6onbdoro Ha6nloAalorcc cr.Jl68at 3t6Kocrr,, He6o'ltujoe
noeuureruereuneparypHTera. rorloBHat60,'Ib,oTcyTcIaHe )Raxabl. 4. M e r oA p e r y r'l t q fl r o p r a H r 3 M a, Cocrour a npuue'
nvrbc
" noBeoxHocrHhlfi (Qy). cr{ardn (xxaH). HeHrl,l.rreKapcTBeHHbrx cpeacTB,oxa3HBap ll{x perynupyroqee Bo3'
, ,rlexipcrea, Bbr36lBalouxe<npoxnaAy), crrMynrlpylolrlte no. aeircrBre Ha opraHn3M, a-!t re'reHfifl 3a6oieBaHlfi B <nonynoBepx_
TOOT,4eJresrre,rcnoJlb3yloTcf,npl{ cllHApoMe<HapyxHat xapar, xorl Hocrxoi-noryBHyrpeHHefi) craAsfi, Anfl peryntrqlll oyttKtlsli ne'{e-
aa y 6o,,r6noroHa6nloAarorcsHe6orhllaq 3t6Kocrb, Bbrco(at reM' l|rr, ceJreseHKt,xenyaxa. c gToi xe ueJbro MoxHo npl'rMeHnTb pe-
nepirypa rera, rotoBlat 6oJIb, xaxra, nyril6c IIoBepxHocrlblff lrenr <Tbrey cafi xo rxafir> (nerKoe xaponoHlxarc lee sa ocHoBe
(0y), 6blcrpHft(caK). BriDleurum sinense Dc) 'rx6o Bo3AeficrBoBarbHa roqKt rll-Kay
flpuueuaa nororouxoe ,'IeqeH[e,Heo6xoArMo[Merb B BnAy c"le" (qxtl roy, 6TR), 3blo8r_naHr_Ty€H (cH_n'lH_qrcaHb, 34VB), a rax'
AYIOUTIiE MOMEI H: xe peuefiT<Tbrey3to raH> unt Bo3aeicrBoBar],Ha roqxr rxai-cyH.
- IIo,'IBoBarbct 9TrM MeloaoM MoxHo rlllllb B ToM c'rlyqae, (ran''{yH, 3F), ryK'raM-.r}i (q:y-casr-'rr, 36E), Hofi'xyaH (rcft-
xorAa BHemHl,lt 6orBflerBopHui .QaKTop eure He IIporHK B r'1y6L ryaHb,6 MC).
oDraH13Ma (KoaAa 6one3Hb B (noBepxfiocrHorl> craAnH). npn6erar K Meroay p€ayJ|tqtr, Heo6xoAlMo fiMerb B Btry cr're_
- Meroa nporliBono(a3aH npn 6onl,lxofi norepe xpoB& Ilrfi co_
I(OBTe./ta. Meroa noKa3aHro,rbxo B rex cJlyqatx. Koraa 6o'1elH6Ha_
- flororoxnoe neqefifie cneAyer npeKparl'trh cpa3y xe nocne )\onHrcaB .nory'|oBepx{oclHofi-noJ}sHyrpeHHefi! cla[0n, llpHMe-
rr,rKBfiAaIlrll 6one3HerBopHoro 0aKropa B (noBepxHocrHot) craAl,ls HgTbero B <noBepxHocrHoi)I,rrrd(BltylpelrHefi> craalit 6o',Ie3HsHe
pa3BllTxi 6one9Hrj. Pel{oMeHAyeTct.
Ilor,ruenenne lloroloHHoro r'IerleHltt neloM, Bo BpeMt xapbl Meroa noxagaH&'It peryntulrlr QyHXqxt neqeHl'r,ce'le3eHxu,
r o , r x H o 6 b l r b o q e H bo c l o p o x H b l M . )Kenyaxa,,Eirr neqeHnq 6on€Hei, Koraa BepxHga IIoJIoBtHa reJla
2, fl D n ue xe r re p Bor H bIx c peacr B, Ant cflrMy,tllpo_ rxor'roAHaa),flrxHqn - <roptqaat nI,60 Bepxx'It noJtoBfiHa<ropt"
uasnn oiot" norldytorct Cucumes melo L.. noBapeHHoico'lbto x qaflr, sljxHaq - <xoroAHatr, He cneayer npn6erarb x y(a3aHHoMy
Pichorda ibrutuga Lour' ceM. SaxiIragaceae C ?rofi xe uerhro M€roAy,xorAa y 6o,rbHoroxaxAa, 6peA, 3anop.
rpolrJBoltfiT recxoe MexaHtrlecxoe pa3apaxeHxe r,'lorxl'I. qTo6bi x3' 5. Mero q c o r pe B a H I,It o p r a H n 3 M a. A,'rn corpeoanaa
6 a B H T L c r o r M a r e p f i a , l 6 H b l x6 o ' r e 3 H e r B o p H H xO a K r o p o B . n A o a , c o - "praHu3Manor63vtoTcfl ''leKapcTBaMLl,
Bbl3blBarcLuHMtr Tennoly (Aco_
xpallclo ltxct B xeJlyAxe, ntxBriAnpoBaTb cxorlJlefiIr€ MoKpoTbI x rrit.rm naoetlus L. ceu. Raiunculaceae.Zinsiber oflicinale Rosc
c,tlt3fi. 3a6HBaoqHx fpaxerc, MoxHo TaKxe Bo3aelcTBoaaT6 Ha reM. Zineiberaceae, Cinnamomum loureirii $ss. cev. Lauraceae).
r o q K n H o t - K y a ( F a n ' r y a H b , 6M C ) t r q y H r - ( y a H ( q x y l r - D a H b , l 2 V C ) . ,'r}16onpixararor roqK8, cnoco6crBylou{&enoaB,len rc TenrorH B
IlpriMeHrr ?Tor MeroA, Heo6xoAnMo y'lxrHBarb cneAyroqxe 06_ rene. MeroA noxa3aH B crlyqatx) xotAa 3a6oJleBaHrgBbtgBafihl
crosriDcrsa: Meroa nporlBonoKa3aH He(oropoli xareropnq 6orb- 6one3HerBopHl,rM (pa(TopoM(xonoaa), KorAa ocJaonefia 9B-gfiepri'tt.
rrblx oc,ra6neHflblM, crapblM, 6€peMeHH6lMxeHu{tHaM, 6on6HbIM, ,rleqeHxecorpeBaHlreMnpfiMeHterct a ocHoBnoMB c'rreayloqlrx
crpaaaDunM acrMoit, l'l c cltHApo-MoM4nycrorblr,
3. Mero.( oqHrqeHI{t.3ro1 M e r o a n p f i M e H f l e r cAa n s J l e - Ara BoccraHoB,reH!fltH-gEeprrl{l, 3au$trHbtx cltn opraHl'3'
.{eH r 3a6oneBaHtfi, Bbl3BaHHbIxraxuM 6one3lerBopublM OaKTopoM, v!. Har6o,reepacnpocrpaHeHHbrM anfl gfhx qenefirBnterct peuenr
Kax 3arrop,3acroi KposH, cKoflnexr€ MoKporH u cn]l3tl, rpe6yournx "Tbl Hfx rxaHr, t<qerHDex orBaDoB'), KyAa Bxo,afl1Aconitum
o q ! u e H u q o o r a H s g u a . 3 r o a o c r t r a e r c t c I r o M o u l b l oR h e u m s p . c e M . r,apellLrsL. ceM.Ranuncuiaceae, Zi;giber ofiicinale Rosc.ceu Zin_
Polygonacede, Mirabilita, cyrbQara Harptt, rnay6epoBo* confi giberaceae, r. e. cr,'IbHble corpeBaloune cpeacrBa, Kpor,{e roro,
x ap., nu6o Bo3aefrcrBueM Ha roqxl: Tyx_TaM_rr (u3y-caHb-nt, rt KaqecTBe ?KcrpeHHoiMepbtnprjMeHt|oT HenpephlBHoenp,lxuraHl,|e
36 E), rxxeH- y (rstrb-lny, 25 E), raM_aM'3to (csEb-uHb-q3'lo, t"'th, rras-Kx|oer (rlrHb-uroe.8 VC) ao rex nop. no(a He corpe-
6 RP). rorcrl KoHeqHocrH6o,'llHoro, qro tB!'Iterct cpeacrBoMnporrB 6one3-

52!
Hei, BH3BaHHbr:(BpeaHbIM 0axropoM <xonoAar, flpoHnKuuM cpa3y ceae nr6o Bo3aeftcrByrorHa roqKy SoHr_'loxr (S3H'nyH. 40 E).
B H y r p bo p f a H r 3 M a . - .&,1r v,,ry'{uenxf,uxpKvr'ltrlr{l{Kpoax flo"4grylorceSparganium
- Arr coapeBaHxr gH_3Heprnl,l,firKBliAaqlrx cl{xapoMa <xono_ i u c h - H a mC
\ l o l o n i f c r u nB , u r c u m az e d o a r i aR o s c c e v Z i n g i b e r a
Aar. floxa3are,lr,HblM aJIf ocyurecrBneHfiI sTllx lrerell cBJrterct.pe- c€ae. Flos cafthami ceM. compositae nl,160ao3aeicrBylor Ha roqxn
uenr <,rla qyHr rxaHr), Kyaa Bxoarr xeHr,IueHb, Aconitum nap-ellus xtoe,-xai (crce-xafi,l0 RP) r rxafi cysr (rai-qyH, 3 F)
koidzceM.Com_
macrocephala
Aiactylodes
i. c"". Ran'unculacere, - A,'1r o6,'rerqeHl|t BbIBoaa x[aKocrn Ir3 opraHH3Ma nptMe-
colpesarcurMBo3aetcrBlevfia opraHl|3v
positae,06raaaroulHe anrcr Crataequt pinnatilida Bunqe ceM.Rosaceaer&60 BolneicrBy-
l l p h M e H g o I r a K x e n p h x r l a H t r e K y a H - H r y e H{ r } a H b I o a H b . { v . , I x l i - S r H 6 .9 V C r n q l H f - x b r Kt q x y H _ u 3 l l
r o r u a r o v x H - r x r o r - O a(H
ri KxH-xai (ux-xaii, 6VC) trnu yxanHBaHneB ro'{xax ryx_raM-nn 3 VC).
(36 E) H qyHn-xyaH ( l2 VC) ars crflMyntqh| cun opraHr3Ma qTo6br npaBt{nbHoHa3Ha,rMr66o'lbHoMy neKapcrBo I'tr''IItcoqe-
B 6opb6e nporrjB 6on€HeraopHoro (paxropa <xonoaa>. TaHne ,'reKapcrB,npaBri"lbHoBbI6paT6 aKynyHKlypHbleToqxn. He'
Iipn npnteu"nnl yKa3axxoro Meroaa Heo6xoa Mo yqrrblBarl' o6xoarMo npexae Bcero roqHo nocraBfiTbAsarHo3.
C,leAyer rrMerb B BHAy, qro B 3aatcfiMocrt or cocrof,Hliq 3ao
Meto,q noxaean nrrlrL B c!'Iyqae crxApoMa <norxorbl) B poarr 6o"rrnoro MeroA ?r KBaaauuu cKonnestii Moxer 6bITr,
coqeTaH I c <xoroAoM). npnMeHeHoraenbHo t!'Ix B coqeraHtt c yxpennqbxll{MgcpeA_
- C,reayer 6urb oqelL ocropoxrblM a He npltMel{rrb reqeHl{e
TaK (ax 9ro Mox€r
corp€BaHrreM n p t c I { H A p o M e< n o x f i b l i x o r o A > , 8 . , q e q e H H e ' x p e n ' r e H l , | e t lo p f a H f i l M a C B o n f i T c t
nprBecTL
' X Cepbe3HbIM nocreAcTBgnM, l{ Ha3Haqexlo cpeAcrB, Toxn3ltpyollfix oc"Ia6neHHLliopraHH3M
6 . , t e] , r e i H e o x n a x a e H H e M o p I a H I r v a . O H o . c o ' 6o",rbHoro, raxrx iax xenrruenr, Radix Astragali cev. Fabuceae,
c T O T B n p I M e H e H H lc n p o r r ' l a n H b l x tC p e 4 c l B .T a K H xK a K r H n C K J l 1 2 O Anqelica sinensis (oliv.) Dilo ceu. Umbellifeiae, Rhizoma Reh-
m a c o o l i i i s c e u . R a n u n c u l a c e a eR, h i z o m a f e h m a n n i a ec e M S c r o ' ma-nniae.Placenta Hominis, Cormi cervi parvum, Radix poligoni
Gardeniaiasminoides
ohular'iaceae. B 6opb6e
Ellis ceM Rubiaceae multiilori cellr.Polygonaceae, Vigna cylindrica SkeelsceM.Papilio-
nporur aa6o,reaaHI,fi, BbI3BaHHblx npoHlrKHoBeHteM B opraxl'l3M
6o,resxersopnux Oa(TopoB <xapbl), <nccyrxabrusx KpoBb>' npft_ Bce cpeacrBa, nprMexfleMbrenpH yKpenrrloueM neqeHHH,Moryr
MeHtrcT TaKXe yKa!'lHaaH{e B ToqKl,|_tcToxll c xpoBonyc{aHleM 6HTl, noapa3ae,,reHllHa qerblpe ooIoBHbIeKareropuH:
Bbl6op cpeAcrsa neqeHxt 3aBIrcHTor creneHl pa3BI'rrLt 6orIEHl'{' - ykpen,'ItroUfie3Heprl,lrcinpenapaT6rno peqejrraM <1bI xyaH>
cTenel] opoHa(HoBeHIrq B opraHIl3M 6one3xerBopHoro QaxTopa (<'{erbrpe,leKapcrBa,yKpenrtloqnx sHeprtrcr), <bo qyHr xr6 xxt'l>
(<yxpen,ltlouee 9HeprrK)cete3eHKl,lfi xenyaKa>), a ra(xe yl(ar'lbl_
- Anff r'IuKStAaUUL CtHApOMa (Xapbl> ucnorb3yKlT <npo)LnaA_ "rnni toqex rbr-3y (ntr-iuy,20 V) ryK-raM-nn (36 E); -
H H e r c p e a c T B a ,T a K I i e , K a K . t n c ; ToHrr3xpypnrrre kpoBb: npenapaTblno pe(enTaM:(lH BaTt
irporus uorHg, npxMeHtrcT <ropbKlle>, <xonoafl ruae' cpeAcr_ (<qerbrpe HHbc(HxlrreKapcrBa,yKpenntrculx KpoBh)), <KrcH Tbl>
.a raxre xax Rhizoma coDtidis ceM. Ranunculaceae; (<,lexapcrBa, so3BpaUlarcuIaeKpoBb B ce,le3eHxyt) x yKaJIblBaHue
a , l t o c , l a 6 , 1 e H r e( x a p b L c r y x a r c p e l r c r B a o x n a x r a r c u f l e roqeK rxoHr'rxuefi (ryH-'ttHb, 7V), l<ao_xoaHr-3y (rao_xyaH_ury,
x 'p o s b . r a f i x e x a h R h i z o m a r e h m a n n i a e c e M S c r o p h u l a r i a c e a e 4J V) l,l x|oer-\aii lc|oe xafi. l0 RP):
Meroa ox,raxaeH[fl [portBonoKa3aH 6o,'IbHHM, a.]Ig cocrotHtt yKpenr'rfrcn!.refiHb: npenapaTH no peqenry <rlyK BIt xoaH)
3AOpOBbr xoTopblx xapaxTepH6l <nycToTa) a coqeTaHuH c <xoJlo' t.uecrh ieKapcrB.yxpenitrcufix trHL-noqKyr)H yKarHBaHrero'{eh
IOM,, a raKxe xeHtufiHaM. HeaaBHo nepeHecul'lM poAbl. \ a H - r ) { u l 3 H b - u } . 2 3 V r t i r a M - a M - r e ioc a r s - i s l _ u r n o , 6 R P t :
7 . , r l e q e H f i e c n o M o r r l b r c J ' |I , tK B r { a a u g u c x o n ! r e _ - yKpenncrcuue tH: npenaPaTbl no peqenTy (ttar B1l xoaH)
H u i p a 3 , ' r I , l ' { H u xc y 6 c r p a r o B x MoKporbI. Lyrb Me- ("BoceM6JeKapcrB.yxpen!'ItrcuftxnH_noq|(y.)H yxarblBaHHe roqex
roaa aax,roqaercc s yHnqroxeHxx cxonreHlrfi pa3nxqHblx cy6€Tpa- \ ) a q - H r y e H{ r y a H 6 r c a H b 4
. V C ) u v e r s - v o t t ( v H H _ v ? H b
4 . vu)
Tos, HapyrxaK)unx HopMa!'lbHo€ QyHKu}toHIrpoBaHHe opraHx3Ma flpfi ucnonrioBaHLtuyKpenrtrouero cnoco6a "1e,JeHuc Heo6xoAx-
,I[rf o6,lerqeHUfl nfi qeBapeHIt npuMeHtloT Lrataegus plnna_ N1oxMerb B Bllay c,]reayloqee:
tifida Bunse ceM Rosaceae nll6o Bo3aeftcrByIor Ha roqxn ryx-raM_ yKpenr'Iflqry trJlfi Hylo cl.,cTeMyopraHli3Ma, oxa3aBuylocg
,rr (36E)-ir qytr-xYas(12VC) B pe3y,,rbrare6o,'Ie3HqB cocrotrll{t{ <nycrorblr, HyxHo cor'racoBbl-
' A,1t BoccTaHoMeHHt flpololl{MocTllMeptllxaHoBnpxveHflIoT Barb cTeneHbyxpenrltroqero Bo3aeicrBfit co creneHbrc<nycrorbl>
Fruclus Aufantii immaturti cev. Rutaceae.Clperus rotondus L i o H U u o x e r 6 b i r b r H e p r H . l H H vl , t , l I n u c r e f l e H H H M ] l
ceM. C)pelaceae,Lindera myrrha {Lour') Merr' cev. Lauraceae He,1Br 3noynorpe6,lqrL yKpennttrcIjIIlrMneqeHlleM; o6pauarh-
A,lt,,rftxBHnaurjxMoxpolbr llcnoJb3ylorI yphonlum IrlloDa_ cr K HeMy cnelyef 'Inur, npr o6HapyxeHlrll cI'rHApoMa <IIyCrOThlt;
lurn (Scholt) ceu. Araceae.Peric€tpiumcilri deliciosaeceM Rula_ H€o6xoAnMo xoporro flpeacraBnflTb ce6e xaPaxrep repafleB-
55
54
 Bar rraBa nocBquleHa MepaM no yKpenneHnro 3AopoBbg u npeAy-
ruqecKoro Bo3aeicrBlrt 3roto Meroaa BocroqHofiMeA[IllHbr iyKpen-
(paK_ npexAeHr.{o 6o,'re3Heft. Bor H€c(o'lbxo llo!'loxeHfifi u3 3Toi KHI'{r :
,",tr" "rur-*l 3xeptrl{. [3rHaIIue BHeuHxx 6one3HerBopHblx - <Koraa Ayua qficra fi cnoKoiHa, 9Heprllg poBHa, a ayx
1 0'6 r ' s l q l o 6 b l a n o H n v a x H e Mn o l b 3 o B a t b c g H M n p n e q e H n f i : TBepa, 6one3H Bo3HlrxHyrb He npocro>,
e c , r r 6 n , r e : x e r e o p H o eH a q a l o a x T t ' t B H oa. 3 a l { H T l l a l t H e p r f i t l - <yirefi xopounr6cc or xapH l! Henoroar,I,
npor$B Bp€aHo_
o.na6rena, c.'reayet cHaqa,TacocpeAoroqxrb 6opb6y <Xopollrfii Bpaq ,1eqsr 6o,1e3Hb Ao ee [otBr'IeHuqr,
_
'_ 'daxropa
ro r rorb(o lloroM y(peflntrb opraHL3M; Ilpeacras,'Iexfie ApeBHfix o npoQura(THKe c,loxu,rocb Ha 6a3e
HaqanaB opraH[3vec
nni,"urn"u, 6o,rerxerioinoro oc'']a6_
Becrlloopboy reopHt] eAI'IHcTBa qe,loBeKa u npfipoAbl' Ha KoHqenqafi eluHoro
rexrol :auurnoi )HeprHeft oaHoBpeMeHHo
c''Iealer
n 'n o r u B 6 o n e r H t l H y K p e n , l t l T b3 a u l T H H e c u , ' ] b l o p r a ] l | , | 3 M a ' B xraccHqec(oM BberHaMcKoM rpyae no apeBseaocroqsol Me-
5. Jlpxfiufin rx6Kocrr npr| nplrMeBeHrl aocbMfi TepaneBrtl{'cxxx Anllrse BHralonl€roct BberHaMcxoro spaqa Ty3 TbIHt Bct cyul-
ycnexa Bpaq '4orxeH
r".oao". An" aocrt{xeHrc repafleBTlqecKoro HocTb npo(pr,'raKTfiKU oTpaxeHa a HanyTcTBnt t{3 HecKor'Ir,xrx
toro t!'In
a a u " o t , " r u r r u n p a - Br b H o o n p e a e n k l h M e r o n n e q e H H t
,r.',, , a o o n e e a H U cO l H a x o B n p o u e c c e J e ' { e H r f l o H n o / l x eH npo_ ypaBHo
nHe paiBpalHtqai. c o x p a H t i i ? H e p r H l o ,a e p x r lyx
r.n",o ru*ant"noryo r x 6 h o c 1 6 n o c K o r l ' K y . K a K n o K a 3 H B a e Tn p a K _
3 a K o H a M ' H 6 3 aaac!-
iaxa,6onegflr flporexaer flo onperenenlblM - .Byab qrcr cep,4ueMo , rpaHtqHBafr crpacr[ He noaaaaaficq
"". ', n, "renetrl e e p a l B t l r H s y o r l l l o l o l ' i r o r o ) K e 6 o ' l b H o r o vorlr
eMolluoHa!'rbHhlMnorpsceHI,ltM. x36erafi He6,raroDpl'{trHHx Qaxro"
i * . . " " r " " n e n u r D a : , r a v r t s r ev e p u C a e a y e r 1 ' t l r u a a r o r a x x e Q o p - poB BHeuHefi cpeAbl, rpeHrpyi Te,Ior.
no&lHH_
ri ,o6or"ur"r" lxponauecxoe mx ocrpoe) oflpeae'erb
, I , ' t l l n o x x b l e . c r e M qro6u. npHHrMafl Bo BHli
,,1" .'n arrntott E E P b I I I O N P E , ( Y N P E ) ( [ I ] H I ' I N6 O J I E 3 H E N
I, HEKOTOPbIM
Meroa neqel'l|g'
ra,ru" o6crogre,'rgcrsa, cBoeBpeMeHHo IBMeHl,lrb
A. npooina(Tx,{ecxxe nepH, npxM€nteMHe ao sa6oneaaHI'1fl'
I A P Y X H O T OA E f fC T ' I I g
i . T t . P A n € B T l l q E c K l l EN P O l l E t r Y P b H l. ,ll,ri coxpaueuxa x yKpenteHtq 3aururHofi gHeprfis Heo6xoalMo:
KpoMe BocbMH rraBHblx MeroaoB reqeHfit 6one3Hefi,
B BocroqHot - r€Dxar6 B qIICTOTe nOMbTCJIhIg )l{er'laFl'lt; orpagxqllaaI.ll
p r a r e p a n e B T x ' { e c K t x c p e a c r B HapyxHoro 8o)<Ae,'rei e pa3yMHblMll npeaenaMu (<qtcroTa ayul|,l>);
MeIHUUHe Cy4ecTByer
- Becrx yMepeHHyro lloJloByo xIJ3Hb, q36erarb paSBpara;
-ncnxb,rornqecxlx
L napexreBcerorera. - rr6erair norpqceHtfi, so3aeicrB s lue-
2. flpoMblBaHI{e crD BpeAHHx norcrHbrx (baxropoB, c[oco6Hbrx l1aHecru yurep6 3Ao'
3. IIPrnaPxtr.
4. n,lacrHPI'r' -- 3aKa'ltTb t{ yDpaxHqTb Teno -- y(pennqTb 3AopoBbe noBl'l_
ytuHble or_
5. BayBaBlle rrekapcrBeHHoro noporx(a B EocoBble tl a r b c o n p o T t B r c e M o c T bo p r a H U 3 M a ;
-- peiy,rnpxo nprixnrarh rorrKy ryx-raM-!rtl (rcy'ca8'nx'
6. nonocKaHlte Pta. 36E) - noBHIxarb conporuBr'IqeMocrb c'praHI'r3Ma.
2-, Mepu npeaocropoxtlocrt nporl{B nary6Horo Bo3aeiicrBnfi
8, OqrcrHft''IbHaq Ii'I03Ma' cnpuHqeBaHne fi cBeqI{' B r r e r n H H xQ a K T o P o B :
rKa_ K oxpyxarcueri cpeAe; HanpuMep,
L flpfi MeHefifieMeaBKaMeHToB'BbI3HBaK)tlltx oMeprBr'IeH'e - yMeno Ipncnoca6rlBarLct
Hr lHanbJlMeD, n p { n € q e H f i c e M o p p o g , . neroM l{oct rb nerxylo oaexay, fi36erart, co.tlHqeneKa, nor'Ib3oBarbct
B c e i r o n o i n u r e , r s n u e c p e r c r B a B c o q e r a H H Hc n e p e L t x c ' e t H b l M l l ReHTr,rlrFTopoM; 3!Moi - Hocurb rennylo oAexay' np,r6erarb l(-no_
^"' ;;" ';;"t", M e l o a a M l ln e q e H t t r 6 o , 1 e 3 H e in e r a l o r 6 o " t e e c o B c p ' Mor t o6oaDeBare'1ei, ,'IoxHThcq cflarb Il BcraBarb no3xe ooblq_
rneHHHMTepaneB,tqecK{fi apceHa'r, KoTopbIM pacnoraraer
Bocroq troro; secno& |l neroM - no3x€ roxl{Tbctl cnarh' paHbuie Bcra_
Barb; oceHr,Io- paHblue "IoxnTbct cnarb;
! 3 6 e r a r b q p e 3 M e p H o r o\ r o v n e H x e H a p a 6 0 1 e
- Erue a XIV sexe.taxonbv Xonr ,[l.uxa (rHHacrrq 'rle) 6t'r'1o
I POoll,lAKl l'tKA 6OJIE3HEE
3anoe[leHo npoAaBaTb Hacer'teHuo HecBe)Kee Mtco l't apyr{e fpo_
I, TOIIKA 3PEHU' APEBfIEBOCTOIi}IbIX MEAII|(OB HA lyxiu, aanperualocr ynorpe6"Icrh B nllqy Maco xIlBorHbIx Bo
r|POOHJIAKIIIXY- uierva :naAeuau, npeanxcbiBanoc6 !e 3roynorPe6ntrb Aparoqelx6I-
u u l l e r a , u a u s x a p a r o q e H H H M t tK a M H f l M I IB K a q e c r a e , e K a p c T B e H
y r xe a x o B c ' r o x l | J l o c b l o B o , l 6 H O K O H X p e T H O e
n D € t s d e B o c r o ' { H bM HHx cpeAcrB, nocKoJlbxy Hall6onee axrl'lBHbIe t,l3 Hxx oKa3HBanx
;o"l'.i;;r;;;; o cymxocIr'r 6o''re3HeiB Maccrqe'
npooxraKrrxr'r BpeArroe AericTalle Ha xe"'IyAoK.
"lo" ve!rurHe (xlaHAX l{1i_rl1HH'Bca nep'
'prn" rro socroqHofi
57
50
 - He cneayer xegarb 6ere,'Ibarq corpeBaHrq s npoflnrblBarb f n a a a2
ruaft oy6oo qepHofiKpacxofi alltt ee 3aurlrrbl' ChCIEMA MEPhAIi HOB
io6,roaai s urciory oxpyxarourei cpetrbiH ''llqHylortlrreHy:
nnoBotrrlrLexelHeBfiYo ytpeHHlotoy6opKy noMeureHHs4elr,|HQex_
uiio u"raLr:erroil:eifltio ans 6opb6bl.c vyxaMr' rHrHeHfiqecKoe
rororaxre, norloc|(aHl,ttpra noaco'IeHHoftBonoi
I fn.nu"nu""*nu uiponpanraa xeglqriH aonxHbl 6blrb eue
BpeMq
6o,reerulare'16HblMI'ioco6enio e MeHcrpya''Ibxt'linep olr' ao
6epeMeHxorrr,s flpeapoloBofi fi noc'lepo4oBoi fleplroaH He veHee r. o6lq|.E nPoEJlEMblCl4CTEMblMEP}iA}|AHO8
iuiu."niro aor**i cd6,rpaatscs rr'rrliua aerefi Bonpocbl trx no_
troo6Ho ocBeqeHhl B coor Bercl Bylouei nHleparype flo r HexoJIo- t. ocBoBHbtE noJoxEHl{fl
.i,l .r, nearatprn. y ' { e H H e o M e p n a a H a x ( K a x a n a x ) t B , r t e r c t o c H o B H o f ic o c r a B H o t
5. lloorbniaxrnqecxne Mepranpx notBneHrtr ncpBHx npx3fla(oB qacrbto reopDfl rpaaruxoHHofi BocroqHofi MealrqxHLl OHo oKa3blBaer
.acorerinnr. l. [1ptt o6H'rHUx 6one3Htx K reqeHl,l|ocneayer npfi_
''ler- onpeaelrqrouee BnfitHIJe Ha laarHocr&(y, neqeHI're a npoQfinaKrxKy
i-nuro *u* voxn6 paxsue. xorla 6orerxb HaxonfiTcleLneB
IeM caMHV ee pacnpocrpaHeHfirc or oaHo_ h a K s H f n o y x a J H B a H { . T a K H B , l e K a p C T B e H H o fTi e p a n H r ' B o l
*oil "ruarn. npenarcieln
noqeMy B apeBHocrx foBop '1r: tEc,1H Bpaq xe lHaer xaHa,'IoBoH
ro ooraHa K Apyrovy (lilanprvep.01 fleqeH Xa ce'leJeHhy)
ll nor anxiitusi. npll Bo3HrrKHoBeHftr enraevfii c'leayer 3a_ rerko BflaAaer B otlrx6xy>,
pacleHlrt Sanialaceae araceae qro6bl 143 csoero ,leqe6Horo onHla, Ir3 cKpynyne3Hblx fia6nrcaeHufi 3a
*"i " iot" r"*up"t"eHx;e
Bo3ayx. rerre.rrbxocrbro 3AopoBoro opraHIi3Ma t{ npoflB,!edl,ltMti 6o're3Hefi'
fiefi'rpanrBoBarbBpeAoHocHHfi n3 cr'roxrBlxrxcq y Hfix npeacraBneHu* no aHaroMI'aIl qe,IoBe(a
- Teppqrop rc, rAe xMerl Mecro cryqal, xo"Iept'l' c"Ieayer
(Ha Bo3MoxHoM s ro BpeMs ypoBHe) MeanI<I'lAaL'IeKoro npouiJloro
o6firbHo flocblnarb !3Becrbro. BbrqBr.rrx uelryro cucreMy nyrei npoaorLllblx a nonepeqHblx'
HocoBbleorBepcrBfl 3arblKarS BarHbIMnraMfloHaMu' nponfi' (pyrrHblx Ir Me,lKl,tx, !'Iexa lxx B rry6[He k Ha noa€pxHocrH qeJro-
rasHbrMs qecHoqHDIM coKoM. qro6bl 3arpyallljrb llporlltKHoBeHleB
Beq€cKoro Telra, no xoTopblM uspxynupylof gHeprrlt I KpoBb' nlrTaq
*"?ilX""t""&""X?1,T'l'fi Becb opraHfi3M. O6ecneqnBat €ro HopMa!'lbHyro xr3H€aegTeJI-1,HOCTt"
f,i',i;"1;"1.-""MepblBoMHoroMcnoco6cr
xace,renaaBr'erlaua o6re.qnxss sce ero qacru B erHHoe ueroe. flo 3TIiM flyrrM 6o"le3Hb
"ou"ri co*pr"""uto iaopoara n p o H r K a e r B o p r a H ! 3 M , B H e a p q q c bB H e r o c n o E e p x H o c l H H xr K a H e h
ui,1v6b u Hao6oDor, O8ll cBnqlorct raxxe ctcreMoi, Koropat or-
pariaer naro,rourto opraHI{3Ma, Bocnprilt,tMaer pa3Apaxenrfl aHe[I-
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xa. flpesrre MeaxKt Ha3Ba.rluHafir€HHhIe nyrt KaHa'laMH (MepnaH-
aBaMx). a Bcrc clrcreMy xalraJlbHot ( Mep&alrolrar bHoaI .
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llpoloasnud ueprunalu. K tix qnc'l! orsocst l2 rnaBHH\ vepn
xraHoB. l2 orBerB,'IeHldfi or HIix fi 8 Heo6hrqHHx (<qyaecHblx),
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roro xe rrMeHIr (Hanp&Mep, BefBr' (6on6uoro qHa> pyxs r- a.),
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v a T r . t H o H r - 1 t o u { f l H - t l r i g oM a f i ) .HapyxHUi IreroqHHll, vaTL'_
59
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pvr{HbrMMepaaraHoM flepxKapAa <KoHe!l
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o e H H H M lO ' DraIaMt.
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63
62
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c noBepxHocrHblx cnoeB Br'1y6b (Koraa 6onBH6 nporpeccrpyer) x
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- 3auepurt gneKrponpoBoAnMocrL B To'{xe'[oco6Htxe, onpeAe_ HanpHvrp. HapyueHue B vepHnxaHe roJcroH KHtxkx DpotBieK)tct
,rxrr creneil rlyBcrBnrerbHocrl B roqxe-ucro(e (HoBhli cnoco6)' q n l l h I n a , l b u a \ p y K H . 3 a 6 o , l e B a H H er o r o u t l x H H o r o B H y r p e H H e r o
B repan{x. MepsrtafiH o6hl,rHo €,'ryxar npoBoAHrxaMfi pa3aPa- opfaHa oTpaxaeTcq Ha coorBercrByloueM MepnIHaHe: HapyueHt{t B
xeHfiq, cTrMy,ItUtt, nyTflMn AocTaBKn !'IexapcTBenHtilx cpeAcTB K roHKofi Krjnll(e Bbl3blBaror xap B npeAHAyureft o6"racru, HapyulleHxtl
B H V T D e H H ToM p l a H a M B o B p e M qr e q e H H f l 3 H a H H er r o l o l ' l x c B o i c r B a B MOqeBOMny3blpe - )xap B nneqax x r. A.
- 60.ree yBepeHHblM
-re,'rabraeqer.re 6o,ree to(beKTxBHbtM.a Bpaqa 3HaqeHre l2 rnaBHblx MepltAlaHoB ucKr'tIoqt{r€J16HoBelrfiKo,
H a n p u v e p . n p t , j r o , l o B H o f i 6 0 ' 1 1 1B o 6 , 1 a c r [ r 6 a ( K a x o c H o B H o M B rraBe o Mep[AtaHax <KHvrn o BxyrpeHBeMtraercs no 3roMy
ToqKt (cBel!'Iofo qBa,; ecJIH
c x M n r o M e ) c , l e a y e TB o 3 a € i i c r B o B a r bH a ,loqxu 'rouory c.,reAyrouree 3aK,'IlorreHre: <Ha3HAqeHUe xaHaroB B roM,
ro,'roBHafl 6o,1b JloKart3yerca B 6oKoBbIx o6nacrqx ror'IoBbl, qro, c oaHofi cropoHbr, oHlr orpaxalor HopManbHylo Qu3ltono-
Bo3aeicrBsq Ao,'rxHbI 6bITb oro6paHbl Ha MepnaxaHe <Marbll{-rH>: rxqec(yro (pyHKur,trclr llaTor'loauqecKre u3MeHeH&9B opraH{3Me, A C
npr 60,rfi B 3arblnoqHoft 06"Iacru (Kax ocHoBHoMcllMIIToMe 3aooJle- apyrofi - no HIM Moxno cyatr6 o ero x!3Hecnoco6Hocrr, onpere-
BaHsq) Bo3aeiicrBoBarb cJleayer Ha roLIKll (Berllxofo tHa> Jtrb ,'trc6ylo 6ore3Hb, HopMa,r&3oBar6 coorHouleHte <Do,'lHorbl> ll
<rrycrorblr, rcno!'rb3oBarb nx KaK pyKoBoacrBo B neqe6Hoi npax-
r K e , n o g T o M yx a H a ! ' I u H e r b 3 f l u e 3 H a T h >
64
 P Y l lH O N T H b C K f i NM E P ' I A I , I A H . N E | K X(XP )
(tro li roce( c xa)i(IoncropoHd)

Xoa r,,repxaxaxar.MepranaH Ha,ruriaercrlB o6,,1acrlrcpeaHdft'racr!

rynoBrrqa (o6nacr6 xenyaxa), cnycKaerca x To.4cToiKl1r|xe,3aTeM
cfioBa cBoparrHBaefl< xe,lyaKy (nprBparHxK, I(apA[r), nepecexaer
xBaoparMy, HanpaBncrcr, K tlerKnM. (JT ,.lerxu! npoAonxaer nyrb
x fopTaHn ropny, cDycxaeTct K nolMbrueqsoi qMKe Ir BbIxoaI'lT
K nepelHefi BHeuiHeficropoHe pyKu (narepanbHee MepfiAxaHoB
ceplua u nepuxapAa), cnycKaeTctrx qMXenoKreBoto cycraBa u no
rrepeaxefi cropoHe npealneqbt BblxoanT x xoHuy JlyqeBoi (ocTl,l
ls o6J'acrn nyrbcosoft no3ruulr <rxoH>), Ha nepeaHeBHyTpeHHei
' lopoHeee. Hanpaa'l]ttcbx yrny HorTeBoro ,'loxa l'lyqeBofixpafr,
I aa,lbua 0vKH (Drrc,zl,
orge'isaixfit, B T o q k er ' t r e r - K x o e t , l e - u r o e . 7 P )o r v e _
pxaraHa oTAenieTct BeraL, xoropac no TblrbHotr cropoHe KucTr'l
anycxaeTct I( HorTto ll flaJlblla, rae coeafiI{teTct c Mepfin aHoM
rorclon KtIIlxH.
narororuqccxre cl|rnrouu, cBrgafi ue ronorpaoxqecKt c 06-
n a c r f l M r ,r a e n p o x o A x ri € p x a r a t z . l . n p | , r H a p y l r l e H r l t x
I M e D B t r f i a F e J . 6 o r M B o 6 n a c r nH a a x n l o q f l q s o' {iM x x ( x o r a a
6o,rr Aocraraor oco6oi cu,1u, 60rt Hofi HenpougBorlt Ho cKp€[lIiBaer
pyKx Ha rpyau, oxBaTUBasce6t 3a n,reqs), noTeMHeH[e B rJla3ax,
irpr]TMuflcepaua, 6ont IIo BHyrpesHet cTopoHe BepxHtx xoHeqHo-

2. fIpr HapyueHrtx B .cBoeM>opraHe: crec_

[eHre B rpyAlr, acTMaTqqecKrn Kalxenb,3aTpyaHeHHoe abrxaHte,xax-
ila, qacToe MoqeBbIA€r'!€H e He6o,laurMtl nopqEHMlr,Moqa xerToro
uBeTa, 6ecflprqfifiHo€ 6ecnoKoficTBo,crpax, roptqte naAoHIj; npt
]a6o,reBaHur.ror narorefiHoro Qaxropa <Berep xo,1oa>- noBbl
ureHHacTeMnepaTypa,c3Ho6, Bo3MoxHo noTooTAelteHHe.
IloKa3aHxi x t{ctt(ttbsoBaHrt) Mepxarana rerolx. lloBHuieHHat
r€Mneparypa, xapyrxeHfit a ,lerKEx, B o6nacTn rPya,r, ropna,
racroi 9Heprnr ll (poBrr. 3arpyrHeBHo€rroqencrycKaHre,Moqe-
r{cnycKaHHe B MarHX KOrlHq€CTBaX, Bo34efiC,rBl]eHa 3TOTMepfiAUaI{
axrrBs3rpyeT ur.rpKyJlflurrc 3Heprrt I{ KpoBt,
\"i!
., fyqHorl qHc(xfr MEPtt,4l4AHTOJ'rCTOfiKHtllKl-l (cl)
{no 20 roqe( c Kaxaoncropord)
XoA nepxaxaDa. Haqqtaerct Ha ryqeBofi cropoHe yKa3arenbHoro
IanL,ua, oT Bapyxdofo yrrta lrorreBoro Joxa, npoxoAt'lTIIo rHllbHol

IIp, onrcatsr, xola sep,nraBoa npnruMaerca noioxeHue

l e r c p \ K a ! r . . r . r o h t { r . p a ' B e p h \ r u v , B n " p r d .r l o { q r k e
!rar.panLruit' fl <Mea!-ahrufi> onperenrDrcr noroxeHreM orHoc8rerhno npo
r ,bHon ocn. nouroltueA
I n r r p e ! c ^ p s r r " . ' q i e ' a e b v a e ' . o e o p rr . c . l l a ' { " , f c " { t r " , i v , o q d .
3rrarnue c Mepr a{oi,
lePrataB rorx,x (P) ' B o6nactflx, r,le lrJiolrt MepnAndi.
Prc. i. Pyctoi r{!ckri
 .ropoHe t,1)qesoMy xparc) ero qepe3 npovexyToK i"t-exny I fi
ll necrHhrMK Do . r s v r q e p e 3T o q K yx o n - | ( o x { \ 9 r y . 4 u l ) K sve
aHaroMfiqecKoi Ta6aKep(u Mexay cyxoxnnnqMn arltHHoro fi Kopor_
K o . o p a 3 r r 6 a T e n e f i6 o n r ' l r l o r on a n b q a . l l e p e 3 l o q I r y 3 b r o H rK x e ( g s _ c u ,
5 C l ) , r a r e M n o r H n b H o' l y q e B o i c t o p o H en p e a n n e q b e| { H a p y x H o t
' M { e n o K T e B o r oc y c r a B a l r o q x a x x y x - q r ( u r o i - q x , l l C l ) ] s n o
n . p e ! H e H a p \x H o i f l o p o H e n n e q a n o n x o r r . l l K n e p e 4 H e i q a c T I r
onbo"ro"d: r o q x a x r i x H r l H r ( u 3 t H b - r o i i ,l 5 C l r . n a n e e v e p v n {
aH nepexolr.rT Ha 3aaHrolo noBepxHocTb n!'IeqeBoro cycTaBa I, BcTpe
r r a e , r c qc M e p x a r i a o M r o H x o & K I r u K s l B r o q K e 6 r H b o o H r ( 6 n H - 0 3 H ,
l2lG)l H ratHecpeAxHHbrM vepHnraHo{ B roqKe aax-r|oH
I n a q x i ) f i . l 4 v C ) B M e l i r eB r r l e q x 6 q H c l ( r x M e P t r a H o 8 3 a l e v
oH Bo3BDanlaerct x '{aA(rrcqrqHofi qMKe [To'rKa xxoer'6oH (qro?
nsHs, l2E)], cnycxaercq ( rerKItM tr, npoiat auaoparMy, HanpaB'
.leerce x roncrofi xnUlne (pxc. 3).
orserg,!eHun. B o 6 ' 1 a c r u H a a l u l l o q r i q H oqi M K u o r M e p l r _
araHa oTxoarrT BeTBb. npofi,4q lrlelo, oHa noAHxMaerct r{ nxqy, K
aecHaM HUxHefi qe,'Iocrrr, oru6aer B€pxHrorc ry6y, ra€ 06a Mepraxa
I rra Bcrperrarorcn B roqxe rxrcu-xay (x3H6'qxyH, 26VG). npaBblfi
\i O4GD MepuauaH 3axaHqgBaeTcq ptAoM c neBbIM I{phIJIoM Hoca, r'IeBbIu
y npaBoro xpH,tla soca, rae ofit coelfiHeK)rctr c ffHcKlrM Mepxaua-
H O MX e r y A K a ,
naroaornqecxne c iinto !r, cBg3alrxu€ c i{epxAxalou. L fl p !l
HapyrueHt{tx B MepxA a H e : o n y x a H l rneJ e r , 6 o n LB 3 y 6 a x
HfixHeri qe"qlocrlj, 6o,rx B o6nacrfi nJleqeBoro cycraBa, Ilp€AnJleqbt-
_ r s a q r r . , rB
3arpyAHeHne s x oABfixeHnn
v 6o,rblxoro fi yKa3arentHoro na'lbqeB
llpr.r p a l B H r H x B M e p H A H a H i6 o J e r H e r B o p H o i g H e p
rrH Ha6rrc,naorct nlnnlxnocrb,6o,rr no roay ero. [lpx oc'1a6'1eHxH
Hxyr-c, {11G1)
xaBa.qbHofi 3Heprl,lx 3q6Koc,b B yrlacT(ax npoxoxaeHxq Mepfi-

2. npn Hapyor€gxqx B (cBoeM, opraHe: )(enrbln

uBer rluqa, cyxocrl Bo pry, 6o,1n B o6nacrn rop,la, xpoBore_
'reH{e l,l3 xoca, 60,r! x ypqaHne s xIrBoTe, ant (xonoaHHx> 60-
rle3Hefi XapaKrepeH noHoc, aJIt <roptqHx> xr.lAI(Ire, K!'lefiKre,
r c n p a x H e H x q , 3 a n o p . n p r p a 3 p a c r a H L r nB M e p l r a x a H €6 o n e 3 H e r B o p -
rroi 3HeprHs -- BtlcoKaq reMneparypa, Bo3MoxHo 6peAoBoe coc-

il IloKa3aHxs x rcnorb3oaa8l|rc M€pxaxaHa. Hapyur€Hnt B 06-

r a c r f i r o n o B b r , , ' r f i u ay, r e f i , r n a 3 , H o c a , r o p r a H t , 3 y 6 H a s 6 0 , 1 6 ,H a p y -
I r e x n r r B K { u e r i E s x e , n o B H e H H a f ,r e M n e p a T y p a .

:]. HOXHOft 'HCKUN MEP}'A.}IAH XEJIYAKA (E)

(no 45 ro{eK c {axaofi cropoHu)

XoA MepxA aHa. O6e BerBx groro napHoro MepqAliaHa HarltHalorcr

Prc, l. Pycrot rHcKri loprarac
B o c a , n o o 6 e u M c r o p o H a Me r o . f l o A H o c o M ,B ( e s r p € a e c H H
y K p b r r r b eH
BepxHefi qenrccrx, oHI,t Bcrpeqabrct Apyr c ApyroM. 3areM pacxo
L H T C rB C I O p O H H B C T p e q a l O T CCf l t I H C X T MV F p I T A X a H O M
H \ ' tO ' { e B O r O
ton.ioi RXU(, (Gl). I ] l b r p q B r o q t { er b l H b - v r { H(bu l { H M l r H .l v l . o n y c h a r c l c an o B H e L U H e H
69
 nrHur Hoca x BepxHei qe,rrocrn, noaxoatr K yrnaM pra, orH6ag
BepxHroro ry6y, Bcrpeqalorct sa 3aaHecpeA&HIroM MeplrafiaHe(B roq-
Ke rxror-Kay (x3H6'qxyH, 26VG) 1.,o6orHyB HlrxfiIorc ry6y, conpx_
Kacalolcrr c' flepeaHecpeauHHbrM M€pfiafiaHoM B TorrKerxbla_TbloHr
(q3H-rcqrib,24VC), 33reM,pe3Kol,l3MeslrB HanpaBneHlre. Bo3Bpa_
urarortr no HUxHefi qacrr HrrxHefi qe,lloc,r, Bblxoatr I( yrraM
HfixHefiqenocrrr [B ToqKeaai-HreHb (Aa-llH,5E)], noBopaqlBaor
K o6nacrn nepeA yluHofi paKoBfiHofiL noAxoAflTK qHcxoMy M€pH-
Ts-6ar5 {2 E) lrany xe,ruuoro nisupn [s ro'rxe rxuoxr-xyaB (IrraH-ryaHb,3VB) ] ,
HnyT K ArCXaM, COeAllll9lOfcf C Mepl,lAraHOM XenqHofo ny3blp'I
ro (r3E) l B r o q K a xx | o e H - , ltxc r c a H h - , r r . 6 V Bxt x a M - u e M
{xaHh-tHb.4VB)1.
{-e (l5E)
noAHrMarcTcr x yr,,taM n6a k, npoit, AropH3oHta,lbHo BAo,1bnepe!Hei
fpagrllbl Bo.4occHoro no(poBa, BcrpeqaloTctc 3aAHecpeaHHHMxaHa-
noM lrxaH-Arnb (Ix3Hb-rrH,24 VG) ].
I43 06,'racrfiKnepeAnor ro,rKr rai-HreHL (aa-nH,5 E) Beral Mepu-
xr1r9E) araHa cnycKarorcq K lrree H BAonb ropraH noAxoaqr K Hatrxrlo_
qrrqHofif, Ke [Kxroer-6oH(rrlo3-n3Hb,12 E)]. npoxoAqr no rpyrHofi
M o H( 2 2 E )
Kner(e(no cocKosoinfiHnr), cnycKab,ct K xxBory l.rno o6enMcro-
poHaMnepelHecpeAsHHoro M€pnauaHaaoxoAqr ao naxoBoro xara"qa
OyK-rxo (oy-ry, 328), no nptMod Mbluue 6eapa cnyc(alorct K Ko-
,reHy [Aox-r6r (ay-6fi, 35 E) ] , BAo,rhBHeurHefinoBepxHocru6onbnle_
6epuoBofixocrn onycKalorcc K npeaflnocHer aaJee no rhllhHofi cro-
poHe cronbr noatoatr t< BHelrHeMyyrry sortegoro ,roxa II na,luqa
g*;fli'[:".f) Horl, (prc. 4).
OT B er B,,re H r.ir. B o6nacr, HaarorroqfiqHofi rMxr [(xloer-6oH
({rc5-n3Hb,l2E)] or MepxaraHaorxoafiT serBb. xoropaq nepeceKaer
AlaoparMy U noaxoarrr K xenyaKy, 6raroaapt qeMy ocyqecrBr'raer
cBt3L Lt c ce,'te3eHKo[.
B o6nacrlr nprBparHsr{aor Mepr.ralraHa orxoafiT BerB6B HItxHtoro
qacrb xHBoTa,coeaxHggcb BHoBbc ocHoBHHv MepHnl,taHov B patoHe
naxoBofo xaHaJIa.
I,l3 roqxrJTyK-TaM-n (Il3y-caHb-nr, 36 E) orxoarr BerBhaicra,'Ib_

ili H€eocnoBfloro Mepxanala, Koropaq cnycKaercq x uorno III na,'rrqa

B o6nacrx rbubHofi cropoHbrcronbr IB roq(e cy8r-SbIoHr(qyH-qH,

42E)l orxoar.rr BerBL I( Haqany Horrt 6o,1buoro nan6lla Hou,l, rre
coelEHfle'|ct c HoxHbrMfiHbcKr.rM Mepr,rarraHoM ce,'Ie3eHKt.
Ilaronorxqccxre cxMrrmMH,cBrsasfibre c aprata8ou. l. II p H
HapyueHfitx B M e p t ! l t { a H e : x p o B o r e q e H1f3i eH o c a B
, bI_
cHnafil,lrHa ry6ax, 6onr a o6,'racruroprarri, nptnyxrocrb lxe , nepe_
KouefiHbrfipor, 6o,'rx B o6,'racrlrrpyax, onyxaHre, 6o'rri, oHeMeH[err
noxoJroAaHr{e HLixHIrxKoHeqHocreli.Ilpu pa3Bu'rvnB MeprataHe 6()_
,le3HerBopHr,rx (FaKTopoB Bblco(at reMneparypa, norooraeneHlle,
Bo3MoxHo6peroBoe cocroqHte,
2. IlpI{ HapyueHrtx B n o , I b r x o p r a H a x : e c " ' lxqe -
iyAoK Saxoar.rrct s cocToqfixl{ (x(ap6lr, noBnlxeHHuff anneTHT,
Moqaxenroro qBera, 6e3orqerHoecMqreHse,crpax, Bo3MoxHo6peAo_
BOe COCTO'HOe; eCrX Xe,lyAOX B COCTO'HIT <XOrOAat - qyBc' rBo eco

Prc. l. HoxHoi rHc&rt MepkA,aH xoryaRa (E). treoenonHesriocrtt. fi,loxoi amlerfiT.

7l
 lloxa3aHra |( xcnoJlb3oBa rlo MepuAllaHg. np|j 3a6o'leaaHux B
rrqa, Hoca, ropna, 3y6Haq 6onr,. npL 3a6oneBaHtqx
06,racry r(),,,1086l,
reM'
B o6racru ro,roBHoro Mo3ra, xe,lyAKa, (IjuleqHltxa. BHcoKat
rreparypa-

4. HOXHOI{rfibcKtlll MEPl4a}rA}lc}:JlE3EtlKl'(RP)
l
(no 2l roq'(e c (axaofi croPoHH)

Xoa nr€praxana. HaqnHaerct or BHyrpeHHero yrr'Ia HorreBoro iloxa

I rrarbqa HorH, c,reayer BAoJlhrr'rHslt nepexoAa yrlacrxa l<oxll rblna_
Hofi croponbr cron6l a yqacroK Koxt noaoluBbl, npoxoarjr I( saaF€My
xoHuy I nrrccHeBofi Kocrlr, cBoparrtBaer BBepx, npoxoAq nepeA M€_
aaa,rixoi,roAHxxoi, sareu no io'renr'r, BAo'1b3aaHero Kpat 60"lbue-
6epuoBoi Kocrr, flepeceKaer MepHAfiaH rleqeH,Ij r, npoxoat neper
3 r H \ 4 M e p H 4 f i a H o v ,n o , l l H s M a e T c sK B h ) l p e H H e t c l o p o H e x o J e H H o r o
(21 RP) . y c f a B a . n e p e ! H e B H y r p e H H e in o B e p x H o c r f i o e t r p a l l a ' 1 e e . n p o H A f l
B nor'locrb xljBora, npoHuKaeT B ce,'re3efiI(y,ycTaHaBnfiBan qepe3 H€e
'ti.'- . 8 9 r b c x e r y l x o v , n p o \ o a r T ! r a O p a f M ) H . M f lH o B a Br p ' 4 H l l o K J I e T I { y .
n o a x o a H r K f o q K e r | o B r . l H h( q x o y - x y H , 2 0 R P ) , o l r ) r a B H r r ' x r o ' { K e
. A o n b . r o p r a H n ,q e p e 3 K o '
, 1 a i - 6 a o ( a a - 6 a o , 2 l R P ) , I , tc H o B a B B e p x , B
p e H b f l 3 H K a ,p a c n o l a t a t c b n o A B b l K o M ( p l ' l c . o r .
O TB er B,r e x r q, B o6,racrn xe,ryaxa orxoAlrr BerBb, Koropat,
v n H y r a H a Q p a r v ) . n o l x o a t l r K c o c y a H c l o H e p B H o M yn y ' { x y o 6 ' 1 a c r f i
cepaua, rae cruBaeTct c pyqHriM IrHr,cKt{M MeplraraHoM .cepAIIa
llaro.nor qecKxe CTMIIToMH,cB93a8fiHe c epxafiafioM. l. II p I
HapyuleH gx B MeprAxaIe: r o M o T a o' r q y u e H l t Te t x e c T M
go BceMTe,'r€,floxeJrreH e Koxlr, 3aTBepAeH e fi 6orfi B 93uKe, oreKfl
a BHyrpeHH€i cropoH€ Hor, oHeMeHI{e MH[lIl BepxHr'tx u Hl'lxHl'tx

2. llpr uapyueHfiqx B (cBoeMt opraHe:6ont r

vyacreo nepeno,lleuxocrfi a 3nltracrpa,'I6Hofi o6nacr, HenepeBapt-
e!xae ntulr, rorxHora,3alpyaHellHoe rnoranfie, ocrphre 6onfi B 9ntl-
racrpafl bHofi o6,'Iacrs, flofioc, 3arpya8eHHoe MoqeBbIAereHt{e
tio*asaflxc x ficnorttoBaHxro Mepxar|afla. 3a6oneBaHuq xeryaKa,
Ad- a.Hr -ry€r (9 FrP) x{ueqHdl(a l,l MOqeDOlrOB6llOplaHoB.

5. PvqHOft l-lHt'CKln MEplt.[tlAI{ CEPJItIA (C)

(no 0 roc€( c {axaot cropoxu)

Xoa irepxa aHa. HaqtHaercfl MepfialraH or cepaqa, npoxoallr B-clcre_

My BeHeqHHxcocyaoB. MliHoBaBanaoparMy' noaxoallr l( roHxor{ KIllx-
xe, Or cncreMbl BeHeqHHxcocyAoB noaHliMaercq K nerKfiM' BAo,'It'AEa
f l o A M H l n e q H o it M x s I n e p e a H e B s y r p e H H € Mxyp a 1 0B e p x H n xK o e q H o -
crefi c,I€Ayer MeAsarbHee pyqHblx MeptAsaHoB (BerrKtff llHb' t
<(oHeu nHfl>, 3areM I|o nepea8eHapyxHoMy Kparo Ml'l3rlHqa K[crl't
Bblxoar.rr K xoHqy ero (co cropoHLl 6onbruoro narbqa), coea&IltHcb
M e p r a r a H o M r o H K o f ix H t ! K u l p r c O )
c p 'yOq rH H Mf , H c I ( } r M
(RP). serBre H x t . B o 6 , 1 a c r uc r c r e v H B e H e q H H cx o c y r o a o 1 _
Pi.. t, HoxHoi ,Hbcsri aep,aN.a <6re36Hk,
73
 xoAfiT BerBb,xoropaq cneAyeTsAo{'IbropTa,{fi BBepXK [lla3y ( cHc_
'feMe nepxoxynqpH6lxcocyAoB,
lar6norriqecine orr,rnioxu, cansannue c M€pxaxaloM. I II p t'{
napyrirenrrx B M e p t A I { a H e : 6 0 1 6 u o 6 i a c r u n n e q an- o
BHyT peHHeinoBepxHocrnpy(, roptql,e fin{ xonoaHHe'laAoHt, cyxocrl,
Bo pry, xaxAa,6onn B o6nacrHr,ra3.
2 . f l p r . rr a p y u e u t t x B < c B o e r , ro, p r a e : 6 o , r b3 0 6 -
,racru cipaua. xKora, oc,pat 60,rb B o6nacrH rpyaHoii K'lerKt,
np,, <lonHore>6onBHx - 6peaoBoecocroqHtr€,npx <nycro,e>"
Mer'laHXO!'IHC.CTDaX.
not(a3axfic x rcl|o,tb3oBanfiroi,repxaxaHa.3a6o,1eBaIc B o6"1acr,]
cepAUa,IpyAHoi K!'leTxri,nclrxliqecklre paccTpoacrBa

-"- -"--.t.
="--Y-l\!/ - 6 . p y q H o B t H C K r . r t lM E P X A U A HT O H K O I -( IX I X K X ( l G )
(no l0 to{e( c Mxnot croPoHH)

,.,-:.Ii..i"6"..* XoA McpxA&afia. MepLtALtaH6eper t{alla,ro d3 yrlra HorreBoro ,oxa

Mn3$Hua (c ,roxreBofi cropoHbt), cr'IeAyer aao'tlb ntHfiu nepexoAa
yqacrKa Koxn rbtJlbl{oi cropoH6l xllcrll pyKn B yqacroK Koxu 'raacHll'
..-i !.. I DOAH'MaeTcrl ( 3anqcf6lo, npoxoauT M''IoBnagtlli oTpocToK JoxTe
Boi Kocrl H, cn€ayq BAo,'Ib ,roKTeBoi (ocrH co cropoHbl Mlr3lHua] noa-
xoanT k oTpocrKy r'loxTeBoro cycraBa q MeA[a/rbHoMy HaaMblul€"']xy
flJe,{eBofi xocrr'r.3areM nyrb MeptaflaHa nponeraer no BHyrpeHHeMy
Koaro 3arHefi cropoHbl nnerla. noAHnMaerce K 3aaHefi cropo[e nre
leBoro cycraBa li 3ur3aroo6pa3Ho npoxoAl'lr cBepxy rl -cxl'{3y K ocru
JOnaTKfi, BcTpeqaercq c HoxHbtM qHcxliM MepfiInaHoM lB roqKax Qy-
daH td\ O3xb, 4l V, H aafi-'{br (aa-q)h}. l l V)l :aaxecpeasssuv
v e p H a r i 6 n o r vl B r o ' t K e a a i - r r c r ( a a - q ) k ) f i . l { V G I ] , n p o x o a HI B H a A _
' . , r i o ' r x u x y r or n r x y I s ] o q x e x x r c e r - 6 0 H I u r c , t _ n 3 H bI.2 t ) I cnyrxacrcfl
B cepAIIe H, crleAyfl BIoJb n{qeBoAa' npoHsxaeT qepe3 AlaqparMy,
n o a i o a r r x x e n y . i x y a t r a i c e - K r o H K o i ix H l l l K e { p x c 7 )
OrBerBneHus B r o ' r x e x x l o e r - 6 o Ho r x o t r u r B e r B b .K o r o p a t
rroAHrMaercr l{ rqeKe; noaxoalrr x HapyxlloMy yfny ma3fioi le'Iu ,l
BXOAuTB yXO.
B o6nacrx ueKlr orxoAlrr apyrat BerB6, (oropatt cr'leAyer K Hux
HeMy Kparc rna3HqqHofi BnaAxHbl, npoHsKa€T B no{'Iocrl, Hoca, Bblxo_
arrr x BHyrpeHHeMyyrny rna3Hoi srerB. rae coealrHqerct c HoxHbIM
s H c x r M M e p f i A f i a H o MM o q e B o r o n y 3 b l p q l B r o q ( e r h I H L - M t H b ( | l H
v r u . I V ) l t t r a r e v c n y c K a e r c ex c x l n c
nama6rxqecr e crinronu, ccraaxnue c mepa4xanou.I ll p a
Hao\ueHrtx B vep{nlaHe: r J y \ o 1 an. o x e ' l r e l l r6ee , 1 ( o B
rnal. nprnyx,rocrb B o6nrcrx trHxHci q(nlocr .60,rx B ropne B 06
nacTr rrJreqeBorocycrasa x Blty-rpeHHefo '{paq 3aaHei! cTopolL{ nre
qai cracrfiqeckoe cocrotHl|e MbIIxrr lneiBo-3arHno. Hoi o6nacrM,
2. flpn napyUreHrqx s <cBoeM> opraBe: 6o"1t'
I, s3Ayrse BHr3y xrBora, tppaAralll{c 6onn B noccHtqHylo o6,1acrr,
r B o6nacr6 ttqHllxa, xfiaKre ficflpaxHennjt tn! 6o,1tl B xHBore.
Pxc.6. PycHoiaxrcu; reprarax cepaua(C). 3 A n o p , 3 a r p y a H e H s a qI e Q e K a u t f l .
 floKa3aflr{c |( cnorh3osaunro €pxAxaHa. 3a6o,1eBafil,ls B 06"Iacrr'l
ronoBbl, 3arbltKa, r!'Ia3, ynll€fi, ropra, roJoaHoto Mo3ra, floBblueHHaq
r€Mneparypa.

7. HOXflOf, tflc(lln MEPHAIIAH MO.IEBO|O nv3blPt (v)

(no 67 ro,rex c xaxaot croPoHu)

XoA ep Ataxa. MeptALtaH 6eper Haqano or BHyrpeHHero yrJla rJIa3

7'/: Boi qe,1fi, noaHnMaerca Ko n6y H Ha ronoBe Bcrpeqaerct c 3aaHecpe-

l l ] H H H Mv e p H A x a H o M B . r e M e H H o io 6 ' r a c f ] i o H f i p o H x K a e rB l o r o B H o i
*ta Mo3r (nepBaq BerBb), 3areM BblxoAnr K 3arblaKy, npoxoAtr BAonb
BHyrpeHHefi cropoHblronarKt, oflycKaerca BEt3 BAonb no3BoHoqHl|-
( a , B n , 1 o r H y r ox H e M ' . n p o r o l l H T B r ' r ) 6 b K p e c f u o B o i 0 6 ' 1 a c r H . r a t
B c r p e q a e T c rc n o q r { a M HI q e p e 3 H r x c v o q e B L I Mn y 3 d p e M l p r c . 6 l .
OTBerBn e H L i f i , B T e M e H H o io 6 n a c r n o r M e p u a ! , a H ao r A e i , q -
eTcrr BerBb, xoTopaq noAxoaHr r{ BepxHeMy Kpalo yrDHot paKoBtHbI-
B norcHrrq8ofi o6nacrH orBerB,lterct Apyrat BerBb, xoropat npo-
(11tG)
l o , r x a e r n ) r b f l o o 6 e x v c f o p o H a M n o 3 B o H o q H H K an,p o x o n H l e l o a l l q ] .
( n l c K a e r c a n o l a a H e i c f o p o H e 6 e n p a K n o a K o , l e H H o ir M x e L a B y x
(9 rG) c r o p o H H a y p o B H e? r o n a l h I o r t r e f l e e r c e e u e B e f B b , x o r o p a t n p o t n t
flneqo, HAer BAorb no3BoHoqHaxa, no o6eltM cropoHaM ero (rare_
o o panbHee ocHosHoro M€pfirlraHa), aoxorxr ao 6o,'Ibuioro Beprena Il'
npoiAq ro 3aaHeHapyxHoi cropofie 6eapa, BblxoAtr y BepxHero
xias ooaxoaennoft qMKH,3aTeM npoAoJxaer nyrb '{ep€3 o6nacrt,l
..-..,,-""'''.'L'l'i;1;;,.,,,,, ai ,roorxroi lqep€ ro,{xy xon,'rou (xynu',ryna, 60V)] I aa,ree
BAonb Br{euHero Kpaq rHnbHoi €ropolrbl cronbl BHxoallr x BHeIxHe_
vv' xoaro V narrbqa, BnaAaq B HoxHofi trHcKlii Mep|jaxas noqeK
l|aro.rorriecxne cnnrflToirH, cBq3anfiHe c ep axaxox. I fI p H
H a D v l n e H H r x s M e p l 1 l A t a H e : 6 o , r LB o o n a c r f i r r a 3 . c n e 3 o
Tuev-rda rcr | \....-j,.:..r.
teqdnne. xoosoretenr{e tl3 Hoca, 60"r B o6nacrl ro'loBl,I, 3arbln(a,
, ' " "a..i"
r- '+-: l'
',';i i,,j
IL';;":::,i?;ili:':
( n r H H , n o s c H l { u b r ,n 0 3 B o H o t r H t j k ax, p e c r u o B o _ K o n q H X o B o0i 6 n a c r H .
3aAHefi noBepxHocr Hor; noBblueHHafl TeMneparypa re,ra
2. Ilpn Hapy l€HIrsx B nor'IbIx opraHax: 3arpya
'j'i::r'i::ji..1j/ HeHHoeMoqeBhIAe!'IeHue, ocrpble 6orfi a HrxHei '{acrl'l xaaora, Hoq_
r, r,HhrTrcr '1r'jl- '' Hoe HeAepxaHfie Moqri.
'
\ IloKa3aHxn AJI'.r{cnorLsoaaHrt M€Dxanalra. 3a6oneBaHIrt rna3,
t":t
3 d o H r r a o( 6 r G ) IIoca, TOIOAbI,3aTLIr'lKa.nOtCHllIIbI, 3aAHerO nPOxOAa,rO"{OBHOTO Mo3_
\
r a ; n o B h r u e H H a r r e M n e P a r y p a r e r a ; 6 o n B H H B t l y r p e H H n xo p r a H o B
( H e o 6 x o a r M oB o 3 a e i c r B l r eH a t o q y B c r B e H H N e To q x r c n f i H b r ).

8. BOXHON HbCKTN MEPHAXAfi NOqEK (R)

(no 27 roqcx c |(etqor cmporH)

xoa lrepnAfiaHa. MepltaltaH saqlHaerct Ha HrxHe[ IIoBepxHocrH

P r < . 7 . P y c H o i r H < x h i d e p N A N a Hr o i * o t
V nanbqa cronbl, Lraer ( noaoruBe, 3areM, npoiiaq BAonL rarbeBsAHoH
KOCTXnO BHyTpeHHei noBepxHocTl't cTonbl lloqxa HHeH-KoK (xaHb_
ry, 2R)], npoxoaHT caaaq M€aranbHoi .noablxKu, cnycxaercq BHI'13
x nerKe fi BHoBb noaHlrMaerct K jrKpoHoxHoii MbIrIue, Aanee noaHn-
x,ukr (lG). Maerct no BHyrpeHHefi noBepxHocrH ronefir x IIoaKo,reHEo[. tMXe,
77
 noBepxHocrH6eapa noaxoAftr K npoMex
3areM no saAHeBsyrpeHHefi
HOCTIIX COeAIHgeTC'tC 3aAHeCpeAl]HHHM XaHaIOM, lAeT BAOnbnO3Bo
HOqHrxa K noLlKaM)ycraHaBnfiBaeT cBfl3b c MoqeBbIMny3blpeM (nep
Baq BerBr,), Or no,tex M€pxafiaH noAHHMaerct K neqeHlj' npoxoAnr
a r a Q p a f v y f i n o a x o , t r n rK n e f x H v , 3 a r e M n p o t , n e n o J o p r a H H o - l J l o
r o q n o i o 6 , r a c r r , l a K a H q r B a e l c s B K o p H ef l r b l K a l f H c v l
O T B e r B n e B f i f l . B o 6 ' r a c r ( n e r x u x o r x o a f i T B r o p a t B e r B b ,K o
ropar cBr3brBaer MeptAIraH c cepaqeM ll, pacno'laraqcb B o6nacrq
plKll
- - f l \ rp' -y a r r . B c r p e q a e r c g c x H b c x H M v f p r t r f i a H o M
llaro.norrqecxne npx3Haxx. cat3aHHHe c MepraxaEoi{. l lI p r'l
l ra D \ L ! e H u e x B M e p r a x a H e : o L [ y u e H r xe a p a B o 6 n a c r t ' 1
p r a , r i e p e c o r r u ua f i: u x . o n y r a n u e r o p , l a I r o p r a H r . 6 0 , 1 r B o 6 n a c l H
nosgofloqH{xa. 6o,'tb lr'rIr noxo'roaaHre no aHyrpeHHex noBepxHocrti
H n x H x K o H e q H o c l e l ' I .o p s q x P n o n o u B b l
.2. nph HapylueHs'{x B <cBoeM> oPraHe: oreq"'
HocTb, 3arpyAHerroe MoqeBblA€neHlle. xpoBoxapKaHbe' oo,nbHoI{
crapaerca,i"xaru, aclva, pt6b B rrarax. yqarrreHHoe cepaue6reHfie.
6 " r e a n a n c c e p o e a r s r r , 'ur l r e H x o M x o ) h a , I I o H o c ( o 6 b i ' t H o n o , 4 ] T p o )
Ilorasax t aas ficnor63oBaitc l\iepxAxaHa. PaccrpoficrBa Moqe_
no.roBblx opraHoB, KrueqHrxa, B o6nacra ropra, rpyaHot (JlerKl,r

Tr.v-quoHr-3y(2?V)
6asr-syarr-3v(28 V) 9. py' toft xHbcK]'n MEPt,|AltAflflEPEKAPAA(mC)
(no 0 'oqe'( c (axAot croPonu)

xoA MepxaxaEa. Meplt,4t,laH6ep€r Haqano BHyrpIl rpyaHoi o64acru,

o r n e p H K a p t r a :n p o H x 3 b l B a qn x a Q p a r M y . c n y c K a e r c a n o B c l p e q H ^c
qacrtM,l llrloBHLua lprc. lul
Oxr H e i . s a r e v c D e a H e f rH H I r x H e i
B e' D
eer a,reiaq, B o 6 ' 1 a c r Hl p y n H o l x o n f i T B e r B bl ' 6 o K o B o i
cropole .pyaHoi Knerx!, Ea 3 qynt HYxe rl noaMurneqHot cKnaAKH'
orr6aer aoAMblmeqHylo o6''Iacr6 I't no nepeafiet noB€pxHocrfi npo_
xoar{T Mexay IrHhcIcrMHMeplianaHaMtt 'lerKHx li cepaua, sanpaBnt_
eTct x cepeatxe noKTeBofo cycraBa, 3aTeM cnyc(aeTcq K npeAnneqblo
H MeXAy CyXOXunI{tMX npOXOAIlr K rlaAoHll r' l Aar'1eeBAOI6 CpeAHero
nanbua KIrcTI,tBblxoAllT x KoHuy ero.
BToDaq BerBb orxoAlrr or M€pltafiaHa B o6nacrl'{ "raaoHl'l' c"'IeAyer
gao,"a beastrrsnnoro na'rrqa xxcr (co cropoHbl Mx3rxua) x ero
xoHrry, rAe BnrBaerct B py,{Hoi qHcxfii MepraqaH rpex qacrei Tyno-
BItua.
flarororxqecKle cn nroitH, csg3aHHbre c epxaxaHoM. I n p r
hapyueHHq\ B vepraraHe: f H n e p e M H' \f xl u a n p f i n y \ _
,locrb B n o A M b l u e q H o i o
i 6 ' 1 a c r H . p l k t ' l 6 o n b H o r o c f l a f M a r u q e c K Dc o -
fHyTbI
'2- B noI(TeBbIX L n!'IeqeBbIX CyCTaBaX, Xap B naAoHtx
npl, HapyueHltex B <cBoeM, opraHe: 6o'rtr
B o6racrx cepaqa, 6 e o r , { e r H a q r p e B o r a , c T p a x , c r e c H e H u eB r p yAl{'
cepaue6reHlie,
'noxa3aHxc 6pea, I(oMa,
Ars xclorh3osairc itepxafia8a. 3a6oneBaHlt B
o6nacrrr rpyAHofi KJIerKx, cepAua, xeiyaKa: flcrxfiqecKre 3aooreBa_
T
Pi.. E. HoxHoi rH<*,t MsprAx.N Mo,{.roro ny!5'p, (V). HUr; noBbrrIjIefiHaqreMnepaTypa e'ra.
79
 'r'.-
--/
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\ /

i i,:
t
'il,
, ..

: l

..........--.,",C.-----.........
( 1 0F ) :r
dl\
or*-'v*rrFrl\

Prc. 9. HoxHoi rhbckkt aepqAnap

BM - rHeM6prar.HHsr. roqx, (3ae.r k Pr.. 10, PycHot rHb<R,i M€pen".H n€psk.pa. (MC)
 t0 prtl Ho rl t HCKLltl MEPttill-l1HI PEXqAcTEll TyJloBxltIA (TR)
{Do 23 loq({ c {nxAon.roporo)
T d q y x - { x o s r( 2 3 T R )
^oa-arey(22 TR) Xoa iraprAxala. MepxafiaH 6eper Haqaro or 6e3blMqHHoronanbqa,
H,-Mo{ (2i TF) npoxoar no elo T6l,1l,Hofi cTopoHe,6flixe x Mt3uHuy, noaHliMaerc9
.( npoMexyrKy ,.{er{lv Mx3HHueMr 6e3HMtHHHM.npoxoaHr no
3e{-ror (20TF) rurailof, n6eeirr.cilr xlrcrl (vexay IV r V nacrnsrul xocrrrvrx,.
n r - r s N ( 1 9T R ) nalreec"'te]lyeT r 3antclLo, noaHHMaerctaHlUe Melklr) JlyqeBonF
h r 6 , M a L ( 1 4T R ) noKTe?oq KocrqM. Mxflyet ,rpocroKtroxreBorocycraBaH no 3?,,qHet
E - O c r r ( 1 7T R ) BHeuj.ren noaepiFocln ilJleqa IoXOAlrr Ao n,leqeBolo cycTaBa,
T r , e H - 3 y( 1 6r R ) nepecexaercHcxnfi MepnAraHxenqHoro ny36rpt r, MrltoBaB n!'Ieqo
lubpe: ro,rxy xreH-rbrHb(u3rHr,-u3xH.2l_VB)]. flpoxoaHrB Ha.{l_
r.arcvl,!,rxyn tMXy lKxrcer-6oH{urot-neHb.l2 E)].3areM oH cnycKa
c r ( r M e x A yM o n or ' { H M nx ^ r e i a M r h a H - q y H r( r a H b - , r x } nl.7 V C ) 1 .
Bcrpeqaercr c nepfirap,4oM!nepeceKaerAl,laQparMy,otyc(aerct B
o6racr5 xflBola, K BepxHefi,cpeAfiefi x HHxHefi qacrflM TynoBlrqa
l D n c .l l ) -
OrB.Tsnexnc. B r o v x e 4 a x r - u y x ro r M e p r i a u a Hoar x o A l r
BetB6, (oropat noAtfiMaercr x HaAx,rrcqrqHofirMxe lKxroer-6on
( u r o 3 - n r H bl 2, F ) l n a n e ex l a r H , / I x y . 3 a r e Mf l.p o f i a i n o r a n H e i
noBepxHocrt{ csodbaxoroxpaa yu.txoi!axoarnbl. aoxonrl ao Bepr'
HFrO_ Kpaq ee H cBopaq:iaaerBHr,r3 K rrr-(y. no]r riaJHyrc Bna4xHy.
: \ .l,pyraa rer"s orxJtlr.tr or MepxafiaHaa raltuHog 06,1acr .
npoxoanr B,xo, Brlxo,r.TB npeayurHyro o6,1acrb,npoxo,[vr nepe,
r o q x o i l r x H o H r - K y a(Hu a H - . y a H b , 3 V B ) lx B b l x o l H K r HaplxHoM)
yrny rna3Hofrue,lll, aae BhoB6cJliBaeTccc ocHoBHbIM MeplraHasoM
xe,lqHoro ny3blpi.
TradL-iaH5-yetr(1iTA naronori{edx c cq nro !r, clcganrtrrc c MepxAflgxorr.1. fl p x
HApy|Ire8firlx B Mepra&ale: rnyxofau , yM B y ax, npx-
n/xnocrb fi 6c,,1bs o6nac,k ropraflt H t,lorKr, 6o',IbB o6,rrac,r r'1a3,
nianyxaocrr ruex;6o,'M sayuftrofi o6,racrl, s o6rlacrH n,reqeBoro
cycTaBa, nrleqa, BHeLqHetnoBepxHocTr no(TeBoro cycTaBa, Hapy
{'*... UleHIlenorBqxHocrt 6e3HMfl HHoro nar'tblraxllcrr{.
2 , n p r H a p y e s r t x B < c B o e M to p r a H e : a 3 A y r r e
r{ Hanprxer ocTbno BceMy )t(rBoTy, 3aTpyAHeHHoe MoqeB6rler'leHse.
geAep)(afiIleMoqlr, qacTHe no3btBbtK MoqeflcIycxaHr{lo,BEIIeneHue
Moqr Be6orLrxxMt nopurrMn, oreqHocrb,
Jlo|(f,3lttrc x rlcnoJrh3oiafir|o epraxaHa. HapyueHur B yrrHoi
o6,racrt, B o6nacrq fonoBLr,rna3, ropra; [oBbrueHHatTeMnepa-
rypa.

x E d ' r q H o r on v 3 b l P t ( v B )
ll. HoxHofi tHcKrn MEPr{,axAH
(tro 44 roc(l c {axaoft ooposH)

Xoa x€pranaxa. Mepr4raH 6eper HaqaJIo or HapyxHoro yrr'Ia

rra3,.ofi qenfi, crycKaelat x 3ayuHofi o6nacrr, ort6aer ro'IoBy,
rroAxoalT vo Jt6y, Bo3BPaqaerca K 3dT6InKy,3areM A40,'16lueti
(nepeA MepIiA axoM Tpex 'racrerl rynoB{ua) cfiycxaerct K nneqy,
P;.. ii, PyqHoi rH<Rri Mep'Araa rpex qa.rei tyros.ura (TR)- npoxorr.T3a pyqHHMtHcKxM vepxa aHoMx HaaK"roqxqHon qMRe

83
 x aanee 8Hfi3,B noaMblueqHyroo6,racrb, 3areM fiAer BAor'lbrpyaHol
x,,rerKr [ruoHr-MoH (qxau-MeHb, 13 F)] x 6o,'bnrouy Bepreny x no
BHeuHeii cropoHe 6eapa BbrxoArr Ha HxxHrri Kpafi xoneHHoro
cycraBa a aaree no ro,reuu; npoiAa no BHeuJHefi cropoHe Ma,lo6ep-
qoBoii xocrn l,r nepeAnarepa,rbHofi,']oabrxxofi, BHxoaxr Ha rHlrr,Hyro
cTopoHycroIIhI u 3aKaHqtBaeTcty BHeuHero yr!'Ia HorreBoro.Jloxa
IV na,rsqacmnbr (plic. l2).
OTBerB,,reHfir. OAsa u3 BerBefi orxoArrr or ocHoBHoro
MeprAHaHaB sayrllHofi o6,,racrr.tr npoxoanr B yxo, Bbrxoaxr lrepea
yufioi paKoBr.iHofi Ir noAxoAr? r( BBeuHeMyyrny r,ra3Hoi nte,1r.
BTopaq BeraL or BHeuHero yr,ra rna3Hofi [le,rlj crycKaercfl x
roqKe Aafi-HreH6 (Aa fiH, 5 E), Bcrpeqaercq c pyqfiblM qtcKLtM
MepnAnasoM,noaHrMaeTct K HqxHeMy Kparo rna3xolr BnaauHLI,
cBopaqHBaer8Hfi3, x yrr'Iy Hfixuei qenrocrn, ri aar'Ieek lrlee, BcTpe
qaercr c ucHoBHhrMMepHAHaHoM Ha,4 KJIrcqIueft lKxrcer-6oH
(uro3neHb,12 E)1, Bxoaxr B rpyAHyrox!'rerxy,npoxoaxr AxaQpar-
My, coeAnHqerctc neqeHblon qepe3 Hee c xe,'IqHbIMny3blpeM,npo-
xoAxr no pe6paM, cnycKaerct K [axoBoMy KaHalry [Kxl, cy]f, (IlH-
,ryn, 30 E)], orfi6aer ,ro6(oByro o6,1acrb L Bblxo,qHrK 6orbuoMy
-Tperra
aersr orAerlqercfi B rHn6Hofi qacrl,I cronbl, npoxoAl'rr
uexay I r II n,rIocHeBHMn KocrsMri x xoHrry I na,rlqa cronn, sarev
cBopaqfiaaeToKo,ro Bo!'rocrlHoronyqxa I na,lbqa l, BcTpeqaercflc
UOXHLIM TIHbCKHM MEPI,TAIIAHOM NEqEXN.
narororr,{€cxre cfiirnroMu, cBr3aHHH€c MepxAxaHo . L II p Il
rr a p y rx e H r,rq x B M e p u A fi a H e:,rrxxopaloqHoe cocroqHl{e,
rnyxora, roJroBHbre 6onl,, 6o,rn B o6nacrn qenocrefi, rra3, npxnyt_
nocrb n 6on, B o6nacrn HaAKarcqaqHoi SMKH, np[nyxnocr6 B
noaMbrueqHoi 06,racrrr, Ty6epxyne3Hbrfi ,rHM0aaeHHT, 6onu B
o6nacrx ra3o6eApe8Horo cycraBa I no HapyxHofi noBepxHocrl,t
Hr]xHnx KoHeqHocrei,xap Bo BHeuHeiiqacrlr crorr, norept noaBnx-
Hocrs IV nanbua cronri.
2. npr HapyllreHxrx B (cBoeM, opraHe: 6on,
B rpyAHofi K"re'rxe no 6oKoBoi rroBepxHocrri, ropeqb Bo pry,
suorr-raHr ryeH(34 Va) noxa3aHxs x r{cno ,soBal|rro MeplAxaHa. 3a6o,resanrrq e
ynen, ropra, Hoca, rpyarj, 6ona a 6oky; rroBbrueHHat
o6"1acTr.r,'Iriqa,
reMnepaTypaTeJra.
- 3uorr-oy(33VB)
r2. floxHoft xHbcKtln MEPl,|at,lAHnE!EHLi (F)
( o 14 roq€r c (axAofi cropofld)

XoA n€pnA ata. MepxaraH 6eper Haqa!'ro y HapyxHoro yrna

HorreBoro no)Ka I natlua cronbr, npoxoA[T no rr,ubHofi cropoHe
croflbr, K narepa,rhHoftnoabrxxe (Ha paccrorrHHHI qysr nepea Hefi),
OAHgMaeTcq BBepX nO ror'reHHi BCTpeqaeTCfl C ItHbCKIM MepHAHaHOM
cere3exKr'r,nepeceKaerero HaA MeArarbHoi noAbrxKoi (Ha pac-
crorHl.{ 8 qyHerfior Hee). noAxoAr.rrK BHyrpeHHeMy
r(pao noAxoreH-
Prc 12. HoxHoi tHckti MepkaNaH x€nqHoro ny36rP, (VB). Hofi qM(ll l.r no BHyrpeHHefinoBepxHocrfi6erpa - r( ,ro6Ky, 3areM
85
 oH orrr6aeTBHeufiHeI|oroBHe oDraHH, noaHsMaercqx HHxHei
npoxoan napar,renbHoMepsaraHyxeryaKa, noa-
xoAnr K xenyAxy, neqeHn,xenqHoMy ny3brpro,npoxoAxr AraQpar'
My.floAHriMaercsBHlne,cneryer no o6nacrfi pe6epr, npoian o6nacrb
3a rpaxeei x rop,arbro,noAHHMaerca x MqrKoMy He6y.,4aneeoH npn-
xoasT a xoHTaKr c cHcTeMoar nepsoKynqpHbrxcocyloB, BbixolHr a
o6nacffi,16ar cr'rrBaercrr Ha reMeHrc 3aaHecpearHHblM MeDHAnaHoM
d\ B ro,rKe6 a r b . x o i { 6 a * . x } , f i . 2 0 V C ) ( p r . t ci .3 l .
j: OrBcrBneExc. B o6nacr grcreM6l neproKyncpHLrxcocyAoB oT
l: f.s ocHoBHoroMep}lAtaHaoTxoAIT BeTBb,KoTopar onycKaeTcqk qeKe t
cBopaqfiBaerx ry6aM. Or nerreH| orxorrr rpyrar BerBh, Koropar,
npoHr3aBAfia{pparMy,uoaxoanr K,rerKnM, rAe c!'rnBaercrc fiHhcrqrM
MCPI,IAI,|AHOM !'IETKl,X.
Ilaronorlqecxne cr nroMra, cBs3anHHec €pliArarlor. l. Il p r
H a p y r j l e H n t x B M e p q A x a H e : r o r o B H b 6t eo , ' u p, t 6 6 B r n a
(14F)
3ax, norept ccHocTuBuaeHrrq,lxyM B yuax, BhrcoKatrTeMnepaTypa
i ,'"ii..r Te,la; BO3MOXHH KOHByJILCHT,FOqHOe HeAepXaHHe MOqr{, 3aTpyA
HeHHOeMOqea6IAe.'IeHre,
( 1 3F ) 2. IIpIr HapyueHntx B <cBoeM) opraHe: crecHe-
Hne B rpyAu, rornHora,6o,rx s gnuracrpa,'IbHoi o6"racrt, floxen-
reHue Koxu, xxaKre xcnpaxHeH rr, ouyqeEfie senpoxoAnMocTr.j
B ropne, rpHxa.6onfi B HrlxHei qacrx xlrBoTa.
flo|(a3aHxf, x rcooJrhsoaaHnro eplArraHa. HapyueHrt B 06
"(acTll Moqeno,roBbrxopraHoB, MoqeBoro ny3brpr, KnueqHtKa, rpyA-
Hofi KnerKq, rra3.

lll. BOCEMb HEOEblqHblX(<{V,QECHblxr) MEPIIAIIAHOB

- MATb-AOK(Jly-MAn)
mEPrAl,rAH
3AAHECPE,ql.|trlrbrn
(2E roq€x)

Xon riepnAraBa, Beper Haqano s o6,1acrn [poMexHocrn, npoxoAnr

ili qepe roqxy qbroHr-KbroHr(qaH-qrH, I VG) r BAonbno3BoHoqHI,Ixa

floAHlrMae'rcrx roqKe (poHr-Qy (03H-0y, 16 VC), BxoAfir B ronoBHofi
Mo3r, npoxoaur ( TeMeH[I Aarre€qepe3 ,106 K Hocy, KopHqM3y6oB
HfixHefiqerbcrn (pxc. 14).
namrorrqecxrc crl nroM6a,cBr3a8ribr€ c MepxaxanoM. Orpa-
HtqeHHa9 noaBlxHocTb no3ao8oqHrka, npll cepb*HbIx HapyrteHx-
rx cra3Mbr cnBsHbrx Mbr[rq xapaxrepa cror6Hrxa nr6o rynafl
ro,toBHafl6onh, coDpoBoxAaeMaqcna6ocr6o B 06,racrH cnxHbI-
floxa3anit art cnoJlh3oaaExqMeprAral|a. CxoBaHHocrbrl03so
HorrHt(a t cna3MbtcrlfiIrHbrxMblluu xapaxrepa cron6Hf,KaB pegyn6-
rare HapyureHufiB o6,,racrHro,roBHoroMo3ra, nopaxefirt Bo BHyr-
(3F) peHHrx opraEax, pacnonolKeH8brx B6n|l3t,lnyrn MepnataHa.
t2 fl
(1F)
NEPE,IHECPEAXH1IHN ITEP]IAXAH_ MATb.H'M (X3Rb. AN}
(24 ro{xx }
XoA Mepfiaxalla, Beper fiaqano B npoMexHocrr,rlxoi-aM (xy3fi-[Hb,
Pr., lt. HoxHoi ,ds.kri a€prar.H n€'i.H, (F). I VC)], npoxoafiTno6oK, Bxoanr B o6,lacrb xlrBora n qep€ Toqxy
87
 KyaHHryeH (ryaHb-rcaHb,4 VC) noagruaercs K Mecry coeariHeHfifl
fJroT(r,rt,l ropraH! aar'1eeqepe3 noa6opoao( Bhlxoarlr Ha ,'Ixqo,
3aKafiqrBatcbB r,la3ax (PHc-l5).
llaro.'rorxqecKxecrirflroMr,r,cBcsaEHuec €pxA aHoit. y M y x-
q I,lH: rpbrxa. y x e H rl r{ H: 6e,'rH,onyxonl B o6,racru Mar(x.
llo(a3aHrq x rcnorb3oBaErrc eprAraBa. HapyrxeHlrqB o6,'Iac-
tH rtoqenoroBbrxopraHoB. xen)qKa. fp)!Hoi K"reTXr,fop,la H
ropraHx; r{cno!'rByercqrakxe npr Heo6xoarMocrr.r ycrrr'rlrrbffH-gHep-
rrro rrrr6o nono"rHrir69HeprHroBoo6qe.

no[HtMAolll1.l ficq MEPxatlAH- MATb-CvHr

(qxvH-MAn)
(roqxr coBtraaapr c rocKaMx ocf,oBHuxMeprataHos)
( 1 3V G )
{ 2 8V G ) X o A M e p r A x a n a . H a ' I s t I a e r c i 0 1 M a T K f i ,n p o x o a ] t r B n o s a o H o q H I K
( r 2v G ) < M O D e( a H 3 ] ' r o B >B c e r o o p r a B s 3 M a .
Or roqxu xofi'au (xi:i-uar. I VC) eerel orxoaur B cropoHy
{11VG) roqxr xxu-cyHr (q|,l_qyE,30 E), orKyaa c.neAyer xoAoM ItHbcKoro
00vc) Mepr.qrraHanoqe(, aoxoanr ao nynKa, pa3BerBnterct no o6nac
I pyar.rfi BHoBbco6Hpaerct3 vecte nepe)\ollaropna a ropraHb I'l
aa,reeor||6aer ry6d lPfic. 16,.
(8VGi llaronorx,rec(rre cxMnroMH, cBc3aEHbI€c cpnaranoM. nepe-
ryrrpHbrfi MeHcrpyanbHbIfi utiK'I.6enlr, fiorept cnoco6Hocrx x 3aqa-
( 7V G ) 'rH|o,xoqHoeHeaepxaHneMoq!, rpblxl, c(onreHue ra3oB B Klilxeq_
Hnr(e,noanHparoqtx !xa{pparMy ll Bbr3blBa()nltx60rfi a cepr€'IHoH
o6nacrni 3arpyIHeHHoeMor{eBblrelreH}te.
IloKa3arrxr { xcnonb3oBaHxro uepl|Axafia. Ocrp6le 6onH B o6nac_
rr{ xr,rBoTsn rpyax, acrMarxqecKfietBneHXt, clrMnroMbIHapyueHlj'{
r,{Hr}c(oroMepr{aaaHanoqe(. orpblxKa, oa6llllKa! xt,ruieqHoeKpoBoTe-
qeHHe-c,ra6ocr6 noc,re oa6orbl.

onotcblBAlolLtr n MEPt.&l'lAH- mATb-aotl (IAn"MAn)

iroqxr coBraaa|or ilep{a arlou)
XoA uepl|AraHa. Beper Haqa,roor Kpat HtxHero pe6pa, cnyc(atcb
HarcKocbx rov{e MarbAoii (aai-Man, 26 VB), aarcu, o6ornyn
i{l.rBor, uaer Hnxe, x roqKarv Hry-Kxy (y-lxy, 27 VB) l{ 3r)lt_aao
{sgi-aao, 28 VB) (ptc. l7).
Ilaro,rorr,{ec{re crMnroMhr,cBc3aEHuec iieptA aHou. B3Ay te
xfiBoTa, noxo!'roaaH{ecnfiH},I (y 6o,rbHoro oqyqeHl,Ie, cnoBllo oH
cxAr.rrB xo,rroaHofi Boae), seperyntpHbtftMeficrpyan6Hbliur'{K,r,6enll,
B O J M O / { ( Hnbot x o , l o a a H f i eH o H e v e H f i eH L l x H t t x x o H e q H o c T e i .
nola3aHnq lJrfl rcnorb3osaHttt In€pxltxaBa. 60'1x lr Blayll,te
xfi Bora, HeperynflpHr,Ifi MeHcrpyanbHhlfi qsx,'I, 6e'1t, cllJlbHat cia_
6ocrr, B Horax Bnrorb ao norepH cnoco6Hocr! I( nepeABtxeHxb,
-
3ya xoxu,6onb B HnxHefi qacrlr rpyaHot K''rerxs, roJroBoxpyxeHue,
Pl.(. ll. 3.AH6cpeArHdbrn a6p,A,.H M.lr-AoR (Ay-Man).
rr'rvxoTa.,'IrixopaaKa.
E9
 \

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(t VC)
Xor,_aM

nepeAHecpeA,HHHt Mep,araH - sarb-H'M (x3Hr-Man) Px.. 16, noAHNA.pr{,i<r M6prak.H - darb-<yH. (qxyH-r.i).
 Ht-K r,rEv
flAPvXHHr.lntToqHbtn,mEpXAltAH MATb-3brO
(flH-Il3tO-MAfr)
(ro{r({ cGoaaaor c depnAranoB)
XoA nrepxAxaHa. MeprAnaH 6eper Harra,ro Ha BHe[fiefi cropoHe
n q r x l l r x a H M a r b ( t u 3 t r b - M a i 6, 2 V ) 6 o x r x a M ( n v r o 3 H b '6 l V ) 1 .
c.4eAyef g4o,16 yqacrxa 3a MeArrar6Hoi noAHxxofi It no BHe[Hei
cropoHe 6eapa noaHr,tMaercn ao 6oKosofi o6,lacrr l,l aa'lee or
3aaHei cx,,raaKn noaMbrue,{Hoi qMxH raer k nr'leqeBoMy cycraBy.
3areM BAOJ'[,nllefi K BHyrpeHHeMy yrny rna3Hon IIIer[, rAe Bcrpeqa_
ercs c BHyTpesHnMnttroqHr,rM MepraxaHoM (HHb-q3to Maii) B Toq(e
r b r H r , - M a H 6( u f i H - M r H , I V ) , 3 a r e M B M e c r e c q H c K r M M e p t A q a H o M
norHrMaercr Ko ,r6y, c,'rsBaercq c flHcxxM MepnaxaHoM xe.tlqHoro
, r y 3 b r p eB r o r { K e o o H . ' { n ( O 3 H - q L { 2, 0 B V ) ( p t { c . l 8 ) .
n a r o n o r x q e c x x e c r x n r o M H , c a e 3 a x H b t €c e p x a r l a H o x : H a p y u l e
H u s B o 6 n a c r H r n a 3 ( o c n a 6 " l e H l r e3 p e H n q , 6 o n n B r , r a 3 a x , n o x p a c
HeH!€ rr'1a3), 6eccoHH ua, gnrn€firuqecKre nprIIaaKE, 60,IIr B 06-

llo(a3aBrc a.,rc cnorr,3oaaHxfl uepxarafla: crorlbl, c,rrDXoM

cHnbHo pa3sepHyrHe B clopoHbr. rnrJenrHqerhHe nprflaaxH. 6ec

BHyTpEHHI -- MATb-Am-KIEv
n ntTOqnbrn MEPltIll.rAH
( HHb-U3tO-r{An
)
(ro{xx co8naasor MepraxaroB)
xoA €p|laxa8a. HaqrHaercr s roq(e rney-xafi (qxao-xa , 6 R),
npoxoaflr Haa MeAnanbHoii ,roabrxKoii, noaHHMaqcb BBepx no
3aAHeMy Kparc sHyrpeHHefi cropoHbl 6eApa, Aocrrraer no!'IoB6Il
opraHoB.Aanee rraer nprMo K rpyaHofi x,/rer(e!orryAa - B xarxirlo-
qrqHyro qMxy, 3areM, cleayt ptraoM c ropTaHblo, BHxoanT nepeA
roqxoii HrH-Hr€Ht (x3HL'IrH, I E), nAer BAonb cKynbl K BHyrpex-
HeMyyrny rna3Hofi qe.nu lruur-urns (q!H'MIrH, IV)] r coeatHter-
cn c HapyxHHMnqroqH6rM MepnrnaHoM(iH-usqo-Mafi) (prc. l9).
Ilarororl{ecKre c finroirH, car3a||nlr€ c MepxAfiaHoM:coHrll-
Bocrb,?nhrenrHqecxxe nprnaaKn,6onr{ B HfixHefrqacrt xtBora.
rpbrxa (y Myxq'lH), Merpopparnr (y xe8rqnH), 6o,'Ie3HL rna3.
IloKa3aHrr arc rcnoJxrcBa8rc MepraraHa: xocoraflocrb, 60"'ll.i
B ropr're,coH,ttBocrb.

HAPYXHbIN NOA,IEPXI,IBAK)IUI{N
MEPI,IA1IAH _ MATb-
3broHr-3K)tt (tH-83ft-MAn)
(rosxx coBtraaaprc Mepr^,aiotr)
xoa Meprarana. HaqltHaerct B o6racrH ntrxr cronu [rouxa xr'rr,,r
MoH (usr.rHb-MeHb,63 V)], cneayer BAo,'IbHapyxHofi noBepxHocrx
roreHrr, npoxoAHr no Hapy)(Hoi noBepxHocru6eApa BBepx K 6onb-
lxoMy Bepre,ry,n BHe Hei ,racrr.rHnxHeft o6nacru xr.rBora, npoxo-
Pr.. 17. Oflo'ch'.aburri a€pxA,.H - M6r!-Aot laan-M.n). anr no 6o(aM K 3aaHet cropoHe nneqeBoro cycraBa, no,4HlrMaercq
93
 naro"rorr,recKl€ cxr,roroMEt,cBrsallfihre c MepxaBasoir: ynaroK
dr!'r, !trxopaaoqHr,IetBneHti, Tynat ro,,IoBHat60"lb. pq66 B rna3ax,
acrMa. npfinyxr'rocrbIr 6onu B o6nacrt noccutqbl
Iloxa3a r trJrs rcnoJrb3oaarl|fl M€p axaEa: xap B HapyxHot

BHYTPEH H',Iff NOA,qEPXHBAK)qI fi MEPIIA',IAH MATb-

AM-3K)14( X Hb-83ff-MAn)
(roqrx .o.naaa'or Mep{aiaxoB}

XoA McpfiAraxa. Ha,ruBaercqHa BHyrpeHHeficropoHe roneHxiToqKa

'{yx raH (qxy-6uHb,I R) I , noaHrvaercsno eHyrpeHs€nnoBepxHocrfi
6enpa K ssxHefi qacru xnBora H K xpa'o HB)(Herope6pa,npoHri3br-
,{erF{e . npoi,rq
Baq anaOparvy. Bbr{o,4rIx rpytrfi. K Mo,lo,rHoii
rlo o6ex cropoHaMropraHH I, rop,ra, coearHqcrcqc aepeaHe-

06racfr nDoruerxr r.oatr.rrxcexoro sooerra l4 octsotrHr r.pxAxrHoo

Ipy!6. "re.xre. ropio. roprar6

I pyn6, ceplac, x.ry,1oKi lcrxrqc.RHe paccrponcrBa
rpyn6, cepjrrre,ncHxHcec(Hep2..rlotcrBa
lHcnrn roicrot {HU(t fonoBa, ria3a, yu,, no.. por,3y6u, xeiynox, xfl
e c H f{ , f o p n o i n o B l r D . H H a lne M n e P a r y p a
q H c M n r o H k o r i( r u x n f o i o u a , r a r d n o ( , u e r , y u r . H o c ,r o p n o i n c N x r c e c k n e
paccrpon.ruan . o D d u e H n a er . r u e p a r y p a
tHcKxnrpex cafen ryro f o n o 6 . , B a c o Nf.i a 3 . , y r r n . r p y , ] b , 6 0 ( 0 8 r q o 6 i a c r ! ,
. o t n o i n o t r d u r e r n a rce M n e P a r y p .
BepxHfi qa.r6

HrxBcH cacrb

flnxHqc cacrb
urcHrk, roP,o, nerK!.
fonoBa, rra3a, roc, por, ry6d, fopno. aei_vjLox,(n
rreqH{Ki ft rxf cccKre paccrponcre.
lHcKnti aen!Horo ny3dpH foioua, urcox. troc, yui{, ria3a, .opro, fpyrLl, 60(0
B a e o 6 i a c r b r n . n x H c e . x s fp a c o p . i c t u a , n o B H U e r

9HcKxii Moqeuoro ny3up, roroEa. 3arHro(,

o 6 i a c r b , B H y r p c f l n H .o p r a H b r i n c r r x r N n t e p a c
Prc. 18. HapyxdErn nrrocHbrn Mspra,aH - a.rr-3!roH.-x,6y (rfl-q3'o- c l p o r . r B a i n o B u u e n H a rr e M n e p a r _ v 0 a
roroBa, nnrLo. 3"v6br.por, .ty!b. iefk|e, xeiy,ro(,
o l . a H H r N o q e n o i o s H eI ) 4 .
P|.<, i9. BHyrpeHBNt ntroqHbrt !ep,a,.H - |ar5-td-K,€y (rHb-q3to- crpoucrla, ncHxHqecknep.cqpon.rBa, ocrpNe 3a
6 o n e B a H H roi 6 u c y k p c n . r r D q e eB o l x e n c r u n {
IoxoBa, inuo,3y6H, por, rpub. i..Kr.. xe.lynax.
opfaHb'i Moqer.rosde Ii,.
^ ceDeaHHe nneqa, JaTeM x 3afbl,rKy. nporoll'lT Btro'tl6 9l{cKoro crponcrBa, flcrx{qccxrc p.ccrpoilcrBa, o.rpdc a.
";;:?:"'"'r'-'0,i":;'0,""";1."011i',iil8""f
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6 o i e 5 , t s { r , n o B U U r e s H a rne M n e p a r y p . , 0 6 u e y ( .
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( p x c .2 0 ) .
9,1 95
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MEP}IAI'AHOB ( M EPHA]IOHAJIbHbIE OTBETBJIEHI,If
)
Kaxabrfi s3 12 MaBxbIxMepfirxafioBrlMecrcaoexpynBoeorBerBrte_
Hfie, KOTOpOe Ha3ugaelcg Mepn,lllloHaJlLHLlM, oTAer'rf,tcb OT r.IIaBHhIx
MepriaflaHoB,mBetB"'IeHBtnpoHtKalor B rny6h opraHU3Ma,ocyqe-
craJrc rax{M o6pgSoMcB{3b rnaBH6rxMeplanatoB c coorBercrBy-
rcunMfi BHyrpeHHnMropraHaMn, nocne sroro 6o,r6ltlHcrBo I|3 tltx
IIoAHlMaercg a o6nacr6 ro'IoBba.
BgrBr,r,orAenxBuHeccor pyqHbrxr HoxBbrx tHcKlix MepnAnaHoa,
sHoBbB.{l,raaloTctB caou MeptAHaHbI.
Bersll pyqHblx Lt HoxHHx rH6cKllx MepHAHaHoB BJlrBaprct B
KOHUe nyrn B rHcr(BeMeprAraH , nMerorqe <HapyxHo-BHyTpeEHne>
cBt3r c feMu ltHbcKtMll MepBAlaHaMt, oT KoTopblx maerhlllcb
BCTBfi.
TaKIM o6pa3oi,r,12 MeptAroHa,lLnHx orBerB,'reHnfiB xoHeqxoM
cqere MoxHo noapa3renrrb (ocgoBuBatcL Ha !x <HapyxrroBHlTpe -
Hfirt cBr3rx) Ha 6 rpynn B coorBercrBrruc 6 r,'raBHLIMtr,tHcKtrMrl
MepxAUaHaMn, I,lx HagLIBa|oruecrbro coeArHeHrtMIl,
Bo s3arMocBt3ix MexAy HnbcKHMfl,t tBcxfiMt MepI{AnaHaM[
cyur€crByeroco6eBHocrb:rHcKse MepraHaHbrHrparor rnaBfiyro p(l,Ir,,
a llxbcxl{e - noAq[ue8Hyp (flocxo,rbKy oHI{ aoJlxHH coorBetcrBo-
Barb rHcxr{MMepruraHaM),
,IlBeHarqalr, Mep8AroHarbs6lr orBerB.lleHrfi<Hecyr orBercrBefi-
HOCTb) 3a CE'3I{ TIinA <pa3AeJtegle- COeAI{HeHte>,(orxoa -
BxoxAeHuer, (HapyxnHi - BHyrpeHHrfir. OHx yMHoxapr cB93H
Mexly rJraBBHMl,MeptiAraHaMHr BHyTpeHHtMnopraEaMn, MexAy
rHcxnMt{ r qHbcKrMr MeptlAxaHaMg,fiaxoA9ultMllct Bo B3afiMooT-
[oure xqx (Fapyxro-BHyrpeHHero] Tsna, ae.nae eule recHee earH'
crBo fi B3a{MOCB93I Me)t(Ayps3nHqHUVroyHKUXsvHOprafiX3Ma.

OTBETBIEH}I' rJIABHbIX HOXHbIX MEPIIA I{A HOB

(BEJII,|KHnqHr l,| {mAIblti l|flb'
l. OTf,ersre xx Hox[oro clcxoro epxaxal|a. OTBerBnenfieorae-
Jsercr or rltaBtoro Mepr{rraHa B noAxclerHoi o6nacrn, npoxoanr
Ha 5 uyHefi llrxe Korq{xa, Bxor[T B 3aAurf, npoxon, aocrmaer
MOqeBOTO ny3blpc, pa3EeTMteTct B IIoqKax Il, noaHcBuxcb BAonb
ro3BoHorrgrKa, pa3Bercnnercr B cepaue. Apyrar BerB6, npofiat
B4OJI6 nO3aOIlOrlHliXa.,[OCTgraeT 3aTbIJIKa H CIHBaeTCfl C rrlaBHblM
pr.. 10. H.pyx{hrn noaaepx,B.burrt uepraqas - rar*ruosr:or (rr- Mepu!raHoM.
2. OrrclsJeHxc lroxroro { bcloro Mepx,lx&rra. OTAe"lflercq B
P r c . 2 i . B H y t p o H H , in o A A e p x N s a b q r l M e p , A , a H- a a l E - a M - 3 E h( , H b - floa(onetion rMKe, npoxoarf naparnel6Ho orBerBJreHBro HoxHoro
cpeAsrHHM MepyanasoM B roqKax .rxxeH-Aor (rsHb,ry, 22VC),
rHcxoro MeptauaHa Ae noqe[, gareM y XIV nosBoExa (II noicH|lq-
, 1 l r e M - r y e r( r r H ! , - u ' o a H b ,2 3 V C ) ( p r c . 2 l ) . Horo) BhtxoArrK 3a4Hecp€anHHoMy Mep{A aHy Marb-AoK(Ay-Matr).
fiatoroFrecKxe cxxnToMu, cBcsaHHH€ c xep||Al|ano : 6o,,ru B Apyrar Berab [oAHrMaercq l|psMo BBepxx Kopfllo q3HRar AaJee K
o6nacrr ceprqa, B 6oKax, norcHliqe, B o6racr! noroBbtx oprafioB.
3aTbuKy, rAe nprcoea[EqeTcn x HoxHoMy flHcKoMy MePxanaBy,
Jloxa3aHxf, Are rcnorrb3osaHrc MepxAl|aHa: 60,1x B 06,1actr
3 r o - f l e p s o € c o € , r f lH e I r e ( p n c . 2 2 ) .
xe,lyaKa, ceplua, rpyax. s7
96
 OIalTBJlEtll'lI fJlABHt'lX HOX tlblX,!lflPl'1,[l'lAHOl]
.MAflblll tH" l'l (XOHl,U l'lHr,

i. OrserBn€Hxe Hoxfioro xepraraxa <MaJHi x8t. OrxoArir or

r!'raBBoro MepnAqaHaB 06,racr, nata, oru6ar 60,1r,uofi Bepren,
rrpoxoArrr I( no6Ky, c,lr.rBaercq c BerBL'Io HoxHoro MepnaljaHa
<KogetrHHt>, Bo,ree Men(at BerBb orBefBreHltt, o KoropoM Ira€T
peqL, noaHfiMaercqK pe6epHofi qacrx, Bxoat{T s o6nacrh rpyaHoi
rdeTK{ r{ xttBoTa. noaxoaHr K xenqHoMy ny3hlplo H, pa3BeTB,uascr,,
naeT Aa!'lbrxe K DeqeHl,l,coeArHqercg c cepalleM. IloaHlMaeTct
BAorb ropraHfi Lj BHxorlrr y HxxHefi qenlocrx (B yr'Iy pra), 3areM
oHa pac[pocrpaHqelct no rrrly, coe,qfiHqercec cxcTeMoI'rnepqoKy_
"qqpHbrxcocyaoB lr Bo BreuHeM yr"ly fna3Hot lqerH BHoBLCrHBa_
Mep[a[aHoM,
ercq c r,'IaBt{brM
2. OrgcrsreH e oxHoro neplAraHa (KoHeq trtr. OrxoAur or
rr'laBHoroMeprAxaHaB o6nacrfi rbr,rbHoiinoBepxHocrncron$, no,q-
HuMaercqK ,'106Ky,Bcrpeqaerca c ofBerBr'leHreMr.IIaBBoroHoxHoro
\iepsarraHa <Marbrt en>, cneayq KoropoMy noaHrMaerct BBepx.
3ro Bropoe coe,r!{HexFe(pnc.23).

0TBETBnEHl|t rJlABtllrlx HOXHITIXmEPl|.lll,tAHoB

( B E t J l b l f iq H ' rBEJ|Hh{[i llHb,
L Ors€TBJ|eHrexoxfloro it€pnArafla <cBernsi fl8>. Orxoaur or
r.qaBHoroMepuuaHa B o6"1acrfinaxa, npoxoar.rTB xrBoT. x xe'ryl-
Ky, pa3BeTBr'rteTcg B cene3eHKe,Ilo,4HliMatcb BbIule, coeArEflercH
c cepaueM-3areM BAonbroprasfi aoxorlrr ao pra lr aa,lee K nepe
Hocrue, coear,rtercq c cscreMoi nepHoKyr'\tpHblxcocyaoB x 3areM
BnaaaeTB rnaBllt l,l MePtlAtaH,
2. OTB€TBreHreroiaoro r,repnAeaxa<s€nxx[fi ,Ir6t. OTxoArir
Yc^o$de ooo3Na{€rir or rraBHoro MepI,t,(HaHa a o6.'Iagrll naxa, coeArHtercq c oraerBr'Ie_
8fieM HO)XI{OrO MeptAlraHa <CBeT!'rbIi 'lH' X, noaHflBultcb K ropTaHL
- FHcRr6 MeplrraHd
f i r o p r y , n o A x o a x rK x o p B r ot 3 b x a , 3 T o rperLe coeAIrHe_
Hne (prc.24).
..... hsrc{f6Mep"!,aHH

(F--.} HaqMo orBerdeNri

i)TAETBJI EHI,|' TTABHbIX PYTIHbIX MEPI-IAI,IA
HOB
.(REJ'I
uK I n 9H, <M Ibllr }|Bb,

l. OTEerBneHrepyqfioro iiepxAliaHa .BenxxHi tn>. OTxoa r or

rJraBHoroMepllrllaEa B o6nacrl, n,leqeBblxcycraBoB, Bxoalrr B noa_
nruureuxyroivxy [Toqxa yes-3nrb (toaHb'e,22VB)], npoxo.qn,
K cepaqy, coeanHqercac roH(oi, xxrnxoff.
2, Oraeraacaue pyqsoro Mepl,rAxoHa rxaiDli xFr't. OTxoat'{Tor
rr..Hh,r "Ee,,R,n .M.-
r"laBHoroMep ttraHa B o6,racrtr Mexay aByMtlcyxoxr['rntMx rIoaMbI_
Px<. 12. OrBeEr€H,' Hoxklrx eep,A,.Ho6 cH,,
ureqHofirMXr.{IB ro,IKe yeH'3rrI' (92VB)1. npoxoatr B rpyAHyIo
xr'rerxy, noaxoarr x ceparry, Ito4HxMaercq B (:)6racrs ropraHH 'r
99
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T

a , /
[i'

Prc.2t, OrBer.nei,t rr.6B5rt pyqHUr MeP,A,aHoB (oen,khi tH, , <da-

ropra. JareM BbrxoarT K floBepxHocTlrHa r'rrue I B Kosqe nyrx

qHoM>Bo BHyTpeHHeM
coeaaHqercec <Be!'txKIrM yr,'Iy ria3Hox qe'rfi.
3ro qerBeproe coea HeHIe(prc.25).

OTBETAIEHII' IJTABHbIXPY{ TIbIXMEPI,{AIIAHOB

tr.. 21. Or.eruedrr MePHA,.ho! (Marbrt rH, N (Ko- . M A I b l f f t H ' l ' I. K O H F U1 ' l H t .

l. Ors€TBr€Hxe pyrBoro epxAxafia <iraibri cxt. OTxoaur or

rr'raBxoroMepsAHalraB TeMeHHoio6nacrri, nporoanr B HaaIUIrcqI,lq
Pr.. tl. OrserBreHrr i.prAraHoE (<.etrLrt rH, , @6- Hyro HMrry (roqKa Kxoer-6oH, 12 E), cflycKaerct x rpeM qacr9M
rynoBuua I,l pacnpocTpaHqeTcfl
6 rpyaHot KneTKe.
t0l
 A /

pyqHHx *ePNA,.Hos (<Eorrsrn iH' ' (6€-

(sdrh,i Prt. 17. Or.eBreH,t.r6BHbrx
Prc. 26. OrsersneRrr n.sHbrx pyeHh,r Mep,a,sHo!

oIaETSJlEllllt |IABHbIX Pvq Hr'lx MEPI'IAHAHoB

(CBETIbIA tH" fi {BEJrl,lKxI IHb>

L OrBcrBneExe py{ oro MepxataEa <cBernHI t8t. OrxoAlir or

2. Orremaerxe pygxoro nepxarala <xoxeq xnrt, Orxoaar or
rraBHoroMeprAraHa13 rotrx, yeH-3rjrb(22 VB) Ha 3 uyua xnxe
IroAMbrureqHoi sMKr, npoxoaHTB rpyaHyro KlreTKy,noaxoAr,rT
rrooqe-
peAHo K TpeM qacTrM ry?roBltrua,3areM noAHrMaeTcflK o6,'lacTr.r
ropTaH, u ropra, Buxoar,rTr{3 rry6r,Hbr K noBepxBocTfiB 3ayruHofi
o6,,1acrlt,coeAlrHteaacf, c pyqHHM MepfiAtaHoM <Marbllt tH> IIon
llrrrJrococqeBrrAHr.lM orpocrKoM lToqKaxoaH-xor (BaHbry. 12 V B) ] .
3 T o - I I r r o e c o e a r H e H r r e ( p H c 2. 6 , ) .
.naeloro nepna'iu-nae ro,rxi xuen-nryur lu3tHb-ni. 159]l;^1{
\ o A f i r B l a r b r ! ' I o q H )or6cn a r r b l T o q x aa a HT l o H{ t r a _ q x y l q v \ l ' 1 .
cnycxaercr x roqie Aafi'qHonr-sy (Aa-'IaH-my, 25 V)' flpoxoanr
x erXnv, nOAnnuaerct K IOpTaHI'tU rOpJIy' BtlrXOIXTK HaAX!'IIo_
,rxqHoi eMxe, rre BHoBbnpHcoearHgerctK rJIaBHoMy MepfiaHaHy
2. OrBersJetrxe plnrxoro nepnanaxa .BeJl|xrfi l|Bbt. OTxoAxr
or rraBHoro MepuanaHaB noaMuueqfioi cMKe, npoxoAnr nepeA
rnaBHbrMpyqHbrMMepHAlaHoM(Marhli liHr,>,flpoHuxaer B rpyaHyro

102 103
rolerxy, IIoAxoAHTK r'rretxnM,pa3Berarqercq B To,'lcroft K&urKe, BHoBb ,reprx|o plqHoMy MepfiafiaHy.cBernHfi tH) [B foqKe rx]le8-.4ll1b
noaHtMaeTcq K HaaK,IloqrqHoff qMxe, npoxoa'T BAo,Ib ropTaHl,t g ( n f , H b - , 1 x6, G I ) 1 .
mp,,ra, npficoeAr{Hf,eTcs K pyqsoMy Mep&AraHy <cBeTnhrii flfi>. llaroror{qccxle crMnloMtlr cBt3a[fif,|e c |(a|.aro : cBMnro-
J T o - r U e c T o e c o e A f i H e f i I l e ( p l | c 2, 7 ) , M bl (n o,'r B o r H>: xap B o6nacrq unr'loaljAHoro orpocrKa r'ryqe-
<nycrorbl>: qrxaEbe'
V. N'THAAUATb KOJIJIATEPAJIT,HbIX q Hl,IX) Boil Kocrn a naAoHtr; cITMIIToMH
( BTOPI,I fioqHoe HeaepxaHlle MoqE, yqaqeHHoe MoqeHcnycxaHlle npx 3Hatlx-
KAIIAJIOB Teft,HLIx 06r,€Max BbueiteMofi Moql,l.
Jleqeflre. Bo3AeficrBne Ha roqKy nfler_Kxrcer (7 P)
lItTHaAuarh xonrarepa,'rr,Hblx KaHar'roBqBnrrcacr orBerBneHrfl Mlj
B J o - f l y H K r a xo r r r a B H b r x 1 2 n a p H b l xx 2 H e n a p H H xM e p l A ' t a H o B
(3arnecpeAfiHEoro fi nepeAHecpeanHHoro) , KaHarH 3TU o6HqHo A T O P I , I qH b I f i K A H A J I P Y q H O I O M F P } I , [ I ' I A H A
npoxorqr nonepex rena n[6o nepecexaDTcr Hauckocb, pacnoJra- "MAJIblll llHbr - Txoflr-Jx (TvH-Jlll)
ratcb Bo BHeuHei qacrx Te,ra. OHU coeAUHrroT MexAy co6oii qyHq Bblue
r n a B E H e M e p x a n a x b rc B q 3 q M u( f l a p y x n o - B H y r p e H H e f o >r x n a , r r p e B XoA |(a ana. OTxoaxr or rrraBHoro MeP[a aHa Ha 1,5
langcrbg {co cropoHH ,laaoHll H MH1HHua). B l o q x e rxofir_',lx
pauaa Bcro crcreMy ruepriarraHoBB eAnHyto cer6 nyreti o6paulerxq cepA[a'
tTvH.rH, 5 Cl, orHocatrreica K l l H 6 c K o M y M e p a x a H ,
S}teprlll' It B3aI{MOCBn3ea BCefOOpfaH 3Ma, KaHanbr, oTBeTB.4flouxe. a H a r ! o C e pA(a n
noonlVaerCo B A o J l b f I a B H o r O M e p n 4 A O X O !
ct or r|lr6cK]rx MepuA[aHoB, noAxoArr K rHcxtM (n Hao6opor), co3-
aaBar TeM caMHM Mexly Hl.tMfloTHolxefirn (HapyxHo-aHyTpeHHero> BH e, X KOpHIOt3UKa' 3aTeM IIOAXoAiITK cqCTeMe [ep[OKynqpHt'IX
tH''
TTDA. i o . y a o a . K i f l a , l H e c e r ? H e p r H I oB p y q H o i v e p l l 4 u a x . ( B e r l r x r l i
c xoroosrnr c a r e a e r c g a r o q K e l H _ T x H b( q x H - q x ? H . / I u l ( p t c zo'
I43 12 r,'1aBu6rxrrapnbtx MeptAraHoB ro,rrr,(o MeplAraH cer'1e3eH- c x a { l u l o M : c I M n r o _
xlt ,MeeT aBa BTopuqxblx llo-xallaJa, qocKolhxy B 3alaqy ceJle, naroJorn,tecxre crM||aoML' cacoa flhle
C T e C X e f i B
t e r p y l l l ; c H M n T o M b I < f l y c To-
3 e t l ( u B x o A u r o 6 e c o e , t e H I rrep a E c n o p r f i p o B ( l ,cl o x o B , r e n a o r x e n y A , Mbl <rroJIHoTH>i
'a br>: noTepf peqfi
l ( a r l o B c e M yo p r a H n 3 M y .
Jleqen i. Boaeficrare Ha roqKy rxo8r '1Il (5 C)
KonnarepanbHHe (BroprqBb|e) KaHa,rr| sMeror sa3BaHrn roq€I(,
B Korop6Ix ogr oTxoArr or rnaBHHx MeplrAraHoB.HaflprMep, Broprq-
HNff KaHar py'rHoro MepnlraHa <Be,lfixxi xHb> Ha3HBaercr nr€T- B T O P I , I qH b I f i K A H A J TP Y q H O T O M E P I I A I I A H A
xxlo€r (ne-urce), nocl{onbxy oH 6epeT Haqa,to B ToqKe 9,roro Meptlua- "KOHE[ ]rHJlr - HOtl-KvAH (H3t'l-fvAHb)
Ha nxer-Kx|oer (,re-lrloe, 7 P) lr r. A.
KonnarepanhHHe xaHarH Me|or co6crBefiHbre nyrx crt€ro xoa xaHa.Ia. OTror I or lJaBHoro vepfialaH€-Ha 2 uystl Bblrxe
BafiEt, rAe oHl,t nocrotHHo aerBqrcf, Ha 6oree Me,'IX[e |(aHa,tbt. r a n f f c l 6 r . B r o , r x e H o i _ x l a H ( H 1 n _ ' y a H bb m L l lcv Prrc z6r'
Ha3HBanulttecfl <ToH-JIax>,, Te t3 HLlx, Koropble. pacnonoxeull llaro.rorrqccKl€ crilnrouL' cBtga HHe c xaHa,oill cI|Mnro_
HenocpercrBeHHo floa xoxefi, 3oByrca <0y-naKr, K noc,'teAHfiM M H < n o J I H o r b I ) : 6 o ' 1 u B 0 6 , T a c r l cl e p A q a ;c I r M n r o M 6 I <nyc
oTHOC'|TC9l.t MerlKHe I(pOBefi,OCHHe CO(.)IH, BX4liMHe HeAOOpyXeH T' O T blr: CnacTflqecxtle tBJeHfin s o6"IacTI' I 3arbLlxa'
HbJv rrta3oM .xtoeT-,'taxr. 3Tx cocyAbt xcnolb3ytoTct B trflorepa- Iet""r". Bo3AeicrBfie Ha roqKy Hofi-(yaH (6 MC)'
nn& Anr Herry6oKnx yKo.rroBc no!,qeBaHfleMRoxr.t lt yKoroB c nocr'te-
IyrcrulrM BbuaB,rrliBaHreMl{poBr.
groi cl,tcreMe oTBerB,leHxi KorrlaTepa,rbHbre xa- BTOPXqHHfi KAHAfl PYIIHOI-OMEPr,|AI,IAHA
6raroAapt
rAeJll.lKl.lft tH' -- Ttl-Tt'lHb (qxfi-qX3H)
HaJId nox?brBaroT noBepxHocT6 Tena rycrofi cerbo, o6ecfle,r Ba|o-
ulefi Bce qacrfl opratu3Ma n rareJlhltblMli BeulecrBaMt u B3aHMo Xon laflara. OrxoAur or rr'laBHoro Mep AfiaHa B roqKe rs'TliHb
(7 IG) Ha rHnbHon cropolre 3anqcrbt (co cropoHbr Mr'r3tHlra' fia
s ttu""l uotu," aero). Bilreaer cBolo 3Heprxro B pyqHoi Meptaflal
ATOPIqHbIN KAHAJI PYIIHO|O MEPI,I.I1'AXA oua,lun antr. BerBb Ka|lana rg'TIlHb Aocrr'Iraer noKTeBoro -cy
{BE r|(tlB l'lHb, - Jl}lEl-KXnEt (JtE-lltOE) crasa, 3areM srrBaerct B ToqKy xfieH-rryHr (u3flHb_loi, lSGl)
(prc.
'_ 29).
XoA xalam. Orxoatr or rraBxoro Mepfiar.jaHa Ha 1,5 ulHe sulue c |(ataJloll:cgMnro_
cr ntoMH,cBcSaHHf,lc
Ilarororx'tecxne
iaflqcrbfl {co cTopoHU 60,1b|lloro na,rhua), B Toqxe r1HeT-KxloeT norBlrxlocrll JIoKTeBoro
M bI (n o !'t H o r 6lr: cna6oclb, norepf
(ne-Uroe, 7 P), orxoccqeficr K nHbcxoMy Mep!.qriaHy nerxax; cJreAy. <nyCTOTH': B h l C b I n a E l I tH a X O ) K e
C V C T a B a Ic I t M n T O M t I
et Mexay MirrrrqaMr, Iraparne,lbHo tnaBHoniy Mepl|anaHy, l.r BbtxoAltT B x . l l yc 6 o p o a a B x a M I
Ha raAoH6, Ha Bo3BbIUeH[e 6o,lbuloro naJl6ua, KaHan AocraBnqer ' i r , r r . r q x o i s e J r q H H b r .c x o a r u d n o s H e u H e u y
p
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t04 106
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P|lc. 2 8. P.cnoroxeH xo Brop,cH hrr Kararo., orHo< rurr xc, x rpea pye{6rM ,Hs- Pr.. 29. PacnonoxeH,e sroPqqHrrx Pvq-
ckrd 'eP,a,.Had, Mep,ataHaM
BIoPsqHblfi KAHAJIPy'l HOfO MEPI,|AI.IAHA
(CAETIblA tH, TXI{EH-JIl-lTb
(ntHb-Jll-l)
XoA [aEana. Orxoarr or rrrraBHoroMep]rAraHaHa ft,InbHoficropoHe
3anecrbr (co cropoHbl 6o,rbrxoro na,'rbqa), sa 3 qyHs Bblrxe ero,
B roqKerxroH rr.rrb (orHb-,'rlr. 6Gl), n aoxo,ax'rao pyqHoroMepfi_
axasa <B€nxKxfirau- Ero BerBb noasrMaerct napa,rierbHo
rraBHoMyM€p}raraHy Ao roqKfi K{eH-HtyHr(15 GI), 3areM!o yr"la
HXxHei qe,'Iocrr x ocHoBas!fi 3y6oB,.[pyras BerBb npoxo,(rr B
yxo, rae BHoBbBcTp€qaercqco caoxM KaHa,/roM Ha yqac,Ke,nporera-
rcueM B yursoi o6nacrH lcM. pl,lc. 29).
nafo.torrqecKrecx oroitN, caq3a{fiHec KaHtuIoM:c MDTo-
M b r < n o , r H o r b r r : k a p H e ca y 6 o B ,n o r e p r c n y x a ; c x M n r o M b r
<nycrorH>: noMora 3y6oB (Kax or xonoAa), oulyueHHecrec-
HeHfinB o6"racrs ar.jaOparMH-
Jleq€Exe.Bo3aeicrBrre Ha ro,rKyrxueH-rnrb (6GI).
aToPttqtlblIl KAHAJ|PytlHol-o MEPI{al-IAHA
imAJ|bll tttr - HrOAn-KyAH (BAft-ryAHb)
XoA Kara,ia. Orxoasr or rraBHoro Mepr,qsaHaB ro,rKe Hroaii-Kyafi
(Bafi'ryaHb, 5 TR), aa ru,rsxon cropoHe3anHcrbq,Ha 2 uyHq Bbltxe
ero. JareM npoxoatT Mexay aByMq cyxoxn,,IlrrMU, noBoPaqlBaeT
x BHeuHeiinoBepxHocTrr, noaHsMaeTcqK rlneqy, npoxoasr B rpya_
Hyro KneTXy,rae cnrBaercr c pyqHbrMMepfialaHoM<xoHeunHg>
(cM. olrc.29).
flaro,torx,recxre crMnromH. cacaaxEEe c xa8aJron: cl, M o r o-
M H <n o !'IH o r br>:cnacrllqecKr corHy He pa3rt6aerct noKTeBo[
cycraB; c x M n r o M br <rry c r o r 6r>: c,'ra6ocrb.TyrofloaBtxHocrt'
!roKTeBorocycTaBa.
JleqeRie.Bo3aeficrBae Ha ro,rKyHroaiixyaH (Baii ryaHb,5TR).
8TOPI,Iq HbI9 KAHAJIHOXHOTOMEPI,I,IIXAHA
( B E , l t l K ] | nt 8 , - o x - 3 N O H r ( O 3 f i - t H )
XoA xaxana. OTxoafiT or r,'raBHoloMepraxaHa B Toq(e tpx 3bloHr
(S3ft qH,58 V), Ha 7 rryHei BbrDe,rarepa,rrxoi ,roauxxx. floaxoam
K H o X H o M y M e p x A l j a s y < M a J I b I tI H b > , c J r B a e T c q c e r o B T o p l t q H H M
KaHanoM orBerBlreHneM B ro'rKe Aa;l-TroHr (Aa qxyH, 4 R)
( D x c .3 0 ) .
fiaro,rorrqecKre cnMnroirht, cBt3af EH€ c xanarou: c r M n r o-
M H <n O n H O T bl>: npo3paqHHe BHAelreHHqx3 Hoca, 3aro)KeHHocTh
I | o c a , 6 o n sB o 6 , 1 a c r !c n r H b l ;c x M n r o M
Hbre BHAe,reHIrf,,'Ifi6o xpoBore,{eHre Hs Hoca-
J l e q e H x e .B o 3 A e i i c r B n eH a ' r o . r K y O n ' 3 H o n r ( 5 8 V ) .
108
BroPtqHbrq KAHAJT floxnoro MEPLIIIAflA
(mAIbl n tH> - KvAHf-Ml'tllb(rvAH'MtlH)
XoA KaHana. OrxoAr'rr or rr'laBHoro M€pl'lAfiaHa B Toq(e xyaHr-MHHb
(ryaH'Mr.r8, 37 VB), Ha 5 qyHei B6rllle !rarepanr'HoB noAblxxx
3areM rlpoxoaxr Ao Bcrpequ c HoxHblM MeptaxaHoM <I(oHeu ItHt>'
cr''IlBaercri c BTopxqHuM xaHa,loM 3TOIO MeprAXaHa B TO'{Ke ra[_
Kay (nE-roy, 5 F). BerBb l(aHara cnycxaerct K rblr''lt"lot cropoHe
cronbr (cM. ptc. 30).
Ilarororxqecru€ cB nlo bl, cBt3aHl[Ie c KallaJloil: cfiMnro_
M b l < n o n H o T u ) : n o x o l t o A a H r e H f i x H l ' l x K o H e q H o c T e nc; x M n T o -
M br <n y c T o r btr: c,la6ocTb Hor, norept cnoco6Hocr! n€peaBli-
IaTbcq, BcTaTb c nor'loxeHBtl ctaq.
J l € q e B n e .B o 3 a e i c r s l i e H a r o q K y K y a B r ' M n H b ( 3 7 V B )
B T O P I ,qI H b I f i K A H A J T H O X f l O T O M E P I T A l I A H A
{CBETIbln tH, OOHf-JlOHl_ (43H-JrvH)
XoA xaBalra. OTxoAxr or r"IIaBEoro MepriAtaHa B ToqKe OoHr"noHr
(Q3H-nyH, 40 E), Ha 8 qyHefi BulUe narepa"IbHoi ,oa6lxKn JareM
npoxoArr I( HoxHoMy Mept'lAraHy <Ber'lIrxl'li IrHb), cJI{Baercfl c
s i o o f i q H b r ' r K a H a , D o Ma r o r o M e p f i A r a H a B T o q K e K o H r _ T o H( r y a u b _
" y r l . I n P r E r o B e r B b n p o ) , o t r H r B A o , ' I bn o B H e L x H e v !x p a t o 6 o n b '
ure6epqoBoi Kocrlt Ao 3arbI"IXa, BnuBaercq B pycro MeptanaHoB'
c n'y c K a r c q u x c q K r o p n y ( c M . P n c . 3 0 ) .
llaronoruqec e crMnroMH, cstaaflEble c Ka aJIoM. Ecnx naro-
reHsaq gHeprfit, npoItHKHyB a opraHn3M, noAHHMaeTCt BBepx' Bo3_
MoxHbr notBreHfie 6o"IH B ropne r,l ropraHl rH6o BHe3anHat norept
ro,roca: c, M n r o M bl <n o, H o r bl>: 6peaoBoe cocroffHlle, 3nH
r ' I e n r l r r e c K t { en p B n a A K I r ; c a M n T o M H < n y c T o r b l > : napalrljq
HxxH|,lx KoHeqHocrei, arpo{put MbIruu roneHl]-
JIeqeHr€. Bo3aeicrBlre Ha roqKy OoHr-noHr (40 E).
BIOPIIqHbIN KAHAJIHOX IIOfO MLPHAI,IAHA
( B E J Il ' lK t ' lf r l | H b ' (OHr-TOH (rvAHb-cvHb)
xoA Kafiana. Orxoarir or rraBHoro MepfiaqaHa B roqKe xoHr-ToH
(ryaHb-cyHb,4 RP). npflMo fl3noA nep€aHero Kpan I nr'IlocHeBoa
xocr! {co cropoHhl I nanbua cronH), npoxoax, K Ho)Kl{oMy Mepx_
xxaHv <cBer,rbrii qFr, c',rxBaerct BToprqHblM KaBar'loM 3Toro Me
DfiaxaHa B roqKe Oo{a-noHr (408). BerBL' xaHana noAHfiMaerctl
BBepx, npoxoAri, B o6'lacrb xltBora ao xenyAKa t |{rueqHuKa
lIam.[or[,{€cxxe cruoroitH, ca93aHHLre c KaHaJlox. ^oraa
B.r3Hnraer 6o,,I€3HerBopxat 3HeprHs, notBr'ltlorcq pBora H noHoc
Caunrouu <nor''tHorr,I>: 6onx B o6nacrfi xfirxeqHliKa.
<nycrorbr>: npo3pa'{- CaMnrovu < n y c r o r b l > : c H n b H o eB 3 A y r n eI H a n p t x e H _
HOCTI, B O6NACTE XNBOTA,
JleqeHn€.Bo3aeiicrBre Ha roqxy KoHr_roH(4 R P).
r0s
 BTOPflqHbIN KAHAJI HOX HOfO MEPIIAI,IAHA
(MAJblfr 14Hb) AAn'TIoH t (AA-qXvH)
elrs Xoa xaxaia. OT\oa[r or r.raBHoro vFpr/rraHa B Toqhe ,ai rrcHr
19./ (aa-qxyH, 4R), 3a MeAxanbHoii JloAt,xKoii. O6oruya nnrxy.
npoxoarir I( HoxHoMy MepHAxaHy <BenfiKtl tH> a coeaxHteTcq
. n o n e p e ' r H b r MK a H a n u v r i a B H o f o v e p H A r a H a B T o q , ( e Q n J H o H r
( 5 8 V ) - B e r e r ( a H a , ' I a n o A H a M a e r c qB B e p x n a p a n r ' l e n b H or n a B H o M y
M e p B A r r a H yr r p o x o a u , r r o a B r o p q H 6 r M x a H a n o M M e p H A x a H an e p ! , i _
xapaa, 3aTeM Ha HapyxHylo cropoHy a sxoAUT B no3BoHoqHHL
(aHa,l B noqcHuqHoi o6nacrn (pHc. 3l)
Jlarororrqechlie crMnroMH, caq3aHxHe c xaHa,loM. Koraa eo:
Hrxaer 6ore3HerBopHaq 3HeprAA, 6o,rl'soii ouyqaer crecHeHfie a
rpy!r,6ecnoxoiicrBo.
L H M n r O M b r < T T o J I H O T H > : 3 a n o p , 3 a T p y a l e s H o eM o q e l r c _
IIVCXAHfiC.
C f i ^ a n T o M b r < n y c r o r H > : 6 0 , r l rB o 6 n a c r un o e c H l l u b l
Jle,reln€. Bo3aeiicrBxeHa roqrq Aaii-rroHr (4 R).

aToPtlqHblfl KAHAJIIIOXHOfO MEP14,llllAtlA

.KoHELl l|flflr - JIA|n-KAY(Jlll-fOY)
XoA xaHaJa. Or\orrr or rnaBHoru MepHaHaHa B ToqKe"1afi-Kay
(,1n roy, 5F'). Ha 5 (yHefi Br,rrre Meaxa,rbHoinoabrr{Krr.noAxoalrr
x HoxHoMy MepraraHy <Ma,'[in esr, coeaxHHercgc BTopfiqHb{M
xaHa,roM 3Toro MeprafiaxaB ToqxeKyaHr-MxHb (ryan-unr,37VB).
BerBl, 9Toro Karrana [poxoaHT Do ror'IeB]t.ItoaHlrMaercgao tlqxa
H 3axaHqrBaerce B norloaoM'r!'reHe (cM, pnc. 3l).
Jlaronorx,recKxecr [ToirHJ carSaHHbr€c xaEaJoM. B roM cny_
qa€, Koraa po3HriKaeT 6oneHerBopHat 3Hepafit. Ha6rlloaaeTcs
npl,rnyxnocrb,BHe3anHbr€ 60,'Il.rqxqKa, rphlxa.
L fi M nro M br <n o,r I orb:>: caMonpo!3BorbHat 3pe(wtr

C l l M n r o M b r < n y c T o r b r > : 3 y a B o 6 , ' r a c rB

r H e u H f inx o r o B 6 l x

Jleq€Hxe.Bouei.rBHe Ha ro'rKy,1afi.Kay15 F).

- -ooHr-for (40 E)
8-TOPXq H fi OTO MEPX,&I-IAHA
HbIfi KAHAJI TIEPEAHECPEAX
Kbrv-8I.t( u3ro-83fi)
XoA xafiana. Orxolar or r,raBHoro Mep Axasa a rorl(e xbII{_BI'{
(rr3ro'Bn, l5VC), rra I qyHr, Hxxe pe6epBoiiayrr, 3areMcnycxa_
rrcr BHr{3r{ pa3BerB.rrrerce B o6,racrhxHBora (prc. 32).
llamrorrqec(xe cl,|Mnrott|H, cag3aHBhle c xaEallon: cBMnro-
Pr(. :0. PacnonoxeH,e Erop,cHlix xaHaroBi orHocrul,xo K rpoM Hox-
Mep,araHaM.
Mbr <n o ,t H o r br>: 6o,1e3fleHHocr6KoxHoto noKpoBa B o6nacrl
x r B o T a c; ! M n r o M < n y c r o f H > : 3 y A x o x H o l on o ( p o B aB o o -
Pr.. ll. PacnonoxeH,e Brop,qHrrx {aH.no6, orBo.rul,xcq k rpeM Hox-
AEP'A'AHAM. Jl€qeH{e:Bo3reficrBneHa Toq(y xuy na (i5 VC).
Itl
 KAIIAT3ANHECPE,IIIIHHOTO
BTOPI,IqHbI'I _
MEPIIAI'IAHA
,rbroHr-KbtoHf(qAH-utH)
Xoa xaHgJa. OrxoAfiT or rr'raBHoro Mep[,4IraHa B roqxe qr,IoHr-I(tloHr
l q a H - u s H , I V G ) . A a . , r e en p o x o A n r B A o r I b n o 3 D o H o q H U R af l,o o 6 e t M
cropoHaM ero, aocrtraer 3atHrKa. pa3aerBJlqercfl B 06'racfx roJloBbl
l r , f l p o i a r n o o 6 e c r o p o H b rr o n a r o K , B c l p . q a e r c t c H o x l { H v M e p f i -
@l[@ aHaHoM (6onbuofi 9H., 3areM Bxollltr B norBoHoqHK lptlc JJl
narororfiqecxre ctitnroMht, cBtgal|rLl€ c xalta'rou: c fi M nro-
, Lq) M In <II O !'I H O T bI>: CnaCTtqeCKHe COKpaUe q MbIlXq cnuHbl no
\q / o6euM croDoHaM no3BoHoqHtKa.
JI€qeHie, flplr 6one3HeHtr[rx tBJreHl,ttx BAorb no3BoHor]H{xa
-'-\ B o 3 a e i i c . B u er a r o v r < y ' r u o u r ' x u o n r ( l V G ) .
.,- \ /
--=-v-----./-' ttroP ll q H t'l fr KA ttAJl 6OJl blllo 1l KOJIJIAIEPAJIb HO fi BETBI{
r € P f l A r | A H A C E J I E 3 E H X } , 'I A A N - 6 A 0 ( A A - 6 A 0 )

XoA xaua,'ra. OrxoAlr or MeplrataHa ce!'le3€HKI'IB loqxe raii-6ao

( a a - 6 a o . 2 t R P ) , H a 3 q y H r r i x e r o v x u y e u _ : a r l ( I o a s b _ e '2 2 V B )
Kafian pa3BerBnterct B o6,racru rpylHofi KnerK! (pnc- 34)
naroJrorx,tec|(x€ cllMnroitH, cBt3afi a[.e c xataJloll: L ll M n r o-
M H < n o r ' tH o r b r r : 6 o , 1 l tB o B c e MT e J t e ;c l l M n r o M H <nycro"
TbI): CJra6ocTt'ao Bcex cycTaBa(.
Jl€qenr,i€. flpl, 3acroe KpoBtt Bo3Aeficrsre Ha lo'{Ky aaii_6ao
( 2 1R P ) .

VI. ABEHAAUATb CYXOXIIJIbHbIX MEPI'AHAHOB

qacrblo
,ilBeHaallarb cyxoxanbHbrx MepHAIiaHoB BxoAtr cocraBHo]i
I o6ulyrc cncreMy MepfiAnaHoB It tBrqlorctl MecroM, c noMoluhlo
qepe3
xoroporo co6Hpaerct s pacceuBaerci xaHaJlbHar 3Heprtt
xoropoe oHa noaBoarTct K MbIlrIIaM n cycraBaM.
flyrs cneloBaHltt cyxoxl,l"'ILHblx MePIjAtaHoB, sx naroJloruqe-
cKue crMnToMbI fiMelor HenocpeacTBeHHoeoTHoueHlle K MbIMqHbIM
cBrr3KaM,O6ecne,rxBat coKpauIeHHe t paccJa6neH e MLItrq. llBeHaA_
uirb cyxo)t(tlr'lbHblx MepfiafiaHoB oTHoctTcq K MbiueqHo_cyxo)klt"'|b'
HoMy annapary. nocKonbKy nyrfi l]x cjeroBaHxtl noBToprtor no
cyqecrBy xoa 12 t aBIrLrx MepnafiaHoB r nl,lrarcTcq oHIl sHeprfieH
3A CqET f.IIABHbIX MEPI{AIAEOB, HA3BAHX'T UX 3ATMCTBOBAHbIOT
. o o r B e r c T a , | o u l n x r , l a B H H t M e p f i , oa H o B . H a n p t r M e p H o x H o l ' l c y x o _
, { H , r b H H i iM e p n n [ a H . B e , l r x x f l e H o , p y ' ] H o f i c y i o x f l n h H b l l M e p f l a H a H

CyxoxltrbHble MepxanaIbI, pacnoroxeHHble B KoHeqHocrtx' Kop-

Pr(, ll. PacnoroxeHqe oropNqHoro R6ts.ra, orHo(rulero<r
<P64'dHoMy sePqaN.By,
nyce, s o6,racTt , tBoTa fi rpyan, 6epyT Ha'Iaro B KoHeqHOCTttXr'{
npoxoatr B Ty!'rosxue u rono8y, Eo,r6ltlxHcrBo cyxoxfinbHblx Meplr-
nra[oB aoBorLHo nL'IorHbIen pacno.trararcTcq B o6,lacrtx 3angcrbff.
rto(TeBo!'o cycraBa, noAMHure.IHoii tMxt, njleqeBoro, roJleHocron8oro
( nopeAH€- cycraBoB, KoJleHa, naxa, 6eaep, no3BoHoqHfi(a; He6o'1r, afl qacrb
Hao6opor, o,reH6 Mtrxre, cna6He, pacnoraralorct B o6Jacrl{ ronoBH,
I13
 srop,cBoro KaHara, orHo.rqeroct ( 3.aH€- Pr(. 14. Pa.notoxe-"e .rop,qHo,o RaHd,a, orHocrurorocr K 6on6uoi
Pt<. t3. Pacnonox€Hke
cp€arHHody M€p,a,.Hy. korr.rep!r6Hoi .€iEq MePrA,aH6 cene3€HK,-

Pr<. 35. Hox{on.yxoxhr!H6rn
rpyar, xl.rBora. tHcr(ne Mep[anaHbl HaxoaflTcr nHub Ha BHerxflefi,
a aHscxre Ha BHyrpeHHefi noBepxHocrx KoHe,{HocTei rynoBHqa
x npoxoArr Bgyrpb, B o6nacrb xlBora, rpyrHoii Kr''IerKLt,Ho He
Rxoaqr Bo BHyTpeHHHeopraHH.
3HaqeHxe cvxoxn,rbHbrx MeDxnxaHoB 3aK!'tloqaercq B o6ecne,{eHtH
Mexay co6ofi Kocrei cKerera, a noAAepxaHxt{
coearHeHr.jrr
Mexay BcervfiqacTnMsopraHlr3Ma.
npx ne,reHrrsHapyueHni B cyxoxx,rhHhrx MepnAnaHaxCJICAYET
nDolr3BoAarbxrnoyKa,lblBaHrieB 6oreBble roq(t, noBToptq
Io no!'ryqeHxr3(pQeKTa.
HoXHOfr CvXOXxJrbHblLl l{EPl,lAl'lAH.B EJIxKu n t H!
XoA fiepxAxaHa.6eper Haqano or V na,rbua croflr,I, noaHrMaercq
K "larepanbHofi ,roAblxne fi aanee Haficxocb creayer x (o,reBnoMy
cycraBy, cnycxaercrr K ,rarepanbHol roAnxKe t nt,xe, 3areM
BblxoArr BBepx K cepeArHe noal{o",IeHHofitMl('r. OTBerB,leHre Mepfi-
!fiaHa npoxoAxr no BHerxHei noBepxHocftt aoJIeHn, noallliMaeTcq
x noaKoneHHoi nM(e (c BHyrpeHHefi cropoHH), 3areM Bce serBs
MepranaHa D3 noaKo,leHHoii eMxn ca'reayror K qrotxue. Orryta oHH
noAxOAtT K IO3aOHOq lll<y, nOIHIlMaloTCt K 3aThlt(y' fAe mler'lteT_
cq Berabr KoTopa9 3aKaHqIrBaeTcH y KapHq q3H(a. ur 3aTbl.rxa
MepxAfiaH r{Aer BBepx no 3arbrroqHofi xocrr K reMeHIi, 3areM
cnycxaercg Ha nruo, x Hocy, rae oT Hero orae.rrHercn BeTBb,o6pa3yt
cerxy Ha rra3y, x cnycKaercfl K cKyne, y Kpbrna Hoca, IJTopaH BefBb
BIe' r or 3aAHero xpan noaMbrlxeqHot qMK| BBepx K -loqxe KneH-HryHr
( u t q H b - r o i il.5 C I ' ) . r p r r b H o r r a n H e t o x p a e n o n M H | x e q H oei v K H
rDoxolxT BneDea. K Halr(llrcqrqHoH qMXe, I IaJIee K [rlt,']OCOCqeBI,IAHO-
My oTpocrKy B 3ayuHofi o6,1acr,l. Eue oaHa BerBr, HaqrHaerct B Haa-
",ltoqHqHoi gMKe r BbixolHT K cxlre y xpuna Hoca (plc. 35).
l l a r o J o r r , r a c x x € c x n r o M $ , c a r 3 a H H U Cc M e p x A x a H o M ,L n a f l x .
qecKoe coKparqeHre Mr,rmu v na,rhqa cTonH,6o,rb B ncfKe s npHnyx-
.rocrb ee, cnacr[qecK!€ coKpaureHtq MbIt!u B floAxo,'reHHofio6nacrll,
cnacrqecxuI r'Iopao3, cnacTl,IrlecKMe coxpauleHr,t 3aTbIJoqHhlx
Mblrxq, noTept noABl.rxHocTu nJleqa, cnacTfiqecKre coKpaueHng ri
6 u " 1 H a y q a c r h e o r n o a \ , r b i L r e q H o0f i6 ' 1 a f l H n o H a a h " l r o ' l H q H osl 'vl x t l :
3arPyaHeHHocTbB aBltxeHLr'{x-
<MArbr ff ' H,
HOXHOS CvXOXltJtbHbrfi MEpr.rtrr.rAH
xoA epxAxaEa. 6eper Ha,rano or IV na,rrua cronbr, npoxoar{r
h .rarepa,,rbHofr
rlonbrxKer, cJeayrrBAorb BHerxHero Kpan 60,1brue-
6cpuoBoi xocrH, aoxoanr Ao BHeuHero xpac KoneHa, B pafioHe
nareparbHoro MbrqenKa 60,rrbure6epuoBofiKocr,r or MepuauaHa
orAe!'lteTct BeTBr,.KoTopaflnoAHllMaeTctK naxy. LnepeAs MepnAtali
ro6rpaercq B cep€rnH€ 6eApa, caaan B pafioHe Kpecrqa. ,Ilanee
rlerBb norHriMa€rcHno 6oKaM, rae oaHo orBerB.reHr.re 'noAxoa r K
fpyAfioi Mbluqe I co6rpaerca B HaAxnlo,rxqHofiflMxe, a apyroe
aoP'a'aH (Bdnrk"'r' IoAHsMaercq x noAMhlrxerrHotqMKe fl, npot,atr HaAXnIo'{xqHyIo
tt7

Prc. t6, Hoxtson cyxoxkrbHb'n
fMKy, BLTXOATTT
nepea HoxHlJMcyxoxnnbHbrMMepfiar{aHoM <Be]'rrKnfi
qx>. 3areu oHo, npoiaq no 3ayuHofi o6nacrrr, noaHHMaercq (
,ro6HoMyyrry, co6[paercr s reveHHoi o6nacrn, cnycKaercH K qe-
!'tIocTI,t, BHOBb nOAHrrMaeTCq X CI(y!'lOBOa KOCTX, y (p6L1a HOCa,
rA€ OT HC'O OTXOAIT BCTB6, KOTOPAH 3AKAHqHBAETC' BO BHEUHEM
yrny rna3fiofi qe,rr (psc. 36).
llamrorr,recrure cflunroirH, cBr3axHhrec i{epralaxo . Cna3M
IV nan6qa crorbl, cnacrt:recxne cyxoxHJrbHbrecoKpauIeH,tHHa
BHeruHeifloBepxHocrr.r roneBrr. Hapyuesr{e rroaBnxHocrn xoretHoro
cycraBa, cnacr qecKUeco(paqeHnr B no4KoneHrofi o6racrn r Ha
flepeaHei cropoHe rera, aoloaHnrne Ao naxa, Ha saaHefi cropoHe-
,{o o6nacrx Kpecrqa, B6r3brsarcure 6onll B norcHlrue r 6oKy;
cnacrfiqecKfieco(paueHlrq B o6.nacr! Harx,'l!oqr.{,{HofitMXLr. Bb€r'I-
Baroutte cna3M6rM6Iuq rpya!, Moroqlofi xe,'re3brH urex, Mepuala-
Hbr npaBoi u,resoi qacrei Ter''laBcrpeqarorcq Ha cBoeM nyrti H
noaHrMarorcr B o6nacrb Ina3, nosToMy, ecnr MHuIeqHbIecfla3MLI
facnpocrp3Hqrorcq c,reBaHaflpaBo,ro nepecraeToTKpbrBaThcq npa-
Bbrfi r,ra3. Cneayfl BnpaBo, M€pnaxaH npoxoarr BAorL, MepaAHaHa
Marb-xxey(urffo-Mai),H,nocxonbxyvepHAHaHbr npaBofiti ,reaofr'rac.
Tefr Tena flepeKpeurBarorcs Mexay co6ofi, TpaBMu B JIeBoMyrJy
r"'ta3aBH3[.IBarcTHapyuleHll, B IIpaBOI llore, B pe3yrl6TaTeqelo OHa
nepecTaeTnencTBoBaTb.
HOXHotl cyxoxxJrbfl bl ft M€PIIAUAH cCBF.T.tr
bl n fl H,
xoA ircpxAxaaa. Deper Haqaro or rpex naJrbqeBcronbl - ll, III t,r
lV, co6upaercr Ha TbubHofinoBepxHocrucronbr, noaHI,IMaerctl Ha/c-
KOCbX !'laTepantHoffr'loaHxxe r aanee x BHeuHet cTopoHe(oneHa,
3aTeMCnelyer nptMo BBepx ao 6onLuoro BepTena, IlpoxoatT no
6oKoBofinoBepxHocrrirena B cropoHy no3Boxoqlx(a, BerBh MepLlaH-
aHa npoxoarjr BAo,rb 6onbue6epqoBoi xocrri, 3axafiqsBatcb B
o6,racrr.rronexa. Apyrafl BerBb n6axoaar x ,rarepanbHoi ,'roaHxKe
r.oe4rHgeTcq c HoxHbrMcyxoxl{r'tLHHrv MepulxaHoM<MaJIbli9Hr.
OT Ko,,reHaoHa npoxoArr Bno!,rLnepeaHefinprMoi Mr,luqbl 6eApa,
'raer K [axy, B HapyxHbrefloroBrie opraHH, no o6,'racr,.{xltBora x
noaH,{MaercrK HaaK"roqnqHofifiMKe! x uree r ranblre I( yrny pra
n cxynosofi xocrr. Aanee oHa Aoxoarr Ao Hoca H c,rrBaerct c Hox_
HhrMcyxoxl.rr'rbHbrMMepraflaHoM<Be,rrKl,lfirH>, o6pa3yt <Dorrna3-
Hyro ceTb>. lpeTbr BeTBr,oTxoAl.rToT qeKfi Il npoxoaxT B lrpe.qynll-
Hyroo6nacrb (pnc. 37).
llaronorx,{ec*xe crmnroMH, car3dlrHH€ c uepnAranox. Cnacrr-
qec(oe coxpaure8fies o6,'racrli III narbrla HorH H roneHll; cy.qoporfi
x cnacftqecKre coxpanleHxfl Mb|lIIIIcTonbl; cIa3M6r npqMoHMbIruqbl
6eapa, cnacrH,recxxecoKparueHHrB o6,racrr HaaxrrcqrqHofi gMK'I
fi qexx, naparlrrr MHlllu ,'IIua, np0qeM rna3 napa,l[3oBaHHoIl
cropolrbr He 3aRpbrBaercr. Ec,rx fiMeror Mecro 6one3HerBopHHe
To repqercs MbrueqxbrfiroHyc, 6onbHof,He
0axropH <xapH>,
B cocrorHflIr orxpbrrb r,ra3, ecnn xe aeicrBylor 6o,'I€HerBopHr,Ie
MePha,.H (Marbri 'HD Oahropbr (xo,1orar, ro B pe3ynbrare cIacrHqecxIr coKpaueHni
I l9
 ML[urr !'rflqa y 6on6Horo nepexaurBaercq por, npn Hapyure]Ifi9x
B MHuqax ureKfi or 6ore3HerBopHbrx(paKTopoB<xapbr> HMeer
vecfo .Bq,rHi naparH'{r.xorna Mbrrxua'eprreTcnoco6Hocrb coKpa.
urar6c9, B p€yJlbrare qero y 6o,thHoro orBficaer HgxHtt qer'Irocrb.

H .BEJtr,tKt-|n { Hb}
HOXHOII CyXOX[|JtbHbtr)l MEpn,Ilr.tA
XoA repr|Arar|a. Eeper Haqano B xoH{e I flanbua cronH, 3akaHqa

4
Baercr Ha Meafta.rrbHofi ,'roabrxxe. Berau MepnAuaxa raer nptMo K
MeafiarLHoMyMbrnle,,rxy 6onbue6epqoBoi KocT{, 3areM no BHyTpeH-
uei noBepxHocfl.r6eApa noaHuMaercr r{ naxy, rae co6}rpaercfl B
HapyxHux noroBHxopraHax,noaxo,qxTK nynxy, Bxr',flHfs )K BoT fi
aaiee, npofine 86,rH3Hpe6ep. pa3Berarrerca rro fl,)aH. Apyrat
, / BerB6noaxorfiT H3Hyrpn K no3BoHoqHfiKy(prc. 38).
Ilaro,torxrrecKre crr|nroMra, cBs3aHHbrac MepxAxa[o . Ocrpble
6oJr.r& MbrueqHHecna3MbrHa yqacrxe Mexay I nanbrreMcronH x
MeAraJbHoflnorbrxKofi, 6o,rri B Merla,lbHoM MhluenKe 6o,'rbrxe6ep"
uoBoi KocrH, npqcrynbr 6onH no BHyrpeHHefinoB€pxHocrl 6erpa,
xppaarjl,lpyloune B o6,'tacrb Daxa, 60rr B HapyxHbIX noJroBblx
opraHax c Bo3MoxH6rMpacnpocrpaHeHr,teM 6o,'reBblxolllytuerlri Ha
o6,racr! xrBora, nyflxa rl y pe6ep, 6o,1fi B no3BoHo,rHt Ke.

fl (MAJ|bttl }l Hb"
HOXHOff CyXOXllnbHbl li MEPI-lJll-lA
XoA Mep{Ar{aHa.6eper Haqaro Ha HHxHeii cropoHeV narLua croflbr
I BMecre c HoxHblM cyxoxr!'IbHblM Mep]rAlaHoM <Be,'rsKn !Hb>
npoxoalrT Hancrocb noa MeAua!'IbHoit!'Io4blxKoIt, 3aTeM ( nqT(e,
H O ) k H L I MC ) X O X { X 4 b H H MM e p } t 4 r i a H O Mr B C - n r Rif i t H r .
IpoxoAsr noA MeAfiaJIbn6rM Mr,rulerlxoM 60,'rbure6epqoBofi Kocrri,
cr'reAyflAan€e B oaHoM HaDpaBJ'refifiHc HoxHbrM cyxoxfinbHbrM Mepn-
a[aHoM <Be,'lrKHfi r.rHI,).3areM oH npoxoAxr no BHyrpeHHefi nosepx-
HocTU6eApa, DoaHHMa€TcqK HapyxHhrM no"rroBriMopra8aM s aanee
Bnr'roTHyrox no3BosolrHlrxy, BAoJrb Hero, cr'leayr oT KpecTqa ao 3a-
THIKa; Ha 3aTbI.nOqHOtKOCTIIOH C'!IBaeTCC C HO)l{Ht'lMCyXOXHnb_
HHM MepnAxaHoM <Be,IHXIrfi rH) (prc. 39).
flaro.lorrqecxxe cxunroirbl car3a8riba€ c ep]Axaflom. Cna3Mr,r
cyxoxHnfifi croflbr, Bo3Moxt{bt cnacrfiqec(re 6onq Ha yqacrxax, no
r(olopHM npoxoArr MepaAsas; 3flfiJenl qecKne KoHByrhcar.r,cyaopo-
rr; crr,rrbHbre60rll B o6nacra cnfiHbr, B pe3yn6Tare qero 6onbHofi
He B cocTotHl,tl, corHyTr,cfi, a nph 6ongx B xnBoTe -- BHnptMIrTbcq.
nocxo,lbKy cnuHa orxocrrcrl x o6,1acrfi flH, a xlaor - K x]r6, To
npl,l <rHcxoMr xapa(Tepe 6o,re3HH 60,rLHoii He B cocrorH&lr corHyrb-
cq, a fipn <rH6ckoMr - B rrpfMrTbcr.

HOXHOn cyxOXllJlbHblA MEPtlAt-lAtl "XoHEtl xHt,

Xotr i|ep Axafia. Eeper Haqano ra repxrrefi uoBepxHocr! I na,lhqa
cTonbl, flpoxoa&T nepea Mearar'lLHoii noabrxKoi, noaHxMaeTc9 BAoJrb
Pt.. 37. HosHoi cyxoxrrbHbrri aePrA,lH (c'etrbri 'H' 6onbure6ep{oBofi xocrri, nporoAHr noA MeAqarbHbrM MHulenKoM 'l ao
t2l
 etrG
\ 9 .,/

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Dr<. !8. HoxHoi cvxox,n6{5ri M€ptA,aH (.en,Rri !H6'' Prc.:9. HoxHoi <yxox,$Hhrt MeprAqas (Mardi NH!D.

tr(. 10, HoxHoi cyxox,,bHrri
a6PrAr.r (FoH.q rit,
124
BHyrpeHHefi noBepxHoc, 6eAPa
[oAH MaeTCq ( HappKHLIM nOnO-
BbrM opta8aM, coeafiHfltcr, c apy_
ftM cyxoxllrbllLlM MePnInaHOM
(prc. 40).
Ilamnorrl,|ect(xc ctnloubr,
clr3arruc c ep{axalou. Cna3Mbr
rl 3arBeDneHI,Ieuuuq I narrua
cronu. sususapure 6onr' B 06-
,lacTn MeAItanbHoIi'loablxxfi,6orx
B o6,tacrl Meara,t|Hoto MbIlueJIKa
6on6ure6epqoBofiKocrt r no BHyr-
peHHefi floBepxHocrlr 6eapa; cna-
crnqecxtie coKpaueHxq B noroBoM
qJreHeq'ls €ro napannq (npn qpe3-
MepHoMnoroBoM Bo3lepxaHsn),
coxparqeune B o61,eMe (c6€xll-
BaHxe>(|1pu6on$HerBoPHHx Qax_
Topax <xonoAa)) rt6o 3artxHaq
3peK{ t noJloBoaotueHa (nPll oo-
re3HeTBODHHx oaKTOpax<xapH>) -
Pvq Hofi cvxoxll.IlbHbl ff
MEPtl,[l{AH .BEfl fi l(]|A tH'
Xoa MepxAlaBa. 6eper Haqa,lo Ha
BHeuHeicropoHev narbua K crli.
npoxoair sanncrre u IIo BHyrPeH-
Hefi noBepxflocru npeAnnerrbtnoA_
HtMaeTct, aoxoAq c3aAt Ao Me_
Afiar'rbHoroHaaMbIuleJI(anJeqeBofi
xocrn (npuKocHoBeBfiex sToMY
MecTy BbI3blBaeT orqyueHlle B
V nantqe), 3areMnpoaorxaer cBoi
nyrb BBepxll 3aKa8qnBaeTctB noa_
M6rue,{Hoftf,M(e. OT MePrlAtaHaor-
aerreTcq BeTBb,KOTOpaq npoxoaLr
no3aaH noAMbIreqHoi o6'1acrt,
no.[HuMaerctK nneqy u BAoJIhuell
BHXOAT{T nepea HoxflEIMcyxoxltnb_
HbIM MeptllaHoM <BeJIllKnil tHt'
troxoAltr Ao roqx[ xoaH-xor (BaHb_
ry, 12VB) B PaioHe xnococue_
BI,IAHOIOmpocTxa; oTAeJltBIueect
or 3Tofi BerBt 6o"Iee MenKoe or_
BETBJIEH{EBXOAIITB YXO' A BETBb
3aTeM BhIXOAIlr Hapyxy HaA yxoM) MePrAr.d (.efuxi, tH'
Pr(. 4i. PycHot cyroxrt6asri
cnycxaeTct I( qeJIIocrH g BfloBh
noAfluMaeTcfl, cneayf, K BHeUgeMy
Pr.. lZ, PycHoi .yxoxrr5Hbrt MePraraH (M.rbr, rH'.
yrny rna3Hoi re"'rn(pnc. 4l).

(c'ernbri 'H'
Prc. !3. PyqHot <yxox,n!Xhri MeP'a'at
cxMnroMH.cBt3aNxlaec M€pttaxaEoilCnacrH'
naro,ro.xqecKxe
qecxle coKpaueHra MhIrDuV narbqa Kgcr'l, 6o.'Is ua BHyrpelHex
noseorH.crirroKTtt.cflacruqechrecoxpaueHUsMbllllu pacIpocrpa_
Hr|oruhecgao o6'lacrx Huxe H no3allr nonMHLxeqHoff nvKfl orryra
6onb r{ppatrrHp)elao uefi. Eorb ll Lx}v B yLriax Borb B qe"t'ocrtx
or MHrireqHHx cna1M,60"'rbHoiic rplllov nonHxvaerBeKx
PY'THOfl CYXOXIJTbH}'I fi MEPI-IAXAHTMAJTHflfl II}
XoA MeprAxana.6eperxaua,roB KoHqeIV narbqa (BcrH,8a ero
BHetljlHeiiDoBepxHocrv,npoxoalrr K 3antctbK), 3areM nocepeAxlre
npeAnneqbt c,'IeIyeT ao JIol{Tt L Aaree Blorb Hero noAHlMaeTcfl
126
1 r c B H e U l l r e i C T O p O H en n e q a a o n r e q e B o r o c y c T s B a , K u i c e , r A e
(nxBaeTcff c pyqHbrMcyxoxrjJL'HHM MeptaqaHoM <Be'1rKxI tn>.
BerBb <Ma,roro qHar onycKaercq ao yl.na HtxHei qerrccru l,j npo_
xoAar B xopesb q3brKa. ApyraH BerBr, ot 6aer 3y6bl x no,qHxMaerca
n n p p a l u r H y r o o 6 , ' r a c r b ,n o 4 \ o a H r )r,1) f'la rHoii ur' "rH
B a a n e e c r e a y e r n o , r 6 y , 3 a K a H , { H B a r c bB e r o y r , r y ( p l r c . 4 2 ) .
Jlaronorx,rec[xe cxnnroMEr, cBr3aEHEre c MeprAxaHo . Bo'1fi r
Mr,rueqrible cna3Mbl B yqacTKax, pacnoJoxeHH6rx no xoAy Mepsana
HA: 3AI]AAEHfiE'I3bIKA.
py'rHol,lcyxoxfi "lbHbrn MEPriaxAH<cBETJbrll t fl,
XoA ircprAxaHa.6eper Haqanosa 11 na"rsuexrcrx, npoxoanr x
rantcTL,Io,noaHfiMaeTcq no fipean?]eqbrc, n.JBep
noaxoAr{Tx BHelxHer'r
xrocTq ,'roKTs,aoxoalrT ao nlteqeBoro cycTaBa K Toqxe KLjeH-HryHr
lu3qHl,Il)ft, l5 GI). Ero Bersb,or{6aq fl,le'{eBoiicycraB,flpoxoa}tr
Jroo6efiMcropoHaMno3BoHoqHrKa, BnrorHyrc K HeMy,Apyraq RerBb
or rgqKnxreE-HryHr(rr3qHb-rofi, l5 GI) fioaHrMaercrnpr^4ox UJe€.
3!ecb orAe",rnBnJatctor Hee 6o,ree MenKat BerBb npoxoAltr ueKy
fi 3a(aHqlBaeTcrHa BHyTpeHHea cTopoHecKy,roBotKocT, a caMa
oHa Bbrxoar,rT nprMo nepea pyq brM cyxoxrnbH6rM MepuaraHoM B
no6HoM yrry, noAH[Maercr Ha reMeHHyloo6nacrb r cBopa,]fiBaer
K qer'rrccrqnporfiBono,roxsoii cropor6r (prc. 43).
narorort,{€c(te cx ltroM6a, cst3annH€ c epfiAraHoM. 60,'In
fi MrJ eqHbrecna3MbrB o6racrrx, no Korop6rMnpor'rerae,MepfiAraH.
6u,1bHofiHe B cocroflHHilnonHqfb plx). c rpyaov Bpauaer reefi,
cMy rpyaHo noBepxyrb ro!'roBy,qro6H nocMorp€TbB cropoHy,
PvttHOtl CvxoxxJ|bfibln ^ EPUnl'lAHrEEn]lKtln l|Hb'
XoA Mepxaxaxa. Eeper Haqa,roHa fioHue I narbua Kscfl{, Ha Bseru-
Hefi noBepxHoclll ero t, npoftat BAonh nar'lbua, BblxoAnr B roqKy
Hrbr-rs (rcfi'rr3r, l0 P), orKyaa nar:epanhHee,ry'{eBoii aprepil,'
I|oaHrMae,cr BAoIL npeanneqr,9 x cepeaHHer'roKTf, npoaor'rxaer
.r] rb no BH'rpeHHetno8ep\Hocrxnie'{a, noAxoar1rK no,nvHule,rHot
HMKe. IrOAHnMaeTCt BbIUe, X HaAKr'IlOqXqHOIr gM(e, OIIyCXaeTCfl Ha
rpyA6, rAe pa3BerBnf,ercrr cHoBacooHpaercq y xapA anbHoro or-
Bepcrxrr.orKyaa HanpaBntercrx [pyArrHe(pqc. 44).
Ilaroror[{ecKre cr nronH, cas3axHHec MepfiafiaEoM.Mblnlle,{-
HL,recna3Mbrx 6onr, Ha y,{acr(ax, liexa lrrx no nyrl clreaoBaHtfl
Mepl,tallaHa,B Tqxe,rHx c]'Iyqasx Bo3MoxHbr Mf'rueqHblecna3Mbl
ts 06,racTnrpy4rHbr.B pealJbrare qero BorHrKaerhpoBaBaepFora.
Py{HOn CvXOXl.lJrbfibl n MEPX.[nAIr (KoH EU }{ Ht,
XoA M€pxAxana.Eeper Haqaro Ha III nanbue Krcrn, c"re,4yerpHAoM
c pyqHHM MepxAsaro <Benrxfii l.rHr,>,noaxoafiT c BHyrpeHHet
cropoHbi K .4oxTrt I no BHyrpeHHeficropoHe n,reqeBofo cycTaBa
aoxoArr Ao o6,racr, Hrxe noaMbrueqHoi HMKri,3areM cflycxaerctr
r'r sbrxoArr 3a rpyaar{y (neper Herl). Bemr, r,repaaJ'lanaaxoarr
127
 I

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tti:tf',!,1# L:.. --....--'

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MeP'a'aH (!6"Fri iHb'

Pxc. la. Pyctsoi.yxox.rrHh'i pL(.45. PycHon cytox|n6Hsn M.p,ar.H ({oHe'r 'HtD'
 R noaMti eqHyroqMKy a 3areM B .pyAHot Knerxe pacnailaercfl IIa
6o",r€eMe,lKfie orBerBneHrq. xoropbre, co6lrpaqc6, oKaHqnBarorcH
R o6nacrr.{Kapar.ja,rbHoro orBepcrrq (no.q AxaoparMoft) (pHc. 45).
lIaro.lorfi'r€cxse clunrouu, caraarrue c MeplAraEoM, MbIlxeq-
lrHe cna3Mbra o6nacrsx, pacno,roxeHHbrx no xoay Mep aHanai
60,rs B nepeAHeiiqacrr re,'ra.pacnpocrparrtorqlrecq Ha rpyAhi cna3
vbr B 116,,lacT[ xpoBaBylopBory.
rpyAxHr,r,Br,r3HBarcul&e

Pyq HOq CvxOX]|fl bHhtfl MEPl.llll{AHnMAJrbln fi Hb}

XoA M€prianaHa.6eper Ha,ra,ro xa Bxyrperueii cropoHe V na,rbua
Kxcrx, npoxoAtrr3anec,be (y ropoxoBxaHoiiKocrtl). floAHliMaerct
K BHyrpcHfienepealreiicropolre noKrr, aoxoar{r ao o6nacrH noa
norMr,rlxeqHoiirMKoi, coeAnHqerca c cyxoxlr,lr'HblM MepuafiaHoM
<Be.rfiKn&rHb>.3areM npoxoAr.rrr\4o{'IoqHyloxer'Ic3y, Bxoanr B rpya-
Hyro K!'rerxyu, MXHoBaB06rac16 Kapr0a'rr,HoroorBepcrtq, cny-
' l<dercsK nJnh' lpr{c. 46)
naronor{q€cxfie cx nroMH, cBr3aHHbr€c M€p axaro . LoKpa
ueHxfl cyxoxs"rxii Ha BHyrpeHHeficropoHe, pacDpocrpaHqloruxeca
Ha ()6"racrbnoa cepAqeM, flpx HapyueHtrflxB cyxoxnrI19x aepxHl{x
KoHeqHocreiipyKa c cx,'roiicr 6aerct B rloxretsoMcycraBe. y 6.)'rl,-
cna3MtlHa y'racrKax,pacno
6(),'Ira Mbrue.IHbre
lroro Ha6,'lnaarcTct
.qoxeHHbrx no xoay MepulxaHa.

v[. .IBEHAAUATbKOXHbtX3()[l
B <KHrre o BHyrpeHfieM> B r,raBe <y"€Hne o xoxHtrx 3orax> cKa3a_
HO, qTO rpaHrrlbl r(oxr{blx 3l]H onpeaerti()rc9 rryTqMIr npoxoxleHfiH
I.qABHbIXMEPHII'AHOB.
llo cBoeMy xapaKrepy KoxHH€ 3oHbr orHocfiTct x xarefopIn
MepaAxarloB. Or,urq e cocrosr ,rxrxb B ron 6()"rbrueii n,roularH,
horopyro oHH ,aHHvarcr no .paBxpHn|(' , Mrpr4HaHavH. 3aurfirHat
JHeprnrr paqno,raraercq rr'raBHblMo6pa3oM B Koxe, Ilosror\4y (oxa
c"1yxr]r nepeaoBriM 060poHrre,rr,HL,lM py6€xoM opraHt3Ma B ero
nporxBoaeircr8xu 6o",re3HerBopHbrM QaxropaM oxpyxarcuren cpeAbr.
A B T o p < K H U r ! o B H l r r p e H H e Mn >r u e r : < P a 3 s p e a H a e g H e p r t q n p o -
HHXia B xoxy,3Haqur, orxpbrrlr 6li,1r nopbr, pa3 orKpbrrbrnopbl,
B p e a H a 93 H e p r l , l t r o r a l a e r B K a H a J 6 I , 3 a n o r H d a n o r e p e q H H e k a H a -
JlbI, BxoA T B npoAo!'IbrHe, a 3anonHrB llpoAonbHble, npoHllxaeT Bo
BHyrpeHHfie o p r a H 6 r > ( r , 1 a B a < y ' { e r r u eo K o x H b l x 3 o H a x > ) , H l a n e e :
< M e r o a B H y r p f i l < o x H o r or j H a x o x H o r o y K a r b r B a , i u s ,a r a x x e n p r M e -
HeBqe Mo,roroql(ots c nyql(oM firJi ocHoBaHbr Ha gTItx ocooe,lrlocrHx

Pt<. 16. Pyqtsoi <yxox,n6Hbri r€PcA,.H (t.nL'; IHLD

f aaea3
Tor{t(l,taKvnvHKwPbl
t. oBunE noJtoxEHl.lto TotlKAxAKvnvHKTvPbl
r. onPEIEJlEllxE
B < K H r r e o B H y r p e H H e MB> r , q a s e< O , t e B q r H B x a a x f i r ' ! u , 4 B e H a r q a '
Tx ro,{Kaxfloco6Hlxax> foBopt,cq, qTo roqKu 3To Mecra BxoAa
B b r x o a ax l l l 3 H e I I I r o si iH e p r u x .O H u p r c n p e r e . q c H L0l o B c c i l l o B e p x H o
cru re.na,Ho He [Melor MopQonorrqecxoroBblpaxetltt Ha Koxe, B
M b l r x q a x ,c B 9 3 x a x ,K o c T 9 x -
T o v x u a x y n y x x r y p ; t ( r o , { K x B o 3 r r c n t r B u i a )r M e r c r c a M o e l r e n o c
peAcTBeHHOeOTHoueHue K AegTen6HOCTAOprarIH3Ma x naToJroru
q e c x B Mn p o q e c c a MB H e M ,n o 3 r o M y 3 H a H l e n x n o M o r a e r 8 p a ! y B a l r _
arBocrxKe,,'reqesvfi x np€aynpexaeHqfi 6o,1e3Heii.
B , r p e B H U x r p a K r a r a x r o q x a a x y n y H X r y p b r 0 6 0 3 H a q a , r a c bl r c )
p a 3 H o M y r: o q K a ( a B a r 1 a .' t H e p r c r o q e c K a tr o l { K a u T . r . B c o B p e M e l { H o i
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t48 149
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t56 t57
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t59
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rry|lo( c BepxfillMKpaeMno6Koaoi Kocrn, /orBoTe HHxe nynKa, noHoc. RpoBaBHfinoHoc, norrlaxfiyplir,
TonorpaorqecKar a{arouns. Toqxa HaxoAnrcr Ha 6enof, ,r&Hnt 60,'re3HeHHoe MoqescnycKaHEe, rrrxypriH.
xrBoTa, 3a (oropoii - nonepeqHar Oacunr r 6ptorxHHa,na,lee O6utr{e paccrpoficrBa: cuHApoM < n y c r o r b r () n o r e p r q H -
al.,']y6r, TonKat &iuKa, rrpn cxonJeHrr Moqfl- MoqeBofiny3brpb, 3Hepr!r) or naroreHHbrx OafiTopo8 <Berpa> (rlpr,l 3roM Bo3Aefi-
Bo BpeMa6epeMeHHocrn -. Mar(a. cTByroTHa ToqKy A!'rr cTrrMy,rrqx! rx-gHeprnlr), aHaoapxa.
Koxrrui noxpon s pafioHe roqKs xHHepB[pyercr notcHuqHHM Texfixxa. flyH({xq f,1y6r{Hoi0,3 1,0 rryHr. flpfixxraHne or
HepBoMLr x,rE rpyAHdM HepBoMThrr. 20 Ao 20O MrrH(B cnyqarx crHApoMa<nycror6r) - o6qero rcroue-
Jloxa3axr{r, M e cr rr bre ri a p y rx e H u r, c B q 3 a H l| hI e c H fl ODfaHU3Ma),
M e p s A u a F o M: Bapyuefire qlxrHrrHocrlr MeHcrpyaurid,6on{ a flpruevarur. L flpfi fionaAaHlr rll,ld B roc(y-oqy,
xrrBoTe flpr MeHcrpyaurnx, 6onfi n 3ya a HaPyxHbrx nonoBHx ueEre HanptuKeHHocrn, pacnrpaHHr B MecTe yxo,rra, KoTopoe MoxeT
oprafiax, 3aAcpxKa orcnofixr n,raIleHTbI, 6e,!r, naroJlortqecKte ro.,t- ,ppalnrpoBaTb BHr,r3,r{ HapyxHhrM nonoBHM opraHaM.
JIIOUIll,l.rMIIOTeIUfit,
Xelep)l{aHIreMOqX,noJrnaxfiyplttt6O,le3HeHHOe 2. flpH DoKoBoM c HApoMe Arq DoBnuleHrjr aprepuanbHoro AaB,
MOqescnycI<aHte, Iuyplr. neHr{t cneAyer coqerarb c ro,rKoi xxs-xafi (q}r-xan,6VC).
O6une paccrpoi crsa: orexh. 3, nepeA nyHKuuefi 6on6HoMy c,,reayer oflopoxHnr6 MoqeBofi ny-
Texnxxa.ny Kufiq r,1y6uHoi0,3-1,0 uyHs. flpnxHra8se 20- r pb, flp{ xurypxx H 6epeMeHHocrfi yKaJrHBaHxe npor BonoKa3aHo.
60 MHH.
l6l
t60
 5. TOTIKATXATb-iltOlt(llll,t-M3db,5 vc)
(Ioqxa-rieuarat rcp,axasa'pex'racmi ry,roExnB) 2- A,rq noBbrueHrr aprepnan6HoroaaBreHrq nplj uoKe nprMe-
HrrTb nprrxfiraHle 3Tofi roqKn B col{eTasrt c TortKofi kyaH_HryeH
Jlorarr3auxr. A. Ha 2 uyHr Hr.txen\n^a. (ryaHb-rcaHb, 4 VC).
6. Ha paccroeHfiH ,/, tcBcp\), oipe.xa
npnuor, coerrHHroureit 3 , n p I { H e n p o l o A t a M o c r rK u u e q H r K a B c B q 3 n c O y H K q f i o H a n r ' H b I M
nynoK c BepxBnMKpaeM,o6KoBofi Kocr-. f l a p e 3 o M- B c o q e r a H H s c r o q K a M n r ! - K a y ( q x u ' r o y , 6 T R ) , r y x _
TonorpaoxqecKar axaroMrfl. Toqxa Haxorrrc, Ha 6€,rofi ,,rxErfi raM-ru (rr3y'caHb'ns, 36E) n aai''{Ho,f_3y (aa-,{aH-uy, 25V)
xxB-oTa,noA Koropoli Jexar nonepeqfiaroacuH,,,6pprxrHa. 4. Ilpa rurypur creAyer HcK!'rloqlrrhr,1y6oKyrc nyHKu Io, npr 6e-
rryoxe roHKaexl tKa, npfi fieoonburofi
Hrxyptll_ MoqeBoiay- peMeHltocTHyxonbt B TorlKy npoTllBonoxa3aH6I.
?brph.Ilpl,l 6epeveHHocrr.t6o,1ee3 Mec
KoxHHfi nokpoB B pafioHeroq(h xHHepBMpyercq rpyAltbrMHep-
7. TOq(A AM-3,O (llHb-U3tlo,7 VC]
(Toq|.a cotrpcxer{c MepxAxaxoB:aoa ri.ahutetoct,
Iloxigaxnc. M e c r H br e s a p y uj e H r.{q l H a p y ur e H n q,
c B t 3 a f i H H e c M e p a A n a H o M : 6 o , I e B hcr e nep€rf,ecPearHHoro|l .naroro rstt trofr)
x B a T KBf iH l t 3 xv l t B o -
Ta, rtoHoc.vyrHaq Moqa,nH,rypHr.Merpopparrr.rvenopparrin. ave- JlolaJt{3aqxt. A. Ha I IryHE Hnxe rlynxa.
HOper, '/r (cBepxy) orp€3Ka npeMoft, coeluHqrouleft
B- Ha paccroflHnr
O 6 L x H e p a c c r p o i i c r B a : p a c c r p o i i c r BnaH u e a a p e H f i r , nyfloK c ro6KoBofr KocTblo.
aHacapxa. Tonorpaorqccxas axaroflrt. ToqKa ,'rextr Ha 6enofi r'rlrHlilt xll-
._ TexHxla.flyHxquq rny6uHoi 0,b-1,0 qyxc. flpaxrraxte 20- sora, Aanee BrJIy6b - IroDepeqHas OacIlI,c, 6prourufia, eqe a'ry6-
x{e - ToHXar Kfirrxa nr'ls MarKa (npu 6epeMeHHocrll 5-6 Mec).
flprMeqaHrr. l . f l p r n o n a 4 a u a !r r n 6 , B r o q K y o u l y u e _ Koxa B p a f i o H e r o q x x l i H H e p s r p y e r c q r p y a H H M H e p B o M Thro
Hfie HanpixelrHocTU,pacnxpaHur, KoTopoeMoxeT rppaAs[poBarr, flor(43aHnr. M e c r H bI e H a p y rx e H I,l t, c B t 3 a H H hI e c
aaonb no MeprauaHy. MepsaflaHoM: 60,'rr.B r xrjBore BoKpyf nynKa. Hapyureula s
2, CornacHo ApeBHriMltcroqHxKaMixexulr.rHr,ro6br,{Hoor(a3hr- o6nacrn HapyxHblx no,/IoBblx opraHoB, paccrpolcrBa MeHcrpyanr'Ho_
Balorceor yxoioB_B ?ry toqxy, onacarrcbnorepflrb cnoco6Hocrb ro llHl(na,
x AeropoxrexHK) pn HUypxr It joyxajusaHHe nporHBonoKalaHo. Tex fiKa. IIyH(Llns rry6lHoi B 0,5-1,5 uyHe. npljxnraHfie
20-40 M n H .
6. TOqKAXXtl-XAn(U[-XAB,6VC) n p u M e q a fi ri e, IIpfi 6o,'IbuioM cpoKe 6epeMeHHocrn xrnoyKa_
JloKans3aqr'I.A. Ha 1,5 uyHr HHxe nvrxa. I b i B a H fel n p o T l l s o f l o x a 3 a x o .
6. Ha paccroaxrl'r/s icsepxyl orpe:xa npnvon,coearHerrureti
oynox c BepxfiuM xpaeM,,to6xoBoi xocrh. 8. TO'|XA TXAH-(XIOET (lX3Hb-lllOE, 8 VC)
Torcrpaoxqccxafl afiaroMxe. To,{xa fiaxoAgrcrrHa 6e,tofi nrrH H
xxBora, sa Her norepeqHaeOacqrs, 6pousHa, eqe rny6xe Jlo(ail3aatq. A. B cepeAuHe nyDKa.
ro8(a9 KnuKa (npn 3Ha'{fiTe,tbHoft
3aaepxxe Moqexcnyc(aHtrq,1s60 D, B caMoM ueHTpe nynoqHoro orBepcrlrt,
B Haqanefl€pfloAa6epeMeHHocrH,KorAannor eureHeBe.inx),MoqeBofi TonorpatDtqecKat araroMxc. Toqxa ltaxoAllrcfl Ha 6enoi 'ltHIjH
lnpr rHaqnrenbHoii,laaepxxcvo,rercnycKaHilrr. xrBora. ,4anee Brny6b 6porulxa, ronxan KtrxKa ll!'rlt MafKa
:y3hrpb MarKaInpr (npr.r
o e D e M e H H o c T n4 - 5 Mecl _ 6€peMeHHocrs 7-8 Mec).
Koxa e paione roqKr uHHepBxp)ercrrpylnuv tepsov Th1.. K o i a g p a f i o H e .r o q K L I E x H e p B u p y e r c qr p y A H H M H e p B o M T h r o
t t o x & 3 a H xMr e. c T H b l e H a p ) u . r e H , r ex H a p y u e H H g , n o x a 3 a B r t .M e c r H b I e Hapy eHI,tt t{ HapylxeHHfl'
c B q , 3 a H f i H e c M e p n A f i a H o M : 6 o n r ,B o 6 , r a c r n cBr3aHHbre c MepxaHaHoM: 60'1r B xuBole B o6,1acrs
' y n K a p, a c _ n y f l K a . y p g a H f i e B x n B o T e , J a r q x H o f i I I o H o c . B b l n a t r e H h en p f M o t l
crpoicrBa noroBofi c|,lcreM6r,y xeHurH - paccrpoficrBa ;eH,
c1pyanbHorourxJa: nonrypxr. Kttutxll.
o6 ure pa ccTpoficTB a: cfiHApoM < n y c T o T b l (t n o T e p gt H -
O 6 u r r e p a c c r p o f i c r Ba : . n l c r o r a , x x r H e H H o ?
f iH e p r H H ,
.nycToTa,nJoTHLt\opfaHoB,noxonoaaH[eKoHeqHoclei. tHeprfir) B p$yr'lbTaTe 6o,'resxeraopnnx (paKTopoB <Berpa>, ox'rax_
Texfilxa. nyHxuHflr,1y6rrHofi 0,5- 1.5 u]Hr. nprxHfaH]te 20_ aeHre KoHeqlocTei, norepi co3HafiI,tq, Bce cJtyqa , B KoTop6lx
-^ TOeoVeTCt
' aoccTaHoBJleSfi e f H-)8epf rH.
IIprrMeqaEr.rfl, l. IIpH nonaaaHrrj r,rbr B roqKy ouvrue- T - e x x x x a .H r r o y K a , l d B a B H e n p o r H B o n o h a 3 a H on. p x H r a H H e 2 0 -
Hre HanprxeHHocru, pacnxpaHrrlB vecre )KoJ,ra, 200 MrH qepe3 c,'roi noBapeHHofi co,It, B 3xcrpeHflHx cnyqatrx,
xor-opoev6xer KOrAa Tpe6yeTct BoccTaHoBreHlle t[I-3Heprsn, npfixrraEl,le npoBo-
rrppaarupoBaTLBAo!'tbno MepfianaHy.
4 T6 IO noTenreHlt KoHeqHocreff.
ts2 t63
 I I p I J M e , r a H r c . L f l p a a r o n a ug c , l y q a ea b r x a H &LgI e i H a nporll-
fl p u r,,re'r a x r e. npx 'le,reHl,lnacqrra ljruIoyKa.rlHBaHlte
Croxca - coqerarb c roqxoi 6ar6,xoi (6afi-xyei, 20 VG). Bonol{a3aHo, npuMeHf,rbro,lb(o nprxtraHte.3a I MecAo poloB xaK
2. npr racrpfir€ Ii ocrpoM anrreHAnrrrre coqe,rarLc roqxaMx fir!'toy(a,/IHBaH e. TaX n nplxllf aHl,le llportBonoKa3aHbI.
r x r e H - x x y . - . x nrMx x e 8 . c y ( r s H b . l u y .2 5 E ) , r x 6 j o H r -. xr lyKa-H
1( uaaMH- n f t
B a H b . l 3 V C ) , H o f i - x y a Ht H ? f t . f y a H b 6. M C ) l r (ltEH-Jtl'l {|13tHt'-'ll'1, IIVC)
136E) ll. IO{(A

Jloranr3aqne. A. Ha I [yHb Ht)Ke roqKr qysr_xyaH (qxyHb-BaHb,

0. Toq(a fxtol|-oAd (u.tyfi-o3Hb,9

r 2v c ) . 3/a (cs}l:y) orpe3Ka llpnMofi, coearfiqrcqefi
vc) B. Ha paccronHxn
lyroK c roqxofi n€pecer{eHr'l pe6epsbrx ayr.
Jl^oxa.nBaqxr. A. Ha I uyHb Hrxe roqKB xa-xyaH (cq BaHb,
IO VCI Tonorpao qecMs aHarox t. ToqKa Haxoarrct{ Ha 6enog "1!jHss
E.'Ha paccrorHrr,r/a (cHnsy) orpe3KanpqMon,coeanHqourei x Bora. f,ry6xe nonepcqHaq 0acunfl, 6prourrHa; noflepeqHat
nynoKc mqkon nepeceqeHxr pe6epHHx o6oAoqHar Kr.r (a L noAxe,ryAoqHat xene3a.
!yf.
TonorpaQxq€craeanaronin. Tbqxa picno,roxena Ha 6e,1oft'lrl- K o x a B p a i o H e r o q K l r H H e p B I r p y e r c qr p y a H H M H e p B o M T h s
H,rfi xliBoTa. 3a Hefi B rny6sHe Haxoirlca nonepeqHar OacUfir, I l o [ a 3 a n x e .M e c T u b r e HapyureHxfl ]I Hapytxe
6prouHHa, eqe rry6xe H s. cBq vepraraHov: 6orH B o6nac
floAxe,lyAoqsa, xene3a, ABeHanuarx
nepcrBaq KslnKa,opli 6epeMeHHocllt x e n y a K a , r o u r H o r a , p B o r a , B 3 a y r l r ex n s o r a , a x c n e f l c q t .
8_g uec _ uarxa_
noxa B paftoHeToqxl ]tHHepBxpyercr rpyllHHMHepBoMThc. O6urxe p a ccr poicrB ai oreKn.
l l o x a s a f i rM
n .e c r H H e H a p y l r e H H r I H a p ] u e H x q . Texnnxa, hyxxuri ray6nHofi 0,5 1,0 uyHe- IlpuxuraHqe
cBr3aEHbre c MeptaHasoM: ypqaHrB r ex H B o T e , 6 0 !B, lor .r r( - 15-30 MLiH.
pyr fiynka. fIpnMe,raHre. IIpeBbIIxeHfie r,'Iy6HHH nyHKql,fi Mo)Ker
O 6 u r e p a c c r p o i c r B a : o r e k r a, c q s r . npuBecrr K lpaBMe noaxe,'ryaoqHot xer''re3bl.
Tcxxxxs. nyHxur.rr r,1y6flHofi 0,5 1,0 uyHr. llprxxraflxe
20-200 MnH.
IlpfiM€'raHt,te, flpn reqefiuu oreqHocrl n acq ra fiptMe- t2. loqKA 'tyHt-KvAH (qXvH-BAHb, l2 VC)
HreTcs Ar!HTe.IbHOe IpIX]iraHne. hr,ro]xa,lblBaHHe npofHBonoKa (Toqxa-.nauaraii Meptatata xenyarat roqxa conptxertc noiux
3aflo. npx 6onblnoM cpoKe 6epeMeHHocrr Hrr r,trroy(ar'tl,lBaH'{e, o p r a r c u . T o c x a ( o n p c a e H x t t r e p e M e c p e r r n d o r roe p x r r a x a . p y c H H M x
HIl npfixt{taHfle He nprMeHtroTcq. rDenxMI rtsr, .Man!ii eH' { roaruM repxa{aHoY

J l o x a i f i r a q x c .A . H a I u l H b r r H o H r - n l a H ( u i a r r b _B a H b .
10.Tort(A xa-KyAH(ct,BAHb.l0 vc) l S V C ) . H a 4 q y H e B b I U en y n x a .
(To{{. cotrpcxerrr rcpearecpe4riroroucpqrana 6, nocepearHe orpeKa nptMofi, co€al,Htlouei nyno( c roqko*
f, f,oxHororcDrAraxa rB€nxut rr!) n e'pTeocneoqr e pHa oH;ep
qee6
c ieapf ,H b l xA y r ,
afiaro ss. Toqxa pacnoroxeHa Ha 6eiofi
Jloxarrc,aqtf,. A. Ha l -uysr, Hlrxe KxeH-.r,t (II3rH6nfi, ll VC) J l H H rr. x r r B o T a . n a , l e e B r n y 6 b n o n e p e q H a qs a c u x f . 6 p r c u x H a J a
6. Ha paccrorlrl t/, (calsyl orp$xa nprMofi, coearHro CTeHKOE )I<I,IBOTa - Xer'IyAOI(,
urefi nynoK c ToqKofinepeceqeHlspe6epH6ixalr, Koxa B pafioHe roq(s [HHepBrpyercq rpyaHblM HepBoM Thz
Tonorparpn,recrranaiaronln. Toqia pacio.noxera na 6e,roi Ilola3aHxc. M e c r H H € H a p y ru e Hlr q x H a p y uI e H Ir q,
r'lrfinot xsBora, 3a Hefi floflepeqHar Oacullr, 6prorxrHa, rny6- c B q 3 a H H H e C M e p n a I , l a H o M : 6 0 r l r B o 6 n a c T r xa e n y a K a , K t l c '
xe - nolxer'IyAoqHat xete3a, aBeHaauaTrnepcTHatrr{uKa ,lnH .'rat orpHxKa, TOIIrHOTa, pBOTa, Arcnenc|rq, Mereop!3M, B3Ay-
Marxa (B KoHqecpoKa6epeMeHHocTu). Tlie xllBora.
Koxa a paioie roqxt rlHHepsepyerca rpyaHHMHepBoMThs. O 6 r q n e D a c . l p o f i c r B a : n o H o c x. p o B a B H fni o H o c n. o B H _
J l o x a a a HMr re. c l H H e H t p i u e " H r r HapyueHHr. TTCHH€ADTEDAJIbHOTO AABJEHHN.
c B t 3 a H H U e c M e p , A I J a H o M : 6 o n l l B x f i B o T eM , eTeoDr3M, Ternixai flynxtrt{q r,ry6ltHoi 0,5 1,0 qyHt. llpsxtraHxe l5
TOUiHma,pBOTa,6O,rrR B XeJyAxe, AUCnencHr. 20 MxH.
O6nIre pa ccrpoicrBa: f l o c r e f l e H HHocer o r q e r r rar e
cq, rrr. llpr.rMeqaxrs. f l p u n o n a a a H l r uu r n b r B r o q x y oqyueBte
Tcxrrxo. nyHKtlxr rny6rHoft0,5-1,0 uyHr. npnxxrasfie l0- HanpsxeHHocTx, pacnrpaHnf, B MecTe yKo'ra, koTopoe Moxer I'rppa'
30 xH. r'tr,ll,rpoBarb B o6racTl,r xxBora lrrl,r B cTopoHy cnI'tHbI K Toqxe Bn-3y
ta1 t65
(a:n-uy, 2lV). Bo3Moxxo u qyBcrBo oHeMeHHeHa yrracrxe IlpI, npeBHUeHriH rny6llHbl yKona r'rerKo BH3Barb rpaBMy
Bonpyr firl1H. neqeHn r,l BHyTpeHHeekpQBor,r3rrqHxe.
npeBHueHnerny6rHhl yKoJraMoxer nprrBecrx x rpaBMe xeryr,
KA, ! 5 - T O q K A K b t v - B l , l( u 3 m - 8 3 n , l 5 V C )

r 3 . T O T ' K AT X b t O H r ' - K v A H ( U | A H B A H b , r 3 V C ) Jlo(arx3ar{xr. A. Ha 0,5 uyHfl HI{xe MeqeBsAHoro orpocrKa rpy

(Toqxa conprxeH{r nepeaHecpeardioro Mepnnxana c pycHuM AnHLr, H3 I qyHh HI{Xe 'TOqKt BCTpeqt pe6epHblx Ayr.
/ s ( c H ' . t 3 y )o r p e 3 K a n p t M o i , c o e a l r H f , l o o l e i
MepkAnafloM (uentrMi Mep{ftafioii (cB€rnui cr,) 6. Ha paccroflxHn
nynox c TotrKofi Bcrpequ pe6epHbrx Ayr.
J l o K a n x 3 a q r c . A , H a I u y H r H H x e l o ' t K H x h t - K X | o e T( u 3 r o i - u r c e . Tonorpaoxqeclat aHaro r|t. ToqKa pacnoroxeHa Bn.norH,ylo x
1 4V C l . H a 5 u l H e i B H U r e v n k a r o r o o r p o c l h a r p } j r n H H . H a B e p x H e M K O H U eO e . r o r
xoHuy Me'{eBr
6. Ha pacciornar "nxn;* t/. orpe3Ka npflMoi, coeAnHflroqefi
JraHfifi, 3a crellKoi xIrBOTa - reBat aont neqefifi
n l n o x c r o ' r x o i n e p e c e q e H H rp e 6 e p H b l x4 ) i . B paioHe roqKll llHHepBxpyerct rpyaHblMt HepBaMu
Koxa
'rh.-Ths.
TonorpaoEqecxitf, afiaroM;r. ToqKa DacnojoxeHa Ha 6eJrofi
,,rlrHxli xfiBoTa, .tla,,reeBrry6r, - 3aaHrfl ayra ca!'tbHrKa I nonepeq- l l o x a 3 a H x tM. e c r H b l e H a p y u e d s q li HapyrueHfiq,
Hat qacTb xe,lyaxa. cBs3aHHble c MepxaxaHoM:6onl, s snHracTpa,'IbH 0o6 f- t
Koxa B pafiole roqxr,r &fiHepBrpyercrtrpyrHHM HepBoMTh6. n a c r f i . r { x o - t a ,6 o n l , x q y B c r B o p a c n H p a H r B n e p e a H e t q a c r H r p y A t '
f i o l a 3 a f i rM r .e c r H H e H a p i r u e " r r x HapyueHre.
cBr3ar{HHe c MeptAnaHoM: 6 o , 1 r jB O 6 , ' r a c r x e , I y A x a , O6xrre paccrpoiicrBa: 3nxr'1eflctq,

O6ul,|e paccrpo;crBa: , n ' l e n c H e ,c e p d u e 6 H e H h e . Texrflxa, fIyHKqLlt r'ry6lHofi 0,5-0,8 uyHc nptxqraHre l0

TexE{Ka. nyHK[nq rny66Hofi 0,5 1,0 uyHs- npxx raflxe l5 l5 MHH.
30 Mt{H- IlpLMe,JaHIr€, IIp[ nonaaaHll]t vrnbl B roqKy - oulyulefifie
flpxMeqaHae. f l p r n o n a A a H r u a r , ' r b r B , r o q K y- o u l y p a . n H p a H H t . H a n p n r ( - e H H o c TBt t M e c r e y x o r a . x o r o p o e M o x e T x p p a '
ueHXe HanpexeHsocrIi pacnspaHrq B Mecreyxora, koropoe Moxel n[uDoaaTS B DaxoHOO'IIJ
xppaAHr.jpoBarb B o6,1acrb xaBoTa rns no xoay MepfiaxaHa. flpeanrueire r,ry6rnu nyHK[nn Moxer npliBecl, x rpaBMe neqeH,
llpx ocrp-ov c J c r v e l c o ' { e T a T hr r o q x a v f i H o i - K y a x x BHyTpeHHeMyXpoBolr3!'Il'ltH}llo.
( H 3 f rf y a H b .6 M C- rra cI r pr ryrxe- r a M i H { u r y - c a H b . n H3. 6 f )

1 4 ,T O t l ( A K t I - K X O E T( U 3 l O r l - U l i O El 4
, vC) t 6 . T O q K Aq v f i r - [ | | H b ( q x y H - T x H , l 6 v c )
(Toq{a-rraoaran reptsara{a cepaua)
Jloxanl3ar{xe. A. Ha I ayur rl{xe roqr(a xHy,Bn (u3lo.B3ii, Jloxa,rr3aqrc. A. Bo enalxxe noa rorrKoi aaH'qyHr (raHb-qxyH'
l5 vc). 17 VC) Ha 1,6 uyst.
6. Ha pacc,oflHnlj Hrjxflrx 6/s orpe3Ka nprMoii, coeAfiHriour€ii B. B BepurHeyrra, 06pa3yeMoro ayraMlt(npr orcyr-
pe6epHbIMit
n y n o K c T o q K o i n e p e c e q e H l , |pf le 6 e p H b t x! y r , cTB r MeqeBx,qHofoorpocrKa) 'rH6o l,ix opo,qonxeH flMr't (nplt Ha'Ix
Tonorpaolqec[ir axaroxic. tbqxa oacnoJroxeHa Ha 6erofi 'rx- qrr Me'{eBrjAHorooTpocTxa). ao nep€ceqefiHt c npoaoJlbHoli oceBoll
HrrJ,3a xoropot Haxorrrcr non€peqHar 0acqxr H 6prclxuHa, !.raHriei B rleHrpe rpyAr,rHbl.
Ja cTeHXOltxltBola - ieBat norr9 neqeS[ Tonorparpxqec(at aEarorrxc. ToqKa pacIIoJIoxeHa nepea coqne-
KoMa B pafioHe roqxr HHepBrpyercr rpyanuv nepeov Th.. HeHlieM rpyAtrHbl c ee MeqeBsAHbIMorpocTKoM, B aeprullHe yrna'
I l o [ a 3 a H rM c .e c r H H e H a p y r x e H H q H H a p y u e H x q , u 6 p a r y e M o r o p e 6 e p H b l M la 'lyraMr. IIoa Hefi cyxoxH,lbHHi flyqo(
c B q 3 a H H H e C M e p I A ll a H O M: 6on]r B )X!BOTe. {KOTa, TOutfiO- r p ! , t r H H HI i Q a c u H a n b H b l i n y q o K 6 0 , r b u o f i n p s M o i \ t H L l l u b lx l l a o T a
T a , p 8 o r a , K H c , T a eo r p b i x R a , 6 o r x B c p e l H e f i q a c l D r p y l x . HHfiepBaqrt MtI1lrq ocynrecrB!'trercs noaMbIIueqHHM HepBHhrM
O 6 u n e p a c c r p o fi c r s a: i{aiuaxa.noaoe cocrorHne, cepa, cnJreTeHreMI{ MexpeoepHblMs HepBaMll.
qe6l]eHre, 3nrrtencnr. cHtxeHxe naMtTrr. B pafioHe rot{x lrHHepBnpyercfl rpyAHblMs HepBaMx
'Ih1 Koxa
Texnx(a. nyHKtr.rr rny6ssofi 0,5-0,8 uyHr. npxxxraHxe lb Th5.
40 MxH. noKa3aH{q M.e c T H b I e H a p y u e H I r ' { It HapylUeHIt'
npr.{Me'raHrq- n p s o c r p H x 6 o n q x B o 6 , 1 a c r r c. re p A l r aD e , c B q 3 a H H b r e c M e p t a L t a H o M : q y B c T Bpoa c n t p a H x q B rpyas'
K o M e H A y € r c cqo q e 1 a T 6c r o q K a M x r a M - 3 y ( c f i H b - u l y , l 5 V ) , T x o F r . . r x orpHxxa, Hxofa,
( r y H ' , r x , 5 C ) , x x s 1 6 , M o H ( c x - M 3 H 6 ,4 M C ) - T€xHx|(a. llo,lxoxHaq nyHKuntl, floqrfl aaont (oxHoro noKpoBa'

| {t6 167
 KOHeU r r n H H a n p a B J r eB
f i c r o p o H y ) A r B o r a , r J r y 6 l i H an y H X u r r 0 , 3 _ 0 . 5 E. Ha nepeceueuaunpoaonbHoi oceBofinIrH u B qeHlpe rp-yAtHbl
r r y H r . U p r i x r f a H H e5 l 5 M H H , npoxoanUlefiqep$ aepeAHHyIII rpyarHope6epHElx
c ropn3oHra!'rbro,
npnMeqaHse, B c a e A c r a a e M f f r x o c r l , r p y r n H 6 r ( o c o 6 e H H oy
aeTefi) rray Bo BpeMr yKoJa Her''lLsaBBOAUTbnOA npHMbrM yrnoM x Tonorpaou.recKas axaroMfic. floa KoxHhIM noKpoBoM- rpy_
KOxHoMy rroxpoBy, tr6o 3To MoxeT nprBecrs x npoKony rpyalHbt rl axHa. Koia B paftoHeroqKu nnHepB[pyercq Th3.
npoHr.rKHoBeHl,lro rrnH B cpeaocTeHle, qro Bbr3HBaeTocTpyto 6orb. l l o K a 3 a H xMt e. c r H b t e H a p y r x e H L ' q : 6 o ' 1b B r p y a n
O 6 u r r e D a c c r p o f i c r B a : a c r M a ,T o u r H o r a .
t 7 . T O q | ( A[ A H , q y l l r ( I A t t b - r t x y H . t 7 v c l Tcxnnxa. fioaxoxuix nyHKuxF noqrlr BAor'Ibxoxxoro noxpoBa,
(Tocxa-rnauarafi Mepr^raha ncptr(apAa. Toc{a conpqxe{rq xoHeu TTJIDIHanpaBJIeHB CTOpOHy)|{l'tBOTa;rny6rHa nyHxqqk
erep.l{_ roe{a conpcxed{c nepe/rHecpea{Htsoro ffpx4rana
c p y q H d M rM c p r a { a r a M , i 6 o n L r o n q d ) , < M a j u i e x ' (
0,3-
"- 0,5 uyHs. np xxraHfie 5-l5 vtttt.
doxndMr Mep{axanad <6or6uofi xshr, (Mandfi 1116'} nl r,i " ,'r" ri n e. cM. <To'rKaqyHr-anHbiqxyg-rtH, 16 VC) >.

Jloxa.rr3aurs. A. Bo snaaHHe Hrxe r o , { K r . tH r o x - n b r o H r ( r o i - T a H , :o toq|( xoA-(Ati (xvA-aAl'1,20 vc)

l8 VC) xa 1,6 uyHr. Jloxanrlauxr. A Bo BnanHHeHH)Xelo'l(l,l roaH-xo lcnaHb_urH.
B. B roqKe nepeceqeHncnpoAonhHoi oceBofi rr.rH!fi B qeHrpe 2l VC) Ha 1,6 qy q.
rpylr.rHbrc ropr.r3oHTarrbro, npoxoaruleri qepe3 cocK, (y MyxqfiH), 6, Ha nepece'rennuflpoaor'lbHofioceBofi"'IItHn! B [eHTpe rpf,{fiHbl
nn6o c ropu3oHTarbro, npoxoAqlqei qepe3 V rpyIr.tHope6epHlte c ropH3ollfanblo,.npoxoatuefi qepe3 cepeatHy II rpyatHope6epHblx
cyclaBH (y xeHuIrH), cycTaBoB,
Tonorpaoxqecxar aHaro xe. fIoA Koxefi - rDvruHa. Tonorpaolqec(ac axaroiirt. Iloa KoxHblM Ito(poBoM rpyall_
Koxa a paioxe roqx, xHHepB[pyercsrpya;HM Hepeov Thr. Ha, MecToBcfpeqx py(ofifKt L feJla rpyAIrHbI.
0oxa3an[r. M e c r H rJ e n a p y_rire r { r x H a p y rx e H x r. Koxa a pifione roqKlr LiHHepBxpyerctxepBoMCa
c B t 3 a h H h r e c M e p t r A x a H o M : 6 p o H x t a n h H aacc T M ao, A 6 | l l t , n o x a 3 a x x cM. e c r H h I e H a p y u l e H r q : 6 o r b B r p y a !
KA, I,IKOTA, HEAOCTATOqHOCTb'AKTAUTfi. O 6 u r r e p a c c r p o f i c r B a : K a r u e i l ba,c r M a .
Texxx(a. floAxoxHar nyHl<qrc noqrr BAo{,rbxoxHoro noKpoaa. TexHx(a. IloaxoxHaq nyHxllxt noqrs BAorb KoxHoro noKpoBa,
KoHeu rr,lbr HanpaBneHB cropoH) xnBota: r,1)6HHanyHxuyr KoHeu rrJbr HanpaBneH B cropoHy xIrBoTa: rny6xHa nyHXr.lsx
0 . 3 0 . 5 u y H q .n p x , l { r r a H Hle0 2 0 ' M n H C,3-0,5 qyHt- IlpuxxraHUe 5-15 MIrH:
flpnruevaile. C M . < T o q K aq y H r - A X H(b, { x y H , r u Hl,6 V C ) > _ fl p r M e'{ a H lr e. CM. <Toqxa qyHr'AlrHb(qxyH_rljH,l 6 V c ) , .
r{1.ToqKAHroK,,Il6roHr
(|l)n-IAH,r3 Vc) 21.1()rr(AroAB-KO(ClOAnb-U3tl,2lVC)
JloKanx3aq&t.A, Bo BnaIrXe HDxe To,tKliTH-xyxr (q3rit ryu, l9 VC) Jloxar{3aurt. A. Bo anaAale HIrxe roq(u rxI'reH_Aor (TtlH6-Tyr
Ha l.fj qyHs. 22 VC) Ha I u\Hb.
E, Ha nepece,re8srjnpoAonbHofioceBoftrrrHUI s ueHTperpyAxHLr B, i-Ia neoeciqenur npoaonLHot oceBofintHl'll'l B IreHTperpyAttHbl
c ropnloHTaflbro,npoxonHuei ,repe3BepxHHri c roprsoHra;brc, npoxoA;urefi qepe3 BepxHItfixPai I rpyAnHope6ep'
Kpafi IV rpynHHope.
oeDH6tx cvcTaBoB.
_ To'norpar[nrecxae araro n. Iloa KoxHbIM noxpoBoM- pyKo-
Tonoria{nvecxar anarolrxr. noa hoxndM noxpoooM, rpy,

Koxa s paioHe roqKXtHHepBrpyercqrepaov Thr. Koi<a s pafiofle roqKn l]tHepB[pyerct HepBoMC3

l l o x a r a n i cM. e c r H b i e ; , p i r . " r I l o r ( a 3 xa t , M e c r H b I e H a p y r l l e H I q : 6 o n bB r p y a u
r I Hapy urcHlr,
c B q 3 a H H r , r ec M e p f i r r a H o M : 6 o , t bB r p y a r _ O 6 u t u e p a c c r p o f i c r B a : K a u e , l b a, c r M a
O6 |jIIr e p a c cr p otft cr B a: Katuenb,acrMa, Texxnxa. floAxoxuan nyfixqtt noqrl 940!'16KoxHoro noKpoBa'
Texxx(a. JloAxoxHl,li yxon, nyHKttrd noqrH BAor,rr,KoxHoro KOHeUHrrrJ HanpaBJIeHB CTOpOHyx<llBOTa; rny6tHa nysxuuu
no-x.po^Ba, xo8euttrrH HanpaBr'reH B cTopoEyxtBma, rny6[Ha yxona 0.3-0.5 uyHs. flprxfiranre_5 l5 wtrtt
0,3-0,5 qyHfl. nprixr{raHse 5-15 Mni. tlox e q a i r e . C M . . T o q K aq l H r - n n u (bq x y H - l H H1.6 V C ) '
n p r . r M e q a H r e . C M . < T o q ( a , { y H r - A x r(bq x y H - r s H .1 6 V C ) } . 22.roqKA TXrl€H,[oT(TtHb-Tv,22VC)
( r o q r a ( o n p c a e H { t n e p e r H e ( p r t r N r t roo rM e P x r r a H x
t$. Torl(A Tbr,Kyrit(u3tt tyH, l9 vc) r u H J r p e { H e r oi o A 4 c p a 4 a a o u e r o r c p x r { a H a {Hb-t)H-Mat,
JloKanx3a{xf,. A. Bo BnaAeHe Hrxe roqKnxoa,Kai (xya.rafi,20 VC) JloKai*3&qxc. A. Bo gnaalse 8I,Ixe BLlcryna roprafiI{ Ha 4
Ha 1,6 uyHr. 6, B lle8rpe tpeMroi Bblpe3x[ y BepxHero (pac rpyA! 61
t68 169
 Tonorpaorq€cxat anaro rr. ToqKa pacnonoxeHa noA ropraHbro
fi nlluteBoAoM,B yfrry, o6pa3oBaHfioMBHyrpeHHrMfipaeM.rpyariHo-
xroqfiqHo-cocqeBrAHofiMbrruqbrx BHyrp€HHrrM KpaeMaByx rpyAlr-
HOlllfifoBltaHHxMblluq.
MHuubr nHHepBnpyrorcrr BerBrMx Xl n XII napaMn qepe[HLlx
Koxa B pafioHeroqKu rHHepBrpyercrHepBoM Ct.
l l o [ a 3 a 8 rM
t.ecTHHe HapyrteHrr li HapylxeHxt,
c a r S a H H 6 r e c M e p r {a n a H o M ; 6 o n n B r o p n e , a Q o H l i Ho, x -
prnrocr6, orphrx(4, riKola.
O 6 uI fi e p a c c r p o fi c r B a: KaueJL, 6poHxua,'rr,Haq
TexHtxa. floc,le npoKona xox|l ocTpre rrrH noBepHyTbnoA
yrnoM r HanpaBnr6sa rpyrrHy. fry6nHa nyHKur.lr0,3 0,5 qyfiq.
flprxHraHne 5-15 MLiH.
fl pllMeqaHr.re- flpri HanpaBrefixxl,lrru nepneHAHxynrp8o
KOXHOMynOKpoBynerKo npoKoroTb Tpaxerc, Bbl3BaBy 6orbfioro
cyAopoxHbll Kamer'lL,
2 3 . T O q K A , ' l t | E M - T y E H( J t t n b - U r c A H b , 2 3 V C )
t roc(a cotrPrxerxr trepeaH€cpeaxHHono
r BHyrperHeronoaa€pxrBa|oqero Mepraratsa - xrd-Fn-Man)
2 4 . f O q | ( A T X b I A _ T b l O t l(fq 3 H - U 3 t H t ' , 2 4 v C )
( T o c r a c o n p c x e r r r n e p e r H e c p f l t { rof lro M e P { r { a H a
s o a H o f o x p y q r o ' o M e p x a x a H o'sc u f r r H n c H '
{ 3aanecpeaxBHorouepxaraHa,
Jlo{anxsaq q. A. B BbreM(e Ha noa6opoAKe.
6 . H d n H e B h r e M I ( rB c e p e r x H e f l o a 6 o p o a h a , n p t M o n o a H r l x H e i
_
Tonorpao qecKar afiaroirrn. ToqKa pacnoroxeHa Mexay aByMfi
X s A A P A T f l H M XN O A 6 O P O A O I { H H M MN hItxqAMfi,NOA H}!XHHM KPAEM
acrMa. xpyroBofi Mbrruubr pra, Haa BepxHrM (paeM no,46opoaoqHoi
Mbrurrbr xxHepBnpy()rct B e r B e M n v l l n a p b r q e p € n H H x H e p B o B .
Koxa B paiioHe ro,{x, r i H H e p B r p y e r c f l v n a p o n q e p e n H b r x
HepBoB.
noKasasrcM . ecrHHe HapyureHre x Hapy e-
H x q , c B t 3 a B r | b I e c M e p n A u a H o M : o n y u e H x yer , I ap r a ,
ooyxaHrer'rnua.3y6Haq6o"rb,BHe3anHari norept aoroca.
O 6 uI ri e D a c c r D o fi c r B a: MaHxaka,lbHoecocrotHae-
Texnaxa. flynxqaa rny6rBoi 0,2-0,3 qyHr. flpnxfiraHfie
Mepxarara n p t , r M e q a H r e . f l p r n o n a 4 a x x rr r r , r HB T o q l ( y o u y u e H x e
HanprxeHHocTrr,pacn{paHr.rqB MecTeyKona rnll B ry6ax.

Jloxanx3aqxs. A, flo.( noa6opoAKoM, Ha 80386I[IeH]I]t BbIcryIIa

aopTat{u (aaaMoBa s6,1oxa), noA ocHosafiseM r3brKa. MnE P X A U A H( V C )
3AAHECPEAXHHbT
6. Ha BepxHeM xpae qr.rroBr,raHoro xprqa.
Tonorpaosqecxas aHaroMrlc. ToqKa pacrror''roxeHa nepeA qer'Iblo qdoHr KHotrr
M€XAy noA' bq36rqHot r(OCr6rO I, nlrTOBliAHHM XpflrlleM, Aa!'ree xoA epnarat|a. MepxAriaHHaqsHaerc
(qas-uqHb, I VG) (Ha xorqe KoflqxKa) n roaHxMaerct BBepx
Brny6h r p y a u H o - K n r o q t r r { H o - c o c q e B U A H auql x, r o n o A b q 3 H r l H a t
M b l r x r l b r3, a H r M B ropraHb, nrrureBoa. no cpeaHefirlrHr.rr cnnHbl,no xoAy no3BoHoqHlt(a,I( ro,'IoBe,npoxo-
t H I M e X A \ r , l a J a M HC . n y C K a e r CBt H r l h l o q x e H f a H3 t o ( r H b _ u 3 q o .
Mbrur.lbr nrsepBupyrorcr BerBiMr r{,ry6oxoro rnefiHoro HepBHoro
28VO), p a c n o , r o x e H H o nB M e c r e n e p e x o a a A e c s b l B B e p x H t o l or y 6 y
cnreTer{fifl u xll ,{epennbrM FepBoM. (pvc. 63).
Koxa a paiore roq(x fiHHepBnpyercq HepBoM Ca.
floKa3alltti cnoHAfino!'rxc,e3, cla3MH Mbrlru cngHbl no r ny
Jlo(a3aExM e .e c r H H e HapyrxeHxq s HapyueHfit,
caq3aHHHe c MeprArraHoM: 3 a n a A e H r en 3 a r B e p a e H f i e cron6HfiqH6rx B pe3y,rbrare HapyrueHrfi ro,,roBHoro Mo3ra, 3a6oneBa_
q3r,rKa, noHtrxeHHbtt ToHyc t3blxa. 3aTpyaHeHHoeablxaHue, AI,tcQa- Hnfl BHyrpeHHfix opraHoB B paaoHe npoxoxAeHxq MepfiAraHa.
TexBrxa. nonoxeHae 6onbHoro npR Bo3aeficrBnu Ha roq(fi:
rnq. fxneDca,rlxBauH'l. r { b l o H rx H o H r ( ' { a H - r r e H 6 .I V G ) - . " r e x a H I r I r x o M ,p a 3 ! s H H y B H o r l r ,
O6qre p a c c r p o f i c T B a r n o r e p rp e q .
T€xxxxa. IIoAKoxHaq flyHKqnq noqr'r aaon6 xoxHoro roKpoBa, ,11160B Ko,teguo-,'roKTeBoMltorroxeH x, nprnaB lrtqoM x 3eMre s
xoHerl mrbr BanpaBneH B cTopoHy ocHoBaHrrg t3HKa; r{'ry6ltHa nplrnoAHtB Ta3;
- roqKr, B paioHe ra3a "rexa xrqKoM H,'r Ha 6oxy;
nyHKqrrr0,2 0,5 qyHr. flpnxlraHHe 5-10 MrH. - floncHrrr.lH-,rexa HxqKoM c noayrxxoii lloa xHBoroM. 'rexa
flpsMeqafl{e. n p r n o n a l a H r a l , r , l b ,B T o q K yy 6 o , ' r b H o r o
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- cnnHH. 3aTH,'IKa Ii 3aAHet qaCTIr rOnOB6I- L'IeXa HfiqXOM,
xoropoe MoxeT [ppaanfipoBa,rb K ocHoBaH&|,or3br(4.
H36erarb flyHl<qr.rH noa nprMrirM yrroM, raK Kar( 3To nerxo Moxer ,exa Ha 6oKy xrB crrAq ccyTy!'rfiBurucb s HaKrro I,rB ronoBy BHfi3;
- nepeaHei qacrr ro,loBbr ri ,'rfiqa -nexa Ha cnHHe, ctat
opnB€crr{ x npoxony rpaxen r{ BH3Barb y 6onbBoro cyaopoxH6rt
c!'rerKa orl(tlHyB ronoBy r{a3aA unq nexa Ha 6oky,
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v e p r a n o M .T o c r a c o n p c a e H r e r a r s r c p e r r H H o r o _ . v e p , l x a H a "
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Jloxair3aurt. A. Ha cauou KoHue xonqt(a

B. B BbreMKe3a 3aAHIrM IlpoxoaoM lr napea Kon'tfixoM Ha paccro-
eHxr 0,3 lryHt.
TonorpatDx'rec(at aHarouxc. Toqxa pacnoJloxefl a Ha MhIuIeqHDIx
BOIOI(HaX B O6nacTri Mexay 3aaHlM npoxoAoM ll xonqHKoM' noa
Hei Mbruubl HapyxHoro colrHKTepa 3aaHero npoxoaa I MHuIra'
noaHuMalou-(at cQnxKrepHyIo qacTb 3aaHero npoxoaa' Ianee
Br,ry6b - HIix sfi yqacroK 6plourr'HEl.
MNuqbr [HHepBtpyprct BerBr,to BHyrpeEHeto cpaMHoro HePBa'
Koxa B pafioHe roqxn uHHepBtpyercfl rpecrltoBblM EepBoM 53"'
r-oy (16VG) lloxa3a8tc. M e c r H bl e H a p y u e H H q: BHnaaeHre npsMot{
xsruKr. reMoppol, cTyn c xp0Bhlo.
Hapyureura. c B q ; a H H r , I e c M e p H a n a H o M : 6 o J r bB

O 6 nr fi e p a c c r p o fi c r B a: MyrHat MoLIa, Alt3yptt' MaHxa-

--TraH-qy ( 1 2V G ) Ka,rhHoe cocToqHfie.
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l0--30 MuH.
flpHMeqaHnt, l . f l p f l n o n a a a H utrri n 6 r B T o ' l x yy 6 o n b f i o r o
no3HrriaercIuIbHoe oqyqeHse HanptxeFHocr,, pacd{PaHfit B Mecre
-Th rboHr (9VG) \KOna.BOKpVT 3aAHeronpoxoila,1 xonqHKa.
qro Mo,(er
2. Cnei.ier ftr6erarb c'll.turxoM r'ly6oxoi nyHKultx.
IlpaBecl I( npoKony nptMofi Kl,lnrKt.

2- TO{KAt'rEv-3v(tlo-lxv.2 vc)
Jloxanr3aqrt. A. noa XXI no3BogI(oM.
6, B yrry6neHfift noll ocrncr6lv orpocrKoM lV xpecruoBoto
no:JaoHXa rr'lr, nocepeAliHeoTpe3xa nptMoi, coeafiHflolrlex 4opcarb-
HbreorBeDcrur{IV KoecrqoBorono3BoHxa.
Toflorpaox,recKat aHaroxxq. floa xoxei B paioHe rorlKlt Haxo-
Aercq aoqcHtqHo-.rpyaHat Qacqxg u.ltpoqafiures brurqbr cafiHI'I",
MbrmqH.BHnpqM,rrn|ouen rynoBlqe, cas3Kli KpecfqoBo-KonrlnKosoli
06,racrn n ocrncrbri orpocroK IV KpecruoBom nosBoxKa
M6lurqH nHHepBHpylorcq no3BoHoqHLIMr BerBtMIl ABgrar€,rlbHoro
HepBa.
Koxa B pafioHe roqx fiHHepBrpyercq HepBoM Ss.
l l o { a 3 a E x c .M e c T H 6 I e H a P Y l x e H H q : 6orri .B o6,1acrlr
xpecTqa.
HapyueHtr, c B q 3 a H H b I e c M e P I r a s aH O M : 6 0 n r
B O6JIACTII CDIHLI T NO3BOHOqHI,II(A'
O6urse M Y r H a t M o q a ,sapylueHrt
paccrPoficrBa.
MeHCTDVaTbHOTO qllxJla.
TexHx[a, nyHl(ut'tt noa yrnov s6epx BAoJI6 KaHaJla Kpecruoaol
P||c. 6:1. 3aAHo<peariilrn MepkA,as. e l5 -40 MrH
xocrr, r,ry6rroii 0,5 0,8 uyHt. flpl*uran
J roq(,1 3HoHr-(v^lt (to-tH-rvAHb,:, vc) 5 . T O T I K AX m E H - ( X v ( c l o A H b - l l l v , 5 v G )
Jloxanr3aurq. A. no,a XVI no3BoHXoM. JloKa.r[3ar{{n, A. noA XIll no3BoHxoM.
6. B yr,ry6neHns noA ocflicrbrM orpocrxoM IV flocc8srtsoro 6. B yrny6reHnx floA ocrncrblM orpocrKoM I noflcHHqHoro no3-
n03aoHxa.
Tonorpaoxqecxafl aHaroM[r. noA Koxefi B pafioue roqKll saxo- TonorDaox'recxaq afiaro xs. [lol Koxefi s paioHe roq,<h Ha)\o_
af,Tcr norcHn,{Ho-rpyAHar(pacqsr ulupoqaillllei MbIIIII{6IcnfiHH, a r f c a n o ; c H H q H o _ r p l a H H H a t( b a c u H s l x l i p o q a i u e f i M H L r l u b lc n H H h I '
(pacqrr M6r rlbr, BbrnprMnrroqei TyroBriue, nonepeqHo-ocrcrat
MecTo np KPenneHljc Mbllll(H, HalocrHas fi MexocrllcTai cBt3xH'
MHrtua. HaloclHat cBt3IG, MexocTflcTat cBf3xa, xerTafl cBqSka, xe!1Tar cBt3Ka, no3BoHoqHHt KaHa.n
n03BoEoqHbr[ (afiaJI.
Marurqu tHaepnapylotcq no3BoHoqHbIMxBerBtMl, ABitrare"'Il'Horo
MbIUlqH uHBepaxpylorccno3aoHoqHblMLl BerBttMIraBliaare!'I6Horo H e- p B a ,
HepBa. Koxa B Dafioge roqKn n HepBupyerct HepBoM Thlo
Koxa B pafioHeroqxn rrHHepBripyercfl ItepBoM lhlr. Ooxasaais. M e c r H bl e H a p y ru e B L tr: 6onb r xoHTpaKTypa
l l o | ( a 3 a l | f iM
f , .e c r H H e HapyueHtc: 6 0 , 1 6B o 6 , 1 a c r n
t o_
norrcHfiq8()fi o6racTx.
Hapyuefitt, cBt3aHHbI€ c MepfiaxaxoM: 6onu
O6 uue p a c c r p o f i c r B a : n a r o r o r t q e c x H en o r , l r c q [ [ , CnItHti.
B O6,'IaCTfi
HapylreHr,rrMeHcrpyanbHorouI,tKJIa,6e,1r. 60,,rr B 6o(ax, Bocnane- O 6 u r n e p a c c T p o i i c r B a : l x c f i e n c x q a' x a p € t '
H e cetra,l}iulBoaoHepBa. Texnnxa. flyuxuna noa yl,roM BBepx. BIoJIb..HIixHero Kpat
Texxxl(a. flyHKqsq noa yrr'roM BBepx, BAoi6 HtxHeao (pat j exlly I x ll no9cHI'l-qHLIMx
o c l x c T o r o o T p o c T X a ,B H a n p a s n e H l ' t l 'M
ocrHcroroorpocrKa,B HanpaBreHHH Mexny lV r V noccri qHuvg I.0 uvHt flpuxHlaHre lU 40 Ml{H
rroJBoHKavr,r,1y6rHofi 03
norBoHhavr. nlH|(u e r,1)6 Hofi 0,3. 1.0 ulHfl. [lprjxHra,{ee
l0-20 MrH.
{ i -l 0 q K A l b l T b - r t v H r ( | I 3 x - r t x v H , 6 v c )
JtoKan 3aqxg. A. noA Xl no3BoHXoM-
4- lO{('1 MEUIr-MOll lMtlH-MAHb.4 VC) 6 . B v f n v 6 , l e H r H f l o ! o c r H c l b r Mo r p o c r x o v X l r P y n H o f o n o l s o H K a
Tonoipabnrecxar aHaro fis. Ilon xoxei B paioHe rorlxl Haxo_
JloKa,rr3auxs. A. IIoa XIV no3BoHXoM.
B, B yr,ry6neHrrx Doa ocrr,rcrbrMorpocrxoM II noqcHl,IqHoro t r q r c t v e c T o n p H K p e I I J e x H t c y x o x h l l ' t t T p a n e u , e a H A H O f fM 6 I L U U b I
r p ) A n n o - n o a c x t ' i u x a nQ a c u r q t i p o q a f rl t r e f i v b l L i l u b lc n s H L I H x x H 9 9
si;nna ey6,raran Mtllrqa. artl',HHag ocrqcraq Mbluua cnI{HbI' none-
Tonorpa0l,{ec(at a8arours. floA xoxefi B paioge roq(r saxo-
arTcr noflcHlqHo-rpyanaq (pacqnr uspoqafiuefi Mulx116Icnulbl, pe'ruo-ociucran Mbluqa, - xaAocrHaf r M€xocrxcrac cBt3KIJ' xe'l_
Mecro nprrKpenJreHr,rr HrxHei qaclrr 3y6qaToftMHlllr.lbr,MexocTtcTat TAg CB'3XA, NO3BOHOqHbIH KAHAJI.
qepenHHx HepBoB'
s nonepeqHo-ocTgcTac Mbluiqbl,MexocTac1aqr HaaocTHaqcBt3(t, MbItuuH HHHepBxpllolcq BerBbK) XI napH
xerlTat cBt3K3, no3BoHoqHHtxaHar. B e T B b r ol ,. l , a y L x eof ir I ' 1 ) 6 o h o l o u l e i H o l o c n ' l e l e H H 9 .r n o l a o H o q H b l M l ' l
M6rrllqH r.tHHepBrpyrorcq no3BoHoqHHMr.r BerBrMl.rABrrarer6Horo BeTBnM trBrfaTerbHoroHepBa
HepBa. K o x a a p a i o r e r o q K H H H e p B x p l e l cH t e p B o M- l n 3
tloxaranis. Me(rHHe HaplueH fl: 60rr B oonacrx
Koxa B pafioEeroqxx HlrepBnpyercflHepBoMThr,
ro:rBoHoqHoro c r o n 6 a a c n x H H
l l o x a 3 a f l f i r. .M e c r H b l e H a p y l n e H t t : 6 o , r t ,B f l o t c H l l q e .
O6urre pacc1poftcrBa: f i K o r aK . p o B a B apt B o l a n p f ' l c J y '
oLrr]ueHte HaIrprxeHlrfltt,1t c,ta6oc1HB M6ll!uax notcHfiqHoii
I H 6 o , 1 r .B t e;yaxe xe'lIyxa. lrrapeg B H n a n e H H en p s M o H K l l u l K r l '
o6,rac,t-
H a p y l x e H x q , c B r r 3 a H H b r ce M e p a a r a H o M : 6 o t 1B|
o6racrlr cn{Hhl. roroBxble 6onr, TexHrxa. fllHxure noa yrnov BBepr' BAo"1bHn)|.Hero Kpa'r
ocrHcroro ofpocll(a, B HaflpaBrexH Mexly \l xll rpyaHblMl'{
O 6 nrr e p a cc rp ofi cr B ai HapyueHrrerepMoperyrnqrr f l p , r , { t i r a H l , e ll] JU MIH
noraoHKaMx, f r l ' 6 l , | H o f i 0 3 l 0 u y H t
Hl.rxHflr xoHeqHocTefr(noxonoAaHrieHof oT xoreH u Hnxe), naTo-
,notgqecKrieflor'tnbqgfi, fiMnoTeH(nq,6enn, MyrHat Moqa, rltxopa- t B H e K o l o p H \ K H X T a XI p n x r l a H f i e c q x T a e T c i n p o T l l B o n o x a J a H H h I v r '
aoqHoe cocTorHrle 6e3 noToBbrae,leHfia, 9nfi,1enTfiqecxHe xoHBy,rl,-
c lI y Aerefi, crra3MHcnrHH6rxMb[!q no rllny cron6Hrqxbrx. 7 . T O q K Aq v H r - K X v ( q x v H - u l y , 7 v c )
TcxHxxa. IIyHXqnc noA yrroM BBepx, B HanpaaneHnx Mexay Jlo(anxrau{e. A. lloa X noJBoHKoM
ll u lll norcHrqELIMLr no3BoHKaMr, rny6sHofi0,3-1,0 qyst. npr- 6- B yrny6neHrx no! ocrl{cTblM orpocrKoM x rpyaHoro no3_
xnraHfie l0-40 MrrH.
174 175
 Haxo_ PeqHo-ocrlrcTa9 Mhltxubl crlnHbr! HaaocTHat r.t MexocT{cTa, cBr3t{r,1,
TooorDadnqeclaf, afiaroirfit. [lotr xoxei B paioHe roqhH
v H t ! u H . n o t l c H x q H o - f P y l HHHac xer'ITat cBq3Ka, no3BoHoqxt t KaHar.
,rrca cyio)iHn e rpaneuHeBk!Hofi
MHrxlr6l cnHHbl, ar'lnHHat ocr[crat H nonepeq- MHuqbr HHlepBspybrcr reMll xe H€pBaMr, qro fi B paiiolc
6acuna urrpouafiuefi cBrr3Kll' r u q K f i T U r r , - q y H r ( u r H - . r ) X y f i ,6 V C ) .
rio-o.rficrai MblmIlbI cnl'tHbIr HaaocrHat t M€xocrflcrat
IIO3BOHOqHbII KAHAJ' K o x a B p a t o H F r o q j { H H H H e p B r p y e r c gH e p B U v [ l b .
XE,'ITA'I CB'3KA,
qro fi B paioHe l l o , ( a 3 a H x cM. F c T H H e H d p y u r e H r ; : 6 o , 1 HB c n r H e ,
MHUTuHt{HHepsxp}lorctrevfi .xe HepBaMH.
uourxe paccTpofrcrBa:
TO'{KITHTb-qyHr(u3H_qxyH.o vq_,. x e , 1 l ' x a .y p , t a H r e
c H r j x e H f i ea n n e T x r a , x a r x e n l , , a c r M a , 6 o , t l . { B r p y A r r .
B xHBotc,
Koxa atrepslpyercr HePBoMt na-
Iioi""a"r" j M "'. . " ot e H a py rIeH n t: 6onl B o6nacrrino3' Texarxa. tlynnqlia noA yrnoM Bsepx! BAonh HXXBero xDafl
o c r r . r c r o r oo r p o c r K a . a H a n p a B n e H H vHF x A \ V l l . V I I I r o v r u b l u u
cHtxeHte ocrporbl flo3aoHKavr. r,ty6 Hon 0.3 0.8 uyua. llpr.ixrraure l0
O 6 q t e p a c c r p o ii c r B a: racrpanrrt, i5 vrrr
' Kp€s r 0 . l o ' r ( A . l | l . t H 6 l l ^ o ( J | | , t t t _ l . A 1l .0 v c )
Ta*""*a. [lyHr<urHltoa ]l'[oM BBep\. BAonb HrixHero
B HanpaB'leHnr Mextry x x xl rpylHblMr
oclrcToro orpoirKa. '1 J f o | ( a . r x 3 a q l | n .A . l l o n V l r p v a r r r , r v n o r a o H h u M _
;;:;;;;". l;i6;;"n 0.r 0 ulxq nprixra'ae l0 -15 ttttrtr' 6 . B y r , l y 6 , 1 e H H , rn o a " i r u c ' o ' r o u f p o ( r n u v V l rpyaHojo Io.{-
I t . I O q ( A ( A H - C y K l U 3 t l H t ' _ C O l.t V C ) To[orpaolqecrac anaTo xc. lloA r{oxefi B paioHe roqxl'l Haxo,
Jlo(anx3aqrt.
' A- floA IX [o3BoHKoM- llflrcr fyxoxDJHe ]pafl(ureaxaHoi vbll ULi, norcHl,lqHolp]JHafl
IX rpyaHoro no3-
E. B yiny6,reuru noa ocrl'IcrllM o,pocrxoM 9 a C U H f l t ! H p O t t a t L ! e 1 .v1b u l l U b l C n H H b t ,t ! t { H H a q O ( | l . 1 f t a f l , ] n u n e .
peqHo-ocTHcTat MbIIlIuhr, HaaocTHas r,t MexocTrra'I cBg3xri
BOHXA-
Haxo' xenTarJ
ionoroadnqecxaq ataroMxi. llol xoxei B paioxe loqKlt qHag cBn3Ka. no3BoHOrIHbIltXaHarr.
n"t"r cv'xoxu re l p a n e u H e s a H o f i M b l t l l o L l . l p y a H H o - n o t c H Mbrur(br nHHepBspyrorcg TeMx xe lcpBaMlr, qro I'l B parolre
facur"'r:rnpo"alru"ir vblLxuH cnHHhl. !'1 Hfiaq ocfl,lcIaq vHLrua l o q K I l r H r b - t r y H r { u 3 H , r ) { { y H ,6 v G )
Jnu"i, "uli"tnr" It Mexocrltcraq cBt3Kt'I, xe-rrat cBq3(a' no3ao_ ^ o x a B p a r o H er o q h r r H f i e p B H f y c rn, i ( p B u v T h . .
' ' i u l " t uxaHarl.
'xoqHui " I l o x a 3 a x n e .M e c r H b r e aiiymenxr, 6o,1bB cnrue
x H H e p B H p y l o T clte r \ 4 r/ K e H e p B a ! l r ' ' r 1 o H s p a f t o f i e T o q n a p y r u e H H e , c B q 3 a H l r b r ec M e p x a r a H o M : p n r l r ^
xr Tnrt-'ryHf (u3 -qxyH. o vu)
K o x a e o a i o H e r o q x l H H H e p B x p y e ] c qH e p B o v I h r ' O6urYc pac, r poic
I l o n a g a H i s .M e c r H H e HapyueH s : 6 o ' 1 t lB o o ' l a c r t I e x x x r a . I t y H X U H en A ) | l o v B s F I r \ , d , r , r r b H r x t , e r i , x D d , l
o c , l ] c r o r oo r p o c r K a .B H a O i r B n F H r vHe , h r y \ l r \ll ror,rusrvu
Hapyuenrn, cBt3aHHble c MepYA'laHoM Do"lx r o r B o H h a ! r H I. n ) 6 H H o i i 0 , J 0 . U u l r r n I l p r i x r r a r r e I { , i j M H
B o6,1acr{ nof,cHl'lllbl. lt. Ior[(A fxAH ll^o (lllr]tb,aao, lt v(;)
O 6 u r e p a c c r p o i c r B a: 3nl'leDcltt, cfla3Mbl cnuHHblx
Tfiny cTo'16x;qHHx, MaHfiaKa'1bHoe cocroffHne' cyaopox-
Mbrrxq no Jloxa,rr3a{xq. A. non V rro3BonkoM.
HOe MHraHI,Ie,racrpaJlrl,l'{ 6 B ) i " 1 y 6 , r e H nnxo n o c r H . r H Mo r p o c r h o v \ r p y u r o r u r r o r e u r r . a .
lllyniuua non yrnov sBepx s]lo'nr "']":19-.1q.1:
Texnr,rxa. ronorpaerqecxae aHamM fl. nn, |(o,{cf n patodc
ocrHcroro orpoiTXa. B HanpaBieHhx
't.0 vexay lx x ,\ rpyaHblMr
;;l;;;;", ;;F;;"r 0e uv"" rlprxara're r0 -30 vuH A'{T(s cyxoxr.lrrne rpaneqxeB0AHofi Mblllul'lj AnrHHa, ocrricras I
n o f i e p e q H o - o c T u c T a iM b t r x r l b r c n r H t ' , H r a o c f H a r r l l
c B e 3 K r i ,x € r r a e c B e 3 K a ,f l o 3 B o H o q H H iki z { a r .
c loilh/r lH-Jblotll (tldr-qH s v(i) M b r r u u b rx n x e p B r p y K r r c r r e M x x e x e p B a M x , q r o n B p a r o n e
rotr.
notuo"*o" (u3r,,.rxyH,
6 VG).
Jloxa.nrsaqtc. A. fIoa Vll ipyl""" Koxa B patoHeroqKx rxaHa6o (urer{b
B. B vr'1v6reHHl,tflo,troclrlclblM otpocll<oMVII rp]]rHoIo noJ_ aao, I I Vc) }rHHep-
c Bxpye.rca
HepBoMThr.
sonxa: n! nipece'renfih npsvofi coe[xHsloIuefi ylr'lH r'lonarox noxa3aHxr,Mecrnue
nDonor'lbHofioceeoi aaHHeil npo\ongureft nocepeAHHe nolBoxoq H a p y ur e H Lrs: 6o,,rbB crifiHe,crroH_
nl*iono.oo6ru""*oo paccrpoicrBa:
afiaro ,.t. noa Koxefi B paio*e roqx, Haxo _ _ _ 9 _ 6 y ncHaxerue
9
q y B c r B oc r p a x a , r p e B o x H o €
cocroqHxe, naMsrq, karrer16,cyaoporl y aerefi, na,rrpll,
agTca cixo;fixnle rpaneuHeBrlHoi vbltllllH. notcHYqHo_rpyrHag
fi none-
dacuuq urpo,{afiulefr MbItuIlBIcIlLHbI, AJIxHHat ocrtcrag
t76 t77
 O6qre paccrpoficrsa: M a , 1 r p u rcp, s f i n H
, o q H oreo B b r -
T€x rxa. flyHKrrrrt noa yrnoM BBepx, Bronb HtxHero xpas
ureHrieteMnepaTyPbr,[oTooTlereHqe ao apeMr cna, qyBcTBocrpaxa.
ocrrc,oro orpocrKa,B HanpaBneHt,MexAy V q VI rpyAHbIMtnos_ Tel{xra. nyHxqHr noa yrJtoM BBepx, BAor6 Hnr(Hero Kpat
BoHXaMu, rny6rxoi 0,3 0,8 qyHe.flprxrraHLre l0-15 MI'iH
ocrftcroro orpocrKa, B HanpaBreHr{HMexAy Lr II rpyAHbrMfinos-
12.tO{l(A TxAH-{v(lXAHt'_qXv, l2 VC) BoxKaMr,rny6firod 0,3 0,8 qyHr. Ilpuxuraue l0 15 MlH.
JloKanxsaqxe. A. flo'a lll rpyagbtM no3BolrxoM. nprMeqaHxe. n p r f l o n a A a H f lrH r T o q K yy 6 o , i 6 H o r o
, r r r bB
E, B yrny6,1eHHliroa ocrl{crbrM orpocrxou lll rpyaHoro no3_ so3HrKaerouly4efise HaflpcxefiEocT{ x pacnupaHtq B M€creyKona
rrs BAorrbao3aoBoqfiorocron6a.
To[orpaorqecxat aHaroi,rxt, noa Koxe& B pafioHe roqxli Haxo- flpr neqeflsfi Manrprr roq(y Aao-aao (?ae-aao, 13 VC) pexo-
aqTcq cyxoxure TpaneqlreBnarot MbIuIllbr,peMeHHatMIruua uer, MexAyercccoqerarb c roqKorfi3r8-cH (q3rHb-rllll, 5 MC),
IrtHHat ocTlicrac a nonepeqHo-ocruc,latMriuIILi cnltHbI,HaaocfHat r1-TOqKA,[An'TIOtl(,[A-{Xvn, 14VC)
I M e ) | { O C r r C T aCr B t J K r , ) | { e , l r a f ,C B n l h a , n o \ B o x o q H 6 I i K a H a ' l . (Toqr.aconprxenrq saAHecpeAxnroro
M H l I r u H t , l H H e p B r p y r ) r c qB e r a b K ) X l n a p H v e p e n F b l x H e p B o B , Mepraradac irep{/r$aHartr)
Bersr,rc, fiayulefi oT rny6oxoro HepaHoro cn,1ereHfiq, no3BoHoqHblMn
BCTB'MH ]IBNTATEJIbIJOTO EEPBA- JloKamrga(rr. A. B yrny6neHrn Haa I rpy4E6lM no3BoHxoM.
Koxa e paioxe roqxa rxaH uy (u:rr-uxy. 12 VG) nHHepBtpy' B. Jloxaru3au lo roqx& MoxHo onpeaen 16 cneAyrculrM o6pa-
3OM: npfl HaKtOHe iOJTOB6I6OnbH6IM B lrxHefi qacfu ujleq 'IBHO
ercr HepBoMTh3,
r . e c r H b re H a p y l n e x n q : 6 o , 1 bB o 6 ' 1 a c r cr n x
I l o K a 3 a r | xM o6o38aqarca l-3 KocrHhrx Bblcryna, Cneayer Har'Ioxllrb lla xax_
Hbl. cnoH]llt!'tor'Irrcre3. ahrfi s3 Hr{x no llatlrbqy s nonpoqlTb 6o,1r,Horo BpauaTb for'IoBoq,
O6qxe paccrpoicrBa: B H c o x a ree M n e p a r y p6ap, e A o _ fiax"loHfrb ee Bnepel q ra3a,{. To.rxa Aafi-Tor (.4a-qxyfi) nexur B
BOe COCTO9HXe,XotlBynbclrl,t, floxo,loaaH e KoHeqHocTet, cna3Mhl yrry6neHHs noA 6o,tee noABlxHbiM BbrcrynoM, Korophlfi tBnterct
Mbrrxq cnrHbr, BocflareHlre car'II'HNx xene3 BeK. ocrrcrhrMorDocrxoMvll ruefixoronoasoHxa,
T€xHxxa, nyHKulie noa yr.rov BBep\, Blo-nb HrxHero xpaq Tonorpaoxqec(anaHaro rr. noa Koxefi B pafioHeroq(L Haxo.
o c T ' r c r o r o o r p o c r K a . B d a n p a B , l e H H f iM e x j l y l l l r l l v f p y n H b l v l r IrTCr CyXO)l{U,'|,|9 TpaneUH€BnAHOd,pOM6OBrlABOit BepXBefi 3aArefi
n o 3 B o H K a M r ,r n y 6 n H o f i 0 , 3 0 , 8 q y H q . f l p t x n r a H x e l0-15 MEH 3y6qatofi MHuiq, octrlcrar fl fionepei{Ho-ocrrcrai Mhllllllbl, HaAocr-
IIpnMeqaHlre. flp nonaAaH D Ilr,'ILIB ToqKy y 6o'lbfioro H a f l . M e x o c T f i c T a t r x e J T a t c B t S K l t . n o 3 B o H o q H b l ik a H a , I .
Bo3Htxa€r oulylAeHxe HanptxeHHocrll, pacnflpaHfiq B Mecre y(or'Ia' Mbrurt6r xfiHepBnpyp?cfl TeMfi xe HepBaM[, rrro fi B paioHe
KOTOpoeMoxeT lrppaarspoBarb BAonL no3soHoqHfiKa. roqKs rxaH-qy (u3Hb-,rxy, l2 VG).
Koxa B pafio8e roqKn aai-rrofi (aa-qxyfi, 14 VG) fiIrHepBljpy'
eTcr HepBoM L3.
r 3 -l O q X A , I A O - t r A O ( T A O , I A O ,1 3 V C ) noxa3artr. M e c r fi LI e H a p y u e H x r: 6ont, ptrfiAHocr6
(foqt€ conpexeH{e 3aaHecpeaxHBoro MeptArana x {oxroro
M b l n u u e f i r 3 a T H r x a . c n H H H . f o J t o 8 f l a g6 0 n r , .
d e p u ^ t a H a( B e t x ( { n s H , )
O 6 u r e p a c c r p o fi c r B a: acreHrq€cxoe cocrotlHue, Ma!'It-
prfl, rprnn, (ar[enb, Mexpe6epHar HeBpanrfifl,6on6 B o6racTu rpy-
JloKa,r[3aurfi. A. B yr'ry6reHus noa roqxofi aafi'rlofi (aa'qxyn'
afiHbr, o6tlnr,Hoe BErAe,!€HfleMoKporH,3acrofinbre flBreHfit B 6poH-
1 4v G ) . xax. C qenr,o npo(prrr'rraKTfir{, cr'reryer npuHrMarb Mepbr no ykpenne-
6 . B y r J l ! 6 , 1 e H r xn o ! o c r H ( r b l M o l p o c T K o \ 4| r p l a H o r o n o 3 a o H K a :
Htrc o6qero cocrotHl.tt 60JIhI{oto.
H x ) f i e r o q K HA a i - r r c r ( n a - q x y f i , l 4 V C ) H a o a r H n o l B o H o K
Texnnxa. flyfiKI-(st lloll yrroM BBepx, aaoJl6 HHxHero Kpae
Tonorpat0xqacKafl anaronrq. flor Koxefi B pafroHe roqxr Haxo
ucrr{croro orpocrKa, B HanpasneH x vexal VII uefiHHM fi I rpy,q-
t r f l r c r c y i o x r n f i e r p a n e u H e B r a H o i lv u u u u . c Y i o x l n r ' r e p o r v 6 o a H a _ H H v n 0 3 B o H K a M x ,r , 1 , 6 H H o i 0 , 5 - 1 . 0 qyHq. flPexH16Hxe l0
Hoi MHurqbr, cyxoxtlrIre BepxHeii 3aafieft 3y6qarofi Mblruqbl, peMeH_
ll nonepeqHo-ocTucTan l5 MnH.
Hat Mbltllua ro.tloBl,l, A,rIrHHat ocTlcTat
nprMeqaxrq- L n p H n o n a A a H { ns r n H a r o q ( y y 6 o n b H o r o
MUlxllbl CnIrHbI,HaAOCTHaSH MexocTHCTat CBq3Ks, XeJITafi CBq3Xa'
a o 3 H r K a e To u l y u t e f i r e H a n p f x e E H o c T H ,p a c n t p a H k t B M e c f e y x o r a .
rolBoHoqHHl KaHar, xoTopoe MoxeT nppaattpoBaTb BAoJIb no3BoHoqHtxa, a HHoraa x
MHlJqbr fiHHepBl,lpylorcT t e M n x e H e p B a M I r ,q r o u B p a t o H e
q x ( y , B CTOpOfiynneqel.
roqKn rxaH-qy (u3Hb 12 VG)
2. flpn,'reuenar ManrpHH pexoMe8Ayerct coqerarb roq(y rat'
K o x a B p a f i o H er o q x x n H H e p Rp y e r c q H e p B o MT h r . ' f l , o n( A a - q x y f i , l 4 V G ) c r o , r K o i 3 t l r - c b r ( q 3 e H b - u r t . 5 M C ) . B c , r y -
I l o | ( a 3 a x xM e .e c r H b I e H a p y l I I e H I q u H a p y I U e H u q ' qae 3acTofiH6rx rBreHni B 6PoHxax npfi ocTpbrx 3a6o,'reBafifltx -
cBs3aHHHe c M e p s A o a H o M : 6 o ' r f l B n o 3 B o H o q f i H Koex' l y _
coqerarL c roqKofi Qe-3y (o3fi-uiy, 13 V).
u e H r . j ec n a 6 o c r n B o 0 , 1 a c r f ic n t H b l u n o 3 B o H o q H s x a
179
17E
 3. Ec"rn Bo BpeMf, BpaueHxt Itrnbt B cryqae npt 3acrotHblx l6 VG) pacrlo,IoxeHa B yrny6reHr.rr MexAy aByMr rpaneuneBhaHbr-
r B r e s x r x B 6 p o H x a x y 6 o n 6 H o r o s o 3 l r t i K H e rp e a K q } t e B O o p M e y c n _ Mri MHrrqaMll, Ha ypoBHe ocHoBaHnr r{epena.
r l e H H O f OA b r x a H x f l ,r o 3 r o f l B n q e T c q n o K a : l a T e r e M3 Q q e x r r B H o c r t l Tonorpaolqecxan a aroMxn. floA xoxHhrM nol(poBoM B parf,oHe
TOqKi HaXOITTCT CyXOXlllrse TpaneqreBr,aHorl M6rrnuH, noJyocTnc-
Taq Mbluqa, 3aav'|tl Mana'{ npflMaq MHUqa ronoBbr, 3aaHffq aTnaH-
t 5 . T O T I K AA _ ' l | O f ( t _ M 3 H h , t 5 V C ) TO-3aTbUIOqHatnepenoHxa I1 KaHaJt DpoaoJroBaToro Mo3ra.
(Tocra conprxenne 3aanccp€AxrHororepratani MHuqLr B pafioH€ ToqKfi fiHHepBr,tpytorcr 3aAHrrMr BerBHMn rpex
r Hapyx oro nf,.oqHoro) BepxHrx ueiHbrx cIIfiHHoM03roBhlxHepBoBn orBerBJreHr.trM11 XI napbl
qEDENHHX
Jloxanx3aqxg. A Ha 3aaHefi rpaHtue Bor'roc' B 3arHno'{HoM yrfly6 HCDBOB,
!'Ielrnr. B ero MqrKot qaclH. Koxa auiepanpyercr HepsoMC3.
Ha 0,5 uyxt BLIrrre 3aauefi KpoMXx BoroctHoro noxpoBa (no floxa3arrrc. M e c r H brC H a p ] u e x I q: roJroBHar6or'1b,6om
n o 'v6f.H M A p e B H r Mr c r o q H r x a M ) . B 3aTbIIXe, HaflprXeXHOCTb MbIutIl 3zTbL'IXa.
B r a r s r , r o q r o n r) r n y 6 i e H r x . H a 0 . 5 u y H t B H l t l e l a n H e i r p a ' napyrxeHn'r, cBr3aHH6re C MepxaraHoM: Bsrna-
Hr.r116lBo,'rocrHoro noKpoBa. npt oTcyrcrBllfl qeTKo BblpaxeHxot AeHrie nptMot K lUKs, BbInaAeHI,IeMaTXr, HaCMOpl{.
rp3fil.{r16r B 3aTblloqHofi B6leMKe, HrXe roqKj ooHf_Qy (Q3H_Qy' O6 ure p accrpofi c T B a : 3 a 6 o n e B a H n rB, H 3 B a H H b nr ea T o -
16 VG) Ha 0,5 qyHfl, IIoa ocrlrcrblM orpocrxoM I ueiHoro no3BoHKa. reHrbrMu QaKTopaMU <B€Tpa>, ocna6neHr.te naMqrx, rrlyM B yluax,
Tonorpaor't€cxaq aharoitut. noA KoxHtiM noxpoBoM B patoHe pq6r, B lna3ax, MaHtaKanr,fioe cocrorH{e. crrr6Hoe noxoronaHrie
Toqxr HaxoAqrct cyxoxr',rne rpaneuueBnAHo[ MbIlxuti, noryocTl'lc- acero rera, c€pAqe6reHHe.
Tar M6IlUqa, 3aAHtq 6o,'Iblxaq nptMa'{ Mblrxua ro{'IoBbl, 3aaHflq _ T€xHx[a. flyHxqxr noA nprM6rM yrr'roM, r,1y6nHofi 0,3 0,4 rryHr.
a r , l a H r o o c e B a g n e p e n o H K a f, l o 3 B o H o q H b l iK a H a ' l . I lpIxxraHn€ npoTtIBonoka3aHo.
MblouH rHHepBtpyrcTc'{ 3aaH',IMIl BerBqM rpex BepxHnx rueH_ U p r . j M e ' { a H r e , T o x e . q r o a a n r r o , i K H a - M o H( e M 3 H b ,
Hbtx c[ttHt{oMo3roBt{x HepBoB l'{ orBerB'reHaeM XI qepenuoro HepBa. l sv c ) .
K o x a B D a f i o H er o q x u a - M o H ( t - M 3 H b , l S V G ) , H H e p B t p v e r c q r 7 . T O q K | I A O . X O{ n A O - X y . t 7 V C )
r e p' neoo u (foqxa conpcxeHrc aaaftecpea{HHono ep{a{aHa
K aCl sa. h r t . g : 6 o ' 1 HB o 6 n a c r r <oen{{{fi er>)
MecrHHe HaplLxeH c Hoxxd MeDtrAsaf,oM
Jloxa,rx3aqxq. A- Ha 3arhrno,{Hoi xocrr. Ha 1.5 uvHr Hljxe roqKfi
H a p y n l I e H H g ,c B t 3 a H H b r e c M e p I r a t a H o M : 6 o n r I hHoHr-3rH ( urH-u3efib. l8 vc).
p r r r ] l H o f r r , n o r B o H o ' { H r x a .0 6 H , l b H o ex p o B o l e q e H H er , H o c a B. Bo BrlaAnse,senocpeAcrBeHHo noA xapyxHblM 3arbJ,loqHbrM
O6urne D a . c r D o i c r B a : v a H u a K a , l 6 H oceo c l o t H H e .B H e - 6vfDoM,
aanaaa. norepri ronoca; HeMora, orBepaeHHe e3bl(a, paccrpoficrBo Tonorpa@r,recxan anaroMxr. floA KoxH6rM noKpoBoM s paioHe
' e ' l ! . 3 a n a a e H r e ,a r p o Q t q t 3 H X a .
D roqKr HaxoarTc9 {pacqnr qepena. MecTo fiprrKpenneHMr cyxoxtnrfl
Texfirxa. fltHxuHn ioq npeMtrv yrroM. r'ly6HHoil0.3 0.4 uyHt rpaneuHeBxaHoi vHUubr x c) '(oxllr' .lr nonyoctHcfofi MHrrlubt.
f l D' ful x f l f a B H e n o o r H B o fol x a 3 a H o . HapyxHbri Bbrcryn 3arbr,toqHoii Kocr ,
o u v " , r i H I e . H e l o n y c r x v b , n p e B H L x e H HI n e ! 6 H H b r) K o r a . MHlrrrbr fiHHepBnpyrorcr orBerBreHr.,rrMx XI napH qepenHbrr(
n y u r , u r r r r o a ) r " 1 o MB B e p x .' r r o q p e B a l o B e ,b M a o n a c H o f rr p a B v o i IeDBos H 2-ro ueixoro HeDBa.
npoao,r.osaroro Moira r haK oe,yrbtal v r H o B e H H ooi ic r a o B K o i Koxa B paioBe rouxu runepsrpyercr HepsoM CiJ.
AHxaHnq ar1[ cepAqa n o x a 3 a f i r c .M e c r H H e HapyueHrrs , Hapyue-
|'te, cBs3aHHHe c Me p x A n a Ho M: 6orrr x pfirfiaHocrb
r0. foqKA oo r-ov (o3ll-oy, 16 vc) B o6nacrr, lxex roJroBoxpyxeH e,
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c <Eapyxrsr noaAepx{uaDqrM' dcpraraxoM) x€Hne ocrporbr 3peHrr (6,1n3opyxocrb ) .
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Ba Ha I rryHr,, Ha cyxoxl,l!'Itfi TpaneuleBnAHoll MblrIlIIr,I. r . r ) 6 H H o f0i , 2 0 , 5 u y H e . n p r x n r a H r e l 0 l5 MrH.
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BonocIc'|oi qacru roJloBbl; B npoMexyr(e M€xIy 3arbr,']oqHon
KOCrbroU I ueiHbIM Io3BOHXOM. flpfi HaKnOHe rotoBbl BHfi3 o6o3Ha_
r8. TOq(A (broHf-3tH (lltH-u3tHb, 18vc)
qaerct cyxoxrr'lfie rpaneqreBtAsoi Mbllllllbl B Mecre, rAe oHo nptr'
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onycKaercrrax, qro ee Moxso npoqynarb. ToqKa QoHr-Oy (O3H_0y' 19 VGI

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Tondrpaot,rccxlr olrdtoitf. floa xoxHblM lloxpoaoM B paxoHe n a M r r r r , c u n b H o en o x o J r o A a H r r e uiyM B yuax, pq6b B rna-
fo'{xn gaioanrcs qepenuac (pacu8t, aanee Brry6b - qepen. 3 a x , c e p A q e 6 n e s u e ,H a p y u e H r r €c r { a .
l l o ( a 3 ar r . M e c r H D r e H a p y l l l e n f i n x H a p y u t e H l , c ' TexF!{a, nyfixqrn noa yr,roM, noqrr BAortr, l<oxHoco [oxpoBa,
c B n 3 a H H ! t e c M e p s A t { a H o M : r o n o B H a6t o n L ,p ' r { A H O C f b f,iy6xHoi 0.2 0,5 uyHn. flpnxnrsrHe l0 20 MrrH.
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O 6 u x e p a c c r p o i c 1 s ai MafilaKanbHoecocrotHre' pt66 BO3HflXaeT OU.lyUIeHHeHaflpg)KeHHOCTU,pacnHpaHnt, oHeMeHUt B
g flIa3ax. Mecre yKor'Ia ll''IH no xoAy MepnAua,la. Bo3Moxuo qyBcrBo oHeMe-
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q a H x e . uYHs.
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H KxyK qH luoi-qfi. ll Gl). npk rleqeHllxcocy!&croi HelocTaToq-
coqerarb c roqRaMr soi l<yafl (H3fi-ryanb. 6 MC) I rxlt)u-
ts. ToqKAxAv-,IlHnb(xov'[uH, l9 vc) xay (x3Hr,'vxyH, 26 VG), flpn abrnaaeHrrxnpqMoi xulnxr - c ro,r'
Jloxdrxsaqrn. A. Ha 1,5 qy8q Hnxe roqxt 6arb-xofi (6ai'xy3i' x a M f l r { u o H r - x H o 8 r ( q a H - r r q H ,M ) r riHa-coH (q3H-uaub, 57 V).
20vG). I,l36era,b nonanaHar n.,tbr B Kocrb.
B. Ha ceoearne otpe3xa nptMoi, coe/rxHsrorueiloqKH xHoHr-
3rH {qeH-q3;Hh,lE VG) H 6aih-xoi (6an-xyefi,20 VC) 2 r . T O q X AT U E H - A I H b ( U t H b - A I r l t , 2 t v C )
TdnorpaQnrecxan aHamMxt. IIoA Koxefi B pafiolle roqx,
qepenHai
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Koxa d paioxe roqi, rHHepBfiPyercs HepsoMCa. r(vrrr.
n o t t s a l t tM . ecrHHe HapyueHxt. cBt3aBHHe c 6. Ha npoAonbHoi oceBofi,rrHrrj B TeMeHHofiqacr[ roJroBbr,Ea
M e D r Irt a H O rr: ro,loBHble6oJIt. 1,5 uynr KnepeAr.r or rorrKn 6arb,xofi (6afi-xy3f,, 20 VG).
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'nqxr - qepenHagoacul,ts.non oacurei 'tepenHaiKocfb.
raurcxt, r(MoBol(pyxeHI{e.
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n o K a 3 a H xMqe. c r H b r e H a p y u e H f i r f i H a p y r u e H n t ,
q a x n i . uyHt. npl,txrraHxe 5-10 Ml|H.
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rJ|I| 6lq,rb no xoay MepxasaHa. O6urne paccrpoficrBa: 3 x r a M n c r r ,p r 6 b B r n a 3 a x .
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6. Ecalr oror8ylb ydHue paxoBlrHuBneperI x BepullHd coe_ 22.TO{KAlbtH-XOfiICt,|Hb-Xy3n.22 yC)
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npeMbr\r yrnoM x ;e npo,lonbHoi oceBo; ,rxHt{l. To loqKa 6arb xoi rxbroHr-rbrHb (udH-cnn.23 VG).
(Aat-xyei, 20 vc) 6yirer 'nexaru s {ecre Hx nepeceqel,s B }IoM oceBoi nufir! B TeMeHHofiqacrr roroBH, Ha
6, Ha fipoAonbHoift
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O o x a r a n nMe e. c r H 6 I e H a p y u e H I I x HaPyruefirt.
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O6|IlHe pacc rpofic rBa: psob u r ' ' I a J a x 6. B qeHTpe xofiqul(a Hoca.
yrnov noqrH B4orb xoxHoro noKpoBa' Tonorpa(Fr,rec[ac aEarofixr. IIoA (oxHr,rM nokDoBoM B DaiioHe
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K o x a x H H e p s { p y e r c HV n a p o ; q e p e n H H x f i e p B o B .
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MblrxI$r B pafloHeroqKn nHHepBliPylorctBerBtMri(oxHo'Mblrueq- BoArrL aKT[BHoreBpallleHriql,lrr'rbl,n6o 3To qpeBaTonoBpexAeHtleM
fioro n r'lyqeEoroHepBoB. cocyAHcroi r.r,rr HepBHoirxaH .
Koxa lrrHeDBrDYercaHeDaoMLo.
. do*"ta"r".' M i c r " u il HaplLxeHnt: Horoluas6oJlbll"Ill
7- TOqXAJ|ltET-KX|OET (nE-UIOE,7 P)
(oHTpaKTypaMblurqB o6nacT! noKTesorocycraBa. (CraoxrBrpyDqac rocxa, coearic'olqai c pyq8uM
F i a o V u t e n l l , c B t 3 a H u b I ec M e p n A s a H o M : x a u e i b ' Mep{araioM<cBernEirtrr.
(ooBoxiDKaHbe, 6poHxrarbHatacrMa.qyBcrsoPacnxPaHrta rpy!r'l Toqxaconprxexrr trepeAr€cpearDroro MepxAraHa
O6rirre p i c c r p o f i c r B a : n o B H U e H Hraet M n e p a r y pnao c epxaxaHorrer{xx .uerx'("n rn6>)
goqan (xaDaxiepnan 4,re ry6epxy.lernux 3a6o'1eBaH!fi ), cyAopor! JloxaJxsaqxc.A. Ha 1,5 uyHr Bbr e.3anrcrhr, Ecru coernHnrb
v' aerefi, HoqHofi9Bype3 naaoHr.r,cxpecrHB x npoMexyrKaMr.rMexay I n II na,rlqaMn, u
TexEx[a. flyflKuie rry6 Hofi 0,3-0,5 uyHf, nuranyra II naneq BepxHefinaAoHri, To ro,{Ka nHer-Kxroer (7P)
nDsve'raHtle. e a c \ o x t r e H f ict y x o x t '
I l p r . ty K o n a xs M e c T p
oyaeT TaM, Kyaa KocHeTcrKoHeuBbrTrHyTorona!'lbrla.
,rui ailvr,rasofi vbltrJuhlnreqa, r4e pacno'loxeH r'lyqeBonHepB.fi B 6. B Mecre nepexoaaHHxHeii ro,rirexr ayveaoi KocrrJ B ee
MecTe.rae npoxoAnT rry6oKac nlreqeBat apTeplt' npmnBonoxa- reno, Ha 1,5 uyHr Bbrrrlenyqe3anrc,rHoro cycraBa, Ha nepeAHe-
raxo a,rlre.nlioe apauleH,lelr'rH Ta|( xax 9To voxer nPxBecTfll{ BHyrpeHBeMKpae cyxoxxr'tnq Aluunofi ,raaoxxofi Mbllrl|tb| (qro6n
rDaBMeHepaaH |(pogeHocHoro cocyaa llpl,lxrraH|teHexeiaTerbHo'
nPuxrfaH&e, He aoBorllrb ao oxora' HaArr ryxoxrrxe. cJrenyercorHyrbxucT6,tanoHbtox flpe4nne,rbrc).
B KpaiiHeli cryqae, fipoBoat
Tonorpaox'recxar aiaro rr. nor KoxHUM noxposoM B pafioHe
x6o oxoroBEe py6qhl cHBxalor noaBl'lxHocrb JIoKTeBorocycraBa' roqKl] Haxoarrcr nepeaHeBHyrpeHHxi xpai cyxoxynxfl nlrrHHofi
(KvH-U3vn,6 P)
fi- TOq(A l(XOHt-TOn naAoHHoi MhrrxUbr,,4nriHHLrfi crr6aTenb I nanbqa pyxu, MecTonpll,
Kpe[I.1eHfig KtsaApaTHoro npoHaToDa K ,t!qeBoiiKocrtt,
Muuutr e paioue to,rxx annepeaiyrurrr BrrBbtu epearHHojo
Jloxajrx3alut. A. Ha 7 uyHeft BHue gattcrbg HepBa,
6. B Mecre nepeceqeHl'ttHapyxtoro xpat Mbruqbr-cynriHa,ropa Koxa nHHepBspyercrneprou C6.
tl,|Jll, HaD\xHoto Kpag 6onbuot ,alollfiofi MHuluH KOTOpagf,cHo llola3aHxr. Me cr H H e H a p y u e H r,tr: npHnyxnocrbfi 6onrt
o6o:Ha'riiicc, ecJII npou3Becrtl cru6ate'l6Hoe fi pa3l-t,t6are"1bHoe B nyqe3arracrHoMcycraBe, 6o'1n B rrpeArr,'reqbe.
aBlr)ieHxq|\ ciblo) c aopr'l30HranbHofi ?rHH,tei.npoBetreHHox Ha
Htixe H a p y u r e H u q , c B r 3 a H r r b r ec M € p n a n a H o M : K a -
7 uyHefi Bb'ue nyqe3antaTtroro cycraBa Itr'Ill Ha 5,5 [yHt
rxenb, 60rlj B rpyAu_
roKTeBorocyclaBa.
l9l
190
 O6uue p a c c r p o f i c r B a : x e , . ] T a qM o q a ,n o n l l y p l { f l ' . A u - Mbrln{r.l B paioHe roqr,in HHHepBxpylorcq B e r B r M H r p e n H f i H o f o
Jrorr,
"i;;;;. 60,,rbB ropre HapyuleHq B ueiHo_larb|no'rHoi06'14'rl, HepBa'r nyqeBHM HepBoM.
nunnhro nori vtro' rnv6HHoi0.2 0.3 uvHfl rlpxxH Koxa rHHepB,ipyerci repaoru Cd.
rasue 5 l0 nrin n o x a 3 a H xMq e. c r r r u e Hap)rueHrt: 6onx B o6,racrtr
r. Toq(A ( Hl'-Khl(ll3tlH-Unll 8P) H a p y u e u r n , c B q 3 a H H N e c M e p I t A f i a f i o [ 46: o n | l
lToqxa-6{.rDrq., tarerop x {dcrann')
no nepe,l;eHapyxHofi noBepxHocrri nreqa lt npe4n,reqbq)6ont B
Jlo|(aix3aqxc. A. B yrny6''IeHxfi Ha 3antcrbe, y ny,bcoBox Bo3l'l_ o6,racrri nr€qeBoro cycraBa, conpoioxaarcqfiect 6o,,IiMl B rpy,q!
ur.rH(IxoH) KpoBoxap(aHbe,opoHxrarbHat acrMa, (oKr'lrorll.
5 B 6oDr'.rae ,yqcBoitraplepr Ha BHyrPeHHei clopoHeHxxHeH paccrpoiicrBa: 6 ( ) " 1 fI i, l r p D n y x ' r o c r B
b ropne
O6urte
ro,rogxH,1tqesofi(ocrH, Ha I uyHb Bbilxe,]'{elanecTHoricK'1anKM Texxnxa. llynxrlrr noa yr,roM, KoHeq tr,rbl HanpaBr'leHsBepx;
Tonoroarbnqecxac aflaroMxc.non hoxHHM noKPoBovB panoHe fry6lra nyHkulrr 0,2 IryHn.
ro"nu uu^oir"t"n 6oporaa nyqeBofi aprepHr' 6opo3a2. 06pa3o- n p r, M e q a H x e- flpu,le,reHxxKoKnburapexoMeHrlyerct coqe
BaIHae c\\o)i.Hn eM vHtuublc)nHHaropaH BHyrpeHHen cropoHoll
(cHapyxr): cyxoxt'lrHe oo'bLUoH rarb c roqKofi Eoii-xyau (6MC) L rH'+yHr (sHeMepHAnaHHa,{).
fiH,rrHel fu,loBKH r\qesoi Korrx l,l36erarb fionaAannn tlrr'rbrB xpoB€HocrHfi cocya Il (oc'rh; Hc
,laaoHHot Mbruiubl H cyxoxunte o6uero crl6arent (BHyrpx);
npfiMeHrTbrp€xrpaHHyrorrlry ar'rq KpoBonycKaHLlq.
"uio*rni" cru6arenfl I flalbua fi KBaaparHblilnpot{arop (Ha aHe
6-ooogaur).
'Mbrurci
B paioHe 'ro.lxl'I aHHepBllpylorct BerBqMI'{cpealjHHoro lo. To{KA Habr'r3(lofi-u3H,r0 P)
lj ,yqeBoro HepBoB. (Toqra'pycefi, xateroPrn .ororh,)
Koxa uHHepBlrpyerct HePBoML6. Jlo(aJx3au[r. A. Ha BeHe Bo3BbruieHllflI narrbqa pyKx, no3a,qH
IloKa3axnc. Mecr H bI e H a p y ui eH tt ff: npHnyx'Iocrt" 6o"'rr.r
c Kox[eBo*daraHrH I Danbqa.
o 6 , r a c r t3 a n q c r b qH. a p y eHun, cBs3aHsHe
6. Ha ipanrue ,raaoHliofi 'r rblnbsofi noBep)tHocrefi,Ha ypoBHe
x r o p n e , 6 o n xa r p y a [ .
p x A f i a H o M : x a r t i e r b , 6 o nB .epeanH6rI nqcrHoft Kocrt (!"19 yroqHesxt Heo6xoa Mo rlllarerlhHo
O6qfl e paccrpoicrBa: J r x o p a a o q H l t3ea 6 o r e B a H r q rrpoqynarb o6a KoHqa 3Toii Kocrn).
6c3 noToBtiAe'rleHl'rg ToflorpaoxqecKac axaro xr. lloa KoxHbIM aol{poBoMa paloHe
TexHxKa: flyHKqfie r,ry6raon 0,2 qyHt. flpfixsraHlre npornBo_
roqxr HaxoAtrct BHelxHtfi Kpai xoporxoro pa3rx6arer'1t I nanbqa,
r{oporxxi crr6.arerb I na,ruua, rapyxxori fly'{oK Koporxoro crr6are-
flpxMeqaHfie. C , r e A y e rl r 3 6 e r a r bn o n a a a H a qu r J l N B a p r e _
.1lrI I fla!'lblla. I nqcTHat xocTb.
pu'o i, *oat", tleaonycrxuo norb3oBarbct rpexrpaHHoi xrnofi c MlJururi B paioHe roqKu r'rHHepBxpyrorca BerBtM, cpeartHHoro
qerbro xpoBonvcxsHllg. HepBa,
Koxa |rHHepRHpycrctnepnov C7.
9 - T O q ( A T X A I I - y E H( T A l l - K ) A H b , 9P ) n o ( a 3 a E x s .M c c r H b l e H a p y u r e H o r r : 6 o , r bs x r . j c r ' I xo ,q y -
x (areropxr {3eMne' (To!{a- ueHue xapa B,Iaaoxqx.
(CoqyscrteHrae
'i.cori"'x, " . " r , a c o n p e x e i r ' r e p { a a Ha,erux} H a p y t x e H r s ,c B 9 3 a H H , ' C C M e p U A S a U O M : f i a u l e J b .

Jloxanr3aqrrr. A. B yrry6'reHax 3a naAoHblo. O 6 ur x e p a c c'r p o ii c r B a: TeMneparypa,rorroBHat6onb,

6. Ha Mecre nepeceqeHl'{t 6opo3abljyqeBofi apreput c Jlyqe3a- 6oJrr,l,l nprnyx,locrb ts rop,1e.
nficrHoti cxr,daKofi. llpx sanfiq n HecKorbKr'lx nyqe3anflcrlHx cKra_ T€xBx|(a,flyHKqfit noA yrr'ror{,KoHerrar,rH HanpaBlreHR cropoHy
qTo6H onpeAerrTb raAoHIj.[,']y6xHanyHKuu 0,3- 0,5 uyHq.Ilprx .all[e 10-15 MfiH.
aoK creayer rlplrrHyr; raloHb K npeanreqbrc'
Har6oJrreerry6oxyrc t{3 HIlx, Kolopat lt tBljrct pp|teHrljpoM llprl ll p I M eq a r H r'. llpr r.punorapr.aHbc
pcKoMeHnyercflcuqerarb
OIlpe^eIeHI',t to(ar'IU3aUl{n ToqKL, c Bo3AeficrBlr€M Ha roq( KH Kor (16 Gl) u ctrb-qarb (5 P).
'Tono.Da{brqecxas
a E a r o l r r x t . f l o A x o x H b l M n o R p o B o MB p a i o H e
ro,{Kr Ha;o;Hlca 6()por!a ,TyqeBoi aPtepftu Eoporaa o6pa3}elctl (UAO-IXAH,!l P)
ll. ToqxA TxIEv-TXbrOHr
a , l H H L , Vp a J r r 6 a r € , ' l e MH c y x o x r r r f i e M x o p o T K o i M b l L l l u b l o . TBoat_ (Toqxa-lcroK, xareroput .repeBo')
u r e i i I n a , ; e u { c H a p } , 1 ( l ' t ) c: y x o x l ' t r x e M 6 0 , ' 1 6 u o f i, l a a o H H o r lM H u l u t ' l
n c \ x o x u J l r e M r l o B e p ) \ H o c r H o f oc r s 6 a r e r q f l a n b l r e s I s H y ' r p x| : JloKanr3awrs, A. Ha EapyxHoi c'ropoHeI 0a"1bqapyKr{,orcro}rr or
cyxo;(rrneM Artt{HHoro crr6areit I nan6qa ri r'IaAbeBHAHot Kocrlto yrrra HorreBoro!'Ioxa Ha <ToJlllttHycTperxll Merxoro 3e,'Iefiol'o
nyKa-
(Haane).

t92 t93
 6 . H a n e p e c e q e Hf i r p a H l { u b ln a A o H n o i x T H , r b x o i i n o B e p x H o c r € i Irylo noBepxHocTbnr'reqar laree Ha nepeaHrolocTopoHyal(poMHofia
n y q e B o i c r o p o H b r p y x r i c n o n e p e q H o i ir t H l r e f i , n p o B e a e H x o i q e p e s Iro[aTxx, 3aT€Mqepe3n,leqeBot cycraB noatftMaeTcc x uee r nluy,
yror'I HorTeBoro ?roxa. oru6aer BepxHIoIory6y, r,4e B ToLIKerxl.oH-Kay(26VG) Bcrpeqaercq
Tonorpao rccxar aEaroxxr. [Ioa KoxHHM noKposoM B paioHe co cBorM MepsarasoM-ABofiHxxoM c nporuBononoxHofi croporbr.^3-a_
TOqXI HaXOAtTCg l(OCTb,MeCIO npHxpenneHIr K XOCTLCyXOX(I,I!'Iltt KaBqrBaercr MepfiaraHTorcrofi xrruxlr B ToqKeHreHb_xHoHr(20 cl),
a r n H H o r o p a 3 r r 6 a , e n t I n a , r 6 r r ap y K x . \' hpHJraHocara nporraonoaoxxoficropoHe(pHc.65 ),
M6rlrqbr B pafiofie ro,rxr nHrrepsspyrorcfi BerBbro ny:reBoro HepBa, Jlor<a3arlnc.flireuuelre reMneparipblre,ra. Hap]ueHHHB 06'
Koxa firHepBrpyertr uepeou C7. naCTqtO'lOBbI,ytnen, rr'Ias, gOCa,nOJIOCTIIpTa' KriUeqHIrI(a.
I l o ( a 3 a H r r .M e c r H b r e H a p y u e B n r : 6 o r ' r sb TaxHxxa, npt ao3AeficrBrnHa roqxH IIarbIreB,xtcrr, 3anecrbt t
(oHTpaKTypaMHuru naJrb{eB. rpeArJreqbr ro,loxesqe pyxq 6ortHoro ,laaoHblo BHt3 r'1l{6oKricrb
n a p y t l r e H r , r cr ,B r 3 a H H 6 t e c M e p E A H a H o M : Ha pe6p€, cnerKa pa3BePHyraraaoH6lo BBePx;
- Ha roqxy xxyx-qti (l I GI) - npeanne,rbecorHyro noa npflMbIM
O 6 q r e p a c c r p o i c r B a: 3a6onesaHrq or naroreHHbrx yrnoM r( nr'leqy,xrcr6 npnxaTa K xnBory;
(DaKTopoB <Bmpar, KoMa,BLrcoKarreMneparypa,rfixu, 6oJrbB ropr'1e, - fla ToqKfinneqa - 6o,'rbHofi"lexHr unu cuALtT,pyKa corHyTa,'l
onyxaHte qer'1rccTt,fl3bll(4, HocoBoeKpoBoreqeHrre. npnxaTa ( xlBoTy;
T€xarxa. Kocaf, rroAr(oxHar nyHxqrr, KoHeqHrnbr HanpaBneHB - fia roq(y KreH-HryHr(l5GI) pyKHpaccraBneHbl B cropoHhl
cropoHyrcrcrr. nyHKqfir rny6HHoi 0,1 qyHc. llpI, BLrcoKofireMnepa- I,lrH onYIIleHbIBAO!'Ib
Ter'Ia;
Type, xoMe,ocfpoM Bocnar'reHr.ru ropna pexoMeHAyercrnyHKqfir Tpex- - Ha TOqKI lxel. ?rr[a 6o,']bHotnexlT Ha cflxHe {nu cstrIlr,
rpaHHofirfnofi c qeJIbIoKpoBonycKaHns. 3anpoK'rHyB roroBy Ha3aa.
n p n M eqa H Ir e. flpn ocrpoM Bocna!'reH!{MnHAarrH pexoMeH-
ayercr coqerarb xpoBonycKaHse B Toq(e rxrey-TxbroHr ( I I P) c [yHx-
L TOq(A rxbronr-3blollr (uAH-qH, I Gt)
uxeft B ro'rKy xon-xoK(4 GI) (Toq{a-{cro{, xar€roprx .Mera.rrr)
Heo6xoaflMofi36erarb nonaaaHljt ltfrhl B Kocrb B gToMyqacrKe
floBHlneBHOfi rIyBCTBHTerbHOCfi, flOCXO,'Ibl<y,laKat nyHXUHr 8613HBaeT
ocrpyro 6onb. Jlotarrsaqxc. A, Ha II aa,lLqe pyKll, co cropoHblI naJlLua,orcrour or
vrl'ra HorTeBoro"Ioxa Ha TonurrHy <cTpe!'lK|lMeJIKoro3eJIeHOrO JIyKa-
pv{Hofr tHcKI,lfi MEPl,l,[xAH TOJICTOfrKt'lll]Kt-l (Gl)
6. Ha rpaHque,'raroHHofin rLlnbfiofi noBepxHocrei JlyqeBoficro_
(ro 20 roq€( c l€xron cropoHn) poHbrpyK[ c nonepeqHofillrlHllefi,npoBeAeHHoiqep€3yron HorreBoro
XoA x€plA[asa. Haq Haercqc roqK]trxbloHr_3uoHr (uaH_qH,I GI) r'loxa.
BHeuHero yrna HorTesoro noxa ll na'Ibua, qepe3IIpoMe_
npoxoAfir Tonorpaox{ec(as aHaro rlq. IIoa koxHbIM noKpoBoMB panoHe
v
it"rox "exay I u Il ntcrHglMx xocrrMu x aaaloMnqec(oftTa6aKepKe, roqxr Haxoaf,TctHapyxHas cTopoHaMecTanpltKpenneHrtcyxoxu-
noAHriMaeTcffBAor'r6HapyxHoir noBepxHocrnnpeanneqhf, IrepecexaeT ,rrr ll na,1bua,l,|4]rueroor pa3rx6alent nar'lbueBHapyxHbli Kpaff
,5OKTeBOfiCyCTaB nO ero fiapyxHoi noBepxHocrll,BHxoasr Ha Hapyx_ III {ba,laHruIl nanhua.
Muuruu s pafioxe rouKIr tHHepBll_pylorcq BerBbIonyqeBoro HepBa.
Koxa anxdpwpyercn HepBaMI
C5-C7.
l l o [ a 3 a H x s .M e c r H H e HapyrueHfit: o H € M e H lxe. r l l rl l ' l x
MbIIUll NAJIbIICB,
H a p y u e H r f l , c B q 3 a H H L I ec M e p a a r a H o M : 6 o t l B
't
o6,1acrun,reqeBorocycraBa c uppaaBaqnei B HaAK"lloqqHylo sMxy'
6onh B rop,re, 3y68ac 6onb, 6oaa u npxnyx'rocrl qe"Ilocrefi,pt6l' B
rJ1a3a1,rryxoTa, lllyM B yuax.
O6lllrse D a c c r D o i c r B a: 3a6oneBassq or Bo3n€tcrBxqna
ToreHlbu (baxiopoB <BeTpa>,KoMa, noBbllxeHxeleMneparypbl Tera
6e3 noroorae,leExi.
TexEw(a. nyHKqnc noa yrJIoMrKoHeut'lrrbr HanpaBrrreH B cropoHy
xrrcr . f,'ry6[Ha nyHKllrx 0,1 qyBq. npfi BHcoKoil reMneparype,
xoMe cJeIyeT npor.{3aecTfiKpoBonycKaHXec noMousro TpexrpaH-
Plrc.65. HOtlrr!'Ibt,
194 195
2. TOqKA$ll-3tH (9P-U3{rlb,2 Al) B. Ecnr pa3Becrri6o,,rbuoriH yKa3arenbHLlfina,lbqbl oaHoi pyx,
(Idq{!-pycen. mnocxrci i xarerop{x .EoAr') H noroxr,rTb 6onbuofi na,req apyrofi pyxt Mexay HUMrlHa ypoBHe
cxrarxg Mexay I ri II Oa,'raHnaMu, ro roq(a xon-KoK(4 GI) npxAe,cq
JloKaJx3aql|c. A, B yr,ry6,reHUI,nepea nrcrHo-(pa!'raHroBbrM cycra- Ha npoMexyror{ MexAy I s II nrcTHbtMu(ocTsMr,r,B ToM MecTe,xyAa
soM II na,rsqa pyxfl co cropoHhr I nanbua, (ocHeTcq Kofieq 6oft,uoro na,'rbqa (puc. 66). npr HaaaBJItBaHutl
6. Ha rDaHaqe naAoHHofil, Tr,rnbHofinoB€pxHocrefipyKlr, Ha Ha 9TOMecro BO3HfiKaeT Har6oree OCTpOe OrqyrueHne6o,'rlt,KoTopoe
thrnr,Hoi noBepxHocrxII na'!bua, fia yposHe llepexoaa aucraJlbloro MOXet [ppaAuupoBaTbB clopoHy Mr,r3IlHua,
(oHqa I oanaHrr{ a re.,Io(pa,laHrlr,raM, rAe xocrb ltplrHtMaer Ayro_ Toqxa pacnonoxeHa B yrny6neH n MexAy ,rarepa,,rbHofiBeHoi
o6pa3HyroQopMy. Harbrnbfioficropole Klrcrtr { II ntcrHofi (ocrhlo, Ha ypoBlrenepexoaa
TonorpaorqecxaraHaroMrq.noa KoxH6rMnoKpoBoMB paioHe npoxcrrMaJr6Horo KoHrlaB feJlo II ngcrHofi xocr!. yrny6reHrie 0603Ha-
TOtIKt }Ia)(OAgTCq CyxOXIlJInt THnbHbIX MeXKOCTHLIX Mblrxq, EOCTb. qlrTci. eorfi Da3BecT[I r ll nanbubr.
MH uH B pafio8ero,rKn nHHepBlrpyrorcq BerBLtonyqeBoro HepBa. Tonorpa$r,recrar aHaro fir. noa KoxHbtM noKpoBoMB paiioHe
Koxa rHHepBrpyercn sa ypoBHeCvr-Cvrr.
HepBaMH TOqXft HaXOAqrCt Tbt.rlbHble Mex(ocTHble MbIt!IIbr, BepxHI,Ifi Kpafi
I l o K a 3 a f l r { rM
. ecrHbre HapyueHrq: 6ona B o6nacrll Mhlrrrlbr,npuBoaruefi I naneq, BHyrpeHHUfi xpafi cyxoxsnfit AnuHEo-
ro pa3ru6aTenq I flanbqa,
HapyureHrrr, cBfl3aHHbrec MepHanaHoM: 6oJILr MLruqbr B pafioHe roqx! riHHepBr.rpylorcs BerBsMI,rI'IoxreBonou
B o6Jacrr n,reqa,flreqeBorocycraBa, 60!'rbB rop,Ie, 3y6Hafl60,rb,npH- rrvqeBoao
' HeoBoB.
nyx,locTbB 06,1acTl,tqer'rrocTei,
onyueHre yrlra pTa, HocoBoe(poBore- Koxa nixeparpyercn xepnaua C6-C7.
qeHue.Dfl6b B r"1a3ax, I l o [ a 3 a H x rM
. ecrHbre HapyueHHr: 6onr { oH€MeHre
O6 u I e p a cc rp ofi cr B a: nrxopaaoqHble3a6o,reBaHltt. Kr.rcTriri nanLqeB pyKlr.
Texxlxa. fIoAKoxHat nyHK(ut, noqrlr BAo,/lbKoxHoro noxpoBa. Hapy e H n r , c B f l 3 a H H b r ec M e p L A ! a H o M : 6 0 , ! r
fny6rHa flyHKunn0,2-0,3 qyHe.llprxfiraHxe 5 l0 Mr.rH. B o6rracrHn-4eqa,nreqeBorocycraBa, 6onb B ropne, 3y6Hat 60,1b,Ipll-
nyxnocTb nn{a, naparl,Iq JII{IIeBoto HepBa, HocoBoeKpoBoTerreHrie,
rl. TO{KATAM-3'H(CAHt}"U3ttlb.
i}Cl) [lyM B ylxax,6O,!b B O6,racrt ara3.
(To{xa-par",u, rareropxr .^!p€ror) O 6 u u e p a c c r p o i i c r B a : 3 a 6 o n e B a H sBf lb, r 3 B a H HrHa er o -
reHrbrM(FaKfopoM<Berpa), B6rcoxacTeMnepaTypa rera 6e3IIoTOOTAe_
Jloxa"rr3aqric.A. p yr,,ry6,'rerul3a aHcrar'rl,HbrM
noHuoMII nqcrHoi .[eH|1r,roroaHan 6on6, aMeHopet,rfinepr ap03.
KOCTIiCO CTOpOHLII narbUa. TcxHrr(a. nyHKutr'I DoA nptrMhrMyr,IoM rry6 Hoi 0,3-0,7 uyHq
6. Ha rpaBxrre naaoHHofi n rblr'IbHoti lloBepxHocreii pyKti, Ha flpxxxraHre 10 20 MHH.
HapyxHoM Kpa€ II na,lbqa, Ha ypoBHe nepexoAa npo(c[MarrbHoro npuMeqaHIrt. L np& o6ure tr,loaxalrbre3ltupeI(oMeHAy_
KoHua II 6a,1aHrn B Teno oa,'raHrr. ercn coqeraTbc ro.rxoii xofi:xyaH16MC).
Tonorp_a{nuecxan axaro xc. Iloa KoXHLIM noKpoBoM B pafioHe 2. llporxBonoKa3aHoBo3aeficrBfieHa roqKy xon-xoK (4 Gl) B Ha_
TOqKr HaXOAtTCqrbL'IhHbIeMe}KKOCfHHeMbIllll.lH, MbIlIUa, npXBOAH_ qane 6epeMe8lrocrn,Tax KaK3To Moxer npltBecrfi K BuKI,IAbIlIly; c,le-
urae 6onLuofi na!'Ielr Kscrri. ayer ocieperarbct nonaAaHlrqtrn6r B_xp;BeHocHblfi cocya Bo li36e-
MHlUuH B pafioHe ro,{Kn uHHepBIpyrorct BerBtMI,r!'IyrleBoro HepBa. xaHue noaxoxHoro KpoBot3!'luflHllt-llocne u3Br'leqeHrqqrrL,I Heoo-
Koxa lHHepB{pyercq HepBaML,C6-C7. xoauMoTuaTenbHo npbaeprrr,xer,rr aapyureHttcocyaa
no|(a3a8rt. M e c r B br e H a p y rx e x t t: npfinyx!'Iocrt 6onq
B O6racTr nanLueB t xllcTll. '. TOq(A jl,loHl _(xf (lH'Cl'1.6 Cl)
HapyueHrt, c B t 3 a H H b I e c M e p I t a I r a H o M :3 y 6 H a t
(Toqxa-6Hctpxra, f,arcropxr .oron6,,
6onr.66,ri a Hrxnei qer'ilocrlr,6orx B o6nacr; xtBora, ocrpae 6onL
B O6racT& r!'Ia3. Jlorarx3aqrr. A- B yrry6neHnlt Ha 3antcrbe, Mexay cyxoxrnutMri
Tex8x|(a. [IyHKqnt floa nptMLIM yr,1oM, rny6fiHofi 0,3-0.7 qyHc. 6. Ec-'rupacnonoxurr' Kucrb r'raaoHbroxBepxy, cr'lerxa xaxr'loHnB
IIpuxlrrafine l0-20 nttx. ee B cropoHy I nanblla, To Mexly cyxoxtrr'lucMripa31116aTerq n MbIrII-
qbr, orBoarqei 6o,'1hruoftna,1eq (rcTlr, o6o3Haqxrct tMKa, Ha aHe
4. TO{KA XOn-(OX (X3-tv. 4 lil) KOTOpOiIpourynHsaercf,rxr,losrr4Hhrfr oTpocTor(,lyqeBoi KocTx
( Toqxa-noco6xr{} To,rxa :uoir-Kxe (5cl) pacnonor{eHaBflnorHyloK xoHuy tloro
o,rpocTxa.
JloKaJrx3aqxc. A. B yr,ry6neHlrt MexAy KocrtML 60'rhlxoro t,l yKa3a' Tonorpaofl'rccxar aflaroMnfl. IIoa KoxHbIM noxpoBoMB paffoHe
Ter'rbxoto na{'IbueB. TOqKtHaXOAtrCt(OHeIIIuIJIOB|AHOTO OTpOCf(ar'lyqeBoiXocTH,Bepx-
196 ls7
 H { i x p a f i , ' r a a b e B H A H o lf(i o c r x , c H a p } x H o i c r o p o H b l c y x o r : ( t i r H e
a J l r . r H H o iM t r u r u b r , o r B o A f , u e i I n a ' 1 e ' 1 . f i x o p o r K t i f i p a 3 r l r 6 a 1 e r b
6o,rbuoro naJtbua Kncru, c BHyrpeHHefi cropoHhl cyxoxll"IlHe ar'lI'IH_
rroro pa3rn6aTer'lB 6onr, oro flathua fl cyxoxl'trl,e cynlrHaTopa.
MbruruH B pafioHe roqKfi tHH€pBtpyrorcq BerBtMH nyqeBoro HepBa
Koxa lHHepalpyerca HepBoM Ls,
--TrtreH-a,Hb (17G1) n o K a 3 a Hi . M e c r n u e HapyllleHHt: 6 o " I bB o 6 " I a c r t3ra -

HapyureHLrt, cBt3aHHbIe c MepHAHaHoM: HoIo_

Illlat 6onb B o6nacTli noKTeBoro l{ nJleqeBoro cycTaBoB, nnella' npea_
__ x , e H B r y B r( 1 5 G 1 )
rllreqbr,60,,16 B rop,'Ie,3y6Haq 60,16; 6o'rb B r'ra3ax r lloKpacHeHue fix'
uyM a yuax, rnyxoTa.
O 6 ur x e p a c c r p o fi c r B a: BbrcoKat reMneparypa, ouly,ure_
Hne flepenonHe;nocTlr u crecxerruq B rpyafi, ollblltll(a, npxcrynbl 6pe_
]1OBOrOCOCTOqXfiC. rOrOBXaq OOrb,
Texxrxa. IJvnxqrs noa nptMblv \rr'IoM, Bronb ue!'lr Mexay
^ o c r e M H .f n y 6 x ; a n y H K u r . t H 0.3 0.4 uyia. flplxrranle l0- l5 MrH.
[l p r v e r a H I e . l l p r i e q e H l , t x n p H n y x J o c r t H 6 o r f i B o6,1acrtt
_rd B r c( 1 4 c t )
r a n q c T b qp e K o M e H A l e l c t c o ' l e T a T bc T o q x o f ii t ' l e T _ x x o e r ( 7 P )

-Hrv -rtr (13G1)
H r y Rc h ( l r G l )
- Try-raM nr (10O )
. T x s o H r - i t r e M( 9 G r )
H,-3FH (2Gl)
6 . T O q ( A I X I I E H - J I l t T b( n t r | b - n f i , 6 c D
(Cra6ru 3xpybuat roq(a, coearHtourat c pyqljuu rHbc(nM
MepxaxaBoMnerKn)
Jloxa,lr3aurq. A. Ha 3 [vHr Bbrue 3anrcrbq.
6 . H a , r a s r u , c o e a x H s t o q e i r o . I x r . i3 N o H r _ x x e ( 5 G l ) Y
( l I G I ) , f i a 3 u y H f l B b l u e n e p B o f iL H a 9 , 5 u y H e H n x e B r o p o f i .B yrny6
J-reFunMexay Koporx M pagrn6are,'reM I,I aJruHHof, Mbluuei, orBoat-
lLrefi 6onbuofi narelr KHcrI,t.
Tonorparbxqec(aq anaro tc. floa KoxHbIM noKpoBoM B pafioHe
roqKn HaroarTcr xoporxlifi pa3rl,16are"1b60,lbuoro nar'ILila, aJIfiHHat
Mbrruua. orBoarrqaq 6onbfiofi na,,req KncTLr.
M b r r x u H B p a f i o n er o ' r x H H H H e p B x p y t ocrl B e r B q M Hn y q e a o f o H e p a a
K O x a I H H e p a r p y e r c a H e p B o ML 3 .
lloxa3aHt, MecrHL'Ie HapymeHfit: 6onri B o6nacrt
npeanr'leqbq r, 3antcTbt.
H a p y r u e H r { t , c B t 3 a H H b I e c M e p I r A f i a H o M : 6 o t ' IB x
o6nacrr lt,teqa, nr'leqeBoro cycraBa, 60,rb B rop'Ie, fiocoBoe (poBore-
'{eHxe, ruyM B yuax, rnyxola, floxpacHeHlle x 60nb B o6nacrfi rna3'
oc,ra6reHfie 3pexHt.
O 6 u n e p a c cr p ofi c r B a: oreKl (Kax clrMnro}l nopaxeHuq
,lerxnx).
TexHrxa, IIyHKqLrfl rny6tHoi 0,3 0,4 uyHt. npxxxraHue l0-
20 Mr.rs.

7. TOrt(A OH-Jltrlv (A3Hb-JllO. 7 Gl)

JloKanr3aurc. A, 3a 3anqcrbeM, y B3poc!'IblxBbIUe Ha 5 qyHefi, y ae-

Pxc. 66. MepNA,.H ror<toi 8,ur, <c.6rnhrt ,3'. ren Ha 6 u.yHei.
 H a p y u r e n u r , c B e 3 a H H H e c M e p r a x a H o M : 6 0 ' 1 '6
6, Ha ,rrxra, coeafiHtloqefi ToqKI,t3HoHr-xxe (5Gl) q Kxy(-qx oHeMeH;aB o6nacrx nreqa, napa,{&q BepxHIrx KoH€qHOCTefi, r'lOMqulaq
( I I GI), Ha paccrotHflfi 5 qy ei or nepBofi I,l7,5 uyHtl - or Bropoi. n o " l b B 0 6 , 1 a c r Hn r e q e B o r o c y c l a B a H r x e x , y p q a H r e 6 o J l t rB - x r l B o l t '
B yr,ry6reHfiHsaa r'lyqeBoirKocT|ro,(oropoe xoporuo o6o3Haqaerct, TexHxxa. flyHxu,{q rtoa npqvH\,I ylnov lr}6liHon u.J-u.b u}Hq
ecllfi cxalb KHcTh B KynaK.
llpr{xfiraHxe l0 20 MxH
Tonorpao[qecxac anaroM c. floA xoxHtIM noKpoBoMB pa,ioHe
Toqxx HaxoAtrctrcyxoxtnte l-ro x 2-ro cynxHaropoB,rJIIrHHatMbrlx-
[a, oTBoAgulag6onbuoi naneu Klrcrfi, !'IyqeBat xocTb, t0. To'lKA TXy:tAM-Jllt (llloy-c^Hb-Jlx, l0 cl)
MbrrrtrbrB paioHe roqKx sHHepBupylorcqBerBqMfirryqcBoroHepBa. Jloxan saq{i. A. Ha 2 uyHfl Hnxe xxyK qa (ll G ), npl, HaaaB,r,-
Koxa nHHepBBpyercq uepsou Cr. s a o x n H a M b l r u q y n p e l ( f l n e q r , sB p a i o H e
'roqxl, ro{annsaqt{ti roql{}l
I l o { a 3 a H r c ,M e c r H b I e HapyrlleH t: 6on, B o6nacr sbrcTylaeT peJtbe(Fxo; To'IKa pacnonoxeHa B Haqaae Mblrxqsl npeA-
npennreqbt,
H a p y u e H t t , c B r 3 a H H b r ec M e p t a r a H o M : o o , l l t 6. Ha rvnul, coealrHtloruei roqKli 3HoHr'xxe (5 GI) tt xxyx-uu
s o6nacrll fl,leqa,n,leqeBorocycraBa, 6onh B ropre, oDyrnocrb nxqa, t l l C l ) , H a 2 r l l H q H x e B l o p o i H H a 1 0 5 t r l u r e o t u r en e p e o t r '
60,16B 93NKe,ocrpbl€ 6or''IllB xtBore. I onorgaox'rec xaq aHaroMxfl. flo,a l{oxfiHv noKpoBoM B palroHe
Tex8rxa. flyHKqn'{ noa npsMr,tMyf''loM r'1y6xHofi0,3 0,5 lly q. r c q K a n a i o a q r c H 3 a a H B i ix p a i a n s H H o f i , l a a o H H o i M H u J q 6 IK
, oporKat
nprxuraHue l0 20 MtH. . , r : r A o H H aM t 6 J l u I I a , , l y q e a a 9l ( o c r b -
MHruql,r B parioHe roqxt qxHepsspylorctr BerBqMfi JyqeBoro HepBa
l'tEM(Ct-,rtHh,30r)
L TOqKAXA-"'l K o x a r u r e p a t r p y e r c a H e p B o MC d .
l l o | ( a 3 a 8 l | s . M e c r H I ' I e H a p y [ J e x x t l : 6 o a x B o 6 ' ' I a c r an o K -
Jloxa,Ir3aqnfl. A, 3a JyqeBoi Kocrblo,Ha I uyru atxe ro'rxn rxuonr'
rxeM l9 Gl). H a p y u e u a a. c B t 3 a H H br e c M e p l'{ a fi a H o M: napantrq
6. Ha ,'rnxrn, coealrHflIouefiToqKfi 3broHr-Kxe(5 GI) u xxyx_qtl epxHtrx KoHeqHocreil,,'IoMqqas 6onb B o6!'Iacrx nreqeBoro cycTaBa
t l l C I ) . H a 4 u l H q H f i x e s l o p o i H H a 8 . 5 u ) H t s N U r en e p B " n , r r u r ' H , 6 o n HB x H B o r e . l o u H n r a , p B o r l .
Tonorpaorq€cxaf,aHaroMxg.[lor1 xoxHHv noKpoBo\4 B paioHc
Texfirxa. flyHxlufl IIoa llpgMr'rM yrnoM rlry6l,rofi 0,5 l'{) uyxq'
l.oqKr{HaXOATTCq 3aAfiLji Kpafi A,lrHHOi ,'raAOHHOfi Mftullltll, HapyxHbll
l l n H x f l f a H t r el l ) 2 0 M H
K p a i i c y n u H a r o p a , K o p o r K a q r a , 4 o H H a qM H r x I l a . n y q e B a s x o c r l '
n p I v e , { a H H e . l l p r n u n a l ] c H q }r r n b l s r u q K y y 6 o n b H o r ' B ' o,3
MbrUlIq6l B pafioHe roqxs lHHepBrpylorct BerBsMt 'ry'{eBoro
r r R a e r o r q y l c H t r e H a n p q x e H H o c l f i ,p a c n t p a H r q B M e c r e y ( o i a ' r l , 6 c )
HepBa. ri() xoIV MepHAraHa.Huoraa sa6'rrcaaerca oqyueHxe, aoao6Hoe
Koxa tHHepBupyercq repnou Cz. u o a a e i l i r r r r c e " r e K r p H q € c K o rroo K a ( < y A a p r o x o M ) ) .
noxa3a rc.MecrHHe H a py uIe HIr 9:6onq B o6racrt npeA-
nieqbt r'r r'IoKleBoro cycTaBa.
H a p y u e f i t , l f l , c B ' { 3 a H H b I € c M e p H A f i a H o M : 6 o n l rB . TOt(A KXy(-qlt (ulon,ql't, lt ot)
o6nacrt )xt{Bora. ( T o ci r - y c r F . hate'opx{ 'reqnc')
T€xfirxa. flyHKqrit noa npflMtiM yrnoM r"ryorHofi 0,3 0,5 uyHtl. ,loxanfisaqni. A. B yr'rry6,'IeHnfiy BHerufierc I(oHqa nonepeqHol nol{Te-
flprxxraHtle l0-20 MtrH. lloi cKlaAXH. Koropar tcHo o6o3Haqaercfl npr crx6aHnL pyx| B noxre,
6- Ecnr corHyrb py(y B no(TeBoM cycraB€ ral{, qro6Ll,raAoHb
(UIAH-,ltHb, 0 Cl)
I TO'{(A TXbtOHr-"'IUEM Jerrla Ha rpyah, To gcHo o6o3HaqrTcfl !'IoxTeBat cK,'IaAXa- tlaqaJlo
f(.q3axri npll ra(oM llolrox€Hlill pyKx I ecrb Mecro pacnonoxeHttl
Jloxanx3aqlr. A- Ha I uyub Hrxe roqx! rxy'rau',rx (10 GI). rouxr.r. flyrxqr,ro npou3Boatr B no,loxeHx pyKH, coruyrou noa
6. Ha ,lrrHfifi, coeaxHsoqefi ToqKx 3broHr-Kxe (5 GI) fi KXyK-qL
(ll GI), Ha 3 uyxa nrxe Bropoii ,i Ha 9,5 uyHe Br ue nepBoir. '
Tonor:parlnvecxar afiaroMH'r. floa (oxHblM noxpoBoM.B P a t o H e
T o n o r p a + x q e c x a r a H a r o i r l | r . n o a K o x H H M . . I I o x p o B o MB p a i n H e roqKfi fiaxoaflTcq MecTonptKpenreHtt a"IHHHOft lIaAOl]HOi
TOqXr HaXOAf,TCT 3aAHrji Kpaii A,1rlHHOfi ,raAOHHOfiM6rr {bI, sapyxHbli ,)IrHarop. KoporKatIaIoHHae MHUlua.noxreBoi cycTaB
Kpai cynrHaTopat xopoTKat raAoHHafl MbIruqa, ryqeBat Kocrb. MHuuhl B pafioHeroqxu IHHepBnpylorct BerBtMIinyqeaoro HepBa'
Mbrurqbl B pafiose roqkr., xHHepBxpyrorcff BerBqMr ryqeBoro Koxa rHHepBrpYercfl HepaoML6.
HepBa, I l o x a g a t x s .M € c r H b I e H a p y u e H I e : 6 o , r ] b x n p u n y x n o c f t '
Koxa [HHepBnpyercq HepBoMC7. B 06,1acrr,rno(TeBoro cycraBa,
n o x a 3 a x n nM. e c r H b r e H a p y r n e H u q : 60,'rb ri ofi'eMefiue B H a p y u-re n u t, c B t 3 a H H H e c M e p,t a Il a H o M: noHl'l-
o6nac'ru npeAnneqbt.
201
200
xeHHHfrMH eqHHi rOHyCplKr. napa,lHq BepxHxxr{oHeqHocrei. n o r v e q a x r . re . B n e K o r o p H x r p y n a x y K o r b r l r r o q x y l x y _ H r y r l ,
,oMtlllat 60Jlb a 06,lacTu BeDxHuxKoHeqHocrei. rl3 GI) aonycxarorcs. tlynxutn rny6xHoi 0.3 0.5 uyHt 14r.[hl
O 6 Drx e p a ccr p o i cr B a: TeMneparypa,a,'r,reprrqecKat ,4o"'rxHH 6brrr, KopoTKHM , pa3apaxeHxe - HecI'tr'1bHbIM
cbrn6,oypyHKyne3,3KeMa.
Texxrra. IIyHKqfis noa nprMbrMyrnorv r,ry6nHofi 0,8 1,5 qyrq. 1 4 ,T O r t ( A T b t - H l o ( 6 I - H A O . 1 4 G t )
flplixuraHte l0-20 MnH. (Io.rxa-ycrbc pyqrono Mcpxarana <cBetntn nB,, Mcclo coeaxdeHric
II px MeqaHre. npr,re,{eHsfi arreprrqecxrx 3a6o,,reBaHnft c {apyx{ir roaaepxxuaoqrir MepraxaEoM,
pexoMeHAyercq colreraHre c roqxaMlr rxafi-cyHr (3 F) r x()er-xafi pycxHf, x oxru ileprlraHaH{ .Benrrrl cH.)
(10 RP). npr BblcoKoi TeMneparypere,Ia coqerar6 c roqKaMll
Aan-rron (14 VG), xon-Kox(4 GI) n rxan-ryeH (PC 86). JloKanx3aqxt. A, Ha 7 uyseit Bhllr'le,!ol{Ttl, B BepxHetl qacr,l MHllIll
?/, (cxt3y) ,TlrHfit, coeariHflIoqefi noKTeBoi
12.foqKA lbty-Jll,tEv(qxov-nto, 12 Gt) B, Ha paccrotfixri
c y c r a B c K o H u o Mn o a M H U e q H o f tc K . / l a r x ! . H a ) p o B H e H n e p e a _ M e c r o M
Jloxa.rx3aqrlx,A. Bo BnaAnHe, KHapyxHor M6rure.rrKa n,'reqeBofi KocTfi, i H U l l l h lx n n e q e B o i K o c r r 1 '
n'b n x p e n , r e r a r B e p x y u r K H, A e n b l o B x t r H o fM
6. Ha HapyxrioM _paccrorxalKpae nrrcqeBoi xocTr. Ha BepxHeM orpocrKe ee T b n o r p a r S r r e c x a n a x a r o u n c . n o a K o ) K H H Mn o K p o s o v B p a t o H e
MHLuerrxa. H; I.5 uyxn or rovxa xxyx-vr.r{ll Gl) {Ha r o q x H H a \ o A t l T c e B e p L ! l { H aA e n b r o B H A H o rMi b l l l i u b i .H a p y , X l { b l nK p a I r
paccrorHrr! '/6 yqacTKa,1rrHHr,npoBeaeHHoff or roKTeBoro cycTaBa MLIrx[bI, MecTo nplrKpenneHtt fl,'IeqeBon MH[IqbI' no3a-
aByrnaBoi -
ao KoHqanepeaHefinoAMHOeqHoficKJraal{lr). Ar - HapyxHafi ruxpoKat qac'rh TpexrlraBoi MbIluuH n!'Ieqa, aaflee
TonorpaQrqecxar aHaroMrs. flol l(o)t(HUMnoxpoBorvB paftoHe
TOqKH HaXOArrCr6OpO3A(a,O6pa3OBaHHaC rpexrnaBOi M6rlllUeinre- Mur ubr B pairoHe ror{Kx rHfiepBxpylorcq orBerB,neHreM noaMH-
qa (y ee Hapyxflofi urpo(ofi qacrr) H MecroMnp Kpen!'reHsH aqfiH- HepBa flreqa t r'lyqeBofo
uerlHoro HepBa, BeTBHMLXO)t(HO-MblluerIHOrO
HOrOCynlHaropa, npoHaTop,nyqeBaq xocrb. HepBa.
Mbrujqbr B pafloHe roqKr rrHHepB'rpyrorcrBerBtMtt flyqeBoro Koxa uHHepBt{pyercq HePBoM L4.
HepBa, noraraxnc. MecrHHe HapyueHnt: l r o M t l q a q6 o ! ' l bB
Koxa nHfiepBnpyercffuepoou Cs. o6racrx n,Ieqa, rrnoroHt{n lvbllxu pyKH.
l l o r a l a a n c .M e c r H u e H a p y u l I e x r i g : 6 o , 1 kB o 6 " ' r a c rnf oi x - HapyurenIs, cB'{3aHHHe c MeprAriaHoM: r'IoMq_
TeBOTOCyCTaBa. uras 6oii s roKreBoM cycraae, ry6epKynBHblfi,lrM(DaAeHrr
f l a p y u e H r t r , c B t 3 a H H b re c M e p s A f i a H o M : T x x } { I l Texs ra. nyHxqlrt noA npflMbrM ir'IciM, rny6fiHofi 0,5 0'7 {yHt.
oHeMeHlleMHnlIq pyKlr. IlprxsraHlle l0-20 Ml,l8.
Tcxfix|(a, IIyHKqfic noa nprMbrM yrrroM r,'ry6uHoii 0,3 0,5 IryHq.
flpfixxraHHe l0-20 uuH.
15. rO'tl(A hHtH-HllHr (UJiHtr-1Ofi. ls (]l)
(Toc'(a conpcxeHrc pyqHoro yep{rraHa.cBernun c{o c Hap}xnHM
13. TOqXA TXv-Hrv-r'lll (lllOv-v-J'lll, l3 Cl) neroqHuM Mepxa'aHoM)
JloxaJrsaq{c. A. Ha 3 uyHH Bbrue no(Tr, no xoay KpynHolo KpoBe-
HOCHOTO COCyna. Jloxanx3aqttt. A. B yr,ry6"1eHtIr, 06pa3yrorireMcanpx noaHtroM
6. Bn,lorHylo ( (parc n,1eqeBofiKocTrj, sa paccTorHr.lrr
'/3 (cHs3y) nonoxeHnx nreqa B npoMexyrKe MexAy xocrtMr n.rleqeBoro cycTaBa-
J l H H l r l l .c o e a f i H g t o l l l e i , 1 o K T e s o f i c y c T a B c x o H u o M n o 4 v b I U e ' ] H o i 6. B npouexyrxe Mex,4y al(poMr'roHoM nonarxt L 6oJIblxl'IMBep-
cxJraAXt; Ha HapyxHo3alnet roBepxHocTs nreqa, rer'1oMflJreqeBofiKocrq, BnnoTHylox nepeaHeMyKparc aKpoMI'IoHa
Tonorpat0$qacxac aEaroxr{c. IIon xoxHHM noxpoBoM B paioHe qTo66ryroqHs , ,'IoKa!'rngaqrlo roq(ll, cneAyer fia ouynL onperenuft,
TOqKr HaXOACTCCHapyXHaC rDrpoxar qacTb Tpexr!'raBoi MbIllUH neDenHriKDaiiaxpoMHoHa xnr nonpocHTr' 60"1bHoro pa3BecTHPyxl'lB
flneqa, fiapyxHa9 MexMbrtUeqHar neperopoaka, cr6por,u. r6raa Mex!) axpovr,roHoM x 6onbuHM BepreroMo6o3Ha-
MbruuH B pafioHe roqKl r,rHHepBnpyrorcqBerBbro rylreBoro HepBa. qalcs,ABavfrv6,'leHH9, a veHbuev r1 Hl.lx,6,1Hxe Knepe!h.HaxonrT_
Koxa uBBepBapyercr H€pBoM Cs, c s r ; q k a i h e i - H r y H r( l 5 C l ) .
n o x a s a H x r .M e c r H b r e HapylxeHfir: n o M f l q a r 6 o n r , ,T t r K Tonorpaorqecxae alraro xc. floa KoxxbIM noKpoBoMB palloHe
M6rI!U B O6JIaCTI|nreqa, TOqX! HaXOAqTCgyr"ly6neHte Mexay KlrIoqsqHhIM I a(pOMIlOlHblM
H a p y u e H r r r , c B r 3 a H H ! r e c M e p r a r . { a H o M :J o M q - n y q x a v a e r b T o B t l r H o f iM H U l u b l ,c l c f a B H a n u r e n b v e x a ' r l o n a r K o l ' tM
uar 6on!, B noI(TeBoM cycraBe, Ty6epKyn€Hbri ,'l[rM(DaAeHfiT, nreqeBot (ocTbK).
Texrr(a. CornacHo ApeBHfiM r.rcroeHnKaM, nyHxqr.It aroi TotiKL MbrlnuLI B pafioHe roqKI,I tHHepBtpylorct noaMEIueqHLlM HepBoM.
npoTHBonoxa3aHa. IlpHxr,traHre l0-20 MHH. Ko)Ka llHHepBnpyerctr HepBoM La.

202 203
 llo[a3aHrr. MecrHr,Ie Ha py uIeHs q:6onll B o6nacr[ nne_ Mbrlxur,r,!'raTepanr'Hofi BeTBbto xl napH q€penHdx HepBoB, BeTBSM'
r,ry6oKoro rueiHoro HepBHoro cn!'lere8ts.
HapytneHnt, cBt3aHHHe c MeptaraHoM: ,'IoMt- lloKa3aHxe. M e c 1 fi 6I e H a p y u e H fi fl : 6onh H npsnyx'Iocrb B
u a r r 6 0 ' 1 b , n a p a i r ' { B e p r H H x h o H e i { H o ( l e i i ,r e v H n , l e f H t IOpL'reloxpnnrocTb, 3arpyAHeHre r'loraHrt' Ty6epxy"le3HbIii nxMQaae-
Texrnxa.flyuxura ioa npcuuu 'i'roM. rry6rHoi 0.8 -1.5 uyxs.
B o t M o x H a n v H X u H qc H a n p a s , l e H x e Mr r , ' l H B A o r b n r ' l e q e B o i K o c r H TexHrKa. llyHKqrrtr noa np'lMt M yrnoM, r,ry6r'IHofi 0,3- 0,5 uy t
flpuxrraHne'15 30MLjH. flpsx,lraHne 5 l0 ntrx.
l l D h , a e q a H l , e . n p r n a p a n h q e s e p x H x x K o x e q H o . T e fpr e K o v e H (av-rv,
16. IO{(A Ov-[Ot 18Gl)
! \ e r c ; c o q e r a r bc r o q x i M r K i y i { , { r . r( l i C l ) r l x o n - K o Kl 4 G l l .
JloKanfi3auHr. A. Ha uee, Ha I qyHh Hfixe qeKlr, Ha 1,5 qyHa KHapy_
r 6 . I O { ( A K b l - K O T{ U 3 l o n - r v , 1 6G l ) x r . r o r r o q ( , H e x - H r e H b( 9 E ) .
( r d x a c o n p t x t H t ' p y c H o r oM c p x a r a r a ( c B e r n u n t ' c r a p y x H d M E. MexAy rpyalrHHbrMMbrrneqHbrMnyqxoM r nyqKoM rpyAHHoK,r()
rrroq }| Mep4rxaHoM) qsqHo-cocueBr.rAHofiMulxubr, Ha flonepe,JXoi !,rr{Hnr, npoBeAeHHofr
qepe3 BepxHnfi Kpafi ulnroBlraHoro xp qa, Ha 3 uyHr no3aal,r r !are-
Jloxanx3aqrn. A. B yr,ry6,1eHlrn, o6pa3ylouleMct MexAy KocrsMlr,
06HapyxsBaercq nplr npoxrynblsaHxL nreqa no BanpasreBnlo or T o n o r p a ( D f i , r e c ( a ca H a r o f i r i c . n o n h o ) h H H M n o K p o B o v B p a f i o H c
H a p y ) K H o r ox o H u a K q e H r p y . roqKH Ha\onflTCt no,[KoxHafl vHUUa Lxet. fpyal]HHHi Mr,tLxeqHbrii
6 . A . r r o n p e a e , l e s r e n o K a n r 3 a u a u c ! ' I e A y e rn p o u y n H B a r b ( n l o _ rryqoK s nyqok rpyar,rHoK!'rrcqrqHo-cocueBdaHoar Mbrruubr, rpaneure-
q s u y o r H a p y x H o r o K o H u ae e A o c o q , l e f i e H t t c a x p o M n o H o Mr, a e , H e
a n l U a r r M H l r u a l , M e c f o n p t K p e n J e H u t K K o c r l . rM b l r x 1 1 6nl ,o l H f l M a l o
, oxHo 3aMerurb yrJy6reHxe B coqneHe_
M f i o r o o T c r y n n B K c e p e A l r H eM
H u s M e ) R A yx n o q u q e i x o c r b r o, r o n a r K n : r o q ( a K H - x or ( l 6 G l ) n e x a i Mbluurr B pafroHe roqhr rHHepBrp)rorc9 HepBoM,roaxoxHoi
3 ?roM yrry6,reHrr. Mb rrubr r!el,l. JrareparbHofi BerBf'ro xl napbr q€penHblx sepBoB, BeT
Tonorpaorqecxac aHaroMxq. lloa KoxHHM noKpoBoM B paioHe BrMr{ r!'ry6oKoro rxefiHoro HepBHoro cn!'rereHxn.
TOq(r HaxoatTct TpaneurieBxAHaq s qaaxocTHat MbIrrqbl. Koxa nHHepBfipyerca HepBoM C3.
MHlxqH B paioHe ro,{Kn IHHepBspylorct HaaJlonaroqHblM HepBoM I l o x a 3 a H r fM
l.ecrHbIe HapyuIeH t : 6 o , 1 bx n p r n y x ' l o c r b
[oAMbruerrHoro HepBHoro cn!'rereHfie, HapyxHoft BerBblo xl napbl R ropraHx, oxpvn,rocr6t 3aTpylHenxe r",IoraH{t, Ty6epKyne3xbli
qepenHbrx HepBos Il BerBbrc rJy6oKo[o dleiiHoro cn,'Ier€HHt, rriMdaneHHT.
Koxa rrHHepBrrpyercqHepsoM C3. 06urre paccrpoiicrBa: K a m e , r b6, p o H x n a " r b H a cf lr M a -
n o x a 3 a { r q . M e c r s o re H a p y l r r e H f i e : 6 o , ' 1 fBi o 6 n a c r u n n e - T€xxnKa. flyHxqar noA npqMbrM y.,roM, r,ry6xHoi 0,3 0,5 IryHfl.
qeaoro cycraBa. llp{xrraHxe 5- 10 nrH.
Hapyu€Hxfl, c B s 3 a H H b I e c M e p t a x a H o M : 6 c t , 1Bf i
o6,1acrn nneqa, napansq BepxHnx xoHeqHocreii, Ty6epKyne3HHi ro.ro{(^ xoAJt|ev (x3-nfo. r0cr)
ntrMdaneflqr.
TexfixKa. flyHxufit noa npeMbrM yrroM, r"ry6!{Hoi 0.5 1,2 uyHt Jlo[anrsaqrn.A. noa HocoBbrM Ha 0,5 qyHqKHapyxn
orBepcfreM,
flpnx raHxe 10-20 MxH. n r r o q x Hl x r o f iK a y .2 6 V C , .
Ha nonepeqHofi flprMoii,npoBeaeHHoii HapaccrosqHr'/3 (cBepxy)
t7. 1(){KA TXlt€H-IUltb (Tthb-AXH, t7 Ct) tlirrHbrBepr xarLHofi Hocory6Hofi6opo3abr.Ha 0,5 uyHq naTepaft,H€e
IpoaoabBoii oceBoii J'rr'rHru 3roft 6oposabr.
Jlo(aie3aqxe. A- Ha 6oKoBoi floBepxHocrt ueH. KBepxy or roqKl't Tonorpaofiqecxag aHaroMre.nu, Kor{HUMnoxpoBovs paioHe
x x r o e r - 6 o H ( q r o 3 - n 3 H b ,i 2 E ) i H a I r r y H b H 0 x e x K 3 a A Lor r r o , { x x + y roqx[ Haxoagrct BepxHqtrqacr6 KpyroBot Muurun pTa, BePxHeqe_
a o r ( 1 8G I ) .
6. Ha n€peceqexrr3aaHero I(par nyqKa rpyanHoK'rrcqr,lqHo roq(H !{HHepBrpyrorcaBerB6rcVII napH qepen_
Mbrurqri B paltroHe
cocqeBHAHoiiM6rmubl nonepeqHoit ,1 Hrefi, npoBeAeHHolfrB cepeAxHe HbIX HepBOB.
lxerr, Ha 2 qyHt r{fixe qerlocrHofi KocTu, Ha ypoBlle HrxHe''o Kpat Koxa nHHepBupyerct snx(Hefirna3HsqHoiBerBbIo V napH qepen-
qrToBlraHoro xptua, {blx HepBoB.
Tonorpa(Pr,{ecxat aHaroM[c. floa KoxHLlM IIoxpoBoM B patoHe lloxasaH$e. M e c r H bI e H a p y u e IJ s '{: fiocoBoeKpoBoreqe_
r o q x H H a x o A q l c f l n o t r i { u r ( H a r M b r L x u a L x e H ,r a n H r i K p a i f p y 4 H H o - Irre, 3anoxeHHocTr,xoca, onyqeHr.reyrrla p,ra.
KnroquqHo-cocqeBfilHoi ML xqfr, necrHrqH6le M[,Iluqbl T€xB |(a. nyfiKulrq r,'ry6rlHoft0,2 0,3 uyun- flprxaranre nporu-
MbrurqH B paioHe roqKr,l sHHepBupyrorct fiepBoM noa(oxHol'

20,I
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fl D n M e,r a H ne flplt Bo3AeicrBt'lxHa
nn**,j"to. "u* Kax oHa pacnoroxeHa B oflacHoM,rer(o noABepxeH_
'nou
aapa*eanro veare.

20,IortxA lttEHb-xhtolf (rH-cttl. 20cl)

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ii.,iii ii,"pn**," pvirroro l soxroro epra'taloB <crern'f, cr')
xoa_'Ixey(l9CI)'
JloKarx3aqxe.A Ha I qyHbxHapyxfi oT roqKl'j
Ha 0,5 uyHt KHapyxL or HocoBoro orBepcrfit-

.""5,#" {;*:Y:;t*.j'"l :,?,trffi:

*:*:l.T;1,*1ru*"G,?i,"fi T!-6ar6 (2E)

--+3''ll;J","i1"'.tJ Bo
* noxpo v BpanoH€
il"TJiXI. noo *o*,oqacTHHocoBoxMbruud
Ir'da rro{r (2avc)
1o,{KrHaiotrtTcqHapyxH6IftKpafixpbl"1-bHofi
Kpai vanofi
ry6) BHylpefiHhfi
, ""rqo,, noonu*riourefiBepxH|olo kpau
pla
yf'1bl
x vhtt!ub. nolH Malourei BepxHttx
a*ir""* i"tt*t
tti.?i""lili'ilil"l]"';qKn BerB'Mvll napHqepen'
r',r{HepBIrpv,orcn
""*ntifruX?""o"nor"'cq v napbrqepen-
BeT
Hax'eii r'rra3HHrIHoiiBo,,o
""*n1",|u1X"""". Hoca'
M e c r HbI e i a p y'r e I x a: 3a!'IoxeHHocrb O*-€ (l5E)
HOCOBOe KpOBoleqeHHe. naparHtl?1l,|ueBoro HepBa
HacMoDK,
teixnxa. Ilvxxu r r'1y6lrHofi 0.2- 0 3 uyHf,
nJ;;;";*," c oaq e r a l hc B o r a e s -
l h p a ' r e ,e x r ' ' r . u a c u o p K
np r]e::lhu pr'rHr'ira corle_
crBfie; Ha roqKy rxbloHr_rblHb-{23\U)
r r . c l o q x a M xx x l h _ q H{ l l
r'-a _i, ( l l l l, xofl_xoK l+\J'i
n Bo'rablpex'
Bo "p"t" npn*rra'rt,tq Heaoaoatrb ao 06pa3oBaH
H o A H O nt h c h { n { E P S A t l A H , ( t n v , [ h Al E )
rno {5 ro,r€rc raxaoAcroPoHH)

liiifi
:iil ",;;"#"%;:?'",I'lxts.if
#i.T:ilHi:l;
" nrp""" tipr.un""o"'flp6ruBofl
:qi-3:iti
rropfj"Ji;1e;"HTff;
o'IoxHofi
aannbu uepaalaxe, Bo3Bpaqaelct; np qenocrfi' noA'{t{_ Xoar-trDn MoH (2zlE)
ixxnea "ejrocrv, nuxoalri nepea yrnoM HaxHefi
;;;;;; ";;p;;"; B npelyurHlo o6racrh. Bhrxoattl K '1o6Hovvvr'1v
t8Er' Or roqxn rafi_HreHh l5-E) cnlcxSit-c:^l:
u1o"*"or-rxl, cocoK'
ir"to , aui"" K HanMlortHqfloi tMKe 3areM npofinr rpylHol
run.noao xxBor' npn6n 3gBlrrllcb( nepearlecpeAnHHoMy
i"p"""*""t KaHa''lyx
*"'pnoru"y "u p"a.'u"Hlre2 ulHg cnlcxaelcttk naxoBoMyHa Io'1elh
o",i"i. ^i6t"q;' Blonb npqMoiivHurribr 6enpa cnycKaerct
-**
;.-";'";";"" 6o,ruue6epuosoi
cfonbr' iilli',"#"iJyiii;i1.13;;
c
xoarT nb r6lnbHofi noBepxfiocTl't
II nanb(a cronbl
llBE), " "upy*not yrny HorreBoronoxa
(o'ii"?t;fi];. B o6nacr,
rena,3a6oneBaHItt
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\w, t,/
t
Mo3ra'
aono"J, ,no", rlren, Hoca, 6o,lesri 3y6oB, ropra, ro'loBHoro
xe"lyAKa, Kt eqHltxa Pr.. 6t. Map,Atai x€ryARa (<.€t,Hi ta'.

206
 TexHxka.no,roxeHye6onbxoro npt BolneiclBrr:
- Ha TOLIKTtor'loBbl, ,lfiUa, UIeX, rpyAI,I - nexa Ha CnHHe, Ha
6oKy l,t,rr cra9, cr'lerKa orKriHyB noroBy Ha3aA;
Ha roqxri xraora r{ 6eApa rexa Ha cnrlHe u,ra la 6oxy;
Ha TOqKH kOJr€Ha,TO!IeHI'i,ClOflH, flaJISUeB HOIL llexa Ea
c f i x H e , H a 6 o x y , c n a t c o c B e [ I e H H b I M IBt H t 3 { o r a M l t ( H o r t H a B e c y ) .

l . T o q ( A T X b I A - K X A n( t { 3 H - l l l l , I E )
(Toq{a conpcxesr,r noxHoro MeprA aHa <cseantt $n, c Hapyt(rlh'M
neroqrHr r ncp€aHecpelrflfldH Y e p t i r n a d a Y ){

Jlo(anBaqxr. A. Ha 0,7 IryHfl Hrxe ula3a, npqMo noa 3paqKoM

6- Ha nepeceueurr uaxsero Kpaff r!'ra3fiHqHofrKocrli c Bepr!(a'lb-
H o i n H H H e i . n D o B e A e H H oqi e p e 3 u e 8 T p f r a 3 a .
Tonorpao;,recxae aharo;rc. noa ho)xefi B pdiiole roqxH Ha
x o n H r c r r K p y r n B a t M H L ! u a t J a r a ( ) ' { a c r o k M e ) K A yn o l r J a 3 H l r _ q H o i
q a ( r b | o l , q a c T b l o ,o l H o c t u e i c e x l l H x H e v y B e K y ) , a a J e e B r r l o b
Hrlxrlfffi nptMat I'l HllxHfl'i Xocai MulllllH ara3a, rla3Ho€ q6r'IOKO'
Muurqir n paioue roqKs tHHepBrpytorct VII napofi.repenxux
BepBoB fi BeTBTIMHIII napu ,repenH x fiepBoB,
-AM *, (33E) Koxa [HHepBupyercn V napoi uepennux uepaon.
-nuoHr-s,av (34E) n o K a 3 a E x t .M e c r H b I e H a pylxeflItt: 6onb t noxpacHeHHe
r{'Ia3, cre3oTerreHfte. rcMepar'Iofl,t, Ilapa,lt,lq ruueBoro HepBa, TtKfi

T€xxxKa. HanoxliB nareu Ha HrxHee BeI(o, noaHfiMalor BBepx

-- - nox-rH (35E) r , l a r H o e r 6 J o x o . n l H K u H n n o n y r J o v , x o H e u l , r r b l H a n p a B r l e HB H t l s
o D r e H r x p \ I o r c a H a f l ) x H H i x p a i r r , 1 a 3 H o f ia n a a l x u r . l l y x x u r ' r n r ' r y _
6 i H o i n 2 : 0 J r L l H q . l ' ' lf , 1 y H e B p a u r a r b . n p u x r a H x e n p o r H B o n o _
-Tyx-raM itr (36E)
fl p x M e q a H & e. Heo6xoafi Mo npoqBtttrb MaKcliMa'rbHylo ocro_
poxHocTb, qTo6br r€6er(aTb npoxora r,la3Horo q6noKa l,lau KpoBe'
iocrroro cocyAa B o6r'lacrr,I HlrxHero Bexa; noc'leaHee o6brqfio nprl'
soA[T K noaKoxHoMy KpoBon3rlltHl,lrc.

2 . T O q K Al b l - 5 A T b( ( b l _ t A f l . 2 E )

JloKarr3auns. A. pacnonoxefia IIoa r,1a3oM, BHII3 or 3paqKa Ha

I uyHB.
6, Ha uecre coq,reHeHst nepelHeHtxHero yrna cKynoBoff KocTn'
c nrpaMraHbrM orpocTKoM BepxHei qe!'IrocTHoll xocTl'i, BnJIoTHyIOK
HuxrreMy Kparo nepeAHeHuxHero yrna cxy,IoBol (ocTri, Ha paccTot'
H r , u ,It u v H t n D f M o n o a l p a q K o M .
Tonoiparfivecxan axdromns. floa KoxHUv noKpoBoM B paioue
{43E) roq(fi HaxoatTct HfixBfii Kpafi KpyroBoi M6IlxubI rr'ta3a, B MecTe
{4tlE) n p H R p e n , r e H HMf ia r o f r c x y a o a o f t v u U r u u r ( o r H o c t l l l e i c q K x B a 4 p a T H O f t
(45E1 u s r u i r e a e p x x e r i r y 6 H l r v e c l o c o q J e H e H H ec K y , l o B o i H B e p x H e q e -
nrccrHofi xocreft,
Mbrurur,rB pafioHeroqKH xHHepBupyrorctBerBrMnVII naPH qe"
penHbrxHepBoB.
xeryA(a (cBerrlrt rHD Koxa fiHHepBfipyerccV napofi qepenEHx HepBoB.
Pr<.6E. MeP,a,aH
209
 llo{a3an*r.MecrHHe fiapyuIeHts: rna3Hbre6ore3Hlr Texrrxa. B cryranx napanxqarrrueBoroHepBa KocaqnoA(ox_
(KofilloxxrxBnr, cKnep r), TtrKt a xoHTpaxrypa MbIUU BeK. pt6b Hat nyHXuHg. xoHeuHlrbl HanpaBJIeH B cTopoH)To'lxl,|3tn_ca lo Er.
nvxxqrt r,1\6xHoi0,7- 1,0 ulHf,. [lpl apyrrr 6o,lerrrr n]HKuHe
B ura3ax, naparHq JIrueBoro HepBa.
T€xHn|(a.nyHI(I.lxnrny6rHofi 0,2-0,3 uyHri. IlpnxrraHue nporn- n6a npsvsl'v yrnoM, r,1y6rHoi 0,2 0,3 ulHt. npHxhfaHHe l0
20 Mfir.
n p n M e q a H u e. flpH Heo6xoarrMocrl, Ha roqKy
Bo3AeficrBoBarr, IlprMeqaHfie. f l p f i n p t x t r a f i H u H e a o B o A x r ba o o x o r o B .
nptxllraHn€M rrecr'leAyeT ao oxofa, rB6eraTbo6pa3oBaHxt
aoBoal.rTr, r36erar6 o6pa3oBaHHtPy6|1oB.
py6qoB.
5, TO{KAIIA'-HfEHb (AA.XH.5 E)
(u3loE-r'rto, t E)
3. TOqKAKbr-r'lr.tEv
(TocKa conpcxeHtrtxoxHoro irepraxaxa <c8€rnh|tqH, c rapyxHhr)\l Jloxaarlaqxn, A. Ha 1,3 uyHfl nepeA qe,rllocrHofiKocrblo,B yr!'Iy6,1e'
ncroqnb'M MeprA aHoir) Htlu Ha xoctl.l.Tav, c]le npoxoallTxpoBeHocHHH cocya
6. Ha nepelHev Kpae xeBarerrbHoiMHtlluH Ha I nonepeqHblH
Jlo(a"'rr3aqxt. A. Ha 0,8 qyHt or HocoBoroorBepcrnt, nptMo noA naJle[ Bbl e HrxHero Kpafl HItxHei qerllocTlt,B xaHaBx€,rae npo'
3paqKoMHa ypoBHeroq( fxloq-(ay (26VG). xoarT JrxrleBaffapTepxt. llpu onpeAeJeHtrinoKant3allrx npe4!oxrirt
6, Ha nepeceqeHrEBeprr.rr(arbHoft nptMoi, npoBeAeHHoiqepe3 6o,rr,aouy crucuyu qenloarfi, qro6bl o6o3Haqtr'lcq nepeAHlrfiKpaii
qeHrp 3paqxa, t qeqHo-ry6uofi cKnaa(fi (IIpI onpeaeJeHtx no(arll- xeaaTerbHoffMHrxuhl.
rauru nonpocHrb60,lbHoro',rH6Hlrbct) Tonoapaoxqect€c aHaroMxt. floa KoXHLIMnoxpoBoMB panoHe
Toflorpaorq€c(afl zrxaro xc. lloA KoxHtiM IroKpoBoMB pattoHe Toqkt HaxontTct Mulllqa cMexa. cocaTejlbfiat Mbllxqa, BnnoTHylo
TOqK HaXOA9TC'Ma!'IaqCKy"'IOBat M6lllqa, MHlIjIlbI,noaHltMarclufle K lOq(e - nepeAHHfi Kpaftxesare,lbHoi MHruuH,RaHaBXa '1vueBofi
HOCOBbTe KpNnhq t yrcn pTa, BepxHeqerbcTHaflKocrb. anreoria
' Huxiei'{e,1ocrr.
Muruqor a pafioxe roqKll nHFepBxpylorct BerBqMt VII napbl qe- Muuruor u pafioxe roqKfiHHxepsxpyrorcfl Bersflvr Vll H V nap
qEDENHbIX HEDBOB,
_
Koxa rixxepnlpyercn V napofi qepenHblxHepBoB. Koxa rniepsapyerct V napofi 'repenxblx HepBoB
noxa3aHrc. Ilapanrq,I[qeBoto HepBa,TI,iKMl'Iluu eex, Bocnarr_ IloxasaxxcM . ecrHHe fiapyuIeHEt: napa'I q n[qeBoro
Te!'IbHHe[Douecc6l B 06,racTt ule(, croMaror'Ioruqec(ne 6ore3Hl'l HepBa,BocDaJIufe?'IbHbI€ npoqeccri B o6nacrt qexll, 3y6Haq 6onb
TexanxiL.flynxqan r,ry6uHofi 0,2-0,3 (yHt. npkxfiraHre 10 Texxxxa. Kocat norKoxHatl nyH(qlfl, xoleq rrrbl HatpaBnel B
20 MxH. cropoHy roqxx 3tn-ca (6 E) ; rny6i{Ha xyHXqHt 0,3 0,5 lryHt- npr_
flpnMeqaxne. I l p s n p x x l r a H a r i H e a o o o a l r r ra, o o x o r a , xHraHrrel0-20 MfiH.
r.€6erarb o6Pa3oBaHutPY6qoB, ll p fl M e q a H I e. CneayerHr6elal6 nonaaaHxtur'lH B aprep n
He los,iAflTb40 oxoroB, li36erarbp)6uoB
4. TOqKAllrrA-TxbroHt (,Ufi-UAH,,r E)
(To{m cotrpexe8xtHoxHoroM.pxarara .cB€r,tufitD c pyqHrMMcps- 0. To.{KA3tn-CA (U3t-q9, 6 E)
anafloM.cDernHfi sr' x flapyxrEM ntroqHbrM MepuAxaHoM)
JloKa,r{aaqxc. A. noA yurHofi pa(oBr,rHofi,Ha paccrorHrrt 0,8 uyHfl;
JloxaJrfiaaqfir.Ha paccroaHl,r 0,4 qyHs or yrna pra. 'B
HAqaJeqer'rrocTHofi
KocTr, pqaoM c yrny6resueM, pacrolroxeHHbIM
Ha nepece,{eHn,ropfi3oHTa,rbHoi qepe3yrnhl
,'rfiHIrIr,npoaeA€HHoff BNEDEIII,
pTa. co ueqHo-ry6Hoi cK"'ralxofi (flpx onpeae!'Iexx, 'l]oKa,lr3aufitt E- B Haq6o,1ee BbrnyKioM Mecre xeBarer'ihHoi Mbruilr6l (,q,It on-
noflDocxrb6onhHoroyrbl6HyTbct). peAer'reHfinnonpocxTb60,,rhHoro crrcHyTt 3y66t). IIps paccna6neHHot"l
ionorpatDe.recxar aHgroMttt. IIoA KoxttblM noKpoaoMB pafioHe cocTotxl { xeBaTerlbHofi M6Irxq6r B 3ToM MecT€ o6o3HaqaeTcc yr'1y6_
TOLTX'HaXOAHTCtMeCTOnpnKpen{'IeHltr Bor'ro(oll KpyroBoH MLIMH Jreltrie- IIpx HaaaBrr,rBaH,{u Ha Hero 6or6Hofi AorxeH scnhlrblBarl>
pra,6onbr[oi cKy,roBoi MHllqbl, MblulqH cMexa, Mbtuuril, onycKaro- ! r y B c r B o H a n p q ) h e H { qI o H e r { e H h r B o 6 , ' r a c r r , \ e B a f e n b H o i v H u H .
qeft yron pra, n Aar'IeeBrJy6b - cocarerr,Haq MbIrUuaIr MbIlllLla, noa-
ToqKa HaxoAHTca nepea Bepfr,{Hofi yrr'1a HtxHefi qerrcclfl, Ha I no-
HnMarcuat yroJl pTa. nepeqHbri Iran€u 8aA HrxHr,tM r(paeM HrxHett qe!'lroctlt.
MhrurqLl B pafio8e tor{Kn fiHHepB[pylorctt BersiMt VII Dapbl qe_
Tonorpaox'tec[at aHarorrne. IIoa KoxHtlM noxpoBoM B patoHe
-OCflHbIXHEDBOB. HaXO,qCfct xeBaTerbHat MbIlllqa, HHxH9q qe'llocTb.
Koxa fiurepaupyercn V napofi vepenHHx HepBoB TOqXr
qepefl'
lloxa3adrc, M e c r H bI e fi a p y rx e r fi q: napanlq JlnlreBoro M H r x u b l B p a i o H e r o q x f i f l H H e p B x p l l o r c f lB e l B h ' o V f l a p H
x e p B o s l .H e t s p a n r r tr p o t H H q H o r oH e p B a
H e p B a( v l l n a p a , r e p e n H H H Hblx HepBoB.
( V n a p a q e p e n H u x H e p B o B ) ,c n r c H o r e q e s n e ,q 3 B o q K , B y r r a x p T a Koia rnueperpyercr V napori qepenflblx xepBoB.
2tl
210
 noxa3ax{c. M e c r H bI e fi a p y lll e H Ir c: napansq rlqeaoro Tonorpa(Pxqecxal analoirtt. noa xoxHbIM noKpoBoMB patoHe
epBa,Tpr.3M, sy6HaH6onb, napoTLlT. TOqKr HAXOAfifCtMeCrOnpBKpenr'reHljtx cyxoxxnbHoMy noxpoBy
T€xHt|xa, B c,'Iy.rasx naparnqa rrqeBoro HepBa- Kocac floA- Mbr[ruhrtrny6xe - qepenHblexoclu.
Br.{coqHofi
xoxHat nvHxrlr.{t,KoHeu ltrrlH HanpaB,IeHB cfopoHy Toqx afia_ MHUluHs paftoHeroqxr HHHepBxpyrorct Bersbb V napH qepen_
rxsrosr (4E). flyHXuaq r'1y6nHofi0,3 0,4 qy8fl. flpux'raHue H6IX HEPBOB.
l0 20 MaH. Koia rnnepsnpyercaV [apofi qepenHHxHepsoB
n p x M e , { a H x t . l l l p u n o n a A a H ut ar n H B r o q K yy 6 o r b H o r o l l o x a 3 a H r g . M e c r H b l e H a p y | j I el H H t : r o ' l o a H a t6 o r b l B B H -
BO3XrKaeT OulylleHte r'lxecrl'r ll pacnxpaHfifi B MecTeykor'Ia. coqHoi n r'Io6Hoi 06racrtx), 6onb B r',ra3y,cre3oreqeHfie,TIII( Mbllulr
2. flpa ,reueur nept(beprqecfioro napanfiqa ntqeBoro HepBa Bex.
p r v e H r e r c r , x o , B r o q K y3 t l l - f a t 6 E ) L n o n o l p c B opMy ' l K HH f r H , B Texxxxd. Kocat IIoAI(oxHat nyHKtllic, rny6nHofi 0,5-0,7 qyHt.
' irqeranunc yxo,raur e rouxr aHa rxHoHr l4 E) x rHHL_vuHb{l V) nprMeqaHte, L I I p s n o l r a A a H ut r in H B T o q x yy 6 o n b H o r o
( H a \ q a ( f h eH a p y r x e H r s , . Bo3HfixaeT oxlyuleHaesaflpqxeHHocrlr,pacnnpaHxt, oseMeHfit B
3. flDr npsxfiraHLru x36erarb o6pa3oBaHHqpy6qoB- Mecreyxona, KoropoeMoxer HPPaAunpoBarb no o6utpHoMy yqacrKy
ro,'roB;. IlonaAalte rrr'lbl B xocrb BbI3HBaerocrpyro 6o!rb
2. IIpsxriraHHe npofliBonoxa3aHo.
i. 10{(A xA-(YAll (Cl-rYAl|l'' 7 6)
(Tocra cotrpci{e8xc no)r{noro €pxa,a a ..aerrr* ||H'
pxaxl,ira . anu, efl,l $. roq(A ntH-fltEHb (x3Hb-uH, c E)
(To.ria conprxeft{x noxitHx ne0nauatros(cRtr,!Hn tn' n <Marufi str)}
Jloxa,rx3aqxc. A. non roqxofilxbloHr_KyaH {3VB). } HHXHeroKpafl
aDrephr,a Mecre, (oropoe ne''laercs)rrry6r1eHfieM. xorna oor6Hot'l Jlo|(aJxsaqxg. A, Ha KpyltHofiujefiHofiapreplir, 6xeHfiexoropofi 'rer-
ciH,:ineaer 3Y6br, x BhIAe"Iqerct, xoraa oH or(pbrBaer por' xo npoqyrrbrBaerct. Ha 1,5 uyHs B cTopoHy or BHcTyna fopTaHlr
6. B yf,r!, 06pa3oBaHHoM nepe!HeficropoHoficl(ynoBoro orpocrKa (aaaMoBar6noKa).
oTpoclxoM HHXHefi qe"llocfl{ {npr 6. Ha nepece,JeHHu nep€aHeroxpaq rpyatl1ol(nloql,lqHo-cocueBI'lA-
BrcouHoiK6ctx x Mbluler(oBblM
nonpoctirb 6onbHoro crHcHy fb 3y6bl) Hofi MLrrurlbru ropr{3oHranr,HofiruHHr, npoBeaeHHofi qep€ aepuHHy
JnoeAe,'reHH
'Ionorpa(0rqccxac
aHatonxt. IIoa KoxHblv noxpoaoMB paroHe BbrcrynaropTaHn; Ha Mecre pacrrolroxeHnq ToqKqouyulaercfl nyJb-
ToqKx Haioatrca o(oroy Hat xeJle3a, Mecro npfixpenneHra 3aa_ cau r coHHotaprepHH.
Hero xpat xeBaTer'ILHOii MtllxqH, aa'ree Br,1y6b* narepa'rbHaffKpbI_ Toflorpaor,recxat aHaroMxs. IIoa KoxHHv nokpoBoMa paioHe
noBvAHatMLluIl4. rorrhH HaxoarrrcflnepeaHHrhpai rpylrxHoK,loqxqHococueBrArofi
qePenBhlx
MHuubr B paiioHe roqxt{ fisHepBtrpylorcqV napoi Mbrrrqhr, HepBHo-(poBeHocHHi nyqo( colrHoli apTePnx, aanee
' BrJry6L- r',recrHHqHatr MHuiIra,arlltH{at MbIIlIqaueu, Mbllllqa,noaHl't_
Koxa rHHepBrpyelcfl V napofrqepenHHxHepBoB Malor{aHronaTKy.
Iloxa3a8Uc. M e c T H u e H a p y ln e H n t: 6o'rfi L HapylleHle Murlrlu a pafioue roqxfi r,tHHepBr,tpylorct BerBqMnXI H XII nap
DOlBtiXHocTIll,l!rl,tBblBItxBncoqHo-HrxHeqerlocrHorocycTaBa' 3y6_ qepenHHxHepBoa.BerBf,vxLxeiHofoHepBHolocnnereHLlt.
Haq 6onb, napanrq ruueBoro HepBa,rxyM B yluaxi Koxa.lJHHePBrPYercq HePaoML3.
Tcxrxxa, ilyxrutn npsM;IIr{yrJIoM,
rqBq noa npgMbIM r,{y6uHofi 0,2-0,3 qyHt-
yr,'roM,r'ny6uH( . e c r H h I e H a p y r x e H I , t t : 6 o r u I , io n y x ' l o c r bB
f l o ( a 5 a H x rM
5 - 1 0 MtlH.
f l p a x H r a H n e 5-10
IIDaxHraHrre Mt'lH. rop!'re,BHe3anHaqnmept ionoca, ry6ep(yre3H6Ii nnM(paaeHur.
II p q M e q a H L e, flp|l npfixlrraHllH He aoBoaljrb ao oxora' t3_ O 6 u r r e p a c c r p o i l c r B a : n p t t c r y n ba tc r M b or ,q y u e H u ep a c -
6 e r a r b 0 6 p a 3 o B a H x f ,P Y 6 u o B . nrpaHnq B rpyAlt, noBHueHHoeaPTeplranbHoe aaBneHlre.
TexHrra. B HeKoropslxapeBHuxncroqurKax 3anpeqar'rucbyxon;I
B ?Ty TOqKy. nocKoJbxy. Kax cqfiT:Moch, BoJMoxefl cMepTenbHbti
{t. TotrKAaAv-3lolt (10v-B3tl, 8E)
(Toqxaconpqxetrt noxnoro reprAraEa .crcriua cB, t o i , [ e i c I B r eH a r o q K yH e
B H a . r o q u e eB p e M rn p a x r H K ) e r c B
c lroxHbtft itsoxalafion . a,rHlt tlrt
r rapy^hur noAAepaxsdD|llrf rcpilraxoil)
rny6oxofi nyHKqrei c floMol[broMerxrx Hr!'],Pa3ApaxeHueHeAonxHo
6brrr, c!,rhHbrM,nepeA yKonoM Heo6xoaHMocM€crnrh apreplrlo, or-
J l o | ( a , r n r a q x g .A . B , i o 6 H o My f n y . B t ' r u e f l e p e A H e i l p a H H | I H B o n o c f l AaBrB ee B cfopoHy, rrTo6brfi36exaTb npoKora cocy,4a.
H o f o n o K p o B a .l a r c q x o i 6 a H r x a H { l 3 V B I H a p a c c r o t l H x l , |l . 5 f i y H 9 fl p I M e q a fi ri e, C,,reAyernMerb B B[Ay, qro yKon B roqKy HtH-
6 . H a B e H e , { H o vL x B e , a r e p a r b x e e r o ' r t ( t x a H _ a t H b l 2 4 ) L U r H a HreHb (9E) HepeA(oBbI3bIBaerronoBo(pyxeHle, a npfi nonaAaHnn
4,5 [yHff. Irrbl B apTeptro conpoBoxaaeTct onacHblMKpoBolt3r'IrltHfieM,

212 2la
r0. ToqxA Txtolt-aol (uryn-Ty,lo E) qepe3rpyaHoi cocox, B qenr MexAy
npcMofi,npoBeAeHHoii
THxanr,Hortr
rpyAriHqxnrowrqHo.cocqeBnAHotx,rrecTHrqHonMbllruaMll.
Jloxaix3ar({c. A. nepea (pynHoi ueiuofi cManKoi, npflMo noA Tonorpa(0Hqacxarafiaro xr. noA KoxH6rv noKpoBoMB paiioHe
roq(ofi HrH-HreHL (9E) n Haa roqKofixxH-ca(l I E). Tottxl HaxoalTct HaIX,roqHqHat tMxa, r'lecTHrqHat L IonaToLIHo-
B, Ha nepeaHeM(pae rpyanHoxJlloqrqHo-cocqeBlAHoiMbIIlqH, nol'bs3blqHaq M6l rut I-
TOqHOnOCepeAHHe MeXAy rOq(aMUHtH-HreEb KXfi-Ca, Mbr|llllqri B pafioHe roqKH HHHepBr,rpyrorcr l|epeAHr,rMrBerBrMu
Tonorpao rcclan arialout*. flo,q xoxHHM noxpoBoMB paffoHe 3-ro,4-ro,5-ro rueriHHxHepBoB, BerBr,bXII nap6rqepenHbrx HepBoB,
TOqKx HaxoArrcrr nepe,AHrrixpafi rpyAttoKnloqHqHo-cocqeBtIlroff Koxa HHHepBrpyercrHepBoMCa.
MHrxqbr,ue,lb MexAy trofiaToqHo-noAbfl3hrqHot,rpyltrHo-noa6c3hrq_ Iloxa3aHrq. M e c T H bre H a p y u e H k r: 6o"1d x onyx,'tocr6
Hoi s rpyanHo-ullrroBrafiofiMbrr[qaMn,AaneeBrny66 HepBHo'Kpo_ ruer, 6o,1HB xxBore! qyBcrBo crecHeHrr B rpyAri.
BeHOCHU& nyqoK COs8ofiapTeprll, AJTOHHAT rreiHac MbIUIqa,nepel_ O 6 u r e p a c c r p o fi c r B a: Karllle.rb,6poHxna,rr,HacacrMa-
H'|fl J'IECTH qHA' MbIUIUA.
Mbrullq6rB pafioHeroqKn flHHepBnpyrorcfl BerBrMr,lXI u XII nap __ TexHlKa, flyHxqlr rny6rHofi 0,3-0,4 uyun. flprxsraxne 5-
qepenHErxrepBoB, BeTBfl Mfi lrl€ftHoro HepBfi oro c[JIeTeHrc. ll p x M e q a H H e. Cneayer ll36erar6 rny6oKoi nyHKqnrix cr,'rr,-
Koxa nHfiepBfipyercrHepBoMC3, Horo pa3npaxeHrr ToqKH,qro6H He rrpoxor'torL BepxlruKHnerKrx.
I l o [ a s a x n . M e c r H h r e H a p y r x e H I | r : 6 o n u x o n y x n o c r ba flyxxuln a roqKyxxrcer-6oHtl2 E) HepeaKoBbr3HBaer ro,,toBoxpy-
ropre. no,rHaaeHfiT. xeHfie lt TpaBMyr'lefkr,tx.
O 6 q u e p a c c r p o f i c r B a : x a u e r b ,a c r M ao, A h I U K a .
Texxrxa. flyuxqfiq rny6fiHofi 0,2-0,3 qyHs. npsxtraHlie 5- 13.TOq(A XXtl-XO(qlt-Xy, l3E)
l5 MrrH.
fl p x M e q a H t e. Cneayer r36erarr, r,ry6oxoi nyHKtlltn, qro6hl Jloxarx3aqxr, A, B yr,ry6,reuua noA Knroqxtlefi,Ha 2 qyHf, KHapyxx
He DOnacTbB uefiHNfi cocyAncTErfinyqox no3aak ronaToqHo_IIoa6' or roqKlr 3y.Qy (27 R), Ha paccroflHlru4 qyHefior npoAo,lhHofioceBofi
g3HqHOfi MbItULlbr r He B6r3BaTr, OnaCHOTO XpOAOTeqeHIrc.
JIUHIiU.
r!. TortKAKx[-cA (ufi"|lt3, n E) E. Ha BepxHeM(pae I pe6pa, Ha nepec€r{eHnfiBepxserc Kpat
pe6pa c BeprnxanLHoi.nrHnefi, npoBeaeHHofiqepe3 rpyaHofi cocoK;
Jlo[aJr[3aq[r. A, B yr,1y6,reHrrxHa uree, flprMo IIoA Toqxofi HcH- Ha paccrotrHrrr,4 UyHei oT nepeAr{ecpeAnHHoroMepfiIHaHa.
HreHh(9E), Ha ypoB8eroqKa rxreH-Aor (22VC). TonorpaorqecKaq aaaroMl|c. floA KoxHbrMnoxpoBoMB pafioHe
(pap x,'IrcqxuH, ToqKI,lHaxoAcrcsnoAxoxHar Mhrrnqalx€n,6onr,uae rpyAHar M6rurrla,
6. B yrny6nesln,Bn,rorHyoK BepxHe\ry B le"rfi
Mexay aByMt nyLIKaM rpyAr.rHoKnloql{qHo-cocqeBllaHoft MblltllH - noAx,'rorrxqHacM6ru{a, BepxH,ri kpafi I pe6pa, BepxyruKunerl(Irx-
nyqKoM,npu(pen!'rflrolturvcfl
K rpyarrHe,r{ nyqKoM,npuKpennqnqnnc9 MbIu.IqblB pafioHeroqKH LiHHepBripyrorcrnoaKoxHoii Mbruie'rHori
BeTBbIOJtIIeBOtO HepBa. BeTBnMr.rnOAMbllljleqHOTO BepBHOiOCnr'IeTe-
TonorparDxqecxdralaro xr. IIoa Koxei B paioHe roqxfl saxo_ H r q . n p o \ o r e l r r r M H n o 6 0 , 1 l , u r o i ri p y 4 H o f i l j n o , 0 l ( r ' l r c q x q H oMf ir , r u l [ a M .
ri X'lrcqlqHHMnyqKAMt rpyAHHOXJlIo'
Arrcc uler16MexAy rpyAlIHH6IM Koxa ,HHepB pyercr nepaov C{,
qfl qHo-cocqeBtaHot MbIl!tlht. n o x a 3 a H x t .M e c t n s r e HapyrllreHss H o6t;l1re pac,
MbrurubrB paioHe roqt< fiHepBrpyrorccBerBtM[ XI fi XII nap c r p o li c T B a: Kauenh, acTMa, qyBcrBo nepenonxeHxocTs l.{ pacn!-
qepenHbrxHepBoB,BeTBbp2-ro uefiBoro HepBa, paHfir B rpyaHoil lc,rerKe-
Koxa xHHepBHpyercfl HepBoMCa. TexH[xa. nyHKuxfl r,ry6HHoi 0,2 0,3 rryHr. flpuxrrante 5
.-
noxa3ax c. MecrHHe H a p y u e H r.rr: 6onr u onyxnocft' B IC MI,IH.
ropne, norlfiaaeHsT,306. fl p fi M e q a H n e, f,iy6oKaq nyH(urrs nporrBonoKa3aHa Bo rs6e-
O6qfi e paccrpoicrBa: 6 p o H x n a n b xaact r M a o, A h l u ( a . xaHlle rpoKor'la {'IerKlrx r.r cBq3aHHbIx c 3TtrM ocnoxHeHfii.

._ Texhrra. nyHxutlq rny6nHofi 0,2 0,4 qysr. flpuxHraHne 5

1 4 .T O q ( A K X O - O O H r( K y - O A H , 1 4 E )
fI p fi M e q a H r e. Creayer r36enarL r,ry6oxofi flyHxql,tl,r,qro6u
He npHqnHnr6TpaBMyHepBfio-cocy,4vcToMy nyqKy coHHoi apTeplrs, Jloxanx3aqrr. A. B yr,ry6"rexrl Hrxe ,roql{rj l(xr-xo (13E) Ha
1,6 uyHr; Ha paccrorHlrk 4 qyHeir or cpeaHeti,1r.tHtill rpyAx.
r2. TOqXA(XIOET-BOH
(tlto3-n3Hb,r2 E) E . H a B e p x H e MK p a e I I p e 6 p a , B M e c T ee r o n e p e c e q e H x qc B e p r n -
h a n r , H o i n p g v o i , n p o E e A e f i x o fqi e p e J f p y A H o i c o c o K . x a p a c c r o r H H r . l
Jloxarr3aqrr. A. B yrry6re ur HaAx.rbqtqEofi nMKn. 4 u y H e f i o i n e p e A H e c p e a l H H o r oM e p H l x a H a ,
6. B yrny6,1efinHBn.,rolriyloK BepxHeMy(paro xnloqHqbl,Ha BeP_ TonorpaoxqecKac afiaronaxf,. noa xoxefi B paroHe roqKH Haxo-

214 215
/lnrcn 6onbuat rpyaHac Mbtuqa, MEtlxubl llapBoro Mexpeoepb'{' rperhero Mexpe6epbt, BepxHni Kpaii IV pe6pa, nerkre x cepAlre (Ha
BepxHIri
' Kpaii ll pe6pa, BepxyluKt,lnerKrx.
Mr,ruruira pai_one-rovKis;HepBrlpyrcrct 6onbuerpyAloi BerBbro MblruqH B pafioHeroqKr fiHHepBr,rpyrorcff BerBqMLfioaMbllxeqHoro
noansrueqsoro HepBHorocfi,'IereHfifl, 1-M Mexpe6epHHMHepBoM' sepBHorocnreTeEfir, npoxoaflrqnM! no 6oflblxoi fi Ma.'roiirpyafiblM
Koxa xnHepBupyerci HepBoM C{. uuuqar,,r, 3-u Mexpe6epHbrMHepBoM,
n o { a 3 a f i r fM
,.icrnue fiapyrxeHIrfl t o6nrue pac_ Koxa finHepBHpyercrHepBoMTh,
c r p o i c r B a : k a u c J l b . 6 o , l bql yl B c T s o n e p c n o , l H e H H
a or p
c ryra H o i i I l o r € 3 a E nM
r .e c r H L , r e H a p y u e H r q n o6olre pac-
crpoficrBa: 6onb B MonoqHofixer're3e,Kaule.rb,acrMa. Me)Kpe-
T€xHfiKa. Ilyn(urtr r'ry6rxoi 0,2 0,3 qyHq. IlpqxHI'aHfie 6epHar HeBpairur, qyBcrBopacnxpasHnB rpyA!.
T€xxxra. flyH{ur.tr rny6srofi 0,2 0,3 uyHq. flpxx,{raHfie 5 -
llprMrqaHrt. I B c " l l v a el c r e p H n p r \ ' { e H t r }r K
b o ' '-l c n o l5 M&H.
4aBnrourHii6oJ,r e rFerBop Hoe Haqa''lo,3loqKy xxo_QoHri l4 E^i-B fl p n M eq a H e. lny6oKaq nyHxirun nporsBonoKa3aHaBo 136€_
coqeTaHL rH , J a v rB T o q x l x r e ) _ r a r rI J L i
o c c r H M y r H p y l o u r HyvKr o aaHHe npoxo,laierl(nx fi cBn3aHHLix c trllM Itxeiblx noc.Ie,[clBHH
n rxaH-Marb (62V). (oco6eBHoo[acHr,Ir flpx nyHKunfi Ha neBofi clopoHe rpyau).
2. tle cneAyer np MeHflTbrny6oKyto nyt{xqrc Bo fi36exaHne
npo\o,,ta.rprKlrIH cBfl3aHHblx c ,1HMocnoxHeHrt
tlto-rlvHr(xv-qxyH, l7 Ej
17.TOTIKA
15.TOqKAOK-II(v-ll, l5!)
Jloxa.Jrx3aqxt.A. B qeHTperpyAHoro cocKa,
Jloxanx3aqxe.A. B yr'ly6neHnlrHrxe roqKr Kxo_QoHr(14E) Da 6. B ueHTperpyAHoro cocxa,
1.6 uvHt. Tonoapaol{ec[ac aHaroMxs. floa (oxHbrM noKpoBoMa paioHe
6. lla aepxxeuxpae lll pe6pa,B Mecreero nepeceqeHnt c Beprn- roqK! HaxoAr,tTcq rpynna rpyaHbrxxere3, aar'leeBr",ry6b- 6o/6nlas
xa,{rrroii np;Moii, npoBeaelrHoiiqepe3 rpyAHoii cocox; Ha 4 qyHq or H vanar rp)rHHe Mblurubr. vriuril6rtrerBeproro\re)i{pe6epbt.
nepear"cpiaxrsoroMeprAHaxa. Mulnuhr B paf,oHeroqKU HHHepBxpyrorcrr BerBrMx rpyaHHx HepBoI|
IonorpaQnrecxarixarounc. [loa KoxHHv noxpoBoMs. paxoHe s 4-M Mexpe6epfibrMHepBoM,
ru'rh Ha\orqrcq 60nb|xaf fpylHaq vbluua BepxHHiKpan-varlox Ko,{a hHHepBr.rpyercr HepBoMTha.
rlyrlroi vbruru6l.vbllxuH BTopofo Mexpe6epht. BeP)\Hrr kpalr fl p r_Me '{ a fi fi e, BccKoe Bo3aeicrBHeHa sry roqKy rrpornBono
III pe6pa,aa,leeBrny6b rerxre. Ka3aHO-tt ApeBHOCTII OHa l,Cno,'rbSOBanaCbnrtnb KaK OprjexrxP Ant
MbIruublB pafioHeroq(g l,HHepBxpylorctBerBtMI noAMr'IlxeqHoro oopeAereHqerloKarr3all&lr roqeK B o6Jacrx rpy,4n l, xHBora.
nepexolo cn,rirealn, npoxoat ruML no 6o,lbluoi l'i Maroi rpyaHblM
r,rsrurqav,2-M Mexpe6epHtiMHepBoM- 18.TOq(A HtO,KAn{Xv-f3Hb, lrJE)
Koxa oxHepBfipyercqHePBoMThr'
J l o x a 3 a x r rt r. { 6 c r x u e H a p y r r l e H I ' l t n o 6 l l r r e p a c _ Jlo*arx3aqxr. A. B yr,ry6reHfin Hsxe roqKu Hro-,{y r (l7E) Ha
crpoiicrBa: 6onr s Mo"lo,rHoixer'le3e,Kauenh' acrMa' Mexpe_ 1,6 uyfiq; Ha paccroqHris 4 uyHefi or cpeAHefinlrH'l' rpyarl.
6eDHaq HeBpanrfit.
'Texxrxa'. B. Ha BepxHeMxpae VI pe6pa, B Mecre eao flepecer{eHrsc Bep-
flyxxuas r,ry6tHoft 0,2*0,3 uyxH flprxtraHne 5 rrrKanbHoi nBHnei, npoBeAeHHofi qepe3 rpyAHoi cocoxi Ha paccTot-
l5 Mr.rx. Hxfi 4 qyHefi or nepeAHecpearJHHoro MepsAnaHa,qTo6br Bo3aeficrBo
fI p Ir M e,r a x fi e. f'ry6oKat nyHKuns nportBonoxa3aHa Bo Bar6 Ha roqKy, cneAyeTnpHnoaHrfb MoroqHyroxeneSy.
l,l36exaBxeflpoKors rerxnx x cBt3aHHblxc 9THMocroxHeHI'lI,l' Tonorpaox,r€cxac axaroMxr, noa KoxHbrM nor{poBoMB p.afioHe
TOq(nHaxoatTct 6o!'It,uraqH Mar',rattpyaHhleMHuIqht,MbrrxuunqTolo
16.TOqXAblHr-COHr(n -qv^H 16E) Mexpe6ephq, BepxsHfi Kpafi VI pe6pa; Aa,lee Br,ry6b - ner(ue
(cnpaBa),BepxyuKacepaua (cneBa).
Jlokarr3aqre. A. B cepeArHeyrny6r'1eHfiqHllxe roqxB oK_e (l5E) Mbrurrbr B pafioHe roqKx r.rHHepBr.rpyrcTcq BerBrMfi noaMHueq-
Ha I,6 uyHti Ha paccr6tBxlr 4 qy efi or cpeaHefi,IITHITH
rpyA,r' HOro HepBHOTO Cn,r€TeHfir,I|poxolslllnMx rro 6o,lbrxoii fi Manot
6, Ha BcpxHeMKpaeIV pe6pa, a Mecreero nepeceqeHksc Beprl_ rpyAHbrMMb[uuaM, 5-M Mexpe6epshrMxepBoM.
Kan6Hoi DpiMofi, npbBeAeHHofi qepe3rpyAHoii cocoK;fia paccrotHl'tn Koxa nHHepBrpyerct HepBaM[ ]h{ - Ths.
4 u\Hen ur nepetrHecpenrHHoro vep trxaHa . ecrHbre n o6urHe Ha p y lne HIi t: 6o,'rH
n o | ( a 3 a f l x rM B
I o[orpa(0xq€crae afiaroMrt. flon KoxHbll4 IIoKpoaoMB pa oHe MOJlOqHOi Xere3e, IrnoLlaKTau[t. acTMaTtqecKailxaDeJh, 6or'Ib R
TOqItfi gaxoatTcfl 6o,,Ibtxag l,' Manat rpyAHHe MLIIUUbI' MbtlUIIbI rpyar.l.
?16 217
 Texrxra. flyHKlll'ifl r'1y6Hxofi 0,2 0,3 IryHt- nprxtraHfie 5-- Tonorpaol{cclar aHaroMxr. noA xoxHHM noKpoBoMB pafioHe
15 MHH. roqKl' Haxolgrcc (pacqrn HapyxHofi Kocofi MHurqHxriBoTa, npcMac
flpnMeqaH e . f , l y 6 o K t r e y x o n b l f l p o r H B o f l o x a 3 a H HB o n 3 6 e - Mbrurua)KrBora, ronepeqHar Oacuur, 6i)rcrrlHBa;B 6prouJHofino-
xa ue npoKo!'la c€paqa tl r'lerxfix tl cBt3aHHblx c ?TIIM OnacHblx !1OCTIi- XeJIyAOK.
noc.neacTBn[. Mbrurr.lhrB paioHe rovxll sHHepBr,tpyrorcquecrbn HllxHr,tMr,r
MexpedepHblMHEepBaMlilt no4B3Aot!Ho-noA'{peBHhiM HepBoM.
lg, ToqKA FATSyHr (Bv-XvH, l9 E) Koxa aHHepBnpyercrHepBoMTh?,
noxa3axxt.MecrHbre HapynlIeHxq: 6on, B xe,tyAl{e,
Jloxarrcaqxt. A. Ha 1,5 qyxt B o6e cropoHbr or roqxn-y-MoH (21 R) ' 6onn B 3nfiracrpanr,Hofio6nacTr, TorxHora,pBora, orcyrcrBfie anne,
6. Ha 2 uyHq s cropo;y 01 roqxn iu-xxroer ll4VC)
Trra, no80c.
Tonorpadiqecxan aiaro rn. [loa KoxHbtv noKpoBoM B paioHe
Tex[xra. Ily8xq|lc rny6[Hofi 0,7-1,0 uyHq. flprxnraHxe 5-
T o q K H a i o A ; T c f f O a c u u q H a p y x H o f r K o c o i i M H L l l u bxl l a o r a . n p q M a r l5 M''H.
Mbr qa xrBoTa, ironepevlai'oacunq, 6plolxl{fia; B 6plolxHofi no_
IIprMeqaHUg. l- npll nonaAaHrn u r n b rB T o q K yy 6 o n h H o r o
BO3HuXaeT OrUyUIeHrre HanpqxefiHocrx, pacnupaflfia B MecTenyHK-
M6IruubI B pafioHe roq(ll uHHepBtpylolcfl necrLlo HHxHIjM]l M€x qrri. IIprl neqeHUnxenyAoqHux 3a6oneBaHsitHeo6xoAlMo Bbr3Bar6
p e 6 e p H H M H e p B a M HI n o A B r n o u r H o _ n o l q p e B H b H l ve p B o v
I h , .
yKa3aHHoeouyueHfie rax, qro6H oHo xppaalrripoBano rny6oko
Koxa l , t H H e p B x p y e r cHq e P B o M
HapylxeHx'{ t o6nrfie pac- BHlTpb x!,rBoTa,
IloraaaxxcM . ecrHbIe 2. npn 6orcx B 3nnracrpa,rhHofi o6,1acrn cneAyer coqeralL c
cTpofi.TBa: OLUyureHHe n e p e n o r ' l H e H H o B
c r
T l('uj B o T e . 6 o n xB x e '
pBora, 60'rI' B 06racrl r o q K a M !q y H r - x y a H( l 2 V C ) n r y ( - r a M , n ( 3 6 E ) _ I I p 0 O y H K q n o -
nyaKe, orcyrcrBlre annefnra, KpoBaBa'{
EarbroM 3a6oreBaHxxxenytrKa coqerarb c ,roqKaM& qyHr,KyaH,
cepAua.
'icxnxxa. H o i - K y a H( 6 M C ) l r n b r o H r - K X a( 3y 4 L . J .
flylxqun r'1y6!xofi-0,3 0,4 qylt. flpllxtlraHne 5-
l5 M t H .
IIpMMeqaHne. H e n p o r 3 B o A l t r br n y 6 o K n xy K o n o BB o fi36e-
22,TOqKAXyAH-MOH (ryAHb-M3lth,22E)
xaHlte npoKora neqeHI L onacHoro BHyTpeHHeroxpoBoreqeHHq
Jlo|(a,rxsaqxt. A. Ha paccrotlrx I qyHr noa rolrKoi ,'r6!oHr-MoH
( 2 1E \ .
2 0 . T o r l K Al x b l A ' M A H { q 3 H - M A n h , 2 0 E )
E. Ha 2 qyHr narepan6Hee roqxfi KaeH-rx (ll VC).
Jlo(a.rrBauxs. A. Ha I uyHb Hnxe roqKa 6ar-syHr (19 E) Tonorpaoxqccxas axaro[xr. noA xoxHbtM noxpoBoMB paioHe
B. Ha 2 qyHt r'Iarepa?'IbHeeroqKl Txblollr-Kyafi (lxaH-BaHb' rorr(v Haxoarlcc (pacurr HapyxHoii Kocofi MHrlluhrxftBoTa, npcMa9
1 3V C ) . M6[xqa xtBora, flonepeqHar(pacuHf,,6prornl,Ha;B 6prourHoi no,'roc-
ToootparDr,{€c|(at aHaroMxc. IIoA KoxHbIM noKpoBoM B paffoHe T - no[epeq&ag o6otoqHaf KHruxa.
TOqKr HaXOA'TCC(paC[Xe HapyxHofi Kocoi Mblrxubl xxBoTa' nptMat MNIIIIIH B pafioHe1o,rKuxHHepBr,tpytorcr lxecrblo HfixHrrMuMex-
MLrrIlqa XI,IBOTa, nonepeqHat 0acqng, 6prcnlIrHa' aa'ree neqeHb pe6epdLli4r HepBaMllq noAB3AolxHo-noAr{peBHriM HepBoM.
(cdpaBa), xenyAoK (cneBa). Koxa rHHepBfipyercr HepBoMThs.
Mbturqhl B paioHe roqKx IrBHepBltpyorcf, uecrbro HIlxHtM Mex
I l o ( a a a f i x tM
. ecrHbre Hapy[reHfir rl o6xIre pac-
p e 6 e p H H v x H e p B a v l r l , n o t r a 3 l o L ! H o - n o 4 ' l p e B H b lH' i e p B o M cTpotcTBa: ypqaHneB xI{BoTe,noHoc, oTcyTcTBreanneffiTa,
K o x a x H H e P B H P Y e T cHte P B o Mi n r ' oreqHocT6,6011l B 9nfiracTpa,rhHofio6nacTH,B3AITllexxBora.
O o x a 3 a a f l c/ v. l e c r H H e H a p y u e H x t ll o6tqEe pac-
Texnfit(a. flyH(u e rny6nxofi 0,7 1,0 uy8q. nprxsraHre
c T p o i c T B a: BAyrIre xtBoTa, ypqaHre x 6o,1H B xllBore' TorxHo-
5-15 Mtl8.
Ta, p B o T a ,o r c y T c T B H a
e n n e r x l a . x e i T l x a . h p o B o x a T x a H h en o H o c - .
icxxrxa. llyuxunn f'ly6 Hoit 0.3 0.4 uyHt llpHxrfaHue 5-
l5 Mttn.
23.TOqKATXAn-AT(rAn-'d,23E
Il p u M e'{ a H fi e. He c,leayer npox3Boalrl ary6oKy}o nyHxullo JlotaJxsaulrq. A. Ha pacclorHrrH I rryHq no! ro.rKoi rryaH-MoH
BO lj36exaEre npoKo"Ia neqeHll fi oflacxoro BHyTpeHHero(poBoT€qe- ( 2 2E \ 1 .
6. Ha 2 uyst narepanbHee roqKn xa-KyaH(10 VC).
- M 9 H b ,' l E ) Tonorpaox,recxat ataro xr. noa KoxHHM noxpoBoMB pafioHe
21.TOTIKA '|btoHr-MoH (nt
roqKIJHaxoArTccoacuua HapyxHofi xocori Mbrrxu6rxr,rBoTa,npflMaq
JloKanr€aqxt, A. Ha I qyHs Hl{xe roqKr rx a'MaH (20 E)' Mbluqa xrBoTa, nonepeqHarQacufir,6prculIrHa; B 6proruHorinonoc-
E. Ha 2 qyHn 'larepa;blree rovxu vynr_xyan (12 VC) TU TOHXA' Kl{lUKA.

2la 2t9
 Muurqu a paftoHe ro,{KH rHHepBr,rpyrorcruecrbro HuxHI,rMrr flpxMeqaHr.tn. l roq(y y 6orlbHolo
l . l l p H n o n a a a H l r n r , ' r hB
Mexpe6epHLrMrHepBaMr.r I,l noAB3AourHo-noAqpeBHbrM HepBoM, BO3HIrKaer OUIyrUeHxe HanpqxeHXocTx, pacnrpalrtt B Mecre nyHX_
qlrl,r. KoTopoe MoxeT IppaAr,[rpoBaTb x MecTy HapyrxeHHq.
Koxa [HHepBnpy€rcqxepBoMThs.
I l o x g s a x x s .M e c r H r , r e H a p y r x e H r q : 6o,rnB xenyAKe, 2. B noc,TeaH e Mecaubr 6epeMeHHocru nyHKullg nporHBonoKa
arcnencuq.
O6qfi e paccrpoicrBa: c r o c H r e6,e c -
M a H u a K a r L Hc o e
NDTqTHHAfl
' TDCBOTA.
T.xflxKa. nyHxqrr r,ry6fiHofi 0,7-1,0 qyHr. nplxxraHse 5- 2 6 ,r o { K A r r o ^ S - J | A H r ( B A n , J , t H . z r i U J
l0 MHH.
n p r M e t{ a x !,le, B noc,,reAHxe
Mecr{br 6epeMeHHocrr,r
nyHKqrig JloKanrGaqxq. A, Ha paccroflH{l.r I uynn noa rortxoi rxreH_Kxy
IrportBonoKa3aHa, (25 E): Ha 2 qyHt B cropoHy or cpeaHeii !,rrHtrx r(LlBora.
E. Ha 2 qyHr r'rarepa,rrbHeeroqKl,l aM-3qo (7 VC).
24. roq(A XOAT HK)( MOtl, tlJl ll XOAI-IXLIK-M(,tl Tonorpaox'rec(ar aHarorixs. flor xoxHbrM nohpoBov B pailoHe
(rya-aoy-Mih6, 24 E-) roqKn HaxoAtrct (pacqtfl HapyxHofi Kocofi 14blruqblxllBoTa, np'IMag
M 6 l l x q a x r j B o r a , n o n e p e q H a r o a c q s c , 6 p r o u J { n a ; B 6 p r c r I l I H o in o n o c
Jloxaix3aqtte. A. Ha paccroHHrn I uyHq noA ro,rxoi rxafr'ar (23 E). Tn roHKan KHrrxa, MarKa (Ha 6-7'M Mecaqe6epeMeHHocrH),
E. Ha 2 qyHfl,rarepanbHee ro,{xx rxror.{'oaH(9VC). MoqeBoiiny3brpb (npri 3HaqnrenbHoi 3aaep)dKeMoqencnycxaHutr).
Tonorpa(txqecKaf, aHaroMxc.noa KoxHHMnoxposov B paioHe Mbrruqbr B pafioHe roqxfi qfiHepBfipylorct lllecrr,ro lillxHr'rMlr Mex
roqKj HaxoAsTctQacufit HapyxHofi Kocoii MHllrr.lbr xrBoTa, rptMat pe6epHHMrH , r e p B a M Dh n o a B 3 a o u r H o - n o r ' r p e B H b lHMe p B o 1 4 .
Mhrrxqax Bora, 6PrcunHa; B 6plouiHofinonocTfi ToHXar Kqrxl(a tr X o x a r H H e p B H p y e r c t H e p B o MT h
Mar(a (B nocr'leAHxe Mecrqbr6epeMefiHocTB). l l o ( a 3 a H r c .M e c r H h r e H a py ureHL q:60,1 8 xtlBore,6o,rb
MHlrq;I B pafiole roqKfi nHHepBspyrorcr ecrbro HuxHnMll Mex- B O K p y rn y n K a ,
pe6epHbivl,l HepBaM norBrlol!Ho rroaqpe8HHM HepBoM. Texxnxa.Ilyrxuxr rny6aHoii0,7-1,0 qyHt- nptxxraHre 5
Koxa nHHepBHpyeT ca BepBoMTho. l5 uutt.
n o x a 3 a H x r .M e c r x b r e H a p y r x € H r r r i 6 o , 1 l iB x e , ' r y r K e , np u M eqa H xe. flplr 6epeM€HHocTH
nyHl(utfl flporrtsottoka_
TOutt{oTa.DBoTa. 3aHa.
O 6 q lr e p a c c r p o fi c r B a: MaHuaKa,rbHo€ cocroqHfie-
TexxlKa. nyxKqrH r,1y6,rHofi
0,7-1,0 qyHs. flp&xuraHue 5*
__
lc Mllt{, 27.TOqXA[All-Xbr (n^-L3nn,27 E)
n p r M e q a H tr e. B noc,reanueMecffuH 6epeMeHHocrsnyH(Ilns
nporqBonoka3aHa. JloKa,Ix3aufir. A. Ha paccronnrr I qyHt noa roqKofi Hroafi-,rrrr
126 E); Ha 2 uyHs B cropoHy or cpeaHei rIl{HLrnxltBora.
25 TOqKATXll€[ (Xv. ltJll.tIXOrH,a]y(fbtHb-Ulv,25 E) 6. Ha 2 uyHq !'rarepanbHeeroqxl,l rxarb-MoH (5 VC).
(Toq{a{iantaraii Mep(rratrarotcrol 't urtr) Tonorpa0['rec(ac aHaroMxs. IIoa KoxHHM noKpoBoMB paioHe
TOqKU HaXOA9TCT QaCUsC HapyXHOfi XOCOfi MbllllrUbl }r<IIBOTa, nptMafl
Jlot<aJrlgaqrt. A. Ha 2 qyHc B cropoxy or nynxa. M b r r u q ax r B o r a , n o n e p e q H a r Q a c q r r , 6 p r o [ r H 8 a , B 6 p r c u H o f i n o n o c _
E. ,rlarepa,'rbHee roq(Ij rxaH-xxroer (8 VC) Ha 2 qyHt. rn--ToHxae xrilnKa, Mar(a (Ha 5 6-M Mecrue 6epeMeHsocrn),
Tonorpaor,recxar aHaroMxr, [Ior xoxHUM noKpoBov B paiioHe Mo,reBon ny3brpb (npl, He6on6uoii 3arepxKe Mo'relrcflycxaHn'I).
TO'{K' HaXOATTCq (paCqriqfiapyxHoft Kocofi M6ruqbrxHBora, nptMafl Mhtrxqbr B pafioHe ro,{kq tHHepBlrpylorct uecrbrc HuxH,tMt{ Mex-
MbrrxqaxrrBoTa,noDepeqHarQacq!r,6p|.omrrfla; B 6protnHofino,roc- p e 6 e p H b l M HH e p B a v f i r n o I B r a o L ] l H o . n o l l q p e B H H vH e p a o M .
ra ToHKasxnnxa d MaTKa(Ha 7-8-M Mectue 6epeMeHHocrH). K o x a r x r e p e l p y e r c a r e p e o r , ,T r hr.
MBrrxqu B pafioHeroq(r rHHepBupyrcTcs uecrbro HlrxHHMuMex- J l o { a 3 a H r s .M e c r H H e Hap} ueHrfl: B r , n y r r eH r x H e l r
pe6epH6rMfi HepBaMLr noAB3aourHo-florqpeaHNM HepBoM,
Koxa HHHepBrpyerctHepBoMThro. Hapylxefillt, cBq3aHfibIe c MepI{araHoM: atr3y
n o x a 3 a x xM
t .e c r H H e H a p y u e f i r r H o6qre pac- pxn, nonnrcqxx, flpexleBpeMeBHar 3rrKynHqxfl.
cTpoicTBa: 60rr BoKpyr nyrrKa,ypqafine B xraoTe, B3ayrHe TcxH[(a. flyHxqrt fiyd:,{oh 0,7-1,2 qyHt. IlprxrraHlr€ 5-
xnBofa, Al,Icnencrq,rouJFoTa,3aIIop, noHoc,Au3eHTepxt, l5 MrrH.
TexxxKa. flyfiK{l'q rry6[Hoi 0,7-1,0 uyHr. Ilpfixri.aHlre 5- fI p r M e q a H u e, IIpx 6epeMeHHocrs nyHKuut nporfiBonoKa3a-
l5 MtlH. Ha. nplj rluypxr.r cneAyer orpaHrrqxrb rry6sry y(o!'IoB.

220 221
23.TO'IXATXtO[.,tlAO(tltyfi-AAo,28 E) 2. llpn unyptu creAyer orpaHr.rqnrbrny6xHy flyHKqrH, nepeA
nyHKqrei 6onbHoMyH€o6xoAuMoonopo)Ktrrrb MoqeBoi ny35lpb,npt
A Ha paccrollar I qyBt floa roqKofiAafi'xrt 127E);
JfoKanr3aqxc.
6epeMeHHocrr nyHKqxr nporHBonoKa3aHa.
;; t;y;;; ;;;p."v' or rov<uxva''urvea(4vc) ,,-.
roq(r KyaHHrleH (4 VC)
6. ila 2 uvxs 'lareparbHee 30.TOqKA|(Xr-CvHr((X-qyH,30 E)
Tonoroarbni{ecxaraiaroxxt. flon xoxHHM not(poBov B palroHc Jloxarrcaqxn. A. Ha paccroqHsI I qyHr noa roqxoii KoLt-,1an(29 E) ;
npfivat
ToqxHHaiol;Tcc Qacufit HapyxHoi Ko{oi MbllllublxhBora Ha 2 uyHs B cropoHyor cpeaHeiJBfillu)t<uBorat Ha 2 qyHr xr.rapyx!
B 69Io119l-1T:l-
qa.urr' 6-prcu'Ha:
"uruu *r"orr. nbnepeonai 6epeMeHHocrx'' or roqK, Kxyx-xor (2 VC).
inlio"*u" xnuxa, Mar(a (Ha 4-5'M Mectue 6. Ha 2 uyHt r'rarepar'tbHee rovxa xxyx'xor (2 VC).
MOqeBofiny3brpr'(flpt't 3aaepxxe Moqe,cnycxaruf, ' ToflorpaQr,{ecxas anaro xr. IIoA KoxBbrM rroxpoBoMB paioHe
MHuruir s bafiol-eroqxlt t HlepBtlpylorct uecrblo HHxHrlMt Mex_ ToqKr HaxoArrcr oacq|rr HapyxHofi Kocoft MHrxubrxnBora, Hapyx-
pe6epHblMnHe_pBaMfi |{ noaB3AorxHo-norqpeaHblM HepBoM
I n . HHi xpafi npqMofi M6lrxrrbrxHBora, Qacurr BHyrpeHHeir(ocofiMnur
Koxa uxxepeuPYercr HePBoM
r HtlxHel'l ubrxr]Bora, nonepeqHan MHuua xrBora, noflepeqHarQacuHn.6prc
ho*"t""r"j M"ecrx"i HapyureHxe: Br'4ye
3 6ploulltoi norocr[ {acILTl urrHa; B 6prorxHofinonocrfl ToHxar xrllrxa, Mar(a (npfi 2-3-Me-
qacfn xHBoTa,cKon,'teHre ?KccyAaTa
lluy' crqHoi 6epeMeHHocrr), MoqeBo*ny3hrp6(KorAaoH sano,lHeH)-
HaovueHng, cBq3aiHbIec MepI'tAnaHoM: MbrurubrB pafioH€To,rxHuHHepBxpyrorcrlxecrblo Hr,rxHr,rMx Mex-
DItt,
- qrcrllT. pe6epHbrMH HepBaMrH noAB3AolxHo-noaqpeBHbrM HepBoM.
5-
TexE{{a. Ilysl(u c r,ly6rHofi 0,7-1,0 uyxt. flpfixrraHlle Koxa nHHepBnpyerca HepBoMLr.
l5 MLiH. noKa3aBxf,. Me cr H 6re H a p y n e H r.rr:ofiyxaHriex 6one3HeH-
c
n D l I M e , r a H l r q .l . n p t acqr,Te peKoMeHAyeTct coqeTarb rroc'rbB 06,lacrHnHqHrKoBll HapyxHbrxnonoBhrxopfaHoB,fpbr)na,
roq(a;r rxlot-oaH (9 VC). (8
ar,,r-,ranr-ryex RP) x ryK-raM_'1
HapyLueuua M€HcrpyarbH0ro unxna, Merpoppar r.
(' 3 6E ) . stuypBr'l TexBxxa. nyHKquq rny6aHofi 0,3 0,5 [yHq. npnxsraH e 5-
2, IIos 6epevelnocrl nyHxul'tqflporl'tBolloKa3aHaflpll l5 MrjH.
cneayer orpa;rqlr'rb rny6fiHy yKoroB
n p I, M e q a H H q. L IIpfi nonaAaHur nrrbl B ToqKy y 6o,,rr,Horo
BO3BUXaeT OUlyUIeHneHanprxeHHOCTI,,pacnspaHr,rrB MecTe[yHX-
qnH, (oTopoe MoxeT rppaAxr,rpoBarbB HapyxHhle noroBHe opraHbr.
29.TOqKAXor'r-JlAfi(rvn-nAfi,2e E) 2. llpu 6o,ttu B HapyxHHx noJoBbrx opraHax q onyxaHlrH Hx
rxloll'Aao pexoMeHAyercqcoqerarb c roqKaMs l(xyx-Tyefl (8 F), rxai-cyHr
JloxaJrsaurfi. A. Ha paccroqHrl'l I uyHs noa roqKolr (3 F) r raM-aM-3co(6 RP).
{28E).
'-"s: 3. flepeA nyHKqnefi 6onbHoMy c,leayer onopoxHHT6 MoqeBoi "
H, z nvHt raleoa,lbHeeroqKu qyHr-KHK{3 Vc} ny3hrpb,np,j 6epeMeHHocrtr nyHr(r.lnflfl porriBonoKa3aHa.
ionoio"otir..*u" rinaroxnc lloa ioxr'ruv noxpoeorue paftoue
Hapyx-
Toqx, Haion;T(qOacufit HapyxHoftxocoi MtilulublxxBora 31.To'tKA6E-KyAH(Et|-rvAHt',3l E)
*r; -p"l "p"t"*'t"*uu xiriaora. nonepe'{Hat Oacuxe 6p|oulrlral
B 6oouiHoii no,locr roHKat KYUha varxa lHa J 4 v vecsue
MoqeBoro [y36lpt (Koraa oH Hano''IHeH) Jlolarx3aq[t. A. HaA (oneHoM, B yr,ry6,reHnx, 3a ro,rxoi Qyx-rxo
c"r5"""""iitit,
'MuuruH 4"" 1 3 2E ) .
e ;aioHe roqKll sHHepBt'tpylorct uecrblo HrxHnMu Mex_
HepBoM B. Ha uepeceqeHusropr.t3osTanbHofi nrxrl,l, npoBeaeHHofiqepe3
pe6epHbrvHepsaMhH notrB3lotllHo_noaqpeBHblM ro6KoByro Kocr6, I,t BeprtKar'rbHofi,npoBeAeHHofiqepes BepxHolo
Koxa rHHepaPyerct HePBoM ln r'
x a p y u e n t , t * : 6 o n t B t l l i 3 yx l l B o r a ' noAB3AoluHyro ocrb; B yrny6,resxuMexAy nop,rx{oi MbllnueiiH
t i o x a s a l x nM
. ecrtlue
Mbrruqefi,FarcrxBarcqefi rxrpoKyro Oacuftrc 6eApa,
BOCfl ar'leHtenpraaTXoB. ToflorpalDr,{ecKaqararo rr. fIoA r(ox8brM noKpoBoMB pafioHe
H a p y m i n u n , c B t 3 a H H b { e c M e p t , r a f i a H o MB:T c _
roqKr HaxoAflrcH yron, o6pa3oBaHHbrfinoprHrxHofi MLrruqei n
Mb[Ijqefi, HarrlriBarcqei uupoxyro Qacuslo 6eApa, nprMar M6trxqa
O O r u He p a c c r p o f i c r s a : 6 e ' l Ha M e H o p e e ' 6eapa, qe.r6, Mexay npoMexyroqHofi uxpo(ofi Mblurqei 6eApa t
o-
Texxrxa. flvnr.uun rr!6HHofi 0.7 1.2 uyHt llpxxHraHre noAB3Aor[Ho"norcHuqfiofi Mbrurqei, 6eApeHHacKocrr,.
l5 MnH. M6rirqH B paioHe roq(r xHHepsxpyrorca BerBrM! 6eapeHHoro
nnxMeqaHxt L n D Hn o n a - l a Hrnr rn b lB r o q x ) ) 6 o n b H o r o
"oa"r'i"it otya""r" Hanp;xeHHocftt. pacnlpaHues MecreyxoJa' Hepaa, BeTBbloBepxHerotrolHqHoro HepBa, oTBeTaIeHErMfinotc-
xolopoe Moxd uppaAriqpoBarbB I{apyxxble noJloBbleopraHbl
HXqHOTO HepBHOTO CnIeTeHfi rI.

222 223
 Koxa HH epBrpyercsHepBoMLr.
Koxa rHHepBxplerct HepBov L . n o K a 3 a r i xMr .e c r H b , e H a p y u e H E q n H a p y r x e H I r r ,
noxa3anst. MecrHHe HapyrDeHuq: 60"1IjB o6''racrt
c a q 3 a H H H e c M e p ' r a t a H o M : 6 0 , ! t lo, H e M e H rHapyuJ€Hre
e,
6 e a p a f i n a x a , H a p y u e H f i en o A B i ' l x H o c r t rB r a 3 o 6 e a p e H H o Mc y c r a B e [oABnxHocrH a I(o!'IeHHoMcycTaBe, napa!'][q HuxHrrx l(oHeqHocret
MUO3ITTnOAB3AOIUHO-nOflCXUqHOi MbIrXIIbr,naparrq Huxllxx (oHeq- s pe3ynbrare 3a6o,leBaHr.iii oT flaroreHHbrx oaKropoB (BeTpa> tlnn
HOCTefiB pe3ynbTaTe KpoBol,l3r'IqaHll'{B Mo3r xrll xa( noc,leac1Bx€ Kax nocnelcTBre no!'llro MueII,ITa,
T€xrnKa. nyHKqnq r,1y6HHoft 0,6 1,0 uyHq. nprxljraxfie 5-
Tex xxa. flyHxuaq rny6sHofi 0,6 1.0 qyHr. nplxsraHxe 5-
l0 MHH.
10 MlH.
34. TOqXA JIHOHT-KXAy (ntd-Ulo, 14 E)
t 2 - r o q K ^ 4 y K - T X O( O v - T v , 3 2 E )

Jlo(anr€aqt{c. A. Ha paccrorHl.{H 6 {yfiei Han xolleHoM, Ha Mb:uleq' Jloxsnr3aqxr, A. Ha paccrorHaH 2 rryHefi Haa Ko,reHoM, Mexay
AByMe cyxoxn,II{eMIr.
6, Ha paccroflHriu 6 uyaei or Bepxlrero HapyxHoro yl'Jra xoJIeH- B. Ha pacc,orHnlt 2 qyHefi Haa nepeaHtM HapyxHHM yrnoM
H O i q a r U K f i r, . e . r a p a c c T o t H r , r E ' / 3( c H t 3 y ) o T p e 3 K an p t M o l ' , c o e a x - h o n e A H U fqi a u K H , B ) r , 1 y 6 " 1 c H H H
vexr) clxoxxruqMH flpqvoi Mr,lLli'
Hrpnreft BepxH ft HapyxHblfi yro,l xon€HHoi qaullxx c roqKoi 6e_ (br 6eapa r{ HapyxHofi rrrpoxoii Mbruutr r{erblpexr!'IaBoii Mbruqbr
x 'v a s ( 3 1 E ) . 6€Apa (nplr onpeAeneHlrn 6o,lbHoMy pefioMeHAyerct npoH3Becr! cr -
T o n o r p a r 0 r ' r e c K a ea H a r o M x t . n o a K o x H H M n o K p n B o v B p a f r o H e 6are,'rbHbrelt pa3rt6arenbHble aBfixeHrt B xo!'IeHHoMcycraBe).
TOqK! HaXOAeTcCHapyXHbIi l(pafi nptMoii MHuubI 6eipa, BHyTpeH_ Ionorpa$iqccxafl afiaroMxe. floa KoxHHM noKpoBov B pa*oxe
BHfi xpail HapyxHofi rurpoKoii MbIlrIuhI 6€apa, npoMexyloqHaq uu_ roq(fi Haioacrcfl yray6neHne MoKAy nptMofi x HapyxHofi urpol{oi
DOXar
' MHlrqa 6eapa, 6eape.HHatrxocTl'. MblurIaMn 6eapa, npoM€xyroqHaH urfipo(aq MbItIlIqa 6eApa, 6eApeH_
M b i u r u b r e p a f r b n e r o ' i x r r H H e p B u p y r o r c FB e r B q M H6 e , n p e H H o I o
HepBa. MHurabr B pafioHe ToqKl,l nHHepBxpylorcfl BeTBHM{ 6eApeHHoro
Koxa lrHXepBapyerct HepBoM Lr, HepBa.
lloxa3aHxt. M e c r H bI e H a p y ru e H lr s n H a p y rx e H fi qt K o x a r n n e p r l p y e r c n H e p B o ML 3 .
cBt3aHHHe C M e p A A l t a H O M : 6 O ! J X S O 6 n a C TnBa x a . x o n e H I l o x a 3 a E r f , .M e c r x H e HapylxeHltt: 6 0 ' ' 1 6u o n y x a H f i e
HOrO CyCTaBa,HapylxeB e ioaBltxHocTu xoreflHoro cycraaa, napa xoieHHoro cycraBa.
, r t r i H x x H n x K o H e q H o c r e iB c n e A c r B f i e3 a 6 o , r e B a H u foi T n a r o r e H H b l x HapyUlIeHut, cBt{3aHHbIec MepnrnaHo.M: npu_
6a(ToDoB
' <BerDa, IIr'IIl KaK floc,reacrBfie no'l}{oMfieJrra crynbr 6onn B xer'IyaKe, Boclar'IeHHe Mo,' loqHblx xer'1e3 (MaCTIlTr,
Teinnxa. flynxqra r'ry6rHofi 0,6 1,0 qyHt. np xtraHae 5-- 3aKVIiODXaMO,TOqHbIX nDOTOKOB.
l0 Mxs. icxinxa. nyuxuta iny6uHofi0.6-1,0 qyHr. flptixxraHge5
fl pIl M e q a H H e. flo HeKoropriM ApeBHsM ricroqHnKaM, np,rxr_ l0 MfiH.
raHr€ npoTfiBonoKa3aH npuMe,{aHxe. q q e r a r bc
I l p t r a c r p r i r ep e x o M e H A y e rc o
r o q x a M rr r y H r - K y a(Hl 2 V C ) a s o n - I r y a H (6MC).
3 3 . T O q K AA M - T X l . (l l l H b - l l l t t , 3 3 E )
35. TOrr(A AOX_Tbt (Ay-6n. 3s E)
Jlo[anx3aqxg. A. Ha paccrosHnfi 3 uyaei la4 KorleHoM' B yrfly6r']e
rux rroafoqKofioyK-rxo (32 E). Jloxarx3aqls. A. B yr,ly6neHnl noa (oneHHofi qauxofi, saa 6o,'rb-
B. Ha paccroHHxo 3 uyuefiua4 BepxHaM yrnoMKo-
HapyxHHM o r e 6 e p u o B o i l { o c , b r c ,K H a p y x l , o r c B q 3 x t H a a x o n e H H n x a .
reHHoi qaurKr, B[norHylo K HapyxlloMy Kparo cyxoxtnljq flpflMox
6 . B ) r , r y 6 , 1 e H r f in o n H H x H H M H a p y x H t t v y f J o M K o ' l e H H o l r
MH rqbr 6eapa {npll onpeae,IeHltr 6oabHoMy peKoMeHAyeTCt npot3_ Kr.r, rlaTepanbHee cyxoxsnHf qeTblp€xrnaBofi Mblruqbl 6eapa ( n p
Becr| cr[6arer'1;HbIe t pa3ru6arenhHL{e aBtxeHltq B (oneHHoM CyC_ onpeaer'leHlrr.r6o,1tHoMy peKoMeHAyeTct crerKa corHyrb Hory
raBe). " I I E H H O MC V C T A B E I .
T o n o r D a d r q a c ( a s a [ a t o M { c . [ l o A K o x H H M n o K p o B o MB p a x o H e Tonorla6x,ricxar aHarourt. IIoa KoxH6IM noxpoBoMB pafiole
r o q K H a x o 4 t r c n y r r ! 6 n e H r e . o 6 p a J o B a H H o eI I p e M o i i f t H a p J X H O i roqKr] HaxoArrcq yrny6,'IeHlieMexay,lerblpexr'laBofi MHr qeii 6eApa
r u r p o ( o i M H u a M t 6 e a p a , n p o M e x y r o q H a qr n H p o K a t M b l l r u a o e a p a , u cyxoxa!'rueM MbrurqH,HarHrfiBarcuefi urrrpoKyrooacqHlo 6eapa.
6eApeHHat l(ocrh- Hr{xHfifi HapyxHblt yro"'] (o,reHHoi qalxKl, x nle,rb xoneHHorocyc_
MuurqH a paioHe roqKn tHHepBltpyrcTct BerBsMx 6eapeHHoro 'taBa.
HepBa.
225
224
 MHrrrlbr B paioHe roL!(s l.{HH€pBl.rpyrorcsBerBqMX6eapesHoro 37,TOq(A TXbtoHr-(U-Xbt {lllAn-|I3K)n"Crct, 37 E)
HepBar oTaeTBreHreM BepxHerorroaqqHoro HepBa. ( flxx8ir roqra-ycrh. rorcror x xxx)
Koxa BHHepBrpyercq HepBoM L3.
Ilo{a3axrr. M e c r H br e H a p y u e H x q: 6o,rn, onyxas[e JloKar[3aqrr. A. Ha paccroqHxfi3 uyHei Huxe roqKx ryx'raM-"'Iu
KO,IeXHOTO Cyc' raBa. ( 3 rE
j ).
Texxnxa. Kocag nyHKq[t, BAoJIb suxHero xpatl (or'leHHori B. Ha paccronnar 3 rryHei npeMo noa roqKofi ryl('raM-nt
qauxri. KoHeq LIfr'IbI HanpaBIeH B cTopoxy BepxHero BIlyTpeHHero (36 E), pqaoM c HapyxHbrM KpaeM nepeaHei 60,16rre6epuoBoi
yrr'ra KoneHHofiqauJKrr;r,'ry6fiHa nyHXqxx 0.6 1,0 uyHfl- npfix,{raH|,le
5 l0 MrH. T o n o r p a r 0 l q e c x a q a n a r o M x e , n o ! K o x H t r M f l o K p o B o \ aB p a i o H e
fl pI, M e q a H r e. Ilpri Bocna,reHro Ko,reHHorocycraBa PeKoMeH_ roqK! uMercrct HapyxHblfi Kpai flepeAHefi 6o,'Ibrxe6epqoBoi Mblulqn.
ayercr coqerarb c roqxaMr{ rhroHr-xxay (34E) fi 3HoHr_TyeH BHyrpeHHxi Kpafi 06qero pa3rlr6are'rq naJrbueBcronH, uIe,'Ib MexAy
( 3 4V B ) . 60,rbrxe6epqoBori lr Malro6ep{oBoi KocrfiMIl,
MbruqH B pafioHe roq(r tHHepBspylorce BeratMH nep€aHero
6o,'rbue6€D(oBoro HePBa.
36. fOq(A Tvl(-TAM-Jllt (U3v-CAdb-J|l{, 36 E)
(TocKa-yc"bc, xa"eroprx <3enr{r) K o x a a n n e p a a p y i r c n H e p B o M5 1 .
lloxasaHfit. M€crHbI€ HapyureHxs; 6o'It{ B o6'racrtl

Jloxanr3aqrc. A. Ha paccrorHrn 3 qyHei Hr.txe KorreHa,'la MHtIreq_ HapyueHHH, cBt3aHHbIe c MeptaxaHoM: 60"Ill
HOMBblcfyne r(HApyxr or 6o,1r,ue6epqoBofi o(orbHofi cBq3Kn. B XO.IICHHOM CYCTABE, 6OTH BOKP}T NYNKA,YPqAHN€B XTBOT€.
6. Ha ypoBxe yr,ry6neHriq B 6yrpncrocrx 6oft'ue6epuoBot Koc_ O 6 n r H e p a c c r p o i l c . ' r B a : A l j c f l e n c r t ,n o H o c ,x p o H x q e c K a f l
Tl,l, Ha fiprlHy nanr,(a r(Hapyxn or ocHoBaHfit oyrpxcTocrlt. allaper, 3a6o,reBaHIr9 TOJICTOII KI'lIUKU
T o n o r p a ( b | q c c x a q a h a r o n c . l l o t r K o x H b r Mn o h p o s o M a p a l o H e iexxxxa. flyuxqun r,1y6r8ofi 0,5 1,0 IryHs. IlprxnraHfie l0-
TOqKn HaxoaqTcr nepelHqfl 6onbue6epqoBaq MbI ua, Mecro npfi- 20 MtH.
(penneHrir cyxoxxnaq AByr,raBofi MbIlnuH 6eApa, ue!'Ib MexAy n p f i M e . i a H L ie . f l p r s o c n a , ' r e H l l x H l x e q H x x a s 6 a m e p u a , r b -
6onbue6epqoBofi l,' Marrlo6epuoBoiiKocreMn, MexKocrHaq n€penoHKa HOil An3eHrepHa peKoMeHAyeTct coqeTarb c roq(ot TxxeH l(xy, Ir'TH
rxneH'cy (25 E).
Mbruqbr B paioHe roqKfi [HHepBHpyrorct orBerB'leHxqMH 6orb_
ero ce,4anEulHoro HepBa Lr nepeAHero 60,rbue6epqoBoro HepBa, 33- TOrr(A AfiEv-(XAv (r'lo-|(Oy, 18 E)
K o x a n H H e p B u p y e r c qH e p B o MS r .
n o x a 3 a n x q .M e c r H b I e IapyrueHsqi 6 o " , I bB x o , r e H H o M Jlo[aJt€aq[t. A. Ha paccrotHttli I uytr uaa roqKoi xa-Kbl_xtl
cycTaBe, onyxorb xol'IeHHoro cycTaBa, HapyueHle noaBrixHocTl'l (' 3 9E ) .
KOreBt{oro cycTaBa. B. Ha paccroqHrr 5 qyHeftno,Aroqxoi ryK-raM_nx(36 E), Ha
Hapyuerur, cB'{3aHHHe c MepxatraHoM: napa_ cepeAnHe rovxr aox_ru (358) u
&pe3Ka npnuofi, coeAanrrourefi
nsq Hnxufix x o H e q H o c r e i iK a K n o c r ' l e I c r B l e 3 a 6 0 r e B a H x i o r n a r o asfi-rxe(41 E).
reHHr,rx (paKToPoB <Berpa> Ir,rl,r (ax floc,leacraHe nonroM ersra, TonorpaoxqecKaq aHaroMrq.IIon KoxlrbrM noKpoBoM B paioHe
racrparfuq, o6Typaqxt nporoxoB MonoqHofi xene3bl. MacTfiT, 6one3_ ToqK HatoAqTct yrny6reHlle, {)6pa3oBaHxoenepeAHe; 6onbue6ep_
H',l rJIA3. uoBofi Mhluuefi x 06 lItM pa3rr6are'1eMDaltblreBcronbl. nrenb Mex-
O6 qre paccrpoficrBa: a x c n e n c r t y, p q a a r eB x l r a o r e , ay 6onr, e6epuoBoi x Ma'lo6epuoBofiKocrqMt, MexKocrHaq nepe-
noHoc, r'rnxopaaoqH6Ie 3a6o,reBaHHfl. Toqxa fl po(bx,'IaKTrKr, 6one3-
Hefi, noBbruexra conporhBnseMocrfi opraHH3Ma, Mr,rmqH B paioHe roq(, tHHepBl,rpy'orcqBerB'{ML nepeAHero
T€xHrxa. flyHKq r f,ry6nHofi 0,5-1,0 qyHr. flprx[ra ne 5 60,'rbue6epqoBoro8epBa,
l0 MaH. Koxa riHHepBnpyerct nepaou Sr,
f l D l , M e q a H r e . f l p f i t 3 s e x e n y a x a p e ( o M e H A y e r c qc o q e r a r b noxasaHxc. M e c r H hI e H a p y u e x LrH: norept qyBcrBt-
c r o q K a M aq y H r - ( y a r c( l 2 V C ) , H o f i - ( y a H( 6 M C ) , r x a n - c y H r ( 3 F ) . Tel'rbHocrfiq ABrrareJlbHoi (byH(qnH ro,'reHlt.
IIpr.r ar.rcDenqr! coqerarb c roqKaMu xon-xox (4 GI), TxseH_Kxy, H"II, TexHrKa, flyHKqtt r"ry6tHofi 0,5 1,0 IryHe. nprxnraHxe 5-
r x r r e H - c y ( 2 5 E ) , K y a H ' H r y e H( 4 V C ) . l0 urs.

226 227
39.TOqKAXA-Kbr-X5r (Ct-|l3lon-Clon, 39 E) O 6 nr t e p a c c r p o i c r B a: roluHora, o6r"lbHoe oraeneHse
(firxHir mqxa-ycrL€rorxol xxu'(x) Moxporbr,6poHxtatbHat acrMa, MaHua(a.4r,Hoe cocrogHre' for'Ioao-
'-TexHfiKa.
JIoKaJr3aq r. A. Ha paccrotHrr.r 3 uyxei naxe roqxs rxbloHr-Kbl_ flyHnqlrq rny6ltHofi0,5 1,0 uyHt. npxxrraHlre l0
20 MnH.
B. Ha paccroaxau6 uyHefiHfixe ro,rxx ryx-rav''ra (36E), e n D r M e q a H r e . f l p H r o r o B o x p Y x e H HpH e K o M P H A y e cl cofql e _
yr,ly6neHx; Mexay nepeAiefi 6onr'rue6epuonofrMlltllqefi ,t o6ql'tM rnro " rouxurr rxtreH-.ri ( l 0 V ) , i o * - x y a n t 6 M C l I x a H br t H
pa3rr,16arereM rra,/IbIIeBcToflbl (npr oipeaeneHfid 60'1bfioMyc"leayeT (2 F).
c o f H l r bc r o n ! B B e p \H H a p y x y ) .
Tonorpa(pflqecKas aHaroM[t. no,n xoxHHM noKpoBoM B patoHe 41.TOq(A 3qn-KXE(U3E-Cll,4l E)
TOqKn HaXOirrCt yrJy6neHne MexAy lrepeaHeir 6o,lblue6epqoBoi (roqKa-6tcrprHa, €r.ropt|r <oroHb')
Mbrlxueft,{ o6q}rM pa3rlr6afereM na!'rbqeBcronti, rny6xe - BHyr_
peHHfifi hpafi,trnrHHofo palrfi6aTeJtt60,lbtxolona,'Ibua.lonH Ue'lb Jto[arx3aqlc. A. Ha paccro'lHux 1,5 qyHq HaA Toqxoii cydr_36lofir
Mexa) 6aubue6ep(oBoir va,ro6epuoBofi Ko.rtM9. (42 E), B yrry6neHr t Ha npeAnnrocHe.
Mbr[ruH B pafioHe roqKl{ fiHHepBrpylorcq BerBrM0 nepeaxero 6. B cKraaKe nepea npean,rrccHeBuMcycraBoM, B yr'1y6neH,rl'1,
6onbue6epqoBoroHePBa, o6pa3oBaHHoMcyxoxxr'rneM nepeAHefi 6orlbue6epuoBoi MH lubl
Koxa nHnepBxpyercq HePsoM s1. { cyxoxlnueM &rHHHoro pa3rlt6are,rc 6o'lbuJoro narlbua cronbl
[oKa3aErc. M e c r H b' e H a p y lx e H I'tt: no, epq qyBcrBa_ llprj onpeae,leHlrljro,{Kt 6o,rbHoMycneayer ororHyrt crony BBepx,
,re,'rbHocrrr{ ABfiraTe,lbHofi(pyHXqxxroneHll. {ro6buerqe 6Hno npoqynarb B o6nreMpa3ru6are"le ra,'IbqeBcronbl
HapyueHIrt, cBq:rHHbIe c MeptaIaHoM: 6onfi a,rxHHoroparrr6aTe,lt 6onbuolo na'lbua ptIloM c Hr'1x
ctxoxr.i!'rue
B HrrxHeil qacTx xllBoTa, xxeHfie B ?nrracrpa.rlLHofi06"'racft,6ont nifi. uapyxnoft qacrbrcc)xoxnrHe 60,15rxe6epuoBoi vbluubl
B xrBme (B peynbrare r'rrcrHllx IjHBa3Hfi),o6Typaqtt nporoKoB Tonorpa(hfiq€cxacaxaroMxc. floA KoXHLIMnoxpoBoMB patoHe
MO.TOqXHXXe,1e3, MaCTLIT, roqxs Haxoaqrct yr,1y6,1eHae. 06pa3oBaHHoe cyxoxs,']rieM nepeaHeff
3nsJrlen' 60,rbue6epqoBoft Mbllnqr,l q cyxoxt'rI,'eM arIrHHoro pa3rt6are-at
O 6 rq Lj e p a c c r p o ii c r B a: nor,lxeHfie afl nerrra,
cllfl. 3a60,1eBaHHc roHKo[t KItlllKIl, 60,,rbuoro na,lbqa cronbr, ulei'rr, 6ort ue6epqoBo-Ma''ro6epqoBo_
0,5 1,0 qyHt. npuxxraHsel0-
IlyHKuLttr,1y6fiHoi
T€xHrKa. T a'D a H H O TCOV C T a B a .
MHruq; g paioH€ ToqKx Lr,{HepBtpylorcq BerBtM! nepeAHero
20 nxx.
6onbule6epqoBoro HepBa.
40. TOq(A OOflr-.'tOHt' (OgH-nvH, {0 E) K o x a r x n e p r n p y e r c a H e p B o MS r .
(Cra6turirpyDnrat ro']ra, cursraaouac c eprAxaHon no(a3aflxt,MecrHbIe HapyuIeHIlt: 6 0 , 1 6B o 6 n a c r
cc'cac xx .8en {x|| xDL', npeAnnrocHbt, aTpoQaq Mrrruu roJreHlt.
HapyulIeHLrfl.cBq3aHHbIe c MepxAl,laHoM: B3ay-
Jloxanr3aquc. A. B yr"ry6neHxx Ha paccrotHlrlr 8 uyHefi Haa nare- rr,te xHBora, ro,roBHaq 60,rr,, 6o,resHfi r,'Ias, ore(,'lxua, 3y6Haq 6oJr6,
panbHoi r'loAHxKOfi, C HapyxHoil CrOpOHhr6onbUle6epuoBoi KocTll-
o6lypaullq nporo(oB MoJIoqHbIxxe{'Ie3, Macrl,lr.
B. Ha paccrorHfi! 8 rryHefi Haa Bep xHoii r'larepanbHoi ,'IoAbIx- paccrpoficrBa; e A e o e l ( a q l l rM
O6qre 3arpyaHeH , a-
xr.r, B yrr'ly6neHnx, o6pa3oBaHHoM q6ulrM pa3rlr6aTe,neM nartqeB
HXararbHo€ cocroqHxe.
cronLr fi Koporxofi Ma,Io6epqoBofi Mhlrxqefi (npl, onpeaeneHx! 6onb_ TexEnxa. flyHKur{'{ rny6rHoi 0,5-0,8 qyHt. IlpHxlraHlre 5-
HoMycneAyerororuyrt' crony sBepxs Hapyxy). l0 MrrH.
axatonrt. lloa KoxHhIMnoxpoBoMB patore
Tonorpa(bfiq€c[as
Toqx,{ HaxoArTcg yrJIy6JIeHne,o6pa3oBaHHoe06qriM crl,6aTe,IeM
nanbrleB cTonH I,r KOpOTKOfiMano6epqoBoii Mblllqelii, aa{'Iee 4 2 .l o q | ( A C v H r - 3 b r o H f ( q v H - t f l , 4 2 E )
(ToqKa-nocoor,r)
Brr'1y6h annHHHi pa3ri6arenb 6o,Tr,urorbna,rlqa cronr,I, Mano6ep-
Jloxarx3aqxt. A. Ha rbl,lbHoi cropoHe cfon6l. Ha paccrotHxx 3 u'_
Mbrurqbr B paftoHe roqK, LiHHepBMpylorctBerBsMH nepeaHero
Heii 3a roqxoi xaM_Kox (43E), raM, rae nynbcxpyer apreplrs
6onbrre6epqoaorcHepBat koxHo-MbrueqHoroHepBa.
uepnou Sr. E. Ha nptMoii, coeaxHqlouefi roqKl 3tfi-(xe (41 E) n Hofi'arjHb
Koxa lrHHepBupyercfl (44 E), B Hau6onee Bo3BbtuIeHHoMMecre rblrbHot cropoH6l cronbl'
lloxasaH t. MecrHLIe HapyueH.utr r ' r o M t u r a60,,rb,
t
oHeMeHUe, DapanaqroreHr{. Ha paccroqHlru 1,5 qyHt flepea ToqKofi 3cfi-Kxe, TaM, rAe nynLcupyer
H a p y l U e H n q , c B t i 3 a H H h I ec M e p n a s a H o M : 6 o n s
TbnorpaoruecKaq a8arontf,. IIoA xoxHt'lM floKpoBoM B patoHe
B xsBore, rpyar, roprre,ronoBHaq6onb.
228 229
ro' (H Haxonrrce BHyTpeHHlri Kpaft cyxoxr,lrfl paltH6afeit Tonorpa(brqecxatararonnn. [loa xoxHHM nohpoBovB paioHe
l l n a , r b u a . m H o c H U r e r o c f lk 0 6 u e M y p a l r 1 6 a l e , t t o n a " ' t b I e s c t o n H . roqKr Haioisrcq yrny6r'refixeMexAy cyxoxunneMi II x IIi nanb'
Koporxr.{i pa3rn6are,rb 60,rblxoro na,'rbqa cronbr, xrrHor'raA6eBuAHbrft ueB,orHoctIIIIMHcq I( !/ll1lHHOMy l.l KOpOTKOMy pa3rH6aTer'IgM nanb-
cycraB. a a t H n e c l o n H , u r e n bM e x n ) |
u e B . r o n H , 2 . Hv e / h h o ( T H aMeH L x u h
-
M H U r u b rB p a i i o H e T o q x r r H H e p B r p ) t o t c aB e l B r v r n e p e l H e r o QaraHraMlrII x III na'IbqeB.
Mbluqbr B paf,oHe roqK}r lrHHepBltpyrorct BerBtMx flepeAHero
Koxa uxxepaupy6rca repaou 51. fi 3€AHero6onbule6epuoBblxHepBoB.
l l o l a s a E x cM
. ecrHble HapyueHrn: 6o,rb onyxaHr.{e Koxa fiHHepBUpyercr HepBoMSr.
cronEr,Bq,rbri naparrHqcTonH. Ilo|(a3anac. M e c r H H e H a p y u e H l,l q: 6onb B crone l,l ony-
H a p y l n e H x q , c B r r 3 a H H H ec M e p f i A r r a H o M 6: o , t t i
B xHBore, ,y6Hae6o,rb.napa,1r,rJtueBoro HepBa. H a p y n l I e H I t q ,c B f l 3 a f i H b t e c M e p r a u a H o M : 6 o n 6
( J o u H e p a c c T 0 o I t . T B a r M a H l a ( a n b Hcooec T o t H r e . B )r{r,tBOTe. 3y6Hat 6orb B BepxHerlqeJllocrll, KpoBoTeqeHl'te t,l3Hoca,
Texxxra. flyHxqur{ r,ty6r.,Hofi0,2 0,3 qyHr. llptxHraHfie 5 6or:bB ropne, naparHqnrueBoro xepBa.
l0 MrH. O6 u I,le p a c c rp o fi cr B a: Ari3eflTep!fi,noHoc, Dorept
flprrM€qarifi€. C,reAyeru36eraTr,nonalaHxq trrhr B apTe, annerxra, J rxopaAoqHoecocToqsre 6e3 noTooTAe,,reHIrt, 3aTpyaHe-
pfi() Ha rr,rne cronbr. rrbrr.roTxoa ra3oB.
TexHrKa. llyHnur,r rny6fiHoi 0,3 0,5 qyHq- Ilprxl,lraHue 5-
43. IO{KA XArn-XO((CrHb-ry, {t E} l0 Mr.rH.
(Co|ryrcracfirlr roqxa cflr'rr, orxocrrci x rrrcropxt| .Acpasor) r x o a e r a s o Bp e K o M e H -
f l p f i M e q a H r . t e . n p r . t3 a r p y a H e H H o M
Ayercr correrarb c rourofi ryx-rau-,rr (36 E).
Jlor(anriaqfit. A. B npouexyrxe Mexay I u II fla,,rbqaMl cronH,
B yrny6,reHnH3a I rpanaHrofi.Ha paccroaula 2 qyHei 3a ro,{Kofi {5. rotK^ J|E-AOAn(Ilt-Ivn, 46 E)
flofi-nnHb144Ei. (To.tra-rcror, qmocrrcr x xarcroprr .r.ra.rx')
E, Ha ypoBHenepexoaarer'ra II nriocHeBofixocrr B ee nepeAHfifi
KoHeq,B uleJR MexAy II I, III n.{rocHesbrr,{fixocrriMrr. Jloxarx3aqxc. A. Ha KoHue II na,rrqa cronbr (co croponu V na,rl-
Tonorpaor{ec|(as aHaro xc. noA xoxlrHM noxpoBoMB paioHe rla), <Ha paccToiHr.{xTo!'rrqHhr crpen(r M€r'rKoro3elreHoro,Iy(a-
rortKl HaxoAflTcflyr,1y6,1eHxervexAy cyxoxx,rrauu Il fi III na,lb- ceffH[a> oT HofreBoro "'roxa.
qeB, oTxoctutrrMl,rcfl ,j (oporKoMy pa3ru6aTenqMna,IL,
x A.nxHHoMy B. Kuapyxu oT HorreBoro noxa II nanbqa cronbr, Ha paccrofl-
qeB cTonbl.z-rl Mbrtrqa fia Tblre cTonbr,qeJrb Mexlv Hfin 0,2 qyHq or yrna Horrr, Ha rpaHnqe rLubHofi fi noAouBeHHoi
ll l,l lll nn|ocHeBHMr xocrrMx. noBepxHocTefi.
Mtrllrur,r s paioHe roqKx HxHepB[pylorcf, BerBrMr nepeAHero Tonorpaoxqecxacararonrn. noa koxHHM no(poBoMB pafioHe
x 3arHero 6onhue6eDrroBbrx HeDBoB, TorrKuHaxoltrrcfl III danaHra II na,rrua cronur.
Koxa rnaeparpyirca nepnou S1. Koxa B parioHeroqKrj nHHepBspyercqrepaou Sr.
Iloxa.Bar|rM {re
. crHbre HapyueHr,ir: 6on6 I,lonyxaBne noxa3afixq. M e c r I br e H a p y rn e H n r: noxonoaaHre Hrx-
HflX KOXeqHOCfei.
H a p y u e s r . r q ,c B r 3 a H H b r e c M e p H A f i a H o M y: p q a - HapynlIeHfit, cBt3aHHbre c MepHAHaHoM: B3Ay-
Hre x 6onb B xnBore, 6o,re3Hr r,ta3, TEe xrBora,6otb B x r l B o r e , 3 y 6 H a q 6 o n b , H o c o B o ex p o B m e q e H n e ,
O 6 q I e p a c c T p o il c r B at,luxopaAo,{HoecocTorHne6e3 IlaDa"'ruq r ueBoro HeDBa.
noToBbIAereHrt. O6qHe pa ccipoicrB a: norepr annerfiTaH , o q H u ef i o u r
TcxEl|xa. flyHkrtqn r,1y6rHofi 0,3 0,8 uyHq. flpfixrrraHae 5 Mapbr,,rxxopaAoqHoe cocroqHxe 6e3 noTooTAereut,lq.
10 MLrH. Texsxxa. flyHKq[t rny6nHoi 0,1 uyHr. nprxfiraHse 5-O MxH.
44. TO{XA flOn-.(ltHb (H3f,-TXn, {{ E}
(To{xa-ty{cl, |(At.roprr .ro!e') HOXHON 1{HbCKIN EPTAI{AII CEJTE3EHKX(RP)
(no 2l mq{c c x.xAofi croPo's)
Jloxanr3au{t. A. B }rny6neHrr xHapy/hl,l
or I t] ll na"lbueBcrorN
6. Toqxa naxoarrcs y ocHoBaxuflnpoMexyrKavexA) ll H Ill Xoa M€phAxaHa.6eper Haqaro 3a BHyTpeHHHM yrnoM HorreBoro
naJbLravfi,
KoropbriiFcHoo6otHaquTcfl.ecJlHnioTHocBecTHut xoH- roxa I nar'lbrla cronH, y roqxr aH-6arb (l RP), npoxo.qfir sloar
uH; Ha rHre cronu, ea yposte MecTa,rAe reno I danaHrx nepexo- rpaHnrl6r rHnbHofi u noAolrBeHHoii noBepxHocTei cronbl, BbIxoAHT
lHr B ee raaHHfi. npoKcHVa,lbHbriihoHeu. x 3aAHeMy KOHUy n!'IOCHeBOffKOCTI,U CBOpaqHBaer BBepX, Mr.lHy'{

230 23t
cnepea[ MeAsaJbsyp roar,rxxy, JaTeM noaEriMaeTcqro roneH]l
BAo!'rb3aaHero BriyrpeHHeroxpar 6orb[e6epqoBoi KocrH, nepece-
xaeT cyxoxlr,'rr,xbrtMepHAnasr, nporoar nepel HriM,noaHUMaerct
K BHyTpeHHen noBepxHocrr,rKo!'teHHofo cycTaBafi aanee no BHyrpeH-
xeu noBepxHocTlr oeApa, MnHyeTnax l,r cneayeT BAonb xHBo,ra Ha
paccrorrHrx 4 qyHeft or nepeAxecpeAqHHono Mep AHar{a. 3areM
cBopaqvBaer Ha0cKocl, KHapyxx n Bbrxoar{rHa rpyab Ha paccros
HtIr 6 qyHefi oT nepeAHecpeAlrHHoro MeprAxaHa, npoxoAtr roqKy
rIo-BrHb (20 RP), rAe y BepxHeroxpar lV pe6pa pe3KocBopaqrsaer
K noAMbrruerrHoiflMKe, 3axaEqfiBarcb B ToqKe aaltr-6ao (21 RP)
y BepxHeroKpafl VII pe6pa (pnc. 69, 70).
lloxasafirt, 60re3Hr xe,tyaKa, KrLxeqHHKa.paccrpoftcrBa
MOqenonoBotcHcTeMH,
TexHxxa.flpri Bo3AeficrBrfiHa roqxfi na,'rr,qeaHor, cronbr, ro,reHrr,
o6,!acrt Ko,'IeHHorocycraBa Ir 6eapa noJloxeHre6o.rlbfioro n€xa Ha
cnrHeco crerxa cofH!"rblMH B xoreHrx HoraM, (flon xoreHo noA,to-
xxTb noAylreqKy); qiAq, flocraBr.rBnoAoluBbrcorHyTbrxHor Ha l(po-
BaTb}trt cBecaBgort c (poBarr.r.B no6oM |,l3y(a3aHHbrxno,qoxe-
Hulj ,lexa HJr.rcHAs cronbl, ro!'leHr,r u 6eApa c,'reAyeTpacnora-
rarb rar{, qro6H oHfl 6H,,rHpa3BepHyrbrl(Hapyxg,
flpx so3AeicrBr.ruHa ro,{Kfi B o6,raaTr xlBora noroxeHr€ 6onb-
HOfO - ,/I€Xa Ha CflUHe,
npr Bo3aeficrBlru
HaroqKn B o6JracrHrpyAfi ,rexa Ha cnrHe r,l,'rH
crar nprrMoco crrerxa pa3BeAeHHHMr B cTopoHypyKaMlr.

l. IoqKA AH-6AT[,(rlF6An, I RP)

(To{xa-xcrox, xareroerx <!epeBo')

Jlor€Jfi3aqrr. A- Ha BHyrpeHHefi
cropoHe I na,rbua cronbr, <Ha pac-
lj
tl
!'ty(a-cetHua>oT yrna
cToqHriHToJIulnxbrcTpeIXI MelrKoIo3e!'IeHoro
HOTTeBOTO!'lOXa,
6, Ha paccrorHut 0,2 qylr or BHyrpeHHero yrr'raHorreBoro!'roxa
I narbua cTonH.Ha rpaHfiuerHnbHoi H noAouaeHHoinoBepxHocrei
cronH, ua BfiyrpeHHeicropoHe I nanbrla,
TonorpaoxqecKaf,aHarourc. noa KoxHbrMnoxpoBoMB pafioHe
roqxs Baxorrrcq Kocrb II Oa,ranrn I laoua cloru.
Koxa s pafioue roqKfi nHHepBr.tpyercq nepeou L6,
Iloxa3anrc. M e c r H r,re H a p y ln e H ri r: noxor'roAaHrre Hfix,
HfiX KOHELIHOCTEN.
H a p y u e H a , c B i 3 a H H b l € c M e p H A r { a x . o Mf i: a p a -
"lfirr HnxFrx xoH€qHocreixax pe3yn6raT3a60neBaHri or naToreH-
xbrx QaxTopoB <ae,pa>,B3ayrsexnBoTa,
O 6 nr t e p a c cr p o fi c r o a: norepa annerrrra, TolxHora,
noHoc, MeTpopparnt, cocrorrHre,3rrar€nrlqecKse
nprflaaKs.
T€xEIKa. IIyHKqr.rt f n y 6 r H o f i 0 , 1 - 0 , 2 q y H s . n p x x r f a H u e 5
l0 MrH.
n p n M e q a H x eflpx
. Merpopparnr peKoMeHAyercqcoqeraib c
roqxaMxxroer-xan(i0 R p ) , K x k ' x a i ( 6 V C ) a r a u - a u - a n o ( 6 R P ) .
Pr.. 69. Mep,at.H cere3edRN (B€r,krt,Hh,
232
 2. roq(A aan-,[o ([a-avt I RP)
(To.rxa-pyq.I,ornocntce x xitcmpxr .omn5')
Jloxanfi3auxc.A. V ocHogasaq6onbuoro DanbuacronH, B BbIeMXe
Ha ero BHyrpeHHeicroPoHe, Ha rpastqe rbllr,Hofi n noaouBeHHoq
noBepxHocTeir.
B. Ha BHyrpeHHefi cropoHe6d'Ir,Doro nanr,ua cronbl, Ha rpaHI'rue
-rbrrbHofir noaouBeEHofinoBepxHocfeftcTonbI,Ha ypoaHe nepexoaa
3aaHero(oHqa B re.ro I (panaHrri 6orburoro na.nLqa,
Tonorpaoxqecxataxaiomnc. noa xoxHHM noKpoBovB fraioHe
TOqKIHaXOntTCg MeflO npflKpenreHrtcyxoxHrxq MbltlJuH, oraotrtl-
urefi6o,1huJoft na,leucronu. BHyrpeHHriKpafi raaHeroKoxua I Qa_
,raHrr 6o,lburoro na,lbua.
MH qbr B padoHeroqKfi rHHepBljpylorcaBerBqM[ 3aafiero 6ort-
ue6epqoaoro HepBa.
Koxa nHHepBItPYercti HePBoMLr.
f l o ( a 3 a H r l t .M e c r n u e H a p y t l r e H n t : 6onlj B o6racrlr

HapyulIeHIt, cBq3axHHe c MepEAxaHoM: 6ort

Boxpyr MeAr{anbHonroAblXKLr.
O 6 q u e p a c c r p o fi c r B a: B3ayrse xrBora, alicnenctt,
TOTXHOTa, pBOTa,3anop, nOHOC,TqXeCTb BO BCeMTe!'Ie,"lHXOpaIOqHOe
cocrotHte 6€3 noToBbMreHHt.
T€xHxxa. flyH(quq r,1y6nfiofi 0,1-0,3 qyHt. Ilpxxr.raHte 5
l0 Mr.rH.

.. TOqKA TIAfi.EATb (TA'.64N, I RP)

( Toqra-Da3rr!, mxocrrcc r xartmpxr.3.rrrt.

' '41 To{x.-oo.o6rxr )

Jlo|(a,r 3aq s. A. B yrny6reHlfi noA KocrLto Ha BHyrpeHHeM xpalo
HOflt.
E, Ha rpaHriae ru,1bfioi I, floaouBerIHofi noBepxHocrei cro-nbl' Ha
B H y ' r p e H H exMp a l o e e , H a y p o B H e n e p e x o l a n e p e a H e r ox o H u a I n ' ! x ) '
cHeBotar{ocrE B ee rero.
Tonorpao qecxa{ aEaroMxc. floa xoxHbiM nokpoBov B paioHe
roql{l,l HaxoArTcr Mbrrlua, oTBoaqnlag 6onLnoi na,'Ieq, L KopoTKni
crlr6aren6 6o,'tbulloro narbua cronhl, cyxoxlt{'Ire anLHHofo crfi6are_
r'lq 6oJblioro nanbua ctonbl, HHxHtq cropoHa nepeAxelo xoHua I
nnlocHeBol (ocrlr.
Mbruqr,r B pafioHe roqKu r{HHepBrpyrorcr BerBrMH 3aaHero 60!'rb-
ore6epqoBoro Hepaa.
K6xa annepeupyercn HePBoM Ls.
JloKa3allrf,. M e c r H br e H a p y lx e H x t: 6o"tb, onyxaHlre

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o teop r a r a H a : nynoK,
da pa.croeHnrJ.5 uyHe hHapyxHor cpenHei r'uuuu xus6ta Toflorpaoxq€c(ac adaroMxg. floA koxHblM noKDoBoMB DafioHe
. E . H a p a c c r o u H r 0r . 7 u l n n x a e r o q k o nc ) H r M o H ( t 2 R p J H a roqKr Haxoarrcs fiapy*Har xocaq x aryrpenvnf xocaq MHurubl
4 rlyHr naTepanbHeenepeAHecpeAnHHoro Mepuava:da.,rlareoa,,lhH€e xr,rBora,nonepeqHarML|lxqa xrBora, DonepeqHareacurr, 6ptonllr_
6eApeHHofiapreprju, HaA IaxoBofi cx,ran(oi.' Ha, Bocxoltnlaq tr'tl.tSucxoAtrqaq o6onoqHacI<uur(a.
Tonorpaorqecxac aEaroMrr. noa KoxEbrMnoxDoBoMB DanoHe paioHeroqKHfiHHepBHpyrorcH
roqKr Haxoaqrcr uerrb Mexly nyvxavr.rnoncxauio-noaasqouHoir -Mbrr!uH B
peoepHUMr
LuecrbroHr1xHHvH Mcx{-
HepBaM9 l,l nolA3llorxHO.nOAqpeBHblM HeDBOv.
Mb[uuH. 6enDeHHatI{ocrL. Koxa HHHepsHpyercr repaov Thro
Muruqu i pafiore roqxr tFHepBxpyrorc, nonepeqH6rML BerBrMl J l o | ( a 3 a f iMx e* .c r n u e H a p y u e f l x r x HapyrneHHq,
notcHlrqtoro HeDBHoro cnIeTefiut, c B f l 3 a H H b r e c M e p H A x a H o M : 6 o , r sB H u 3 yx L j B o T aA, f i c n e n _
Koxa rHHepBfipyercrHepBoML . criq, 3anop, Afi3eHTeprr.
240
241
 1,0 IryHt. npHxtraHte 5 Tcx8llKa. nyHxurr r,ry6xHofi 0,2 0,3 qyuq. flpllxnraHxe 5-
T€x8rra. nyH(qHn r,1y6 Hoi 0,5 l0 MuH.
l0 MLiH. np v e q a H n e H , 6 e r a r bI n ! 6 o x o iai l H x u n H .
il p u v e v a u u e. flplt MHoroMectqHoii 6epeMeHHocrx nyH(qss iroxer flpasec.rB( npoKony r.rerKrrx.
npoTtBonoxa3aHa.
18.ro{KA rxl€lt-xxE (ttHh-clt, 18 Rp)
t 6 . T O q X AO y ( , A n ( o v - A o , 1 6 R P )
(To{ra corpcxeHit {oxno.o repxaraHa.Nnxxxt,H5, Jloxaitsaqxt. A, B yrny6,reHfi! Ha paccrorHrr 1,6 uyna noa ro'r-
crcaureDuat c snytp.nHxit floa'qepx|laarurt|r M.pxAtaxoir, I<ofixyHr-xbroHr(19 RP), Ha 6 qyHefi KHapyxr or npoaorbHofi oce-
BOi nXHsfl rpyAri,
Jloxafl3aurc. A, Ha pacclosHllE 3 uyHe* Haa roqxofi aafi_xoaHb 6. Ha BepxHeMxpae VI pe6pa, Ha 6 qyHefi narepanbHeenepea-
( 1 5 R P ) H a B e p r H X a J r b H oJ*I I H H l t .n p o B e A e H H o fqi e p e 3 c o c o K M o ' l o q ' HecpeaxHHoroMepnA[aHa,o6brqHoHa n€peaHefinoaMH[eqHoi nr-
Hofi xene3H, Ha 4 uyHt KHapyxx or nepeAHecpeAlrHHoroMepriAl'raBa' ttutt,
qep$ co_
6. Ha neoeceqennr Beprl{Kar'rrbHoinlrHxr, npoBeaeHHo! Tonorpa0x,{ec[afl ariaroMxr. noA KoxHHM noKpoBoMB pafioHe
npoBeAelrHoi qepe3.roqKy
cox Mo,loqHoi xe,'re3bl, L ropu3oHTanbHofi , ro'rKfiHaxoarTcrrpyaHarrMHUua, clxo/fiHabHafqacrb HapyxHoff
xlreF-,ru (ll VC). pacnonoxesHyro Ha paccroflHrlt 3 qyHefi HaA KocoftMr,rruqbr xuBora n neperHei 3y6qarofi Mbruqbr,M6 xqu nrro
' ro Mexpe6epbq,Aan€e Brny6r, - nerKne
TonorDatDtqccxat afiaroxxt. IloA KoxllbrM noKpoBoM B pagoHe Mr,[uubr B paioH_eroq(, fiHHepBxpyorcfi anrHHHM rpyAHbrM
TOqKn UaXOAtfCt fiapyxHat L BHyTpeHntt Kocbre MbIuIubI xIlBoTa' HepBoMx o-M MexpeoepHbrMHepBoM.
florepeqHar MLlrrqa xsBoTa, 6ponllnHa, nonepeqHaq o6oaoqHaf Koxa uuxeprapyercn reprou Thr.
Kr.{rnia. Kpafi neqeHlt ttrl,t BlixHti Kpafi cene3eHKlt. noKa3aHxs,M e c r r{ br e H a p y rx e H x n: 6onr, lt qyBcrBo pac-
M6lrnr.lbrs paioHe roqKIt fiHHepBl'rpytorct uecr6lo Hl'lxHllMIj Mex_ IllpaHl,lff B rpyAH, XenpoxoAtMocTLMoIoqHoro npoToKa,HeBpanIuq
p e 6 e p H r , r MH r i e p B a M uI n o n B 3 l l o l l J H o - n o a q p e B H HHve p B o M MexpeoepBoroHepBa.
Koxa x H H e p B r p y e r cH q e P B o Ml n s . TcxHxKa. flyHxqHq ray6rHofi 0,2 0,3 rryHr. llprxrraHHe 5-
I l o r ( a 3 a x x gM. e c r H L I e HapylIjIeHuq t HapyrneHx'r' l0 MrH.
cBt3aHHbIe c M e p f i a f i a H o M : a l r c n e n c r i ' { '6 o ' ' l x B x H B O T eB fI p u v e,r a x r e- H36erarh r,ry6oKrrx yxonoB, xoropbte Moryr
' e 3 \ J I b T a I eA H C n e n c n l l3, a n o p , a l { 3 e H T e p H t .
D rlpr,rBecTfi K npoxory n€rKxx,
ie*t|lrxa. flynxurr r.ny6,nof, 0,5-1,0 uyHq
fl p r v e v i n n e, I436erarb rny6o(ofi IIyHKITI{I{t HanpaBneufie r9. IOqXA XyIr-XUOHT (CtOB-Cfltt.ls R?)
[ o H u a r r r l r H B B e p x ,r a K K a x e r o M o x e l n p x B e c T l l K n o B p e x a e H u l o
neqeHfi u,In cene3eHXx. Jloxanrcaqxc. A, B yrny6,reHnuHa paccroqH!fi 1,6 qyHr noA ToqKofi
rro-BHH! (20 RP), Ha 6 qyHen xHapyx, or npoAonbHoi ocesofi rH-
uxu rpyrr.
17. lOq(A TXbt(-AAv (UrX-AOv, l7 RP) E. Ha BepxHevKpaeV pe6pa,Ha 6 uyHeftratepaJrr,Hee nepellHe-
cpeArHHoro MepxrflaHa.o6brqHoHa nepeAHeinoAMHIxeqHoi JrxHar.
JIofia,rr3auxq. A. H
Jlofia,rr3auxq. a paccTotHl{H 1
Ha , 6UyHq noa
I,O noA Tonorpaoxq€cl(aq aHaroMrc, IIoa KoxHbrMnoxpoBoMB paiioHe
(18 RP). Ha 6 uyxei xxapyxr or llpolrorbHofi oceBoirl'IHHHrpy4H
roqxr HaxoArrcr 6orr,rxar fl Manar rpy4HHe Mbfiuqbr,nepeAFsfl
6. Ha sepxriu xpae Vll pe6pa.Ha paccroqHflH-.6 uyxefi or ne-
3y6qarar Mbruua, MHrxqLlqerBeproro Mexpe6epr,c,Aaree Br,,ry6b
peaHecpe4tHxoro !(epfiaraHa, o6HqHoHa nepeaHennonMHUeqHOlr ,,lerKIre,
,rrxau (npr onpeAeneHlrljnoKarrlr3aul'lt 6o'lbHoMy p€KoMeHAyercq MbrDrqbrB paftoHeroq(r rBnepBrpyrorcHanHHHbrM rpyAHbrMHep-
noaHqrb pyxy) . BoM u 4-M Mexpe6epHHMHepBoM.
Tolorpaoxq€cKan aralox q. floa KoxHbrMIIoxpoBoMB paEoHe Koxa HHHepB{pyercrr;epeorr,r Th;.
ro'rxH Haxoltrcfl cyxoxti,lbHaeqacrb HapyxHoi l(ocoi vHlllllbl no[a3axxr, MecrHbre H a p y ln e H x c: 6o,rb, qyBcrso pac-
d{xBora,nepeaHst3y6qaraevblulua.MblluqaLxecToro Mexpeoepbfl.
nllpaHHrB rpyAu rr 6oxax, HeBpanr!9Mexp€6epHoro HepBa,6o,rH B
aanee Brry6h -- nerKlre. cariHe(Dpn noBopofaxfy,roBnqa).
Mbluqbr B pafioHeroqKH rHHepBxpylorct HepBoMuecroro Mex- TcxHxxa. nyHxurq rny6xHofi 0,2-0,3 qyHfl. Ilpuxsraxre 5-
- I0 MuH.
Koxa urxepsrpyercr ueProu Ths. npIrMeqaHHe, Ll36eraTr,My6oxrx yKonoB.KoropbreMoryr
nol(a3arl|x.MecrH6Ie H a p y u e H r tt: 6onb, qyBcrBopac_ nprBecTl, K npor(ory nerKHx,
nnpaHvrB rpyanI,I6oxax, HeBparrxt Mexpe6epHoro HepBa
243
242
20.TOrl(A TKt-Bllllb (qxov"xvtl,20 RP)
JloxaJH3aq[r. A. B yr,1y6'1eHufl Ha paccroqHnn l,6 uyHq noa rOqKOt
qyHr-Oy (l P), Ha 6 qyHei l( apyxrt or npoaonhHofioc€Boi,'lflHxu
-
E. Ha BepxHeM(pae IV pe6pa, Ha 6 uyHeft "'IarepanbHee nepea
HecDeIxHHofoMep axaHa, o6blqHo Ha nepeAHet [oAMbIUreqHot

Tonorpaoxq€cKaqasaloirxt. noa KoxHbIMno(poBoM B panoHe

roqKH r{axoaqTcfl6onb[rat MaJIat rpyaH6le MbIluul]r,IIepeAHts
3y6qaraq MHuqa. MbltxllH rperhero Mexpe6epbt, Aalree Brry6b -

MHuuH B paioHe rotrxH HHHepBxpyrorcs arrlHHHv rpyaHbIM

HepsoM.xopotxHMrp)llHH\{ HepsoMH 3-M Mexpe6epH6lM HepBov
Koxa HHHePBrPyercq HePBoMI n2.
f ,e. c r H H e H a p y u e H l r q : 6 o n b s q y B c , Bpoa c
n o x a s a H nM
nllDaHHs B
'Texnrxa. fDV,4r{ r 6ohax,Kaue,1b, HeBpanrHe vexpeoepHofoHepBa
flyrxurn r,1y6 Hofi 0.2 0.3 uyHe IlprxHfaHne 5
l0 MxH.
n p I, M e q a H s e. l436erarh r,ry6oKHx yKo,'loB,xoropble Moryr
npfiBecrr K rpoxo,ry nerKux,
2r. roqKA IAn-6AO (AA-640,2rR9)
(Crr6xnrcxpybrrst ro{ts c.-r€enxx)
JloKaJx3autc. A- Ha paccroanuu 3 qyHeft noa ro. Xofi yeH-3Hrb
t22VB]'.
6. Ha neDece,reHrlicpeaHefr noaMHIUeqHoiJrxHar c BepxHfiM
(paeM Vll pebpa.Ha paciroanln 6 uyxei non noAMbruerlHot Bna_
qiHofi (ulcqer Berrx or X peopa BBepr).
Tolorpaofi,r€cxar aHaronrxr. floa KoxnbIM noxpoBoMB pa'loHe
Toql(tr uaxoasrcq,,rarepa,'IbHbrixpai LUfipoqaiillleftMbllxubl
nepeAHqr 3y6qarat MbIlxqa, MblurIlbIDecroro Mexpe6epbt, Aaree
af!'ry6b n€rKje.
Mbrurubl B pafioHe roqKl,l HEH€pBnpyrcTcfl BerBtML nreqeBoto
HepBHOTO Cr rereHuF, 6-M Mexpe6epH6rM HepBoM,
Koxa lHfiepBripyerct repaou Thc.
n o x a S a a x t .M e c r n u e Hapy e H n t : 6 0 ' 1 6 ,q y B c r B op a c _
n l l p a H r r B r p y A l r H 6 o K a x , 6 p o H x f i a , l L H a t a c T M a ,o a h l l l K a .
06ur e paccrpoficrBa: 6 o n ! I , t r ' I o M o r aB o B c e M T e r ' l e .
60,'ll B cvcraBax. c,ra6ocrb KoHe,rHocrefi.
Texanira. Ilyxxuna rny6nHofi 0,2-0,3 uyxt. flpqxnraHl're 5
l0 MlrH.
n p n M e,{ a H t €. I4s6erarb rny6oKofi nyHKIIr{H,Koropafl Moxe,
nprrBecTu K rrpor(o,,Iy!'lerxlx,

PyqHofi xHbcKIn MEPI|A]|AH CEP.IUA (C)

(no I roqex c rnxAol crogor!)
XoA M€pxaraHa. Deper Haqa,lo Ha aHe IIoaMbIUeqHoi BnaAIlHI]r' B
ToqKe (bIX-TyeH (l C), cnycxaercs no flepeAHeBHyrpeHHeffnoBepx' Pr..7i. Mep,Ar.H cepAqa (rarbri rh6,,

244
HOCTXII!'Ieqa I,j npeAnneqbs, nepeceKaeTBo3BHlxeHte v nanL'ua nox'reBhrMcycTaBoM(npI, onpeae,,reBnn6opo3AbraByrnaBofi MbIruubl
Krcrrr, npoxoalrTBAorlbno ero nepeafieHapyxHoMyxparo x BblxoAxr 6onr,HoMypexoMeHAyercccorHyrb pyKy B ,oKTeBoM cycraBe noA
x roqr(e Txrey-cyHr (g c), KHapyxx oT BHetxHeroyrna HorreBoro yrnoM 90").
rroxa V flanbua Kficrl,l (pxc. 71). Tonorpaorq€cxac anarorinr. floa xoxHbrM noxpoBov B pa'ioHe
fioxa3arxc. Eore3Ht cepaua, opraHoB rpyaHoi K?'IEfKH, ncrxfi_ rorrKfi Haxoar,cq 60po3aa aByr,laBoi Mr,ruiubr,nepe]lHqq nr€qe-
qecK e DaccTooicTBa. Baq Mbrnrua,BHyrpeHHqsMexMbrureqHarr neperopolxa, nneqeBaf
Texirxa. flo,roxexre 60.rLHoronpI Bo3aeicrBltr:
- Ha ro.Ixy KLI(-ryeH (l C) pyxu Ha 6eapa ('11066lorxphlrb Mbru{br B pafioHe roqKn u8HepBupyrorcFBerBqMri KoxHo-Mr,l
noaM6IljleqHyro BnaAI,llly; ueqHoro H nyqeBoro HepBoB.
- Ha TOqXqnr'leqa'npeAnleqbt I'l KIICTH - nexa ,JIIr CXAt; pyxn Koxa rHHepBfipyercquepnou Th:.
r.rnaaoHn pa3BepHyTbI BBepx; Ilo|(asarrc. H a p y rr e H H r, c B r 3 a H H br e c M e p n a ri a-
- npr.rBo3aeilcrBlrtrHa roq(y ?xRey-xafi (3 C) 6o'rrrofi ao,rxen n o M: 60,16B nr'1eqe r flneq€BoMcycraBe, 6o!rb B rpyan fi 6oKax, no-
corHvrL
' DVKV B no(le. nOr'IO){(I'lB'tIa,[OHb Ha tor''IoBy;
-ro*xr x€r,eHxe cKnepbr.
si rxHe\-cyHr(9 C) coruyrs V na'reu raK qru6tl Texrl|xa. flynKqlrr rny6nHofi 0,3-0,7 uyHr. flpflx]rraHne 5-
yqacro( ToqxB 6btn o6paqeH (Bepxy. l0 MnH.
fl p n M e q a H U e. nplr nyHxruflx rMerb B BxAy, qro y xyAorqa-
r- Toqx^ (u(-TvEll (u3x-ulo^Hb, I c) Bbrx 6on6rrHx rerxo 3aAerb HepBHo-cocyAUcrbrii nyqo( B 6opo3ae
aByrnaBoi MHrxuH,
Jlo(arl3auuc, A. Ha aprepr.rr^,Ltayurefi no BByrpeHHeircropoHe
nneqa,B floaMHLxeqHoi BnaaHHe. cpen0cyxoxlr,rHi.
6. Ha AHenoaMuueqHoftBnaaltHr'r,B qeHTpee€, 3a cyxoxfinlieM
aByr,raBoi x KrIoBoBxaso-nneqeBofiMbIulu, flepeI noaMHueqHoi 3. TOqKAlxt{Ev-XAn (|||!O-XAn, S C)
(noaKpburr,qoBoft) r''Io(ar!3auuli rorrKfi
aprep&ei (npt onpe/r,e!reHLr! (Toqxa-ycr!., orrocxrcn x rar.roprr <roaa')
6on6HoMy peKoMeHAyercq orBecr! pyrry B cropoHy ao ypoBHt nneqa
l.l, cr'leAyt flo xoAy AByrnaBot MbIluIIbI'Haqynarr, nynbcupyloqym
BnaarHbl), Jloxarr3surc. A. Ha BHyrpeHH€MKpae no6re, Ha HapyxHoi cro
apreprroB cepearHeA a flo,aMHmeqrloii poHe nneqegoi Kocrn, xa paccrogHrrr, 0,5 uyHq or "roxreBoro
Tonorpaoxqccxat al|aronxg. IIo4 KoxHUM noKpoBoMB paioHe
roqxg HaxoAtrct yrlry6rleHHeMex4) noaMblueqHoiapTepHenl,l
lanHe* cropoHoficyxoxHrHq KrroBoBHAHo-nneqeBoi MHrxubl,cyxo 6. B yrny6,reHqn, BnnorHyro x MeAnanbHoMyKofiqy noKTeBofi
xr,lre xopor(ofi ronoBKrl AByrnaBoii Mbllxll6l, 6rlixe Knepeall cxnaaKr, nepel IIJ IxoM cyxoxl.rrtlIl, npuxpennrrcqllxcr ( Meanan6-
HOMyHaAMHqerIxy nneqeBofixocTr.r,flpr yToqHenEnJoxar'rn3arlrur
3aaHfiq cTopoHa6o,rbuofi rPyAHofi Mbllrubl, caepxy - BepxHlraKo-
Heu nrleqeBotl(oc,lu. oo,rrb8oMypeKoMeHAylorMaxcuMar'rbHocorHyrb pyKy B !'roxreBoM
MNUqr,r B pafioHeroqKfi fiHHepBrpyrorctBerBqMfiKoxHo_MhIlljleq cycTaBe.
rpyaHblMHepBoM,oTxoltlulrM or nreqeBofo Tolorpaorqec(at anaroMxr. noA r(oxHbrMnoxpoBoMB paf,oHe
HOroHepBau AnnHHbIM
TOqKlt HAXO!,gTCgVeCrO npl,II(penJleHIrffk r(OCIn llr'leqeBol.tMbitXUhr.
HepBHOTOCn!'IeTeHltt- 'tepe!Hflr cropoHa Mealla,rhHoro HanMHuteJlka nreqeBoi xocrH.
Koxa nHHepBnpyercs HepBoM Th3.
Bfi]'TpeHHeq cfopoHa noKreaoro cycTaBa,
I l o ( a 3 a H nM
c .e c r H b I e H a p y u e x r s : 6 o n bB r p y a xu 6 0 Mbrurrlbl B paioHe roqKu riBsepBnpyrorcq BerBqMu cpeAnHHoro
Kax,6onh B o6racrl cepaqa,60,,15 ll noxo,loaaHtle BepxHllxxoHeq I,t lloxTeBoto HeDBoB.
Hocrei, aar{rare,'rr,Hue paccrpoficrBa B pyxe.
Koxa unnepeapyerca nepaou Thr.
O6 u u e p a c cr po fi c r B a: ry6epKy,lelHHi ,lxMoaaeHrr' lloxasarxr. M e c r fl br e H a p y ur e H rr r: KoHTpaxrypa Mr,rrx|l
Texnnxa.Dinxuan i,ry6xHoi 0.3 b,5 uiHt. flpHxnraHre J JIoKTeBOTO CyCTaBa.
5 uutt. flapyllJeHnH, cBq3aHHLre c Mep{araHoM: cH[)Ke-
fIp Meqa Hqe: He npuMeHtrhBpaueHrienrrlblBo t36exaHl're Hlre qyBcrBfiT€nr,Hocrn pyK, Apoxb B r(xcrrx pyK,6onB B o6nacrH
TpaBM6rnoAMbrueqHoroHepBfiococyal,rcToronyqKa, cepArla,
O6que paccrpoficrBa: r o n o B o K p y x e H nper, 6 b B r , r a -
(UrlH-JlllH,2C)
2. ToqKATXAHtsJlttlll, 3ax, cHr{xeHre naMqrfi, ncuxHqecxue paccrpoficrBa, ueifiblri Ty6ep-
XYNC3HbIfi''IHM(PAAEHHT.
JloxaI€aqtt. A. Ha 3 {yHq BbIIxenokrt. TexHx[a. flyuxqnt rny6rrHon0,3-0,7 uyHq. npuxrraHue 5
E. B 6opo3ae aByr,'Ia;oi Mbrur{bl,rra paccrotl{tl{ 3 {yuefi HaA l0 MrH.
246 247
 TexEnxa. llyHKql{r rry6rHoii 0,3 0,4 uyHr. npnxnraHne l0
a. Toqxa J|l!Hr,-IAo (Jrx[,[ao, 4 c) l5 ustt.
(Toq{.-6rcrp'rEr, oflocr.cr x rlrcmprr .rc rJtt fl p H M e q a Hl, e: npl,l apnrM{rj cepAua pe(oMeHAyerce coqerarb
c ro'rxot raM'3y (15 V).
Jloxarfi3aqxc, A. Ha paccroqHxr 1,5 qyHr Bblxe 3antcrr,i.
6. B yr,ry6reHHn MexAy cyxoxunrsMli noxreBoro crr6arer'lt 6. TO{(A ANr-KXrrb (llHb-CN, 0 C)
3a A..rhtl tr cru6aTe,'rr nanbrleB, Ha paccrorHnr{ 1,5 uyHfl Haa Toq_ (To{xa-urcnb)
xofi rxaH'MoH (7 C). nprl yroqHeHuri noKan!3autt 6onr,HoMy
peKoMeHAybT nprrHyTb KHcrb x rrpe]lnneqLm JloKa"lrsaqrfl. A. Ha flyrt KpoBeHocfioro cocyaa, Ha pacc,oiHxr,
TonorpaorqecKas afiaronxr. floA KoxHrnM nol(poBoM B pafioHe 5 lvHeii 3a 3antcrbeM,
TOqKx HaXOAflTCT yrny6neHre MexAy noKreBuM crr6aTe"'IeM [aJIbueB b. B yr,ry6,reruu Mexay cyxoxl,r!'IIrflMIl !'Iox,eBoro cffi6arent
(c Mear,a,1bHoficropoH6r) n cyxoxlinlieM noBepxHocrHoro crn6arent 3an9crbfl H crH6arent nar'1hqeB,Ha paccfoflHl|rr 0,5 qyHq HaA ro,IKoi
nanbues (c narepanbHofi cropoHbr), BHyrpeuHHfi Kpafi cyxoxr,'lfit rxaH'MoH (7 C). IpIr onpeaeneHnfi r'lol(a i3arlrr 6onbHoMy npea
r,ly6oKoro crr6are,lt IanbrreB, KBaaparHLIfi npoHarop, noKTeBat r'rararcl cxarh 'KtrcTb B Kyrla( fi npnrHyTb xynax K npeAnrlerrblo
Tonorpaoxqec(at afiaroirnn. floa KoxHHM noxpoBoM B paioHe
MHurrrH B paioHe roriK, xHHepBrpylorct BerBtMx cpeaHero I ToqKI, HaxoaaTcq yrny6reHfie Mexay cyxoxxJlttMx !'Io(reBoto crli_
n o K T e B o r oH e p B o B . 6are,1q 3antcrba n qoBepxHocrHoro crfi6are,'rt na'rbqeB, BHyrpeH
Koxa uHHepBnpyercc HepBoM Thi. HHfi hpafi cyxoxHn q rry6ohoro cr r6are"lq na,lbueB. xBaaparHHn
I l o K a 3 a F r f ,M, e c r H H e HapyrneHxr n Hapyn-Ie llpoHarop, noKTeBan (ocrL-
H f i r , c B f l 3 a n H b r e c M e p H A f i a H o M : 6 o n b B o 6 n a c r Hn p e A _ Mblmqbr B paioHe roqKn rrHHepBl,rpylorce BerBqMfi cpeaHero t
nne'{6r,60nb q KodrpaKrypa B lroxr€BoMcycraBe,60nx B o6nacT}l .rloxreBoto HepBoB.
cepaqa, Koxa r.tHHepBnpyerct uepnou Thr.
O 6 u r e p a c f r p o f i c r B a : q y B c r B of r p a x a . B H e r a n H a s IloKa3axxc. H a p y u e H r.rt, c B t 3 a H H bI e c M e p x a l,i a_
H O M: qyBCTBOpacnxpaHfiq B rPylfi, 6o,,Ib B o6nacrn cepalla, cepa_
T€xnx[a. flyHKqfifl r,1y6nHofi0,3 0,4 qyHq. npuxnraHne l0- ue6neHxe. 6ecnoxoficrBo,
15 MrH. O6 uxe p a c c r p o i c r B a : H o q H N en o r b l , H o c o B o eK p o B o r e _
qeHne, KpoBaBa'{ pBma.
5. TOqKArXOflr-JlX(TvH-Jll{.5C) rny6nHoir 0,2 0,3 qyHq. I]prxsraHne 5
(Crmyn{pybqrc rocxa, cBt3uraDuac c rcp|lareHor rorxol t us) Texaixa. Ilyxxqut
l0 MxH.
Jlot<art3aqxt. A. B yrny6,leHxl Ha paccroffHrn I qyHt Bblue 3a_

6. B yrny6neHrt Mexay cyxoxt,rrqtMu,loxreBoro crt6areJc 7 . T O q ( A I X A I I - M O H( l u 3 H h - l l l 9 t l b , 7 c )

(roq{a-pa3nrr,
3anccrbr i iyxoxr,rr.raua irri6are,rs naruqes, Ha paccrotHnH I
UyHr HaAToqxofi TxaH-MoH(7 C). Ilplj onpeAeneHHrloxaJl&3a{r}l JloKail|3aqltr. A.3a xucruro, B Bblevxe Ha hoHUe ropoxoBxaHoi]r
6orbHoMy peKoMeHAyrcT cxarb xrcrr, B KyJIax x npnrHyrb ero x
' 6- B yr,ry6neHtn, BnrorHyn I( !'rarepa!'IbHoMy l<palo cyxo
Toflorpaoxq€c[ac anaroirxs. Iloa KoxHbIMnoxpoBoMB pafiose )Krrnrq no(TeBoro crr6arerq na,'rbueB fi lraTepa!'rbHoMyyrny BepxHe-
TOqK!HaxOArTCryr,ry6nefite MexAy cyxoxnrl,leM J'toxleBoroctfi6a- ro Kpaq ropoxoBrraHoi xocTn (flpfi onpeaereHrH roKanl,t3aqHU 6onb-
Ter'Itlt cyxoxti.rlHtMllnoBepxFocrHorocrll6aTert nan6qeB,KBa,{pal- HoMy npear'lararoT BbrnpqMrTb Kr,rcTbraAosbro KBepxy fi cnerKa pa3-
HHa npoHarop, roxTeBaq Kocrb. BepHyr6 ee BHyrpb).
Mburq6r B pafioHe roqKn lHHepBxpylc,TctBerBeM, cpeAHeroE Tonorpa(brqecKaq anaro nr. IIoa KoxHbrM DoKpoBoM B paioHe
r'IOKTEBOTOHCDBOB.
TOVX HaXOAtTCf CyXO)Xfi,'Iue,rOKTeBOrOCrr6ATe!'In OanbqeB, tOpOXO-
Koxa rnieparpyercn HepBoM Thi. BfiAHat KOCTb,TpaneUneBAAfiat KOCTb,
[ | o K a 3 a l | r | cM. e c T H H e sapynlIeHxq: 6 0 ' r r ,B o 6 ' l a c r r 3 a - M6r ruH s pafiofie ro.rKrj ,rHHepBxpyrorcq BerBbo noxreBoro
nrcTbr r npeanneqbq, HepBa,
H a p y n l I e f in f l , c B t 3 a H H H e c M e p I r a n a H o M : 6 o n bB K o x a r H H e p B H p y e r c qH e p B o MT h .
,/roxreBoMcycraBe, cepaue6reHre, 6ecnoKoficrBo. Ilo(a3aHrrM , ecr Hbre HapyuJeH u n: xap B nanoHqx.
O 6 ur r e p a c c r p o fi c r s a: auxopaaovuoe cocrotHne, Tpe- HapyrxeHIq. c B q 3 a H H b r e c M e p I , a a a H o M : 6 0 , , rBr
BOra, ItoBuIrIeHHafl TeMnepaTypa 6e3 floroorae.,IeHr't, foJoBHac 0 6 , 1 a c r H. e p n u a , c e p a u e 6 x e H f i e ,6 e c n o x o i c r B o .
60rb, pq6b B rr'1a3ax, xoHrpaKTypa MbIIlllll q3HXa, norepr peqt
249
248
 O6urie paccrpo*crBa: 6eccoHHrua o ,c n a 6 n e H r ne a M q I l o x a 3 a H rHr .a p y t n e H x q , c B t 3 a H H H e c M e p H A I r a -
Ts, aeMeHqltq. 3n[,'IeIIcnr. H o M: 6o,1flB o6,'racrucepaqa, 6orq B 6oKy, cepAue6rreHxe, TpeBox-
TexHxKa. IIyHKrrat rny6sHofi 0,2-0,3 uyHt. nprxnraHlre 5
l0 MrH. O6Ulre paccrpoficrBa: o c r p b r e3 a 6 o ! ' r e B a Hor r, r fn,a r o -
nprrMeqaHne. f l p u a p s r M t x c e p a u a p e x o M e H A y e r c ct o _ reHH6rx(FakTopoB<Berpar. TeMnepa,rypa,3MouHoHanbHatra6Hr''IL-
qerarb c rolrxaMx rav ay (l5V), son-KyaH (6MC), ll 3bloHr-naHr-
ryeH (34 VB). TexErKa, nyHKqrfl rny6fiHofi 0,1 uyHr (npl, 3a6oreBaHxtx, rpe'
6ypunx HeornoxHot lroMouls, nocne yKo,'raabIAaBIrTbKanJrrrc (po-
3. TOTTKA TXl|Ev-Ov (UrAO-Ov,8 C) Br)- nprxrraHre 3 5 MaH.
(Toqxa-|tcrox, orl|ocxtcr r( rar.roprx .orottlr)

J l o | ( a r x 3 a u r , r r .A , 3 a I O a , r a H r o f i V n a J b u a . B y r n y 6 , r e H H r v e x n ) ToHKOnKl'lxKX (rC)
Py'rHontflcKr|n MEPlralrAH
coceaHrMr nrcuvH, Ha )pirBH( ro'rh, aao-xynr l8 MCt. (m 19 m{.x c r(txaol cropoxs)
6. B yr,1y6,1eBra MexAy IV u V narsqaMr (npl, onpeae''IeHlrl,l
? r o K a J r H 3 a | l r l6, 0t ,rbHoM] c,reryer cBecrH na,rbubr BMecre). Ha no XoA MepsA{aHa. E€per HaqarroB roq(e rxrey-qarb (l IG), Bo BHyr-
nepeqHofi cxna,4Ke naAoHrr. peHHeMyr!'Iy HorTeBoro,roxa v na,lhlla kuc,ll,l,noaHlMaeTcnBAor'rb
T o n o r p a o x , r e c x a n a H a m M x s . f l o n x o x H b l M n o K p o B o MB p a i o H e rpaHnrlbrnaroHHortrx rHn6Hofi noBepxHocrefiHa BHyrpeHHeficropoHe
1OqKI, HaXOASTCT,'raAoHfibrfianoHeBpo3. qepBeo6pa3HNe MbIlrlllbl, V na,,rbqa,npoxoarir noKTeBofiorpocroK, qenb MexAy MeaxanhH6lM
BHyrpeHHfiil Kpafi cyxoxt!'ttn IV na,1Lqa, noBepxHocrHoro t rny6o- HaaMbI[le?'IXoM n!'Ieq€BoH KocT]t Il IoKTeBblM oTpocTKoM r no 3aAHe-
Koro crx6ar€,1efi narblreB, raaoHHHe r rnr'lbHble Mex(ocrHble Mblllr- BHyTpeH'retrnoB€pxrocrr,r nr'leqa aoxoafiT ao nneqeBoro cycraBa.
ubr. BHyTpeHHrfi (pafi HllxHero (oHqa IV nrcTfiofi KocTH. 3areM 3rir3aroo6pa3HocBopaqfiaagr 3a nreqo, noAH[Maercq K [ree,
MbrrlqH B paioHe roqxfi xHHepBDpylorcq BerBtM, cpe,aHeroI, BbIXOAI,iT BDepeA. nOA yron HrXHeli qe! OCTU,nOAHtMaeTCfl Ha r'rrqo,
.noKTeBoroHepBoB, noaxoalrl k cKy,'re B 3axaHqfiBaercq B rolrKe rxrrHL-KyHr (TrH-ryH,
l9 I G) nepeA HapyxHbrM cnyxoBr,rM orBepcrneM (p[c. 72, 73\.
Koxa rHHepBfipyercq HepBoM Thr.
no|(a3aHxg. M e c r H H e H a p y uJ e H x q: (oHTpaKTypa Mbllxu IloKa3aHxc. HapyueHIr B o6,racrll 10,1086r,3arhr,l(a, n!'rerreBoro
V nanbua, xap B r'raAolrflx. nogca, /aua, yruet, rop!'la, Hoca, ro,roBHoro Mo3ra, a Taxxe ruxo-
H a p y I l I l I e H u t c, B t 3 a H H b I e c M e p t ! r a H o M : 6 o r s B paaorrHoe cocTogHI,le.
r p y t r r i , c e p ! u e 6 f i e H I r eT
, p e B o x H o ec o c r o t H H e . TcxHxKs. npu Bo3aeftcrBrr.r ra roqKy rxriey-qarr, (l IG) 6o,rbHofi
O6urre pacc rpoi( r B a : l a l f l x H o e n v r o p a / l o q H oeeo ' AOr'rXeHCOrX)"rhv na,rerl xr.rcrr,rraK, qTo6br TorrKa Haxoalrracb cBep-
croqHre. 80qHo[ tHv0e3. xy; npr Bo3AelicrBtl,r Ha roqxy KHcTx fi 3anrcTbe - cxarb lla,lbubl
Texxrxa. IJlnxririn r,1'6Hdofi 0.2 O,J ulHfl. nprfirraHHe 5- B Kyr'laK r pa3BepHyrb efo r'raAoHHot noBepxxocTbro BBepx,
l0 Mr.rH. noroxeHH€ 6o,'rbHoro npH Bo3AeiicrBBr.r:
Ha TOqKHnpeanleq6r - r'rexa Ha cnlrHe, pyKa corHyra B,'IoK-
re, K cTb nexliT Ha rpyan;
0. toqK^ TxltEv-cvHr(u^o-.rvll,0 c) Ha roqKy rbrey-xafi (8 IG) r'rexa Ha cnlHe, pyKa corHyra
(roqt€-r{cror(, mr.roprn .!tpeto')
B IOKTe, XXCTbJreXr{T Ha rOrOBe;
JloKaix3aqnr. A, Ha BHyrpeHHeficropoHe B KoHueV flanbqa, <Ha - Ha TOqKg B O6naCTr n,leqeBoro CyCTaBa !'rexa Ha )I(TBOTe
TonuxHy cTpel,rlrxMer'lxoto3ereHoro 'ryKa-cetHua) or yrra Horlt. r{r}t cr,tat c BHnDsMneHHoficnrHofii
E. Ha paccrorHLrfi0,2 uyHq or HapyxHoro yrna HorreBoto"{oxa, Ha TOqKn txeri r.rr''rriqa Jlexa Ha cnttHe l'lltr cr.rat c BHnpqM-
Ha rpaHfiqe THnbHoi a raaoHHoi noBepxsocTl{HapyxHot cropoHbl rreHHoi cnnHori, por cnexa nprorKpbrr,

Tonorpaorqec{aq axaro ttg. floa (oxHHM noKpoBoMB patoHe r. roq(A lxtlEv-qArb (ulAo-(3g, r to)
Toqxfi HaxoAtlcq npocrpaHcrBo Mexay Mec,oM nptxpellneHHe (To,rxa-xcrox,orrocxrcc x xar.ropxr <rcra.Jrrr)
rry6oKoro crtl6aTent a MecToMnpltxpenne_
cyxoxrnxg MI,r3LrHqa
"na cyxo*unnr pa3rt6are,]s nanbqeB,HapyxHbI&(pan lll 0a Jloxa,rs3aq 4. A. Ha xoHqe V narbqa fiucrr, B yrny6"rennn pnaoM
r'lAHTI' V DAJIbUA. c HapyxHbrMyrl'roM HorTeBoro!'roxa,
MHmubr B paiofie roqlQ nHHepBupyrorctl BerBqMlj cpeaHero k 6. Ha paccronuau 0,2 uyHr or BHyrpeH8eroyr!'ra HorreBoro ro-
!'IOXTeBOTO HepBoB. xa V fianbua Kncrri, Ha rpaHHrlerbrnbHofix raaoHHofi rroBepxHocreii
K o x a x H H e p B r p y e r c qf i e p B o MT h r . V nanbqa c BHyrpeHxeiicropoHbr,
250 251
 ___H"*,qykf 3y (15rc)
,. --r1,eH kroai 3y (1atc)

// , , t'

(3rG)

Pn.,72. Map,At6H roHKon (,uR, (.errKrn ,Hb).

Pr..7l. M6p,AtaH roH(ot a,ukr (BeBKrt,Hr)
T o n o r p a t $ r q e c K a t a r a r o u r s . f l o a K o x H H v n o K p o B o MB p a i i o H e
roqKl Haxoatrcq npoMexyroK Mexay MecroM npnKpenneHtt cyxo-
x!,tr'lltt MI,t3I,tHqa r,ry6oKoro crr6aTenf rarhqeB xltcfH n cyxoxl,Ir'll,t Koxa riHHepBUpyerctHepBoMThr.
eM pa3rn6are,1t narbueB xrcrr, BHyrpeHHrfi xpai III Qaranru V n o x a 3 a H xHc a. p y u e H f i q , c B q 3 a H H H e c M e p u a l i
HOMi HanpqxeHre Mblluq 3aTbI,IKa,3arB€pAeHxe q36IXa,6onr'l
IlHlxuH B pafioHe roqKfi xHHepB,{pyrorcrr BerBHMr,r.rroKreBoroll ropne, 6one3HHrra3, ro!'IoBHafl60,'rb,HocoBHe(poBor€qeH tl.
.ryr{eBoro HepBoB. O 6 ur r e p a c c r p o i c r B a: oKa3aHrieHeorroxHoi noMorqt
252 253
npfi 06Mopoxe,xoMe,rxxopaaoqHoe coc,orHse 6e3 noroBbraeneHaq, H a p y n J e H I q , c B q 3 a H H u e c M e p f i A x a H o M :6 o n b ,
nrxopalKa, MacTtT, rfi loranaxTr.rr. HanpqxeHx€ MHtlq 3aTbI.'IKa,ronoBHat 6onb, HocoBoeKpoBoTeqe
T€xnr{a. flyHKqris r"1y6lHofi 0,1 qyHq. flp, oKasaH |l Heor,,rox- HXe,rrrra3HHe60ne3Hr.r. ruyM B yuax, rryxoTa.
uoi noMolrtnno oKoHqaHIr,yxorla BbrAaBrrbr{annroKpoBrl,npnxx O 6 q u e p a c c r p o fi c r B a:,1xxopaaKa, 3nltr'rencfig, Moqa
KpacHoBaToro(BeTa.
5
.- Texnr*a. nyHKqsq r,ry6uHoi 0,3 0,5 uyHq. flprxrraxue
2. TOqKATUEI|-|(OK(|lrHb-rv, 2 lG)
(Toqr{.pyqcl, orrocrrci |( rarcrop,r <!oaa') fI p n M e'ra H lle. flpfi,1l.ixopaAKeper(oMeHAyercr correrarbc
r o q x a M r A a i i ' r r o x( l 4 V G ) , a a o - a a o ( l 3 V G ) t 3 t H - c H ( 5 M C ) .
JloKarx3aq e. A. B yr,ly6neHrir'rnepeA I OanaHrofi V na,rsqa c na'
pyxHofi cropoH6l 'r. To{(A yEH-(OT(BAnb-rv,{ rc)
6. Ha rpaHr.tqenaAoHHofil,l TH,JrbHoiinoBepxHocrei Ha BHyrpeH- (Io{'(a-rcco6rxx)
Hei cropoHeV na,1bua,B caMoMHaqare cruraAxr|.o6pa3yoqe;'
cq y nrcTHo-OanaHroBoro cycTaBa. JloKaJr3aqln. A. Ha HapyxHofi cropoHe pyxH, B cepearHe yrny6-
IonorpaorqecxaeaHaro xr. no,a xoxHHM no(poBoMB paiioHe reHllt Ha ,roKTeBoMBo3BbrueHfit3aIItcTbrr.
TOqI(ll HaXOA'TC9MeCTOnpHl{penneHl,tffMbIl|IIhl, OTAOA'UIet Mrr3!HeII E. Ha rpaHsue,raAoH ofi fi rbrnbHoi noBepxsocrefrBHyrpeHHero
K H c r H . r . r K o p o r K o f o . f H 6 a r e , r n l ' t H 3 H H r a .B H y r p e H H r n h p a f i B e p x Kpar naroHH, Ha ypoBHeyrry6reHfis MexAy V n'{crHofi l, KpIoqKo-
H€ro KoHqa I Oa,raHr V na,rbqa.
Mbluqbr B paiioHe roqxr sfiHepB[pyrcTcq BerBrrMr,,roKreBoro
Tonorpaoxq€c{ac aHaroMxs. IIoa (ox(Hb:M noxpoBoMB paioHe
,loqKrj Haxoa9Tct noaxoxHat MbllIIIa lIaAoHn, MbIUua, oTBoAtnlat
K o x a r H H e p B r r p y e r c rH e p B o MT h r .
Mn3r{HerlKncTr{, yr,1y6",reH|re
Mexay BepxHnM xoHrroM V nqcrHoil
I l o ( a 3 a H x s .M e c r H H e HapyueHr.rr: o H e M e H s e6, o ! ' I bl , l KOCTan rpexrpaHHoi xocTbrc, aHo yr,ry6,reHrre- KprcqKoBnaHaq
3y.( B nanbqax pyl{.
H a p y n l I € H n n , c B t 3 a H r J H e c M e p I A I a H o M : 6 o , ' IBb Mbruqbl B pafioHe roqKr.r rHHepBnpyrorcq B€rBtMa roKTeBoro
pyxax,6onb B roplre, HanptxeHr{e M},rrurr3arbtrxa, xocoBoe KpoBo- HepBa.
T€ q e H n e ,m y M B y u a x . Ko)KaHHHepBrpyercq HepBoMThr.
O 6 ur r e p a c c r p o fi c r B a: TeMneparypa 6e3 noroB6rAe"'Ie- [Io{a3aEre. M e c r rr r,re H a p y [r e H n q: 6onn B xscrex, 6onn
Bfiq, !'uxopaaKa, MacTI,tT,3nrrenctt, Moqa KpacHoBaToro{lBeTa, r.rKolrpaKrypa Mbluq nalrbueB pyK.
T€xllrra. Kocat nyHKqxq r"ry6rnofi 0,2 0,3 uyxa. llprxrraure H a p y m e H r.rfl, c B q 3 a H H br e c M e pI,l a t a H o M: ror'1oB_
- HHe 6o,'rx, HanpflxeHne MH[rrr 3arbr]rr(a.UJyMB y axt ocrra6reHfie

3. TO.|(A XAy-(XE (XOy-Cll. r tG] O6ur € paccrpoicrBar x e , , r r y x ar €, M n e p a r y p6 ae 3 n o -

(Io{ra-pi3rrD, orrocxrcr x rereroprr .aep€uo,).
(J|rq.sar ro'rxr, crr3HaaDuri c aan|tccpcarxllrM TexHnxa. flyH(uut r,ry6rHoft 0,? 0,5 uyun. flplxuraxre 5
l5 MrH-
Jlot(anx3aqx'|. A- B yr"ry6,reHr, 3a I Oa,raHrofi V na,rbrra c Hapyx s. loqKA 3HoHr-xoK (tH-rv,5 to)
(Tocra-6ucrp m. xaEroprr .oroxL')
6. Ha rpaHrue,raAoHHortr x ru,rrxofi no'repxlocrefi M{3aHqa c
BxyrpeHHei clopoHH, Ha ypoBHe Mea a'lbfirrro hoHUa rronepe'rHot JloKa,nr3au[r. A. B cepeAuHe3anHcrr,q, B yruy6,leflfitj Ha xoHqe
I'raIoHHov cx'raaKn. noKTeaofikocrlr, Ha HapyxHofi cropoHe KHcrx.
T o n o r p a o x { e c l a s a H a r o M r i e .n o a h o x H H v n o K p o B o v B p a f i o H e 6. B yr,ly6neHrr BnnorHyrox KoHqynoKreBoro orpocrKa.
TorrKn HaxoAqTcH Mblxqa, oTBolrulaq Mr3uHerr, BHyrpeHHrfi xpai Toflorpaoxqecxar aHaroMfic, floa KoxHHM no(poBoM B pafioHe
KoporKoro crr6are,rH naJrbueB, Mhltlqa, nporrBonocraBnrroqaq MLr- Toqha HaxoaflTct ue!'I6 Mexay cyxoxn,rreM,roKTeBoto cru6are,ffi
3riHeq, BHyrpexHni Kpafi srxHero xoHqa V nrcrHoi xocrr,r. 3arrrcrbrr r cyxoxu,'rHeM noKTeBoi Mr,ruqbr, noxreBofi orpocrox,
MHUrrbl B pafiofle roqKx rHH€pBdpyrcTcs BerBtMrj ro(TeBoro ule!r[, Mexay TpexrpaHHofi xocrblo rr Hr,rxHrM KoHrloMroxreBofi
KOC,tI,l.
HepBa.
Mr,rrxqbr B pafioHe roqK! fiHHepBxpynrce BerBrMr ryq€Boro fi
Koxa annepnnpyerca HepBoM Thr.
JIoKTeBOTO HepBOB.
no(asaxxr. MecrHHe Ha py lrreH r rr:6onb n orpaHrqeHfie
Koxa uunepeupyercaHepBoMTh1.
ABXrarenbHofi OyHKurrx na"!bqeB pyx.
254 255
 l l o x a 3 ax t . M e c r H h I e H a p y l j l l e H t s : 6 ( ) 'bT B 3 a n e c r r ' e - I l o K a 3 a r x cH. a p y n l e x H q , cirfl3aHH!te c Mepnafia-
HapvueHtc, c B t 3 a H s b I e c M e p I A f i a H o M :6 o r b HOM: r(OHTpa(fypa M[rurq pyxh a narlbqeB, onyx!'rocTh k 6or'rb B
no :aAniinyrpeuneii clopoue nreqa, 6o'rh R o6'1ac,n trrer It 3arbl!t- o6racrr lxet x 3arblr'rKa,6o,'rb B HfixHefi qeJrrccrfi, pr66 B rra3ax,
xa. urvM B yoax, r{llyxoTa, O6urIe p a c c r p o f , c r B a : r e v n e p a r y p a6 e i n m o o r a e r e
O'6 'lIra_e p a c c r p o il c r B a: reMneparypa 6e3 noroorae'e Hti, MaHraxarhHoe cocTot8ne, crpax.
Hfiq. MaHfiaKanbHOeCoCToqAne, nOJrltOMte!'IIlT.oTBepAeHI'refl3HXa Texrx(a. nyHKurr rry6xHofi 0,3-0,5 rryHc. flprx raHqe 5
' r l o v c n o c o 6 H o c T bc o c a f b r p ) ! b l .
i r D' i\eaxHxbrrxeaA. e r r r e p t b T n p l0 MrH.
n y r i u l l r r , 1 ) 6 H H o i0 . 2 0 3 u y H q n p x x H r a H n e 5
l5 MnH. 8 , T O q | ( AT b t E v - X A 9 ( C t O , X A n , 8 t C )
(Tocxa-y.rbe, xarcropx'r .3erJ'c')

6 . T O q ( A 3 b l O l l I - J ' l A O( t H ' I A O ' 6 l G ) Jloral€aq r. A. B yrny6neHxr Ha BHeuBei cropoHe noxrn, (r{a-

pyxfi or ,oxreBoi Kocrn.
6. B yrny6neHli , o6pa3yeMoM MeAfiar'rbHbrir HaAMbruler'rKoM
JloKanx3aqxq. A- B yr"ly6reHlru HaA roroBxoii ,'IoKreBoi Kocrl{' Ha
nreqeBofi KocrH r ,rloxreBbrMmDocrl{oM.
paccronHlrt I uYHt 3a 3antcrleM
(p,"" TonorpaSrq€clar aHaro rq. noa KoxHHv noxpoBoMs paioHe
B. B yrny6,reHti ptraoMc MeaI'ra'qbHHM iil"'llit-:: roqKr HaxoAflTcfl (pacurq TpexrraBoi MsllruH, ule/rh M€xay MeAu-
\DoBhevefla, rIe ,lohfeBoi olpocroh nepexorrr B ler'I-o -n^oKTeBoH
lb lul A,II6HHM HAAMbIIUEIKOMTI'EqEBOiI XOCTIi It !'IOKTEBbIMOTDOCTKOM
iocru. sa paccrr,nnurI uyHq BHue loqK'l 3bloHf-KoK
aHaroxlte.flo! |(o)hHtlMnoKpoBoM B paaoHP ( c B H l r p e H H e i c T o p o H b r ) , M e ! H a J r b H b l f iH a 4 M H u e ' l o K n n e q e B o f i
Tonorpi<lr'recnan
BHyrpeHHri Kpafi cyxox,l s noxreBofi MLiulIlbI, xocrrr, cyxoxtJ!fie,loKTeBofo crll6are,'It 3alrtcrbfl I cyxoxgr'lne
roqxr tlaioaqtcn
clOpoHaH )|(Helo|(oHuanoKreBoixocrH rry6oxoro crr.i6arert nan6rleB; cHapyxu - noxreBoir orpocror c
raaHeBHvrDeHHee
BerBbronyqeBoro cyxoxEJrteM TpexrnaBoil Mbrr!rlbr),
Muruiuu s paiioxe roqKx rHHepBHpylorcq
Mbru{r,r B pailoHe rorrxfl fiHHepB[pyrorcq BerBcMfi roKTeBoro fi
HepBa,
iyqeBoro fiepBoB.
Koxa luxeporPYercalrePBoMI nr.
Oorasaxu, Mecr x u e H a p y I e H x e: onyxlrocrbIl 6orrbno Koxa uHHepBr{pyercr HepBoM Thr.
cTopoHenpeannevEt. not(asaHxx. l!1 e c r B r,r e H a p y u e H H r: 6o,rb, onyxnocr6
3aaHeBHyrpexHei
TIOKTeBOrO CyCTaBa,
H a p y u e u a a , c B t l 3 a H H H ec M e p r a I a H o M : ' ' I o M f l -
qaq 6on| B nJreqel. nJerIeBoMnof,ce' nol{txeHle 3peHl'iq' HapyrxeHrc, cs't3aHHHe c MepnAraHoM:6orbB
nJreqeBoM norce, 6orb B o6nacT[ ures, HsxHefi qerrocTri,3y6Hat
T€xll||ra. Kocas lloAKoxHan nyH(utr, srna npoxoAxr noA cyxo-
naDaIJeIbHonoBep\HoclH noKreBoiixoclu Bn lulHyrox Fetl 6o,'rb, rJyxora.
)kn,,tfie paccrpoficrBa:
i y r x u r r 0 . 1 0 5 u l H t n p r , { r r a q H e5 l 0 v l , l H O6que M a s u a K a , l h Hcooec r o r He ,
f,ry6ura qyHr. nprxuraHne
T€xHxxa. IIyHKqxr rry6r.rHofi 0,2-0,3
l0 15MHH.
?. TOq(A rt|-Tllrlb ({x[-qxafi' 7lc)
(CrrMynxpyDururocxa' caesHaaDqas 9_TOqXAKsEfl-qltHb(U3tHb-qXEtb,9 lG)
c M.pxAraHor4 ccPAUa'
Jlo(aix3aqrt. A. B yrJy6,re8lrn Mexly noflaTKoi u nreqesol
Jloxa,ll3ar{xc.
'_- A. Ha paccroqHqa 5 uyHei Bbrure3anqcrbt Kocrbro,3a ro.r(oii KxeH-HryHr(l5GI).
S. Un 'iorro* rsnirv, coeaaxsroqeiroqKn 3blo'rrxoK (5 IG) x 6, V saAxeHlxHero xpar Aer'rLloBrrAHoft Ha paccrorHl{t
MH1lfl16r,
ruey-xan (d lG), fla paccroeHnx 5 {yHei or 3bloHr_xol{:BnrorHyro I qyHs HaA 3aAH!M (oHIroM noAirbrueqHoi c(,lalKr,
h M t 4 n a f l b H o M Y h p A l o ' I O K T e B O Uh O C T t Tonorpao qecxai araroMr,rs. lloA l{oxrlbtM noKpoBoMB pafioHe
Tonorpa6r,reciran axaroMrg. noa ho,(lruv nur'poBovB patoHe TOqXUHaXOATTC'Ae.ItTOBnAHarMbr[rUa (y Hr)l{sero Xparr, qeilb
ctr6arereM 3allqcrbfl It
.ou*n xa],oagt.s Ue!'Ir, MexAy ,'loKTeBr'IM MexAy 6oJrbruoliH Manofi xpyrnhrMr,rM6rrxqaMn,IilfirrHar ro,'roBKa
Mec,o npfixpenreHun K (ocrlr yka-
pa31116are!'Ifl
,r;xreBofi Mbruiueii, rpexrnaaoB MEIrrr$rnneqa, nolJronaroqHae Mbrurqa.
3are,'Il,Horona,rbua x rny6oxoro crI'16areJfl naJbueB, !'IoKTeBaq Muruubr B pafioHeroqxr uHHepBrpyrorcl no,{MLrreqHhrMHepBoM,
BeTBCMti HaAr'rOnaTOqHOrO & nyqeBoro HepBOa.
Muruuu e paioae roqKt{ t{HHepBxpynrcqBerBtMIr noKTeBorox Koxa [HHepBHpyerctHepBoMThr.
,'ryqeBoroHepBoB. llo|(436Htlr, M e c r H br e H a p y u e H B r: 6o,rb B n,'reqeBoM
Koxa xHHePBt{PYercqHePBoMI nl.

236 257
 H a p y u e H x g , c B q 3 a H E 6 I e c M e p L A I t a H o M : 6 o r bB t 2 - T O q K A E t l t r t _ O O H r( 6 1 4 x - O 3 H 'l 2 l C ) aaenxx'l' ct'
'-.
nneqax,
'"ie*""*u.JralloHsx,apTpul cycTasoBpyx. ii"'iii ""r0"**- irvquoro ueprarana
Ilynxrili r,'ry6rxoft0,51 1,0 uyxt. Ilplxnraxle 5- c pyrxuu ieprlraror 'cuernui cH' x Pvcruf, tt roxlsv
.falrua cH,,
l0 ML{x.
tl D I M e'r a H fi e. npfi 6onex B nreqeBHxcycraBaxpeKoMexry'
".." iou".r." c rouxaui xner-rrynr ( l5 Cll { KxeH_'lti€y { l4 TR) Jloxanx3aqrt. A. KHapyxx or roqkx rxxeH'rtey (rtHb-,reo' l5 TR)'
rra n!'reqeBoMcycraBe, 3a,'Iar€pa,1bHHM xoHIloM !'IOnaTK[' B yrnyone-
Hrru, Koropoe verxo o6oenauarcl, xoaaa 6o,1b[ofi noAHLMer pyxx
t0 ToqxA hlo-3y (HAo'lllv.lo lG)
rToqm contcxeHxtrPY{HororcPqrara
c rapyxrlEir ntroqrui n rapyxx}|il b.-B uaaocrnoi qMKe, Koropafi o6o3Haqaercc, Korra 6o"lbHoi
noaacpxrsarqxr MepnaraHax) n o r H r M a e l p y K r . r K B e p x ) . H a B e p r x ( a , l b H o f i ? 1 r H l ' t h .n p o B e n e H H o i
' r c p e 3s e p u r i ] , o c r I r n u n a r t < H v. e . k n y r o q K a M K b r - K o rl l 6 C I r I
Jloxa.,rrGaqxc.A. Bo enaaaHe 3a roqxofi kuel{-n'ey (14 TR)' y k r v K B l , t e ||| l J l u l .
Bepx8ero (pat nonaTKx.
'6, Tonorpao qec[ac aHaroMxt. flor KoxHHM noKpoBoM s paitoHe
Ha nep€ceqeHx rllrHltt, npoAor'Ixabulefi 3aAHqftKoleq noA- t t ' I 1 I U a 'n o
T O q X UH a X O A s T C T t p a n e q I i e B D A X a qM b I l U U a ,H a A O C T H a M
M6rue'rHoi cx'!aAxt, c yrry6nefiIleM IIoA ocrr,o nonaTKl.
Tonorpaoxq€crat aHaroMxt. flor xoxHHM noKpoBoMB paioHe MuuuH s paiioHe roqKfi xHHepBl'lpylorcq BerBtMt Xl napbt
TOqXItHaxoatTcg aeibToB[AHac MHtrua, IloaocrHat fi BaaocTllat rreperrHblxHepBoB, rry6{)(oro ueilloro cnrereH t Il HaaronaroqHofo
M6 nubr, H{xHrfi (pafi ocrr 'rrollarxl. HepBa-
MHruq6l B pafioHeroqK, xHHePBtpylorcf,BerBcMfiMerrarbHoro
K o x a o x u e p s l p y e r c n H e P B o ML s .
(nneqeBoec8ner€Hte) H ItartlonaroqHoro H€pBoB n uapyrxeHnt'
f l o x a 3 a n t cM. e c r H 6 l e H a p y l x e H n q
Koxa ruHepBrpyercfi HePBoMLs. cBg3aHHble c M € p l r ! I { a H o M : J o M t u l a t 6onl,B nt'IeqeBoM
no|(a3a|rtc. M e cl H hI e H a p y u e fi r t: 6ofi, x orpaHHqeH- c '\ c l a B e { 6 o n b H o r l H e B c o c r o e H t l H n o r H q r b p y x t )
'__ noABuxHocTbn.reqeBofocycTaBa,c?'Ia6ocTb
Haq B fiJleqax.
Texflxxa. ny Ku t rr]6ttHofi 0.3 0.5 uyHe. npHxrraHxe 5
T€xfll||(a. flyxxuun r"ry6lx6ft 0,5-1,0 lryHt. IlpfixtraHt€ 5-
l5 Mxt{.
l0 MtlH. IlpxMe,laHfie f l p r n o n a A a n a ax r n 6 l B r o q K y y 6 o n r ' H o r o
flprMeqaHlle. npx 6orq, c.la6ocrlrI{ orPaHstleHHolnoA- pacntlpaHlle B Mecre nyHK-
coqeTaTbc toqKaMt{ aoaur,riaer outytueale Hanpqx€HHocrt,
BIJXI{oCTH n!'leqeB6lxcycTaBoBpeKoMeHAyeTcc p a c n p o c T p a H f l r b c t Ha o6,tacrb Boxpyr Toqx
(9 }l xbr-xor (l6GI). ufi. x o r o p o € M o x e r
KneH-xryHr (l5GI), KreH-,IrHb lG)
(|llon-!OAttt'' 13 lG)
t3. lOq|(A KXvK_Bt'lEH
rt. TO'lXATX tH-lOHl (rtl|h'll3yll. ll lCl
Jloxars3aqxc- A. B yrny6neHnE Haa ocrblo ronarKl'! npxMepHo B
Jlo(anx3au c. A. B yr,'ly6neHlfi 3a ro'Ixofi 6nxb-0oHr (12 '{epe3 IG)' cepeaxHe
'6. IIJIeqa,
b. Ha fiepeceqeH BeprHKaJblloi nrHHs, npoBereHHoff H a n p r M o f i , n t t o B € a e H H o iq e p e 3 r o q K y x x e H - r L I H b ( 2 1 V B ) ,
qepe3
BeDrtr,rHyocTtl ,onaTK11.ll ropt3oHTanbHog, IpoaeAeHHofi R HaAocrHoi BnaAsHe.
*ai<one,invxocrlrcroro orpocrxa IV rpyafioro no3Botxa. B lloaocr- TonorpaQr,recxar aHaroMxc. floa (oxHbIM noKpoBoM B paftoHe
'fotlKfi Haxoaqfcq TpaneqfieBl,tlHar Mbtlxqa, HaaocTHaq Mbl ua, Mec-
Hoir sMKeronar(g,
__-
Tonorpaox{ec[at aflaror s. IIo,4 l(oxHbrMnoKpoBoMB pafioHe TO nplrKp€nnefifit K xocTx Mblurllbli noAHHMarcll1eiir'IonaTKy, aepxHti
foq&r gaxoacTct noaocTHacMHuua, ronaTKa I}HVTDCHHI,IIl
' l l i u u r u " ' u VTOI .JIONATKI,I.
M urIH B paiofie roqKfl sHHePBl,lpylolcf, BerBbIoHarrona',oqHo- pafioHe roqKfi tsHepsupylorcq BergtMn Xl napbl
ro epBa. qepenHbrx HepBoB, rry6oxoro ueiiHoro HepBHoro cnneTeHfig, Ha!t1o_
Koxa rHHepB8pyerct HePBoM1fu. fiaToqHoro HepBa, 6l),,ltulofo 3aTH,lo']HoIo HepBa.
lloxa3aHti. M e c r H H e tapyueflxt I RaPyIlteH'Ig' Koxa IEH€pBfipyerct HepBoM C{.
c B t 3 a H S b I e c M e p n A r s H o M : n o M c q a t6 o J t 6B n r l e q e B o M I l o l a 3 a H r c .M e c r H H e HapyueHns: ,roMqllar6onb B
cvcraBe
-'-ie*"r*a. r no 3anHei nosepxHocrxpyxs nJerreBoM cycraBe, orpaHfiqeHHaq noaBllxHocTb n'reqeBoro cycfaBa.
flynxqrn r,nti6nto* 0;i 0,5 qylt llpnxrrasxe 5- Texnnxi. flyHxrrai r"iy6xHofi 0,3 0,5 uyHq. npt x,faHlre 5
l5 rH. l5 MxH.
flpnxe'ranre, nptr nepBaprpur€ n n e q e B o r co y c r a B a p e ' flpfiMe.raHlle- f l p x n o n a a a H H Hr t r j l b r B T o q x y y 6 o n b H o r o
xoMeH4vercr correrarhc roqxaMr KreH_rb|Hh (21 vB). KtreH-Hryfir so3Hr,r(aeToUlyueHx€ HanpHxeHHocTI,l, pacnupaHnq B Mecre yKora'
i i s C l i , * n e ' r , r r " v ( 1 4 T R ) r l l g l o x r - n a H r ' r v e(x3 4 V B ) Koropoe Moxer fippalkxpoBarb Ha ooracrb Boxpyr ToqRx.

258 25e
 14 lC)
l,r lo't(A l(uEH-htoAn-3v{q39Hh-BAn-lllv, E. Ha 3aaHeMKpae rpyafiHoKnrcqaqHo-coclreBraHotMduubr, Ha
ypoBHeBepxHeroxpaq qxroBlraHoro xpqD-(4.
JloxaiBaqrc. A. B yr,1y6,1eHlr& HaA!'ronarKoi, Ba PaccrotHuri 3 qy_ Tonorpaoxqec[an aflatoMxc. floA KoxlrblM noKpoBoMB patoHe
Hefi or Do3BolIoqBrKa. roqKu HaxoAtrcfl 3aaHHfi xpafi rpyAl,tHoIG'tloquqHo_cocqeBljAHoff
E. Ha ypoBHeroqKr aao-,[aotl3VC,, Ha 3 ulHt narepa,lbHee MbIllrlbr, MLIlUqa, noaH Maonlat rlonafxy, l,l "I€cTHI,lqfible MbIlullbl.
e e M e x a i r o q K a M rx x y K - B r e H( l 3 l G ) r x x e H - q y H r _ 3( 1 y5lCl. Mbrnllq6r B pafioHe roqKt nHHepBupylorcq BerBsMn XI napbl qe-
Tonorpaolqacxec axarofir|c. nor xoxHbrM rroKpoaoMB paioHe p e n H d x H e p B o Bn u e i H o f o H e p B H o T oc n r r e T e H l f l
TOqKr HaXOA'TCC TpaneqreBuaHaflM6[!Lla. Mblxqa, noaHrMaloulat K o x a H H H e P a t p y e r c f lH e P B o ML j
nonarKy, BepxHtt 3aAHtt 3y6'aras M6ru.lua. l l o x a s ar | n .M e c r H b I e H a p y r n e H r r tl HapyIIreHIr'
Mbrutubl s DaioHe roql(r xHHeDatDyKlrct BeratMIt 60rhllroro cBt3aHH6le c M e p E A I , I a H o M : 6 o n L f i H a n p q x e a t eM b l r u u
larbrioqHoro uepaa. XI vepenxoro nipab. r.lyooxoro r|lefiHoro HepB uren r 3arbrJrxa, uyM B yuax, r,lyxora, 6on6 B rop'le,6onr, B qenroc_
HOIOCrrereHnfl,Haa.rroraroqHoro HepBafi l"ro Mexpe6epHoroHepBa.
Koxa ssHepBspyerccHepBoMCs, T€xfix|(a. IlyHxqqq rny6lHoi 0,5 1.0 qyHt- nprxrraHne 5
llo|(aoaflrr. M e c r H 6r e H a p y rx e H r,rr ri fi a p y lx e I r t, l0 MHH.
cBt3agHHe c MepxaltauoMi 6orb B flreqeBoM lotce,
60,16fi HanDgxeHre Mblluu fieq u 3arHrxa.
Texnrxa. Ilyuxqrn rny6rHoi 0,3-0,7 qyHr. npsxnraHne 5- 1 7 .T O t l ( A T X t l E l t 3 v 8 r ( T t H t ' - X v , 17 lC)
l0 MfiH. Jloxarroaqxt. A. floa yxou, 3a qeJtlocrHofi Kocrblo
IIprMeqaHHe, f l p u n o n a r a n a ux r r t b rs r o t l K y y 6 o n b H o r o 6. Ha nepeaHeM Kpae. rpyal,IHoK!'r Ioquq Ho-coc ueBl,trHorii MbItxIt6I,
BO3H|KaerOrqyqeHs€HanprxesFocrr, pacnnpaHl,lrB Mecre yKona, HA VDOBHEq3bIqKA HT)xHE' qETbCTIJ,
xoropoe Moxel pacnpocrpaHcrLcgHa o6nacr6 BoKpyr roqKr. lonorpar[xvecxan anaromltt. noa KoxHr,IM nokpoBoM B pafioHe
TOqxr Haxo[cTcq nepenHfii Kpafi rpynrHoKnrcqx'{Ho-cocueBx,4Hoi
(U3tHb-rIXvH-rlv,15 lG)
15.TOq(A Kt|EH-qvHr-3v r\luurl , 3aaHsi Kpafi yr,ra Hr.txHei qer'llocTu, Hr.lxHtt cTopoHa aBy-
6prouHofi
- MbIruIIbr.
Jlo(aJrx3aqxr. A, B yrny6neBrrny BHyrpefiHeroKPat ronarKH, Ha MLruqhr B pafioHe roq(r rHHepBlrpybrcs BerBHMu XL XII nap
oaccTocti|lu
' 2 uvxei or flo3BoHoqHq(a. q e'Koxa
p e n H b t xH e p B o Bx r ' 1 , 6 o K o r o u r e f i H o r o H e p a H o r oc n ' r e l e H t r c
E. Ha nprM6fi nHHt{r, coeanHcrouefiroqKy Aafi-rtot (14 VG) c nepaamrC, u Cr.
rnireparpyer'cr
Toqxofi (ueH.THnb (21 VB), Ha paccrotlHttll 2 uylei or 3aAHecpe_ n o K a 3 a [ { nM
. ecrfibIe Hapy eHfit r Hapylll€Hxt.
naHHoroMepHAgaHa. cBt3aHH6re c M e p x A L ra H o M : u i y M B y u a x . r r r y x o r a ,6 o " 1 bH
Tonorpatlr,recxar axaronrit, fIoA xoxH6IM no(poBoM B palloHe OTeqHOCTL TOP,Ia' I<PI'IBOluefi
.
TOqKI,I HaXOISTC' TpaneUleBI{AHat Mbllllqa, Mbllrqa, noAHtMabulat Texxrxa. flyxxirrn r,ry6'rHoi 0,5*1,0 qyHt. flprxuraHfie 5-
roflaTXy, BepxHcsdaaraa sy6uaran MLurla, noamaoulHo-pe6epHat l0 usu.
lrbtuua rpy4Hon KJIeTKII,t ueh, MexnonepeqHbleMHlrlull.
MHuuu B pafioHeroqKfi fiHHepBHpyrorct BerBtvx Xl napE qe-
penuhrxHepBoB,rly6oKoro lnefiHoro HepBHorocnreteHl{t, 6orbllloro ! 8 . T O q K A K v E H - ! ' l l r E v( u t o A H b - J l t o , ! 8 l c )
3aTbLsOqfiOrO EepBa,[IeiiUhIXr l-ro MeXPe6epHOrO HepBOB. (Toc'{a conpcx€Ast py{noro M€prarara rBerrrr. ch>,
Koxa rFFepBxpyerct HepBoMCa, coelxHe{rqae ero c pyqlEM Mepx/uafloM .ranld tn')
n o x d B a H r cM. e c r s b r e f i a p y u e H n f l : .,roMrqar 6oJrb B
nreqeBoMnotcet acTMaTuqecKlfixallle,lb. Jlo(aix3aqxr. A- Iloa cKy,roBofi Kocrblo, B yrny6aeHtlt cxynoBoi
TexH[[a. flyHKqsr rny6r8ofi 0,3-0,7 qysc. I I p x x x r a B f i e 5 - -
l0 MnH, 6. Bo anaAr.rre noa nepeaHeHHxHHM yrnoM cl<ynoBofi Kocrfi. np|r
npuMe'raHfie. flpn nonaranrr firnH B Toq(y y 6onbHoro yToqHeHI,t r'Ioxarli3aufi H pe(oMeHAyeTcn HanlynaTb caMoe HfixHee
BO3HqKa€T OUIyUeHneHanpAXeHHOCTt, pacnnpaHnt B Mecre yKora. Mecro Ha cKy,loBofi KocTu,
KOTOpOe MOXeT paCnpOCTpaHrTbCi Ha O6naCTr, BOXpyrroqKs. Tonorpaox.r€c[at aHaroMxt. noa xoxHbIM noKpoBoM B paloHe
TOqKI HaXOATTC' nepeaHfiti ftpaft xeBaTe!'I],Hofi MbIlrIlIbI, Mecro ee
(TlHb-{vAH,l6 lO)
t6, TOrt(ATXl,tEl-COflr nplxpenneBHr
' x cxyr'loBoi Kocrlr.
Mr,ruuu g pafioHe roq(n r.rHHepBtpyrorct BerBllo V flapri qepen
Jlo[an[3aqrt. A, nepea cyxoxri,lxeM Tpaneql{€BllAl]otMblruqu' noa
yr,roM qe,,rrocrofi Koc t, 3a rotr(oft Qy-Aor (18 GI). Koxa anreperpyercn V napofi qepenHHxHepBos.

260 261
 I l o | ( a 3 a f l r fM
, .e c r H b I e HapyuJesrq x Hapyrxe_
H I q , c B f 3 a H s N e c M e p L { a x a H o M :f i e p a q e p E q e cn Ka x_ t {
pa,lHqVII nrueBoroHepsa,rBKr{MHrxuBex,3y6Hat 60,16,6o,1€3Hx

Tcx|lr|(a. flyHruxfi rny6tHofi 0,2-0,3 qyHt. npfi npnxrraHxr

x36eaarboxoroB.
IlpnMeqaHne, npfl flonaAaH{fitrnbr B roqxy y 6o,16Horo
BosHnr{aeroqyuefire Hanptx€HHocrn, pacn,,paHvtrB Mecre yxo,ra,
KOrOpOe MOXeTpacnpoclpaHgrbcqBo{pyr roqxlr.

(TtH-ryH,r9rG)
19.TO9KATXl.tHb-KyHr
(To{{a conptxe rt pyetsoro MeprAraHa {8eixx{i flt',
PYcHtM vcPxaraHadn cMaidn tH')

xo3e,lKa,Ha yqacrxe pa3M€poM

Jlof,aJx3aq t. A. fleper cepeAr.rfiofi
c Qacorb,
6, B caMoM qeHTpeocHoBaExcxo3e,rKa,3a MHulerxoBbtMor-
poclKoM Hr{xHet qenrocTr. yro'{Hrf roxari3auxrc. npeanararcT
6onhfioMyorxpbrrb por, qroobr Haxrynart yrny6neurie, rae pacnono-
xeHa loqKa. npfl HaaaBnqBaHHn 8a ToqKy 6o,1r,HofiaoJIxeH ycnbl-
[rar6 xpycT.
Tonorpiox,racxar a||aroxxr. noa xoxHEM noxpoBoMB paiioHe
Toqxx H4(oAqrct 3aAHqfi Kpai oKonoyulroi xene3H, SdAH!fi xpafi
Mbrnle,'rKoBoro oTpoctKa HnxHeE qejlpcTlt.
Koxa B pafioHetoqKr nHHepBrpyerctV Iapofi q€penfiHxHepBoB.
noxa3&n[r. M e c r H bre H a p y u e H s 'r: uryM B ylxax, rnyxo-
Ta, TyroyxocTb,6onb B yuiax.
Tcxflrrt. flyHKqnq rry6ufioi 0,3-0,7 {yFt. flpH nplrxnraHrit
cneAyeT[36eraTb oxoroB.
npriMeqaHtq. l. npu serry6oKofi nyHKul,rfiy 6on6Horo
BO3HUKaeT OUIyqeEl,lefianprxeHflOcrli, pacnHpaHxt B MecTeyxoJla.
npH rny6o(ofi ny8xqn, 3To or{yureHre llppaABnpyerBo BlryrpeHHee
yxo, nonaAaHre firJrbrB (ocr6 B6r3hrBaer ocrpyro 6oJt. Ilo.ryBcrBo-
BaB 3aclpeBa8re KOHqal,Irnhr, BpaLIaonxeH IloaaTD ee HeMHoro
Ha3aa.
2. npfl BocnaneHfixcpeaHero yxa pexoMeHAyercflcoqerarb c
roqKaMxe-4oHr (17 TR) a xon-xox (4 GI).

HOXHOn tHCK},ln MEPIIAXAH MOqEBOTOny3btpt (v)

(tro 67 roc€{ c xaxaoii cropoxd)

Xoa irapxtr*ala. B€per Haqano Bo BuytpefiHeMyr!'ry tna3a, IIoAHII-

MaercqHa 106, MI{Hyf,roJloBy,Bbrxoallrfia 3aTHJtox,r,4e pa3BelB'rrt-
eict Ha ABe BetBr, KoroPEIecnycKarorct naPaJIJIeJIbHo no3BoHoqHI{-
Ky, 3aTeM no 3aaHefi cTopoHe 6eapa cnycxaeTcfl x no4KoreHKe.
3recb o6e BqrBH BnoB6 coeArHaprcr, c'rreAyf,BHlt3 no cepeauHe
3AAlreficTopoHHroneHrl;raree Mep{nlrJHAOXOAXT AO naTepaibfiOH
JloaSlxxll ti BAonbHapyxsoro Kpan TbL16Hofi cTopoHblcToll6l Bblxo_
arr Ha V naneu,oxaEqrBarcbB roqxe te-aM (67 V) (ptrc. 74, 75). Prc.7a. M6ptaN.H soqoBoro ny3brPt (.6nH{tn tH'.

262
 llor€3aExt. l'la3HHe 6ore3Hu, HapyuleHtt B o6'lacrt Hoca' to-
,1oBbI. 3arbr,,rKa, notcHllllbl, SaaHero npoxoAa; 6one3tu roJoBHoro
MO3ra. JllrxopaaoqHLle cocToqfiqt, 6on$Hn BHyrpeHHUx OpraHoB
(nDs neqextru xmopblx Bo3AeficrBylor Ha coqyBcrBeHHble roqKt
cnnHbr).
Teiwxe. flou Bo3reicrBut lla roqKn B o6r'Iacrr rnaS s nep€ABei
qacTr to.'IoBtil no,roxexue 60Jlbfloro - 'lexa Ha cnfiHe ,t'lll cliAt c
sHnprMneHHofi cnfiHofi:
- aDu Bo3aeicTBHfi Ha TOqXI'IB O6JlaCT[ 3aAfl€ft qacTr foroBbl'
Cnlltf,t, I|OqCflHqbI- 'lexa HA )Kl|BOTe tIll CtAq C BbInptMJIeHHhIn'l

I 'npu BojneicrBHx 8a To'{xH a o6'1ac1HnpeanrrccfiH. cronbl.

n a . 4 b u e aH o r - ' l e x a r J l l l c H 4 t c H o r o i . p a 3 B e p H y r o i r a K ,
qrooH
Bpaqy 6brno yao6Ho npoBoAfiTb ykon unlr npxxuraflEe

r. roqh4 lblHb-Ml|flh lutlH Mllll l v)

(Toqxa conDcxe sc pyqBoro I {oxroro M€pranaHoB
i"xr".o ".pratrattu .""€rnbrt efl '. Hapyxnoro tro,uepxhBanurero
A N - M o H( 3 7 V ) , B r y r p e { { e r o n o / ' u e P h r B a | o u roe rM e p r t r x aof lB )

JlotaJrcaqrr. A. y BHyrpeHHero yrJIa rJIaga' rAe BblAaercf, KoMoqeK

6 . H a o a c c r o t H l , t M0 , 1 u y H s K H y r p H o l B H y r p e H H e r oy r J l a r r a 3 a '
TonorpaQrlecxar aHaro[xt. lloa KoxHHM noxpoBoM B paftoHe
- Mecro npxxpen_
r o q K l r H a x o 4 t T c t K p y r o B a f M b l L x u ar n a 3 a : c H l l 3 y
--Y*-oHotr (39V) M H u u b l . M b r t ! u b l . c M o p u lrBa|o*"' oq91,tl
reHHr r r r p a M r a a n b H o i
cBepxy Mecro npltKpenneHxg MHLrluH llo4HHva|oueE BepxH|oro
rv6v ir xosr,no Hocr, Mecro coe!fiHexfie BepxHeqe,rocrHog H JIooHoIl
*bcie&. I] r,rasHaue - MeArarbuat nptMat Mbrlrlqa rr'la3a
Mbrurqbr B paftoHe roqKu xHHepBnpylorcc nBqesErM HepBoM' Htlx'
Hei B€TB1,o III qepenHoro HePBa.
qepenH6lx HepBoB.
Koxa rnnepaupyercn V napofi
noKa3afirc. M e c r s u e H a p y u e H x t: rlnepeMllt r'la3'
naHHvc. ' 1 v . , tB 06"laclx r , 1 4 3 . c H r i x e H | , I eo c l p o r H 3 p e H I r H X y p xHafl
.r"n,iru- napaarq 7-ro cnHHHUMo3loBoro H e p B a .a r P o ( p H FJ p H r e r b -

Texinxa. nosepxxmrHar nyHKulrt rry6fiHoi 0 l uyHn, KoHeu

r r r J l E H a n p a B J I e HB C l O p O H yH O C A .r r y 6 o x a t n y H x u l | t : H a a a B n l , | B a f l '
(64V)
crer(a oioaBuHyrb Hapyxy rna3Hoe t6nofio, BBec"r[ {fny Brnyob'
-HNHb-sor
Aepxa ee Bnroriyo K xparc rna3fillllbl. flpn BHBeIeHItT IrruIH Taxxe
Tryh-(or(65v)
co6Jo.rarb ocropoxHocrb, BblBoAtlrb 6e3 BpaureHllr' 3axorl'luB
BbIBOA,nplixaTr, MeCTOy(OJla CTepIr!'lr,HbIMBaTBHM TaMnOHOM'{In
npe,4yIpexaeHI,c KpoBoreqeHtt
IlDHxr.rrasIle nDorHBoItoKa3aHo.
--6oK riaM (61V)
n p H M e q a x rl e. He c,reayer HaIIpaBJItrb xoHeu tr'lH B r!'la3-
gorloxa llpx fnyoo_
H H U y ,T a K K a K 3 r o r p o J H T n p o x o j l o M r i a 3 H o r o
qTO BeAeT K
KOM BBeneHB|l UTJIbIHe tlc(r'lloqeHo nonaAaHte B BeHy,
P|.c. 7t. M€prAr.H aocesoro ny3b'pr (Esfixrt tr'.
xpoBor.r3,lu'HHro BOXpyr r,1a3a (<qePHHe oqKx>).
2AE
2. ro{xA loAH-qy( (|lyAflb-qxy,2 v) E;. Ha 0,5 qyHq Bhlrrie x Ha 1,5 uyHt narepanhlree cepeanHbt
nepeaHet rpafifiqH Bor'IocqHofonoKpoBatoroBbl.
JloxaJlr€aurtt, A. B yfny6neHfir, ! BHyrpeHHerokoHua 6posr. Tonorpao {cclat ar|atonx9. llor (oxHHM noKpoBol\tB paffoHe
6. B yr,ry6,1eHxx-y ixyrpexnd.o rioriuaopoer, np"rb *raa rou. ToqKs HaxoAxTct MecTonpnxpenneHlrt no6Hofi MHroq6Ix anoHeBpo'
(o, rhrHb-MUHL (1V). rHqecxoMyrlreMy. aa,lee Brry6b - Kocrh qepena,
Tonorpaoxqec[ac aHaro[rr. noA xoxH6IM noKpoBoMB pafioHe MHrxud B paf,oHeToqKHHHHepBHpylorct BeTBboVll napbl qe
foqxll Haxoa9rct no6Hoe 6pbuKo 3aTLr.roqHotM6rrrrrlbr,Mb[!ua, '
cMopxluBarcqac 6poBb, finpaMr.r4anr,Has Mb lrqa r xp€fi KpyfoBofi Koxa i+rreprfipyerct V napoi qepenHblxHepBoB.
IloxacaHtt. M e c r n 6r e H a p y Ix e H I t I H a p y uI e H n t,
MhIUIru B paftoHe roqKfi rHHepBnpyorcc BerBcMfi VII naphr c B t 3 a H H H e C M e D I { , [ U a H O M : r O n O B H a6 t0 J 1S
b o 6 n a c r nn 6 a
qepenHExHepBoB. r Maxyuxn, pt6b B rna3ax, rlta3Hble 6oJlll, 3a,roxeHHocTSHoca,
Koxa nFHepBspyercrV napofi qepelribrx HepBoB, '
flo|(a3aHxMn .e c r H 6 r e H a p y u r e H t g : 6 o n n r i r H l l e p e M l , l t Tixxrra. flynxqun xocan roa(o)KHat, rny6HHoi 0,3-0,5 llyHe,
rna3, pc6b B fJIa3ax, c!,te3oToqelir,{e, cHHxexue SpeHxq,TfiKri Mbltuu UCTDflE [Tlr$ HATPABJIEHOBBEPX,
BeK,r'roMrular 6orb B o6racrx Jr6a, ronoBHar 6on!. i'lprue"aiHe. npr i e o 6 x o a r M o c r tnr p n x l r a H t t c r e a y e r
TexHlKa. nyHKqnr (ocar, noAKoxHar, r,iy6rHofi 0,1 0,5 uyHr. x36etarb oxoroB.
flpll oAHoBpeMeuHoM Bo3aerficrBl{xEa o6e napH6reroqKu roaH-qyx
(2V) pyqxfi Hr,rrocraBfiri, c HaKJloHoM B cepeArHyrax, qro66r oHfi 5, TOqKAHry-Cbt(y-ty. 5 v)
nepexpeu{rBaJrncL Mexly co6ofi B cepeAr.rHe ,6a. IlpuxHraHrle npo-
TI,IBOIIOXA3AHO.
JloKann3aqrq.A. Knapyxr or roqKx rxbrourrbrxs (23VG) ra
I-I p I v e,] a H,r e. npll noMyrgeHrlxpycrarrxa peKoMefiAyercs 1.5 [vHc.
coqeTaTh c ToqKaMk rHHb-MfiHb (36 E) n xyanr-
(l V). TyK-TaM-rrj E. Ha paccroanfir0,5 uyHt 3a roqKoi |(xyx_cai {4 V)
MrHb (37VB). npll 6o,,rrxB cpe,(HeiqacrD,'r6a- c roqKaM! HrH- Tonorparfn,recxan aflaroitxt. no/r xoxHbrM noKpoBoMB pafioHe
TOqKfiEaXOAtTCtafiofleBpoTuqecxfitIuJleM,l(oclb qepeoa.
xey (BHeMeprArraHHaH), ooHr-,{x (20VB) xon-KoK(4GI).
Koxa B pafioHe roqKn nHHepBlpyercs V napofi qepenHblxHep-
3. TO9KAMl.l-CyHr(M3n-qyh.3 v) I l o x r 3 at t . M e c r l r H e H a p y u I e H l r q s H a p y r r l e H l t t '
Jlo{anxsaqrn. A. flpnuo naA BHyTpeHU}rr\4 Ko}ruoM6poBrj, MexAy c B r 3 a E H 6 I e C M e p H A r a f i O M : r O " l O B H6aot J b ,p c 6 bB r n a '
roqr(aMrrxas-Ar.ftrh(24VG) s KxyK can (4V).
"Bbrue
6. Ha. paccroxnuu 0,5 qyxa fi narepanLgee cepeAlHbr O 6 u r r e p a c c r p o f ic r B a : c y a o p o r x .
nepeAHeirpaxsrlbr Bolrocrfioro flol(poBa, Tcxnrxa. fiyxxurn xocas noaxoiHa;, rny6fiHofi0,3-0.5 uyfit
Tonorpaox.tecxac atlaroxnn, JIoA xoxBbrM noKpoBoMB paioHe Il ptiMeqaHfi e. IIpr Heo6xoAxMocr[npHxfiraHnc cieAyer
ToqK, HaxoAtrcc Mecro npxipenneHHr no6Horo 6ppuxa 3arnnoq- a36erarb oxoroB.
HOri MLrruqbrK anoHeBpoTfiqecKoMy rxneMy,aanee Brry6b - KocTL) (q3H-rvAH.6V)"
6. TO'|XATXbrA-KvAHr
qepena.
Mbuubr B paioHe roqr(r HHEepBr.rpylorct BerBbo VII napbl JloKarx3aq[r. A. Ha paccrotHlx I.5 lryHt 3a ro.rxoitHry_cbl(5V).
qeDenHbrx oeDBoB. 5. 3a ro'{Koii nry'cn (5V) { ,larepar'IbHee 3aaHecpealrHHoro
Koxa nniepsrpyercn V napofi qepeflHbrxHepBoB. MepHAnaHa Ha 1,5
'Tonorpaon,recxai qyHt.
Ilo|(agaHxc.MecrH LI e H a p y ur e H tf,: ro'loBHat6onb,pt6b afiaroMxt. fIoA xoxHbIM noxpoBoMB pafioHe
B trra3ax. TOqKHEaXOAtTCtanoHeBpmHqec(rt IxJleM,KocTbqepefl4.
Texnnxa. flynxqan Kocar, uy6nHofi 0,3-0,5 qyHt, (oHeq 'lrrbl Koxa B pafioHeroqxt BHHepBHpyercq V flapoi 'lepenHblxHepBoB.
HANDABT'IEHBBEOX, Ilo|(a3sBxt, M e c r H b I e H a p y u I e H nt u sapylueHllfl'
i1puue,ranre. flps Heo6xoAHMocrllpqxnrasut cneayer c s q 3 a H H H e C M e p I , I A f i a H O M r: o r l o B H a6to J I Lp, t 6 b B r n a -
u36erarb oxofoB. 3ax, 3aJ|oxeHHocfi,Hoca.
n p fi M e q a u xt. I. IIpfi nonaAaHnnurnH B Toqxy y &Jl6Horo
4. TOqXA|(Xv|(-CAn(U,lon-qA,4 V) BOsHnXaeroqyqefiI|e anptxeHHocTl'l, pacnflpaHnt, oHeM€Iltt B
MecTe yxo!'ra,KoTopoe Moxer pacnpocTpaHctr'ct Boxpyr Ha coceaHne
Jloxarx3aqrc. A. BHIre D€peIHefi rpaHr.rudBonocqHoro noxpoBa '
to,rroBf,I,Ha paccrocHnn 1,5 uyHq or roqr{, rxaH-ArHh (24 VG), 2, flpr Heo6xoAnMocr[np xrra8sq !36erarb oxol'oB.
266 247
 7. roqK lxoHr-IxllEH (lylt-TtHh.7 v)
Jloxa,'rr3aqxr. A, Ha paccroqHHF1,5 uyHr 3a roqKofl rxbla-xyaHr
{6 V'I
6. 3a roqkofi rxbla -(ya Hr (6 V), narepar6Hee 3aaHecperufiHoro
Mepr.ranaHa Ha r,c qyHr.
Tonorpaofiqccxar axaroitlc, no,[ l{o,(HHv noKposov B paioHe
Torr(u HaxoAtfcg anorieBporn,recKifilrmeM, Koc,rbqepeDa.
Koxa B pafioHeroqxr lHHepBnpyercr nepnou C2.
IloKa3a|lrc. M e c r H 6r e H a D v l1re H l,rr: ronoBHac 6orb,
H a p y i u e H t t t , c n s g a H u b l e c M e p s a r a H o M : p q 6 bB
r,rlasax,34"'IoxeHHocfbHoca. fiacMoDK.
Texx{Ka. flyfi(urrq xocan noAroxnan, rny6riHoi 0,3-0,5 qyHr,
flpfi MeqaHxt. L Ilp, nonaAaHnrnrnbrB ToqKyy 6orbHoro
BO3HriXaeT OqyrqeHne HanprxerrHocrrr, pacnt,lpafinq, oHeMeHrr B
MecTeyxona, Kmopoe Moxef pacnpocTpaHqTbcrBoxpyr Ha coceAnfie
yqacTXn.
2. flpn xeo6xoAl.rMocrri nprxrraHHr r36erarb oxoroB.
8_TOq(AJ|A(-KXUOK
(Jto-Ilme,3v)
Jlotrtnx3aqrrc. A. Ha paccrocHrr.r1,5 qyxa sa roqxoi TxoHr-TxneH
6. 3a roqxofi -rxoHr-rxneH (7 V). rarepanbHee3aAHecpeAnHHoro
MepHAnasa Ha t,o qynr.
Tonorpa(px,rcc{ar aHaro xr. noA roxHLrM noKpoBoMB pafioHe
TOqXt HaXOASTC' anOHeBpOTgqeCXgff tIJ|eM, KOCTL qepena,
Koxa B paftoHeroqfi rxxepBrpyercf,nepaonrCr.
I l o t a s a l | r qM
. e c r H H e H a D v I I l e H t t : f o r o s H a f 6, o . ' l b .
n a p y I l l I e E f i r , c B c 3 a H H b r e c M e p r a r a H o M : r x y MB
yuax, cHnxeHne3peHng.
O6une p a c c r p o f i c r g a : M a x a a x a r t n o ceo c r o g H r e .
T€xHrra. flyHKulrt Kocar noAXoxHaq, rny6nHofi 0,3-0,5 rryHr.
flprMeqaHnt. l . f l p r n o f l a A a H nr nf n H B r o q K yy 6 o n b H o r o
BO3HrXaerouyul€Hne HanprxeHHocrH, pacnupaHrq, oHeMeHrr B
TOqKeyxo!'ra,xmopoe MoxeT pacnpocrpaHqrbcqBoKpyr Ha coceaHre
2. flpH Heo6xoAHMocrrnprx&raHHr cneAyer rg6erarb oxoroB.
L roqxa llroK-Ttm (rc8,9x9Hb,I V)
MH|jJqLTB pafioHe rorrxl lHHepBl'lPylorct BerBj{Ms 6orll,noro
3arhr/roqHofoHepBa,xl [ap6l qepenHblxIrePBoBI'I luetHoro HepBlroro
cnr'reTeHlla.
Koxa uluepBtpyerct HePBoMCa.
no|(a3atxt._ Mecr H 6re x a p y tlr e n I a: roJIoBHat 6orb.
H a p y l l l e H t c , c B t 3 a H H h I e c M e p I {a H a H o M : 6 o J e 3 '
Hg r,ta3, 3ailoxeHHocrb Hoca
Terxxla. nyHKuHt xocat notrxoxHar, rry6HHofi0.3-0 5 uyHt
e'{ i x r.ts. L flpr nonaaaxnn llrJlbl B ToqKy y 6o'lbHoro
fl p r rr,r
Bo3H iaer oqyureHte HanptxeHHocrn, pacntPaixt, oaeMeltq B
MecTeyKora, KoTopoeMoxeT pacnpocTpaHtTLctBoKpyr Ha coceaHre
"
2. nps Heo6xoAfiMocrunpnx}|raHtfl creayer li36erar6 oxoroB'
ro. toqKA TxtlEH"qy{TtHb-qxv, lo v)
Jlo|(anr€aqtt. A, tso snarxHe. BnrorHylo K 3arHroqHo* xpovxe
Ha HapyxHoMxpae cyxoxlnHt Tpaneq[eati]lHoivbluruu_
BOrlOC,
6, Ha HapyxHoM xpae necrHrqHoftMblllluH, Ha 3arbLloqHoI'I
rpaHgue BoJloctHoto noKpoBa ror'IoBt'I,JlaTepa'rbHeeToqKi a-MoH
(15 VG) Ha 1,3 qyHt
Tonomaonqcciac aHarorxt. floa xoxHblM noxpoBoMa paloHe
ro'.*a xaioinrce lJapyxHbIt xpaft Tpsneul,IeBHAlroiMhllllubl norly-
ocTncTaflMLlIlIqa forloBbl,3aaHHeMa{ac Il6o,rlbuat nptMbre Mblur_
uH, HltxHgt Koc3t MHtOUa TOJIOBbI
MHlxuhI B paioHe roq(n HHHepBxpyrorcfl BerBtMt ,ll napbl
qepenr$rx riepBoB, 6o,rburoro 3aTbt"IoqHoto sepBa x rueiHoro HepBHo-
fo cnreTeHrit.
K o x a n H H e D B x p v e r c tH e p B o MC a .
l i o x a g a n x s .M i c t r u e HapyueHlrt: r o ' l o B x a q6 o r h .
HanptxeHne 3aTbL'IOq[HX MHUjIl,
il a p y - e n r,re, c B t 3 a H H br e c M e p L A I,l a H o M: 6oJlee-
Hfi t,rra3. Dc6b B r,rla3ax,3a,roxeHHocTb Hoca,
pa ccrpoficrBa: c H r , r x e H I ni ea M s r r 4H e B p a c r e H l l r '
O6urre
Tcxxrxa. fiyxxurr rry6 flo& 0.3 0,5 uyHt.
flouMeqixttc. L f l p t n o n a a a H x xHr n H B T o ' { K y 6 o , ' l b B o r o
Bo3fixiaer orqyuleHlte anp;xeHHocrtl, pacntpaHst s Mecre yKona'
xoTopoeMoxe pacnpocTpa8glhct Boxpyr sa coceAHrieyrracr(H
2- flpu neo6xo,qnuoctfinptrxtltaHHt c"'Ieayern36erarb oxoroB.

Jloxaixsaqrc. A. Ha paccrorHr.ru1,5 qyur sa roqxoi JaK-xxbrox lt. TOqKAJlAn-qbr(AA-qXv, Il v)

(8 V), Ha 1,5 uyHc KHapyxr or roqror n;o-xo (17 VG). ( Ko{ar8n rocKa conptx.trrt; oco6acctaor,lt3rPyDurst roq{a
3eAHecp€atrrHoro M€ptraxaHai foqxa conpcxeflrc rox{oro
6. Ha ypoBHe3arhrnoqHoro sbicryna,Ha 1,5 ayHr narepanbHee x PYcHoroMeptAxaroB(Berc{tt cH),
coeAxHcbqae pycEHM eplrAxanad {Manul ttt')
Tonorpar0r,racxaflaHaroMrc. floA KoxHHM noKooBoMB DaioHe
To'{xI, Haxollrrcs 3ardr'loqHoe6prcurxo raru,rouxo-ir06Hot MHUtubl, Jloxarx3aqxt. A. flo o6e cropoHbl no3BoHoqHHxa, no,( I rpyAHbIM
Mecro nplrKpen./reHre rpaneuxeBHlHotvbjurublK BepxHei Bblifioi no3aoHxoM, KHapyxl{ oT nojBoHoqHllKaHa 1.5 uyHfl
,Ifil,|g 3aTHJlOqHOn KOCTU. 'rl,|Hnn.npoaeaeHHoxqepe3
6. Ha nepeceqeHxuropl,|3oHTanbfiofi
268 269
ocrscrut orpocrox I rpyaxoro noaaorxa, x BeprrrtanbHoi, orcrot- Ha TOqKy rrpnx{raHfie tB,,Itefct npo(pBrraxTI,Iqec(HM cpeacfBoM
ureii Ha 1,5 rryHr or 3aaHecpeArH8ororveprAsaHa. nDoixB
' nDocTyatL
TonorpaoxqecMt aflaroMxc.no,u xoxHHM noxpusuv B pa$oHe Tcxxrira. ilyHKurit r,1y6 Hofi 0,2-0,5 uyHt. npx)hxraHHe5'
ToqKfi HaxoAgTcqrpaneqreBl{AHaflMHUua, poMooBfiaHat Mblutqa, 15M{H.
3aaHflrr BepxHgg 3y6qaraq MHmqa, peMenfiar Mhluua uen,
AngHHefiLllag MbrLxua cnrHbr,AJlliHHeiuagMbluua ueH, a,lrHHeiuat 13.rot(A .DE-3v(oefi-uy, 13v)
M6JltUa rO!'tOBH,IrOryOCTr.tCTat MbtUlUa rOnOBbl, nO,tyOCTfiCTaq MbItll- (Coq!!crie{ ae ioqia J'er'(r)
ua efi, noAB3AorlHo-pe6epHar MHurqa llllefi, aanee Brny6b -- ner-
Kte. Jloxaix3aqrt. A. no o6e cropoHbl no3soHoqHuKa'floa lll rpyaHblM
Mbruqbr B pafioHe roqKx rrnHepBrpyrorcs BerBrMr XI nap6l qe- no3BoHKOM. KHSDYXI'I OT nO3AOHOqHl,tXa Ha 1.5 uyHt
peaHbrx HepBoB, rry6oKoro r efiHorol, n,leqeBofo liepBHbrx cnrele- roDH30HTaJIbHoi JIxHrjx.npoBe4eHHoi qepe3
E. Ha neDeceqeHxH
H,.rii{ I-ro Mexpe6epHoro HepBa. BepuxHvocr;croro orpocixa lll rpyaHofo nO3SOHKa. H BeprxKanb-
Koxa fiHHepBrpyercr HepBoM Cs. xo_ii,oriTotue* Ha 1,5 uyHf,or satrHecpealHxolo MepH]lllaHa .
llo(a3a8xr. Mec r Hbr e 1 ra p y [ r e H t l r : HaflpqxeHHocrb TonorpaoxqecKac asaro tt. IloA (oxll6lM noKpoBoMB patoHe
Mblrxu 3aTbLlKa u ues. Hotor{an 60,16 B nne,{eBoM notce. foqKn axoitTct rpaneqnetna8afl Mblrllqa' poM6oBLAEaAMbIllUa'
H a p y l x e H I r . c s r r 3 a H H b r ec M e p f i a r a H o M : r o n o B . 1a,[HgflBepXHft 3y6qara9 Mbluua. peMeHHafMhluua ueH nJlt'lH_
seiuan it;ruua cilxHH, ,{rrnHeiruae Mbll!ua ueI noryoclltcrag
O 6 u n e p a c c r p o i c r B a: npocryaHbre 3a6o,1eBaHnr, Bbr3 MbIIII[a roioBLJ, noJlyocrltclat MHlIlqa lUeH,'rerxfie.
qepenxblx
B a H H d €n a r o r e H H H MO a x r o p o M < B e r e p x o , r o r r , K a l x e , l b ,J r r x o p a - Muuuu e paroxi ToqKI{fiHxePBl'tpylorcrBerstM XI
a o q H o € c o c r o q H r r €6 e 3 f l o r o B H n e J l e Ht . , l o M a r l l a a 6 o n i , B K o c r q x . HeoBoB.rnv6oioao ueiHoro s n'leqeaoro HepBHHx cniereHrft 3-ro
T€xl|rxa. flyHKqtrr{ c,ry6rHofi 0,3 0,5 qy}rfl- nprxftraHUe 5- u&pe6eprioro HepBa, 3_ro cnsHHotrto3roBoro HepBa
l5 MtlH. Koxa riHHeDBHpyercfl HePaoM1fu,
r l_ e c r x u e H a p y u e H t , t f l x 8 a p y u e H r i q
I l o x a t a n nM
r 2 . T O q K AO O f l T , M O H( ' D 3 H - M 3 H 6 r, 2 V ) cBt3aHHue c M e p A l l a H o M : 6 0 , ' 1B6 o 6 t a c r f ci n n H t tH
' a-
( T o q ( a c o n p r x e H n t { o K t r o . o M e p t r r r a H a( B e r r x r n r H , , nptxeHHoclb Mblu.l{3af[rJ!(a, |<pHBoujeq
{ o c a { a r o u a r c a a a H e c p e 4 r H H uMMe p s a B a H o M ) O 6 urt e p a c c r p o fi c r B a: Ty6epxy'le3,rlerxfix' xauerrb'
r(poBoxap(atbe, 6PoHxtantllaq acTMa, IrOBbllll€HfieTeMnepaTyPbI
Jlolanx3aqxr. A. flo o6e cropoHbr no3BoHorrHxKa,noa ll rpyAHbrM fejla no HoqaM,HoqSlIe noT6L
f l o r B o H x o v . ( H a p l x x o r n o J B o H o q H r K aH a 1 , 5 u l H e . Tcxl|t|(a. Ilydxqfit rny6ltHofi 0,3 0,5 qyHt npkxtraHue l0-
6. Ha nepecererrr ropHroxrar'rbHofi J'Il.rHr.rr. npoBrtreHHofr qeptsr 30 HH.
Bep &Hy ocTxcToro oTpocT(a ll rpyaHoro no3BoHKa, c Beprl,t(anb- n p E M e q a t fi €, npfi xpoHtqec(oM 6poHxxre pe(oMeHAyerct
Hofi ,rl,tHrei, orcrorqefi ra 1,5 uyHq or 3aaHecpearjrrHoro Meplrat- coqer;lb c roqKaM! aaf,'rlol (Aa'qxyfi, l4VG) H xao_xoasr_3y
(rao-xya8-tlly, 43 V).
Toflorpaolqecxae axaronrc. o n h o x H H M n o x p o B o MB p a i o H e fny6oxst nyHKqtin nportBonoKa3afla.
roqKu Haxoaqrcr rpaneqxeBriaHar M6r!rqa, poM6oBEAHan Mbruua,
3aaHrr BepxHrr 3y6qarafl Mbrmqa, peM€HHar MHUrla uefi, 14.roq(A KyET-AM-3y(ll3loE-llHb'lllv, t4 v)
!r'ttHHefiruaf, Mltuqa cnfiHbl, annHB€fiullas Mbllxua llrefi, no!'ryocrl{c- (Co'iyrcrlc||rar roqrr nepxxapAa)
Taq M6I[Iqa ro!'IoBH, noJlyocTlcTat Mb uqa uefi, noaB3aolllHo-pe-
6epFaq Mbrrrqa uerr, Aanee Brny6b ,'rerxue. Jlo[anlsaq g, A. Ilo o6e cropoHbl no3BoHoqHHXa, noa IV rpy,u.ttutt'l
MHrxuH B pafioHe roqKn &Hxepsfipyrorcq serBrM! XI napu 're_ nolBoHxoM, xHapyxr m no3BoHo'{HlKa Ha l.o uyHt.
perHHx HepaoB, rry6oxoro ueiHoro 't n!'reqeBoro HepBfiblx cnnere- 6, Ha nepeceqexll ropttloHTarIbxofi,sHHr' npoBeaexHof,qepe3
Hr{fi, 2-ro Mexpe6epHoro repea, 2-ro cnrHHoM()3roBoro HepBa. aepulrxy ocrrcroro orpociKa IV rpyagoro no3BoHKa,u BeprHxan],-
Koxa xHEepBspyercs fiepBoM Thr. Hofi, oTcroruei Ha 1,5 qyHff m 3aAHecpeariHHoro MepsanaHa...
[|oxa3ar|rr. MecrHHe Hapyuerir.re: 6 ( ) ) , 1 I3, 1 B e p x H e i Tonorpaoxqccxat aHaro llt. fIoA (oxlrbtM noKpoBoMB paioHe
IOqKI{ HaXOAtfCt TpaneqteBltaHat MbI[IUa, pOM6OBUAHa'MbIrUqa'
Hapy eHur, cBr3aHHbre c MepraxaHoM:6onb 3aaHrr BepxHgs 3y6qaTat MbIIUqa,peMeHHat Mbnxqa rUeI|' IJIIIH_
r KoHrpaxrypa MHuu 3 a T H J r h a ,r o J o B H a r r6 0 1 1 b . fiefilllat Mbrurqa cnHHbI,ArlHHefiuat Mhlluqa uen, noJlyocrtcrat
O 6 ur h e p a c c r p o fi c r s a: npocryAa, KaueJrb, rlrxopaAoq_ MHlrlqa ToJIOBLI,IIOJIyOCTTCTaF MbtlUUa uen, lonepeqHo_ocTlicrat
floe cocroflHHc, xap B o6JacTn rpyanoii K,rrerxfi. Bo3aeiicrBHr MLrUqa, noAB3AomfiO"pe6epHat MErruqa er, JIerKHe.

27l t 271
 xneTxn. nonepeqHo-ocTtcTaflMhl[Iqa, lIoaB3Ao|1IHO-pe6epHaf, MHrll_
MbrurqH B pafioFe roq(n fiHHepBqpylorct{BerBcMx Xl napbl -
qeperrHLuHepBo;, rny6oKoro uefiHoro u n,reqeBorofiepBHorocnne- qa,-MblmqH
Aaree BrIy6b rerxte
qe-
reirfi . 4-ro Mexpe6epHoro ll 4_ro_crHHHoM03roBoro HepBoa' B'pafioHe roqxl x{nepBl'rpyrorcsBerBffMt{XI nap6l
oenHHt HepeoBf,ll6oKoro uefiHoro u nieqeaofo HepBHHl Cn' eTe_
Koxa fixHepBrpyerca HePaoMIh4
irufi, 6-ro riiexpe6epuoro ll 6_ro cfl HHHoMo3roBoroHepBoB'
noxasaxrr. 06 ur n e p a c c r p o fi c r B a: xarxe"1b. 6o'1h B
pBora,9!BcIBo crecHeHxe a rpyrn Koxa uHHepBxpyercfl HePBoM Ih6
o6nacr ceDAqa,ToLxHora, eHHt: 6on6 B Bepxlefi
r,ry6rnoi 0,3-0,5 ulHfl. flpHxlrraHHe 5 ii.in"."""] Mi.t""" Hapy
Texalrri, tlvrxurn
l5 MtlH.
f l p u u e u a H r r . I n p H H e B p a c r e Hpxexl { o ve H l l y e r ccgo. qf l a r b H a p y u r e u l a , c B t 3 a H H H e c M e p r a f i a f i o M :H a n p ' I -
c r o q i a M xr a M - r y ( 1 5 V ) . h a H _ 3 (y1 8 V ) H 1 \ a n _ 3 y{ z J v , . xeHfle Mlllluu 3aTbIJIxa.
2. f,ly6oxat nyHKqnt nporliBonoKa3aHa,ra( KaK 9To Moxer O6urue p a c c r p o fi c r B a: 6on6 B o6JlacrllcepAqa'm'
flprBecrn K npo(ory nerKsx. '-
io""*.. flvlKuxt rry6lHofr0.3 0.5 uyHr' npHxlraHre l0-
l5 MlrH.
ls. toqKA TAM-3y(CltHtr'l]Iv. l5 v) fl p r u e,r a x r're. f'ry6oxat nyHxqtt nPorfiBonoKasaHa'
(Co{y8crBenHar
roqm cepAqa)

JloxaJrx3aunx. A, flo o6e crcporH no3aoHoqHrKa. noa V rplaHHM

flo3BoHXoM. xHaDy)Kr.r or no3BoHo'{fixKa Ha 1.5 uyHs '7. TOqKAKAlh-3v (f3-lllv, l7 V)
B. Ha neoeceqenan roptt3oHTanhHofi rlrHt$ npoBeaeHlloiqepe3 (TocKaconPcxtd'rr (eo8x)
sepurHHy ocTncroroolpoclKa v rpyaHoaono3BoHXa. l,] Bepr Ka'[b_
Hoil.orcrotqe* Ha 1.5 uyHt or 3a4HecpeAuHHoro MepxAsaHa' Jlo|(aJr{3aqxt. A, ABe ro'{xn ptaoM c [o3BoHoLIfil'KoM'noA Vll
XHapyxr'1 oT no3BoHoqH Ka Ha 1,5 uyHf
ionorpaon,rccxar' afiaro nt. floA I{oxHbIMnorQoBoMB paffoHe fDv4HbrM
"'8, no3aoHKoM
Ha n"0""",,en"t,lrb-px3oHTanbHofi JIrHxli.nposeleHHotqeper
ToqKHHaxoAtrct rpaneqreBltaHat MbIUua, poM6oBHAItanMLItxqa' H aeprfiKanb-
InrHHefilllat MbIt qa cnnHH,norlyocTlcTat Mbllllqa uelt, flonepeqHo- seprllrHvocrxcroro orpocrxa vll rpyaHorono3BoHXa.
Hoii.oraronurei Ha 1,5 uy8t 01 sarHecpe4HHHoro Mepxallafia "
ocTqcTagMHU.rUa, AaI€e B ly6b netKne.
Muuruu a pafioxe roqrfi uHsepBlpyrorctrBerBfrMt Xl naphl
qe- ToflorpaoxqecKat a8aro st. floa (oxHhIM noxpoBov B paloHe
DenHHXHepBOB, rny6oxoro uefiHoro x nJleqeBoro HePaHOTO CnreTe_ roqxl Ha:xo,icrcfl rpaneqteB]uHafl MbIuIqa' lrlupoqafi at Mhllllqa
lxfi,5-ro Mexpe6epHoro H 5_ro cnxHHoMorroBoro HepBoB cnuHbr,aJlrHHeiuafl MbtuluacnrHbl norlyocrrcTaqMHUUa rpya
Koxa nHHeD6xpyerctEepBoMTh6. Hofi K,,terKx, noneDeqHo_ocr[crat MHLuua ra'lee Bt'yob
. blllre p accrpoftcrBa:
f l o x a t a n n cO c e p A u e 6 r , e f iT
xep ,e _ "-'l,tnutun
,lerKre,
naMFTIi, 3aAepx(a pa3BLT'C B paioHe ro'rxl {HHepBipylorct BerBtMs XI napht
BO)KgOe COCTO'tifie, crpax, cHtxe8lle qepenHdx HepBoB,rry6oxoro uefiHoro s nr'leqeBoroHepBHUXCn'le'
peur.ry lerei, (poBoiapKaHbe, ry6ep(yn$, rorx ora, A&c(Darfifi'
Tei4ir,7-ro Mexpe6epEoro H 7 _ro -cnHHHoMb3roBoro HepaoB'
SrlulencI,s.
- _
ie*"r,*.. IIyflKqfid rny6l,t8oft 0,3-0,5 qyHt. flptrxflraHfie 5- Koxa axxeprupyemn HePBoMIn7
n o r a s a H t qH.a p y u e u u r , cBt3aJlHUe c Mepl,|Afia'
l5 MrH.
n pH Meq a H fie. nplt \polfiqecKux cepae\Ho_rreroqHblx H O M: 6o,lb B ilotctlrue.
-34- O6use paccrpoficrBa: r K o r a , c H [ x e He a n f l e r f i r a '
6o,resaHftax pekoMeHtr!ercq coqerarb c roqKa\|n rxaH_MoHI/ L, 6e3 noroablAe'leHrt. HOqHUenoTbl'
rt{xopaaoqHble 3a6o'leBaHHg
n (boHr-,lofir (40E). fry6oKle y(onlrl nporsBonoka3aHd rB6HToqHoetoroorre.,IeHlle,inycrora) xpoBll, (xapt KpoBl'I'Ty6ep_
r(yJre3,
'
AOK_3y(Ay_l!y, t6 V)
t6. TOTIKA TexHnra. flyHxlrljt rny6fiHoi 0,3-0,5 uynr' flptxlraHte l0-
JloKanx3aqxt. A. no o6e cropoHbrllo3BoHoqflo(a!no,4 VI rpyAHblM l5 MLIH.
no3BoHKOM. KHapyxllor no3soHoqHlKa Ha 1.5 uyHc II p r.rM e,{ a H ue. f,ry6oxar nyH(unt npor[BonoKa3aHa.
nxHHH,npoBeaeHHoi qepe3
6, Ha nepecevexrrlopll3oHTanbHofi
BepuInH) ocTgcrofo orpocrKa. u BepTnKanbHoi orcTotluer Ha l.J 18.TO{(A KAll-3v (tatlb-lllv, ln.v)
uvHr or 3aAsecpealHHoro MepraraHa (coqpcloeHxa' roq|(a neqerx,
'
TonorpaQrricxar &raronit' [lo4 KoxHHM noKpoBoMB paioHe
TOq(H HaXOAtTCtTpa[eqleBnAHat M6IuIua, rPoqafiuias M6I
qa JloraJlrl3aqxt. A. flo o6euv cropoHaM ro3BoHoqHfiKa,noa lX rpy,4'
cTat MEIIx[a rpyalloll HbrMIo3BOHKOM, KHapyxH or no3BoHoqHI{Ka Ha 1,5 uyHq.
cflr.lrihr.LrrnH8efiuat Mhllr(a crrHbl, norlyocT
273
272
 6. Ha nepeceqeHrr ropn3oHTanhHofi ,{epe3
nnHll|,l, flpoBeAeHHofi 20. Toql(a Tbt-3v (n[-urv, 20 v)
BepuHHyocllcroro orporrxa IX rpyAHoro[orBoHXa,x BeprxKaJb- (coqyucrBex a"oqxa c€n€3€xxry
Hoi, orcrorfiref, xa 1,5 uyan or 3aAHecpe]lfiHHoroMepxAraHa.
To[orpaoxqccmr axaronnr. floa KoxHHM noKpoBoMB pafioHe '.llor(aJx3aqxq. A, no o6erM cropofiaM ro3BofioqH I(a, noa Xl rpyaHblM
ToqKfi HaxoAHTcrrpaneqneBr{AHarMbruqa, u poqafifian ntHurqa n u r B o H K O Mf.i H a p l x l r o T n o 3 B o H o q H u x a , H a1 . 5 u y H f l '
qepe3
cnxHH, antHHenuag MbItIrua cn&fiH, Ito,lyocftcTaff Mhluua fpyA- B . H a n r o e c e q e n u v r o p l ' { 3 o H T a , r b H oni ir s L l t . D p o B e r e l l H o t
HOt xneTxfi, ronepertHo-ocTucTaflMblrrua uer, Aaree Brny6b - BeoxvLrxv o c i D C r o r o o r p o c l x a x l f p y 4 H o r o n o 3 B o H K a x a e p l H (anb
" o i i . " r c r b s u r e i s a p a c c r u i H r ' r r ,1r , 5 u y H q o r r a a H e c p e a u H H o r ov e p f i t r n
MbIruuHB pafioHeroqKfi &HHepBxpytoTcs BerBeM,Xl napbt ,{e- aHa-
penHHx HepBoB,My6oKoro uedHoro H rrJreqeBoroHepaHblxcnrere- Tonomaotqecxat a[aro rl9. flon xoxxblM noxposoM B patoHe
Hrfi. 9-r'oMexpe6epHorol|9-ro cnrHfioM03roaoro HepBoB, l o q K H H a i o A ; r c e n o n c r H q H o - lp y a H a e S a c u x t u l n p o q a i u e i M H u l u H
Koxa a pafiote roqxn kHHepBlpyelcrHepsoMTh;, . n r H b r , H l t x H n f l r a a u n n s y 6 v a i d n M H U l u a a n k H H e i u a f l M H L r r U ac n
l l o t ( a 3 a 8 f l nM. e c r H h r e HaDvuIeHrq: 6onb B o6nacrr.t Hbl. nun\ocrHclafl MHULTa fp]trHofi hreTxH. nonepeqHo_ocltiflafl
noqcHrruH.6onh a o6,'racrunogaoxoq;rgxr. M b r u r u a;.a , ( n o q e q H X H .
- 06ulle
paccrpoficrBa: p r 6 h B r n a 3 a x ,o n y x J t o c r b
r Mbrrxu5r B paiioHe roqxfi tfiHepBHpylorcq BerBqMr n'leqeBoro
oor'rbB oo!'IacTt rIa3, naHHyc, BocoBHexpoBoTeqeHtfl,xauleJlb c HeosHoro cnneriHHH. ll_ro Mexpe6epHofo i ll'ro cflu BoMo3ro
6onqMlrB pe6epHoio6Jracruu qyBcrBoMcrecHeHrqB rpyAri, xsue"'rb uu.u repuor.
Rax peynbrar 3acroiiHbrxrBneHrfi, xeiryxa, 6peA. K o x a x H H e p B f i P l ecTt H e P B o v I n r r '
.- TcxHx[a. flyfixqsr rnydrHofi 0,3-0,5 uyxn. npuxrraHfle 5- lto(a3aHnn. O 6 q t e p a c c r p o fi c r B a: B3ayr9e xfiBora'
ID MIIH. flpHcryDbl 6onr B xer'Iyaxe, iyao6a npa o6xnbHoM nLTaflqfl, aHopex_
lI p r M e q a fi r e. fny6oxac nyHxunff nporrrBonoKa3aHa. clrg. 6rpuxxa, noBoc, xe,1ryxa, ?fll'l,leflcre y aer€t' BHAer'IeHe
--.i;.;;*;,
19,TOqXAAOM-]y{AAHb-llty,t0 vl rivnxuxq rrty6rxoi 0,3- 0,5 qvHq np'xnraHne 5-
(CocyucrleHtrarroqra xe,c oro try3rp') l5 M{H.

Jloxanr3aqrr. A. no o6e cropoH6rrro3BoroqHrKa,IIoA X rpy,(uHM

2 t . T O I I K AB l l S v ( 8 3 n - l l l v , 2 l V )
no3BoHroM,Ktapyxr or no3BoHoqri[xaHa 1,5 {yHi, (CosyucrBerHa' ro{ftr x(eryA(a)
6. Ha nepeceqeHrin ropxsonraltxofi n{Hr&, npoBe4eHHofi qepeg
Bepurxr{yocTHcrorooTpocTxax rpyAsoro no3BoHKa,I 6epTfi8anb. Jloxairsaqxt. A. no o6edM cropoHaM no3BoHoqH Ka, noa Xll rpya-
Hoi. orcror&efi Ha paccrosHl .r 1,5 uyHc or 3aAriecpe4rHHoroMe- HbrM n o 3 B U H X O Mx ,H a p y x H m f l o J B o H o q f i r f i aH a l 5 u ! f i t .. qepe3
pllAraHa, B H a n e o e c e q e n i n r o p x 3 u H r a n b H o i in r H H r . n p o B e l r e H H o n
Tolorpaor,recxar aHaroitrli. Ilon toxHbtM rroxpoBoMB pafioHe u e o L r l l n x vo . t l c r o . . u r p o c i x a X l l r p y a H o r o n o r B o H K a .H B e p r n x a n b
TO'{X}lsaXOAflTCrrllripoqafiUAr M6rUrUaCInHH, A,rXiHeiUAr MH!]Ua ,roii. oriroqil.Lei Ha pacclof,Ht{rr 1,5 uyxa or iallHecpeaHfiHoro Me
cnrHu, noJryocrrcrar MHlrl{a rpyAHofi x,rerxH, nonepe.rHo-ocrrcras onoiotliiour"".*"t
Mbrurqa, ,erxse (cneBa),[e,{eHb(cnpaBa). a'aloirre. llu,t KuxHHMflot(po'oMB paHoHe
MHruuH s paioHe roqKn r.rxxepsnpyrcrcn aerarMfi L,teqeaoroHepB- ' o " n l n u i o , q n r c " n o r c H x q H o - r p y l l H a eO a c u r e r x f i p o q a f t L U e iv b l u l u b l
noro cnaerexrs.l0-ro vexpe6eixoio x l0-ro cnuarovosroaororbp- cntHbI. HnxHfft 3aaHsq 3y6qaran MH|Irqa, AnnH eiruaf Mbroua cnll-
Hbr, nonepeqHo-ocrltcTaq Mbltnua, MexfionepetlH[ie Mblrxubl' I(BaapaT-
Koxa riHHepBnpyercrnepaou Thto. Ha9 Mftluqa nogcHHIlbl. noaB3aotllHo-noqcH}lqHan rtbltnua.
Jfoxa3a8xc. O 6 ru s e p a c c T p o ft c r s a: B,qyTre xHsor€. Muruubr B pafioHeroqxtr nHHepBltpyrorcn BerBcMfi n,leqeBoro HepB-
60,1l,|B o6,1acr[ rpyrHo_f,K,terK[. ropeqb so pry, TollHora. paora. r u o r oc n , r e r e u r . r r ,l 2 - r o M e x p e 6 e p F o l ' on l 2 _ r o c n n x u o v o : r o r o r o l e p -
axcQarns. xeJrTyxa,TyoepKyrle3. B O B .n O s C H l l , t H o f oH e p a l l o l o c n J l e T e H r t
__ Texfitlxa. flyHxqsr rny6l,l8ofi 0,3-0,5 qyBfl. IlpHxsraHfie 5- Koxa lrHHepBxpYercfl HePBoM I nr2.
n p f i c r y n b l6 o n n B
lio*".an""i o6ulre daccrpoficrBa:
npr.rMe,{aHllr. L npn ry6epKyne3epeKoMeHAyercr coqe, xeryA(e, B3ryrrie xrBma, noxoJloAaHfie B O6' aCTIr XIjBOTa' paxttr'
TaT6 c npsxfiraxheM ToqKn xaTb-3y (l7V). npu BripycHoMre, noreog llllll cH}txeH|,|e a n n e T r ' ] a o T p u x x a . o o l y l u e H fie crecHeHrq a
narxre coqe,a-rbc roqKaMrrfl-3broxr(9 VG), ryx-raM-rfi (36 8) r o6,racru r pyqnoft K'lerKx. pBola MonoxoM ) rpylrH lx 4el et'l floHoc
rxan'cyHr (3 F). Texrria. flysxurr r'ry6ruoi 0.3- 0.5 uyHe llpH'(HraHre D
2. fny6oxar nytxufifl nporxBotroKa3aHa. l0 MrH.
274 275
22.TOqKATAM-TbtEy-3y(CA h-tl3flO-ll|y, 22V) Ilp Me,{aH e- flpt Bocna'reHx MoqeHcnycxarerbHoro--K,a_
(coqyBcr8eHHar
roq{a rpex {acret rynoBxnra) r{ar'ra 3y (28V),
coqerarr} c ro'lxaMu 6aHr_xyaHr
pexoMeHAvercfl
qyHr-KHK(3VC) ll raM-aM-3to (6 RP).
Jloxa,l[3auxr. A, flo o6erM cropoHaMro3BoHoqHrxa,noA XIII no3.
BoHXoM, xHapyxfi or no3BoHoqHr(a Ha 1,5 uyxr, 24. to{KA xxli-xAn-3v (ult-xa9-lllv 24v)
6. Ha nepece'{eHr ropr3oHTarbHoftfln}rltH. nposenefiHofiqepeJ
BeprxxHyocrtcroto ofpocrxa I notcHriqHorono3BoHKa, g Beprtl(arb. Jloxarr3au c. A. I1o o6eHM cropoHaM no3BoHoqHlxa,noa XV no-
Hofi.olcloruei Ha I.5 ulHr or laa8ecpeafiHHoro Mepsatafia, rBoHKoM, xHapyxr.tor no3aoHoqHl,tKa Ha l 5 uyBt.
Tonorparbr,recxaraflaroHxq. [lor xbxHbrM no(poBov B paioHe ropHloHfalrbxofirlrrHHHnpoae4eHHoH qepes
6. Ha Repece'{eHxx
ToqK, HaxoArrcr roccHn.rHo"rpyAHar(pacqrr r!fipoqaftuJefiMbrurqEl BeouHHvocrttcroro orpocrxa lll notcHrqHoronorBoHKas Beprlr-
cnlrHu, HI,txHtt 3aAHtt 3y6qarat M6rruua,AnxHHef,rxatMblllrqacnu- ha;bHoii.orcrotqeft Ha I,5 [yHt or raaHecpeaHHHoro \tepria aHa
HH, non€peqHo-ocTacTac MbIuqa, Mexn03aoHoqthleMbtllll6t, KBaa, Tonoioaor,racxaq afiaroxng. floa Ko)kHbIv noxpoBoM B panoHe
paTHaf,Mh|lllqanotcHr,lbr, noaB3aoruHo-notcHIqHatMbtlljua. foqKH HaioAflTct lrogcHl,trtHo-rp'trHatoacufi q uHpoqaiuei vbIl|lur'l
qa'
MbluqH B pafioHeroqxfi I,lHHepBn py@Tcr BerBrMunreqeBoro HepB- cnI,IHbl,AnrHHefiuaq Mbluilla cngHbl, nonepeqHo'ocrucrafl M6l
Horo cn"'IereHr.r9, BepBaLt, noqcHtqHoro HepBHorocn,tereHtq. MexnonepellHHe KBaaparHat
MbIlxItbI, Mlrrlxqa noqcHtubl' noaB3aou-
Krjxa HHHepsynvercg xeogov Lr. fio-noflcHlrqHai Mbluqa.
n o K a 3 a f l r rO
: 6 u r n e p a c c r p o f , c I s a : B r t r y r x ex l , | B o r a , M H r l l u H B D a i o H e1 o ' l x H r H H e p B r p y l o r c f lB e r a q MI n , e ' { e B o r o H e p B _
A'rcnefictt,TolxHoTa,pBoTa,noHoc,alr3eBTeplg,oTexti.,lloM6aro. H o r o c n r l e r e H i f l . H " p a a L , , r l o t t ( H H ' { h u r oH e p B H o l uc n " ' I e r e H x f l
qyHr. flpnxrraHne 5- K o x a r n n e p a u p y e r c a H e p B o ML : I r r H L 3
._ TexEI|Ka.nyHKqfir r,ry6nfiofi 0,3-0,5 6onb B o6nacru
IJ MHH. I l o x a g a n x c .M e c r H H e HapyrneHUt:
n p fi M e q a s x e. flpr noveunor'rorexe peKoMeHAyercc coqerarb
c roq(aMlr rc(x-xafi-3y(24V), Aafi-qbroHr-3y (25V) u ryK-raM-rrt O 6 ur r e p a c c r p o i c r B a: EapyrueHlie Meficrpyanr'Horo
( 3 6E ) . |rnxr'la. dvH|(ufi oHar'lbHaq Merpopparlrs
Texniria.tlynxuar r,ryorirrin0.3 o.5 uyHe npxxtiraHHe5
l5 MxH.
2ll' TOq(A TXA|l-3y fl!3flb,llty. 2:]vl flDHMeqaHHe. IIpH SyHhuroHarbHoi llefpoppafftr peKo_
(co{yBcrue8Hac rocxa ooqe() M e H n v e r c f lc o ' r e l a f b c r o q x o i r a v _ a v - , q o ( 6 R P ) T o ' { x u i p a c n o _
noxe;Hofi noA ocrtlcrblM orpocrKoM V noqcHlqHoro nogeoHxa'
Jloxa,rl3aqxr. A, I1o o6erM cropoHaM no3BoHorrHrxa, noa XIV no3-
B o H X o MK , Hapyxr or no3BoHoqHqKH a a 1,5 uyHH.
B. Ha nepeceqeHr.{rropn3-o,HTanbHofi,,II,rHnH,nposeAeHHoi ,{epe3 2 5 . T O r t x Ar ' t A l l , ' l b l o H l - 3 v ( { A - t l A H , t l l v . 2 5 v )
BepufiHy oclficforo oTpocTKa ll llotcHflqHoro no3BoH(a, r, BepT Ka,lb- (roqxa corratrc rorcron tnd(x)
Hofi, orc?orqe* Ha 1,5 qyHr m 3aAHecpeAfiHHoroMeprraraHa.
Tonorpaoxq€cxas afiaror,txq. lloa ioxauM no(poBou e pafiote Jloxaix3aq t. A. no o6eaM cropoHaM_no3aoHKa, noa XVI fio3BoH-
T o q h H H a x o a r r T c rn o r c H n q H o - f p y a H a nQ a c u x q u y p o , t a f i u e i t H U l u H Kov. xHspyxx or nolBor{oqHvxH a a l.b u}Hq.
crl.tljllt, Hl.txfitt 3aaHtr 3y6qarafi MbIluqa, AnfifiHefilxaq Mhlnrqa cns- b . H a n e p e c e q e H l l r o p l , t r o H r a l r b H o ir r H r H . n p o B e r e H H o f iq e p e l
Hbr. nonepeqfio-ocTlJcTat MbIurqa, MexlonepeqHat Mbllrua, l<BaapaT- Beouglr! ocllrcTofo oTpocTxa lv noqcHrqHofo noJBoHXa I BeprH_
Hat MbIlDua noqcfi!q6I, Doaa3aotxHo-notcHtqHac M6Ilxqa. xa;L oi', orcroeurei Ha paccroeHHr 1,5 uyHs ol lallfiecpe!l,tHHoro
Mbruqbl B paioHe roqxs fiHHepsxpyrorcr BerarMa nreqeBoro MepxaHalra.
FepBHOTOCnIefeHs'{, HepBa L!, nOCCUfiqBOIOSepBt{OrOC[reTeHr.rs. Tonorpaoxq€c[as axaroMxc. floa KoxHbIM nol(poBoM B panoHe
K o x a n t H e p B x p y e r c r H e p B o ML r r n u [ - ! . Toq(s Haioa;Tcfl notcHllqHo-rpyAHaq (pacrlHt uupoqafi uefi Mr,lurqbl
J l o t ( a 3 a n r {Ml .e c T H h r e H a p y u e H ! r , cnfi HbI, Mbl[IeqHN€ MaccI,IBbI,UIyUr,le BAOJI6nO3BOHOqHITI(a, I lepea
M e p n A r.r? H o M: nroMoaro, ro,roBHhre6onn, pc6b B r!'ra3ax, utyM B MexnonepeqHofi MHurqefi xBaApaTsat Mblurua notcHltllbl tl lloa'
y ax. B3tOlltHO-nOtCHIqHat MHlDqa,
O6 ur ri e p a c cr po fi cr B a: fi]vnoresqr,f,,naroJrorfi'{ecKr.re Mbruruht B pgfioHe roqKfi lHxepBl'rpylorct BerBtML fuetleBoro
n o J I I I O U f i f i , M y t H a t M O q a , X p O B 6 B M O q e . f i O q H O eH e n e p x a H H e Moqfi. H e' D
KoBxHaO f OCnr'leTeHIsB . e p B A L 1 , n o t C H s q H o f O H e p B H O f OC n ' l e T e H I l t
HapyueHF treHcrpyanbHon OlHKuxx,6e.rr, oTexH, ,HHeoBlDvelcfl HepBov L, fi,rH I i
TexxxKa, J l o x a 3 a f l x r l. v t i . r s u e HapyuteHtlf. 6oib B xllBore
.- nyHKqrq r,ty6nHofi 0,3 0,5 uyns. flplrxnraHqe 5-
IO MI,IE, KoHTpaKTypa MbItxq cnfiHbl, nIoM6anrnt.

274 277
 HapyDrerua, cBn3aHHHe c Mep afiaHoM: na-
pallrjq finxHxx KoHer{HocTea.
O6urxe paccTpoicTBa: y p , r a H l rae x a a o r e ,B 3 A y r l e
. 6urxe paccrpoficr
I l o x a 3 a H f i tO
,rorrqecKlle nonnrcql{s, reMaTypl,lfl
60reqHeHHoe
B a : r e M o p p o i ,f l a r o -
, soLIHoi 3Hype3, nor'lr'laKyPl'le'
voqercnlcKaHHe.6oflx BHxJy xHBora.,lrreHTepfie
i
xraora, 6(Mr, Boxpyr nyn(a, noHoc, 3anop, ArseHreprrs. TexHxxa.nlHkurrt f'ly6rHoi 0.3-0.8 uyHe flprxHraH e 5_
^- Texfiflxa,nyHKuuet',ty6xFofi0,3 0,8 qyxa. IlpHxrraHfie l0 l5 MnH.
20 MxH.
28.TO{XA6A r-KvAHrSy (nall-rvAH-lxv,28v)
26.TOqKAKyAH-dryEfi-3y
( tyA Hb-tOAHb-llly,
26V) (coqyBcrBe8{aeroqxa doqcuoronFEpc)
Jloxa,nnsaurr. A. flo o6eui{ cropofiaM flo3BofioqHxKa,noA XVII no Jlo|(aJx3aqxt. A, no o6etM cropoHaM no3-BoHoqHIrKa, noA XIX no-
3BoHKoM, KHapyxx or no3BoHoql{[Ka Ha 1,5 rryHq. 3BOH(OM, XHapyXH of no3BoHoqHtxa Ha I,c qyHq.
E Ha nepece,{eHHx lopfi3oxrarrbgoi ,xHxx, npoBeAeHHofi qepe3 6, Ha flepeceqeHtllroptt3oHTanbHoirl'lHfiI'r,npoBeAeHHon qepe3
Bepu,rHy ocrncroro orpocrKa V noqcHlqfloro no3BoHXa,I Bepr]t- x Beprr-

tt
BeDrxrH]ociltcToro oTpocTKall KpeclqoBoronolaoHKa
xa,rusofi. orcrosuei Ha 1,5 qyHr or 3aAHecpeAuHHoro MepHAxana, Ka;r,Hoi,orcroturefi Ha paccrotHHH1,5 uyHr or JaaHecpe!fiHHoro
Tono4'aorq€cxlc aEarorxr. flo! xoxxuiv noxpoaorvi paione MeDnnIaHa.
-Tonorpao
roqxn HaxoAHTcr:noflcHriqHo-rpyAHafi Oacullfl ruxpoqafiuefi Mbrurqbr qecxac afialoilxc, floa KoxrLIM noKpoBoMB paioHe
cauH6r,MHlneqHbriMaccfiB,xayqrfi BAor'rbno3BoHoqHuxa, no3BoHoq- roqxfi HaxoAttTct oacqut ufipoqafiuei liltulllllb! cnllHtl' MbllllerlHblu
Mbluqbr B pafioHe roqKH xHHepBupytorcqBerBbro nreqeBoro
HepBHoroc[,'reTeBr{s,HepBoML5.
MaccrB. uayullrf, sAo'rl nosaoHoqHrxa, II KpecTuoBbliinO3BOHoK-
MHrxqLI B pafioHe roqxu lHHepBtpyrorcq BerBqMfi n'leqeBoro t
'Koxa Cnr'leTeHlt I HePBa 5t.
HeDBHOIO
Koxa [HHepBHpyercs HepBoM L{ x,1x Ls. uHHepB pyercfl HepBoM Sl llnll 52.
lloxa3arrc.MecrHbre HapynJeHsq: 6 o , 1 bB o 6 n a c r H lloxasaHxM t.ecrHbre HapyllleHtt I HapylneHuq'
cBq3aHHbIe c M e p u A n a H . o ; : 6 o n b B K p e c T q o B oof i6 ' 1 a c T ,

H a p y u e q u r , c B q 3 a H H b r ec M e p r A u a s o M : s 3 A y r x e
nloM6aro.
6 0 , , 1 I l,jr o r e q H o c l b H a p v ) K H H x
t
O6uIfie DaccrpoficrBai l
XI,IBOTa, nOHOC. noroBbrx opraHoB, Mor{a KpacHoro uBera, Hoqfiofi 3Hype3, 6on6 B t
TcxBxxa. flyHKqnq rny6flHoii 0,3 0,8 qyHr- npHxsraHfle l0- xtBme, noHoc, 3anop.
20 MrH. Texinra, flynxutq r,ry6unofi0,3-0,8 qyHt flprxtraHte 5- t
fI pfi Me,r a H s€. npI xpoxrqecKoMaocnareHsr,t KHrreqHrxa l5 MrH.
pexoMeHAyercq coqeraTb3TyToqxyc ToqxaMrrbr-3y (20 V) x TxaH np Me,raHHe. n p x B o c n a n e H f i f i M o q e i c n y c - K - a r e " l b H o rKoa -
3 y ( 2 3V ) . na"ra lexouexayerca c o qerarb c roq(aMI', rxaH_3y (23 V), qyHr_xbll(
( 3 V C ) u r a M - a r r - 3 r o( 6 R P ) . I
I
27-TOqKATbtEy-qbtoHI,3y
(ctO-qAH-!ty,27v) 29,TO{(A qvHr-Jlbl-3v {{xyH-"'llon-uv, 29v) I
( C o c y B c' o e H H a cr o c h a r o H x o I r x u r { )
Jto[a.rr3auxt. A. Ilo o6eHMcropo8aM no3BoHoqHtKa,noa Xx no-
J l o K a n x 3 a q x e .A . n o o 6 e x u c r o p o n a v [ o 3 B o H o q H r x a ir I o A X V l l l n o - J B o H | ( O M , K H A p l x r . l O T D O 3 B O H O q H T X aH a I , 5 U y H f , ,
3BoHKoM,KHapyxu or no3aoHoqBlxa Ha 1,5 qyHr. E. Ha nepece,renuu rops3oHTanbHoi nriHl{It, npoBereHHou qepe3
D, Ha nepece.reHlll, ropH3oHTanbHofi ntHnn, npoBeAeHEofi qepeg BepuHH) ocTrcrofo oTpocTxa III xpecruoBoro no3aoHxa,x Beprr'
BepurHy ocrlrcroro orpocrKa I KpecrqoBoro nosBoHKa, r 6eprrxaJr6- K a n b H o f t .o T c r o t u e f i H a 1 , 5 u y H f l 0 1 3 a a H e c p e a [ H H o r ov e p H 4 k a H a
Hofi, orcroruefi Ha paccroqHt& 1,5 qyHr or 3aaHecpeAr,rHHoro Tonorpaor,tec(as a8aroirtt, IIoa xoxHHM noxpoBoM B paioHe
MepnAIaHa. T o q x n H a x o r e r c q t F a c u x f l t u I p o q a i u e f i ! l h I L x u b Ic n H H h l .v b l u r e q H b l x
Tonorpaor.tec[ar aflaro[xq. IIoA xoxHhrM noKpoBoM B pafiofle MaccrB, rrayqni BIorb no3BoHoqHfixa, KpecTeu,
t o q K x H a x o n t T c t rQ a c u r q r u x p o q a i u e i M H L x u b rc n k H H , M H u e q H b i i i Mdurqbr B pafioHe -ToqKn fiHHepBHpyrorct BerBtML n.4eqeBoro
MaccrrB, fiAyulxfi BAo,rb no3BoHoqH[Ka, II fipecrqoBbrfi nogBoHoK, HepBHOtO
- CnJeTeHrt H J-ro xpecTuoBoro HepBa,
xpecreq, Koxa LtHHepBlrpyerct HepBoM 32 H"4u 53.
MHlllUH B paioHe ToqKn llHHepBnpyrorcr BerBqMfi nreqeBoro n o [ a 3 a H n t .M e c r f i b I e flapyuieHr,lI x HapyuIeHllq'
HepBHoro cflJreresxfl s l-ro Kon'{rrKoBoro HepBa. cBr3aHHLIe C M e p f i A L r a H O M : 6 O n Hl i K O B T p a K r y pMa6 r r l 1 q
K o x a r j 8 8 e p B H p y e r c rH e p B o ML s x , [ M S r - notcHnqHofi 06,,racTHu no xoay no3BoHollHrxa.

278 275
 O 6 x ] l l e p a c c r p o f i c r B a : a r i 3 e H T e p l KIrllJeqfiaq rpbrxa. Texrrxa. flyHKuttt r'1y6tJHofi0,3-0,8 uyHt. npsxrraHr{e 5-
rt,
TexHrxa. llyHKufifl r,ry6lHoi 0,3 0,8 uyHt. nprxnraHne 5 l5 MHH.
l5 MrH. IIDrMeqaHxe. n p s n o n a A a H t r iu r , r b l B T o q K y y o o J l b H o r o
Bo3HIxa€r olllyulefiue HanpcxeHHocTtl, pacnupa fl B MecTe yKo!'Ia'
Koropoe MoxeT ltppaA[fipoBaTr, no xoAy M€pHAfiaHa- llplr flonaAa_
($An-XvAtib-lXv.
30.TOq(A 6ATb-XOAH,3v 30V) B KpecTuoBoe oTBePcTne 6o,'I6Hoi xcnHTblBaer orqyuleHle.
suH urrbr
Jloxa,rrtr3aqtrt.A. no o6euM cropoqaM no3BonorrHr.rxa, noa XXI no- xax oT glleKTpfiqecKoro pa3ptAa.
TBoHKUM, xHapyx{ or noJBofioqHrl<a Ha I.5 u}Hr.
B, Ha nepeceqeHr.tr ropr.{3oHTanLHofi nlrHfifi, npoBeaeHfioii'repe3 3 2 . T O T I K AT X b t J l U E v ( U u - n t o , 3 2 V )
Bepur]Hy-ocrrrcroro orpocrxa lV (pecrqoBoro no3BoHxa, ri Bep- JloxanrGaqflt. A. Ha Mecre 2_ro xpecrqoBoro oraepcrl'{t, B cepeanHe
rxkar16Hol.r. olcTogulesHa t.5 uyHr 01 3aaHecpeakHHofo vepxtraHa. BNAAHHbIPCAOMC TIO3BOHOqHI'IKOM.
Tonorpatb[qacKat anarounr. f]oa xoxxbtM noxposov B pa*oHe B. ,rloia,rugauuq roqxr coBnaaaer co 2_M 3aaHIrM xpecruoBhlM
loqK, axoAtTct (pacUflqrxnpoqai[ei MEirxqhlcnrrHbr,Mecro npq- orBepcTHeM.
KpenlrreHut6onhlrlofi troArjqrrofi Mh[!qhr,,JraTepaJrbHanqacrb M6I- Tbnorpar[n,recxar aHaror|rlt. no,4 KoxHHM noxpoBoM B paioHc
uieqHoroMaccraa, nayrqerc BAonLno3aoHoqHnKa, (pecreu. l o t r h H a x o 4 n I c e d a c u r t u n p o , { a f f u l e l i M b l l r l u b rc n H H b l ,v b l L x e q H H i i
MHUuhr B pafioHe roqx, {finepBfipyrorcq BerBbrc nneqeBoro MaccnB, riayulnfi dAo"lr, nogsdxoqxqra,2-e 3aaHee Kp€cTuoBoe oT_
HepBHOTO CnrereHrff,BepxHxMrroAxqHbrMHepBoM,BeT86I{)IV KpecT- BepcTre.
uoBoro fiepBa. Mbrrx{hl B pafioHe roqKr -riHHepBfipyorct aerBtMfi flJleqeBoro
Koxa xHHepBnpyeTcrBepBoM53 rrrt 51. HeoBHotO Cn'I€TeHrlc fi HePBa 52.
-
l l o x a 3 a E rMq e. c r H 6 r e H a p y u e s f i c n H a p y l n e E f l q , Koxa runeparpyercq HepsoM Sz.
c B r 3 a H H b r e c M e p r , r 4 u a H o M : 6 o n b B a o r c H x q H oof 6i n a c r f l , n o ( a 3 a H x c .M e c r H b I e H a p y l r l e H f l t : 6 o r h a o 6 ' r a c r Hc n l l -
npllnyxrocrb a ()6,racru naxa, Hbr, xoTopa ppaaHl{pyeT BHH3, I( HApyxHbIM nonoBblM opraHaM
O 6 Lun e p a c c r p o i c r s a: naro,rorrqecKfie flor'r!'rroq{r,Ha- Hapyur€Hfiq, cB'l3aHfibre c MepHAIraHoM: He_
pyrneHneMeHcrpyar'rbHoro {rKr'Ia, 6erx, rpHxa l(rrulrrl, BblnaaeHDe Bpa!'rr&tceAa!'rltuHoroHepBa,c"Ia6ocrh HfixHItxxoHeq-
npqMoi K,tuJXx. HOCTet-
__ Texnll|(a. nyHKrrfir r,ry6sHog 0,3 0,8 uyHfl. npfixmaHrie 5- O 6 q { e p a c c r p o i c r a ar 6en, HapyuleHre MeHcrpyarlb_
HOrO U'lX"'Ia, Merpopparfit, naTo!'loruqecxl{€ nor'lrlouux, IlMnoTeHqltt.
n p H ! 1 p q a H H e . n p r B b r n a a e H fr lHp t v o f i x x u J x rp e K o v e r r a y - ID' U X A , n O H O C3, a f p y a H e H H O eM O ' { e l l c n y c K a H t e .
ercfl coqcrarb c roqKaMi rrtrosr-Kbronr (l VG), 6arb-xoi (20VG) TexHl|Ka. nyHxrl{s rny6[Hoi 0.3-0,8 uyHt flprxlrarre 5
s rxbracos (57 V). l5 MfiH.
npfiMeqaHL,e. flpu nonaaaunn firrri B Torr(y y 6o"'Iblloro
( lAH,J'lto.3lv)
3t. TOqXATXbtOHt-Jll.tEy B o l h r { i { a e r o L l l y u l e H H eH a n p 9 x e H H o c r H ,p a c n H p a H } q B ! e c r e } h o r ' I a
HOlopoeMoxeT lrppalrlxpo6aTb no xo4y MepfiaxaHa.llpr nonaar
JloKarx3aqxs. A. Ha Mecr€ l-ro KpecfqoBoroorBeocflrt, Ha I qyHb n r H i r , r u r e K p e c l u o B o eo r B e p c r r e 6 0 ' l b H o i H . n H r b l B a e l ' , l u y t u ( H h e
H{Xe I notcHl,IqHorocoqreHefirg. xax or 3,'lexTpHqecKoro pa3p;aa.
E. Ha Mecre l-ro 3aAHero(pecrrroBoro orBepcrl,Ifl. Ec,1r ltMelorcq 6o,tr npfi MeHcrpya(uqx. peKoMeHAyercn coqe_
TonorparFx,recxaqalaro flr. noa KoXHLIMIIoKpoBoMB pafioHe r a r b c r o q x a M K y a H ' H r y e H{ 4 V C ) , q y H r _ x H K ( 3 V C ) x r a M ' a M 3 t 1 o
TOqKr HaXOAtTCq MblrxrlHcnl|I|6], MbllueqHhln
oaclllitt IXHpOqafirnefi { 6R P ) .
Maccfis, fiAylrlnfi aAo,ru noaeonounr.rxa,l-e 3aaHeekpecTuoBoeor-
BepcTre.
MHruqbr B pafioHe roqK! ,fiHHepBrjpyrorcsBeratMr n.4eqeBoro 3 3 , I O q K A q v H r _ , ' t l l E v( r l x v H _ J l , l O 3 3 v )
HePBfiOTO Cnr'leTeglC ft HePBa 5r. (To{(a conpcxerse Hoxx'x Mepx^laHoR
Koxa rHHepBfipyercrxepaou Sr. r u e n N K x nr t r ) t < M a n N nt H , )
I l o K a g a r l 9Mt .e c r f i H e x a p y l l r e H f i t r i H a p y l u e H s q ,
cBrr3aHxble c Mepr,tAriaItoM: 6orb B KpecrqoBo-flotcHtq- Jlo{a,rfi3aqxc. A. Ha Mecre 3-ro (p€crqoBoro orBepcflit, a ueHTpe
Hoii o6,'racrir,HeBparr t ceAaJrrrulHoro BepBa, vrnv6",reHnt
' -8. p'tloM c no3BoHorIElixoM.
O 6 rlr fi e p a c c r p o fi c r B a: Hapyrueute MeHcrpyanbHoro ,tloxaraaaqaq roqxl,l coBnaaaer c 3-M 3aaxtM (pecrqoBHM or-
{r{K,ra, ony[leHre Marxlr, 6er1fi, 3aTpyaHeHlieMoqeficnyc(afirff t BepcTxeM,
ae(beI(au9Il. TooorpaoxqecKas aBaroirrc. lloa KoxHblM floKpoBov B pannHe

280 2ll I
Toqxr HaxoAfircHOacqnt nJrpoqafiullefiMbrrxqHcnnHrir,MbrrxeqH6ti MH ubl B pafioHo roqKa IrHHepBxpylorcs aerBbrc cpaMfioro
MaccllB,x!yn!jl, BAoIb no3BoHoqHfiXa, KpeCTeU. HepBa.
Mhlirqbl B paioHe roqxfi -rHHepBr.tpyr,orcq B€TBrMx n,reqeBoro K o x a r u r e p o l p l e r c a H e P s o M5 i .
HepBHOTO Crr!'reTeHrr n HepBa53. fiotalannr. O6urIe p a c c r p o i c r B a: 6e'lx MnoleHlll'e'
Koxa {HHepBlpyercrHepBoM 53. A r j e H T e p f i t , r e M o p p o n , x a i ( n p x M e c b r cK p o B l { n o i o f
J l o x a 3 a H xMee, .c r H H e H a p y u e H I e : 6 o , r bB x p e c r u o B o . Tcxnixa. nyaxuur r,ly6 Hoi 0.3-05 ulHe llpH,{firaHre 5
noHcSnqfiotooJIacTfi. l5 Mr.rH.
O6 u I e p a c c rpo i crB a: HapyureHreMexcrpyar'rbHoro
qrKna, 6e,rn, 3arpyAltedlroeMoqercnycxaHr{e, 3anop.
Texfir(a. flyHxqnq .ny6nHorl0,3 0,8 uysq. flpsxxraHue 5 3 6 , I O q K A T X 6 I A - O y( q e H _ o v , 3 6 v )
__
llprMeqaHfie- n p , f l o n a A a s r ]rrr n u B T o q x yy 6 o , 1 b H o r o Jlo*anrcaql|'. A, non croar|jlei. B ueHTpe f,coaxqHot cx'1€Ax]l
BosHxxaer oulyllleHsexanpqxeHsocT,r, pacn paHaqB MecTey(ora, 6 . B ' t r y 6 , r e H r H , o 6 p a r o B a H H o v H l l x H r l v K p - a e M6 o n t ' l u L t t r i o _
KoropoeMoxeT HppaaIIrpoBaTL, no xoay MepauaHa. llpr{ nonaaa- t r H q H O i v L l u i u b l , M e , 4a r I 6 H h l M K p a e M I B y r n a B o n M H u l u b l o e a p a '
rJlrx B KpecruoBoe orBepcrfie 6onbHoi cnHT6rBaeroqyureHxe, r'rarepaJrr,HblMKpaeM nonycyxox[nbHofi MbIrnuEI; B UeHTpe troaqq-
KaKOT sreKTpr.{'{ecxoropa3prrla. toi
' ix,'raaxn, Ha ceaaJIHUlHoM6yrpe rasoBoi xocrr'
Tonoroadn"ecxat aflaroirxt. lioa koxHHv noKpoBoM B pafioHe
ro"xn xuio,icrcs HxxHxi Kpai 6orbtlloi eroauqHo* MHLxud. ve_
34.TOqKAXA-rltEv(ct-Jlto,3{ V) kpan no'l)'
! r a n b H b l f i K p a i a B y r J l a e o l li i b l u l u b l 6 e 4 p a " t a r e p a " l b H H f i
JloxaJr3auls. A, Ha uecre 4.ro KpecrqoBoroorBepcfliH, B rr€HTpe cvxoxn!'rbHoft M H L i l u H r
, a r e p a i 6 H b I i x p a i n o n l n e p e n o H q alo Mblru
yrny6neHfit ptrAoMc no3BoHoqHrxoM, uir, nnyrpennna rr HapyxHat 3anltpare'lbHble Mtllllubl.
Jloxanr.Faqtt roqK, coBraAaer c 4-M 3atHnM xpecrrroBbrMor- MbruuH B pafioHe roqKfi IrHHepBlrpylorct BerBgML celanx(lHoro
fi 3anuparerlbHoro HepBoB.
TonorpSrDxqccKarafiaro xr, IIoA KoxHbrMaroKpoBoM B paioHe Koxa nBHepBnpyercq HePBoM b2-
Toq(x HaxoAtTcqrOacUtt ujrpoqaiueii MHtuubrcnfiHH, Mbru.reqH;rfi llox63aHxtM . ecrH e H a P Y I l I l I e H u q : 6o.m, B tfoauqHox
MaccnB,uayulrit BAo,Ihno3BoHoqHriKa, I(pecTerl. 06,racrll, HeBparrlit ceaaruuHoro HepBa
Mbru'{hl B pafioHe roqx{ -nHH€pBl.tpylorcflB€,rBrMs nneqeBono TexHxxa. nyHl(uHfl rny6xHofi 0,7 1,5 uyHe f l p l l x x r a H l l e 5
HepBHOTO Cn.4eTeHrtI HepBa5{. l5 MxH.
Koxa {xfiepBfipyercr repeou 51.
Jloxa3axrlt. M e c r n u e H a p y u e H fi e: 6onb B xpecrqoBo-
nofcHrqHoi06racrk.
37. TOqKA AH-MOH (ltH['-M3Hb' 37 V)
O6 qne paccrpoficrBa: 60,1B 1 H f i 3xyq B o r a , 3 a n o 3
pa, -
AeprtKaa oqegcflycKaHrlfi, Jloxair3auxt, A. Ha 6 uyHei Hr)ke roqhr rxHa Qy 136 \')
.- T.xxxKa. nyHKuHr{rny6xHoii 0,3 0,5 rlyHr. Ilplxaranre 5- 6. B ureJlr, o6pasoBaHHoi no,']yc]xo,l{t'lrbHo[ MbIUue{ fi nsy
ID MHH.
rraBofi Mbrrx[ei 66qpa; sa paccroixru 6 uyHefi noa aroa|rqHoii
nprMeqaHse. n p r l n o n a A a H x xr ,r r ' r HB T o q K yy 6 o , r b H o r o cx,laaxolr.
BO3H[(aerOl|Iy[IeHre HaIpfixeHHocTr,l,pacnupalr'jtr B Mecre yxo!'ra, Tonorpaox'recrae afiaroMnc. lloa KoxHHM flohpuBov B paHolle
KoropoeMoxer Hppa!HxpoBaTb no xoay MeprrHaxa.[IpH nonaAa- roqKn Ha;oatrca MeauanbHHfi Kpafi aByf'laBot MbIUllH 6erpa. na-
lltlj B KpecruoBoeoTBepcTue6o,rbfioi rcrrbrrbrBaeroulyqeHl,Ie,KaK r e p a n b H b r i k p a i n o J I l c y x o x H J r b H o f t H n o J r !n e p e n o f i q a r o l r- - \ 4 H l l l u '
pa3praa.
oT 3!reKTpxrrecKoro BHjTpertHeqianlpare"rsxat MHtriua. 3attHat cropoHa oeaPeHHoH
fiocTn.
35.TO'tKAXOI-3brOHr(Xv3n-rH,35V) M6ruqbl B pafio{e roqxn xHBepBxpyrorcq BerBtM'i ceAartllqHoro
JIoxanx3aqxt. A, no o6erM cropoHaMxonqrxa. HePBaL 3antrPaTenr,soroHePBa- ^
6, Ha ypoBHeHuxlrero xoHqa xonlrHxa, Ha 0;5 qyHr narepa,rb- Koxa nHHepBupyercrHePBoM52.
Hee 3aaHecpeAxHHoro Meprra}raHa. I l o ( a 3 a | l r cM' e c r H b l e H a P Y l x e H n c I HapylxeHfit,
TonorpatbxqecKataHaroxxr. floA r(oxHbrMnoxpoBoMB pafioHe CB'3AHHbIC C MEPEAXAHOM: o6nacrs
I O M g U I A f f 6o,'1ba
toqxn HaxoatrcflfloaxoxHag)kHpoBatICnerqarKa {rerKo noalaK). noccHr.rq6lxan 6eAPa
T€xxttxa, llyHKul're r,1y6sHo& 0.7-1,6 uyHe. nprxrraH e 5-
Uaqcr IrHQrqfipoBaHsro)ceAanr.ruEo-pe(ranbHoi qMK&, Mbflrrqa,
noafixMaol(as 3aAHtt npoxoa, KonqII(oBat Mbrrrqa- l5 Mr.,H-
2l{l
242
$. TOqKAOv,KXltTb(Oy-CX,38V) 4 0 . T O q K A v l l - q v f l r ( 8 3 f i - r t x v f l . 4 0v )
(Tocxa-ycrbe, orttoc'rc' r xarenopxc (3eMnc')
Jlo[arx3a{xr. A. Ha I qyxr Bhlue roqKr.ryr-qyHr (40V).
6. B yrny, o6pagoBaHHoM MeAl,laJrbH6rM
&paeMAsyrnaBofi Mbrru- JloxaJfi3aqxt. A. B qeHTpe cpeAHefi cKnaaKlj noAKo/'leHKt{-
qbr 6eApa r,rarepanhHhrM xpaeM norrynepenoHqarofinb[!ubr, Ha B. Ha cepeArrre npeMoi, coeAlrHsoqei HapyxHhli L BHyrpeH-
I uyHb Bbrurenolxo,leHHoi cK,raAKri. Hrfi vrrd non(orreHHofr tMKLl, B ToM Megre, lAe HaxoAtrcq aprepHq
Tonorpaor,tecxafl a8aroirxq. noa KoxHUM noxpoBoMB paioHe Tbnorparlr'recran aHaron[t. IIoa KoxHbIM noxpoBoM B paioHe
ToqKr rJaxoaqrcrryron Mexly nepenoHqarofi Mbrrxqeii i{ aByrna TOqKIi HaXO-IltTCtl CepealrHa noaKoreHHoi tMKl{, uleJlb xoneHHoro
Bofi MH[uei 6eapa, 3aaHs9 cropoHa Hfixaero Konqa 6eapeHHofi cycTaBa,
-
Koxa B pafioHe roq(u fiHHepBnpyerct HepBoM L3 r'14 Sz
MLlmqH B pafioHeroi{Krj nHHepBtpyrorcrBerBqMriceaa,rHxrHofo l l o K a S a rc . M e c r H 6 I e HapylxeHue: 6 o ' 1 bB
HepBa- cycTaBe,
Koxa sHHepBnpyercflHepsoML3. H a p y u e H I t q , c B q 3 a H H b I e c M e p l r a l , t aE o M : 6o,1L B
n o x & 3 a H xMce, c r H b r e H a p y u e H f i r { H a p y r u e H n q , 06.rlacrncnHHbl,HeBparllit ceaaJl,lluHofoHepBa
0 6 r n e p a c a T p o f i c r B a : n o x o cx p B o r a , 3 a 6 o r e B a H o rx e
c a t 3 a H H h l € c M e p s A f t a H o M : 6 o n h a o H e M e HB
fie
o6nacrn
rrollrqbr ri 6eApa, aepraroqar 60rr, B iroaxoreHHofiqMKer xoreH- neDeroeaa
'Tcxxxxa. Ha coJIHue,
flyuruun r'ry6nHoi 1,0 1,5 qyHt. npfi IIoHoce'pBore
TFxBx|(a.llyHkqnq r,ry6rxoil 0,3-0,8 uyHr. flprxfiraHae 5 Hifi 3acToftHHx gBre8rex B KpoBeHocHblx co(yaa\ pexoMeH4yrorcq
l0 MI{H. Heriy6oKHeyxorlH s BeHyc noc"leaylottlllMB6lllaBnrBaHueM Heoojlb'
ruord ro,,rrqdcrga xpoBll; MoxHo raKxe aarb xFoBlr caMocrotrer'tbgo
BbrTeKaTb, noxa xpoBoTeqeHreHe ocraHoBrlTctl (nx6o cnycrt HeKo-
ropoe BpeMnBpaqao./IxeHocraHoBllrbero caMl
39.TOqKAvll-3t|OHI (83B-tH,30v) f l p x M e q a H l , l q . l . n p l r n o s o c eH p B o r ep e K o M e H A y e rccoq_
qerarb c roqKoiiKxyK-,{a'r6 (3 MC); npx 3a6oreBaHtrtr or neperpeBa
(Hnxncr ro"'(a-ycr6erpex cacrei rynou{ura.
Oco6arcra6rJ|r3Npybqasrocra HoxHoroMepiaxaxa Ha corHue c roqKaMnrxtox'Kay (26 IG) t rxan_ry€H (BHeMe_
.reixxrr nHt orlnagnag, E6 PC).
2. He c,leAyeToxa3HBarb cll/IbHoto pa3ApaxeHl'iffxrnoi Bo lr3
Jloxaix3aqxc. A. Ha 16 qyxeri Hrxe roqxl rxb'a-Qy (36V). ne- 6exaHxe rpaBM HepBHofil,l cocyarcrofi crcreM.
peA MeprrfiaHoM<BensKlt rH> |I 3a MepfiAuarJoM (ManHii rH),
Ha HapyxxoM kpae noaKo!'reHHoieMKui Mexay aByMq cyxoxq 4r. TOqKAOy-OAfl(Oy-O9Hb,4rv)
8.,.B Beprnr,H,e
yr,la, o6pa3oBaHHot-o (Tocm conpcxe'xq ioxHoro r py{troro Mepxaxaro8
BHyrpeHH[MKp,aeMABy,
rr'raBofiMHtrqhr 6eApa x BfiyrpefifinM KpaeMrarepar6Hofi roJroBi! <rent*xn tH,)
I,rKpoHoxHofivHlxuH. Ha I uyHL,larepanl,Hee I ottkrl! x-qr Hr { 40 V ).
llpx yroqHeHrH noxan{3atf4'/'
6o,1tHoi lorxeH crerKa corHlrb Hor' JloKarxsaur|r, A. flo- o6eltM cropoHaM no3BoHoqHrxa,noa II cntH-
HbIMNO3BOHKOM, HA J IIYHf, KHAPY)r{fi
OT NO3BOHOqHI|KA.
ToflorpaoFrec[as ariaroxxn. floA xoxHHM no(poBoM B pafioHe D. Ha nepecevexur ropr3oHTarihHoi,ll,sxt, npoBeaeHHoiqepe3
TOrrx HaxolgTcr yron, 06pa3oBaHHHftcyxoxrnncMlr aByrnasofr Bepruxsy ocTHcTorooTpocrKa ll rpyAHoro no3BoHKa,H BepTfixa'rb_
MLI!juLr6e4pa r.rnoAouBeHHoiiMbJujuefi,3aAHcHcropoHa narepan6- Hoi, orcroqqefi Ha 3 qyHs or 3aaHecp€aHHHoro MepnalraHa.
aoro HaAMHUle,rxa 6eApa. Tonorpaonqecxacafiaroirrg. floa xoxHbiM noKpoBoM a panoHc
MHlxqH B paioHe roqx& rHHepBupyrorcrBerBsMlrMano6epuoBo- TOLIKIiHaXOAfiTCgTpaneUteBXAHaff MbIlUqa, Mbllllqa, nolHrMaloulag
ro Il ceaansnlHoroHepBoB_ lronaTxy, poM6oBnAHat Mbtruua, BepxHtt 3aaHct 3y6qaTaq MbIulqa,
Koxa xHHepBfipyercrHepBoMh. noaB3AourHo-pe6epHaF MbrurLla rpyAHoii xJr€TK!, MbIMa BTOpOTO
l l o l a 3 a f l fM
i r e. c T H b r e H a p y u e x I r I, HapylxeHrr, Mexpe6ep6c,aaneeBrny6b,'rerKne.
cBsSaHHbre c MepI,IAt a HoM: MbIUeqHH cn
e a 3 M hBt o 6 r ' r a c T l { Maruruu a paione rorlKfi tHfiepB pynrct BerBtMtj XI napH qe_
6eapa r ro,refir, penHbrx HepBoB, rny6oKoro uiefiHoro HepBHoro cn.,IeTeHt,lc,,6onhuroro
O 6 ur fi e p a c c r p o ft c r B a: no,uat{uyprc, MyrHar Moqa. SaTHrOqHOrO HepBa, nreqeBoro HepaHoro cltr,rereHIlt, z-ro Mex-
TexHrxa, flyHxufic rny6lHofi 0,3 0,8 qyuc. nprxrraHae 5- pe6epuoro HepBa.
l0 Mr.tH, Koxa uHHepBrpyercr HepBoM Th?.

244 285
 qe_
Jloxa3altrc, M e c T s H e r a p y rx e H I q I H a p y ru e H fi H, MHu.rubrB pafioHe roqKlr nHHepBHPyrorctBerBnMs XI napH
DenHHXHepBOBtrry6oKoro ueifioro HepaHoro cfi"lereHre nJeqeBo
LBr3aHHbre c MepxaraHoM: c y a o p o x H H ec o x p a q e H [ t
M H u u n n e q l , c n , { f l 6 1 , 6 o r r bI | K o H T p a x T y p aM H r u u e r r 3 a r b r { ' r x a . io lepexoio cnnerilrl{r. 4_ro cnfiHxoMo3rosoroHepsa x 4 ro Mex
TexHr(a. nyHKurrr r,ry6 Hoi 0,3-0.5 qyHs. npuxrraHfi€ 5 -- pe6epHoroHepBa.
Koxa HHHepBxpyerct HePBoMIn.
l5 MkH. p a c c r p o f i c r B a : T y 6 e p K y n eJ 3
lerxfix'
Il p fi M e,r a H x q. L IIpx nonaAaHllH firrbr B Toqxy y 6o,rL'Horo Ilo[asatlt. O6qxe
(aruerL, 6poHxHan6Hat aclMa, xpoBoxaPKallhe' narorlortqecxte
ao3firxaeT olltyuteHxe HanprxeHHocTr,r, pacnnpaHrfl B Mecre yKora,
'' "i"ii"i.. nrloxoe nriueBapeHxe' HeBpaCTeH
noJlJllo4fiIl, 9' acTeHnt' aHeMIt''
KOrOpOeMOXeT rJppa4.ffrporaTb no xoay Mepxa aH€,
2, C,leAyer x36erarb c,lllflrKoM rny6oKxJ( yKoJoB, rax kax Bo3 flynxurlauy6inofi 0,3-0,4 qyxe. npnx,raune 15
MO){{fiaTpaBMa JIeTXAX. 20 MrH.
fIDHveqaHl,|t, L n p f i r y 6 e p x y n e 3nee r K , x p e K o M e H n y e r c t
4 2 . T O q ( A O A T 6 - X Ot n o , X y . 4 2V l nDHx;raH[e B coqeraHfiflc roqKof, 0e_3y ll3 V): npr acreHul
c rorrxaMxxyaH-Hrye8{4 VC) H ryx raM-rx (36E)
J l o K a r [ 3 a { x r . A . f l o o 6 e 0 M c r o p o H a M l o 3 B o H o q H H X ar,o a I I I r p y , ' l - 2. B orn6urenlri x roLIKexao-xoaHr-3y (43 V) qaure nptMeHtror
H b i 4 ,n o 3 B o H x o M(, H a p y x r m n o i s o H o ' r H l r K aH a 3 u y H e . noHxfiraHxe.npx xpoHgqecKHx 6one3Htx npHxxrarcTroq(y xao
6 . l l a n e p e c e q e H r Hr o p f i i o H l a n b H o f i i x H x H . n p o B e a e H r o i q e p e i xbaHr-3y.a 3areMroqxa xxx'xaft l6 VC). xyaH HrleH (4 vL) Jr rlk
BepurHy ocflrc-roro orpocrKa lll rpyAHoro no3BoHKa, ri BeprsKa,rr,' rau-an {36E). c reM qro6H BuBecrfi.oroHtt Hapyxy r43oerarb
Horr, oTcTorr{ex Ha., LtyHr or 3aAHecpeafiHHoro MeprrArraHa. c illlroM rny6oxgll yKonoB, TaK KaK Bo3MOXHaTpABMa "lerKUX
T o n o r p a Q x q c c [ a r a H a r o M r n . n o ] l K o x H b r v n o K p o B o MB p a i i o H e
Toqx!, HaxoAtTcq TpaneqlteBxIHat MbIrxUa, poM6oatAHafl Mr,IuJqa,
aepxHrr 3aAqflr 3y6qarar MHuua. floAB3AorlHo,pe6epHafl Mr,[rrua {4. IO{KA TXAII-AI,IOHr(lllgHb-lAll, .ll \,
rpyAHot KneTKLj, MbIrlJqa rpeTbero noape6ep6r, aaree Brry6b no! V rpyn
JloxaJxSaufit.A. llo o6r[M cropoHav nolBoHoqxHKa.
HUMnO3BOHKOM, KHapy)l<tloT lro3aoHoqHltKa Ha.i qyHt.
MHtllqU B pafioHe roqxruHHepBHpylorcc aerearva XI napu're- qepe3
perrH6Ix HepBoB, rny6oKoro ueiHoro HepBHo.o cfl,'rereHxr, n!']eqeBo-
6. Ha nepeceqeHlHropt3oHranbHoli n HI'Iu,npoBeAeHHot
ro aepBHoro cn,lereHfic, 3-ro Mexpe6epHoro xepBa.
BepuiflHyocTlrcTorooTPocTKav rpyAHoro no3BoHxa' n BepTHRa'rrb_
Hoi. oraTosqefi Ha 3 uyHt oT SallHecpertHHoro \repnll aHa ltprl
Koxa nHHep8Hpyercr HepBoM Th3. 3auI{Il MO)I(HO
.rloKa.rfi OrpeAeJIrT6BHaqare Mecronoroxe-
l l o x a 3 a r x cM. e c r H b r e H a p y l x € I l I r q x H a p y t n e H x r ,
vToqHeHIJI{
cBt3aHHbre c M € p l . ra I a f l o M : 6 o , r b B o 6 , r a c , s n n € q l . rc f i f i
iue rouxa xars-xyax (46V), tcno,lrsyr ee B Kaqecrse opueHTupa'
H b r , 6 o , r b a K o H T p a K r y p aM H l x U r u € n x 3 a r d r K a .
Tonoapao||.|ac|(at aHarou s. IIoa xoxliblM noKpoBoMB paffoHe
O6uxp p a c c l p o f t c r B a : r y 6 e p K y r l e l , ' r e r K r xx ,a u e , l b . roqKri HaxotlflTct rPaneuxesfiaHas Mduqa. PoMooaxaHat MbIr ua.
6poHxxarbHanacrMa, oAHlrka. notB3lorxHo-pe6epHaflMHLUUarpyllx, MtllruH ntrofo Mexpeoepbt.
"aane€ Brty6b - nerKne.
__ Tex|fi(a. nyHKqre r,ry6xHofi 0,3 0,5 uyHc. npnxrrarse 5-
Muurql B paioHe foqx{ nHHePBrpybrct BerscM[ Xl nap6r
qe_
penHblxHepBoB.rny6oKoro uef,Horo HepBHorocnl1eTeHrg n'eqeBo'
npsMeqaHxe. C , r e A y e rr 3 6 e r a r b c J [ { t x K o Mr , r y 6 o x , x y K o -
JOB,TaX KaX BO3MOXHaT p a B M aJ r e r K X X .
io HeogHorocnnerexlf,,5_ro cflrllloMo3roBoroHepaat,t5-ro Mex_
'De6eDioro HepBa.
$. TOqKA (AO"XOAHt'"3y (IAO-XyAIl-llly, 43 V) Koxa rxxipalpyercs HepBoMThs.
IIoxdBa xc. MecrHbre I a p y u e H I'It: 6onL B xoHTpaKTypa
J l o x a n r 3 a q f i c . A . f l o o 6 e M c r o p o H a M n o 3 B o H o q H u x an, o a l V r p y a - MbIIIIU CIIIHbI.
HbrM no3Bofir(oM,xHapyxx or no3BoHoqHfiKa Ha 3 qyHr. O 6 u r H e D a c c r p o f i c r B a : K a u J e J ob p, o H x R a r b Haact r v a .
B . H a n e p e c e q e H H xr o p r 3 o H r a , r b H o f iT H H H H ,n p o B e l e H H o f i' r e p e r Tcxarxa. fiyxxule r,1y6fiHoi0,3-0,5 uyHfl. npfixrraHHe l0
BepurfiHy ocrrrcroro orpocrxa IV rpyAlroro [o3BoHKa, H BeprHXarb- 20 MnH.
Hofi, orcroflqerf, Ha 3 qyHs or 3aaHecpeanHHoro MeprA{aHa (npl{ nprMeqaHBe. I 4 3 6 e r a r bc ' l n u x o M r n y 6 o K [ x y K o " l o BT, a x
yroqueHrfi noKann3arrl,ln 6onbHofi Aor)r{€H o6xBarxrr, ce6r pyxaMr T D A B M AJ I E T X T X .
XAXBO3MOXHA
3a nr'':eqfi,Tax qro6hr ,loDarxr pa3lanxcb no cropoHaM),
Tollorpaor|qecxae afiaroMrr, non fioxHHv noxpoBov B paioHe 45. TO{KA ll-Xtl (ll-cl' l, 15 v)
Toqxfi HaxoAflTcq TpaneqreanAHaH Mr,ruqa, poM6oBraHar Mbruua,
BepxHrr 3aAHflq 3y6qaraq M6ruua, noAB3AoInHo-pe6ep8ar Mbrujua J l o x a r l 3 a u q . A . n o o 6 e H \ | c r o p o H a v n o 3 a o H o q H H h an. o a V I r P y d
IpyaHoi KreTK[, Mbru]tla qefBeproro M€xpe6epbq,,refxre. rrHM IIO3BOHKOX MH, a p y X L O T I I O 3 B O S O q H & IH{ a . i q y H q .
247
286
 D- Ha nepeceqeHrifi ropu3oHTaD,Ho*nr,rHfirr,[poBeAeBHofiqepe3 (XvHrr-M3Ht,
{7. TO{(A XOH-MOH 47 V)
BepunHy ocTrJcTorooTpocTxavl npyaHoro nGBoHXa,fi BepTfi8aJl6- Jlo{ar[3aqrr. A. flo o6etM cropoHaM no3BoHoqnfiKa,noa IX rpya-
Hoi, orcrogulefi Ha 3 qyHr or 3aaHecpeafiHHoro Mep{AIraHa,npfi HL{MnO3BoH(OM, KHapyxri oT no3BoHoqHI{I(a Ha J qyHq
yToqHextnnoKarr3aufiltMoxHo cHaqara onpeaerxrt MecTono!'Io- B, Ha neDeceqeHalr ropx3oHTarbHoi !'tr,Hnfi,[poBeAeHHoi qepe3
xeHHeToqK xaTb'KyaH(46V), xcno,163yt ee B xaqecrseoplteHrxpa. BepurrHyocri.rcroro orpocixa IX rpyAHoro no3Bou(a, u BeprtKaJlb_
Tolorp&lxqecxar asdro xr. noa KoxrhrM noxpoBoMB pafioHe Hofi, orcrorqeii Ha 3 uyBn or 3aaHecpeaHHoro MepraxaHa
TOTIKHHaXOAtrCt TpaneqHeauEac M6 lllqa, rxxPoqairnat Mblruua MoxHo BHaqa!'leonpeaenqrb MecTo_
flox vroqHeHulr r'1oKar'lr3aul,tlt
cnnHbr,poM6oBraHarMbnxqa,no4BgAourto-pe6epHar Mblrrua rpyAu, no,roienre roqKri KarL-KyaH (46V), rcno'rrsya ee B (aqecrBe
Mbllrlqauiecroro Mexpe6epr,c,IaJree Bf,lry6b- nerKne, ODXEHTUDA.
Muurlbr B pafioHeroqir.r rrnepalpyrdtn BerBtMn xl napbl qe- TonorpaorqccxacaEaroMxc.noA KoxHHMnoxpoBoMB paioHe
penHbrxHepBoB,rry6oKoro uefiHoro BepaHorocflJIeTeHtt, nr'leqeBo- ToqKn raioAtrcfl rxrpoqafi uafl Mbllllubl cfll'lHH,noAB3AolxHo-pe6ep_
ro HepBHorocaIgreHr.rq,6-10 Mexpe6epHoro fiepBa, 6-10 cnHHHo_ fiae Mbrlxua rpyAn, Mbiullla ceabMoro Mexpe6epbt, Aa'Iee Brny6h
MO3fOBOTOHepBa.
Koxa fiHEepBrpyercr HepBoMTh6. MbruqLI B pafioHe roqxx xHHepBpyrorct BerBf,Mt fl,reqeBoro
tlo|(alaHxs. M e c r H br e fi a p y [r e H r,rq I H a p y rx e x u fi, HepBHoro cn,'rereHfin H 9-ro Mexpe6epHoroHepBa.
c B r 3 a H H H e t M e D u n n a H o M : 6 o n bB o 6 n a c r tc n I l H b 6
I .o r t Koxa xHHepBhpyercq uepgov Th" rar Tha
B O6JraCTli nJreqa, n o x a 3 a f l r cM
. ecrnue Hapytnesl'jq: 6onb B o6,lacrx
O 6 ur & e p a c c r p o fi c 1 B a: Kaue,i6, 6poHxr.ranbHaracrMa, CN HH.
rfi xopaAoqsde 3a6orleBaHuq6e3 [oToor4e,'reHrrr, O6ulre paccrpoicrBa; r p y a xx p e 6 e p ,
6 o n l 'B o 6 , l a c r n
Texxxxa. flyrxqrr .,1y6tiHoi 0,3-0,4 uyHt. npsxuraHre 5- T O T X H O T ap. B O T a , n X O T a , n O H O C .
15 MliH. Texnnra. flynxqan r,ry6ruofi 0,3 0.4 qyHa. flpuxurauue 5
npllMeqaHne. Creayer rs6erarr cnHuxoM rr'ry6oKtxyl(o- l0 MnH.
noB, fa( |(ax Bo3MoxHaTpaBMarerKux. flptMeqaHne. C " t e a y e r t 3 6 e r a r b r , r y 6 o K o i n y H K I r f i E T, a x
46.TOq(A K Tb,KyAH(r3-tvA b. 46V) K a K n p 3 T O MB O 3 M O X H ar p a B M a , r e r K f i X .

Jlo(aix3aqxc. A. tlo o6eru cropotaM no3aoHoqHr{xa, noa VII rpya 4 8 . T O q ( A 3 b l O H a - K l r l o f l r( t H - r A t | , 4 8V )

uLrMno3BoHKOM, Ha 3 qyEr XHapyxH OT nO3BOHOqHrXa.
6. Ha nepeceuenrnropfi3oHTanbHofi ,fiHxt, npoBeaeHHo*qepe3 Jloxarn3aqxt. A. Ilo o6exl| clopoHav nuisuHuqHrlxa notr X cnxH
Beplxqxyocrrcroro mpocrxa VII rpyaHoro nogBoHKa,L Beprfixarb- BHM flO3BOI{KOM Ha , 3 UyHt KHapyx[ oT no3BoHOqHnKa
qepe3
{oi, orcrosqei Ha 3 uyHc or 3aaHecpeAntsoro MepnanaHa,Ha B. Ha nepeceuexru ropn3oHTarbHoi r1Hfl Il, npoBeaeHHoll
nprMori, coeauHqroqefi HxxFre KoHq6r r'ronafoK, Ha pacclotl{l'ltl BeprllnHy ocrr.rcroro orpocrxa x rpyaHoro no3BoHXa, x Beprgxatb-
xoii. oriroqurei na 3 uyxr ot sa,ixecpeaunnoro MepIrAIraHa flpx
3 uyHei or larHecpearHHoro vepxlllaHi
yToqfieHl,lH !'loKanu3aultl,l MoxHo BHaqane onpeaenuTr, MecTonono_
Tonorpaorqecxas aflaroirrr. flo! xoxHHv nohpoBoMB pafioHe
'roqKl,tHaxoaqrcc nrxxnfi xpafi TpanequeBr{aHofi Mbruqbr,rDIipoqai_ /{eHre roqxH Rarb-KyaH t46 V). xcnorb3yn e€ 6 Kaqecraeop}leHIx_
p a , , r n 6 o o n p e r e r r r b X I H X n o r B o H X s o. p l e H l H p y t c b n o x l { c B o -
uar MhrruuacnrHH, noaB3aorrso-pe6epfiaflMbrrnuarpyAn, Mbluiqbt
ceAbMoroMexpe6epbr, aaJreeB[ry6r, - nerxne. 6oaroMy) pe6py.
MbruuH s paftoue roq(r uHHepBnpyrorcc BerBtMu XI qepenHoro Toflorpaor,racxa{ a aro |{t. floA KoxHbIM noKpoBoM B paffoHe
HepBa,rury6oKororlrefiHoroHepBHorocnreTeHHc,nr'leqeBoroHepBHo- TOqKIt HaXOtrf,TCt ulll,poqafiUiafl Mbllllqa cnFHbI. Et,)t<lruE 3al|l'fltl
fo cflreTeHfic, 7-ro Mexpe6epHoro HepBa, 7-ro cnfiHHoMo3roBoro 3y6qaraF MH[rqa, noaB3aolllHo-pe6epHat Mbluiqa rpyar, MLlluIlH ae_
HEDBA. crroro Mexpe6epbq. aa,'ree Brny6b rerKae unfi neqeHb.
Koxa HHHepBxpyerct HepBoMTh7, MhIUrubI B pafioHe roq(D riHHepBHpylorcf, BerBcM n,leqeBoro
I l o [ a 3 a H x rM
. ecrHbre HapyureH]! r: 6o"1b n xoHTpaKTypa H e p s H o r oc n . r e r e H q t , l 0 - r o M e x p e 6 e p H o r o H e p B a .
Koxa fiHHepB pyercq HepBoM The.
l l o K a 3 a l x c .O 6 u a e paccrpoiicrBa: y p ' { a He u 6 o ' r b B
O6 q{ e p ac cr pofi cr B a: norept aflner{Ta,ToluHora,pBo-
Ta. orDux(4, xr.iBoTe,noHoc, xe.rlTyxa.
TexHl|xa. IlyHKu{q r,ry6qHofi 0,3-0,4 qyHfl. flpr{xuraHne 5
Teixrxa, Ilyxxqar rny6nHoi 0,3 0,4 uyHt- npxxl,lrat{Ije 5-
10 MlH.
15Mx.
nprMc,raHxe. C,'reAyer r36erarr, crrirx(oM rny6o(oi nyHxllr,lq, npxr|€{a8fi€. Cneryer t36erarb rny6oKoi tlyHXqxx. raK Kax npH
9TOM BO3MOXHa TpaBMa n€qeHlr ft'l ,lerKI,lX,
Tax KaK npfi SToMBo3MoXXaTpaBMarerfiIlx,
2E9
288
,19.TOq(A ll-CA (l,l-lll3, 49 V) (XvAH-M3tlb,5r
5t, TOq(A XOAHr-MOH V)
Jloxarx3aq n. A. flo o6erM cropoHaMflo3Bogoqguxa,noA XI rpya' Jlo(anr3auxc. A. flo o6erru cropoHaM no3BoHoqHlt(a,no,4 XIll no
HbIM nO3BOH(OM,KHapyX'l OT IIO3BOHOqHUKa Ha.J UyHt 3 B O H X O M ,K H a p y X I r O T n O 3 B O H o q H s K aH a J q y H t .
6. Ha nepeceqeHlru rops3oaranbHori nHHUL{,npoBeAefiHot qepe3 B. Ha nepeceuenaa ropt3oHrarbHofi !'rHHrt, npoBeAeHHofi qepe3
Beprurxy ocrficToro oTpocTxa xl rpyaHoro no3BoHKa, r BeprlrKanb- BepullHy ocTr,rcroro oTpocTKa I flotcsftqHoro no3BoHXa, L BepTH_
Hoii, oraTocqefi Ha 3 uyHq or 3aaiecpeAtHHoro Mepltal,laHa. npfl KarbHofi, oTcToquefi Ha 3 qyHt oT 3aAHecpeallHfioro MepxaxaHa.
onpeAeneHrifi XI no3BoHKa opteHTtpoBarbcq Ha XI (cBo6oAHoe) flpr onpeae,'reHHxnol(arr3a(Irtr Bllaqalte c!'reayer, oplreHTnpyncb no
D
' e6DO. pe6paM, HafiTn xII rpyAHofi no3BoHoK r,r onycrtrbct Hrxe elle Ha
ionorpaQn'recxar alaroMxs, noa KoxHrJv noxpoBoMB paiole
roqxg Haxoltfct uil.lpoqatuaq Mbllrua cflL{H6I, HtxHtc 3aABtq TonorpaorqecKat aBaro nt. flor KoxHbtv noxpoBoMB paioHe
3y6qarafl Mbllxua, roAB3AorxHo-pe6epHat Mbrlxqa rpyAxoir x"rlerKtl, roq(tl Haxo.atrct (pacqtt nupoqairllefi MbIlrIIbr cnliHbl, HI'txHtq 3a.4_
MbllllIIbr oarHHaauaToro Mexpeoepbt, noLIKa. Hrr 3y6r{arat MbIlxua, noaB3aorxHo-pe6epHafl MblrDqa notcHHqbl,
MbrurqH B pafiole roqxr fiHtrepBnpyro,cfi BerBtML nJleqeBoro nof,cHflqHo-rpyAHat (pacqtt, KBaapaTHaq Mblrxua notrcHItqhI, Moqe_
HepBHOfO CnrereHrt H Il-fo Mexpe6epHoro HFpBa.
K o x a r H H e p B x p y e r c aH e p B o MT h r n H , r r T h " . MHruuH s pafioHe roqKn LrHHepatpylorct BerBgM[ D,'I€qeBoro
n o | ( a 3 a r r { q .M e c T H b I e HapylneHxt: 6onb B o6nacru HepBHOTOCnIeTeHrq l| l-ro cnliHHoMo3roBoro HepBa,
CNTfibI. Koxa rnrepaupyercl nepeoM Thrr.
O6 uae pa ccrpoficrBa; B 3 a y T r xr el , i B o r ay, p q a H l eB x f i l l o x a 3 a H x r .O 6 u r r e DaccrpoicTBa: 6 o J I LB
r 3n,tracr-
BOTe. nOHOC,TolllHOTa,pBOTa, CHfi)l{eHneanneTrTa, noxerreHfie DarrbHofi
' o6nacTri, onyxor'll' B o6nacrll xI,lBoTa, 3anop-
Texsxxa. flyxxuuir r,Ty6anofi 0,3 0,4 uyHfl. npnxxraHlre 5-
TexE xa. IlyxKqr.rr my6xHofi 0,3 0,4 uyHt. flprxlraHxe l0 M}lH.
5-10 MnH. fl p x r,ae u a H H e. C,leAyer x36erarl' c,,rutnKoMr,ry6oxtx yxoroB.
IlprMeqaHxe, Cneayer fi36erart r,ry6oKoi fiyHKunfi,TaI(
KaK BO3MOXHa TpaBManoqeK, 52.tOq(A Ttt-rxAr (qxx-urx, 52v)
B yr,ly6,reHx
Jloranr3aqxr. A. no o6elM cropoBaMno3BoHoriHlrKa,
50,TO'tKABh-TXLTOHT (B3n-qAH,50V) no, XIV no3BoHXov, xHapyxH or norBoHoqHHxa Ha 3 uyHq
Jloxanrl3aur{c.A. flo o6exMcropoHaMno3BoHoqHrxa.nor XII rpyA_ 6. Ha nepeceqeHxnropfl3oHTarLHofirfiHxr, npoB€,(eHHofr qepe3
HHMnoiBoHKo\,r. KHapyxx or no rBoHo,rHxxa Ha 3 uyHc. BepunHy ocrrcToro orpocTxa II norcHrqHoro no3BoHKa,r Beprll-
D. Ha nepeceqeHUn ropx3oHTarlblrofinHHtx, flpoaeAeHHoiqepe3 KanbHofi,oTcToruefi Ha 3 qyHr oT 3aAHecpeArHHoroMepxAtaHa.
Bep[rrrHyocrucToro oTpocTKaxll rpyaHoro rro3Borrxa,u BepT[Kanb- IIpfi onpere,reHnI JroKa,rrfi3auuIBHaqare c,/reAyeroplreHrnpoBarbct
Hofi, oTcrorqefi Ha 3 (yHr or 3aaHecpea,{Hfioro Mepr.,anaHa, nps on- no pe6paM, fiaiTn XII rpyAHofi no3BoHoKr'r cnycrrr6ct Ha ABa no-
peae,reHrn XII no3BoHXaopfieHTfipoBarbcrno XII (cBo6oAHoMy) 3 B O H X AB H I I 3 .
pe6py. Tononpaofl,{ecKacaHaroMxc. [IoA Kox]rbrM noKpoBoMB pafioHe
Tonorpaolq€c(an aBarorxr. flol KoxHhrMnoKpoBoMB paftoue TOqKU HaXOAqTCfl tllripoqatlllat Mblulqa c[fiHbr, HrlxHtt 3a,4Hcfi
TOqKri HaxoatTcff urupoqatuat Mh[uqa cnIHbr, HnxHtt 3aaHnt 3y6qarar Mbtrxqa, noaB3,4oruHo-pe6epHar Mbluqa noqcHrubl, xBaa-
3y6qarar Mhllxqa, noAB3aorrrHo-pe6epHar MbrruqaflotcHl,r{br,notc_ pa, Hat Mblqua IIoqcHnqLI, MoLI€ToqHux.
HrriEo-fpyaHat (pacq|rt, KBaApaTHat Mblluqa flotcH qbl, noqxa. MHixqbr B pafioHe roqKx xBHepBHpyrorcr B€TBtMn nneqeBoro
Mblurlhr B paioHe roqxu xHHepaupyrorcr BerBtMr n!'teqeBoto H€pBHoro eDrereHrH n HepBa L2.
HepBHOTO ClnereHtt ll l2-ro cnfiHHoMo3foaoroHepBa. Koxa rHHepBrpyercq xepBoM Th1r.
Koxa ,tHHepB[pyercrHepBoMThlo, no(a3afixt. MecrHbIe H a p y u I e H t t l : 6 o " 1 bl t K o H T p a ( r y p a
n o x a 3 a H f i sM. e c r H b r e H a p y u e H r q : 6 o , 1 bB o 6 , r a c MbIlll[ cnnHbl.
O 6 u s e p a c c r p o ii c r B a: naro,'lortqecKqe ror!'tloqtu, fl M_
O 6 u n e p a c crpo ii c r B a: B3ayrxexxBora,6onu B xenya_ noreHrlrr, nonnaKHyp!q, 3arpyAHeHrloe MoqexcnycxaHte, 6or'1b l'l
I(e. cHuxeHueann€Trra. nDfinvx!'locTh
' Bo BHeuIHtx Ito.rIoBbIxopraHax, Alrcnencl,lfl, oTeqHocTb
Texx[{a. fly8Kqne rny6FHofi 0,3 0,4 qyEH- npfixBraHxe 5 Tlxxnxa. nyHKqrq rny6flHofi 0,3-0.5 lryHq. npfixuralrue l0-
l0 MlrH. 30 MrH.
npfiMeqaHse. C n e A y e rH 3 6 e r a r br n y 6 o K o f ni y H K q t r ur ,a K nprMeqaHue. C , r e A y e r a a 6 e r a r s c n x r l l l l ( o Mr l r y 6 o K o f i n y H X -
xak Bo3MoxHaTpaBMafroqeK, tlt{x.
290
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53. TOqXABAO,XOABT 55. TOII|(A XOn-36|OHr (X3-flH, 55 V)
JloKarr3aqxc. A, no o6e[M cropoHaM no3BorrorrHrxa,B yr,1y6,1e' Jlo(aJx3aqrc. A. Ha 2 qy8t Hlrxe cepeAn8l,l noA(oreHHoi cKJraA(I't
nxr noa XIX no3BoHKoM. xHapyxu oT no3BoBoqHsKa Ha 3 qyHn. 6, B noAKoneHHofi qMKe, B BepuHHe HHxHero yrna, o6pa3oBaH-
B. Ha nepeceqeHrru npoBeaeHHoiiq€pe3
ropfi3oH-ranbHo;,rr.rHnx, HOrO BeDXHefiqacThlo,laTepaJlbHoi L Me,{Han6Hofi ronoBKaMs HKpo-
Bepur.rHyocTlrcToro oTpocTKarl Kpec,rloBorono3BoHKa, H BepTx- HoxHoi Mbrxqbr. Ha 2 uynn rxxe roqxx yr-qynr (40V).
KanbHofi,orcrotlUefi Ha 3 {yxc oT 3aAHecpeAlHHoroMepnAraHa. Tonorpao{qecKac aHaroMxt, fIoA xoxHbtM noKpoBoM B paioHe
unpeael'rnTbJloKaLlr3aqfircTorrxll MoxHo Taxxe, opneHTripyccLHa roql(ll HaxoAcTct yron, 06pa3oBaHHbli aByMq ronoBKaMfi LlKpoHo)K'
Bropoe 3aauee KpecTIIoBoeorBepcrrie, xFapyx! or KoToporo Ha Hoi MHlnuLr, cepeatHa 3aAHefi cropoHbl BepxHero I(oHIra 6ontue
6epqoBofi Kocrn.
Tonorpa(bxqecxaradaro rr. floA KoxHbrMnoKpoBoMB pafioHe MHnlIqH B pafioH€ ro,{KI, HHXepB}rpylorcr BerBtMIj 3aaHeto 60r'Ib-
ToqKriHaxoArrcr 6o,'rbuar croAnqHaq Mblluqa, HnxHnfi xpafi cpeA- [e6epuoBoao HepBa.
MHrxrlH,nare
Hei sroar'{Hoi Mhrllllbr, sepxHr{frKpafi rpyuJeBr.raHoi Kdxa unnepiapyercr HepBoM L3 t,tl,l S?.
pa,rbHHfihpai Mecra npxxpenreHfiF oacurl, ufipoqafturei vbrrxjlbl Ilo[a3aHxc. M e c r H bI e H a p y u e H ri t fi H a p y rn e H n H,
cBq3aHHbre c M e p I a | t a H o M : 6 o , 1 l iB n o q c H a u e n , oMtulat
MbrrxuH B pafioHe roqK rHHepBlrpylorct BerBtML BepxHero11 6 l ) , ' r lB, H H x H r r x o H e q H o c r t t \ , 6 e r f i . 6 d n rB c B q r l { c l p H , x e t
HrxHero troafiqHHx xepBoB, KpecTIIoBoroHepBHorocn!'leTeHqqIt Texnrra. flyxxql,'r r,1y6rHoft 0,7-1,0 uyHq flpHxlaraExe 5--
fir'leqeBOrO HepBHOTOCn!'leTeHl'tt. 20 MfiH.
Koxa rHHepBtpyercqfiepBoM52.
Jlo(a3afiM x r€. c r H u e H a p y l n e H s t x H a p y l x e H t s , s 6 . T O q K A T X b | A - K A H( q e H - l l 3 l | H b , 5 6 V )
c B t 3 a H I { b r e c M e D t n f i a H o M : 6 o n r B n o q c H l r q Hoo6f in a c r H ,
JIoKanr3ault. A. B yr'ly6'leHxI lrocepeAuHe nKpoHoxHofi Mblu.lIlbI-
6o,1x B KpecruoBoi o6nacrlt.
O6qIe paccrpoicrBa: B 3 a y r l j ex x B o r a , y p r i a H HBe 6. B cepeanHe orp$Ka flptMofi, coeAHH'{Ionlefi roqK! xon_31{oHr
( 5 5 V ) I , lr x H a ' c o H ( 5 7 V ) .
TcxHxKa, flyHxuxq r,ry6auoi 0,7 1,3 uyHr- flpsxrraHlre 5 Tonorpa(Dtqecxae aHaroMrt. IIoa xorlHHv nohpoBou It paioHe
l0 MxH. ToqKfi HaxoAtrcg reJlb Mexay rareparbHofi H Meara.4b8ofi ro'loBxa-
Mr rl{pofioxHofi MHurqbl, KaM6anoBnaHas MHllua, 3aAHen 6or'lbrlle-
6epuoBat Mbruua, MexxocrHat nepenoxxa to'1eHu.
54.TOqKA{AT-6lEH (qX||-69l|b,54V) MHu.ruu e paioHe roqxH HHHepBHplrofctl BerBqMr ra,o.Hero
6onbure6epqoBoro 8epBa.
Jlo|(ann3aqxe. A. no o6elM cropoHaM no3BoHoqHrKa,noa XXI Koxa lTHHepBl{pyercfl HepBoM Lr r'1ll Sr.
n o x a 3 a H x sM. e c r H H e Hapyu€Hnt x HapyllleHat,
ao3BoHKoM, xHapyxx or norBoHoqHHha Ha 3 uyH,t.
c B t 3 a H H b r e c M e p r a I a H o M : 6 o , 1 bB r o , 1 e H l u l ,a p a n r q H r i x -
roprj30Hra!'rr,HoivItIHaa,[poBeA€HHoiqePe3
B. Ha nepeceqeHltr.r Hr,tx l(oHeqHocrefi, 60,,1|,lB notcHlqe clta3Marrqecxoro xapaxTepa,
BeprxfiHyocrr{croro orpocrKa IV KpecrqoBoro no3BoHKax Beprlr cna3MbI lixpoHoxHblx Mbltull,
KarlbHofi,OlCTOnUetiFa 3 UyHfl oT 3aAHeCpeAlHHOrO MepnAtaHa.
O 6 q u e p a c c r p o f i c r B a i r e M o p p o f f 3, a n q p
Onpeaer116 Jroxar'r13arrrroroqKu MoxHo raxxe, opneHlEpyqch Texnxxa. Iiynxurn rny6xHoi 0,3 0,5 uyHq. IlpnxlraHle 5-
Ha qeTBepToe 3aaHeeKpecruoooeoTBepcTxe.xHapyxt or Kofoporo
l0 MnH.
HaxontTctToqKa.
Tolorpat0xqecxas afiaroirxr. floa xoxHHM noKpoBoMB pafioHe (q3H-UlAHb,
57.TO{KATXbtA-COtl 57V)
TOqXIEaXOArrrCr rroarlqHar Mhlxrlar HrjxHufi Kpafi rpyure
6O,1bUrafi
Jloxar[3arlxr. A. noA rKpoHoxHofi MHrnuefi, B yr,'Iy6neHfi Mexry
Mbllxubr B pafioHe roq(u sHHepBr,rpyrorcrBerBflMI,rBepxHero nBvMt
'6, ee folIoBKaMH,
qroAuqHoroHepBaI KpecTuoBoroHepaHotocnr'leTeHriq. B BepuuHe yrna, o6pa3yeMoro Meauar'lbHofiri narep_anbHofi
Koxa {HHepBrpyercr HepBoMSr. roroBKaMr r{KpoHoxHoriMHuq6l, Ha MecTecoeAr[eHxt ee 6PrcueK
Ilo(a3adxs. M e c r H br e H a p y IIr e H r| r r H a p y u e H Ir 'r, (Mecro xopo o o6o3Haqaerct, Koraa 6onbHofi nprinoaHtMaercc Ha
c B q3 a fi H H e c M ep ll A r a H o M:60.rlll B norcHntle I,t B o6nacTn qHnoqKn),
xpecrua,reMoppofi.napa!'lsqHfixHHxKoHeqHocTefi. Tonorpaofl,rccxar aHamMrc. fIoA xoxr{brM no(poBoM B pafioHe
TexH[(a. flyHxurr uy6rHoi 1,0 1,5 qy,{q- flpfixHraHse 5- TorrK[ fiaxoArrcc yron Mex.qy {'rarepanbHofiri Merra!'rbHoi rorioBKa-
l0 MrrH. Mlr uKpoHoxHoi MHrtqH, KaM6a,'roBnAHarr Mbrrxua, yro, MexAy
292 293
anrrHHbrMcrlr6aTeneM nanbqeB H ar'ItlHHblM cru6aTe"leM 60nbuoro 6epuoBofi MHuirIaMs,lirsHHHfi crri6are,r6 6o,'ILuoro na,lr,qa cronr,r,
n a r ' ' I b q ac r o n b l , 3 a a H q g 6 o n b m € 6 e p q o B a t M b I J u a . M e x K o c r H a t n e _ HnxHHfi xpafi 3aAHei 6onbure6epqoBoiiMbrlnrrbr.
penoFxa roJleHfi. MHrur.lH B pafioHe roqK! r.rfifiepBr,rpylorcq BerBrMr I{oxHo-MH-
Mbrlxubt B paioHe roqKq sHHepBlrpytorcq BerBtMx 3aAHero ueqdoro HepBa roreHu Il 3aAfiero 6onl,ue6epuoBoro nepaa,
6onblne6eDuoBoro HepBa. Koxa HHHepBupyercqHepBoMSr.
Koxa rxueprrpyercn uepsomL5 r,rx Sr. lloxasaxxr. H a p y ui e I k f,, c B n 3 a H H br e c M e p H A fi a-
lloxa3aHfic.M e c r s u e Ha p y u e H n t: cyaoport nxpoHox- H o M: 6onb, onyxJrocrb HapyxHofi nor(brxKn, napanrq HfixHqx Ko-
Hofi Mbluun. 6onb, ofly\aHlre, yroMneHFe trxpoHoxHox vHUlubl HeqHocTefi , Mbtr[eqHbrecna3MH, 60r'rr,rB KpecTu,oBo-noccsxqHofi 06-
Hapyueuaa, cBt3aHH6Ie c MepfirriaHoM:6onb nacrll, oqyuleHne rqxecrH B roroBe, ronoBHac 6onb,
B notcHnqe, HeBpanrxt celar'lIrqHoro HepBa. Tcx[r[a. IIyHKqqq rry6uHofi 0,5-0,8 qyHc. np xqraHxe 5
O 6 urr e p a c c r p o fi c r B ai,{cnpaxHexHt c (poBbro' Bhrna_ l0 MxH.
a e H H en D n v o i I ( H I ! K r , r e M o p p o j l , n o H o c H p B o r a
Texnixa, n\nxurn r,ry6rnoft 0,5 0.8 ulHq npHxHraHre 5 60.TOq(A (OH-rloll (KyHFJtvlltr.60V)
l0 vgx- (ros(a-6scrp'xa, xaft.oprfli .ororb')

58. TOqKA 'Dll-36lOBr (O3ff-tH, 58 v) JloxaJlxsaqrtc. A, 3a ,arepa,16rrofi noahrx(o*. s yfny6neHlls Haa

(cra6rnr3rpyouat mqxa, ctcauts|ouat c rcptararon rcqKx fltToqHo[ KocTbIo.
E. B yrny6neHtH MexAy BepruuHofinaTepan6Hoil jrolbrxKu t
Jlo(a.rxrauxt. A. Ha 7 uyHei BHule rlarepa"lbHoi JloaLl)t.Kt'l HapyxHHMKpaeMaxxr'lJroBa cy\ox9rHfl .
B. Ha rpaHHue vblue'rHofi ti c!xoxHnbHoi tlacreE BHeuHefo Tonorpaolqecxae al|aroffrr. floA KoxH6rM noKpoBoMB pafioie
(par na,eparbHoro 6ptoulKa fiKpoHoxHoi MHlxIrbI, Ha paccroflHlrl roqKn HaxoAtrcc qerlb Mexry cyxoxsrt flMlt Kopor(of, s InrrHHofi
7 u y H e i H a r r o . r x o i x o H - r o F ( 6 0 V ) , n p f i M e p H oH a I u y b H l t x e a Mano6epuoB6rx MhIIxq,yqacrox nepeA nflToqHbrM(axunnoBbrM)cyxo-
, r a r e D a ! ' r b E ereo q K H T x H a - c o H ( 5 7 V ) . xur'rrieM,3a Hxxfl {M r{paeM6onbure6epqoBoftKocTr.{,
Tbnorparfnqecxar anarourc. floa xoxHblM noKpoBoM B paftoHe MHrnqlr B pafioH€ ToqKri rHHepBripyrorcr BerBqMr xoxHo-Mbl-
roqro HaxoatTct: BHeruHfifi Kpafi rpaHl,Illbl M6IUIeqHOil,| CyXOXllrb_ lxeqHoro HepBa roJreHr,rr{ 3aAHrM 6o,'rbrue6epqoBLiM HepBoM.
'{oii qacrei rarepanbxoro 6plourKa IrKpoHoxltoi Mb[xIr6I, xaM6a!'lo_ Koxe lHnepaspyercf, HepBoMSr.
BrnHar MHrxlla. a,'rxllHbIi crx6are,,Ib 60,16luoro na''Ibua cTonbl, 3aA_ l l o x a 3 a [ x r .M e c r H U e HapylueHxr: 6 o n b ,o l y x n o c r L B
Bflt 6onboeoepqoBat MHuua, MexKocrHaq nepenoHKa roreHH roneHocTonHoM cycTaBe,
Mbruubr B pafiorre ro,rKa |jHHepBlrpy|1)rcqBerBqMIr 3aAHero 6onb_ H a p y u r e H H r , c B t 3 a H H H e c M e p f i A r a H o M :6 o r n ,
rxe6epqoBoro HepBa. HapyuelrHenoABIJxHocTga 06,lacTt notcHt,|ubt,cfiacrllqec(ne 60r'ltl
K o x a n s H e p B s p y e r c ss e p B o M 5 2 . B O6racTHCnBriti l.r [req, HeBparrsr ceAanfiuHoro HepBa,Hanpc-
I l o x a 3 a r r x sM. ecrHbIi xapyueaxl: 6onb B o6nacrx ro- xeHre MLIlItl ules ll 3aTbtrKa, rna3Hble 6one3Hr,r,pt6b B rna3ax,
r'reHu. HOCOAOe XpOBOTeqerte,
HapyrxeHxt, cBfl3aHHbIe c MepuataH,oM: c!ra- O6 rfie Hapyuefifiq: anrl.,refiTrqecKfie nptrnaaK|,r y retefi,
6ocrb ML,ttuucnflHtl I,' HllxHl{x xoHe'lHocreli, ro'roBHas 6onb, pt6b 3aTpyaHe8HHe poIH, HeBETXOA qaCT&nJraqeETH,3aAepxl<aOTC.JrOlrol
B rra3ax, 3anoxeHHocTb Hoca, HocoBoe KpoBoTeqeHfi€ nnaqeHfhrnpr poaax.
O6urue paccrpoicraa: r e u o p p o i ,n o M t q a t 6 o n b B TextrIrxa. nyHKrtni rny6sHofi 0,3-0,5 qyxr. KoHeu xr,lH Ba"
. \-c t a B a x . r H \ o p a a o q H o F c o c r o q x H e 6 e l n o r o o r n e ' l e H r F . npaBneHB cropoHy MeAranbHofinoaHxKx. np xfiraHHe 5-10 Mfl{,
TexHxKa. n\Hhuue f,ly6xHoi 0.5-0.8 uina [lpHx{raHre 5- flprMeqaHue. n p t 6 e p e M e H F o c rnt y H K u s t n p o l a o n o '
l0 MnH.

50. IOqKA Ov,3brOHr (Ov-ttr, 59 V) 61.TOq(A 6OK-TXAM (nv-Ul3Htr,8lV)

(To'tra-ureib rapyxroro noa,qepxrraDurero nepraraHa) (Toq{n cotrpaxoca Hoxtroro Meprara'a <uenxxxt cD c Hapyx'rM
noMcpxrla$uxM MeprArano. Haqaro rapyxnoro nor.qcpxxaaK'{e-
JloKaJrrrauxq. A. Ha J uytr BHLxe rarepa'lr,Hox roabl)hKH rO M€D'ATAHA)
B . H a p a c c r o e H x f i3 u y H e i H a A r o q K o i x o H _ n o Hl b u v ) B u e ' l r
M e x r v K o D o l h o i v a r o 6 e p q o B o f i H K a M 6 a n o B r a H o tM b l u u a v H Jloxairsaqtc. A. B yrny6neHnH noA flqroqHofi Kocrblo.
Tonoroadnqecxar afiaroMxt. [lon KoxHuM nokpoBov s paioHe 6. BnnorHyro I( Bep{HeMy HapyxHoMy xparc ntroqHofi Kocrn,
l o q K x H a i o a g l c t u e , l b \ e x A \ x a M 6 a n o B [ a H o f i] t K o p o T x o i M a n o - nprMo noA roqxofi (oH-,IoH (60 v).

29't
296
 TonorpaoxqecKag aHaro ttg. floa xoxHblM noKpoBoM B palloHe ArrrHHoii H KoporKofi Ma'looepqoBblx Mbllxu,3aAHIifi I(oHeIr V nnrc-
ToqKfi Haxoaqrcq cnepealt cyxoxtn!fl A,'ltssoi tr KoporKoi Ma- cHeBoii Kocrlj, Ky6oBnAHaq (ocTb.
,ro6epuoBbIx Mbltttu. c3aAx ntroqBoe cyxoxrnte, BepxHI'tl{ Kpal'j MHBqbr a pafioHe roql(s fiHHepBripyorcq BerBtMH KoxHo-MbI-
uerrHoro HepBa r,r 3aaHero 60rbrue6eplroBoro HepBa.
M6r[rqbr B pafioHe roqKt ldHHepBxpyrcTcq BerBtMl'l Ko)KHo_MbI_ Koxa HHHepBHpyercq H e P B o Mb r .
urertHoro HepBa ro!'reHx r 3allHero 60,!Lue6epuoBoro HepBa l l o x a 3 a |t |. M e c r H u e HapylxeHIt x HapylLIeHnfl'
Koxa sHfiepBlrpyerct HepBoM Sr. cBr3aHHble c M € p l l a I , | a H o M : 6 o n h x o n y x n o c r bn a r e p a n b _
n o r ( a 3 a H x r .M e c r x b l e HapylxeHxtl 6 o , , 1 bB f i t r K e . Hofi ,ronblxxn, 6o,,1bn oHeM€Hre HtxHI{x KoHeqHocren.
Hapyuednt, cBq3aHHble c MepuafiaHoM: naPa- O 6 ul u e p a c cr p o t c r B a: 9nt.l€nrsqecxle npHaaaKl' cy-
nn" rrliirrx KoHeqHocrefi. MH[errHhIe cna3MbI, 6on]r B 06''Iacrlt D o r x v t r e r e t r p a H H e r o B o 3 p a c r a , M H L x e q H H ec D a 3 M t i I .
n o 'Texnirxa.
Ilyixurs r,ry6rino*0,3 0,5 uyna [lprxrrarue 3
O6 rfi e paccrpoicrBa: M a H f i a x a . l b H oc e
ocrotHue, 5 Mr.rH.
Tex |(a, flyH(qrie rny6lrHoi 0,3-0,5 uyHH, KoHeIl xrnbl HanpaB
64.TO{XA (tl[|],-KOT ((3XH-rv,6t V)
rex B clopoHy ',roaHxKx. llptxxraHte 3 5 MfiH (Ioc[a-noco6nr'()
6 2 . I O { K A T X A I r - M A T 5( l l l S H b - M A n . 6 2 V )
( T o q x a ( o n p c s e H x t d e p x l a H a d o c e B o r on y t u p c . 3 . r r x x i t H r t l Jlor@Jx3aqxt. A. noA 6orbuofi Kocrbro c HapyxHoi cropoHbl cro_
Hapyxrcro no!.lepxxBaroqcro iiepxAraHa. Haqano HapyxDoro noAAep- rbr, Bo BnaAriHe I{aA rpaHuuefi nepexoaa noAotIBeHHot cropoHbl
xrDaDuero MepxAxara, CTOnbIB Tbl'llr,Hyrc'
J l o k a , r l | 3 a u x s . A , B o e n a a r H e n o a , 1 a r e p a , r b H o f in o 4 b r x K o f i , H a B. B yrny6neHHlt HaA rpaHfiuei l]oaolrBeHHofi It rblrbHoi no-
paccrorHn! ufip{Hbr Horrq or rpaHxqbl noAouBeHHofi n rhrnhEof, no- eepxaocrdfi cronH, Ha ypoBHe nepexoaa re-ra V nnlocueBoi Kocrll
s ee 3arHH8 xoHeu.
B 6 o p o 3 A e M a J o 6 e p u o B o f iM b i l r u H n o a n a r e p a n b H o f i J o n H X - Tonorpaol'rec(ae afiaroMxt. nor KoxHUM noxposoM B-paioHe
_6. TOqKXHaXOACTC'IMbIlXqa, oTBoafiulat Mn3ItHeu K]lcTll, 3aAHHll KOHeII
K O r , H a p a c c T o t H H f iu , D u y H g o r a e p u f i H 6 I J l o a H x K l l .
Toflorpa4r'recxar ar|amMxn. floA xoxHHv noKpoBoM B DatoHe V n,rrccHeBofi (ocru.
Totrkti HaxoAqrcs c)\oxlr'lxr arr.rxloi a xoporxoi va,ro6epuoesrx MbrmqH B pafioHe ror{(n xHHepBpyrorct BeTBr,n 3aAEero 60!rr,-
Mb rrl, M€cro npuxpenneHrr KopoTxoro pagrrjoaTe,tf, na,r6uea, 60- ue6epuoBoro HepBa,
po3Aa Maro6epqoBofi MbrutqH, asroqHar xocr6. Koxa xHfiepBrpyercfl HepBoM5l
M[tlnqbr B pafioHe Toqrfi rHHepBnpyrorcs BeTBrMr, (oxHo-Mbr, n o x a 3 a n n rM. e c r n u e H a p y l x e H x t : 6onb no Hapyxt{off
rneqHoro fi epBa ro"'rexH, nepeaHl,tM 6o,'rhrxe6€pqoBbrM HepBoM.
Koxa uHHepBrpyercfl HepBoM Sr. Hapyrue"xr,, cBfltaHHHe c vepHAfiaHov: 6onb
n o x a 3 a r r rM . ecrHHe HapyueHr.re r{ HapynlIeHrr, B r a 1 o 6 ; , i p e x H o Mc y c r a B e . 6 o n L B n o e c H l r u e , 6 o ' 1 b x H a n p s x e H x e
cBr3aHHhre c MepxaraHorl: 6 0 " , rBr ,o 6 r a c r o J r e H o c r o n - MHuu 3arinKa. ro'loBHat 6ont, pt6b E rna3ax, naHHyc,6one3Hfi
Horo cycraBa,60,1r, rnl,l c,ra6ocrb B o6nacrr xoneHa I roneH]r, Dr6r, rr1a3, HOCOBOe KpOBOTeqeHXe-
B rJaSax, ro'IoBoKpyxeHrre. O6nr e paccrpoficTBa: M a ' r q p n 9 , 3 n l ' , r r € n c q tc' e p A q e _
O 6 ut r e p a c c r p o fi c T B a: Malrraxa,rbxoe cocroqHie, 3nfi - 6seHIie.
TexHxxa. flyHKrrfl r,ry6rHofi 0,3-0,5 qyHq. flPrxl,lraHxe 3-
nerrrnqecr(ne nprDa4xn, 3q6xoc'rb B aHeBHoe BpeMe, Ilor,rrfiBocrr,.
TexHxKa. flyHKuar r,ly6xxoi 0,2 0,3 uylrfl. flpaxrrarue 3- 5 MfiH.
_
6 5 , T O q t ( A T X y K - K O T( l ! v - r v , 6 5 V)
$ . T O q K A ( t t M - M O H ( U 3 l l H b - l n 3 H 6 , 6 : jV ) (Toqxa-pa3ntu, '€reropxx .aep€8o,)
(Ioqxa-ucnB. roqra conpcxeHxc ho,(roro vePrAraha .uenrxxn tH! Jloxa.rx3aqxt. A. Ha napyxnou Kpae V narbua cronbl, B yrry6lre'
r rapyxxoro mrocxoro deptarasa) HIt 3a n.{rccHe(paltaHroB6rMcycfaBoM,
Jloxannlauxc. A. floa ",rarepa,rrnofi ,roahlxl(oi, 3a roqKoi (xay-KxLl B. B ya,iy6reHnHra rpaHsue noaoujBeHHofiI,t rblrbHoi noBepx-
(40 VB) x repea rouxoi rxax-uarr (62 V). Hocrefi cionbr, na ypoBHe nepexoaa rera V nnIl)cHeBofiKocrr B ee
6. B yary6neflxt Ha 0,5 qyxt Htxe 'l qyrb xnepeat or roqKl aeDe]lHnir
' KoHeq,
rxafi-Mar6 (62 V), BnnorHylox KpaP Ky6oBtAHoi (ocru. TonorpatDrqecxaqaHaro||rxs. non hoxHHM noxpoBoMB paioHe
TonorpaoF{ecxat araroutt. floa KoxHHM noKpoBoMB patoHe TO'tKIt HaXOItTCt Mbrrrlqa, OTBOAtUIat Mrl3I,lHeII CTonbI, n€peaHHH
,loqKt HaxolltTct Mblulqa, oTBoAsnlac Mg3I'IHeqxl,lcTl'i,cyxoxsnxt (oHeu v nnFcHeBofixocrlr.

206
 Muu{H B pafioHerorlKr tHHepBripyrorctB€TBt,o3aaHeao6orb_
ue6epuoaoro 8epBa.
Koxa uHepBnpyerctHepBoMSr.
llortgaxtt. M e c r H bI e H a p y uI e H ll fl : 6o1b no HapyxHoff
crooote cfonH.
H a p y t r e n n n , c B f l 3 a H H h I €c M € p r , l a , a I o M : 6 o nBb
o6racrr rorerrB, 6eapa, flotcfi Bubr, Kpecrqa! cn|'l{Ln,llllerl,3arbltka,
roJoBui nepeMnr rna3, pr6b B rna3ax,
O 6 q o e p a c c r p o fi c r B a: nrrxopaAoqHoecocrocHre, 3t6'
KOCT6,XpOBaSbrinOHOC,reMoppofi, MAHraXar'rbHOe cocrotfile.
Tcx'|nrr. flyuxqHn r,ry6rnbi 0,3 0,5 uy8c. flpt xtraHre 3-
5 MnH,
(|l3v-Tvu-rv,66V)
66.IO{KA IXOHr-KOK
(To,rn-pycet, mreropee .8oaa')
Jlot(!r{3aqxr. A. Ha napyxnou xpae V flanbua cronbt, B yrny6-
netrl nepeA nnocHeQanaHroabrM cycTaBoM,
6. B trny6,reHnn Ha rpaHHqe noaorxBeHrofill TDInbHoi.noBepx-
Hocrei c;onH, Ha ypoBlie nepexora lera OarlaHrli V na'lbua B ee
3aAH!fi KoH€Il, Ha ypoBHe HapyxHoro KoHua cxJIaAKs a Mecre
n,locHeoanaHroBorocycTaBav na,1bl(a,
Tolorpao{'rccrac aHaronfir, floA KoxHLtMnol{poBoMB paffoHe
TOrtKitaxoAtTci MecTonprxpenneEngx xocTfi cyxoxrl,lt_tt MblllluH,
msongL{ei Mn3lHeu cronh|, JanHxft KoHeu I oatraHrl,t v flarbua
MduuH B pafioHeroqK$ sHHepBtlpyrorcsae,gb|o ?aAHero6or'11,-
ue6€PuoBorouePBa,
Koxa nrHepBrpyercq HepBoMSr.
l l o r a 3 a { t t , ' l V le c r n u 6 B a p y r n e H u t : 6 o n b B V n a r b q e ,
H a p y u e H H t , c B f i 3 a H H b r e c M € p I ,Al E a H o M : 6 o n b ,
TflXeCTbB 3aTLIrKe,pt6L B rna3ax, HOCOBOe {pOBOTeqeHte.
O 6 u r r l e p a c c r p o f i c r B a : a u c f l e n cr , 0 o 6 s s ,
Tcxxrra. Ilynxuun rny6lfioi 0,2-0,3 qyHr. nprxuraHHe 3
5 MnH,

07.TO{KAIr|-AM (rrXX-l|Xh,67V)
(Io{n-rcrorq xarc.opxx .uera.Inr)
JlorarrSaqrr. A. Ha tapyxaov xpae V nanbqa crolltlt, orcro|T
oT yrJla sorTr (Ha TonuBHy cTpe.,rxr Me,rxoro 3€neHoro ry(a-

6. Ha rpaH8ue no4ourseHHofix rbrJrb8ofinoBepxHocretcron6l,

8a Hapyxsoi croPoHev nanLqa, Ha ypoBBeyrna Holr€Boro roxa,
Ha pacctogrlfifi 0,2 qyHff or H€ro.
TonotDtotqaclat at|aroitr. noA xoxHHM noI(PoBoMB patoHe
Torrxt H!)aoar,|rcrxocTb III OanaHrx V nanbqa,
Kor(a tsfiepExpyercr HepBoMSr.
noxasa|trr. fxnepeMnr noaonrBHcfonH.
H a p y u r e n H t ,c B t 3 a B H h I e c M e p r A t a H o u : r o r o B -
Hat 60,16,nagdyc, 3aJIo)KeHHocTL Hoca, Hocoaoe(poBoTeqeH[e. Pr(.7C. Mep,a,ax noqex (danut rHhD.

2SE
 O 6 ur lt e p a c c r p o i c r B a: naro,lorsqecxre nonnrcul'lH' 3a
rpyAHeHHLIe poa6t, 3aAepxKa orcrlofixr nltalleHrH, rpeBoxHoe co_
c r o q H r e . l a T p y n H e H H o eM o q e H c n l c K a H t e
TexHxxa. nlHKul.tt rny6tHofi 0,1 uyHe. xoHFu I'tr,1bH i anpaBrleH
BAO!'rbcroflH. IlpxxfiraHHe 3-5 MI,H
fl p H M e q a H u t. l- flpu ronoBHblx 6o,'rHx, xoHrpa(rype,M-Llrxu
3arbrnia peKoMeHAyercq coqerarb c roqKaMx (poHr_'rn (20 VB) t'r
Tx a i - 3 b r o H r ( B B e M e p r a x a H H a r ,9 P C ) .
2. npfi 6epeMeHHocrl, Bcrl(oe Bo3aeficrBue Ha roqKy nporlBo'
floxa3aHo.

HOXHOfinrrbcKlrfi MEPlrafiAHnoqEK (R)

(no 27 roqe( c xaxAon cropox!)
xoA epxAl{ana. Beper Ha.ra,ro o'r roqxl'r 3yllr_ryeH (l R) Ha noro
seHHofi cropoHe cronbl, npoxoAnr I{ aHyTp€HHeMy xparc cronbl
(ro,rKa HrreH-xoK, 2 R) noAHljMa€rcn 3a Mealra,'IbHyrc ,'Ionbtxxy,
orn6aeT nqroqHyrc (ocTb, noAHIjMaerct l( tlxpoHoxHot MHrXlle' npo-
xo4rT BAOnh 3aAHem BHyTpeHHero Kpaq 6onbue6epuoBoff Kocrfi (
B H y T p e H H e fci T o p o H e f l o l l K o r l e H K HH a a i e e f l o l a a H e t B H y l p e H H e H
cr6pi,xe 6eapa noaHtiMaerct K xrsory. rpy^ll i ]axaHqx-Baerr9
\ Hr{xHefo x P a q x J l o q u u b l , B T o q K e l y _ Q y l 2 t K l lpu'c to tt'
l22B) lloKa3aHsf,. HapyueHuq B floroBblx ri Mo.IeBblAe,ltre"tbHbrx op_
raHax. Kr{uKax, ropne, opraHax rpyaHot xnerl(n.
Tcxxxxa. flpu gogaefcrsltt Hi roqKy 3yHr-ryeH (l R) 6o"rrttofi
nexltT r.r!'rr cl,lAnr c BblnpqMneHHblMl{HoraML B nor'IoxeHgr, yaoo_

u a - r o q x l c r o n u , B o 6 r a c r x r o ' ' l e H o c r o n H o r oc y c T a B a I f o n e
HH 6o,1t'Hoft JIexIrr Ha cnlrHe, cronll pa3BepHyrbl B cropoHt'l;
- Ha roqxy aM-KoK (10 R) - 6onbfiofi ao,'IxeH c,'Ierxa corHyrl'
I pa3BecT[ xor'leHu;
Ha TOqKt xllBora - rexrr I|a cII[He;
Ha roqxl rpyAri - ne)|(Iir Ha cDuHe JII'I cxauT c BblnpHMneH'
Hoir cnIHofi.

r . T o q K A 3 v H t - T v E H ( | O H - U | O A H bI, R )
(Toq{a-rcro(, {a'erop,' <Aepe.or)

JloraJx3aqxt. A. Ha noaoullBe cronbl, B yrny6neHfit'1, Koropoe or

qeTJItlBOO6O3HaqfiTCt,ecl'Ilt noaxaTb na'r6qhl I' lcrony
' / r p a c c r o f H f i t o T K O H U a-. ll nanbua
6. Ha fpaHxue [epeAHHx
f i o n H A o c e p e a r H H 3 a A H e r Ox p a q n t T f i H l B y r , 1 y 6 ' r e H r HH a n o A o L x B e

Toflorpao*q€cxas araro rtc. floa KoxHHM noxpoBoM B paioHe

roqxH HaxoAtrct xoporKtfi crl6aTe,lr, [a,rIbIIeB cronbl, cyxoxl{nHe
a,rrHHoro cr!6arenq nar6ueB, qepBeo6pa3HbIe MhIIuqH, noaolll-
ll/, BeHHaq MexxocrHat Mbllxqa, TEIJIbfiat MeXKOCTt{at MbItlIIIa' npo
MexyroK MexAy II x Ill nnocHeBblMu KocrtrMr.
MbrnlIqH B paftoHe roqKx tHHepBfip).Iorct aerBqMt{ 3aaHeH oor'lb
Prc. 77, M6prAqaH noc€B <$andi ,kbD. nre6eDuoBoi Mbrrrllbl.
301
 To[orpaolqecxat a amuxr. IIoa KoxHt{r{ noKpoBoMB patoHe Koxa rHHepBxpyercflnepnou Thz ur Tha.
Torrxr HaxoarrTcrnepeaH{i Kpafi uupoqafi refi MbruJqHcnsHbl,6o,1b- l l o x a 3 a r r. M e c r H b I e H a p y n J e H f i t I t H a p y r u € H I , t t l ,
lnaf 3y6qa,as MHuua, MbrroublveTBepToro Mexpe6epbc,rerKHe, c B r 3 a H H br e c M e p ri I H a fi o M: 6o,'rbB 6oKoBoi o6nacrH rpy!
MbtuqH B paioxe roqKri riHHeparpyrorcsBerBtMI{noa blulerrHoro Hoi xnerKM,6o,rn B o6nacrH neqeHr n xerrqxoro ny3brpe,TourHola,
HepBHOTO CnreTeriHct 4-ro Mexpe6epsoro HepBa, HI(OTA.
Koxa xHHepB[pyerct HepBoMTh4. TexE xa. nyHKqr.rt rry6Hltofi 0,3-0,6 uyHc. Ilpu>KuraHxe 5
t , e c r B b l e H a p y u i e H c : 6 o n bB 6 o K o B o0i 6 -
l l o r ( a 3 a f i xM l5 M$H.
,lactr rpyaflofi KJreTKrr, onyxrocTr, B noaMbrueqHofio6nacrlt, f l p l l M e q a H n e . f , 1 y 6 o f i a r n y H K r r x n n p o r , r B o f l o K a 3 a H a ,T a r {
T€xHx|(a.fly8xunc rry6uHofi 0,3-0,5 qyHt. IlptxtraHre nporl'r_ xax cyuecTByeT onacHocTb noBpexaeHItfi ner{eHlt }lJlL ce,,te3eHxr.

n p x M e q a s x e . f , r y 6 o K a sn y H K q f i qn p o r t B o n o K a 3 a HTaa,x 2 5 , T O \ ( A ( t t l l t i t o l l ( l l 3 x H - M J l l b , 1 5V l l )
KaK CyOlecTByeT oIIacHocrbnoBpexaeHIr9rerKrlx. (Toqu-rna'!araii noqexl

2i, lOq(A qtlCll-(All (rlX3-llitUHl' 2i va) Jlo(arx3aqtq. A- B (oHqe XII (cso6oArofo) pe6pa.
(Tuqra ronpvxc r, {.f,nd! {rphtrHa{on .se.'{hrn tH E. noA cBo6oAHhlM KoHqoM XII pe6pa.
{ (ManHti ci}) Tonorpao q€c(at ar|aronl{t. floa xoxHuM noKpoBoM B paioHe
TOLTKnHaloAtTCH HapyxHat Lr BHyrpefiHtt l(ocble Mhli|uH xtBora,
JloxaJ|xSaql|c.A. Ha 3 qyHr Hxxe fi Ha I qyHs xnepe,q!rroaMblueq- <oneu XII (ceo6oaHoro) pe6pa, nonepeqllat Qacqnt, 6pIouHHa,
HOfirMX .
D, Haa BepxHrMKpaeMV pe6pa, ua I uyfiL (nepeA, or roqKri yeH- Mrnurr6r B paioHe ro'{Ku nHHepBltpyorctt uecrbto Huxl{l{Mu Mex'
3urb (22y8\. p e 6 e p F H M HH e p B a M r H n o a B 3 l l o L r l H o - n o ^ q p e B H HHve p a o M .
Tonoapaofiq€c[as aDarox{q. flo4 xoxHHM no(poBoM B paftoHe l \ o x a l t H H e p a f i P y e T cH
t e P B o MI n e
TOqKUHaXOACTCT MeCTO lpri(penneHrC 6o,thrrloi Sy6qaToi Mbruqrll, no{a3aH[r. M e c r H bI e H a p y rx e H x t: 6onfi B 6oKoBoii 06-
HrxHnfi xpai 6oJr6uofi rpylrofi Mbllrrlhr,Mhlr rlbr qerBeproro Mex- nacrn apyAHoi xrleTKl,r,
pe6epr,r,nerK{e. MHuqH B pafioHeroql<I,rrHBepBrpyrorcqBerBcMfi O6urue pacc I poic lBa: Bla!IHe,{HBola n .u k o c .
noAMbrueqHorofiepBHorocn,'rereHrrrri 4-ro Mexpe6epHoroHepBa. TexHxKa. nyHKuxs r,1y6 Hoi 0,3 0,5 iOHt. npfixrraHre 5
Koxa lHnepsHpyerct HepBoMTh1. l5 uas.
llo|(a3a'|xr.Mecr H hle H a p y rIIe r{fi t: qyBcrBopacntpaHug Bcre4
fl p u M e,r a I u e. f,1y6oxat flyHxuljsnporqBonoKasaHa
s rpyaH, 6poHxnanbfiaflacfMa. crBrr€ onacHocrr noBpexaeHIt noqKIr, oco6eHHo B Tex c'lyqaqx, KofAa
O6 qne p a ccrpo fi cr B a: Toujfiora,KucnatorpblxKa. KOHEIIIIJIbI HANPABNEH BHYTPb.
Texxma. flynxqrn rry6liEoi 0,3-0,5 qyHr. llpntlrraHue 3-
5 MrH,
II pn Meqa s He. f,'ry6oxaa nyxxqur flporuBonoxa3aHa, raK 2 6 . T O q ( { A O l l M A T I ( A A I I - M A r l , 2 6v B )
Kax cyulecrByeT onacHocTb noBpeaurbnerKqe (Toq(a conpca.H,r soxdoio Mep.^,aHa
,, :)anHe.pea{nnoro Mepn4naHa,
24 lorl(A HtT-HIvE1(Xh,()[, 24VB) Jlo[a.,rx3autr. A. Ha l,E qy t Hnxe Kpat Xl (cBo6oaHofo) pe6pa.
{loc(a-rraoaran xenq{oro ny3lpfl. Toqxa conprxewe 6 Ha nepeceqeHlrlr BeprHKanr,Hoii ,'raHr,l, npoBeAeHHoi qepe3
Mrprl{{ada .MarlJt depi)uanoM
{ nsptaHH{ lortr{laxBaburv !eP{4ha{oM) Kofieu XI (cBo6oAHoro) pe6pa, l,l ropr,3oHTanbHofi, npoBeaeHHoi '{epe3
nynox,
JloKar 3aqrf,. A. Ha 1,5 uyHt IJlIxe ro'rKl,rxfi MoH (14F). Tonorpao[qec[ac a aromxr. fIoA xoxHbrM noKpoBoM B patoHe
B, Ha seprxKa,rbHofi ,1nHxx.nposeaeHHofi qepe3rpy4Hoi cocox. TOqXn XaXOAqTCflHapyxHan I BHyTpeHHHCKOCbteMH[lllbl XUBOTa,
B ceabMoM Mexpe6epLe.y BepxHero xpaq YIII pe6pa. nonepeqHaf, MblrJua xrBoTa, nonepeqHac (bacqrq, 6porxBHa, TorlcTat
Tonorpa(0nqecxataxamurr. fIoA foxHuM noKpoBoMB pafioHe xlruKa nrg noqKa.
ToLrKrflaxoArrcr Mecro nepexoAaHapyxriofi Kocoi MbIrIrI{bI xltBora MHruqH s pafioHe ro,{Ks rrHHepBupyKrrcffruecrblo HIrxHr{Mr{ vs}x-
B 0acqfiro,MHurubrceAbMoroMexpe6epbr,neqefib (cnpaBa), ceneeH_ pe6epHHMn HepBaMn fi noaB3aorrHo-noaqpeBHbrM HepBoM.
Ka xnr xenyaoK (c.,reBar. Koxa uHHepBnpyercr HepBoM Thr.
Mbruqbr B pafioHeroqKx nHHepBr,rpyrcTcrBerBqMr7-ro Mexpe6ep- noxe3aHflr,Mecrsbre HaDvlxeHufl: 6onlj no 6oxoBoi
tosepxHocTu xHBoTa, .nrcM6afo.

346 347
 O6q e H a p y u r e H n q : 6 e r H , H a p y u l e H nMee H c r p y a n L H o r o JloKa3aHxc.M e c r H b r e H a p y e H x t t o 6 n r t e P a c
rll,tKra,rpNxa. c r p o f i c r B a 6onb B 06,racrn notcHIrIrHI IIaxa, 6or'rbBHIl3yxxBo'
Texxrixa. Ilyxxu n rny6tHofi 0,5-0,8 uysfl flpHxriraHlte l0- Ta,6€rn,
l5 MnH. TexHrxa. IIyH(qrt r"ry6HHofi 0,5-1,0 uyHfl- npnxxraHxe 5
flor.rNreqaHr.rc. l. npn floflaAaHlrq firnbrB roqKyy 6onbHoro l0 MrH.
n p fi M eq a H re, flptr nonaaaHnli nr,1hl s roqxy y 6orbHoro Bo3-
BO3H[(aeTorqyueHne HanptxeHHocTll,pacnfipaEuq B MecTeyxona'
srrKaeTorqyueHne HanpqxeHHocTfi, pacnHpaHuq B Mecre yKo!'la' KoTo-
xoropoe Moxer xppaAllIlpoBarLB o6racTr, HapylueHtiq
poe Moxer xppaalr poBarb B o6lacTb HapylxeHHt
2. IIps yKo,rax Ee c'reAyer HaltpaBnqrb(oHeq Ijrntt BHyrph' Tax
xax gMeeTcqonacBocT6IIoBpexAeHllt noqxfi.
29. TOTIKAt(bt-,rtllEy (q3rcn-Jlto, ,9 vB)
(To{{a conpcxeHtt HoxHoro MepraraEa .MaJrNt tfl ,
i uapyxruu trtroc'ur Mep'A{aHo')
2?.TOq(A Hrv-(Xv (v-lxv, 27vB)
( I o q M c o n p c x e n x c t o x o r o M e p x a { a H aa M a n u n t { >
JloKarx3aq[t. A. Ha 8,3 qyHq Htxe roql(|r rnoHr'MoH 113 F), B yr,1y6-
{ 3aanecpeaxnoro Mep{axaHa)
neHr,rr.,Han 6oJ'I6llIuM BepTe.IIoM-
6 . H a c e p e , l H H ep a c c l o s H H e M e x a y B e p x H e n e p e l H e i n o r a 3 r o L x
Jlo(air3arute. A- Ha 3 uyHt Hlrxe rotl(r aofi_Marb (26 VB) H o t io c l r , o f i B e p u l H H o f6i 0 , 1 t ' u o r o B e p l e ' 1 a6 e ! p e H H o i K o c r H
E , n e D e n B e D x H e n e p e a H enfoi a B 3 n o o H o f io c r h t o H a 3 u y H t H H x e aHarornxtr. IIoa (oxHbIM no(poBoM B pasoHe
Tonorpaot{eclac
foprr30HT;,rb,{oi,l HIit;, coenxHeloueft nynoI( c loqKofi nofi-Marb
(' 2 6V B ) . TOTIKUHaXOItTCt CpeAHttl I Marafl qrol}|qHble MUUlqbI.
gro_
MHruqbr B paioHe roq(x IJHHepBupyl,orct BerBtMIl B€pxHero
Tonorpattxqecxafl aEaroi{xt, noA |<oxHbrM noKpoBoM B patoHe
Toqx! HaxoAtTct HapyxHaq s BHyTpeHHegKocble Mhlulqbl, norepeq_ nuqHoro HepBa.
Koxa aineprupyercl HepBoM Lr xnn L!
Has Mbluqa xHBoTa, nonepeqEat oacqIJt, 6ploulrHa, ToIcTac Kulllx9
M6r qbr B pafioHe ro,{Klr HH8epBllpylorcs Ixecrblo HIlxHIlM Mex- Iloxa3arixt, M e cr s bI e H a py [I e H H fl: 6orb B o6'lacrx naxa,
pe6epHHMri HepBaMt u DoaB3aolxHo-noaqpeBHHMHepBoM 6onr, B noqcrBqe c ppaarallxei B HIrxHIoIo rlacrh xxBma,
Koxa nBHepBvpyerct nepsox Thru. Hapy eHIrt, cBfl3aHHbIec MepIranaHoM: napa_
[ o K a 3 & H r cM. e c r H H e riapylUeH!t x uapyuefillq' ,xq HrxHl{x KoHeqHocTei, c'la6ocrb MbIluu HITxHI'IX KOHeqHOCTeU'
cBe3aHHble c MeptAI{aHoM: 6 o f l b B o 6 n a c r f in o q c u q b l
u naxa- 60nb BHx3vxnBoTa.6eJllr. TexHnxa.nyHxqxt r'ry6lnofi 0,5-1,0 qyHq flpxxxraHt{e
5
0.5 1.0 uyHs.npHxtiraHHe
Texruxa.nyarirra r,1'6nHoft 20 Mtrtr.
l5 MrH.
flpl nonaAaxla llrnbl B roqKy y 6orbHoro 3 0 . T O q K A X O A h - X X l l E v{ X v A H h - T t O . 3 0 V B )
npliMeqaHne. ( Iocxa .onptxexut nor(Hur repxrraHo8 .Manun eHr
BO3Hrxaer orlynleHue HaflpflxeHHocTll, pacnupaHtt B Mecre yl(o.na' t|.8enrx[x 9x),
KOlOpOeMOXeT nppaatll'lpoBaTb B o6nacrL HapyuteHns.
Jloiaix3aqxc. A, B floqcHx,{Hoir o6nacrn.
6. Ha rpaHxqe HapyxHoi rperu paccroqHflt MexAy 6onbull{M
/ a . f o q K 4 . r K ) x - a a o . ( B J l l - 4 4 0 . 2 8v B l
(Toq{a conpn'{enxe roxHoro Mep{ara8a Bepre,roM 66,epeHHofiiocrl a ocilcrui"r orpocTKoM IV KpecruoBoro
n 3aaxecpea{Htoro McP{arara} n03BoH(4,
Tonorpaoxqccxax aBamMsc. noa (oxHLIM noxpoBoM B.patoie
Jloxa.rxsaqxt. A- Ha 5,3 qy8t Htrxe roqKr rroHr'MoH (13 F). roq(n Haioa;Tca 6o'lburat troat,{Hat MbIIxqa, HxxHHfi (paii nrpa-
B, Huxe a xnepean m BepxHenepeaHefinoaB3aollHofi ocrH; Ha MfiAarlbHoft MbImqbI, sepxHti Kpafi BepxHei 6ru3HeqoBoi MbIUubI.
0,5 uyue Htxe xriepeAn or roqxfi Hry-(xy (27 VB), Ha paccroeHat MHuqbl B pafioHe roqKI,t IrHHepaxpylorcs BerBqMIt BepxHero
5.3 uvHr Hfixe mqKr rxoHr-MoH ( 13 F). H HfiXfiero qroAxtlHhlx HepBoB, xpecrqoBoro HepBHoro cnneTeHr'{t
T6norparfnrecxar aHaro nc. non KoxHHM noKpoBoM B pafioHe Koxa qHHepBupy€rct EepBoM Lr.
TOqKfiHaXOACTCtHll,r(Hni KpSi FapyxUOfi ti BIlyTpeHH€fiKOCbIXMUITIII Ooxagaxxc. M e c r * u e n a p y ur e u I n: 6onb B Ta3o6eapeH_
xl.rBora, nonepeqHat M6Illlua xuBora, nonepeqsas (Dacqfit, 6pIolurHa, HOMCyCfaBe.
mrcTat KlllrKa. HapyueHsc, cBt3aHHHe c MepIlaxatroM:HeBpan-
M6ruqbr B pafioHe roqKIr xHHepB[pyrorct rxecrbro HHXHIIMHMex- rrq ceaa,rrulHolo HepBa, reMfinrerlt.
pe6epHU{r.t Hepsa\,|x u fiorB3nouJHo-noaqpeaHHMxepBoM Texnnxa. flynxqri rry6[Hoi 1,5-2,5 qyHt. npfixtraHue 20-
'
Koxa n x n e p a r p y e t c t H e p B o MT h r 2 . 40 MHH.
349
348
31.rortKAooHt-lxtl (ir:)fl-ulu,3t vB)
Jlol(anlr3aqnfl.A. Ha Ko"rere, B yr,ry6.'rexflr Mexny cyxdxx!'lxsMu
Ha HapyxHoi cropoHe6eApa.
6. B Mecre KacaHrt lll nanbua BblTaHyrot BIlu3 pyKu 3aafiero
^pan vblurubr,HdrtrHBaKlL[e ulupoK]|o Qacurtu 6e4pd BunpeM
,rir*rnn nrrl, 06H,rHoFa paccroqHrH7 uyHei Haa xo"leHHhlvc)_
Tonorpaoxqecxac asaroxxt. noa KorKHl'lMlloxposoM B p-afiollc
r{r'l{r HaxoArTcg3irjrHIIi Kpaii u}tpoKoi (pacuHfifi,'Ialepa"15HoxlUa'
poKoil MHrxubt6eApa,nepeAnri xpaii aryrnaaol! Mbirxubl6eapa. Me-
rfiaJrbHaeMHuIIla 6elpa, 6elpeHHaq xoc,rb
Mr,lufirbrB pafioHero,txh uHrepBxpyorcqBerBLnBepxHero
rj ceaa.jlxUlaoro HePBa
fo HepBa,BerBtMu 6e,lpeHHoro l{epBa
Koxa 0BHepBrpyeTca HepBoML?.
Iloxa3axng. rU e c r l{ bI e H a p y n' e H L q x H a p y u e H r t'
c B r r 3 a R H b l c c M e P v a H a H o M : n p o c , y a s b l3ea 6 o " I e B a Hol 'Tl t
fiaroreHfloro(paK'lopa<Berep>.reMxn,!eraq,napa'rll,lqH{)KHxxxoHeq_
HOC1ei,cra6()crt' Mb[llu Hllxtlt'lx xoxeqHocrei, 60ru lt yrolv,'IeHDe
cblnbHa nonoBuHe
O 6 u ae p a ccrp o ti c r B a: 3yuuat
TexHxra.nyHxunt rry6rHoii 0,8- 1,0 uyHt. IlpfixlrraHl{e lLl _
i5 MuH.
n p s M e q a B II e. llpx c'1a6ocrtIj naparlqe HuxHnxxoEeqHoc_
cycraBe peKoMe'{ayerctcoqerarb c roqxaMa
reii, 6.),rrx B KoJIeHHoM
av.rxr {33E) Ii 3bloHr'naHr'ryeH (34VB).
'D. TOq(A qvHr'-lloK(rlxvH-av, 32va)
,tloKa,ix3aqx*.A. Ha HapyxHoftcropoHe6eapexfioiiKocru,Ha 5 llyHei
BH e Xo!'relia,R yr!'Iy6!'IeHljuMexay MbrlxuaMq.
l, Ha .rarepa,lLHoii cropoHe6crpa, B yf,'I!6,reHux
Mer(a) L!xpo
huii Oa.ureH H aBlrraBoir vHuuei, 6eapa. Ha paccrotHHH5 uvHeri
HAA XOTEXfibIM CYCTABOM.
TonorpaotqecxataflaroHxg.llud koxHbrMI]ohpuBovB paioHe
rorrxr HaxoatTcq3aAfiLrfixpafi mrpoKoir (pacqxl,lx naTepanr'Honuri_
poKoi Mb[0rrbr6eapa, nepeaHr{rlKpai aByrnaBoi Mbrlxubl6eapa, Me'
MHUqa 6eapa,6eApeHHatxocrb.
aranhHafluJxpoKaq
Mbrulun B paioHero,{Kx aHHepBxpyrorct atoaurr-
BerBtMaBepxHero
r ceaaltIlqHoro HepBoB,
HOro, HepBa, 6eapeBfioro
HepBoML3.
Ko,{a l,lsHepBnpyeTct
J l o x a 3 a 8 xAc. . M e c r H b r e H a p y u € H t t t Hapyule-
H U r , C B t 3 a H H H e C M e p I I A X a H O M : O H e l VI e , f l a p a l { q
H l { x H n x K o H e q H o c T e uf e
, MtIInerg9.
p a c c t p o i i r I B a : l y a H a r t o r o a f i Hl ey n o B H L [ a
O6urre
Texxnxa. nyrrxu;n r,r)6hHoii 0,5 0,8 ulHt. flpHx{ raHHe i
l0 MrH.
350
3 3 . T O q K A : J b l O f r r - K v A H( U 3 v l l l - f v A H h , 3 3 v B )
JloKarrca{fin. A, Ha 3 lryHt Bblue roqK! 3hloHr.'J'aHr-TyeH (34 VB),
B yrry6neHHr x8apyxll or ro,{(u AoK-rH (35 D)
B. Ha narepa,'rbHofi cropoHe 6eapa, B yrny6lleHIrri Mex,ly llrnpo_
Kofi Oacqrefi H cyxoxul' teM AByriaBofi Mblurqbl 6eApa, Ha paccroq'
B yrr'1y6r1eH[H
l,lr 3 qyHefi fiaA roq(ofi 3HoHr-,1aHt.ryeH (34V8),
sa 3aAlieHapyxsoft cropoHe naTeparLHoro MHule"lxa 6eapeHHoi
flpH oflpeaeJleHfifi !'roKar'rusauut 6orbHoMy creayer c!'terxa co-
[Hyr6 Hoay B KoreHe, qro6br tcHee o6o3Haq[rocb cyxoxl,r!'rl,Ie Aay-
rraBoi M6[xubr 6eApa r HyxHoe yr,,ry6,'reHte.
T o n o r p a ( o x , t e c x a ca x a r o u H c . n o a K o x H H v n o x p o B o v B p a i o H e
9roaxrltlo
TOqKu HaxoarTcH HapyxHhlfi Kpafi utpoKoi (pacqrfi Ir r'Iareparbfiori
ripoKofi Mhlrlut'I 6eapa, nepelHnfi Kpafi cyxoxl'l'rrt rByr,laBot
Mbllrrlbr 6erpa, MeAI{aJI6Hai rxnpoxat Mblrxqa 6€rpa, Hxxxt{[ KoHeu
6eapeHHoi Kocrn.
MHui{bl B pafioHe roqxlr nHHepBqpytorca BeratMlt BepxHero 'Iro-
afiqHoro, 6eapeHHoro x ceAaJrrulloro HepBoB.
Koxa HHHepBrpyerctuepsou L,.
ry-
I l o x a 3 a H xM t .e c r F H e ItapyUleHds t HapyueHtfl,
c B r 3 a H H 6r e c M e p r a H a H o M: 6orh s ofiyxnocrr, B o6nacrfi
(oreHa c noTepel IIoABllxHocTtl cycTaBa.
rny6llHofi 0,5-0,7 IryHt- npxxfiraHlre 5-
Texxxxa. flyrxqun
nporttBonoKa_
I0 MIH (no He(oropblM l,rcroqHfiKaM nptxfiraHre
3aHo).
3 4 . I O r t ( A 3 6 t { r l t r , J l A H t T y r : H ( t H - J t l t H - l t K t A H 6 ,: J , vl l r )
ITo!{a .otrDtxeH{t. (arerop{{ <3tMnn,-
Tocxa totrDtxeH{s (Yxoxutrn)
JloxaJr3aqxt. A. Ha I qyHb HHxe Ko"IeHa, B yr,ry6reHr[ Ha Hapyx-
HOff CTODOHe rO.rIeHg-
6, B yr,ly6,reHlrtt sa flepeaHefi cropoHe Ma"lo6eplroBofi l<ocrl'l'
B MeCTenepexoAa BepxHei lo'loBKll B ee TeJIo
Tonorpion'recrar aaaroMxt. nor KoxHblM nokpoBoM B laiione
yrrly6neHne Mexay arI'lHfiofi Maro6epuoBofi Mbrnll-
Toqfis HaioA;Tcfl
nefi I,l pa3rli6areneM naJlbIIeB cronbl, nepeAHeaHyrpeHHca cropoHa
ro,loBl(fl Ma"1o6epuoBofi xocTl,l.
MHurtIH B paioHe roqxx I,IHHepBfipylorct BerBblo (oxHo-MbIuleq'
HOfO HepBa tt nepeAxnM 6o,'lt me6ePuoBHM HepaoM-
Koxa uHHepBupyerca nePBoM 5r,
n o K a 3 a Ht . M e c r H b I e HapyueHut: 6onL' onyxnocrb
rtflepeMxt ll noTept IIoaBIlxHocTx KoneHHofo cycTaBa
HaDvureHnc, cBt3aHHhre c MepnAqaHoM: napa-
n s q , l a i e i a , r r b H o r o M a " 1 o 6 € p u o B o r oH e p B a .o H e M € H I r eB a p y x H o i c r o -
poHbrHr,rxHr.rxKoHeqHocTefi,60,'rb B 6oKoBoi 06"Iacrfi rpyaEod (r'leT(tl'
351
 O6 Ifie paccrpotcr3a: x o H T p a ( l y p aM b l ( l u ( o H e r r H o c - 3?.TOqKA(yAHf- l,lHb(rvah-MUl|,37VA)
r e i . o l o a H t q e H x e n o , ( B H x H o c r xB c v c r a B a t K o H e q H o c r e I (Cra6rnr3xpyDqac c MepraraHom
Iexirnxa. Illnxqaa fny6nHoi 0,8 1.0 uyn. Ilprxuraure 5' lecetlr (xoHe't{Hc,)
l5 MIrH. Jloxanx3aq[t. A. Ha 5 qyHefiBbrruenalepa,rbHoi noar,lxkn.
6, Ha paccrotHnr 5 uyH€fi HaAnarepanbHofi noAblxKoii, Bnnor-
3 5 . T O r t ( A 3 b t o H t - 3 t o ( l H - u 3 t o , 3 5v B ) Hyrc K nepeaHe^{yxpa() Ma,ro6epuoBo;ixocrn, s yfry6,'reH9x Mex-
(Toc{a-qenh dapyxrcro noaAepx{uanqero Mepra{atra) Ay pa3ru6are,'IeM narbqeB cronbr Lr xoporxoi Mano6epuoBoi
Jlo[anx3aqxfi, A. Ha 7 qyHei Br,rllreflar€panbHoi ,roAblxx'r; or Hee Tqnofpaor{ccxac aHaro xr, IIoa KoxHbrM noxpoBoMB pailoHe
, exayTpeMq qHcKd
n o a H q t b c q B B e p x, , B f i o c bn o M b l u r e q H o qu l e , , r a M roq(r HaxoacTcr yr!'ry6reHneMexay pa3r[6aTeneM nanbqeB cTonbt
Ms Mepr.rAuauaMfi, fi noporxofi Mano6epqoBoftMhlouefi, nepeAfi fi Kpai Maro6epqoBori
6, Ha paccroflHUt{ 7 qyHefi HaA narepa,lbHoi ,'roAblxxorl y 3arHe_ KOCTl,l,
ro I(par M6no6eprloBoi Kocr!, B yrry6reHrr MexAy anxHHofi It KOpOT_ Mbrrxq B paioHe roqxr rHHepBr,ipyrorcrr BerBsMxnepeaHero6onb-
xoii Maro6epqoBbrMr.{MbrulrlaMx, ue6epuoBoro lrepBa lI koxHo-MLIrxerrHblM!sepBoM toJeHfi.
ToflorpatDx,rccKaf, aHarofinr, floa xoxHLrM noxpoBoM B pafioHe Koxa l,|HHepBrpyerctt Hep&oMSr.
roqr(r Haxoltrct yrr'1y6,1eHneMexay arroHHofi t KopoTKof, Mano6ep- llor(a3axxi. M e c r H hI e H a p y lx e H a t a H a p y ru e H rl s,
urJBblMH M b T L X U a MM Ua, i O 6 e D { O B a 9h O C T b c B t 3 a H H b t € c M e p x a n a H o M : 6 o , , r ha ,H e c l e 3 t cr x, n e p e M r q
MhrruqH rrFHepBlipyrorcq BerBcMn KoxHo-MH[reqHoro HepBa. B o6r''racrrro.!eHHx KoreHflorocycraBa, r{'ra3HHe 6ore3Hr.
Koxa sHnepBripyercf, nepaou 52. O 6 u a e p a c c r p o i'i c r B a:,lxxopaaoqHoe cocroqHxe6e3
l l o K a 3 a H lM | ce. c r H H e HapynJeHnr x HapylxeH.fi9,
cBr3aHHbre c MepIraxaHoM: n a p a J l f iH qtxllnx xoHelf,oc- l&rrKa. rly l(qne r,ry6[Hoii 0,5 0,6 uyxa. llprxurarae 5-
refi, 60,'rb B xor'leHHoMcycraBe, qyBcrBo pacnlpafififl B rpyAH, ropeqh l0 MrH.
II p r.tM e q a H u e. npn BocnaJ]eHxr.r
3p[Te,,rbHoroHepBa.HeaaBHo
Teirnxxa. flynxuaa rny6ltHoft 0,5-0,8 lryHt. nprx,rraHte 5- fiaqaBlxe.lcr (aTapaxre pexoMeHAyeTce coqeTarb c roqKaMIl rblH6-
l5 MxH. rvxH6(l V) n SoHr-,rx (20 VB) .

3 6 . T O q ( A H I O A I I - K X A y( B A n - U ! O .3 6 V B )
3HOHr-Ov(qH-Ov,38VB)
38.TOT|XA
(To{m-6ucrp{fla, nrerop{{ <oroHb!}

Jlorranrcaqxt. A, Ha 7 uygefi BHue narepanbxoi roauxKH.

6. Ila paccrorHnn 7 uyxei raa JrarepanbHofi r'roablxKofi (3aAIl
01 3aAxero Kpar Mano6epqoBoi Kocrx, B yrny6neHrrlr MexAy a,'lrHHot
Maio6eDuoBoi u KaM6anoBlraHoi MbIuruaMIr,
Tondrpao$q€c[at aHatoMl|n. noa I(oxnDIM noxpoBoM B paioHe
roqKfi HaxoAqrct yany6!'reHxeMexay arxHHoi Ma,ro6epuoBoi L KaM_
6anoBraHofi MHrrlUaMll, MaJro6epqoBar (ocrb.
Mbluubr B paf,oHe roqxu firHepBrpylorct BerBiMx xoxHo_Mhtueq'
HOIO ri 3aAxero 6o,rbrxe6epqoaorc HepBoB,
Koxa rrHHepBxpyerct repnor,,r Sr.
n o x a 3 a E x s .M e c r H b r e Hapy ue firr:
HapyureHrq, cBq3aHHHe c MepxaIraHoM: 6onL,
qyBcTBopacnxpaHl{t B rpyah, 60,1b B o6nacrq xeJtqHoro ny3blpt.
O 6 u fi e p a c c r p o i c T B a: MaHfia(arbHoe cocrocHlie.
TexHxKa, [IyHxqlir rny6rHoii 0,5-0,8 qyHt. npaxxraHrie 5-
l 5 M H .
flpxMeqaHt€. I I p n n o n a A a H l rrur n b l B r o q x y y 6 o , , r h H o rBoo 3 -
HxKaer olllyqeHtle HanptxeHHocTrr, pacnupaHrc B MecTeyKona, KoTo_
poe Moxer fippaAuxpoBaTb rro xoAy MepriAraxa.
Jloxa,Ifi3aqxr, A. Ha 4 qyHq Bbrue r'rarepanbHoinoabrxxrr; Ha ne'
peaflefi cropoHe Ma!'ro6epqosofixocrx.
B. Ha paccroflHxfi 4 qyHefi Han narepa,rbHoi .roar.lxKoi, Bn,'ror-
syrc x flepeaHeMyKparo Mano6epqoBoiiKocrx.
Tonorpar0x'{€cKaca8aroMr|r. floa xoxH6rM noKpoBoMB paiioHe
roq(a fiaxoarTcr yrny6,'reHreMexly KoporKofiMano6epuoBoiiMhrur-
qeii I,r nepeAHfiMxpaeM Ma"lo6epuoBoriKocrr.
Murnqr,r B pafioHero'rKr.rxHH€pBfipyrorcsBerBbror(ox,{o-Mbrueq-
HOrOHepBaroreHll.
6 o . r hB r o , r e H t . Koxa rHHepBspyercs HepBoMS?.
I l o x a 3 a H fMi ce.c r H b I e H a p y r x e H H t x H a p y r u e H x t ,
c B r 3 a H H H e c M e p u r I1a H o M: 6o,rb B ro,leHD.B o6,racrfi xo-
neHHoio cycraBa,6o,,rb no HapyxHofi noBepxHocrrara3a, cyaoporH
IjKDOHOXT{Ofi MHIUIIbI,norfiaAeHrr, 6onn B O6naCTUHaAK!IoqrlqHOii
tMKti.6o,'IbB ropre, rra3HHe6o"ru,ronoBHat6onb.
O6qre paccrpoicrBa: 6 o n rs c y c r a a a x .
Texxnxa. flynxqan r,ly6xHoii 0,3--0,5 qy;t. nprxtraHue 5
l5 MxH.

:ltt2 353
t r 9 .T O q k A X I o E H - r ' | t } l l tl ( ; K ) A H t - t l x v l l , i l 9 v B ) 4r. TOqXATvK-,'lAM-(XAn( L(3v-JuHb-ll|'|,4l Va)
lTo{(a conDeBe{hq Cra6lihrrPvo"rac (Toq{a-pa3rxB, iare.opxx <[tpeBo'.
roqhd 'fkr HUAtrrl\ tHLkN\ Mtl nados) Krnqe8ae roqxa, ccrxxcnuran c aa^tr€cpeA{sHUMMepx/rrasoM)

JloKanx3au[c. A. Ha 3 uyHtr BHIIle nareparbHoit,oAr'IxKt,|' B ToM Mec- Jlo|(arxaaqxr. A. B yrny6reHHu 3a I Qa,raHrofiIV Dan6rra(co cropo-
T€, rjre npoxoal'tr aPTepfit- HU V nanbua),Ha paccroflH&u1,5 uyHr or roqxfi xuen-Kxe(43 VB),
6. Haa narepa,rbHofi JloaLlxxoi, BnnorHylo x nepeaHeMy Kpalo 6, B MexoanaHroBoMrrpoMexyrxe Mexay IVrl V anrocHeBHMH
Maro6epuoBofi KocTx; nptr HaaaBrsBaBt{l Ha ToqKy Bo3HIlKaer ouy- KOCTTMT, 3a pa3rn6arcqhM Mu3rHerIcyxoxnnxeM pa3-
B ylny6r'rreHrin
u l € H r e o H e M e H g qp, a c n t p a H t , rlr6aTerrI nar!6{eB cfonbl.
T o f l o r p a t D [ q e c x a f ,a H a r o r c . [ I o t r K o x H b l I n o K p o B o v B . p a i o H e Tonorpaox,rccxar aHaroMxr. noa KoxHbrMnoKpoBoMB pa&oHe
T O ' { X HH a r o l r r c t y r r l y 6 i e H H e q e M n } x o p o T K o i v a ' l o 6 e p u o B o t M b l l x _ roqxfl HaioA;rcc HapyxHHfi Kpafi cyxoxlrnxc, pa3r;6aburero V na-
u e i l , , n e p e a H x M( p a e M M a ! ' I o 6 e p u o B oxi o c - f r . ,r€q pa3rri6aTeJltnaJbueBcTonH, MexxocTHacML{uqa Tbll6HofrcTo_
MHuruu s paiioxe roql(Ij nHHepBnpyprct BerBbto xoxHo_Mb| eq- POHbICTOTIbI, UI€NLME)}(AY3AIHXMI{ XOHIIAMI,I IV l't V NN}oCHCBbIX
HOIO HepBa roJeHl' l. (ocrefi.
Koxa IjHHePBt{PYerct ePBoM 52. MHuur,r B pafioHe roqxr HHHepBrpyorct BerBtMr nepeaHero r
I l o x a 3 a x r c .M e c r H u e sa pylneHnt: 6 o " ' I bB r o ' q e H t- 3aaHero6or'rb[re6epuoBbrx HepBoB,
HaDvlxesufl, c B g 3 a H H u e c M e p nAIlaHoM: oonb Koxa nHfiepBtrpyercnuepaou S1.
B xoneHi6M cycraBe,6orb a 06racrfi cntxbl, reMt,lnrlerut, KplBou'et, [Io[a3aHxr, M e c r H br e H a p y m e H ]r q: onyxJlocrb, 6onb
6o,,rb B top,Ie, HocoBoe ltpoBoreqeHre
O 6 qu e p a ccrpo i cr B a: oulyueHre xapa B o6"racrn xl,l- HapyueHra, cBr3aHHblec MepranaHoM: 6onb,
BO,la. noTeDg annerl{Tar {'IoMtulag 6o"1b B KOCTHX r{yBcrBopacnHpafiHrB 60xoBoi o6nacTu fpya8ofi KneTxr, onyxlrocTr,
Tixnrxi. Ilyn*qas r'ly6nHoil 0,3 0.5 uyHe- flpuxlraH,e 5- MOnOqHOi XeJra3hr,CrnLHOeHa6yxaHxe roAM6rllreqqHx,rrrM(paT[qe-
l0 MrH. cKnx y3JroB,pr6L x 6o,1bB r!1a3ax, ro,loBHae6on6.
T€xHxla. IIyEXqxt r,iy6xHofi 0,3-0,5 qyHq. IlptxHraHxe 5
l0 MHH.
40. TOqKA (xAv l(Xr,l ( l1l() CnU' '10vlr)
( T o q x a - n o c o o H){ x , t 2 .T O q ( A A H A - H r v - X O n ( / l r . r - v - X v 3 l l ,4 2 V B )

Jloxa,1e3aqfi9. A, nor narepanbHoi noablxKoi, B yrry6neHl'1lj Knepe_ Jloxarr3aqxi. A. B yr,ry6,reura 3a I Qa,laHroii lV na,r6Lla lco cro'
a o r H e e ,s a p a c c l o e H f i 3 q y H e i i o r r o q K x r y K _ , r a Mf i a n ( 4 1 v B ) poHbr V na,lbua), Ha paccrosHxx I uyHs or roqKk x{en-Kxe
6. B yrny6reHxu flepea narepa,ll'Hofi ,roa6lx(oi, Mexay roqKaMx ( 4 3V B ) .
3rfi xxe (41 E) Il rxaH-Marb (62 V). Ant yroqHeHlq noKarr3aqlt B. B Mex(FanaHroBoMnpoMexyrKe Mexay IV u V nnrccnesr,IMr
6onbHoi ao,rxex noBepHyrb Hory BHyrpb, flplr HaaaBJItBaHI'lr Ha roq_ KOCTflMx, S yn,1y6,1eHfifi
nepea pa3rx6aroUlfiMV naneu cyxoxHr'lteM
Ky BO3HnXagroulyuleH e oHeMeHln, pacntpafitt, pa3rg6aTe"lqfl:ulhueBcTonH.
Tonorparbxqecxat alraroMxc. floa KoxHbIM noKpoBoM a panoHe Tonorpaoxqccxac aHaro rrr. IloA KoxHbrMnoKpoBoMB pafioHe
TOqKr HaxoatTcq KoporKHfi pa3rx6are,rlb nar'IbqeB cTonbl, 3aaH€Ha- mqKfl HaxoArrcc yrny6neHre Mexly pa3rn6aoqnM IV u V na,rsqst
pyxHHft xpafi nepeaHefM i a r o 6 e p u o B o f iv b l t x u b l . u r e ' l b M e x n y x y 6 o _ cyxoxlrraML 4nBlllroro pa3rrl6aTe!'tt tarbrleB cron6I, MexxocrHat
BHAHON. /1 NbEBXAHOII H III KJHHOAHAHOH KOCTflVI'I. MHUUa r6rJrbHonCTOpOHbT CTOdH,rqer'lhMeXAy nepeAHlrMuKoHqaML
MHmqbr B pafioHe roqxfi ltHHepBlipylorcfl BerBffMLnepeaHero 60!rb- IVl,lVl|niocHeBHxxocrefi,
ue6eDrloBoro HepBa,, MbrurqhrB pafioHe roqfirJ uHnepBupyrorcr BerBqM, nepeaHero Ir
K6xa xr:uepalpyerca HepBoM Sr- 3aafiero 6onErxe6epuoBbrx HepBoB.
n o r a 3 a 8 r eM. e c r H H e HapymeHIIt a Hapy esfic Koxa nEHepBupyerctuepeov S1.
cBr3aHHHe C MeptallaHoM: 6 0 , 1 6f i O f l y X . ' I O Cr OTbreHO- noxa3anrr. Me cr H br e H a p y lIjIe H r q: 6orb l,l npfinyxnocrb
cTonxoro cYcTaBa. 6o,1b B ro,leHt, B ToJIeHOCTOnHOM CyCTabe' 60,'lr
no napyxx6fi noBepxHocrt ra3a.60'lr, s 6oKoBoi o6'racrs rpyAflofi HapyueHnt, c B q 3 a H B H e c M e p r A H a H o M :I { o H 6 _
Kr'reTXX,KprrBo0ieq, naHHyc. IoHKTIIAUT, OTerIfiOCfh B nOIMErlUeqHOfi O6naCTH, a6CqeCC MOJOq-
O6ure p a c c T p o i e r B a : c y a o p o r Hx K p o H o x f i o l M t bIuubI. HOI{ Xe"'Ie36r.
T e x f l r x a . n y H K u H t I n ) 6 H H o f r0 , 3 - 0 , 5 u ) f i e . K o H e u H r , l H H a n p a B _ TaxHrKa. flyHKq,rr r,1y6xHofi 0,3 0,4 qyHr. npxxxraHqe 5-
r e H B c y c r a B H y r l )l r r e n b . n p H ) A / r a H r e 5 l 0 v t t t t . l0 MUH.
354 355
43.TOqKAXliEn-KXE(C'-CX,43VB) H O X H O f f X H b C K { N M E P I I A I I A HN E q E H X ( F )
(To{xa-Py{en, (areropr{ ( Bo^a') (no 14 roq€|t c €xAoi cropoi!)

Xor m€pxaxada. Beper saqa,lo oKo.r.rnyqxa aor'rocy HorreBoror'ro-

JloKanBaqrc. A. B MexKocrxofi ul€rll Mexay V r lV na'lb(aM{ cro- xa 6onbrnorona,rbuaclonH B ToqKeaaii AoH (l F). Bbrxo,4x,no rbr,ry
nH. B yrny6,leHx nepel flttcTHo_OaraHroBblMcycTaBOv.
cTonbr,BAorrr,npoMexlTxa Mexay I q II nnrocHeBbrM[ (ocTtM[, B Mec-
B, B riexna,rtqesoicKJaAKevexl\ lV H V na,lbuavx clonu c TOnepeanoahrx(ol, noAHHMaercrr noBepxHoc-
no nepeaHeBfiyfpeHHeri
THILHOi C,lOpOri6I. ,tU rO,r€HH,BCTpeqaeTCq C rH6CKrrMMepUI aHOMCere3eH(r, nepece-
Tonorpar[rrecxaraHaroule. lloa KoxHHv noxpoBoM.BpaftoHe KaeT ero n BAoJlhBHyTpet{Heroxpat nolxoneHKl, noAHHMaerctHa
roqxu Haxolflrce yr,ly6neHlreMexay pa3rH6a|ourH\,ll't lV fl V nanbubl
,tqMlt pa3ru6arenq narblreB cronbl, paglt6apuee BHlTperiHororroBepxHocTb 6e4pa, npoxolrr o6,lacTb naxa ri aa,ree
cvxoxrrr' llJrllHHoro Harcxocr,no HapyxHofi qacfi xHBora rroAxoAnrK KoHqyXII (cBo6oA-
lV na.req cyxoxr,une xoporKoro pa3rlroarert nanL|leB,Mexxocrsafl Horo) pe6pa, |( r{rqxe r oHr MoH (l3F). 3axaHqxBascBoii nyrb B
MbIrIjuarHJrbHodcropoHblcroltbI, xrenh MexAy nepBbtMH (pa!]raHraMI
r p l a r . i l. f u q k r x r 1M U Hr l 4 F ) l p h c 8 J . 8 4 i
lVxVnanbueBcronbr. nora3aHxr. 3a6o,reBaHfi r no,roBH\opraHos, HapyLUeHlre B 06
MbruruH B pafioHeroqKfi uHHepBl'tpytorctBerBf,MnnepeaHerox !'racrfi MorreBoroay3brpr, KrrureqHrr(a,B 6oKoBoi o6racru rpyaHot
3aaHero6onbure6epuoBblx HepBoB.-
K"'rerxr.rnasHHe 60re3Hlr,
Koxa fiHHepBfipyerctfiepBoM5r. T€xHx(a. nonoxeHB€ 6(r,lLHoronpx Bo3aeficrBtt Ha roqKri:
Jloxaaaflxt. 6o,1h u nptnyxnocrb rbl'Ia cronbl
cTonbrr fo,reHH- nexa Ha cnllHe |,l!'Il{cr.{a'ITaK, qTo6H TbL'I
H a p y u e H x q . c B t 3 a H X b l e c \ { e p r a l l a H o ! t :6 o , 1 b cTonH 66r!'ro6pauleH xa€pxy;
I qyBcTBo cfecseHHtB rpynfi (6orbHoi He B cncrotHlrHnoBepHylb B o6nacrr xoneHa rexa Ha cnfiHe nnri cHAt, Horfi corHyrbr
Kopnyc),6o,1bB qe-nrccrt,pq6b r 6onb B rna3ax, rnyM B y ax' rny- B l(oJlefitx IIoA IrPtMr,IMYrJoM;
o e c o c r o t B l €6 e 3 B o6nacrn 6eapa, naxa nexa Ha cnxHe co cr'rerKapa3ABr-
O6Ulte paccrpoicrBa: ntxopaaoq H]'TbrMI HOraMri;
H a r o q K y r H o H r - M o H( 1 3 F ) - , r e x a Ha 6oKy c sbrnprMneHHofi
Texsx(a. IIyHXunqr,ry6rnofi 0,2 0,3 uyHt. flpxxxraHrie 3 Hfi)KHei u corHyrofi B Ko,'reHeBepxHeii HoraMr.r;
5 MllH. Ha roqKy xfi-MoH(14 F) - n€xa Ha cnxHe HrIr crAs, nprcJro-
Htcb cnHHotl x onoDe.

(lI3v-|ltO'XHb, 44V8)
44. rort(A TvK-KXl.lEy'AM
(Iocxa-xcro(. rareropr{ .ne'anrt) L TOq(A JIAn-IOH (AA',{vtrb, I F)
(To{"a-rctor, rateropt, <aePe!o,)

Jlo|(a.[rl3aux9. A. Ha-xoHlreIV narsua co cropoHHV naJlbua 'Ha Jloxanx3aqxt. A. Ha KoHIre I narrbua cronbr, Ha paccrorHqx <rrrfipfi-
cTDerKl]
llll,tDr,rHv
'6. MeJIXbfO 3eneHOrO tlyXa_cetHua,oT yr,'Ia HofTt H6I CTperKq MeIXOIO 3eJIeHOrOIyKa-CegHUa' OT OCHOBaHUtHOrTt,
ila ioasrue rsr'nsnofit{ norouseHHoi noBepxHocreicronH Ha Tav, rae Ha narbue pacleT nyqoK aono(,
,,rarepaarroficropo}reIV nanbua, HaypoBHeocHoBaHHtHOfleBOrO rO- B. Ha xoHqe I nanbqa cron6r, Ha paccroffHuH 0,2 uyxn or ocuoea-
xa, Ha 0,2 qyEt !'lareparbHee HapyxHoro yrr'Ia HotreBoro r'Ioxa Hrr JroKTeBoro,1oxa, TaM, rAe pacTeT IIyqoK Bo.Ioc,
lV narbqa clonH. Tonorpao{qecrac axaroMxc. floI (oxH6rM noKpoBoM B pafioHe
Toflorpaorlqecl(at auaronxg. floa I(oxH M noKpoBoMB panoHe roqKfi HaxoltTct Mecro npHxpenreHrjr cyxoxfinn'r anfiHHoro pa3rt
TOqKHHaXOAl]TCgKOCTT' 6are,'rH I nan6ua cronu xo II oanaHre I nanr,qa.
Koxa B pafioH€ ToqKL tHHepBxpyercf, HepBoM sr' Mr,IurqH B paftoHe roqxu r,rHHepBrpyorcq BerBbro nepeAHero 6011r,-
I l o x a r a x i cH. a p y u r e H x t , cBc3afiHbIe c Mepurxa_ rxe6epqoBoro H€pBa.
H o M: 6otb B 6oKoBoi o6nacrlt rpyAHofi x,lerKt' 6oJt6 B ropJle' roJIoB- Koxa riHnepBrpyercff aepaou L6.
xaq 60,,t. 60nb B Ia3aX, r,ryxora. l l o | ( a 3 a f l xHr a, p y u e H u n , cBq3aHHbre c Mepnara-
O6 use p accrp o f i c t s a : g H e 3 a n u a qn o r e p t r o J l o c a 'K o l l J - HoMi Merpopparrfl, onyqeHre MarKIl, yBerrqeHfie rBqxa, 60,16
MaDHbIeCHOBUAeI it, nl,tlopaaoqHoe cocTotHre 6e3 noToorAeJleHfifl' y Bxo,4a Bo FJraranuqe, HoqHot 9Hyp€, MylHar Moqa, rpbrxa.
cvaoDorr xxpofi oxxofi MHruubl
''-iii"r*".'nv"*'ln" O6xlne paccrpoficrBa: ucreprr,
0.1 ulHe nphxrlraHxe3 5 vtltr'
r,1y6fiHoi Texaxt(a.flyHKrlrrrr,'ry6unofi0,1 uyHr. flpxxfiraHxe 5 l0 uun.
356 357
 li

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2. foqKA xAHb-3lH(CtlH-U3tHb.2F)
(Toq{a-pyrefi, *areropx{ <oroxbr)

Jlor€nx3aqrt. A. B cxnaaKeMexay I n ll nanbuaMacronbl, B cepe_

'aHHeyrny6nesflt, rae npoxoalrTaprep{t Px(. Ea. M€prA,aH neceH, (koHeq,Hr',
8.'Hi ru,rrnofi cropdne cronu, i niua,Te lrexnar6qeBofi cxr'laalc{.
358
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TorrKftHaxoArTcFyrny6nenre MexAy pa3rr6arcuIxMI, II naneu cyxo- (Toqxa-6ucnrHa, Ka'erop{" .Merann,)
u xoporKoro pa3rfi6are'1ei na'rrqeg cronu (c 'ra-
xsrraMn a,'rltHHoro
JIo(aJxBaq t. A. Ha I qyHL (nepeAlt or Mealta!'IbHoli!'toALIxKI't.
reparbHoftcropoHbr)v cvxoxr,rusvr Aaxntoro paJrH6are'l9I tlanb- 6,,[[,rr onpeaenessfl Jloxa,ll3aqst ro'{xfi 6onbHoMy cneAyer
ua 0 pa3rn6alouxMI na,reqcyxoxx,rneu xoporKoropa3rfi6are'1q cr'rerxa npunoaHtrb BBepx nepeaHfifi xpafi cronbl t noBepHyrb,ee
narbueBcronbl (c ueana,runofr cropoHbl),vexxocrHafl MHLxuaHa cyxoxH'rHenepeAHefr 6onbue6ep_
cronu, ure,ruuexay I Qa,ranrar,'ru I H ll na,16ueB sxyrpr rix.,rfo6H 0603Ha.lH'rocb
rHnbHoi cTopoHe
uosofi vHUrubrll yr'ly6neHHe' sHlrpeHHero Kpaq cyxoxHntt
ToqKaHaxo4HrctHa I uyHb nepea Me,4nanbHoi no,lblxKol
MbrurqbrB paioHe roqKn ltHEepBlrpyrorctBerBqMIrneperHero ll Tolorpa(D rccxac anaroul|c. floa KoxHHM noKpoBor,{B paffoHe
36aHerc6onbue6epqoBblxHepBoB. roqxn naioa"r.n MeaHanbHbri Kpafi cyroxxnrt nepeaHeft 6ontrxe,
Koxa flflBepBtpyercnHePBoML6. 6epqoBofi Mbr[rqbl, cycraBHat qeJIL MexAy rapafiHot I'l lltroqHoH
n o x a s a x x cM
. ecrHHe HapylleHuti 6orb B na'lLuax
Mbluqbr B paioH€ roqxt fiHHepBllpyrcTcaBerBqMx nepeAHero
H a p y u e H u t , c a f l 3 a H H b I e c M e p I r A l , l a f i o MM
: eHo-
6()rbure6eDlloBoroHepBa.
uerpoppaiua, 6o.nre noroBoMqrene, rpblxa, 6onb B 6oKoBofio6naclfi
xneTKU, KOHIIOH(TABITT,
Koxa unnepeupyercn HepBoML5.
tpyafiot
Ilor(a3arirfl. M e c r tI bI e H a p y lx e fi !l t: noxo,toAaHuecron'
O6ulre paccrpo i i c r B a l 3 n H , I e n c l ,rlo' {r,l l H m a 6, e c c o H f i t _ 6o"1bB ve4tarbHot,'loaHxKe,
qyHr. flp xljraHne 5 H a p y u e H x t , c B q 3 a H H H e c M e p t { A { a H o M :o o ' r l b
TexBxKa. flyHKqfiq rny6nHofi 0,3-0,4 BHn3y.xlrBora' rpblxa, 3aTpyAHeHHoe MoqercnycKaHse'no!'l!'laxr|y-
l0 MnH. Dnq. MvTllat Moqa.
'
O6urae paccrpoicrBa. B o ' / l bs o 6 " l a c r t c n I ' t H bxI 'e ! t -
3. TOq(A TXAfi-CvHl(tAfi-'lvH,3 F) TyXa.COflpOBO)|(AarOlItatCt nt'{xopaloqHbll!{CocTOtHUeM' naTor''IOrHqe_
(Toq(a-troco6irx,roqxa-pa3nB, {areropn{<3€Mnc,}
ckre flo.rr"lloulll.l.
T€xn |(4. IIyHXqrfl rny6nHofi 0,3 0,4 uyHt. MoxHo BBoAIjrb
Jloxa.lxsaqxt. A, 3a I OaraHrofi I na'1hqa cronH, Ira paccroflHxH rrJry B cycraBHylo !qe,Ib, IlpHxnraHse 5-10 Mnn.
2 rryHei (no He(oropblMr,tcroqHtKaM1,5 uyHs) or roqKr xaxb'3tH, n p f i B t l p y c H o rMe n a , s r ep e x o M e H A y € Tc cot_
llpxveqaHre.
t2 F).
3aAHrMt ronoBKaM! I r II n.locse " " r a t i . . o q r a t u K a H - 3 y( 1 8 V ) ! t c O o H r ( l 7 T R )
E, B yrny, o6pa3oBaHHoM
Br,lx(ocrefi, Ha ypoBHenepexoaa ro,loBoK B rero xocrel
Tonorpaol,recKan aHaroirtt, noa xoxHHM no(poBoM B paioHe 5. TOrl(AJtAn-KAv{Jll-rov, 5 F}
ToqKfiHaxoafiTcflcyxoxn,lle a.IIr{HHoropa3r[6are"rt I uanbqa cro- (Cra6ri{srpynuras rocKat co.a Hcro||{acc EoxHuMeHc(cr MePxAva'
|lor xen{ro.o nFupc,
nH, xopofxtjfi pa3r 6arerb narbueB, Mexxocrliat Mbllulra Ha rblnrii
xofi crbpoxe cionr,r, qe,'rr, Mexay 3aaHxMI,rxoxuaut I x II rr.,ltoc_ Jloxajr*3aqtc. A. Ha 1.5 qyHt Bbloe MealtarbHoll roAbrxxu
B, Ha paccrotHxflraaxei rierl BHyrpeHHeinoBepxHocrr60''16_
MhrlJuH B pairoH€ToqKrl xHEepBupylorcttBerBeM fiepeaHeron ueoepuoa6& xocrr.ru Ha 5 uyHefi Buue ueula'runoi noauxxt't
3aaHero6on6 e6epqoBblxHepBoa. K6xa s pafioHeroqxn [HgepBqpyerct nepeou La.
Koxa nHHepBripyercc HepBoMLs. . ecrHbIe Ha py
I l o x a c a H i sM e H I ' l c : 6 o n bB r o , l e H &
r ta, p y u e H f i E , c B c 3 a H H b I e c M e p a f i a _
l l o | ( a s a HH O6uHe paccrpofi crea: 4nsypal6 , o n 6B f l n q K a xH' a p y '
H o M: 6o,rb Ha nepeaHefifloBepxHocrnMeauanbHoi JIoabIxKl{,Mer_ ueHl,leMeHcrpya"lbHoro unx,1a.6erH, verpoppar fl
popparflq, 6onb y Bxoaa Bo B,lata,rll,lute,MyrHaq Moqa, rpHxa' Texxrua. liyuxuln xocan noaxoxnaq. r,1t6HHoi0.3- 05 uyHf,
nornaKrypst. flD r M e q a H r i e5, Mxfi,
' n pxrraHne3
O6U1(n€paccrpoicrB a : 3 n H J e n r t , r e c kcl lyeA o p o r ly a e - n p o p x u r ep e K o M e H A y e rccoqr l e r a r hc r o q -
TeI{, noBbl eHue aprepllan[Holo aaareHtt. xaur ixyx-ryen (8 F) u rxafi'cyHr (3 F).
Texanxa. flyniunn rny6rnoi 0,3 0,4 uyBs. npflxnraHae l0-
15 MHfi. 8. IOqXA {vHr-AO (qxvH-.[v, 6 F)

JloxaJrcaqxt. A. Ha 7 qyHefiHaa Meal,lanbHofi

'roAblxl<ot, BtepeauHe
6onbrue6epuoBoi(ocrfi.
'300 ,{0r
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6epuoBoixocrH H fia 7 uyHeilaHUe Melra,1bHoir,lo,rb/xKH.
Tororpaox,tec|(ae axaroMrfl. IloA (oxnhrM noKpoBoMB paioHe
Toqxr HaxoArrrcrflepeAHeBsyrpeHHrrr noBepxHocr66onbure6epuoBoft
Koxa B pafioHeroqKx rrHxepBrpyercr uepaou La.
l l o x a 3 a x fH
i sa. p y u e H I , r q , c B c 3 a H H b r e c M e p n ! & a -
H o M; 60,,16Bxrr3y xhBora, 6orb B erqKax, MerpopparrH. ocrpLrfi
rtncrnr. ar.l3yplifi,6ore3HesHoeMoqexcnycxaHxe.
Texxr|xa. IlyxKqlq Kocaq noaKoxHafl, r,1y6,jHofi0,3-0,5 uyHs,
flpnxnraHxe 3 5 MnH.
l l o K a 3 a n r cM
. e c r B H e s a p y L x e H r e : 6 o , 1 bn o a H y r p e H H r i
cropofie xoneHHorocycraBa x 6eApa.
H a p y n l l e H x t , c B t 3 a H H b r e c M e p , i ! I , l aH o M : 6 o n hx
npfinyxnocrr, cnqex, 6onb B no.4oBoMqr'reHerrr'rnHapyxHbrx nonoBhlx
opraBaxy xesurH, 60,1haHr3y xrBora, ar3ypHe. r"ra3r{ue60"1H,
ps66 B rJra3ax.
O6que p a c c r p o f i c r B a : M a H u a K a , l 6 Hcooec r o q 8 r e .
Texfir|(a. flyHxurr rny6nHoft 0,5-0,7 qyHe. flpuxuraHre 5-
l0 MnH.
9 TO{KA AM-EAO (tlHb-6AO, I F)

(UU,rvAH6,7 f)
7, TOqKATAT,KyAH Jloxanx3a{xr. A, Ha 4 qyxn Bblue KoneHa,B yr,'ry6neHuaMex,ty
cyxoxHJlxflvrHa BHyrpeHHei cropoHe6eapa.
Jlo{anri3aure. A. B yrry6,ieHrrx xa 2 qyHe Hrxe xq,,reHa. 6. Ha paccrotHHn4 uyHei Han rdqxoi Kxlx-ryeH 18F) no axyr_
6. B yr,ly6,reHrl Ha ypoBH€roqK[ aM-,raHr,ryeH(9 RP) r.j rcaAlt peHfieficropoHe 6eApa, B urenr Mexay nop,HtxHoii r Meat{a,'IbHot
oT dee Ha llrrprHy naJISIla. nDcMoi MbrulqaM 6eApa,
Tonorpaol,recxacaharoMxe,nol xoxHuv noKposoMB patoHe TonorpaoxqecKat axaromrc, floa xoxHbrv noKpoBoMa paioHe
Toq(Il fiaxoAsrct BepxHtq qacTr,MeAna,rbHairo,roBl(l.tl.txpoHoxHoft To'rxlrfiaxoarrct: ueih Mexay noprHtxHoi H MeAra,lbHofr nptMoi
Mbrrrqst, noaKo,reHHatMblluqa, Mecro npHKpen,telrrr cyroxrrrn MbruqaMrr6eapa, 6onrmaq npHBoatqaq MbIIUqa,MeahaJIbHa'{ IUHpo_
no,rynepenoHqaroil Mbruqr,rl,( 3aAHeiinoBepxHocT,60,lbrne6epqoBofi Kar Mbloqa 6eApa. BHyrpeHHqtnoBepxHocrb6eapeHHoi Kocrl,.
Mbrlxrl6i B pafioHe roqKH xHHepsupytorcq serBqMa 6eApeHHoro
MbrrxqH B paioHe To,tKarHHepBnpynTcrBeTBrMr3aAHero60,'16- 3anflDaTenhHoroxeDBoB.
ue6epuoBoro n Ma,'ro6epqoBoro HepBoB. Koxa rnneperpyerca xepBoM L3.
Koxa aHHepBxpyeTcq HepBoML3. n o K a 3 a H xHna, p y r u e B { t , c B ' { 3 a H H b I e c M e p a r , l a _
n o x a 3 a x r cM
. ecrsue Ha pyrxeH fi r: 6orfino BHyrpeHHefi HoM: nnM6aro,6o,1bBfix3y xlrBorar HapyrxeHe MeHcrpyanbHoro
noBepxHocrlr KoreHHoruclcraBa H no BHyrpeHHeii noBepxHocrr.i unK{'ra,a[3ypsq.
rolleHr, Texflx|(a. llyrl(uxs r,1y6xHoft 0,5-0,7 qyHfl. npxxuraHxe 5
TexBxKa. yHKqrfl .,ry6rHoi 0.5 0,7 uyHf,.flpHXHraHe 5 l0 MxH.
l0 vru.
10.IOqXA Hrv-"'ltl (U5v-v-,'llt,l0F)
L TOqKAKXyl(-TyEH (uK)n UK)AHb, n F)
or{ocnrcc k Karerop{{ (soaa,)
(To{Ra-ycrB€, Jloxarr3aqrc. A. Ha 3 qyHt Hrxe roqKlr xxr-cyHr (30E), raM,
rae npoxoAxr 6eapeHHaflapreplrfl-
Jloxa.trx3aqtf,.A. nol MeAra,rbHbrM MbrulenxoM6eApeHHoixocTn. 6. BmorHyro x Meana,'IrHoMy Kparc 6eapeHHofi aprepsq, Ha
B yf,ry6,1eHfiH Han 6o.nbuxr,tH noI MaJlbtvcyxoxl,rrinun, 1 xorua 3 qyHt Hnxe naxoBo, cxnaAKlr.
noAxoreHHofrcrnlaAxri (qTo6u HafiTfiroqKy, 6on6HoMynpeA,,raraloT Tonorparbrqec(ar analoirxr. floa KoxHbIM noKpoaoMB paioHe
corHyrb Hory B xoneHe). Toqx! HaxoAtrct luer'IbMoKAy rpe6enKoBoi fi AntHsoi nplBoAfluei
B. V nreana,rHroro KoHuanoAKo,leHHoficxJtall(r. BHruefi KneDelrl MbtuuaMH6€apa, ToHXacMbIUqa t 3antpar€nbHHe Mblllrubl
oI loqKr arv-KoKr.lORl. e ure"tlrcyxoxHnri no,rlnepenorvariirI Mbrlxu6rB pafioHeroqxlr l.tlrHepBupyro,
c'{ a€TBfiMIj3antpareJlbHoro
MeAra,tIbHou npqMoriMblrr]qrlpx noroxeHxn Horr, corHyroi B Konexe HepBa.
noq yr,rov 90'. Koxa nHHepBtpyercr HepBoML3.
Tonoryaorqecxae axaroMsr. floA (oxHbrM noxpoBoMB pafioHe llo(a3arxt. M e c r H bI e fi'a p y u e H I q s H a p y ui e H }j t,
roqxx HaxoAercq yrry6,leHxe Mexay cyxox!,'rrcMx nonynepefloH- cBr3aHHble c MepIIxaBoM: B 3 l y r r ex f i a o , a .3 a r p y a H e H '
qaroi s MeAfiarbHofifiprr{oft MHrxq, BepxHrfi xoHeu MeA[arbHofi HOe MOqeECnycKaHUe.
fonoSKx l.txpoHoxHoEM6IULI6I,uenb KOr'IeHHOTO CyC'raBa. TexHnxa. flyHKullt r,1y6lrHofr0,5--1,0 qyHt. npllxxraHne 5-
MHlnrrbrB !aiioHero,{Klr'IlsepB{pyrorcrreraiuu Ma,ro6epqoeo- l0 MsH.
ro |,l 3aaFelo oo,lLDeoepuoBoIofieoBoB. fIprMeqaHlle. Ilpa yxoaax HeaoflycxarbnoBpexAeHtt6eA_
Koxa rHsepBrpy€rcq nepBoML3. peHHoroHepBHo-cocyalrcroronyqxa.

362 363
ll. TOqXA AM-JIllEM (UHt-JltHb. ll Fi B. Iloa KoBuoMXI (cBo6oAHoro) pe6pa.
Tonorpaorq€cKaq aaaro xr. IIoA KoxHbrM noKpoBoMB pafioHe
Jloxa,rrcaqxc. A. Ha paccroqH r 2 uyH€fior ro,rxn KxH-cyHr(30 E), TOqKr HaXOATTCq HapyxHas r,r BHyTpeHHrflKocbreMH[rl6I xHBOTa,
raM, rae npoxoAnTaprepHr. nonepeqHaq (Dacqxfl,Koxeu XI pe6pa,6prcurHa, HLrxHIrfi(pafi ne_
E. Y tuelxa,,rsxoro xpar 6eApeHHoii aprepdn, Ha paccroqHfilr qeHu LJru ce,re3eHKs,Bocxoar[Iafl (r,,rl, Hr.rcxoArnlae) o6oaoqHas
2 uyHei Hnxe naxoBofi cKnaAI(x. KH[IKA.
Tonorpao qec(as anaroMxq._noA KoxHbrMnoxpoBoMB pafioHe Mbrurqbr B pafioHe roqKr,r I,lHHepBfipylorcr lxecrl,ro Hr{xHriMH Mex-
roqKr HaxoArrceLueibMexll) rpe6euxoaofir,n,'l.tHHoinprsoleurei pe6epHbrMIl HepBaMs H noAB3aorlrHo-noaqpeBHHMHepBoM.
MbIIIIIAMI', TOHXAg MbIlxUA X 3ANI,PATENbHbIC MbIIUIIbI. K o x a n H H e p B u p y e r c rB e p B o MT h r o .
Mbr[rqh!B pafioH€ro,rxI{ xr{HepBrpyrorcrBersrrMr3anrpareJr}Horo Ilo(a3aF q. MecrHEIe HapylxeHfit: 6 o , ' I bB 6 o K o B o f 0i 6 _
HepBa. racr rpyAHori K,'rerKx, rroM6aro, 6onb B rpya .
Koxa rHHepBrlpyercrHepBoML3, ilapyueHrq, cBq3aHHbl€ c MepHAxaHoM: MyTHat
Ilo{a3anxs. M e c r x br e H a p y ln e H fi r ri H a p y rx e H Il fl, , 3ayrre xxBora, ypqaHxe B xfiBore.
M o q a , , 1 r c M 6 a n oB
. B s 3 a H H H e c \ 4 e p x a a H o v : 6 o n bn o s H y r p e H Hcerio p o H e O6ljlrre p accrpoficrB a : c H r r x e H x €a n n e r r r a , A l r c n e n c f i f l ,
6eApa, HapyrreBseMeHcrpyarbHororIHKJra.
O6qre paccrpoficrBa:6ecnnoA e y xeHrlxH. nyHxrrHe r,ry6nHofi 0,5 0,8 uyHH. flpt xlraHre 5-
TexflN|(a.IIyHKufifl ray6rnofi 0,5 1,0 uyHr. flp xuraHrre 5 ._ Texnr*a.
l0 MfiH. fl p fl M e q a H'r e. CnalxxoM rry6oKaq nyHKrrr{t nporraonoxa
IlpaveuaHxe. f l p a y K o r a x r e A o l y c r r a r bn o B p e x A e H r . j t
6eApeHHoro HepBHo cocyArcroronyqxa.
12_TOq(A KA[,mATb(tl3x-MAB.t2 F) 1 4 .l o q | ( A K l l - M O t l ( U l r - M 3 r l b , 1 4r ' )
(Toqra-rrararan neceflx. To{ra corpexesr{ xoxfloro rcprA ara
Jlo[aDBaqxq. A. Ha.paccroanax 2,5 uyHrl or no,rosoaoq"1eHa(nax . r o H r q x H e r , c @ a x f l c b q a c f l o x f i o i M e p x [ { a Hc s e n x h x i x f l b r
BXOAaAO B,rara,rrqe). i BryrpenHxt noaaepxxBaDUrxn Mepra{aH)
6. HaA naxoBofi cx"rarxofi, Ha 0,5 uyxs auure r rarepa,rrbHee
ro.rxr xxr-cyHr (30 E), Ha 2,5 qyHr narepan6HeenepeaHecpearHHoro Jlo(anrcaqxc. A. Ha_2. pe6pa H&xe cocKa, Ha 1,5 uyHq KHapyxn or
Mepl,laxaHa. rovru 6ars-syrn( 19E).
Tor|orpaox.rec|(araHaroMxn. Ilotr KoxHHM nokpoBov B paioHe 6. Ha qepeceqeHnrj roprr3oHTanbxofi ,1uHnn, npoBeAeHHoi qepe3
Toqxr HaxoAqrcqnre{rbMexAy rpe6euxoBoi r 4rxHHofi npxBoAruei r o q K \ k r , th \ | o e r t l 4 \ r ' 1 . H B r p t K a n b H u i l .n p o s e a e r r u i u e i e r
MbIltllaMfi, TOHKaSMbrrrlqal,l 3anxDaTenbuHe MbJrxubr. c o c o K ( o 6 H q H oH a B c p \ H e v K p a e _ V l l p e 6 p a r .
MbtllruH B pafioue roqKr HHepBfipyo, cr BerBsMr.r3anxpare,'rhHoro ronorpaQt{ccxat aHaToM9fl. oa KoxH}JM noKpoBov B patoHe
Hepaa. TOqKnHaXO-qtTCflHapyXHa' KOCaflMblXqa XUBOTa, MLllXrIbI leCTOrO
Koxa nHHepBnpyercq HepBoM L3. M e x p e 6 e p b s , n e ' { e H b ( c n p a B a ) , c e n e 3 e H X a( c n e B a ) .
[|oKa3alxt. M e cr H H e H a p y rlr e H n r:6rl!'rr, B HapyxHbrx no- MNlxubr B pafioHe roqxr rHHepBrpyrorcfl 6-M M€xpe6epHblM
IIOBTX OpraHaX y )XeHluXH, orryuleHre MaTK&, flprnyxr'rocrb 9rql(ar
6o,,rb B nonoBoM ,{,reHe. Koxa HHHepBrpyercq HepBoM Th6.
T€xrxKa. nyHKqHr My6rHofi 0,3 0,5 qyHr. llprxrraHre 5 lloxa3aflrr. MecrHbre HapyueHr,rrr: 6 o , , r bB 6 o K o E o f 0i 6 -
l0 MnH- racrr rpyaHon K,'reTKx, qyscTBo cTecHeHnr, pacnHpaxxr B rpyAl,r.
fIpnMeqaHHe. I l p a 6 o , r r x B H a p y x H u x n o , r o B b r xo p r a n a x H a p y lx e H r fl, c B r 3 a H H hr e c M e p r,ra lt a H o M: cHfixe-
peKoMeHAyercacoqerarb c roqxaMB qyHr,Ao (6 F). Kxyx-ryeH (8 F) Fne 3peHxr, noBbrueHlre TeMnepaTypH B pe3y"rbraTe nepeox,raxaeHltt
lr raM-aM-3so 16RP). Bo BpeMtr MeHcTpya!'lr,Horoql,r,'la.
O6nrne paccrpoficrBa: rrlic,,rao f lr p b l x l ( a t r o r x H o r a ,
I J - T O q ( A T H O H TM O H ( I I X A H , M 3 H b , 1 3F ) noTepfl anlr€Trra.
(Tocxa-.J'auaran ceicaerrn. Toqxa .onprxeHrr nnornHr oprano8. TexHxra. llyH(qfir r,iy6nHofi 0,3-0,4 qyHr- flpxxnraHue 5-
T o q f t c o n p c x e H x eH o x H u x M € p x [ r a H o B . M a n d i r x ' n < ( o x € { n H r ' ) l0 Ml,lH.
JIoxaJrx3aqrt. A. Ha ypoeue nynxa, kr{apyxx or roqxx aafi,xoaHb flpnMeqaHIq. l . I l p x H e B p a , i r r u M e x p e 6 e p u b r xH e p B o B
(l5RP), Ha ypoBHe Kolrqa Xl (cBo6oaHoro) pe6pa. Knapyxu or p e x o r l r e H A y e r ccr o q e r a r b c r o q x a M x x a r u - : y ( 1 7 V ) r K a H 3 y ( 1 8 V ) .
roqK Aai-xoaHh, Ha 2 rryHfl Bbr e nynKa, B xosue cBo6oAHoro pe6pa, 2, Ilps r,ly6oKrix yKolrax ocreperarbcq rroBp€xaeHss neqeHH,

364 365
 HtrlE TOqKll
IV. BHEMEPI'IA1'lAH
BHeMepflalia8HbrMlj Ha3btBalorct roqKr, xoropbte He orHoctrcfl }ll'l
x lz fraaHslM, rJr K flepeAHecpear.jHnoMyH 3aaHecpeaxHHoMy Mepu
n f i a H a M .O H I o 6 L r q H op a c n o r l a r a o l c q B H ev e p H A H a H H H IrI y r e f i , o , [ H a -
KO s Te n3 Hux, KOTOpHenonaAaroT Ha MepnAraHbr, He nprxaa!'rexaT
I( HNM.
KaxAaff BfieMeprAfiaHHaq
unt.
roqxa Bbrno!'rHrercBon oco66le OyHK-
A
(
Ilpn Bo3Aeic-rBfinHa BHeMeplrAraHHbre roqxfi noroxeHfie 6o.rb- l\,7
Horo onpeat'rrercfl nprMeHrreJrbHoK xaxaofi orae,rr,Hoi ro,{Ke. c
yqeroM MaxcfiMarbHoro yAo6crBaBo3aeficrBr.rff-npsMep: npfi
yKarbraaxrlfim,rxu, xaxoArqeficr Ha BepxHeficropofie ff3l,rxa,6on6-
Hofi AorxeH norHocrbro BbrcyHy,b r3HK; ecnr Bo3AeicrByror Ha
roqKy Ha firixHefi cropoHeq3HKa,6onbHoi AonxeH 3arHyrL ero KBep-
xy n Ha3aax T. A, (rrr''rrocJpaqfirMnK aaHHoMypa3Aery MofyT cny-
xnTh p{cy,{(l,r pa3Aerlav).
fts um0E rfrlrllrE)
i res 4oi, l2GD -^oa,rrc;ii!Grr=\

TOqXH B ObJtACTt-tfOJtOBbt 14Jlt4UA

l- roqKA Tbt-Txa ,Txoflr ( c bl-tlt3 fl b-llv tl ) !,a-!ror(.E)--

Jloxanr3a{xe. A, Ha paccrotHtir I uyHq KnepeAu,K3aA, }t no cropo'

HaMor roqxs 6arb'xofi (20VG).
B, Anq onpeae,reHrr roKarrr3aurfi Hyx8o orJroxr,trb or roqKfi
6arr,-xoi xa 3aaHecpeAsHHoM Mepl,auaHeno I qyHlo BnepeaH Ea3aa
x no I qyEroB cropoHbror roqKr 6arb-xofi (Ha nrHHH,coeAfiHqloqei
yuiHbrepaxoBrHLI) (pl{c. 85, a, 6).
Tonorpao*{ccxat a8aro flt. IIoa KoXHEIMnoKpoBoMB paioHe
TOqKt HaXOAirCtanoHeapoft'{ecKff llllleM, xocTb qepena.
Koxa rHHepBtpyercs repBoM C2-
. e c r H b I e H a p y u e H H s : r o r o B H a q6 o ' ' t b .
l l o | ( a s a x r cM
O 6 q r e p a c c r p o i c r B a: flpocryaHlle 3a6o,1€BaHfit,BbI-
3BaHHbre naroreHHblMQaxropoM <B€repr, roroBoxpyx€Hlre, MaHta_
(a!'lhfioe cocrogHre. 6eccoHHuua.
Texaxxa. flynrqrs Kocar noafioxHar, r,ry6HHoi 0,3-0,5 IryHq.
flprMeqaHre, n p u n o n a a a Hr , f i a r h ra r o q x y y 6 o n b H o r o
ao3HlixaeToulyuleHfie HanptxeHHocrtl, oHeMeHxt. pacnrpallllg B
MecTeyKo!'ra,xoropoe Moxe, ppaafir,rpoBaTb no o6,'Iacr ao'loBbl

?. TOqKAA[-llbroHl (htlb-tAfr)
Jlo[anx3aqxr. A. B yrny6reHnn Mexay 6poBrMLr.
E. Ha nepeceqeHnx BHyrpeHHtexoHIlH 6po-
nnHsr, coeAxH9rcnrefi
Bek, h nhEAA,npoaonxarcqeri cnnHKy Hoca.
Tonorpaoxqccxar anarounc. noa xoxHHM noKpoBoMB paioHe
TOqx! HaxoarTcr MecTonpfixpenreHnr aByx MHrxrl ropAerloB,coqne- (a, 6).
Hefile AByx HocoBbrxn ,ro6HErx(ocrefi. Pxc. E5. Toqkr B o6,acrr roro6r

366
 Tcxsrra. fly Kuxt rny6fifiori 0,2--0,3 qyHr. Moxxo nprMellqrr,
Muuruu a paioxe roqKL qHHepBxpylorca BerB'iMI'j rI'jueBoro yxon B KpoBeHocHbrtcocyA, qro66r Bbuaafirb oarJy Kan,rm KpoBr{-
H e' p B a . flprxnraHxe flporrBonoxa3aHo-
Koxa HHHepBtipyer.e V napoii qi penHh\ HepBoB'
Jaoo_
lloxasa||rlc. M i c I H b' e H a p ] u e H I ]l ronirBHat Oo.[b. 5. TOq(A Hl,t-IMDM (3P-U3{ b)

O 6 r r l H e n a c c l p o i i . I F a . ' n B " ' l e n ( . yf i Ierex,

t cyaopo.rl.
n . l 0.: u v H t I lpllxtraHne o- Jlo[arx3arur. A. Ha nepxymxe yxa. A,lq yxo,ra cneryer 3aBepHylb
Texnrxa. [ilnxu n rn]6HHoii yuHyro paKoBr{HyBrrepea.
l0 MtH. E. Ha eepxreu KoHqeyuHofi paKoBnHbr,xoropbri MoxHo onpe-
flprveqaHHt l npr pHfirlepeKuMeHA)(rca
neiHTb, raBepHlBee Bnefen x c,lo/<HBnoIo.lav no npoao.rbHoll
tnu*rir, "r""o-*",o"' (2u GI) i xon r<oxt4cl) JUHXn.
He clreayer aonyctarl oxora Ec'ru^,npn
2. npfi nplixrraHxu Tonorpaorq€crat afiaroMrs. no,n Ko,t(HnvfloKpoBoM B pafioHc
u irr,"avn npou"c. fit
BH3/lopos!'Iefi nporeKaer MeaneHHo'
aosqeficisfi IOqXHHaxo,Arircqxp9 r ylxHot paKoBxHbr.
Kaner'It'
nof"o noar" xaxAoro yxo,ra BblaaBr''l[Barb no HecKo'bxy Koxa B pafioHeroqKt HrepBxpyercr V napofi uepcnuux tepsos.
KpoBtl. no[a3anr'rq. llaHHyc.
TcxHx(a. nyHxqrt rny6ufion0.1 uyHq. npuxxraHre 5-7 MHH.
3. TOrr(A Hrbl-tlgv (Kln-to) fl p r v e,r a u a e. ilpx nonaAaHr8lfJrbr B roqKy y 6onbHoroso3
sBXa€ToulyulcHneHanptxeHHocrr.{,pacnspanrr B MecreyKo.la rr116()
Jloxanr3auxe. A. Ha cepeAHxe 6poRa
--- ca!5bHaqrfi nepeMrt ynlHot psKoRfirbr.
i-iin ioo""""u"rn .i'paaontairxofi '1nBHt, pa3aen''touei 6poBb
x Beprli(a'rlxoii, upone4exuoii qepe3 cepeluHy r'1a3Hon
nonoJaM, 6. TOq(A HOBHaEHb-Xt'OHl
Bna4nHhL
ionorpaoruecxar aEaroMxtr.noa KoxxLrv noKpoBov B-paioHe JloKanx3aqxe. A. B HocoBoMorBepcrufi.
''oqxh naioqorco vblluua c'ttopu aaoLxae 6poBb no6Hoe oprcuxo 6. Ha cJfi3xcrofi o6o,roqxe B HocoBoMoraepcrr.rr.
Kocr]'
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xHHepBtpyercq V napoi qepeflfiLlx HepBoB' qeDenHbIx
- HeoBoB.
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iexlnra [lvnxuus xo'aH n'i lKolaHaq dnlaBneHre nl,,rH Texnnta. flyaxuxa rpexrpanuoiitr"roii, 6brcrpas.noBepxHocrBafl
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"u uu ra ro"*y soaxaxaer (npr onpeAe,r€HrunoRarrfi3aUru6onbrroMyc,reAyeTBblcyr{yT6r3riK
a s c r e e H x o s r 6 v r a e r M e ' l K r r i K p o B e H o c H u fcro c l n Hapyxy).
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cf BepxHrq npolonbHafl Mbruua n3brKa,neperopoAKaq3HXa, noa,,-
qepen- q3HqHo-q3brqHafl, noa6opoAoqHo-r3b{qHafl fi flonepet{Har MHlllqbl
MbrmuH B patoHe roqxrl rjHHepBupylorcr BerBbrc V napbl
tHx HepBoB. BerBaur Xl napu ,repen
MbrurqbrB paiioH€ro'{Kfi rrHHepBr.rpyorca
Koxa xHHepBtpyercav n a p o i i q e p e n H b l r H
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DeMeHHatMbIlllUaaor'loBbl,peMeHHatMLIlxqa uer, nonepeqHo-ocrx_
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HIrt, flotxtlf aHlre npmnBonoxa3aHo Koxa l,sHepBlrpyerct HePBoMcs,
Jlora3afirt. OlHuf{a. 6poH)\fia'lt Has acrva. yprHhap t
L T O r l X x ( l ' l M - T A H( U 3 l i l i b I l 3 t J H I ' ) C J I E a Al , l l r O K _ 3 U r b T e x r x x a . n y H h u H t r a 1 6 r n o f t0 . 3 0 . 5 u l H s . n p x r { H r a H H 5
e
( K)n-E) cnPABA l0 Ml,tH.

Jloxanr3aqrlc. A. Ha aByx BeHax noa tl3blxoM- 2. TOqKAXOALA-3tn-TblTb(XoA-ro-u3q-u3lt)

E, noa f,3brxoM,Ha BeHax, flcHo npocrynabullrx no o6elM cropo_
H a M V r A e q l ( 0 :c ' l e a a K I M - T a H ,c n p a B a Hrox_illIL' Jlo(arx3aqrifi.34 To,rKxs o6nacrlt cnBHbIx Kpecrua, no 17 To'reKc
T6norpaon,recxan axaroMxfl. flo! c,l llrcroi 060ro'{xofi Haxoltr Kaxaofi cropoHbl llo3Bolloqfinxa.Pacno"loxeH6l B BUAeaByx Bepr,
cq noA6opoaoqHo-$hlqHat I noA'btr3blqHo_fl3bl'Isat Mblulubl Karl6HUX p'AOB, I(OTOpHe HaqxHarctct Ha ypoBHeocTHcrorooTpocrxa
Muurun r pafione rouxrt IrHHepBxpylorct BerBqM, XII napbl qepen' I rpyAHoro no3BoHka,3aKaHqtBa|()rcq 8a ypoB e v noqcHlrqHoro
Hr,rx sepBoB. no3;bHKa s orcrotr Ha 0,5 IryHHor ocrlrcrblx orpocrxoa nosBoHKoB.
fIDortB Kaxaoro no3BoHKa - ABe roqKlt,
C,rngrcrag o6oaoqxa x8fiepBfipyercfl V napoii uepennux uepnon, -
J l o x a 3 a H x t .M e c r H b t e HapyueHrn: 6oft, I{ onyx"'Iocrb Tonorpaoflq€c[ac aHaroMxe. floA koxHbIM tloxpoBoMB pai'ioHe
q J H K a , K O H f p a K l ) p aM H I I I Uq r H h a . r a T p y 4 H e H r l o er ' t l n l a H u e TOqeK SaXOAqrCtl:
O6rqrti paicrpoic r e a : r o u l x o r a ,p B o l a .l r a 6 e r - Ha yqacrKe or I lo V rpyanoro no3BollKa - rpaneqxeBtAHafl
Texxrxa. BHcrpaq noBepxHocrHa'{ flyHKqxt rpexrpafiHofi urnot u b t u u a , o i l a o l V r p ! d , H o r o n o 3 B o H x an p f i 6 a B ' l f l e r c t p o M 6 o a D A H a e
c qenbro r(poBonycxaHlrs. llpfixqraHre llpoTtBonoka3aBo. M b r r x u aa, o r I a o I l l r p y a H o r o n o l B o H K a- B e P x l l e er a a H e r i ) 6 q a r a q

- Ha yqacrKe o? VI Ao XII rpyAHoro nosBoHxa _- rpaneuxeBx.(_

r0. Toq(A 6aTb-,'lAo 164fl-JIAO) nar r,,rnr|qa, uupouafiruafi MbIIrqa cnriH6l; B pafioHe xl u xll rpyaHblx
J l o K a n [ 3 a q q . A . H a 2 u y H q B H u r eu H a I u y H b x H a p y x l l o T ' r o q K l ' l n o 3 B o H ( o Bn p x 6 a B r t e r c c H s x B t t 3 a a H q q 3 y 6 q a r a r M b [ I l q a ;
- H a y q a c r x e o r I a o V n o t c H l l q H o t o n o 3 B o H K a- Q a c q t q l x n p o -
r a f i r | o ur 1 4V Gr .
Tonorpaox,recxan B paloxe
nohpoBoM
aHaroitxc.IIoa KoxHbrM qatiluefi Mhrrllqbl cnrHbti B pafioHe I I,l II noflcH[qsHx no3BoHXoBnpH_
TOqKLHaXOA'IIC'TpaneqreBltaHatM6Inua, peMeHHatMbllrqa roJloBH, 6aB,rqerct HuxHgt 3aAHtt 3y6qarat MbIlnqa.

370 371
 Aane€ Br"y6h M H u q b r n o o 6 e q M c T o p o H a Mn o 3 B o H o q H l t K aM: e x -
ocTHcTa9,no,ryocTllcTafl, nonepeqHo-ocTrcTaq, no3BoHKrJ'l Mexn03Bo-
Hrer cys -3y 05 tG) HOqHbreoTBepcTnt,
H , e H - t r r o a n - 3( 1
y 41G) Mbrrxqbr B parloHe ToqeK riHxepBfipyroTctr BeTBbroXI napbr qepen-
-rhLHr(2lVB) Hbrx HepBoB, BeTBtMI r,ly6okoro rxeiHoro HepBHoro cn!'reTeHrir, n,'re-
r{eBOrOHepBHOTOCnr'leTeHut, nO3BOHOqHbIX HepBHtlX KOpeUIXOB,
IBM
2AM Koxa B paioHe ToqeK HHHepBripyeTcr HepBaMri oT Thr lo Ll.
noxasar c. EpoHxranr,Har acrMa, Ty6epKyr$, xpoHlr,{ecKlre 60-
!1C3Hft.
TexHxKa.
nyHxux,{r,ry6uHoii
0,3 0,5 uy8r. np}rxrraHre l0-
l5 MHH.
n F n M e q a I H e . B 3 a B H c f l M o c r to r r o f o q r , l l H o r o 3 a 6 o , ! e B a -
Hl.tt Mox(Ho coqerarb or 2 ro 4 Toqex, npri [onaAaHHn lrJlbl B ToqKy
y 60rbHoro Bo3HriKaeroqyrqeHse HaIIprxeHHocru, pacnqpaHfir B Mec-
re y(ora, r(oTopoe MoxeT xppaa&fipoBarb BAoJr6 flo3BoHoqHfiKa,

3. loqxA (x!-ctoEH tuu,qv^Hb)

3BM

JloKaJtx3aqxt. floA ocrrrcrblM oTpocT(oM VII rpyAHoro no3soHKa;

Ha paccrorHrr 2 uyHeft KHapyxx or roqKr{ rx'3broHr (9VG).
(8vG) Ha ypoBHe HnxHnx KoltuoB rlonaroK, Ha paccTorHur{ 2 llyHei or 3aIHe,
5BM cpeanHHoro MepHAuaHa.
Toflorpaofiqeclar a8aToMrl9. floA KoxHr,rM noKpoBoM B par:ioHa
(6VG) I o q K H H a \ o A e r c f l r p a n e U fel B x n H a H M b l l x u a , L U r l p o ' ] a I l I x a ev h t L xU a
(20v) cnrHLl, A,rnHHeffnar Mr,[u{a cntHbr, Io!'ryocTHcTaa Mbrrlqa rpyArt
(2rv) nonep€qHo-ocTncTaq MblruLla, KopoTKre Mbtruubr, floaHr.ti{arcute pe6
6BM
(5vG) pa, Mbruqbr uecroro noApe6epbq, Aanee Brny6b !'rerkde.
l22V) Mbr[rqbl B pafiofie roqxr rHHepBupyrorcr BerBffMq Xl nap6r qepen
(4VG) Hr,tx HepBoB, rny6oxoro ueiiHoro HepBHoro cDrerexrfi, rtrleqeBoro
(23V) c i r , l e r e H n n .7 - r c M e x p e 6 e p H o r o H e p B a .
7AM
\24 K o x a r H H e p B r p y e r c r H e p B o MT h ? .
Iloxa3aHxc. BpoHxra,r6Han acrMa.
TexHxKa. flpxxrraHHe l0 l5 urx.
4 TO\(A rbt XOA

JloraJrrcaqxfl. A- Ta x€, qro r.r y roqex (arb-3y (l7V) r noM-3y

(33v) ( l 9v ) .
(2VG) 6, OnpeAe,refirenoKa,lt3aq&H - aHaJroru'{HoyKa3aHHbrMToqKaM,
Tonorpao|qecKae aHaToMxr.Ta xe, ,rTon y ToqeKxaT6,3y 117V)
H aoM-3y( lg V).
noKa3a xc. Ty6epKy,re3,6poHxnaJr,Har acrMa, acreHHr.
T€xHxxa. npfixljraHr.re l5-60 Ml,'H.flyHKqrs npx,leqeHr.jr nepe
qLjcreHHNx3a60.reBaHxrinporfi BonoKa3aHa,

5_TOqXA|(l.t,qvt(,MA

Jlo{aix3a{ t. lloA ocrncrr,rM orpocrxoM X rpyAHoro no3BoHKa, KHa-

Pvc. 86. TocK, . o6r.d, ..NH!r t 'roA,q. pyxx Ha u,c qyHf,.

373
 TonorpdDx,recxat aHalo r|t. floA xoxHblM noKpoBoM B patoHe
TOqKX HaXOAtTCs TpaneqteaHAHaq MbIuIua, uJ poqatuat MbIrDqa
cnqHH. MexocTlicTaq MHI!qa, nonyocTtcTaq MbIlnua, fionepeqHo_
ocTtrcTat M6llxua, Mexno3BoHorrHoeorBepcTfie,
qep€n'
Mbrr1lIlbIB paioEe roqKL IrHHepBlpylorcc BerBtMI XI napbl
HHX HeOBOB,rny6o(oao ueiiHoro HepBHoro cn'lereHxtt, nreqeBoro
rr,6B lor (22VC)- -
xeogloio
' cn'rerex&q, l0-ro cnt'tlloMo3roBoro HepBa
Koxa xHHePsIjPYercauePsom Ths
no(a3a xs. Pa3nlqHLIe BfiaH KoxH6Ix rHoiilrrq(oBlix l)6pa3oBa_
tlLr't.
Texrrxa.flpax rauae l5 20 uan
O{ e (r5E)

6 . T O q K A E t l - K A H( n l - f 3 H b ) Hro{-a!oHr (l8VC)-

Jloxa,rBaqrr. Ha paccrotHux 3,5 qyHfl KHapyxx or ocrxcroro or- A a H c y H r( t 7 V C ) - -

ypoBHe ero Hrxnero Kpafl
'Docr(a I iogcHl.r.IHoro no3BoHKa, Ha
Toflotpaox{ecrac aHaroMxc. floa xoxt{blM noxpoBoM B paioHe eyHr a,Hb (16VC)-
ro,{xn Haioarrrcq lxtpoqafirxaf, MHIrqa cnsHbl, HxxHflff 3aaHit 3y6_
qa,raq MHuqa, noAB3AortHo-pe6epaat Mblruqa noqcHl'lubl, KBaApar_
Han MHlllqa florcHlluDl, no'{Ka IlJIu cele3eHKa. HH {xDsr(l4VC)
Mbruubl B paioHe ToqKLt xHHepBfipyloTctr BerBtMq nr'leqeBoto
HCpA oro cn,' le,efillq v HepBoM J. _. Tt!oHr;iyar (l3VC)- ./'
K o x a t x H e p B f i P y e r c t H e P B o Ml n . Ltytrr-kyaH(l2vc)_
llola34xtg. Cn,lenoreflaroMera'rrt, 60ru B crlrHe
ii*"tta. Ityxxuna r'ry6anoi 0,2 0,3 uyxq. IlptxrfaHlre l0-
20 Mr.rH.
n p x i'{e,r a H x e. f'1y6oKasnyHXuHtnporl{BoDoKa3aHa
r x 6 r - e a H( e V c ) -
7. TOqKA[Ev'HtH (to-rH6) TraH-k,6er (3VC)- qaii- rcdh (r5FP)

Jloxa,nr3aqtfl. Ha ypoBHeocrxcroro orpocrKa IV noflcHllqHorono3- AM-3io (7VC)--

Bofixa, Ksapyxx Ha 3,8 IryHq' B qeHTpeyrny6neHn*, Koropble ()6_ Hn-xat (6vC)-
pa3yrorcr npfi He6o''IblxoMHax,'loHeKopnyca B6ox c BblrtHyrblM| T r a r s - M o(Ns V C ) -
Azn ra (2?El'
Toriorpaon.rccxacalaro ttt. lloa KoxHblv noxpoBov 3 pafioHe
TOqXfiHaXOACTCSCyXOXnnHe tllnpoqatrll€n M6IUrLlbI noneperr'
Cnr,lHhI, .{--),
HO-OCTfiCTarrM6Iluqa, MexnonepeqHble MHIrqH, KBaapafHat MbIllqa
notcHxuH, OOABSAOIUHO-nOtCHtqHat M6Iluqa.
BMt
MHluubr B patoxe roqKa sHHepBfipytorct BerBqMx n.reqeBoro
HepBsOrOCr"'leTeHrt. d-M cfll.{HHoMo3toBHMHepBoM tl BeTAtMt nOflC_ BM2
HXqHOTO HepBHorocll'rereHfit.
Koxa flHlrepBfipyercq HepBoM Ll,
lloxasaxrc.Mecr x bI e x a py e s f i t : ' 1 l o M 6 a , ' o , 6 0 ' ' rBl ,H
i H3y

O6u e paccrpo icrna: o n y x , r o c r sg x q e K ,r r H e K o n o r r q e _

c(rre 3a6o,leBaHIrt, Ata6er, Ty6epxyre3 rerKsx.
Texrrxa. flylxuaa r,1y6fiHoi 0,5 1,0 IryH. np[xsraHne l0
20 MrH. ,l ,tc. tt. Tocsr a o6ractr rpy4a r xrrora.

374
TOqKn I O6JIACTfi Xl'l BOTA
l. roqKA Tb!-(vHr (u3u-rvH)

Jloxa,lrx3a|lt,|c, A. Knapyxn or roqKq qyHr-xblK (3VC) Ha 3 uyHt

(''p r c . 8 7 ) .
6. Ha cepenxHepaccrottHfit MexAy roqKaM, Klolr''Iaft (29E) t
o'-r . c a i t : n i , t ; n u p a c . t o " t t t l ui u y u e f oi r r o r x u ' { y H rK H x { l V C )
IoflorDadlqecKae axaror|xq. [Io,0 Ko,l(HHv noKpoBov B pa'oHe
'rouxn nairoi:nrctOacu99 HaplxHofi H BlyrpeHHei KocblxMHlllu
xreora, nonepe'+ran usrLxua xrBola nonepe'lHafl Oacurfl oplouxHa

MHrxubl B pafioHe rotl(t tHHepBtpy|.orc'{ ljlecrbn HrxHIlMIi

Me)Kpe6epHslMl'l HepBoM'
HepBaMI{Il nOAB3AOlllHO_noaqpeBHblM
(o*i n"uupuniy"t." HepBoMThp u,rt Lr'
Iio*u"a""". Hapy.""re uelcrpya,rlxoro ulrcna' a"'rfirerbHoe6ec-
'-T:;;r-". -
fl\Hr<unqrnvoHHoir1,0-1.5 ulHs [lpt{xnraH}tel0
- - MHfl.
30
iiou"uuu"n. flpa nonaAaurn r.lblB roq(y y 6onbHoro
*osxn*aer orUyqeHIe Hatlptx€HBocTH, pacnHpasre B MecTeyxor''Ia'
KOfOpoeMoxeT Dppaal'tllpoBaTb Bo BXe Hre noroBue opraHbl
'toq|(A Atlt-aE
2.
tloxa.nr3aqc A. Ha (pecroo6pa3HoicxJlaAsenoa vouloHxofr
E. Ha cx'raaxe, coea Htlo!.(efi 3aAHniinpoxoa c HapyxtlblM}l no_
noBbrMIoDraHa]vH; KHHry X3atrlOT HapyxHblxflo'roBbl\opraroB'
Tonoriaron,recxanaflaroi,txfl. lloa xoxHHM noxpoBoMB paloHe
rouxa naxoanrca nyxoBfiqHo'neuepxcTagMbllxqa' IIoBepxHocTHa9
u r,1v6ot{at noflepeqHHeMHlxubl flpo\rexHocrll'
M"Ixusr a oai'oneroqx, HHepBlpyrcrcq BelBtMll sHlrpeHHero
coaruHoro
- fiepsa.
Koxa uniepeupyercfl fiePBoM53
Ilol(oaa8x9. bot'Ie3HrnoqeK.
TexH t(a. flplrxuraHne l0-l5 MtH.

TOq(1| a osJlACl r| BEPXHI{Xl(OfifqHocrffi

(u3tHh-ury)
L TO'|(A Kl,|Ed-qy-|(or
JloKarx3a{ t. A. Ha xoHqe Jloflar(r'l' rA€ BhlAaercqocrplrr[ Bbrcryn
(pnc.
'' 88, 89).
B. IJa,raieoa,rrnor"rxoBqe KJIrOqUhl' Ha sat6oree Bblcrynaor{etl
qacrl 3'toro x6xqa ua,a axpoula'rt'Ho-x,'ITqtllHuMcycraBoM -
TonorpaOfiqec(at aaamxns. floa xoxHHM noxpoBoM.Bpa8o8e
rouxu rtaloAr,rcauecro npqKpenneHlttK Kocrgae'rlbToBtaHotMt'I rqbr'
Mbrrrubl B pafiofie roqK, tHHepBxpylorct 6oKoBHMKopelnl(oM
cpeaIHHoroHepBa. Px(. 88. Tocxr Ha Bepxsr koHeqHocBx
Kolxa tfiEepBHPYercq HePBoMLa.

376
 Toflorpaoxqec(ac ataromrs. IIoa KoxHbIM noKpoBoMa patoHe
ToqK! lraxorsrct Oacqltt lpexrnaBoi MtiuqH, orpocrol{ ./lo1(reBol'l

Mbr IubI B paioue ro,{Kt{ sxHepBspyrorct BerBtMl'{ ryqeBoro

HepBa.
Koxa rHHepBrpyercq HePBoMLs.
{14Gr) llor€3aHxf . flort{aaeExr.
TexHfiKa.IlpnxtraHne l5-90 MIlr.

3. TO'lKAHtt-6ATl,(3P 64ll)

JloKa,lt3aut|c. A. Ha paccroqHnn4 qyHei Haa,ryqe3anHcrHori cx'rlaa_

Kofi, IIo aBe ro'{KL Ha Kaxaofi pyxe. OAHaroqKa a cyxoxl,'1xqx, T e
Tratrb-naHb-y6H (11TF) Ha I uyHr,,laTepa,ll HeeToqxE3aH-c6l(5 MC), apyraf - BHecyxoxl'l_
nfii (c nyqeBofi cropoHbt), Ha roM xe ypoBHe,qro I,l nepBafl
6. Orra roqxa HaxoAHTctHa M€,(IjaIbHoM,apyraq - Ba "!are-
pansHoMKpaenaaoHlloi Mblutubl,o6e Ha paccToqHtu4 uyHei or ,ry'{e-
3antcTHoro cycTaBa.
Tonorpaoiqecxac ataroMxt. Iloa (oxHbIM noKpoBoMB paiioHe
ToqKfiHaxolltrct Meata'1hHbrfiLt narepanLHLIff(pac cyxox!,lI'j' Ja-
noHHofiMbruur,l,aa,'IeeBrny66 AraHHbIficrfi6are''rbI flarl5ua Kl'lcrll'
OH-n!y (7Gl) noBeprHocrHbrfiL rny6o(t!fi cru6arens nanbqeB pyKs,
Mbr uH B pafioHeror{Kll tHlepBtpyorcs BerBnM! cpealtal{oro u
roKTeaoro HepBoB.
Koxa fixiepnapyercl HepBoMC6 x,'IH Thr.
noxa3aHre.feuoppofi. surnaaerle npevofr I( ruxH
Tcxxrxa. Illnxulli r'1)6trHoi1 0,5 0.8 uyHe nprxrfaHxe l0
15 Mr.rH,
npxMe,JaH e . H e A o n y c x a r l q p e 3 M e p H o apoa 3 a p a x e H s t
TOrtKfi, TaK l<AI< 9TO MOXeT l]ptiBecTfi x nOBpeXAeHrIO MeA[ar'lbHOrO
6ar-ra (BM) nyqKa.
xepBHo-cocyar{cToro

-Hr-sgn (2GD .t. TOqKAqYHT'TYEH

Jloxarrgaqxs. A. B yr,ry6neHI't Ha 3anqcrbe c rbl'rbHoficropoHblpy-

Ka. M€xay roqKaMfiauonr-xxe (5Gl) r s6loHr'T a (4TR)
6. Ha runhHofi cropoHe rlyqe3antcrHoro cyclaBa. Mexay cy\o
xl,t,r|reMn pa3rr6are'1flna,rbueBfi cyxoxH'l ev,lrtlrHHoropa]rnoa'
Px<.89, ToqKrHaBePxH,x{ots€cHo.rtx re,lr 60,rtrnoro na'qbqaxlrcr[, xoropble o6pagyrcTyMy6teHfi€ Mexay
roqKaMH36IoHr-Kxe (5GI) H 3HoHr_,It{ (4TR)
Ilo(a3alrxg, florept ABfirare,JbHofi(pyHKuLfiBepxHuxxoHeqHo_ Toloroadxqecxacaxaronxs. floa KoxHHMnoKloaov B patoHe
crefi, florrar,ertr. to"*a naioasrc" 'ro,1, o6pa3oBaHHufi cyxoxrn tlvx o6uero pa3rH-
Texrrxa. Ilpr'rxlranue l0-15 MxH 6are,1t flanhtleB H arl'lHHoro pa3rt6ar€nfl 6orbnoro na,lbua Kflcrx'
cyxoxr{rre 2-ro cynlrHaropa, ule!'Ir,,lyrre3anqcrHorocycraBa
B paioHe roqKx xHHepBtipyorcqBerBqMxnyqeBoroHepBa
Mr,ruJur,l
2. TO'|XArtbry-TbtEM('txoy-uy) uHHepBxPyerct HePBoMLs-
Koxa
JIoKaJx3auBe.A. Ha roxue noKTq pyl(x, corHyrot B noKTeBoMcy' OoxagaHxc.6o,1t,s o6'1acrucepaua, HecrepnHMas60"Ib B xr'rBore
TexExxa.nyHxrtxfl rny6xHoi 0,3--0,5 uyHe npHxxraHae 5
6. Ha KoHqeroKTeBoroorpocrKa. 7 MxH.
t79
378
 E. B qeHTpeaucra"tbHblx Mex(panaHroBbtx cycragos II Il IV na"Is-
5. TOq(A 6AT-T4 (64-CE)
Jlomnx3aq|rc. A, B npoMexyrKax Mexay narb(aMx pyKfi, Ha Kaxaon T o n o r p a o r q e c ( a f i a E a r o M r f l . I I o a K o x H d M n o x P o B o MB p a l o H e
''-iou*, no 4 ToqKt.
cropoHe TOrrK SaXOAtTCq MeCTO flpHKpennexHt K (ocTl'l cyxoxljnllt pa3-
a"l-ao pacnoJtoxeHa y ocHoBaHHc npoMexylKaMexny I rfi6aTe,'rq na,tbqeB, 0IeJIb At cTarr,Hblx MexOaJIaHroBtlx cycraBoB
l,tll nanbuaMH (s vecre.xoropoeHarblBarol cnacrb rHrpa'l Ha rpa_
Hrqe r6lrbHofi x raaoHHoi noBepxHocrefi Kscll'l; MHUrriH s pafioHe roqxr trHHepBLrpyrorcqBerBtMr'l !'lyqeBoro HepBa
nptl
ToqKarxHoHr-ao- B npoMexyr(e MexAy ll fi lll na'IbqaMfl; K o x a u x u i p s l p y e r c n H e p B a M xC 6 f i C s .
onpelre,leH H,lOxant{3au { 60,1bHoMy cJlenyeT lloxagaxxq. Kourpaxrypa MbIuru nar'tL'qeBpyKI'{-
r o q ( aq l H r a o B n p o v e x l r K eM e x a y . . l lH , l l l n a r h u a M x : TexHfiKa, flpfix{ra'{re 5 l0 MrH
roqKaxa_ao B npovexyl(e qexa) lv I v naJlr'[avr'
6. B noovexYrxeMexay narrbuaMlt. Ha rpaH ue rblibHor'lI na_ r J -T O q K A T b l - O v H r
norno; ndeeorHdcrefi xacrri. na ypoene urerlrrnscrHooa'laHfoBoro
'u"loun1.o.o""..*." JloKa,rr3aqnr. A- Ha cpeaHefi Oa,laHre 4 na,lbqeB pyl(r'i.
attaroMflc. noa {oxHhlM floxpoBoMB pafio'e E. B cepeafiHe cKflaaoK Ha nepeaHei cropoHe arcra"ItHblx Me)K
roqxl,arii-46 (2 RP) Ha\otrerca MexxoclHHeMHruuhl H vt,tuua npn_ tba,raxrorux cycraBoB II V nanbueB pyxs.
'
soaquraq6oabiuoi na'Ieq Kxcru, B pafiose apyr'x roqeK MexKocr_ T o n o r p a r D n , r exca r a H a r o M x e . f l o a x o x H H v n o k p o B o v B p a f i o H e
H H e f i q e D B e o 6 P a l H H ve b l u l u b l ToqKrj HaxoAtrcq cyxoxljrl{t pa3f x6are,'It na'rbqeB xrcrll, (le,'Ib
orHoll
Mb|urqbr s paioHe foqxr lxHoHr_no rHHepBUpylorcfl ar,tcTa!'rbHblxMex(pa,raHroBsrx cycTaBoB nanr,qeB py(s.
H e p B a B paxo
s e r g r | o c p e A H H X O rHo e p B a l ,n B l M g a e T B t M l lr o K r e B o r o Mhrurqri B paioHe roqKt{ riHHepBrpyrorcq BerBtMI'l cp€al1HHoro
He oclaJ6Hblx rcqeh BelstMr n o K T e B o f oH e p B a _ r rrvqeBofo HeDBoB.
' Li
K o x a r . r u r e p e l p y e r c aH e p B a v C - ) [ a i i _ a o r ' L . l l x r ' r o H r " 4 o r i(oxa urn6prupy"t.t uepaa {n Cz L Ca.
l q v- H
no ra , aCt,rr tHl .cr.f i T h ( x a - a o )
t loa, 3 noKa3afixe. PaccrpofrcrBonxureBapeHrqy !erei.
MecrHHe H a p y u e H I e : o l e M e H l eo n y x ' ' ] o c r b Tex8xxa. Bbrcrpaf lloBepxHocrHar nyHKqxfl TpexrpaHHoi fir,1oli
I<r.rcr. napartq na{'IbqeB pyxs B pe3y{'Ibrare npocryaHblx 3a6oneBa_ c qe"'[,rc KpoBonycKaHlrs, flptxxraxne nporfiBonoKa3aHo.
H r f i . c B t , l a H H b l xc l l a r o r e H H H M xQ a x T o p a t l r t B e l e p ' '
O6urHe paccrpoicrBa: r n ' l o B H a f6l o ' t b r y o H a r o o r h 9. JOqKA qvflr-KXOtl (qXvH-Kvn)
qyHf_ao.xa'ao)
( a a n a o ) ; O o " r o ,o n y x , r o . t o p y * n ( r x H o H r - a o , -,, ,.
Texnrxa.Dyxxurn
T€xnnxa. 0.1- 0.5 -ulHtr npft tiy*'lgtll..l
nyHKuq r,1y6HHofi tiy*'lgtll I JloKan 3auxt. A. Ha II 6a,1aHre III na'rrqa. qro6H saira roqKy,
6 0 , 1 r \ v o , | ( H o n p u M e H s r bK p o B o n y c K a H l l el l l H x x r a H l ' r e HaAO CorHyrb nan€q.
6, Ha rHnhHofi c'fopoHe Allcrar'lLHoro MelK0aflaHroBoro cycraBa
{i. TOq(A AAfi-(OT-KXOHT (AA'(v-rvfi ) cpeaHero narrrblla pyxft.
T o n o r p a r 0 { e c x a t a H a r o x c . f l o n K o ) h H b l Mn o H p u B o v B p a t ' l o H e
Jloxa.nnsau{s.A. Ha KoHueOa,lafirr I narFqa (tlcrH, B yr,ly6neHlrs' roqKr, Haxorqrct pa3rl,16are,Ib III na,r6tla 06Drero pa3rI,'6arenq
KoroDoe0603 aqsrct, Koraa corHeulb naJleu.
nar''IbqeB (IlcrH, Iuerb AficTa.tbHoro MexQaJIaHroBoro cycraBa
B, B qettpe rH'1bHofi cropoHbl Mex(paraxroBoro cycraBa' Bo III nan6la trncrH.
enalnne, xoropan o6o3Ha'rxrct npfi corHyrov noJloxeHl| nan-bua MH rqbr B pafioHe roqKr rHHepB{pylorcg BerBqMr ,lyqeBoro
Tonorpaotqcclat aEardHxn. [loa KoxHblv noKpoaoMB paxoHe
HepBa.
roqr,x naioaqrcq MecroflpxKpenneHlinx KocTllclxoxx'r'lf a''lrlHHofo
parf 6are,196onbulorofla,1bua.Mexoa,raHroBHfi cycraB I nalrhua Koxa lHHepBrpyerct uepnou C6.
no{a3aExc. PBora noc,re nprBflTHq flrlllfi, cna3Mhl r"Iorare.4b_
XIICTX,
Hbrx M6lrxu, tKoTa.
Muuruu r pafione roqxt, IrHIlepBl'rpytorct BerBqMI't nyqeBoro
TexH |(a. flpqxrraHfi€ l0-15 MIrH.
HepBa.
K o x a H l r H e p B x P y e r cH a e P B o r 'L, i .
n o x a r a H x g . X D o H l r q e c K Hrer a 3 H u e 6 0 r e ? H f i . n a H H y c ' 1 0 .T O q K AT t ' l E y - X X O H T( C f lO - r v - ( v H )
T € x d l | K a .f l p r x r a t { t { e 1 0 - 1 5 u u u .
Jlo{aix3aqxq. A. Ha xoHqe II Oa,raHrL V nanbqa.
?- TOq(A Hl'v_Xo B. B _cepe4uaerHrr'Hofi cropoHbl axcrarLHoro Mex(paraHroBoro
LIro66I Hairl] cvcraBa
' v naJt6qa KI'ICTIi,
Jloxa,r 3aqtfi. A. Ha II +a,laHre lV u II narbueB Tonorpaoxqecxas aHaroirrt, IIoA KoxHHM no(posoM B pafioHe
roqKY, Hallo Cxarb nanl'qH B XYnaX
381
J80
roqxu Haxoatrcq cyxoxtnl,le pa3rn6are,'rt Mn3I'lHIra, qer'Ib npoKcx-
ManbHoro MexoanaHroBoro cycraBa v narblra Krcrli.
MHrlqN B paio e roqKH ItHHepBripylorct DerB6loryqeBoro HepBa
Cs lrnx Thr.
Koxa rnn6prupyercnHepBoM
n o r ( a 3 af i t , M € c r H b I e HapyllleHst: 6onlj B cycraBax

O6qIe p a ccrpoft crBa: r,ra3Hb6

l eo ' t e 3 H t ' l
(31E)
T€xExKa.flprxuraHu€ 5-10 MrlH.

rXAn-ryEH(lxll-cloAHb)
IL TOTIKA
Jloxa,il|3a{xc. A. Ha xoHqax l0 n anlueB pyx, Ha paccroqExx 0, 1 uyHq

6. Ha caMofi HfixHefi ToqKe(axaoro nar'l|ua pyKtl.

Tonorpao ,{ecKat asato tt. noa KoxHbIMno(poBoM B paiose
Toqx}IHaxolqTcflAr{cTa.jIbHHe KoHIIHKoHeqHblx {par'laxrBcex narLqeB
ixo (32E)
pyKx.
_
Koxa B paioxe roqr{t{ fiHHepBpyerct aepraur Co, C7, Cs |t Thr.
JloKa3afirr. Bblco(at reMneparyparena, ocrpoe Bocna!'IeHrie MI{H_
aarrH, oKa3aHne Heor,loxHoii noMouri npx o6MopoKe, (oMa.
Texlrr|(a. npr ocrpoM aocflaJleHrsMIrHAa,lxH 6blcrpblfi y(on
TpexrpaHHofi xr,'Ioi B KaxAyIoroqKy c nocreAylournMBbIAaBr'IHBaHneM
no oAxofi xan"re KpoBu, flpx ol{a3aHIrI Heor,loxHoi noMoullt
nooqepeaHble yxor'lblB Toqxx xoporKofi fir'lofi Ha r,ly6sHy 0,1 qyHfl c -AoH_rd (3sE)
aKTIBHbIM BpaUIeHIleM tr!'tbt, nay3o! nocrleBpauleFut Il tl3BneqeH]leM
KaK rorbxo nocrpaAaBurxinplaer B co3Haxse,y(onbl npe(pa_
ur,1LJ.

roqKlt B o6,lACTl' HllXHl.tX KOHEttHOCTfn

OA (6An-qvH_Bo)
L TOqXA6ATl,-qvHr
Jloxarx3aqts. A. Ha 3 uyHt Bhl[re BHyrpeHHeicropoHhl KoreHHoro
cycraBa
' (prc. 90, 9l ).
6. B ri,rr6,resar Ha pacrrotl{}tll3 u}HefiHan BHyrpeHsHv yr,oM
sepxHero'xplqxaaxo.reinoi qarllre,]xr.
Ha paccrotHnH I uyHe Han
roqxon xroer'xai (10 RP).
Tonorpaotqecxasanarorurr. [loa xoxHHv noKpoBovB paioHe T,JLi xre I iF
roqhr Haxofltrcflyr,1!6"1eHHe Mexny noprfinxHoi \,tblllrueH H Me_ -

nra,,rbHoii rrpoKoii Mblrxqei 6eapa, flpoMexyloqHaa tlrrpoxat MI'llx'

ua 6eapa, 6eapeHHatxocrr'.
Mbluqbr B paiioHe roqkl,t aHHepBrpylorcHBerBtMIr 6eapeHHoro
{epBa.
Koxa fiHHepBr,pyerctHepaoML3.
Iloxa3afirc. @ypyfi(y,Ie3B 06,lacrx sapyxHLIX fio,'IoBhrxopraHoB
(v' My)r(,{r.rH
), xpanl,|BHrqa.
Tixxnxa. nlnxurr r,1y6xHoli0.5 1.5 uyHf,.npHxxraHlre l0'
Prc. 90. Toq{r
l5 MuH.
3E2
 (KvAHb,rv)
2. TOqKAKXOAH,(OT

Jlo|(aix3aqxr, A- B yrny6,reHl,tn,Ha I uyHb xHapyxH or roqKHJIbIoHr-

Kxay (34 E).
D. Ha 2 uyun Brrrxe BepxHero Kpar Haa(oneHHofiqalxeqKfi; B
yr,ly6reHsu MexAy ulrrpoKoi Qacuaefi 6eapa, Mbruuefi, HarcrlrBaIo-
qefi unpo(yro (Dacquro,fi 6oKoBofimrpoKofi Mbllxqefi 6erpa.
Ionorpaor,rcc|(ar afiaro r|r. no! xoxHHv noKpoBoMs parioHe
Toqxri HaxoAtrct nepeAHlrfiKpafi uspoKoi Oacurn 6eApa,6oKoBat
rxnpoxar M6ruqa 6eApa, npoM€xyroqHar urpoKar Mblrxqa 6eApa,
6eapeHHaaxocrb.
Mbrur[br B pafioHe roqKH r.{HHepBHpyrorcq serBqM{ 6eApeHHoro
HepBa.
Koxa l,|HHepBrrpyerct HepBoMLr.
lloxasaHxr. 6onb, onyx,'rocrb Ko!'reHHoro cycraBa,
r.{yNr,aos(32V9) T€xH[Ka.IIyHKUH'r,1y6uHofi0,5-1,5 uyHq. npuxrraHHe l0-
l5 Mr.,H.

S u o H r - N y a H( 3 3 V 8 ) 3. TOqXAXAK-,tlt|Hb {X3-llflH)
Jloxa,Ir3aqrfl. B yf,ry6reHr1fl,B cepeaaHeBepxHeroKpaq HaaKoneH-
HOt qa[Jeq(x-
(34V8)
sr-naH.-rYeH Tonorpa(Dx.rcc(ar aHarouxr. noA KoxHHM nofipoBoMB pafioHe
roqKn Haxolcrct o6qee cyxoxs,lHe qeThrpexrnaBofiMHtxubr6eApa,
c)\oxHnre 6o(oBofiuHpoxoi MbrrxuLr 6eapa.clxoxr.rrne Menra,q6-
Hoil nJrpoxoft MbIuqhI 6eApa, cyxoxnrre npoMexyroqHofi urupoKofi
MbtluuH6eapa, nepeAHtt cropoHa H xHero KoHqa6elpeHHofiKocrfi,
Mbt[rrbr B pafioHe roqKB fiHHepBrpytorcr BeTBHMI6eApeHHoto
HepBa.
Koxa rHHepBr.ipyercq nepaou L3.
noxa3aHxc. Eon6 B KoJeHHoM cycraBe,nape3 HrxHefi KoEeqHocrlr-
H r o a i s x a v( 3 6 v 8 ) ._ TexHx(8. nyfixqsr r,'ry6rHoi 0,2-0.3 uyHr. npxxrraHre l0--
Xjoek-r'oHr(39v4) IO MIIH,
(37V8)
4. TOI'KA HON,TAT,H9H
(38V8) Trs-raM-dan (alVB)
Jlo(anxsaq t. B yr,ry6r'1eHrn noA HaAKorireHHofi ,raueqKofi, Ha qarlleq-
oy-3uoir (59V)- A s a - H r v - x o i (i 4 2 V 8 )
Hofi cBr3Ke q€THpexr"raBofiuunqu 6eapa, Ha ypoBHe KoneHHoro
T y s - H x r e v - a M( 4 4 v B ) cyc,aBa.
Ho(-ioN (60V)- TonorpaorqacfiacafiaroMxe.IIor KoxfiblMnoxpoBovB paioHe
M a r - N a - H r o a (i B M )- Toqrsj HaxoArrcq: yr,1y6n€r.rresa qaueqHoi cBr3Ke qerHpexrnaBoil
T r a H - M a r (! 6 2 v ) - Mblrxubl6eapa, cyxoxr,rxe noprHqxHoiiMurrlH, HaAKoreHHar qa
r eqKa, lerb Mexay 6eapeHHoi 6o,'rbuie6epuoBoiKocrqM{ B I(o-

M6lrxqH B pafioHe roqxH r.rHHepBlrpyrorcfl

BerBrM! 6eapeHHoro

Koxa rnHepBrpyercfl HepBoML3.

Ilo[a3aHxc. 60,116,onyxnocrb ra BHyrpeHHeficropoHe (oJeHa,
cHtxefiue noIBIixHocTrl Ko{'rexHorocycTaBa,
._ TexHnxa.nyHx{xr rny6rHofi 0,3 0,5 uyHf,.npnxrraHre l0
Pr<.91. Tock,
3E5
 Taflorpa{Prq€c{as axaroMxs. lIoA xoxHbIM noKpoBoM a pafioHe
5 . T O q K AM A T - K A - H r O A f(i B A n - X v A a - [ 3 t H h )
Torrxl,l HaxoAarcq cyxo)Kl,rJl,le ll na,rrtta a,rrssoro crfi6a,e,'IH [a,1b'
Jlo(a.lx3aqxt. A- Ha BepnIfiHe rarepa,rtbHofi noablxKl'l u e B . c o q r e H e r i q eM e x a y I u I I Q a , r a f i r a M [ I ] n a , r b u a c r o n r j .
6, Ha ypoBHe (ocrxoro Bblcryna (narepan6Hat noaHxxa)' Ha lllhrrllqbr B parioHe ro,rxlt ItHxepBxpylorcq BerBblo 3a^Hero 60"rbllte-
rscra,\bHoM xoHqe MaJ'lo6epqoBoirKocr| beDqoBoro
_ HepBa,
Tonorpaoxqec(ac aEaroMltt. llun Koxei B paituHe loqK Ha_ Koxa uxnepenpyercfl rrepBoM Li-
\oaefca HrxHHfi Kpafr vano6cpuoBon hucrr. nql^qHas xocrb Ilo(a3axne. flo3brRbl Ba pBory y xeHltttH, apyrxeH]te MeHcr_
K o x a n H H e p B t p y e r c ax e p B o M S r . pyanbHoro rtrlc'la, ,rpyllHHe poabl, neBblxoa ll?'lallellr6i, BHyTpHyrpob_
IloKa3aDxg. PacrqxeHue cyxoxlrrltt, MbluieqHblecna3Mht lIa Ha_ Haq cMepTb n!'Ioaa,
pyxsofl cTopoHe cTonbr, oTeK HfixHsx xoHer{xocreti, conpoBoxaalo- T€xxlKa. Ilpt{xxranfie 5 l0 nuH.
urrficq noBbrlreHlreMTeMneparypbl Lr o3Ho6oM,
T e x H l | x a . K p o B o n y c h a x H ec n o v o u l t r o r p e x r p a H H o f i H r , 1 L l ' 1 r 9 . T O q K AT t ' l - K Y A H
f l y x ( q e r , ' I y 6 l r H o f0i , 1 0 , 2 u y H n . f l p t x t r a H B e 5 - 1 0 M H H .
Jlol(aJ|x3aq{n. A. Ta xe, .l'ro t roqeK xon (oK (4 Gl) Ir Toqex rxai_
6. TOqXA MAT-KA-{Otlr (HgB-XvAE-U3t Hb) cynr (3 F).
B,,rloKanH3aqrt a H a l r o r x q H ar o r r x a M x o n - K o K ( 4 G l ) B T x a i i - c y H r
Jloxanx3aqrt. A- Ha BepuxHe MeAfianr,Hoi,roablxKIr. ( 3F ) .
6. Ha Hafi6o,,ree BLlcTyflarcueii qacrfi MeAlarbHog "Ioablxxl Tonorpaoxqecxac aHaro rc. AHa,lorrqHat roqxaM xon-KoK
,roqKr Ha (4 GI) n rxafi'cyHr(3 F).
Tonorpaorqechas axaromnc. noa Ko,(ei B palioHe
K
r o a r r c q H u , r t H l , | xf io H e u 6 o J l b u l e 6 e p u o B o i o c l t H n q r o q H ae hoclb llo{a3axtfl. PeBMaroraHL'Ie aprpnrbl, ro,IoBHafl60rr,, pq6!, B rna'
Koxa B pafioHe ToqKril tHHepBlrpyeTct HepeoM Ll I'l't}l Lr, 3ax 6eccoHHuua.
IloKa3a[l|9. Bo,,rbB cyxoxrr'Ixtrx, MhI eqHble cna3Mbl Ha BHyrpeH_ T e x n r x a .A r a , r o r a q n a tr o i . K o r o p s t n p r M e H q F r . nf lp H B o r l e i _
H e f i c r o o o H e c r o n H . J \ 6 H a e 6 o n b B H r . 1 , { H eqf ie r t o f l H . crBaHxa roqr(! xon-(ox (4Gl) r.trxaii-cyHr (3F).
Tcxinxa. flynnuai r,ly6xxoii 0,1-n.2 uvHe. [lp xHraHre 5 [ I p s M e q a H r . { e . T o x r e , , { r ou y r o q K qx o n - k o x( 4 G I ) .
I (l Mr.rB.
6OJIEBbIETOqKII
7 . T O { K A 6 A T - O O t l l (' 6 A " O 3 H )
JloxaJrsaqrr. Toqxs, rae eogrlxxaer 6o"rb npr rex turr BIlbIx Hapy_
JloKanflBaq s. A. y ocHoBaHL{9npoMexyrxoB flanbqeB cTonbl eHIrtx B oplaHll3Me.
6. B qerbrpex flpoMexyrKax Mexay cocenfiriMx ror'loBKaM n.flIocHe- Onp€a€.'refix€ Mecraso3aef,crBr9.Mecro. rAe 6o"I€BbIe ouyllreHI'1fl
sbrx (ocrefi. Ha rpaHlrqe rbubRoi a noaorudeHHofi noBepxHocreal Irp|t HaaaBJrrBafiltll Han6o'lee !HTeEctBHbl-
JIoxa3aH g. 6o,reaue caxgpour,r.
Tonorpaorqecxat axaroxrc. floa t(oi{HHM noKpoBov B palloHe T€xxrixa. f,ry6ara rryHKurI, r.raJfiTerbHocrb npr,txl,lraHnqonpe_
Toqxr HaxoAsrctr qer'lb MexAy cyxoxrnteM pa3rn6are.[t nanbqeB IerttoTct roKar''tlt3alllteuToqex,
It cyxoxnrleM Mex(ocrHoi ME{ulqH TbllbHoil cropoHbl cTonH fIpfi Meqa HHe. lleo6xo,tr.{o M6op a [ l a r bB H x M a H xHea r o ' r x l l ,
MbrurqH B pafioHe roqK uHHepBxpylorct BerBqMfl nepeaHero Il pacno!'IoxeHHbte B Texo6nacrBx,rAe EaxortflTcq BaxHHeBHyrpeHHxe
3aaHero60rbrxe6epqoahrxHepBQB, opraHhr,KpynHbreBepabl, l{poBeHoolblecocyabl
Koxa nnneprr.rpyercnfiepsoM Ls H,lH St.
noxa3a8xc. flpxnyx'1ocr6, Ilo(pacHeHae,6on6, orek, oHeMefiHe
TbulhHoi cropoHH cronH, 3x3eMa. V. KJIACCIIO}I KA UT,Iq TOqEK NO AHATOMIq ECKI'I,U
'
Texxnra. nyHxqre r,ly6Hloil 0,1-0,2 lryHe. npr oreqHocrll Hor 3OHAM
nocle 13Br'reqeHfiq ftr!'IbI Moxllo BhlaaBilTb xan!'Ilo xpoBo.flpuxuraHfle
b-lu MltH. T- e
Bo II- lV paeae"raxro,rKfi 6t'r,'IxnpeacraBneHblno Mept{afiaHaM,
B coorBercrBnn c reopuefi Bocro,rHo* MeAHuxHhI.
8. IOqKA AO(.AM B aaHHoM pa3ae,lenpxBeaesaK'IaccfiOKauut roqeKno aHaroMH-
qecKxMsoHaM,qro aorxHo noMoqb3axpenneHljrcB naMflTrll'11'loka-
Jloxanx3aqxt. A. B cepealne cKnaAKlrfia noAoIrIBeItHoicropoHe ,i13aqfis. To,rxr cljcreMarr3xpoBaHH ropr3oHTa!'Ib_
B cBoeo6pa3Hr,re
II nanbqa cronbl. HbrepraH cBepxyBHr.j3 l, pacnono)KeHbr B rropnnxecnepeaxHa3aa,
B, B qeHTpecKraa('t Mexry I u II oanaHraMfi II na"Ibua cronbl a3HyrpI,lHapyxy.
(c noaouBeHHoficropoH6I).
347
386
 HaMr BHne,leHo7 aHaroMHqecKrrx 3o-. 3, TOIKI IIIEI' t,|3ATb|.DKA
l. Bo,roc craq qacrb 10,1086l. 3arhrnowo-yurHae o6racra. l. "qbr-rbrx(l9TR). 2. Kxsey-aM
2. "rlruega' qacrb ror'roBLl. (llVB). 3. Kxe-Mar6 ( 1 8 T R ) . 4 . X o a H ' x o r( 1 2 V B ) . 5 . E - O o H r
3. lllefiHo-3a, ,roqHac o6nacrb. ( 1 7T R ) .
4. flepeAxnr qacrb ryroBfiua. 3arHro' tas o6nacrr,.6. TxneH-3y( l6 TR). 7. Darb-nao(BHeMe-
0. JaaHfln qacrb rynoBHula. p,{axaHHaq). 8. TxreH-coHr (16 IG).
6. BepxHre KoHeqHocrr. lll€fi ar o6nacrb. 9. Txaen-eyur ( l 7 IG). 10.,'lfleM-ryeH (23VC).
7. HfixHre xoHeqfiocrx. l l . H q H - H r e H( 9
b 8 ) . 1 2 . @ y - q o r( l 8 G I ) . 1 3 . T x r o ua o r ( l 0 E ) .
Kaxaafi 3oHaB cBorooqepeAbpa3Ae!'rexa yrlac, XI,.
Ha orae-,rbHNe 14.TxreH'rr.rHb (17GI). l5- TxneH-Aor (22VC). 16.Kxu-ca( I I E).
17.Kxrcer-6oH (12E).

t. ToqKl,t BoJtocHcloff qAcrt roJlo8bl 4 . T O q K t , |n E P E I H E A r r A c t t t T y , I t O B u U l A

O6nacrDMaryuxx. l.XaM-neM (4 VB) . 2. XroeH-,rbt(5 VB). 3. Xloefl fpya8aq o6nacr6.l. ToaH-Ko(21 VC). 2. 3y Qy (27 R). 3. Kxu-
,lx (6VB).4.KryR-raH ( 7 V B ) . 5 . X o a - n H eryl 9 C I ) . 6 . T x d o H f - t . ) a H x o ( 1 3 E ) . 4 . B a H - M o H( 2 P ) . 5 . X o a - x a f i( 2 0 V C ) . 6 . X o a x - q y H r
( 1 3 V C ) . 7 .X a - x y a H ( l0VC). ( 2 6 R ) . 7 . K x o - S o g r( 1 4 E ) . 8 . t l y B r - + y ( l P ) . 9 . T H - O y H r( B H e M e
nepeqxrr vacfL mnosH. 8. TxaH-anHb(2aVG). 9. M!'cyHr p r a r a H H a r ) .1 0 . T x a H - r a H r( 2 5 R ) . I l . O K e ( l 5 E ) . 1 2 . T r o - B H H b
( 3 V ) . 1 0 . K x y x ' c a n{ 4 V ) . l l . , r I a M - x x a q ( l 5 V B ) . 1 2 . E a H - r x a H ( 2 0 R P ) . 1 3 .H r o K - A b r o H ( lr8 V C ) . 1 4 . , q r H b - k x h( r2 4 R ) . 1 5 . b l H r -
(13 VB). 13.Aay-:rcx (8 E). 14. TxHoHrrr.rHl'(23 VC). 15. Hry-cbl c o H r ( l 6 E ) . 1 6 . X y H r - x h r o H( rl 9' R P ) . 1 7 . A a n - q y H r ( l 7 V C ) . 1 8 .
'Ixren-va
(5 V). 16.Myx-coHr(16 VB). 17.Tur-xon (22 VG). 18.Txbra'(yaH,' T x a u ' Q o n r ( 2 3 R ) . l g . H I o - , r y H r( l 7 E ) . 2 0 . (lMC).
( 6 V ) . 1 9 .T x H b - 3 r H (bl 7 V B ) . 2 0 . T s r e x - a u o(r2 1V G ) 2 1 . T x o x r - 21. TxseH-K\e(l8RP).22. qxen'(aH {23VB). 23. yeH-3n'rb (22VB).
rxuer (7V). 22. Txua-,rllur(18VB). 23. Barb'xoi (20VG) 24 Tbr 2 4 . q y H r - A I r H (hl 6 V C ) . 2 5 . B o - , r a a r( 2 2 R ) . 2 6 . H r o - K a H( l 8 E ) .
rxaH-rxoHr(BHeMeprAuaHHaAl. 25.,rlax-KxbroK (8 V). 26. Cyar_Kot< 2 7 .T X H XA a y ( 1 7 R P ) . 2 8 . K r - M o H( 1 4 F ) . 2 9 . n a i i - 6 a o( 2 1 R P ) . 3 0 .
(8VB). 27.3rx-rou (20TR). Hsr-Hrver (24 VB).
3aarcr .racrb ronosH. 28. TxneH-cyfir (9VB). 29. Xay-alrnb Bepinrr vacrr xxsora. 31. KHy-Br (l5VC). 32. Kbr xxper
( l9 VG). 30. oy'6arb (l0 VB). 31. K6IoHr'3tH(l8 VG). 32. Hao'xo ( l 4 V C ) 3 3 . y - M o H{ 2 1R r . 3 4 . 6 a r - , y H r( 1 9 E r . 3 5 . T x H o H r - K y a H
l l T V C i J 3 . H f o h - r q v ( 9 V J . 3 4 . H a o - h x o Htrl q V B r 3 5 . O o H r - Q ) (13 VC). 36. TxoHr-KoI< (20 R). 37. TxHa,MaH(20E). 38. qyHr,KyaH
r l 6 V G ) 3 6 . O o H f - q r ( 2 0 V B ) . 3 7 . A - M o H( l 5 V G , . 3 8 . T \ n e H . q y (l2VC). 39. AM-ao (19R). 40. "4uonr'r,,ron(21 E). 41. K{eH-nx
( 1 0v ) . l l f V C ) . 4 2 . T x a r b x y a H r 1 8 R , 4 3 . K y a H - v o H( 2 2 E ) . 4 4 . O y K a i t
{ 1 6 R P ) . 4 5 . X a . x y a H( 7 E ) . 4 6 . T \ H o H r - K \ } Kl l 7 R ) . 4 7 . ' l x a l t a l
(23 E). 48. TxoHr MoH( 13 F). 49. TxrcH-oaH(9 VC). 50. Xoar,HtoK,
2. TOq(UJtttuEBOnqACTI rOIOBhl v o n ( 2 4E ) .
Jlo68ar qacrb. 1. 3btoHr-6arb (14 VB). HrxHse qacrb xtrBora. 51. TxaH xxroer (8VC). 52. XoaHr-3y
(16 R).53. Txues Kxy (25 E).54. Iafi-xoaHb (15 RP). 55. ,U,ofi-Marb
O6racrf, rna3. 2 ToaH-qyK(2Vr. J. Hfbl-l|ey (BHeMeplaHaH_
(26 VB) . 56. AM'3ro (7 VC). 57. qyHr-rr,hr(3 TR). 58. Hroafi-naHr
H a r ) . 4 . T r J - ' { y H r . x x o(H2r3 T R ) . 5 . T H H b - v u H tbl V r . 6 . . I l o H r _ r h l '
8 s. Tl .x H a - X J ( a( n| E r ' (26E). 59. Oyr-(er (14 RP), 60. Kxy,xafi (6VC). 61. Txarb-MoH
n H e y( l V B ) . 7 .T x a i - 3 H orf il B H e M e p x a r a H H a
I T H - 6 a r b{ 2 E l . ( 5 V C ) . 6 2 . T u u a a ( l 4 R ) . 6 3 . A a f i - x H( 2 7 E ) . 6 4 . K y a n - x r y e n
(4VC). 65. (xr-xloe,r (13R). 66. Txloq'aao (28E). 67. Hry-xxy
O6nacrh oca. 10. AH-aHoHr (BHeMeptALtaHHac) . ll. To_'lney
(25 VG). 12.HreH6'xHoHr(20 Gl). 13. Hofi-HreHL-xbIoHr (BHeMeplr' (27 VB) . 68. 3lon-aao (28VB).69.9ynr-xux (3 VC).70. Aafi-xarb
(12R). 71. Klon-,rafi (29E). 72. Tbt-KyHt (lsVC). 73. Oy'ca
rranHar). (13 RP). 74. KxyK-Kor(2VC). 75. XoaH6-Kor(ll R). 76. Krr-cyHr
O6nacrb pta. 14. HtH'qyHr (26VG). 15. Xoa-nrey (22TR).
(30E).77. CyHr-MoH ( 1 2 R P ) . 7 8 . K a n - M a r b( 1 2 F ) .
16.Aoafi-aoaH(27VG). 17.HraH-3qo(28VG).18.Ty-ryeH (BHeMe-
p r q H a H H a e 1, .9 . X a f i - r y e H( B H e v e p x , [ u a H H a2q0)..K x M - r a H{ B H e _ n€peAHcc qacrh npoM€xHocrr. 79. HaHr-Ae (BlreMeprararran) .
Mep AraHHaq).21. Hrox-3srL (BHeMepx!HaHHaer. 22, nf,.'z'lxbtoBr 80. Xofi-aM (l VC).
( 4 E ) . 2 3 . T x H a ' r H o H (r 2 4V C ) . 5. TOrtXl 3AtrHEn rrACTl,tTyJIOBI{ulA
l{€qro.nrqeBar o6nacrD. 24. KyeH-nney ( 18 IG). 25. Khl''Illey
( 3 E ) . 2 6 . 3 r n - c a ( 6 E ) . 2 7 . A a f i - H r e H (b5 E ) . CnrHHo-nr€qeBar o6nacrb. 1. KHeH-rbrHb (21 VB). 2. ,l.afi-rror
O6nacrL yoren. 28. Hu'rhIeM (BHeMepnAuaHHat) . 29. Hfi'MoF (14 VG). 3. Crcex-rbIK(BHeMepnasaHHaF) . 4. Kren-,{yHr-3y(15 Ic).
l 2 l T R ) . 3 0 .i x n H L ' ( y H r ( I S I G ) . 3 1 . T x ; H b - x o n( 2 V B ) . 5 . T x D e H - n x e(yl 5 T R ) . 6 . K h r - K o r( l 6 c l ) . 7 . A a o - a a o ( l 3 V C ) .

388
8 . A a f i - q H( l l V ) . 9 . K ' e H - H r o a f i - 3
( ly4 I G ) . 1 0 .D r H b - O o H( rl 2 l G ) . ( 8 C ) . 5 7 . J l a o - r y H r( 8 M C ) . 5 8 . T a M - 3 t H( 3 G I ) 5 9 . 6 a r - r a ( B H e -
l l . K x y K - B n e(Hl 3 l G ) . 1 2 . H r o - 3 y( l 0 l G ) . 1 3 . < D o u r - u o (ul 2 V ) . MeDHrrafrHar)-
_
14.Oy-OaH(41 V). 15.TxaH-qy(l2 VG). 16.Oe"3y( l3 V). 17.Oarb' O6nacfs nanbueB pyls, 60. TbIeH-I(oK (2 IG). 61. 3nrb-MoH
xo (42 V). 18. Kyer-av sy (14 V). 19. l(ao-roanr-:y (43 V). 20. ( 2 T R , . 6 2 . H r . 3 e H{ 2 C i l . 6 3 . T H Q y H rl B H e v e p H n r a H H a6e4) H r y -
T x x e H - r o H( rl l I G ) . 2 1 . K H e H ' q r r H ( 9b l G ) . 2 2 . T x a s - a a o( l l V G ) . x o t B H e M e o H n r a H H a6r l5. , t [ a i _ x o r _ x \ o H i ( B H e M e p HanH H a t ) .
23. TaM-3y(15 V). 24. TxaH'abroHr (44 V). 25. ,'lnxb-aan(10 VG). 66. THev-Kor.K-xoHr (BHeMepfi!l,laHHae). 67. qyHr_KXoi (sHeMepH_
26.AoK'sy ( l6 V). 27. 14-xH(45 V). 28.Tx-3broHr (9 VG). 29. Karb-3y a H a n n a i l .6 8 . T x r e y - u a r s ( l I G l . 6 9 . T \ r e'-cyHf tg C) 70 Ky€H-
( l 7 V ) . 3 0 .K x l l - c | o e(xa x e u e p r 4 a a r u a a3)1. . K a r 6 K y a H( 4 6 V ) . 3 2 . c v H rt l T R t . 7 1 . T ) , b t o H l hr l o B f ( l C l ) . 7 2 . T x x e y - r x b r u lHl liP l
KaH-cyK(8 VG). 33. KaH-3y(18 V). 34. XoH'MoH(47 V) . 35. qyHr' 63. Txan'ryex (BHeMepxruaHxas) . 74. qyHr cyHr (9 MC).
Kxy (7 VG). 36. Kr.j-qyx-Ma (BHeMepr.,lraBHaH). 37. ,4oM'3y(lS V).
38.3HoHr-KbroHr (48 V). 39. Tbrr, ,ryBr(6 VG). 40. TH-3y(20 V). 41..
l4'ca {49 V). 7. TOrtXI HXXHl.lX(OtrEtlI|OCTEn
O6racrb norcHxqu. 42. B{'3y (21 V). 43. Bn-rrHoHr (50V).
44.XloeH-xxy(5 VG).45. TaM-rhrey'3y (22 V). 46.XoaHr-MoH (51 V). O 6 r a c r h6 e a p a .L A M - , l u e v( l l F ) 2 H r y - , r H( 1 3 G I ) . 3 . 6 e - k y a H
47. Er'Kafi (BHeMep[AHaHHaq). 48. KrH6-MoH(25VB). 49. MeHb- t J l E t . 4 . K o - u o n( l l R P ) . 5 . A H v o H ( 3 7 V i . 6 . o y x - r x o { 3 2 8 ,
uon (4 VG). 50. Txau-3y(23 V). 51. Tx-rxar (52 V). 52. Kxr-iafi-3y 7 . O o H r - r x nt 3 l V B ) . 8 . q y H r - a o K( 3 2 V 8 J . 9 A M - 6 a o{ 9 f ) . l 0 . B a f b '
(24 V) . 53. 3HoHr-KyaH (3 VG). 54. Aan-qbroHr-sy (25 V). 55. Hey- q y H r - o a ( B H e M e p x a n a H H altl,.. A M - r x l , l 3 3 E r . 1 2 . X r c e ] - x a f t
HqH (BHeMepHAfi aHHarrJ, t ' 0 R P t . 1 3 ., q b l o H- Kr x a y( 3 4 t ) . 1 4 .K x o a H - K o(rB H e v e p u , [ r j a H H a e ) .
t.oAxqfiae o6,iacrD.56. KyaH-HryeH-3y(26 V). 57. TxhroHr-,rlrey Koaexxac r noa|(oreHfiat o6,ractr. 15. Xax-Aaal (BHeMepuaHaH-
(31 V). 58. THey'qHoHr'3y(27V). 59. Txbr-,rrey(32V). 60. BaHr- H a r ) . 1 6 .3 6 r o H r - K y a( 3H V C ) . l 7 . O y - K x x r L( 3 8 V r . l 8 . H o n r a r - H s H
K y a H f - r )( 2 8 V ) 6 1 . 6 a o - x o a H r( 5 3 V ) 6 2 q l H r ' , 1 H l e( 3 3 V ) 6 3 ( e x i v e p r a n a n x a n )I .9 . n o K - r H ( 3 5 E ) . 2 0 . K x y K - r y e (H8 F ) . 2 1 . A u '
tl!Hr-rbr-ryr29 Vi. M. I,Iey-4 {2 VC). 65. Xa-,1xey(34 Vl.66. Earh- xox (10 R). 22. Ytt-uyur (40V).23. yt'sHoHr (39V).
xoaH-3y(30 V). 67. qar'6neH (54 V). 68. XoaH-Kxrey{30 VB). 69. O6nacrb roneEx. 24. AM-,'raHr'ryeH(9 RP). 25. 3blo8r'naHr.ryeH
Xoi-3b'oHr(35V). 70. qItoHr-KHoHr(l VG). 71. TxI-ra-Oy(36V). (34VB).26. Tar-xyaH (7 F).27. Xon-3brour(55V).28. Tyx-rau-,ru
72. X H-,rl,€yr29 VB) (36 E) . 29. ,U,sa-xo(8 RP) . 30. TxLIa'KaH ( 56 V) . 3l . TxHoHr-Kb'-xbl
1 3 7E t . 3 2 . q v H r - a o ( 6 F ) . 3 3 . , [ . H e r - x x a v( 3 8 E ) . 3 4 . o o H r - n o H f
6. TO9KI,I BEPXNtlx KOHEqHOCTEN
i 4 0 E j . 3 5 . T i H s - c o H{ 5 7 V ) . 3 6 . " I l a y - r o ' r{ 7 R P r . 3 7 . X a - x b r - x b l
06racrL flneqa. L KxeH'qy-Koi (BHeMeprAxaHHaq) . 2. KreH'HryHr (39 8) . 38. 3broHr-3qo(35VB).39. Hroafi'rxay (36VB). a0. On-
(l5Gl).3.KrcH-nrcy ( 14TR). 4. Kblx-ryes(l C).5.Hrc-xofi( 13TR). r b r o H {r 5 8 V , . 4 1 . q y k - r a H( 9 R ) . 4 2 ., l a f i - K a y( 5 F ) . 4 3 . K } a H r ' M ' ' r H b
6 TxHpH r v e H t 2 M C l . 7 . T b rH r o ( 1 4c l r . 8 . T \ f e H Q y ( 3 P ) ( 3 7 V B ) . 4 4 . T a M - a M - { s (o6 R P r . 4 5 . 3 b I o H r . S yl J 8 V B l . 4 6 . X r e H -
9 . T u e v . a a i ( l 2 T R t . 1 0 . X r e n - 6 a r bt 4 P ) . l l . T \ a H h - ' l t t H(b2 C ) rroHr (39 VB) . 47. 3Ho'rHH (8 R). 48: oyx-,'rbly(7 R). 49. @y-3bloHr
12. Hry-,rs (10 F). 13. Txaxr-,raxs-iex ( I I TR) . 14. qHy-'rney 1 5 9V ) .
(l 2G r ) . O6nacr6 roreHocronrioro cycraBa. 50. qyHr-ooHr (4 F). 51. 3flfi-
JlorreBac o6nacrb. 15. T{xey'xafi (3 C). 16. Kxyx-qarb (3 MC). xxe (41 E). 52. Kxay-l(xH (40 VB). 53. Txafi-xxe (3 R). 54. Kott-.notr
17.CHrb-qarL(5 P). 18.Tbrey"xafi(8 lG). 19. TxneH-rH,Hb (10 TR). (60V). 55. Aafi-rloH. (4R). 56. Mar-xa-qoHr (BM). 57. Mar-l(a-
20. qbry-rbr€M ( BneMepnAn aHHar) . 21. KxyK-qIl (ll GI)'. Hroaft(BM). 58. TxHou. xxay (5 RP). 59. Txey'xait (6 R). 60. Txlol,l-
O6racrL npcaflne,rbc.22.'lxyla},-nu (10 GI). 23. TxHoHr-,,rteM r v" e H ( 5 R ) . 6 1 . T x a H - M a r b( 6 2 V ) . 6 2 . 6 o r - r x a u ( 6 1 V ) .
(9 CI). 24.Xa',IIjeM(8 GI). 25. KxoHr'rofi(6 P). 26. Tbr'Aox(9 TR). O 6 n a c r bc r o n H . 6 3 . H r e H - x o K( 2 R , . 6 4 . C y H r ' 3 b l o H{f4 2 8 )
27. Kxrrb-MoH(4MC). 28. Tx'rnHL (7 IG).29. OH-nEIy(7GI). 65. KHM-MoH ( 6 3 V ) . 6 6 . K o H f . r o H( 4 R P ) . 6 7 . T x a n - c y x r l 3 F )
30. Ha-6ars ( sfieMeprjAuaHHar ) . 31. TaM-3broHr-raK (8TR). 32. 3tH- 6 8 . l y K r a M - K x a n ( 4 1 V B ) . 6 9 . K H H b . K o r( 6 4 V r . 7 0 . T x a f i 6 a r b
cH (5 MC). 33. Xofi-roHr(7TR).34.Tr'(ay (6 TR ). 35. TxueH-nrr6 ( 3 R P ) . 7 1 .X a M - h o x( 4 3 E ) . 7 2 . . I l r a - H r y - \ o ir 4 2 V B r . 7 3 . T : r y x - r o r
{6 Cl). 36. Hofi K}aH{6 MCl. 37. Hroafi-xyau l5 TR). 38. .nHHb-aao ( 6 5V ) .
t 4 C ) . 3 9 . " r l H e r . K - \ r o(e7rP ) . 4 0 . T r o n r - a r ( 5 C ) . 4 1 . X r H b - x b r O6nacrbnanbqeDcronu.74. Ia -ro (2 RP). 75. XaHb'3cH(2 F).
(8 P) . 42. 3HoHr'nao(6 lG).43. Au'xxrrr (6C). 76. Hoi'aBHb (44 E). 77. Xqen'xxe (43 VB). 78. Txosr-KoK(20 R).
O6racr6 ryqBanccr8oro cycraBa. 44. TxaH-MoH(7 C). 45- Aait- 7 9 . E a r - S o H r( B H e v e p x n x a H H a8g0)..A H . 6 a r b( l R P ) . 8 1 . I a f i _ n o H
,ranr (7 MC).46. Txan-yeE(9 P) . 47. 3brolr-xox (5 IG).48. 3bloHr- ( t F r . 8 i . , r l ea o a i i 4 5 E l . 8 3 . T 1 x - x x r e ya v t 4 4 V B I 8 4 . T u - a v
qH (4TR). 49. IlyHr'rye (BHeMepnAEaHHar)- 50. 3bloHr-(xe(5GI). (' 6 7V ) .
O6nacrh naaoEx. 51. yeH-xm (4 IG). 52. Hrhr-r3 (10 P). 53. Xor- O6racrr noao[rBu crol|H. 85. AoK-aM (BHeMepLraIraHHaq) .
Kox (4 GI).54. rIyHi'-rbbr(3TR).55. Xay-Kx€{3lG).56. Txsey-Oy 86. 3yHr-ryeH(l R).
390
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I 4 r , r H c r p e x r p a H H b r , M o c r p u e M . A u a . r o r r q H Hc o o r s e r - Pi.. 91. 8rA!, ,rr, npNleHreMhrr cospeMe(HErr, ,r,otepano6raMr.
cTByrorurM apeBHfiM r,rrnaM. Ha koHrle r{MeroT Tplj ocTpbre rpaHr. I - r o p o r x r . x r r H ; 2 - r p e x r p a H H . r! r n . ; I - a ' r H H 6 t r r , . ; 4 * N r n h F x N o n k ,
lrprMeseroTcq anq noBepxHocTHhrxyKo!,roBc rlerbro KpoBonycKaH 'I. {An' .yp,xy,or€pa.x,); 5 - aHoro,ror!c.r6';]Monoroq.K.

39?
 11r n r,r- K H o n K r.r (B a y p t] K y n o .r e p a n x I,) . Hr,rbr HoBoro Hbu tul x Heo6xoafiMo rulare",rbxo nporeperr, Baroi r,ru MapJeri co
Ttna. IrprveH9brcq ,ilr xo)rHHx )xoJloB c laKpe rleHreu HfJl Ha cnrpToM fi Hacyxo Bbrr€pefb.
o n p e l e r e H H o eB p e v e B o 6 " 1 a c r r y u l H o i p a K o B r . i H L r . Heo6xoaxMo oro6parb or|yrde I nprrynxBursecq rrrH, abrrrprr
M H o I o r .|1o " 1b q a r b i i v o , l o r u q e K Tanr{eutHucfilcsKHt- Mli'rb n 3aroqurb xx c reM, lrro6br He repHrb BpeMeHu Ha or6op Bo
r'IaM oBoro rfina. C,lyxrr A,'rr Bo3AeficTBtn cnoco6oM <{Bere-
Hllt> - noxonalrrrBarIHgflo noBepxHocTx Koxu. yx"0aAbrtsa,! rrrbr B (opo6xy c,relyeT B onpea€reHHoM nopraxe:
2. ClepfirbHaq sara. Bara Aon)KHa 6blrb 3apaH€e noAroroBreHa pyq(aMfi B oaHy cropoHyj ocrpusMt{ B.qpyrylo, npuqeM Me)KAy Me-
B BrAe He6o"rburfix TaMnosoB Anr o6e3BpexxBaxrfl MecTa yKora Ta,r,llqeckoji creHKori xopo6Kr.l a ocrpfiqMfi ,qo,'txHa 6bnb npo,roxe-
nocr''reBuBeneHxr trL'Ibl, Ha firrxar creJrrxa, npeAoxpa|srcqan qx oT npurvnreHtrr_
3, Cn*pr Anc cr€prnrcaqxx(HeHrxe 70.). rrpx 4,rfiTe,rr,HoM nepepHBe B noJrb3oBaHr{r'tfirraMr'r l,x HyxHo
4. ABe (opo6oqx,AJc xpaH€Hrig
xrn. OAnanpeanasHaqexa
&,ts xpaHrrTr, B cyxoM, xoporxo npoBeTpxBaeMoM MecTe.
rroAroroB!'leHHbrx x )norpe6,'teHlrrccreprnn3oBaHHrnxfirn (BMec,rn- 3. llcnpaf,refire n . Xorq ur,1u r3roToareHH y3 npo,{Hoii, 3,ra-
v o c r be e o T 3 0 a o l o 0 u t y K ) , , q p l i d r n " r r h c n o , r b r o s a H H b J \ . cl ,rHoi HepxaBcrourei cta,1H, fev He vexee, 6\ay,rx o,teHbroHKx-
5. llBa nxrruera. OnrH npenhalHaqefi&]tr flepr.rrroBa!rbrx MX. OHfi HepeAxo xcxpflBr9oTcrr, rynqrcq, qro co3aaer rpylHocTti B
rrr, lpyron- Arq TaMnoHoB, ynorpe6JlseM6tx npx crepfi,r|3a(}|ir M a H H I ) f l x p o B a x H r H M I B U B p e M sc e a H c a H B b j l u B a r r 6 o , l e B d e o u r y .
u p H n t ) n a u H e H r d . J r u r p e 6 \ . t 0 1 B p a q a B r l a A e H H er e y H l r h o i i r | c
6. Ase crepxrbnHe 6axxx Anfl 3apaHeenprroroBJ,reHHbrx
nponll npaBnesHr r.rrn.
TaHHTJX CntpTOM qtCTbrX TaMnOHOB r Altt rcnoJ63oBaHHHx TaM HcnpasJrcHxe crepxHfl I r , r r , rH . e o 6 x o T r x uc op a : y o r -
6paxoBbrBaTt, l{ribJ co c!'reAaMx norHyrocrx H pxaBqtHbr la)xe noc-
7. 3ManxpoBafiEHInoAfioc.Ofi Ao,,rxeH6brrr,rocraroqHo rorpo ,1e ronbrTKlt B|rnprMrrb, oqucrt{Th l{x, }160 Tai<re rtuhr Moryr cro-
I(lrM, qTo6H Ha HeM Morrt noMecrfiTr,ctBce nepeqr{c!,IeHHbte
tlpeA MaTbcfl B nDcr(ecce vKarlbtBaHuq_
MerH. O6brqHoloib3yroTcr nogHocaMllpasnepol,{ 18X24 cM. flpr caa-oou lcxiua,relrr crepxHn lrj.lbr ero MoxHo BbrnpqMurbi
MHorokparHo nporflraBar MexAy cxarbrMq 6o,j6rrrfiM fi yKa3arer,rr,-
xpAdLH q
r. nPuHuInbt HcnoJIb3oBAH|,|t. H H M n a n b r l a M f i ( x e n a , e J l 6 H o c x B o 3 bc n o f i M g r K o i T K a H x ) B H a n p a B -
T I I I C T I P A A J I E H I { ' U T T O T E P A N E B T U I I E C I ( l , ' XT ' H C T P Y M E H T O B r e r x H n r p y x o q r K Hf i n i r p H r o H r r H f l p r n p o r u x a e r r a n o r r y i u r o
yqacr(a nanbllLl oKa3brBaror aaBresfie ts cooTaercTByroqyro cTopoHy,
1. Iloib3osafire xficrpymefirapreM. nepea KaxAr,rM ceaHcoM rrno- nocreneHHo aHnpqM{,rrfl crepxeH6. [lpH Hcr(pfiBn€H ]r t{rnbr B He-
y8..a,']riBaHr,rfl Bce rrncrpy^4eHrbi xeo6xor],Mo noABeprHyrb ruarer'rL- cKoJrtKltx Mecrax, nponyc(ar ee Mexay ranbuaMfi, craparcrcr BHa,
Hoi crepll,rn3aqrx, B HopManr,Hbrx coBpeMeHHbrx ycr'loBarx Ain qale cBecT! Bce norHyTble ylracTl{r B oAr{y 6on6uyto !yry, KoTopyto
o6e33apaxrBaHrq sr,r, Mera,l,lHqec(ojl xoio6xn a,rr irx xpaxeHrc s 3areM HcnpaBnqror yxa3aHHHM B6rme cDoco6oM.
nqHqera, koropbrM 6epyr fir,ry, AocraroqHo npokrrrrrrl.trb fix B reqe- Hrft,r. TpoHyrl,re pxaB'JxHoii, co6spat.or B nyqox. yxnaAHBat
nHe l5 Mr{H. llpr Ilanuqfir noprarfis}roro aBroKJraBa eqe nyqulle ucrpfiflMx B oaxy cTopoHy, |, pacrr{pa'oT Mexay naaoHsMti ao Tex
c r e p f i r x - l o B a r hx x c r p y M e f l r H a n a p y l n p r l e v e p a r y p e 1 2 0 " ) B r e - nop, noxa pxaBqltHa He Hcqe3He,r. JaTeM HaqrQTo npoTr.{paxrT r,tx
q e H f i e: / U r r r R . b a H K f i l r n o ! H o c n e p e 0 y n o f p e 6 n e H r H Mc J e n y e t n p o . Mapner rl npoBepflrcr, Her r'rHxrn, rroTeprBrxrx rJsHeu B MecTax, fae
leDeIh /u- cnnoToM. oH"l,q Har'IeTbIpxaBqrrJbl.
^axlou firJror npo 3BoAr.jrcq ro,lbKo oltiH yKon, nocr're qefo ee tlcrrpaBr''reHfir ocrpnH xrrH. 3 a r y n f i B u l l e c r t l r n b rc o 6 B ,
cneAye,r o,noxfiTb B oTAenbHyro Kopo6Ky. l,lcnorb3oBaHHbre Hrr''rbr paroT B nyqok ( 3 HecKo"lbxrx IecqTKoB uryK), BHpaBfiHBarcT ocT,
npo,xparcr BaTHHMTaMnoHoM,npI Heo6xoAr.tMocrt,I,rx BHnpeMnrroT! prr no xpoMKe cTo,ra (srJ'rht lrpq sfoM rlexaT Ha noBepxHocTa cTo,
3aTaqr{aarcr|,l HenocpeAcrBeHHonep€n ynoTpe6neHseM crepxnH3yro,r ral. HahialbrBa|or {a Hr\- MerlK}to HaxlaqH}rc 6\Mar} tasa H"1r.1
r p l l H l ' 1 9 , H a p a c c l o e H L l l lU . b L M o t o . t p b t x k o H t l o B 1 1 ,( H , 1 L , H o nDH.
Heo6xorr.ruo [oMHlrb, qro MeroA rrxeab u3lo Bo3HlrK B Te aa- xrMac 6yMary na!'rbuaMfi, HecKor'16r(o pa3 npoBoArr en no HafipaB-
J1€xrc BpeMeHa, Itofaa enle He rMelrocl, noHtTrq o cTepr,,Ir,HocTs. ,eHrrro x ocrplrM. oAHoBpeMeHHoc,,rerKa Bpaqan rr"ru. B pesyntra-
qTo He Mltlo He npr.{BoaHTbK oc,loxHeHtqM rIpH lcno,It3oBaHtH
re ur!'rbr tle ro.rb(o fipro6peraror Heo6xoAtiMylo ocrpory, Ho a coxpa-
M€Tola. b HacTortlee BpeMr Mbl npexpacHo orAaeM ce6e oTqeT, x Htlor Heo6xoA[Mbri npo+r,'lb Ha oc.rp]rqx.
KaKrrMnary6HbIM tloc-leacrBIIqM Moxer np&Bec,rn3aDaxeHxe. B oco-
6 e H H o L T o r v e A f i u H H r x o r ol n c r p y n r e l r a , n o s T o M y I l o r x H b l l e r a t b 4. OAXTOPbt, CnOCOBCTBytoUll,t,EnoBLtI[Et {to
Bce Bo3Mo)I(Hoe,qro6br r36exart, HeAocra,rKoBaDeBHeti qxeHb-u3lo- SOOEKTI{BHOCTIIXT!'IOYXAJIbtBAHI,''I
TepanII,I, [|os€A€Hre spa.ra Bo BpeMr cea8ca. Anq 9O0e(TuBHoro npl,l]\{eHeHut
2. XpafieHx€ alrcrpyllteHra. flocne rcno,rb3oBaHHfl axynyHKTyp- MeTOA€ nrnoyKalrrblBaHrrs, KpoMe ToqHoro AtatHo3a, DpaBHr''IbHoto
394 3e5
rro!6opa ro.re( lt yMenoro MaHrnyJIr,rpoBaHqttr,'IaM , xcx!'Ilorlfirenb
Ho BaxHoe 3HaqeHre npxo6peraer noBeAeHre 'rar'Iorepaneara, xoro-
poe AonxHo rapaHTxpoBaT[,AoBepre I( HeMy 60,lbsoro, ']To tBrterctt
HeMa{'roBaxHbrM Qa(TopoM, cnoco6crByroultM ycnexy reqeHx'{.
Cep6e3Hoe, Bex,rr1Boe, 406poxe,rare,'rbHoe orHoueHIIe K 6(:)'lbHoMy
B6r3brBaeT y Hero AoBeplje K Bpaqy, fi oH oxoTHo sblnolrHtler ace yxa-
3afir9, coAercrByqnpoqeccy,reqeHfin.
To,r6ko npx yBaxxr€,rrbHoM orHoueHlrlr x 6o"1bHoMyxaK K 6rx3-
KoMy qe,loBeKy oH aoaeplrr Bpaqy cBoe 3!opoB6e, orKpoer eMy Bce
cBox rpeBor! Il coMHeHrn. B 3ToM 3aKnlo,{a€rct Heo6xoAfiMbli ncu-
x o , r o r r q e c ( r i i o a x , o p r r , r o , e p a f l e B T H q e c x o r oM e r o a a , T a x K a x n o r -
saq, oTKpoBeHHaq sHoopMaqaq o ToM, qro 6ecnoxotr 6o,'ItHoro,
o pa3Br.i,lr{Iloarororxqecxrx npoueccoB noMofaer Bpaqy rlrlare,rbHo
c,,IeAr.rrb3a 6o,1e3Hbro,cBoeBpeMeHHoBHocarb r.{3MeHeHUg B M€ToaI,l
Ky r'rerreHrqB coorBercrBl.r}{ c reM |,lr'It rjHbrMgranoM 6ore3Hg. yMe-
n o e p a I b e c H e H l { e6 ( ) , r b H n M ]n p e n c r o s u r l , t , r e q e 6 H b l xo n e o a u r f i , c n o _
KoiiHHe. Heropon,rxBhreaeicrBar Bpa.ra noMoraror lr36exarb HeHyx
H o i H a n p r x e H H o c r r 6 0 " ! b H o r oB o B p e M qc e a H c a .n o B H r u a r o r9 0 O e K -
rrrBHocrb pery,rxpyrcuero Bo3aertc,rBxqyKo,'roB,
BH6op no,roxeHrfl 6onDHoro. flo,'roxeHxe 6o,r6Horo Bo BpeMr
ceaHca rfnoyxanHBansq tMeeT. flcxJroqx?e,IbHo Baxfioe 3HaqeHlte.
Bbr6op nonoxesBq Kaxlbril pa3 AonxeH onpeaenrrbcrr roqKaMfi,
IO,qr'Ie,l{aIlIlrM n BO3IenCTBIr().
OcHossbre npflHunnr,I, KoropbrMn cneayer pynoBorcrBoBarbcq
nps Bbr6ope nor'roxeFrs 6o"rbHoro, cocrorr B c,,reayrcqeM: P x . . 9 a . n o r o x e H r e 6 o r B H o r o< , a r , o r ( N H y 6 u , < hH . c n , H k y 8 P e c r . .
l) ToqKIl. noAnexaUre Bo3AeicTBrro, Ao,rxHbr 6HrL ,rerl(o Ao
cTynHH a!'rr yKoia;
2) BbI6paHHoenoJroxeHrre ,qorxHo 6Hrb ylo6Ho A,rH 6o,'rbHoro, H a c n s H e , 6 o x o B b r xc r o p o H a x T y n o B x u a , H a p y x H o i i r 3 a A H e i c r o p o -
qTo6bl oB Mor AoclaToqHo lo!'ttoe BpeMq HaxolfiTbcq B oAHoM nono, H a x p y K , H a 3 a n t r c T 6 e ,r b r r r b H o i ' r B X y T p e H H e t c T o p o H a x , ' r a a o H x .
xeHfiu, TaK r(a( npli cMeHe Do3bl Bo3Hrrxaror qoneBbre onryuleHrq n, . 4. Ctln.e 3a cronoM, cx"'roHnBuiflcb Ha pyKr, flpnM€HH€Tct npx
KpoMe Tofo, Bo3MoxHSl xcxpfiBieHfit, a ,ro x no!'IoMKnnrrr. BO3AetCTBfiIjHa TOqXr Ha MaKyUIKe, 3aAHet CTOpOHerOJ'IOBrrr, Ha 3a
IlonoxeHre 6onbHoro 3aBr.{cur or rtoKar'r}l3aqllfi ,roqex, Bbr6pas- TbJrxe, 6oxoBbrx cropoHax IlIlIefi,3aAHefi cropoHe n,re.r, Ha cnfiHe, 60-
(oBHx cropoHax rpyaHoi xrerKq , xfiBora, Ha HapyxHoii rr saAHei
Ilo,loxeHxe c Iq. CyurecrBy€r7 nonoxeHxfi cnAfl, rrcnorb- cropoHax pyKr.r,Ha HapyxHoi rj 3aAHeii cropoHax roKTeBoro cycraBa
3yeMsrx npx xrnoyxanbrBarrsIl. (prc. 97).
L CrAt, orxrHyBrxHcr, Ha cndHxy (pecna. flpnMeHsercr npt 5. CaAfl 3a croJoM c BbrDprMreHHofi cnuHoii, npr Bo3aeficrBltt
Bo3AeicrBtrl Ha roqK, n€peAHei '{arru ror,roBbr,nr.jqa, nepeAHei qa- Ha Toqr(a roJloBbr, !'rxqa, utet,3aTL,IrKa, ylllHLIX paxoBHH, coIrHLl,
( r r i u e r . r p y n r , n e p r n H e f iq a c i l , { n " l e , r . a p l x H o i H ? a t r H e i . r o p o H nneq,6o(oBbrx cropoHax ryrloafiqa, Ha HapyxHofi H 3aaxefi cropo
p l K . r b r , l b H o Uc r o p o H r , rh r c r e f r p y k , a l l x H o i r I n e p e a H . f r t r o p o n Hax py(, l, noKreBoro cycraBa (prc- 98).
H o r , r b r , r b H o nc T o p o H b cr r o n ( p x c - 9 4 ) . 6. Cx,Aq 3a cro,rroM c Br,lrqHyrbrMr nepea co6ofi pyKaMx. flpr
2- CfiAe, o6,'roKorHBrur.ic6 o cro,rr, ynepeB to!6opoAo( B ,,raAoHx. yKonax B ror{Kx ro!'roBbr,rnua, uerr,3arbrnKa, yuHrrx paxoBHH, cnfi-
I I p r M e H q e r c r n p H B o r n e f i c r B H HH a r o q x H H a r o , 1 o B e ,n e p e t r H e i ci r o - HH, rrrreq, B ro'rKl{ Ha 6oKoBbrx cropoHax rpyAHoii K,ner(II u xxBora,
p o H e , ' r n u a , H a r a r b l f l K e , c n H H e .B o 6 , t a c t l , | , l o n a f o i { , H a H a p } x H o f i H a H a p y x H o i , a H y r p e H H e f ir n e p e A r e f i c r o p o x a x p y K q , , ' I o K T e B o I o
cTopose n!'req, Hapyxsoi x 3aasei cTopoHax npeAnr'reqbr I,l 3aDr- cycraBa fi 3anqcrbg, Ha o6ofix Kpaax Kxcren pyK, nepeAHei r| 6oKo-
c T b f l , H a M e a [ a , ] b H o MK p a e r T H J r b H o ac T o p o H er ( l r c r e H p y K { p u c . Boi cropoHax nanbueB py( (prc- 99).
95, 96). 7. CrlaF sa cro!'loM c pyKaMn, corHyrbrMr.rB ,,roKrqx. llpt{ Bo3Aeii-
3. CxAt 3a cronoM, no!'roxl{B ronoBy Ha6oK, a npe.qflreq6e py CTBXXHa TOr{(X rOnOBH,,rnUa, ll]leu. 3aTbIIKa, yluHr,rX paKOBLrH,Cnq-
Kfi. IlpnMeHteTct npx yKo,rax B Toqxfi, pacno,roxeHHlie Ha 6o[oBofi Hbl, nneq, rpyafi, ro,rtn ra uapyxxoi, flepeAHefi n 3aaH€i cropoHax
noBepxHocra roooBbl, rrex, yrrrHLJXpaKoBIlHax,3aAHet cropoHe x,1eq, p y ( . H a H a p y x H o u f i 3 a I H e H c T o p o H a x r o K T e B b r xc y c , a B o B , n p e a -
396 357
 Pr.. 95. no,oxeHre 6o,bHoro Prc. 98. noroxeH,e
ctAe, o6nokorx.urc! o cron, yne- 6orbHoro <HAr 3a cro-
peB noaoopoAok B n.ao|q, noa c .h'nPrdreHHo;

Pr.. 96. nonoxeH,e roroay ra6ot

Pr.. 97. nonoxeH,e

6orbHo.o crar 3a cro-

Prc. 99. noroxeH,e 6orsroro crsr, <ron B66tByrb,e PyK!.

 Prt. l0l. noroxeH,o 6orsroro rexa ra 6oxy.

pr.. l0!. noroxeH,e 6or6Horo ,exa Ha .drHe.

Pr(..i00. flonox€H,e 6onbHoro .,A', cron pv{r, corivrbre

flJreq ii |r 3antcrxii, Ha HapyxHoM xpan rHrbHon floBepxHocrfi Knc-

reri, Ha rHnr,Hofi cropoHe flar'IbrreBpyK (pnc- 100).
Ilo,loxeHtle r€xa. IIpl ur,royxa,rr,raanul xcno!'rBylorcq c'reayrc_
tuue noro)keH g !'lexa
l.,rlexa Ha 6oxy. flpl yxonax B roqKr Ha oaHoii ti3 6oKoBblx
cropoH roroBbl, "!aua, lxefi fi 3aThlrlKa, Ha 6oKoBoii x n€p€AHefi cro
p o x a x r p l a u o n K r l e r K hh x , l B o r a . H a H a p ) , ' { H o i l e p e l H e f r r a a H e B
c t o o o H a ) \ B e D x H t r xH H H x H x x h o H e q H o c r e f i H a 6 0 K o S o i x J a n H e l ' l
c r o';2o, H a x t r o a l u ( p x c . l 0 l ) .
qacrfi
,tlexa xu cniHe npH BulaelicIBHr Ha roqhH nepeaHeii
r o n o B b r ,, 1 r u a . r p y a u . x n a o r a . u e . I l e p e a H e f iH H a p ! ) + ( H o f r o p o H
c r
n J l e q ,n e p e ] l H e i ,B H y T p e s H e xi H a p y x H o n c l o p o H a F p \ H r x H H I ] x H I r x
KoHeqsocrei, THnsHOfi CTOpoHbII(tCTei I,l cron. Ha [oaollBe Hor
( 'p a c .1 0 2 ) .
3. Jlexa HaxrBore. IIos Bo3aetcrBrnHa roqxri Ha 3aaHellcro_
o o H er o , l o B b l ,J a l H n K e , 6 o x o B b l xc l o p o H a r u e r ' H a c n H H e .t l r o n f i I l a x
i a . r a a n e i n 6 o K o B o i c r o p o H s \ n n e q , 6 o x o B b l ) \c r o p o H a x r p l a H o x
| ? - n e r K rI x n B o l a . H a 3 a , u H e f t .H a p ) , { H o i H B H } l p e H H e i ^ c r o p o H a x
B e' BD x H l r IH H h x H u x K o H e ' { f i o c T e iH. a no4olllBaxHol lpnc iuJl
no,loxeHfir nexa y 60rbxoro pe,{e Ha6,lonaercF ahynyHKTyp_
xr,Ii uroK, oH ,jlerqe qyBcrByer ce6q Bo BpeMt ceaHca Bce rro !ena-
eT yKa3aHHOenoroxeHxe 6oree npeanoqrnrerlbHblM B OTHOtrteHHT
naur{eHToB, BnepBble noaBeprarcrqlxca yxonaM, a raKxe cltllbHo
ocra6,'refiHbIx H I{crouleHHLIx 6on6HLIx. flpfi Har''Ifiqnx npocropHllx
400
Pr., l0l. nomxeH,e 6orhHoro r€x. H. x,sore.
narar r,rAocraroqHoaoqrcna Koex crrery€r Boo6rqe craparbcq npo-
L{3BOAHTbyKo!'lbl B lIOrOXeHrr,t Jr€Xa.
OBnaaeHxe rexdrKofi MaH|nyJxpoaafilg lralra r. VMe,roe sseae-
Hfie srrbr, B!'raaeHqerexHfiKofi ,erKoro H 6brcrporo yxona firparoT
Baxryrc porb B edQeKrHBHocrl.r urnoTepaneBTxrfec(oro MeToAa. Or'
cloaa rr TpeooBaHue x coBpeMeHHorlryBpaqy xopolxo oB!'Iaaerb yxa
3AHHOfiTCXHI,IXO*,
TexHr(y yKona ny,{lne orpa6orarb npeaBapHTerLHo Ha cnellu-
a n b r r o M f i p x c n o c o 6 n e H r n , 3 a T e M ,o B r ' I a a e Be r o B a o c r a T o q H o i M e p e ,
ficnpo6oBaTb cHaqarra Ha ce6e ntl6o Ha Apy3bqx r,rKon.lefax, I, Ton6
K o n o c n e 3 T o r o M o x H o n p n c T y n a T bK n e q e 6 H o f in p a x r a x e ( p l l c . 1 0 4 ) .
,[,1fl orpa6or(r.r MoxHo rcnoJrl€oBarh cBepH]"ryrc B HecKoJILKo
paJ B Brne noayureqKr n!'rorHyrorxaHb r,'rr{ ryro iaBepHyrHH B
r x a H b n y q o K B a r b r , o 6 B r 3 a H H b r fri e c E M o i i ( p r c . 1 0 5 ) .
O T p a 6 o r x a n p a B r r ' r r h H o r oc n o c o 6 a a e p x a r b
xrr'ry. B 3asrrcr,rMocrr,ror Brraa ,cnor'rb3yeMofi [r,']br It rpe6yeMofi
rny6r,rHbryKo''ra Blt6nparor fi Hafi6onee 3Qoe(TLtBHbrfi MeToa BBeAe-
H{' UTIbI.
{01
 Enlr.\

f,r;$
P l r < .i 0 5 . O r p a 6 o r x d r e x H , k , y K o r o B H a n o A y u k e .

Px<. 104. Orpa6orka rexH,k, y(o,os na narxe 6yxar. B rr(a!{b noayrneq(! nocrefleHHo. flpoae,rarr oarr{ 3a lpyrxM He-
cxol'rbKo pnrM qHHX y(o!'IoB raxoro poIa,
Orpa6arHBat yKo"1,Heo6xoAxMo crpeM{Tbcs x roMy, ,1,106HAats
O6qri nplrHuxn npfi Bcex cnoco6ax aepxarb xrny cocror,rr B reflte llar'IbrreB 6H"ro HanpaBneHo crporo BAo.qb crep)t(xri rrnbl fi
3anpeqeHr,x(acarrci Tox ee qacrr, KoTopaqao!'lxxa Henocpeacl KoHqerlrpr,ipoBalrocb Ha ee ocrpr.rc. To,rbKo npfi 3roM ycnoBrrr{ xc-
BesHor{oFTaxrrpoBarb c reroM 60,1bHoro. OsnareBarbcnoco6aMx xrrroqaercr oflacHocrb rlolHyrb drny, oHa 6yaer Bxoasrb B rxaHfi
aepxaTb l,lr,/ryBfiaqar'1e ,'ryque Ha KopoTXHxfir!']ax, 3aTeMrrepexo- nerxo,6e3 3a!epxex, npfiqrHs9 rrpfi 3roM MriHr.rMyM senpHrrHocreii
41116Ha 6oneeanrrHHhre. Aepxarh rrr,'ryclreAyerAocraroqHo KpenKo,
qro6hr oHa He BblcxanrrblBara13 pyK np'l cooTaeTcTByroqrix MaHr- 2. Bpaur€Hre rrnbl Orpa6o,aB BB€aeHxe llrnbr, c"lelyer nonpaK-
nynrrq(rx, oAHaKoycrnxq He Aor'ixHbt6brrr, c,rHurKoM6o,'r6unMrr, q e e t s p a r u e H r l l .a l r r 3 T o r o , 3 a x a B p y q K y r r . q b l M e x A y
T f i K O B a T b cB
qro6d He rrorHyrl,fir,ry (pxc. 106, 107, 108). 6onbIIIlrM fi yKa3are,l6HbIM nanbqaMr. c,reayer Bpauarh BBeaeHHyrc
y r p a x He H r.rs ar r li a,'] b rr € B. Heo6xoAsMocl{creMarr{qe-
a T(aHb rr,'ry, cTapaqcb npoAe{,rr,rBarb9ro JrerKo, nnaBHo, paBHo-
cKr rpeHrpoBarb nan6ubl, qro66l onlr 6br,r, rl{6I<xMlI,.rroBro{Mn. no-
ctryrxHr,rMx, r{ro6H Bpaqcrrfie urrbr 6u,1o nr.laBr{brM, a laBreHxe Ha 3. BseAeHse r BbrseaeEre Brrbl c o,{rroBpeMeHH6rMBpauen}reM
rrr''ly ocyuleclB!'IrlflocbToqHo sAoJb ee cTepxHt li cooTBeTcTBefiHo e€- MaHrny,rqqrr na,rbqaMfi np{ aBeAeHxn Hr',rbr ornrqanrce or
perynspoBaJrocb narLqaMs. OAH'M ci'roBoMTpefirpoBKanaJrL,ueB MaHlnynrqxt npH ee Br,rBeAeHfir.
3ar'IofreaKoro, 6e36o,re3rrefiHoro yKona. llocne npoxo,ra KoxHoro ooKpoBa oaHoBpeMeHfio c BseAeHIieM
Orpa6orxa yxo"roe. rrni,l Haq Haercq H ee BpaueHre. arr qero, xaraq pyqKy trrH Me)K-
L y(onH 6€ BpaueHHr l1rrbt- flonb3yrcl, 6o,t6rxrM x yKa3a Ay 6onb rM r,ryKa3are!'rbH6rMflarauaM . ee BBoarr B r,rry66 Mbllxeq-
re,lbHrlMrra,l6uaMr,cur'rbHoHaIaBnTbHa pyKorrKy fir,rf,rraK, qro66l Hofi rKaHrr. Bpauare,rbHoe aBfixeHfie r raBr'leHfie Ha rr,1y Ao,rxHtI
ocrpxe 6blcrpo npoxoJroilorKarrb floAyueqKx, x!'Ifi cAe.qarbAaB,reHue npo!3BoArlT6cf oAHoBpeMeHHo, c,1axefiHo. fi6o Tor'rbKo IIptt 9ToM
ra ary 6oneeJrerxxMx nJtaBHblM ral(, qro6H oc,rpfierr.rbr Bxo!!I,{o Moxxo o6ecneqrrb cao6oaHoe. 6$6on$reHHoe BB€aeHre fir.Ilr,l B
402 403
 Px(. 106. Cnoco6 aeP- T X a H b .1 4 H a o 6 o p o r , H e y M e n o ec o r { e r a H r eB p a q a r e n h H o r o s n o c r y n a
x.rh Kopor(yp ,.ry re"qbBoro aBxxeHtfr xrrr,I yBenaqnBaer 6one3HeHHocrL yKo!'Ia.
B p a u r e H f i en p x B b l B e n e H HaHH a , r u i ' r H u n p a n H n l u r e v y . l o i
,1rrub pa3Hfiueii, qro yclr!'rhr 6onbuoro x yKa3arenbHoro nanbueB
IIANPAB.TCHH HA BbIBENCHTT l,lT,'IbI X3'IXAHfi. i'HBEAEHXE fiTIbI C BP
urexxeM rpe6yer roii xe craxeHHocru BpaqarenbHoro x nocryna
r e , l b H o r on B h ) h . H x i i c u e n b r c ) v t ' H b u r H r o 6 u , r ' r H p H H o c r hy h o , l a . u 6
JlerqrTb nporreaypy.
OTpa6orKa npreMa HarcrxDaHxq Koxli s Mecre yxona. MoMeHr
npoxoJa xoxHoro noKpoBa rB,rHeTcr Hax6onee 6o,re3HeHHr,IM 8 6, l _
3 H B a r c q r M H a r 6 o n b r x y r cH a n p q x € H H o c T b6 0 ! r b H o r o ,q ' r o r x a K n p a B f i -
rro, cHr,txaer ?OoexrflBHocTb xrr'rorepaneBrfiqecxoro MeroAa. Orcrc-
Aa Heo6xoAr.{riocft,yMeHbrxxrr, 6o"re3HeHHocrb3Toro MoMeHra.
Aocrr.jrHyrb yxa3aHHoii qe,rr noMoraer HarflrxBaH0e xoxn B
Mecre yKona. Cyuecrayer HecKo,rb(o c[oco6oB larerxsaHHfl Ko)xri.
l. HaAaBnfiBaH{e 6on6oxM nanbueM prraoM c MecroM yKora.
K o s r t o u 6 o " ' r s m o r on a , r b q a , I e a o i p y x r H a A a B n a B a I o rH a y ' r a c l o K T o q _
( H . H a T n r r B a ql e v c a v H v h " x ) . r a r e v , a e p x a H r , 1 )B f i p a B o ap v x e .
npolr3BoArr yKo,! BnnorHyK) K KoHq0xy 6()'rbrxoro nanbua neBoi
pyxs. Cnoco6 np{Mel{qercfl B rex c,'Iyqasx, KorAa Heo6xoaaMo
cMecrr.{rb B cropoHy xpoBeHocHbrii cocy/r (prc. 109).
2, HarqrfiBaHfie AByMs narbuaMlr, Bo,lbrxrM a yKa3arenr.HhlM
naxbuaMfi,,r€Boi pyKlr, pacnorloxeHHriMIl no 06€ cropoHbl roq(rt
tl Pxc. 107. Cnoco6 aop- H a a a B , ' r u a a x l rH a y q a c T o K x o a H o B p e M e H H op a c r s r x B a l o T K o x y B
xar rry nP, He.ry- cropoHbr. Apyroi pyxoft npofi3BoAsr yKo,r. Cnoco6 npaMeHqercq Ha
yqacrxax co cna6brM TypropoM Koxr (HanplrMep, aa r{HBore)
(pxc. I l0).
3. Harsrnaanue 3ax1lrnneHueM xoxl, Mexny na'rrqaMfi. flo"lr
r)q.b 6(),1brxHM l , 1! h a i a r e ' l b H b l r r n a , l L , u a M r , 1 e B o f il l K . r a u r u n n q
krt ''raLloK xoxH B paioHe ro'axHn . u a H t l v a He r d h B , p \ ! r a K , q l o -
6br HarrHyrb KoxHHii noKpoB B Mecre yKona- Aep)Ka xrny npaBoi
pyxofi. npor3BoAqr yKo,r. Cnoco6 nplMeHqerca npl, KocHx noaKox
H b r xy x o n a x ( p ' { c . I I l ) .

5. noPtIoK aEncTEIn n P X I I J I O y K A J Ib t B A nI N

Ilpfi ,reqeHr'rfi,Hr,'raMr Heo6xoalrMo crporo co6,rrorart [ocJ]eaoBa-

'rerbHocTb,(eHcrBfln.
Bu6op nonox(et|ri 6onr,Eoro. IloroxeHfie 6()rr,soro x36hparor B
3asnCtMOCT! OT qlrc,la To'{ek, Ha3HaqeHHblX;,lJ'It yxo,'Ia.
HaxoxreHfie ro.r€x. HaxonflT Il orMeilabr no!'IoxeHxe Bcex oro-
6paHHtIxro,reK.
BH6op rr,r. B coorB€TcrBl.r! c noKaxlt3aureii 0106paHHbrx roqeK
tl f,ly6rHoii npeAno,raraeMbrx y(oJroB no!6rparor l,lrrbr Heo6xoafiMoi
a,,rxHri. lloc,reaHr.{ri pa3 nepe! qcno!'lb3osaHr,{eMnpoBcprrc'r roaHocrb
r r , ' r , o T 6 p a K o B b r B a frl o r H y r b r e r u r [ 3 a r y r ] J r e H H b r e .
Ae3xH+nqxpoBafiEe irecra yxona. Ae3BH0eK(r.{Io npox3Boaqr 70"
Pr<. 108. Cnoco6 a€P- c n r p , o M x n s , e q e J y ' r u e , 7 o ' c n f i p r o M c n p n M e c b r oi i o A a . T e x H u x a
xarb rPexrp4hy rny re3aB0Bqr.rpoBaHrt ra xe, qro x npn fiH,L'eKufiflx,C.reAyer l{36erarb
4M 405
Pr.. l09. H6'ernEaHhe
xox, HaaaBrrBaBNeI
6orburM narhqeM.

P x c . t t l . H a r e r k s a s i e( o u r 3 a q N n n e a , e M .

,loro t{<e raMnoHa arff ae3fiH(DrqxpoBaHufl

tcnorb3oBaHrt oaHoto u
HecKoJbxrxyqacrKoB.
HarfirraaHxe yracrKa Koxx a Mecr€ yxoJla. t coorBercrBrlu c
oco6eHHocrqMfi KoxHoro no(poBa Ha KaxaoM KoliKperHoM Mecre
n p M e H f l l o rr o r l , t , ' l rH H o i ic n u c o 6 H a r f l f t B a H r g , r , o f l H c a H H b l xB h I L x e
C n e a v e r D o v H H T b ,q r o B o r 3 6 e r ( a H e r a H e c e H r s r H S e K u l , t r H e " l br q
n p r r , i c a r s c r n a , l b u a M HK ) q a c r K ! r i p e r n o ! ' I a r a e \ r o r o ' x o n a
T e x f l r K ay [ o n a . O n p e a e ' r e r r e lny6HhbI BBerleHHe
rr,rr,r- f,ry6uua nyHKIr{x npfi Bo3.(€icrBttfi Ha xaxaylo Kolrt<per-
nylo roqKy yKa3aHa B pa3Ae"re <AKynyHXTypH6le ro'IKlr> flpliBeAeH
HHe raM rrrQpbl HMercT opleH-TljpoBorlHbli xapaxrep t paccqnraHl'l
Ha B3poc"'r6lx6onl'HhIx cpeAsefi ynfiTaHHocrt. ll fi'lItHItqecxor npaK-
rrxe rny6HHy BseaeH tl fiInbl onpeAerflror llpxMeHllTenbHo K Kax-
aoM\ 6onbHoM), K xaxro\l) hoHhpelHoM) .,1)qarc. yqurHBafl npfi
. r o v e o r p a c r y n H r a H H o . r b 6 o n r , H o t o .n ' l t n k r n e i f l o ' I H H \ L 1 ) 6 t | H a
.ooreercise"xo yBerrxqnBaerct; ant yqac'rxoB c rortl(xM c,loeM
r,abrlxqr,ry6sHa yMeHbrrlaercfl t Hao6opor. Heo6xoauuo yqfir6lBarb
r a x ) h cr " 1 y 6 H H H y axo/r,aeHrB t r a r { H H \ B h } l p e H H r x o p r a H o BH a ) q a _
c r h c y x o n a , r , 1 y 6 x H ! x a p a x r e p ' x o , 1 a { n p e M o i . K o ( . u i ) ,r a x K a K
r,ry6vHa Kocbrx yKoroB Moxer 3HarIUTer'Ir,Ho flpeaocxoArrb rJlyouHy
nDHMbrx. C norB,reHfieM <deHoMeHa l,rrrr,I> BB€aeHre xrnH npeKpa-

Ans opfieHrxpoBK Hlrxe flprBoalrrct ra6,1!qa ycpeaHeHHblx

407
r a H H b r x r , 1 y 6 x H b rn y H X r r l , {filia p a 3 n x q H b r xy q a c r K a x r e . I a ( r a 6 " 1 . 4 )
UfiOpbr nptBeAesbr Alrr 83poc,IbIx ,rroaei cpeaHeii yn{raxHocTEl
npr noJb3oBaHxlt ra6,1uqefi Heo6roaliMa Koppel{rtipoB(a npI'{MeHx
T € r r b H o( K a x a o M y k o H K p e T H o M6yo , 1 1 ' H o M y .

5 10
:J l0
llk u
4 t0
5 t0 5 2 0 Prc. l'12.Yrrbr BseAeHh Mhr.
t0 20 3 | )
l{l ln 2 1 I'Jy6oKxii y K o " 1 . O 6 b r q H o o p o ' t 3 s o A l l T c nB I B a n p f l e M a
l. npoxon Ko){$.r.Ha[6onee 6o,re3HeHHar qacrb yKoJa, flpn xoro-
pon qafile Bcero npoxcxoAl.{r r'rcKpr,tBreHfiexr,rbr n KoropaH rpe6yer
O n p e a e n e H H e y r ' r a H a R ' r o H a r r r r b l , B 3 a B u c r M o c rof T
i B cBq3{ c 9TllM oco6eHHo yM€,roro MaHr{nynrpoBaHr.tr Hrxofi. npH
oco6eHHocrefi Dacno!'IoxeHrt roqKlj, To!'IUlLrHblMHrxeqHoro c'loq I r,,ry6oKrx yxoJlax Bpau€Hne Icrhl, o KoropoM roBopr,t!']ocb Br,rrUe,
qenei flyHKqrl' onpeAe!'Itnr coorBercrByrouti yro,rl sBeaeHBa firrlbl ncKnroqaerce. Heo6xoaxMo npot3Becrr.t 6o,'rbufi M fi yxa3are!'rbHbrM
s rxaxr, louc. l 12). na,qbuaMr oqeHb 6r,rcrpoe AaB,leHr.{eBa pyqKy rir,lhl, qTo6br ocTpBe
L nprMoii yxo,r.Cr€pxeHbtrnbl pacnorloxeHflepneHAxxyrepHo cpa3y npoKonono Koxllbri noxpoB. 3ro 3HaqrrerbHo cHft3r{T6o,1e3
norepxnocrx xoxlr. yKo",rMoxer 6bITb6onee aru MeHeer'1y6oxrM n36exarb pBKoii peaxqrr 6o,1bHoro,.rro He-
IlpuMeHe€rca,xorAa no,A KoxHbrM noxpoBoM,Meercq aocraroqllo peaxo apriBolrjT K HcxpllsneHHro l.{ aaxe no,.loMKaM srnH.
roncrbrfi c"rofi MblrueqHoiTKaHr. 2. yr,ry6neHne arahr B noAKoxHyro rKaHb H MbrueqHblfi cnoi.
2. Kocoi yKon. Ilpn KocoMyKo,IIecrepxcHb xrr'lH pacnorloxeH I loc,'re roro I(aK rr!'ra M0Hyer KoxHt'lii noKpoB, MoxHo npoaonxarb
noa yrroM 30-60" x noBepxHocrx(oxs, flplrMeHtercq KaKnps rny_ B B o n r l b e e 6 e r B p a u a T e , ' r b H b rI{B r x e H x i , a r l x b M s r h o H a r a B r H -
6oKxx, Tax I, np Her,ly6oxax yxo"rax, qaue B cnyqaqx, xoraa ne Rar Ha pyqKy fi nocreneHHo yr'1y6,rqn cr€pxeHb B norKoxrryro rKaHb
o6xornMo ,36exarb ilonalaHut Ir.jlbI B KpoBeHocHt'lli cocya n"lu py- x MbtDeqHllu c,Iou, lexHxxa 3Ta qanle Bcero npljMeHteTcfl x TogKaM
6eu. a raxxe Ha vqacrKax c roH(ltM cr'IoeMM6ltxq. H a y ' r a c r K a x , 6 0 r a r b [ I ( p o B e H o c H r , r Mcso c y A a M , j , K p y n H b ] M I ,H e p B -
yKo,l, yro,r HaK"IoHacrepxHe rlr.rbl
3. flo,rrtr ropa3oHTa,,rbHbIfi H h r M rB o r o ^ H a r r H. . h 6 i , B a x H H r r H r x a H e v H I H a n p i { v e p ,r o q K d H t r H
^ noBep\Hocrr.1 cocras'lrer l0 20' I4rn} Mo)hdoBBoanrbrlor
Ko)r{r{ rrer , i9 Ll. v r t s r .r B H vi , p H J n a rr a F , l , ' . , , , 6 r .H. , -
K u X y r O a , . . l l , H oA a , 1 e x on, p H ' r e MV X O ' lo r I a e I c q H P I ' l V O O X n vl l p H M r 6cx{arr, ceDbe3HblxTDaBM.
Btelct o6blrHo npx Bo3aeicrBsx Ha Toqrci B MecTax, rAe nor Kox_ Ipr r"ry6oxxx yio,,rax uoxuo raxxe coqerarb n()cryrarerrbHoe
HbrM 0oKpoBoM Baxoltrcq KocTsas rl(aHb (ro!'IoBa, ilxqo) nl1oo ARuxeHre rrrH c BDaurarenbHbrM.3ror ueroa o6,,ra!aer 6b,r6rurrM
Koraa Heo6xoasMo npoiTfi firroii 60"'Ibmoi yqacrox no! xoxei p a r / l l a . | ( a r c I r r ! r , + 0 . h r o v , r ' o r 6 ( : ) , r l , r I e i iB e l o r r H o c T b t o B u 3 s a r b
D u c r p sr i, H e r,r y 6 o x x i y t( o "'r. flpr.jMeHqercfl o6blqflo rpaBMy rKaHei. flo orHolrreHfift) K HexoTopb]M ro.lKaM oH Boo6ue
n p r s o 3 a e i i c T B r .H{ na r o q K x a M e c r a x n o B b l u e H H o iq y B c r B I I r e J l b H o c r x ,
r a x n e K a x H r r H - r r y r r(r2 6 V G ) , r x a n - T y e s ( B r l e M e p x A s a H H a q )B, c , I y <O€Hoir€H rrnHr. Aocrr,xexr.re <OeHoMeHa xrnr,r> .' BaxHefi,
qarrx. xoraa 60,'rbHoilHaxoAlrrctl B 6ecco3Hare,'IbHoMcocrotrHllt, npl, rUee yc-roBHe B firrorepanfil,l- To,]bxo norB,reflxe 3Toro oeHoMeHa
,1e,{eHsxAerefi. A"'Ie ra(xx yKotoB no!'Ib3ylorca caMblMH KopmxIIM}l o6ecne,{rBa€T gOOeKrHBHocrb yxo,ra. y6eaxrr,cfl B Hannqall <OeHo-
1lr,'raMd (q-ro o6nerqaer IIpoBeAeHxeyKo,':a) ,t6o rpexrpaHHHMo ar M e H a u r , ' r b r >B o 3 M o x H o A B V M qc n o c o 6 a M r .
, 1 a M r j ( n p 0 K p o B o n y c f i a s x l , r )X. o p o u l o 3 a Q x x c u p o B a B ' l e B o i p y k o i l- Oqyrqexre ar,rorepineara. [1pu nonaAaHtltl ar!,rN a roqKy I
Mecro yKo,1a, Bpaq, B3tB npaBoii pyKoti Hr,ry, ae,raer 6blcrpHi yxon floqBrreHr]l{ yKa3aHHoro {peHoMeHa y Bpa'ra Bo3Hrr(aeT oulyqeH,e,
B roq(y Ha r,ry6nHy HecKo,rbKo Mx,r,rxMerpoB,6brcrpriii noBopor q r o f r r a x a K 6 b t . B n r H e r " B T f i a H H \ .[ l D H n d . ] b H e f i u t x M a H u n v , l ' t
8 r i 6 r l r T o T q a cr 3 B n o ( a e r e e r { 3 r K a H r . l l p f i n o , l b 3 o B a H t l tr p e x r p a B _ u , r s x r r n o i , ( B B o t r , B 6 t B o a ,e p a u r e H l i . ) n q a K a x 6 H o k a l b l B a e t c o
rroii !r,rroii roBopor xcKrrcqaercq. npo, BBJIeEneycxr'rfirrM Bpaqa.

408

2. OqyureHne6onbHoro.O floqB'leHIrB<eQ$eKra xr"lri> 6onr,Hoi
MO'r(e'rcyafiTr' no qyBcTBypacnupaHrs, HanptxeHHocrlt, Ttxecrx'
ycralrroc, , oxeMeAl,tt,Tyuoi 6o,1u B Mecre yKora, xoropoe Moxer
i roi r,rr nnofi crenexn lrppaaxxpoBarb B cocerHre o6,qacrfi-
B c,ryvaax, (oraa ur{'Ia aocrsr,la Heo6xor!Mofi r,ly6rHbl, a
<3QOeKTnr,rbl> IIe Bo3Hljxaer, c,rleayer ycxr Ba-rb pa3apaxeHte
ToqKx, nOXa Fe nOtBtTCfl OnICaHHbIeOqy leHl'lq llr'Is 3TOrO MOXHo
Bocflon630Barbcq cteayIotuI,IMLj cnoco6aM i
- nocTyxsBaHlle ro fitre; nocryrla,tE HecKolb(o pa3 KoHIIoM
cpelHero }rr'rr,ryKa3aferbHoro narbqa no pyqKe rr{'Ibl;
Bpaqegse xtr''It : 60,rhltlLtM t{ yKa3arerLI{blM na!'IbuaMfi no_
A p au r ar h p y q K ' n r , l H :
- nOCTynaTer'I6HO-BO3BpaTHHe
ABrixeHut l'tl,/IOt: CIe.]]aTb He_
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I' hJq,r;.reH e c ulaueHr(!r. cpeasrv na'rsuev 'leBoii nlxh
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fipfixI,lraHHr, BxoatTi
3bIBat conpor}{B"'IeHlteero ycs.rlxqM, t{xt ecrx naus€HT 6one3HeHHo
pearrpyeT xa leicTBi{q Bpaqa. fi3B.reqeH e I,lrJhI c'rcayeT npxocTs_ KOpO6XaC nonsrHHbrMTpyTOM;
- floJIbIHHbrecrrapeTbl;
I { O B A T bH a X a X O e - T O B p e M g H 3 a r e M 3 a X O H q { T be l ' O - -- (opo6Ka cnH'{eK;
2 . H s g ' r e v e H [ e6 e s s p a q e x a q B p a q r a K x e H a l a B r [ B a e r c p e a - - apoMaTurrecKHeIa!'rortKr,r;
xr'rM Da,,rbueMneBoi pyKll Iia Koxy ptaoM c ToqKoii It Mea!'leHHo, - B O X C T O H K T , TOMC T p h t MJ e 3 B t e M A n r i H a p e 3 a n t l q n X a C T U H O K
6es BDallleFoq x3B,'texaeTrrjtv Ir3 TXaHeI{.
HM6spn qns qecHoKa;
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pyKr Ha koxy peAoM c rotlKoiit Bpaq npaBoi py(oii 6brcrpo x3BneKa_
er rr,ry, Taxan cnoco6oM u3B!'teKalor fir"qu npq neqeHrx aerel't'
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ro.toBxa '{ecHoKa;
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floAHOC.
O6pa6or[a xecra yKora. 3aeepurarcqee aeficrBIIe nptt <yKpen-
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3. CnOCODbTnPlrol0BrEHXq. l,|ClIOJrb3OaAHUt
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lt XPAHEHl,tt
noobtHHoto cbtPbq
n p a x a r b e r o , x a K 6 b l < 3 a K y n o p u B a e >o r B e p c r a e r o A n o B p e M e H H o
ooe33apaxrBafl ero, JlpxromsreHxenorErHHoro rpyra. 3arorae,r,rearc
r no,lNHHoer Hpbe
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B TeHr. B cy\ov. \oporlu
414 415
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e BeHfiqKn n3 flo' lblHll noaBeuxBa-
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B e T B e i c o 6 n
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r.xax 6aoxar t r , T o H X H eB o , r l o K HJaI ' l c T b e Bc J o n o r r c l L I M o f T e H K o v
o l q e r o r r ; n H H H b l i l p y l f i n o , l ! q H ' l H a 3 s a H l , e' 6 a p \ a l H o i n o ' 1 H H l ' t |
qev nefle'l no'lhr_
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H He paccblnaercq, rlro aaef Bo3MoxHocrb l{36exarb oxoroB Dy
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CTOTUIATENL.HO BOAOI,.
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'{ro6br y6epeqb or Blrar0, nr'receH{ fi qepBeii. B cbrpyro aoxllIrByK)
rT.n.
fl p n r o r o B x e H H e n or H H H t'l x K o I{ y c o B Tpeua narlua_ noro,{y HeooxoALrMoperytrrqpno npoBepqrb yarepfia"r. [Ipx co6rro,1e-
v ( 6 0 , r b u r H v .y K a 3 a l e r l b x b l Mr { c p e I l H H M l 6 e p y r t r e 6 o ' 1 b t ! y r cu r e H 0 f i y x a 3 a H H h r xy c r r o 8 H f l ,q e M l t o " , r b r x ex p a H n r c s M a T e p t a , l , T e v 9 ( F -
n o l b f l o , l b r H H o f oT p \ r a ( K o r l [ ' { e c l B o o n p e a e n e e r c q B e ' l u q H H O LK o H y . ' oexT[BHeeI rret'le efo ucnoJlb3()BaHre.
c a , l { o r o p h r i H e o 6 x o a h v o n p f i f o l o B I ' 1 T b )K i a ' u ] | H a s M a i X p o - B a H d 6 l I l X p a H e H x e f i M 6 a p q I l q e c H o K a . [ o A r o T o B , l e H n bKr i ni c -
n o a u o c , o 6 x n v a o r e r o . n p x t r a s a g Q o p M y h o H y c a a e ' l n q l ' t H o r- lo r r o IlorLsoBaHl,tto LjM6tph ny,txle Bcero coxpaHtrercrr B cyxoM necxe.
o o u [ ] H n O x D v n H o l o 3 e p H a $ a c o " l r ( B 3 a B r c H \o . T H O l H e o o x o a r ' l 9ecHox xe MoxHo ac,nro xpaHrrb B cyxoM, npoxlralHoM Ntecre B
u o ' o p e x u r " r r 'i e n , r o u o f o B o r a ; i i f I B l ' t t) K o H y L , 4 o ' 1 x e H6 H 1 6 n n o r H o
onoeccoBaH. qro6bl nonblHHat Macca cocraBrqra eaaHoe uenoe a He
n r l c u n u , r a c o B o B p e v n r o p e H H e 3 l o o 6 e c n e q u r B b l n P J l e g r ea o c r a 4. ycJtoBt|9 noBUrxEHIt 3 ( ' 0 E K T l , l B H O C T tM
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2 0 c M . u r r D H H o4 i c v , r a r e M H a c H n a l o IH a H r p o B H H tc r o H r p y r a ' xer B 3HaqrrenbHot Mepe cnoco6crBoBarb floBrjueHlrro 3$oeKrrB-
xax:ro ae,,rarcr c Ta6aKoM, (ofaa KpyTtT caMoKpyrKl' x CBeplHBa' HOCrn,ler{eHtt. Bpa.r aorxeH Aepxarbcrr { npo.qenbrsa,b Bce Heo6-
IOT AIIjHHHE CTIAPETbI,KAXAA'I U3 KOTOPbIX MOXCTTICTb B TET{EHIE xoAr{Moe rax, qro6H Bbr3BaTL, AoBepue K ce6e I,ryKpennrb Bepy 60.rb-
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q c , r e n y n L I c My ' r a c r o K r o ' r K x
B u B p p t l en p H x r r a , r h f l . { d h , r K ) q a o r c B
6enbnM6 oe r,rH1\6oHqrchoxar"1)6oKuv/npoho'lavr' rarev Hape
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,io. ",."o*"i', npHqevIax. q1o6b. coxpaH Tb rpvxox ue'lstv n'lq Ha yqacrxe AonxHa 66rrr, pacnoJloxeHa ropr.r3oHranbHo, qro6br B
IoHhyro rlaplxH)ll) Kox\HUv: Ba)hHo qloobl c,ryqae ncno,rBoBaHxq noJrbrHHr,lxKoHycoB oHq 6br,,tHxopoluo QnI(
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XpalreHte ar€pxana, rrcootIb3y€uoronp, npxx(firaHtl{' renrro KoHueHTpl{poBanocb6r,r Ha Toq(e, He paccefiBancrr no cropo
X p a a e x r e n o r ' l b I H x o r 1o p " y r a ,K o H y c o B I c x r a p e T HaM. KpoMe roro, floroxeHse 6o,'r6Horo lonxHo
qlo6bl Ha nporexeHrti acero ceaHca npv,^fiaHre oH vor .noKofrfio,
6brrb yAo6HHM,
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or BpeMeHI'l Marept,lalr Heo6xoalMo npocyuxaarb' I O , 1 0 ) h e H H hH. e O I A . d r . b c l p e X H y r b n u i b t H H b t i ix o H l c .
Mecrax. ilpeMq
416 417
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Onp€a€n€Execfioco6a nprxrrairg or
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(pac. ll5, ll6) n norbrHHbrMl,l cnrap€raMs.
L f l p r x r r a H u e c n o M o u l b r c n o , rr rr r H H b r x( o H y c o B
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noMonlhb Mar'lotoKoHyca,\oHyc HaxnaaHBarcTHa roqKy x noaxll-
rarcr- Koraa cropaeT nplMepHo'/3 xoHyca ! 6onbHoi noqyacTByeT
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oH croprr nprMepHoHa flonoBnHyx 6ortHoi noqyBcrByer Fa Koxe
npr.rrrHoeTen{'ro,KoHyc 3aMeHHIorapyrxM, 3aTeMTpeTbl.rMu r, a
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IIo oxoHqaHHunpolreaypbl Ha Mecre nprxrraHlrtl oulyxraerct
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6. OnocpeAoaanuoenp xrraHrre cocrorr B npxxuraHvl qepe3
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3areM rrpoaorxfiTb nplixnraHHe- B 3Tfix c,'ryqaqx MoxHo Taxxe
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tItM, L TaX AO TeX nop, nOKa He nOqBtTCt pO3OBOeflHTHO.
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418
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n o i r x r r i n v e , { € p e 3 x M 6 f i p H y I on p o K J I a A K yT e p a r l e B r x q e c K x i ' i
,,QOeKr sToto cnoco6a: ucorpeBaer cpeAHIoIo qacrb ryr'loBI1ula>
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nBxrcq ouryqeHIr€ nplltrHoii rennorbr. clrrapery ouxcapyrc,r sa
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B TeqeHae l MrH Bo3leiicrBosarb 60,16rrllrM rra,,]bueM Ha
ro'{I{y 6arb-xofi (20VC) BHa'{a,le no M€roAy HorreBoro yxo!,ra, 3a-
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I E T O A AN A J | b U E B O I O -- B TeqeHae I MaH Bo3aeiicTBoBaTb cDenHHM narbueM
Ha
Kaxnyro rorrxy rxail,cyHr (3F) u xox,ror (6dV) no MeroAyoaHo-
n a , l b r t e B o r oB o H 3 a H r r .
Bbrreqxrh 6o e3Hb, norb3yqcL rHrxh nar6qeM spaqa-r|,ro.repares-
flpr 6o"1sr B o6.lacrx 3 a r b r , r x a . T o q K uB o 3 r e i i
ra._ H y n o 6 H o . f i A e U J e B oM e T o n u M M o , { ( e TB o c n o J l b r o B a t b c ,
-)Io c r B r q : o o x f , | l . li 2 0 V B r . . i H e r - K \ o e rt ? p r . K o H - . t o tH6 0 \ 1 .
rooofi roporxo uB,1a!pBullli Hy qe-nuBeh Meto, naer cpaBHr- I nocoo BoiaFr( rBr.lF: aJbueBoe pa rvHHaHre, oaHonalbqesoc
r F , l b H O , \ o p o u l x ep e r ) , , t b r a r b tn p f i n e q F H H HH e x o r o p b t xo c l p t i x 1 a 6 0
, r e B a H r [ . y p o h r ] q e c K n r6 o n e r H e j i . . t , i r . 1 \r r . l \ l n r o l y o B .x o t q t p a H H u b l
Bbrno,rHeHfie: flpoAenarh creAyrcuree B yKa3aHHoil flocJreAoBa-
ero npfiMeHeHrir ao crjx nop eule Be BnoJHe flcgbl.
- B TeqeHre I Mr.iHBo3A€iicTBoBarr, 6onbnrrM
x cpelHrM narb,
5 . n P I M E H t H I I E M E T O A AB ( , l h H l r r l E c ( o I npA(TI,|(l uaMn Ha roqKri Oofir-,{fi (20 VB), pacro"roxeHHr,re no o6euM
npt o6Mopoxax. To,{Kll Bo3AeicrBrrj: HqH ,rvHr (2tj VG) cTOpoHaMroloBbrj MeToaoM na,lbueBoro pa3MxHaHrq;
rxan- - Bo3Aer,rcrBoBarbcpeAHrM narbqeM aa rovxy
r y e H l B H e M e p x ! H a H H b r6ed) j. b - \ o i t r 2 0 \ c ) xou,,,ron (60 V)
MeTOIOMOAHOnartbIIeBOroBoH3agtt.
I i p r e M b | r o r T e B o i ! t { u , l . n a n b u F B o ep a r v H a H h c .
i topqnnk BHno,rHeHrr: c{rbHU n
nps npocryAsHx 3a6oncBafixcx. OcHoBHbrero'rKI, so3aericrBarri
Hqa r a B n l b H a l o ' r K y H t H _ ' r v H r
1 2 6V G , . QoHr'MoH(12 V), Hroafi-xyaH(5 TR), xxyx ur ( l l G r ) .
B c,l)qde. pc.rx 6oJhHoi He nlrxorhr ,tlononH TenbHbrcToqKx:
B corHafiHe, HdAaBHrb npfi Bbj.oKoii revnepat\ 0e nar.trcn ( 1 4 V G ) , x o n - x o K
r a K f i M x e c n u c o o o M n o o l e p e r l l o H a X u H q r h / B c e r n a , J b u e Bp ) x , ] .
( 4 G I )i
*r3'ryr - H o r r r o .B r o q . h Ht r a n . t l c p t B H e v e p h n L r a H n H e r . - npr cr.rr'lbHbrxro"loBHr,rx 6o,1rx -
Horfeaori yho.r. ,arev nan6upBne paavfHaHre s OoHr,.Il,l (20V8), rxafi-
,r-o. '.r]x. lep 9o 1a lr:b" -l lxl o t l 3 h r o H r ( B H e M e p u A U a H r r a qa) ,H - A b r o H r( B H e M e p u A h a H H a s ) i
{ZU VU). . n p x c r , . r b H o MK a u r c . r ' r g e r K x r c c . r( 7 p ) ,
o 6 M o p o x a xy h a r a H H b r ct p H e v 6 rc r ' o c o o H Ho h a i a r b +e_3y ( l3 V) ;
. .flpH .toBUrbHo flps HacMopKe HrerbxbroHr (20ct), xon KoK (4ct);
ep9exrrBrylo noMoulb.
- npr ",roMore B Tere
J l p x r o n o s H H x6 o , r c x . p r 6 n n q \ aan_qbr ( I I V) ;
- B oo.,act,i , 16 a B Kaq_ecrBn eororoHHorocpeAcrBa xon-Kox (4 CI), rxHey-
aH.nuoHrIBdtsveDrn
aHHani.\on_xohI4 crr.
rl-.^",1i.::.ll"lj
ralr.lHoHr (BH l:11:
eMepraHaHHar). r x b r o H r( l l P ) ;
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Cnoco6 eosleficrgfig: oAHonarr,qetsoe BoH3aHre, raJbrleBoe MC), rav-
aM 3ro (6 RP).
tsbrno,1
HeHfie: npoler'rarb cr.teAyroluee B yKa3aHHor{ nocrleAoBa Cnoco6 Bo3AeicrBHqi oAHona,,rblleaoe BoH3aHxe, HorreBoii yxo,J,
IlanbtleBoe pa3MrHafi xe, na,'IbueBoe HaaaBr,trjBaHx€.
B o 3 A e n g r B o B a r bH a , r o q x y a H - A h r o H r( B H e M e p x , q r a H H a e ) [Ipfi xpxsouree tB le,]rbrare He]nu6Horo nu"loxeHfe ro.ruBbr)
Me ,
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T -_ r n q x h B U r A e l r c T B l t r\:| o e h f r c H r ( 3 9 v B r / a r x h ( 6 o r e B b t e t u q f i H ) .
O!HOna"rbueBoroBoH3aHsg;
r x x e Hc o H r ( 1 6 I G ) , r x r e r - : y ( 1 6 T R ) .
. Bo3AeicTBoBaTb 60,16rx{Ml, na,rbuaMx rra Toqxfi TxaIr,3r,roHr
LyqecrByeT Hecxor'rbKoBapraHroB neqeHrrr 3Toro Heayra nanb-
( B H e M e p r r t a H H a r ) f i A a y , s r o I , l ( 8 E ) , p a c r o , , r o x e H H b r en o o 6 e r r M
rleBb|\4 MaccaxeM.
cTopoHaM roJ.lo86r, MeToaoM najrrrleBoro HaIaBr,IrjaaHHq fi Itar'lbqe-
B o 3 A e f i c r B x e p a 3 M r f i a H H e MH a r o q x y x r o e H , r o H r ( 3 9 V 8 ) xa
BOfopa3MxHafiur;
cpeaHjrM nalrt,ueM Ha roqKy xon_Kox (4 GI). - Haqynarl, B patoEe roqKs roHKfiii
-ffi,qeiicrBoBarl,
I lpoAo!'IxltreJrbHocrb KocrHbri Bartxj npo-
Bo3leicrBxr Ha KaxAyro rorlxy nopflIna xoaqxIfifi HaHcKocb;
HaaaBfirb sa sror Bar'rr,tK r.r, KorIa rraqrEHT noqyBcrByeT
428
425
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_ O u r y n H B a r M b r l r e q H b rM i a c c r j BH a
3areM [ocren€HHo ycrnxBaH AaBneHr]e; 6o,,t6HoriBo BDeMs Da3Mrr{a ooKoBolr cTopoHe TynoBr,tnla, Bpaq aor,rxeH 3aMeTfiT6 yqacToK TBep_
HIIt Ao,'rxe8 npor3BoAxTb ABlixeHrr lxeeii BnepeA _. uaaaj u anpa , { e c o c e A H } t x ,H a A a B J I H B a H HHea H e t o B t i J H B a e l 6 0 , 1 b .
Bo - B!'reao. qeM crlnbnee pa3MsqaHxe ,r 6oib. reM sddexrssiree Toqx, Bo3AeficrB[t: 6oreBbre Toq(&.
reqeHxe_ Cnoco6 Bo3aeticrBur: narrhqeBoe pasMHHaHue.
na,r.bqesoe pa3MuuaHre HaH6onee 6o,,re3 llopqAoK Br,lnolrHeHrn: 60,16lnnM narrbrreM nDou3Becrx Da3Mr.t,
HeHHoa roqKr H a u e e c o c r o p o H h rH a p \ u r e x x q n D e x a e HaHHe 6orerHeHHoro \qactha: nocre pa',ulnalrn
B C e . u 6 0 , 1 6 u l r v n a ' r r , u e Mp y h r o a x o u v e u s o r i c ' i , " a v . o " 60,1eJHeHHHe
crlrnoro olllyuleHxt AonxHbr 6hrcrpo noiiTt{ Ha v6br,,tb.
H a q a f b n e r h o e p a 3 v r H a H H eu r e * H j , r xM b r u r u ,n a x o a a u l _ i \ c r r c o i r o ,
Hllr, xoHTpar,(ypbr, PasMIlHaHue 60,1e3HeHHo,Ho 6o,,rbHoMy Heo6 _ n p f i 6 0 , 1f l \ r l i o H f p a K r ) ! a ) \ vbrrxu (nrHhr.
toqxr.i BolaeicrBxq: roqxH r)\aH-ry t23 \ t c o6eH\ cropoH
\onhvo norepnerb. I]oc,le rrpeasapIle,tbHoro parvrHaHlr' Bpa,r L f l O C O OB O 3 n e l , | C ] B t l O
9 :A H O n a J b l t e B oB
eo H J a H n e .
n n J r b u H rH v ) x a r a r e n h H b j v a r b u d M Hu a u l n u a . e i H a h 6 u , 1 e e Ilopraox Bbrno,tHeHrr: 6qnbHofi nexrr
6orej DyKr Br,rrs,
H a v b i u e q H n i . B r , t < e , c a e n p H H o i iK o H r p a ( 1 y p o i . I H y r H B n o ' r b 1 e - n a :6 0 , 1 h r ! H M f in a r b u a M f i B p a , r n p o a J e o a l r i o n r o a o e
:o:oI :,9| ]!h L x 1f i1v " t "
n a J b u e M n p o H J B o A l t lp a 3 ! t H H a H f t es. H a q a J e J e r K o e , n o c T e v e H H o e B o , t A e l i c l B H eH a o 6 e r o q K r r r , a n - . r y 1 2 : V 1 n o , e r o A y i r A
neHHo Aoxoaq Ao crnhHoro. Bo speM, pa3MrHaHxq 6on6Hor1 ROnarbqeBoroBoH3aHI,r't.
Ao,1-
x e H _ n l o l . i ' r B o n Hbt u l p e f i p a l n x q H H e n B x x e H H g .
oorrencrBHe _ Ilpr 6o,rrx B )KHBor€. l flpr ct{HApoMe
Ha toqxr T x H e- c o H t t 1 6 I C , H l r r . r r H - Touxu sosAeficrau;: B 3aBhcrMocrfi or loKanr,r3aqfis 6oax (cM.
3y (16TR) MeroAoM DanbrleBoro H a A a s ! , lr , B a H r . ,t Hxxe].
x pasMl,IfiaHrr. LTor,luuoM l( nHuy c 6o,1bHbrM B p. a q n p o f i 3 , C f l o c o d B o . , a e f i c r B x:f l o n H U n a r b u e s o r A O H 3 A H f i E , H A A A B J I ' B A H 1 1 E ,
BOAtir Ha!aBJxBafiIe na,lb!ev Ha toqKI txHcH-coHi p a 3 M n H a H x e( B 3 a B x c x M o c r , o r K a x A o i l
- 6 0 , 1 b l ] l f i v
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MHrxqrJ. nopqaox sbrno,rHeHfis:
UIHOBpeMeHHOC HaAaB"'IUBaHIIeM npor3Boafi,rcfl I,l pa3MxHaHHe, - n p r 6 o a n x B r n H t a c r p a , l b H o r io 6 , r a c r H BoraeiclBosatb Ha
rjo BpeMr HaAaBnfiBaHyq 6o,rrHofi Ao,,rxeH npolr3Boatirb pa3 r u q h ) ' r ) H r - K y a H{ l 2 V C ) v e r o a o M s o H J a H { t , H a r o q x \ r V h . r a M n h
"lrqHbre lBrxeHrq rueei Bnepea Ha3aL BpaxlarenrrHr,renBrxe (36t) v e r o l o M H a , 4 a B r r B a H Hxs p a l v r H a H j r e ;
HIts B oauy x rpyryn cropoHy. IleM 6onbue aMn,,rrjryAa - nplr 6o,rrx B Hr.txHeii qacTd xnBora
aBaxeHri }J Bo3aeHcrBoBaTb Ha
v r n n B p a u r P Hf l , [lncr. 2 J vr]H rixrr aeHxeHrir. roqKH xyaH-HryeH (4VC) n qyHr KyaH (t2VC) MeroAoM BoHsa-
norryBcrBoBaB ortlyuleHte, noAo6Hoe <3+OeKTyl,'r,rH>, 60,1L,Hoi Mo- H l . i e ,H a r o r r K q r a M , a M - 3 n o ( 6 R P ) x a M - , r a H r , r y e H ( 9 R p )
xer npe(parfirl Mero
aBrxeHrjr. B aantor cnlvae <3QQexr ,rnbr> a o M H a I a B J t H B a H r ,rl e p a 3 M x H a H u r ,
n p o e B , l f l e f c aB a f i a e y T o v r e H H e , o H e M e H H f lp. a . n H p a H x q B M H L x U a x . rr p x M eqa Hte: K o r A a c T e H K a x r . t B o T a B b r n r l r r r B a e T c r nr .a B ,
o o / r , x o r n o ' l , r \ p Ht r o ' { v B c r B o B a r bp a c c , 1 a 6 , 1 e H H . Bce n c H H b r xK U H r l a K vleHde cJreAyeT ocra6nsTb, KorAa oHa BTrIrtBaercH. llaBJ,IeHIrevcn
r y p o r M 6 l l x u . t r c l o - n p o u e a l p ! c n e , 4 ) e T n o B l O p 1 4 t hH e c x o , l r , K op a l . . r h B a r br y r J y 6 , l r t h n a i e u B x l r B o r .
. . t t p r n o M c u l l x6 o r q x . n p r 6onqr B rr,reqe Toqxr ior 2 . I I p r c r H a p o M e. n y ( t o r b r , . l o q x H B o u e i c r B H e : 1 \ u e H K x \
a e i i c r . B h t : x n e Hr b . H b ( 2 1V B , . x H e H, r r y H r i t 5 G l r . xx)x-qt ( 2 5 E , . h \ a H - H f l e - (H4 V a r . r ! h - r a v , r , r { 3 h F j
(II GI),
L f l O C O OB O 3 [ e I Cr B r q : O A H O n a J b U e B UAeO H 3 a H t e .
Cfloco6 Bxs: na'lbueBoc palvHHaHre, trorTesoH yKor. npr cyAoporax MErxq HD|(Hsx Kofie,{Hocrefi. qanre Bcero gro
-Bornefict
. rr.pfi o.!rex B noxre. T o , r h , a o r a e r . i c r a u nx :x i x . v r cyaopofil fiKpoHoxHox MrrruJuhrx MHltlu noloruBbr cTonbr.
(l I
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Cno.o6 BornercrBfin: no.reuo;i 1no,,, nanbuesoe par!triHaHHe. Hxe -kox {2 R).
_ n p H 6 o " 1r x B r a n r c r b e . " T o , t h r B o 3 l e f i c r B HN r :r v K _ q x C[oco6 Bo3AeficrBr.jr: l]arbueBoe Ha{aBlfiBaHfie, narbrreBoe
lll^CIr. 3broHr.qH r 4 T R r . y e Hh o l ( 4 t C ) . pa3Ml,lHaHre.
C n o c o 6 _s o r n e i i c r B H F : r . o r r e a o f i y x o r r , n a , l b t L e s o ep a t v f i H a H e . I loDflaor{ BHno!'rHeHt'l:
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Hor-yi
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f l p o x 1 B p f i r p a r v r H a H t e t j o r o v e c T a , n o c T e n e H H ot . t r , r r . r e a sa a s , l e - M r s a r b r o q K ! x o x r - r o H ( 4 R P ) r , 1 n H I r e H , k o K( 2 R ) ( n p , c y a o p o _
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1930 r, n 3 ! q a q a x y n y r r k r y p yJ, ( , y , R ( , s o f d c t a F u y e
n H a - r , \ b r " d rr 4 f i . r f l r r( ? ( 6 f ) . ra-xlaH t7 Er. sbruHr.6drh .C
I r c v b , . r , q q - q yr ( z b v ( r ) . d r e b r r , r o H "
1 2 0G I ) ( c o . f o n o H h HyrorMy, BaeleHHyroB roqKy. CBoii lreroa oun sasga,rx :,rexrpo
n o p ? x e r r H o an a p a n x q o M ) . x o n - x o K ( 4 ( i t ) ( c o 3 a o p o u o n c r o p ; H H ) .
ryHKrypor.r.
Lnoco6 so3,ieiicTBfie: na,rhueBoe HaAasrr!Bafixe, na"!b(eBoe pa3
npnMepHou 1950 r.. B Krrae 6btn np{MeHeHs.reKrpnqecK{,
M X H a H X eO, A H O n a r l r l U e BB OO es3aHre. Tok arrfl crrMy,'rqqfin a(ynyHxryprux
I | p n s H y p e 3 e . T o , r r r B o 3 a e i i c r B I r n :q y r r r K h r x , x x r . , x a n ( l ] V C ) . ro,rex (qepes Brroi) l ,r,rl
(6 VC), Kyarr-HfyeH
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( 4 V C ) , r a M - a 33 ' { o ' ( 6 R p ) , . r x a H3 y ( t 3 V j
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C n o c o 6 B o 3 r e i i c , r s 0 e :n a r r r u e B o eH a r , l a B x r s a H r e n, a , q b r r e B o p
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lil3ll.ilr;llli99p"' re6u"lbuHe ro paiM(py.yao6rsre.
rpalcnopia.
c r q e p e 3 a x y n y x | { 1 y p H L , rxer r b r ( : i I e K r p . r a l ( y n y x K y p a ) u r r c o o e i l b H b l e ,o e 3 o n a c H u e D o 0 p a u r e H r r .
MonLbroHe6oJrr,rxfixsJrexTpoloB. HaKnaAHBaeMux Ha xoxy B Mecre
p a c n o r o x e H f ir r o q K r ( r o q e q H a q 9 , r e ( r p o r e p a n a r ) . 3. eooEKTt,lBHOCTh
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r I x e l , b u l r c r e p a n H H . c o q e t a ' l q e N c u B p c v p H H o i r t e D H U r . l H bc . ! p e B .
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<[BETEH}|t') npocref,uxl cnoco6 x3rorosnc[rt
nyrtxoaux uonolorl*oa t nyqloDHx HrJl
nonoxEHl{t
r. oc oBHbrE
3axpenurb B Bxre ny.rKaHa KoHrre(B l0 M or Kpaq) AepeBtHHofipy
MeroA <qBereHnt,cocrorr B nerKoMnoKo{'raqrrBaHIr
MHororrorh- r(orrKH AnrHofi 25 cu 5-7 rrn xe arqHHee20 MM,rafi, qlo6bl Korl-
qaThrM Mo{roToqkoM (5 7 He6onhlnrx l,lrn, 3ar(pen,'ieHHhrxHa aepe
(br fix rexaJrr cTporo B oAHot nrocKocTn,a yroJi Mexay cTepxHtMt{
BCHHOfipyXOrTXe) nO XOXe C qer'lbro BbBHBaTh TepaneBrrrrecKri
rrr H pyKorlKoi cocraBnsn 90o. Py(oqr(a He aonxHa 6brrb cnnnll'
,rn6o npoorj,raxrrqecKHneooeKr. (oM roHxoi, qro6br e€ yAo6Ho 6r,tro Aepxarb B pyKe,

Pa3sxtre M€mra <uBer€txq,

Kax flpasxnbHo Aepxarb nyq(oEHi Mororo.re(
Bo Bropofiqacru rraBH 7 <Krau o axFpenuexr onl,lcaHo HecKonbKo 6parb B pyKy ryqKoBr,ri Mo,ioroqe( creayer ra(, t{To6u yKa3arens-
cnoco6oB,retKoto pa3ApaxeH[t xoxt c noMourl,roI,r,1, Hbrfi q cpeaHrfi narbr.lbr rrrmHo yAepxrBa,rr ee Ha'/3 a"nHHbroT
- nerxfifi, noBepxHocrlrhriiyKon c 6HcrphIM x3Bt'Ie-
no,r)ryKo,'r (par, a 6e3HMcHHbrix Mu3fiHerlnpfixxMan ee K naAoHfi.Borburoi
qeFreM xrr''r6r,6e3 noBpexaeHfir noaKoxr{brx lKaHefi. y 6onbHoro
nareq ra(xe HaKralbrBaercfl Ha pyqxy, KaK noKa3aaoHa pxc, 136.
Ao"I)xHoBo3lll{I(HyTtorUyrUeHxe,cIoBHo y Hero BbIAepHyn!Bor'loc floxonaqrBaHre MoJroroLrKoM npofi3BoArrcq rraBHNM o6pa3oM
yKon <nrkypa naHTepH)-- noBepxHocfHHeyr(olrbr B qeTblpex
3a cqer pHrMHqHbrx ABrixeHnfiKr.rcTbroIpn cru6afiaq pyKHB nyqea
TOqKaxpqaoMc 6oreBbtMyqacTKoM- Bbrlxe,Hrxe, clpaBa x c.4eBa nrcrHov clcraBe. qro6d Becbnlqox nr,r coDpriKacancr c Koxefi flo!
gn-yKo,r- noBepxHocrflHfiyKo,r flo runy yxolra <ulKypa naHTe_
pH> (pcaoM c 6onbHHMMecroM) nJrlocnrrHii y(o!'r B ueHrpe 6ore-
TepafleBTx,r€c[{f,94rD€|(TMeroAa <qserefil|rt
B Aa,rbHefirreM, yKor'roBB Hec-
yqrrbrBac onbrr noBepxHocrHbrx Jlpeaxae apaur yrBep)KAalrr, qro Haura Koxa crryxur rlacrr,rc
KO"lbXrX TOrrXaX 60.1eBOrO y'raCTKa, firr'loTepaneBTbI CTa,tIH coeallHtTb crcTeMbrMepfiA aHoBn noapa3AerieTcfl Ha 12 KoxfiHl 3or{ B coor-
5 7 fir,r B nyqo( r 3aKpenJrrrbrx na aepeBrHHofipyKoqr(e Arq BercrBlr[ c pacnoroxeHHeM l2 r,']aBsbrxMepHAaaHoB.
462 {G3
Pr<. i16. Cnoco6 aepx6ra nyqxolyb rrry.

<Xo'{eub 3Harh pacno!'roxeHfie KoxHHx 3oH yrlr.rrblBafi nyrlr,

flo xo,opbrM rjayr KaHanbr, JTo npaBr.do anfl Bcex xaHar'loa>
( < K H M r a o B s y r p e H H e M " r, n a B a < O K o x H H x 3 o H a x > ) .
< L o c T o H H x eK a H a r ' I o BH a x o A r T c B o e B H p a x e f i I e H a K o x e ; B o T
noqeMy xoxHbre soH6t -- 3To HapyxHar qacrb KaxanoB, (I{6roHr
K a H bH q K ' ) .
f,raBHbre (npoaonr,Hbre) MepfiauaHbr npor'reraor rlry6oxo B Mbl-
lIeqHHx TKaHsx, qro x€ KacaeTct l,tx nonepeqHblx oTBerB,IeHfii, To
oHr pacno!'roxeHbr no BceMy (oxBoMy noKpoBy. KaxAbrfi MepfiAnaH
s M e e r c B o I ( )x o x H y r o 3 o H y , r a x q r o 1 2 r , r a B H H MM e p u a u a H a Mc o o T P,.c. i37. nonoxeHre 60r!Horo np, o6p66orKe cnrHbr {eroaoM (qsere-
BercrBylor 12 KoxHr,rx 3oH, a Kaxaar KoxHat 3oHa cBt3aHa, TaKHM
o 6 p a 3 o M ,c o c B o r M M e p n A r a H o M t c o o , B e r c r B y r o x l x Me M y B H y T p e x -

{;:\i
fixM opranoM,
<\oxa eclb qacTb cucleMbr KaHar'roB>,nogToMy, <Koraa sHeuJHqt
6on€HerBopHat sHeprfit npoHnKaer B xoxy, nopbr pacKpblBalorcq.
bo,'re3HeTBopHasgHeprxq npoHrxaer aHaqar're B orBerB,reHHq frraB-
H H X K a H a L ' l O A . 3 a r O ' 1 g r ,Ot BT B e T B ' I e H f i qO, H a n p O H r i K a e Tr " r y 6 x e , B
rrraBHbre xaHaJbr. A KorAa 60,re3HerBopHar 3Hepanr 3ano,rrirrr I,l
rr'raBHbrexaHa!'rH, oHa npoHrKaer eqe rJry6xe Bo BfiyrpeHHlre
o p r a H b l > ( < K H f i r a o a l r y r p e H H e M >r,! ' r a B a< O x o x H b r x S o H a x ) ) ,
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Bcero B r(oxHHi noKpoB, qepe3 Hero npoHnKaeT B M€prrafiaHbr, no
KOrOpbrMnonaaaeT Bo BHyrpexHHe opraHbr,
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no MeprArraHHbrMnyrrM aaer o c€6e 3fiarb Hapyxy, nporBnrrch Ha
xoxHoM nol(poBe B BI,IAepas{'rrrqHHxnaTororrqecxlx peaKqnn Bpoae
6oneBhlx yqacTKoB, 6o,,IeBbIxroqex, 6ore3HeHHoro 3y.qa, x3M€HeHrit
qBeTa l(oxll L T. a. uneaoBaTenbHo, cyuecTByeT TecHaq cBtB6 Mex
Ay KoxHuM no(poBoM lr BHyrpeHHlrMri opraHaMn, n 6on€3Hr,,{epe3
xoxy npoHrrKaer B nocr'reAfise na6o, Hao6opor, H3 BHyrpeHHrrx
Pxc. 138. O6pa6or*a 10,06!r, rrqa
r ueh MeroaoM (qBereHrr).
ll i t l
opraHoB BLlxoarrT Ha Koxy. c{'reAyr no nyrflM MepnalaHoB.
O6pa6arhlBac (oxy MHororrorbqarHM MoJ'roroqxoM, qepe3
noroxeHue 6o,rbHoro, Mecro Bpaqa Bo speMr npoqe,AypH
MepranaHH, CB93HBaIOUIreonpeaeneHHbreyqacrKu Koxx c onpeAe-
r'reHHHMr{opraHaMx, Bo3lerclByror Ha opraHq3M, HopManll3yr xpoBr, npr Bo3AeicrBriH MeroaoM <rrBereHrs> 6onbHorl Moxer c{nerb
n Bce BraH 9Heprfifi, BoccTaHaBII,lBa'IpaBHoBecre I,IHL-tH, ycl,rr'IIBaq Ha cTyr'Ie l,t'llt "rexaTb B yAo6HoM I!,Iq Hero noltoxeHfiH.
conporriBJreMocrb oprdxn3Ma, cnoco6crByr npo(prrar{Txxe llnD !']e- ttonoxeHfie c{At Ha cTyne, BbIfHyB cnrHy fi crrerKa HaKIoHfiB
qefirrc 3a60,'reBaHIri. roJroBy, sBr'rHercr Hax6o,'iee yAo6H6rM npfi o6pa6orKe 3oHbr o6r3a,
i l,l3B.crHtn {nrarlc({n BFa! npr rerbHoro Bo3Aer,tcrBfisx o6,racr, 3arbr,,rKa (prc. l3Z).
lHHa.rnn Mrnb (1368 16441 (B6trHaM.M! Bpa-,{ Moxer crosrb prIoM c KpoBalbro, cry!,toM fi!, .{ crAerb
,p.H.kptrnLrn' u[eqr). npuaea. nep

464 465
 \poBarb He cieAyeT npuABuraTb Bn,roTHyto ( creHe, qTo6br Bpaq floKa3aHnqi rra3Hbre60!'re3Hr.
sMe,,raocTyn x 6on6Horvy c arc6ofi cropoHr,r r Mor cBo6olHo MaHllny, 6. HocoBar 3oHa.
!'Ir,rpoBaTbMorloTorrKoMBo BpeMq ceaHca !'teqeHtq. .rlnHfiH Bo3aeicrBrjr: 2 JruHu or roqex rbrHb-MliHb (l V) no
o6efiM cropoHaM Hoca x HocoBbtM (pbI!'IbtM,
2 , T E P A n E B T ] | q E C K I |O
EB J | A C T | , I 3 o f l b l noxa3aHr{t: ocrpble &!'IL xpoHfiqecxue 6o,'ie3HH Hoca.
7. fy6xat 3oEa
,rlriHnr{ Bo3AeticrBlrr: I 2 Ayroo6pa3Hhle rnHxn BAoJlb BepxHeff
I loMItMOK'IaCClqeC(OrOAeIefifiC Bcefo KoxHoro nofipoBa Ha l2 xox- x HrxHefi |.y6.
H b r x r o H , x a K 6 H r o y h a r a H o B H U l e .c l u e c r B y e r I l p y r o i n p l r I u n
lloxa:anfiq: 60re3Hri 3y6oB, qerlocrHo-r ueBble 60,re3H{, 60're3-
n e , l e H r r , c a q 3 a H H o r oc , r e q e 6 H o i n p a x t H K o i . Hl.! t3blKa ll poroBot [oJIocTIl,
E. cxynoBag aoHa
O6racD ro,loBH x nxua JIxHsfi Bosa€ficrB,{t: 2 ,lfiHtx, }iAyrire or roqex HreHb-xbloHr
(20 GI) (,rarepanbHee KpbIJrbeB Hoca) no xpxBoi, ors6aroqei
3Ta o6nacrr, noApa3Aerrrercr Ha 3oHbl (pac. 138). cx,{3y c(ynoBbre Kocrrr, K ToqKe lxr,rHb-l(yHr (lg IG) y ocHoBaHH9
l Jlo6Hac aoxa.
,1nHfit Bo3AeficTBxr: 3 napan,re,lbHbte ropfi3oHTa,'rLHHenfiHsI, B floKasaHfiqr croMarolror qecxrie HapylxeHfit B o6nacrr ,'Irqa,
Hanp?BreH{ cnpaBa Hareao (l,r"1H Hao6opot). 6 o n e 3 H aH o c a , n a p a n s q V I I q e p e n H o r o s e p B a .
lloKaraHrq: c,ralxova. rd60,leBaHrq "4OP opraHoB, ro,loBHat 9. Yurxar sona.
A[aHoB (cBe?rbrfi rH) (MepfiAHaHbr ror'rcro* KquK,l x )Kenya'{a), JIuHfi{ Bo3reicrBre: l-2 l(o,rbrreBblerI,rHnl{ Boxpyr yruHoti
MecTHbIeHapylrleflN9. pakoBriHbr, or roqKs rxnHr,-KyHr(l9lG) xaepxy, I( 3ayuHoii o6!'Ia-
2. n€pcAx€rciic8xar 3oxa r 6oxoB6ac qacrs ro.roabr. crfi,3areMBHx3qepe3roqKy e-OoHr (17TR) , cHoBaBBepxK Toqxe
,rlrifi sq Bo3AeficrBrrr: 3-4 napa,,r,re,l6H6reropn3oHTa,rrbHhre rrHrl rxr.tHb-KyHr (l9lG).
or npaBoi 6oKoBoi ao neBofi 6oxoBofi rpaHBq6r Bo,rocncrofi qacrr.l lloxa:anr.rn: 6one3HI yuJeri.
ror'loBEr (Hrlr Hao6opm). 10. BxcoqBat 3olia.
llo(a3afixc: r,tayKoMa. 3a6o,reaaHus,rloP,oorasoB. roroBHaq ,rll,lHrr.rBosaeficrBrq: 3 4 ,'rfiHtrr.r,pacxoarqltect BeepoM or
6o,1b, cBr3aHHac c p'accrpoicrBoM MepfiaHaHoB <ia,rufi in, lvepu- yqacr(a roq( ua-uox (21 TR).
nrraHbrJpex qacfet rynoBflqa H xenqHofo ny36rpf). floKa3aHtrg:6one3HH,cBt3aHHbIec paccrpotcrBoM clicl(oro Mepfi_
3. T.M.xxac aofia [Ha yqacrxax rolex 6air-xofi (20VG) x 4 H a H ax e , l q H o r on ) r b i p e , 6 o n e r H )r u r e i . r . r a 3
Tbr-TxaH-TxoHr (BHeMeprraxaHHaq, r Aaree B cropofiy y[rHbtx paKo-
BlrHl,
,rlfiH H Bo3aeficrB r: 3 4 Ko,'lbqeBbrennHHr Bor{Dvr roqKll 6arb, O6"1acr6urer
xof, t20VG),3-4 r o p H r o B r a n b H b l e" , r r r r r o r n p a a o i y r u H o f i p a K o -
BlrHErx neBoi (q,lr, Hao6opor). 1. 3arHroqxan 3olla.
noka3au q: ro'roBHar 6o,'rb, MepqaHre B rna3ax, ro,roBor(pyx€ ,rlxHHHBorneicrBHr:5 ,1fiHi cpe!Hse npoxo!r.r1or HIlxHet
Hr{e, npocryaubre 3a6oneBaHufl, cgqdatsue c 6o,resnerropuunr Sax hpovxr.i Bo,locr.rcroi'{acrH roJlosti ,o roqxr !afi_t|or ll4 VG).
TOpOM<BeTpa>, [OTepr peqn, HapyueHxq, cBr3aHHbre c rH-rreqe8r,rc 2 coceaHfl€c Hefi npoxoAsr BAonL MepxaraHa MoqeBorony3brpt or
x a613BafifiHe H36brro'{HHM <orHeMr, rr.tApoHeQpo3, fiapyureH0r, xpoM(x Bonocscrofi qacrH ronoB6l ao rorrKH aafi'qbl (ll v)' 2 oc_
npq KoTopHx oroHL B cocTorHr{r,t <nycToTH) yclpeMnrefcg BBepx. Talrr,HEIe BAonh MepuAlaHa xenqloro ny3r,Ipr or loqKfi (poHr_qH
4. 3o[a 3anHef, rracr ronosu- (20VB) ao roqKn xneH-rblHb(21 VB).
"rlsHrn Bo3AeicrBfiq: 5-7 npoao.rrsxarx,'raul,fi, ,Ayqqx c ypoBHn floxa3aHtt: cnyxor rr'IaBlrofi3oHoiinpr "reqeHt! MeroAoM
TorrKI xay-AI,IHb( l9 VG) Ao rpaHrqbr Borocltcrof, qaCTr Ha 3arHnKe- <qBereHrq>ronoBHbrx6or'refi,60.'re3HefiJIOP'opraHoB, npocryaHb,lx
noKa3aHfif,: ro,loBHar 6on6 B o6,'Iacrr{ 3a,r6llKa, cracr{qecKoe 3a6o,qeBaHfifi, psrnaHocrli 3arbr!'rKa.
coKpauIeHIre 3aTEInoqHHx M6[xrt, 3a6o"jeBaHrrc .IIOP-oprafioB l.t 2. 3oHa n€peaBefiqacrfl uer.
HapyueHlrr B o6nacrq e3r,rKa,6one3Hs, cBr3aHH6rec paccrpoficrBoM c KaxAoi cropoHLi IjIre'r,
.rlqHfin tso3aeficrBxt: no I 2 ,1r.iHr.rr.{
MepnafiaHa MoqeBoro ny3r,rprr. fi3-noAHxxHgx qeJllocTei Ao ypoBHt ToqeKKxtl ca (l I E).
o. I Jta3ltag 3('H4, Iloxa3aBr,t:6ore3Hfirlleu, rop,la (oaptHrlrr), aocna.reH!{e MUH
,rlarrn nosaeficrBrat I 2 Ayroo6pa3Hble rr,tHllll aAo!'rb BepxH[x r1a,1lrH, 3()6, fDneproHtle.
BeK, I 2 ayroo6pa3Hbre,rurus ilo.rr nrr^nrx BeK; Bo3rercrBogarb 3. 3oHa rpya{fio-x o,r qdo-cocqesna{oi HHrnqbt.
B f i a n p a B n e H r no r c e p e a s H h rx a p y x y . ,rlxnrju gosAeicraxq: 1 2 r,tl{ tr, xAyurr{e or Hr1xHefi KpoMxs
466 467
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no rpyaliHoxrrclrHrrHococqesraHori

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n raTeparhHaqpyqHaq3oHa (B oTHo-
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i\ ir i
orBercrByer nepeaHei fi 3aAHeii cro_
ponaMpyx) (psc. I39_ 142).
l. Me4tranlxafl mxa naiqa.
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HHe JlfiHl,tx oT HHxxem
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fipat nonMu_
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Hbre napar'LleIbHbre rrHux oT TorrKn nosoPxHoc k,crH MeroaoM
Kxyx-qfi (ll GI) Ao ToqKs rHev-xaii
\,, (8 IG) (n,1! Hao6opor).
t l o k a 3 a H H g :o c r p a q 6 o n b B , , t o x r e -
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npeAnreqbq. rnxopaaoqHoe cocrorHse
c noBbIDeHHon reMneparvDofi .
& MeA{anbnas:6na' irpe4naeusn. Pr.. l al. O6p.6or(a nePeaHoi
n@6pxHoc Pykr MeroaoM
J IaHrH Bo3AeicTBxrr 3 npoAo.rb-
HHe ,IrHIl't OT r'lO(T' AO 3anrcTbr.
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noseprHocfu Pykr aeroaoM kqr H,nwrr e H r H a rpyauufr no,rucrl. ueHne reMneparypbl no Ho'{aM, fiH(peKuqo[HbIe 3a6o!'IeBaHI'lt,ocrpLie
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o c r p a r o o , 1 6B A o n hf l p e n n n e q b F . 6oJrI Ha naroHHori cropoHe Kucrt{.
4. MeAxanbfiar 3oHa lanccrhe, _ 6, JlareparbHaq 30 a nreqa.
_
. / l f l H r . r HB o r ! e i c r B . H q : 2 n o n e p e q H H e n a p a . l r e - n 6 H b j ej h H x r n o ,rlxHriH BosAeicrBne: 3 nporo,lbHble rxBri{ OT DJTETIA SHI,I3, X
cK!,ralr€M BHyTpeHHet cropoHbr 3aIIqcT6s. r ' l o x r € B o M yc y c , a B y .
llo(a3aHllq: 6one3Hfi cepa{a, nerxfix, 3a6o,,reBaHH, roplra, ocr- flol(a3aHnn: HapyueHtq B o6"'racr ro"loBbr, 3 a T b i , q X a , r l O n a T o K ;
paq 6o,,rh B o6,!acrr 3anrcThr. ocrpar 6onr, BAorb DJeqa.
5. SoHa naAoHHofi croDo Er Ktcrx. 7. Jlar€patD ac 3olra np€anreqbt.
,rlaxaa nosgeicrefin: 5 npoao,ltuorx,runtfi, fi,(yruxx Beepoo6pa3- JlrrHtr Bo3AeficrBxs: 3 npoaonbHHe,'rxHl,llr or noKTeBoro cycraBa
H OO r C ^ r ' l a A O K r a n f l c T b f la u K o H q k j { o Bn a J b l e B .
f l o x a r a a r s : 6 0 , l e r H k o p r a H o B t p y n H o i n o " 1 o c r r . 1r ,o p n a , n o B H [Ioxa3afitq: 6o'1e3Ha JIOP-opraHoB, HapytneHut B 06r'Iacrn
fo.,roBri, nrqa, tH(Fel(uxoHHHe 3a60.reBaHXt; JlHxopaaorlHoe COCTOT-
468
469
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caf3u c paccTpotcrBoM rHcr{oro
M e p l t n H a H aT p e x q a c T e i T y , l o B l { u a .
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cxte 6one3fiI, IrxopaAor{Hoe co-
cToqHke c noBbrrueHLteMTeMnepa-
rypLl.
9. 3ofia naJbqes py[t.
JIsHrri Bo3reficrBns:,,rrfi'rx
840,16 6oxoBErx cropoH naJtbqeB
pyKr, oT Haqa"'ra nepBbrx earaHr
AO XOH.IHI(OB na,'lbUeB, I
floxa3aHHq: 6o,'re3Hr ro,toBHoro I I
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Ha9 HO*(Hafl JOHa, 'aTepaJbHat , I
HO)KHaq30Ha, nepeAHqt HO)(Hat 30, I I
Ha, 3alHtt HoxHar 3oHa (B oTHoneH I, yKa3aHHoro Bbtue noroxe, t I
Hnr crofl) (pHc I43- I46,. I
I
L 3oxa n€peAfi€i croporu 6eApa.
J l H H r r . lB o 3 4 e i c , r B r F :3 n p o , 4 o n b H H e, t r H H H o l n a x o a o i c K , l a n K f i
!o BepxHerc xpas KoneHHo qaueqKr.t. I
no(a3aHHr:3a6oneBaHMr roncrofi r rotxofi xnruxr, ocrpaq 60,rb
no nepeaHei cTopoHe 6eapa, B o6,lacTfi |(o,leHa, 6oreeur, cinsaxxue il
c paccrpolrcrBoM epx!{aHa xery4Ka .cBeTrhifi ,Hr,
2 3ofia neperflal croporu ro,ienn.
J l r H f i r a o 3 l e f r c r B H r : 3 n p o n o , l b H 6 r e , , I } t H l i Ho T K o j e H H o r o A o
ro!'IeHocTonHorocycTaBa,
noxa3aHfi f : 60,re3fl,t nerx{x, xeJryaKa, xenyAoqHo,l{rlueqHoro
rpaxra, xapylxeHxq a o6,']acr, ro,toBbr, rpyAHoi no.aocrk, rnaBHbtM
o 6 p a s o M 6 0 , 1 e 3 r s c, B r 3 a H H b r ec p a c c r p o i c T B o MM e p r A r a H a x e r , t y l x a

3.-.3oHa 3a.lHefi cropofiH 6elpa t| noAxoreHHoi,Mkx.

J I H H HF o r n e t i c t B r r : 3 n p o n o n b H H e" t H H h , o l , r o 4 H q H o , c h - [ a ! -
h H n o n o ! K o , q e H H o i r. M k H : 3 n o n e p F q H H er H H t t j , n e p e c e I ( a r c l r r r c
ooracrb noAxoreHHo,t rrMKru cK!,raAkr, 06pa3yrorquecq Ha Hefi.
lloKa3aHrr: HapyureHHr B 06"lacrx cnr{Hr,r, renoppofi. sa6o,re- Px.. 1,13.O6p66or(a n€PeAHet no- Pr<. l4l. O6p.6or(a 3.AHei no-
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470
 cTopoHerorleHocTonHorocycTaBa, 4 rtrHxft, pacxoaqr{recH Beepo
o6pa3Hoor ro!'reHoc,onHorocycraBa no rbrrr,Hoii noBepxHocrficro
nH BAOJ6Me'KXOCTHHx npOMexyrKOB K MeXnarbUeBbrM npoMexyr-

floKa3aHHr:HapyureHBrB o6.qacrxro,roBr,r,,rfiua.croMaro,ro-
frqecKHe 3a6o!'reBaHxr,3y6Hbre 6()"!e3HH,6oncaHI rop,Ia, ocrpbre
6on,r B ()6,1a,
rI ro,leHocIonHoroc).1aBa H no rL,ribHoi .ropuHi

8, 3ofia noaourBHclonu.
JIt,lrllrtl Bo3AeicrBlrfl: 2 nxHrn, pacxoAflru{ecr or roqxx 3yHr
* ryeH (l R) x 6oxoBbrM kpasM nq,KH.
IloKa3aHr.rs:<nycrora> r.rHb-exeprss,HeBpacreHr.rr.
9. 3ofla KoneHa.
Prc. iat. O6p.6orkd rhDhHo, noseprHo(rH
li( "rltiHnfi Bo3AeicrBxr: 2 KpyroBNe!'lnHxfi Bol(pyr Ko!'reHa.
floKa3aHxr:ocrpble60,'rI B xoaeHe,6epx-6epr.
l0. 3oHa MeAranbBoi ruar€pair,Hoi noAHxeK.
, I l I r H H HB o i . a e f i L r s H q :2 h p y f o B h r e r H H H H B o h i ' ) r \ a e n h a ' T b H o itil
rlarepai6Hon roAbr)(ex-
floxa3aHfiq: 6(),,rI B ro,']eHocronHoM cycraBe, npHnyxrrocrb H
Pr<. i46. O6pd6orK. noAo{BH aeroAoM <qBe_ 6 o , r s B , r o a b l x K a x , n n x o p a a o q H b l ec o c r o q H { r r c l t o B b r u l e H } r e MTeM-
neparypbr-

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ao3IeficTBxri 3 npoAo,,rL,H6re ,IlxHL{r.{
Bo3AericrBus:2"rxnrs, rlyuae BAo,'rbnpaBoii x nesofi
.,^-JluHrr nrHrr, qayulfie oT no!KolreH_
HOqIMXI AO ror'reHocTonHorocycTaBa. cropoH rpyauB6r.
lroxa3asnr: HapyueHsr B o6nacr{ cnrHbr, floKa3aHHt: HapyureHuflB 06,racrn nnureBoaa,B 6poHxax. B
3a6o,teBaHIl' rfl{uor(, cnHApoM<ycTpeMneHxq
ieMoppol. octpHe 6o,tH no JanHci cropuHc cepaqe,,rerKfix, 3Hepr{x BBepx>.
roreFH,
r MeaxaitLfiar Jofia 6e4pa x roneir. 2. 3oHa rpyAHofi K,rerx|.
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ro kpae KoneHa s r{aK npoao!,rxesfie _ eqe xyT(oB,
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uruec,noBHyrpeHsen
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lloKajaHre: 6o,re:Hu Moqenoaogblx opraHos HHLrJoxo(rpbre
6.'rx no BHllpeHHcfi "'.0";";;;;;;-" O6nacrb x Bora
6. Jlarepa"l6fiar 3ofia 6erpa x roneHn.
JjEHflHBolAelcrBtr: 4 IIporo,1bH6tF ,1HHr.iH, l. 9nlracrpanbHar 3oHa.
.. cn]cKaoLuxec,
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5 npo,nonhHbi\ napanreJbHbi\. tHltfi, HaqH-
kpaq xoneHHoro cycraBa s (aK flpoaolrxeHHe to Ha'oqxxcr or HHxHero Kpar pe6epHofiAyrx Ao ypoBHr nynKa
::lII_1919 eqe
i3,"*T;t1;"i;1fr ,llu.""or*"oo cropone
ro.,renk
or r(oJreHa (l nrHrrr no u€Hrpy s no 2 rk+ui c Kax !.oircropoHH); 4 napan-
Ao r're!'rbHHe !rrHr,({, orcrorulHe,4pyr oT lpyra Ha paBHoM
flonepelrHbre
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Ha HapyxHotcropoHe6eApatH{xHr, ,{: oonfi
Ha!'reBo !!'rri Hao6opor{prc. 147).
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2. 3oxa Hrxfi€fi qacrB xrBora.
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474
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oT ypoBHe nynxa BHfl3 Ao Jto6xa; 3

no.eptho<r, iy,o.,qd MeroAoa (qEe-

4 fiapa",]nenbHbrenonepeqHHe
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3. 3oHa naxosux cxnaAox.
raxaoii cropundroI norBoHoqHHKa Bnyrpexxr" nfiHIr llpoxoanl
,rlrHHH BorAeictBHr: no 2 ,txhfi,r ( ha)AAoi cTopoHH, Hnyurye
q e p e ir o ' r h , x o a - r a t P C 8 5 i 0 1 y p o a n rr o u e x a a d r l o H l 1 4 \ n r ! o
c B e p x y B H r r 3B A o n b n a x o B b r xc x r a a o K ,
ypoBHsroqex xa-,rtey (34 V). BHeUH|e ,']Hsrlr'{npoxoAqr or -Melx_
noxasannq: Moqeno!'roBbrepaccrpofi crBa.
anursrx xpaer !'IoIIaroKBHIr3Ao ypoBHqro'leK JIar 6[es (54 V).
474
475
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np npxcrynax 6o,'rH,cBt3aHHHX c flapyueExeMlt B o6,'Iacra xenya
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,176 477
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48{i 487
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11crro,,lh3oBafiIre np ooeparxBHbrx BMellraTexbcrBax c np{MeHeHxeM r o M a x n c H x n q e c x o r op a c c r p o r i c r B a , n p x o n e p a q a q x y a € r e i i , r . e . B
MecrHoro r{"!n l)6utero o6e36onxBaHt{q BcnoMorareJlbHblx rexapcr- r e x c , r y q a e x , ( o r a a H e B o 3 M o x e Hx o H r a K , r c o n e p a p y e M H M .
B e H H H Xr r p e n a p a T o s ,r o B L , r u a q 3 0 O e x r t l B H o c r 6 o 6 € 6 o n f i B a H r q , n o - Heo6xoAfiMa rruarenbHar noAroroBKa annapara ncKyccrBeHHoro
M o r a e To A H o B p e M e H HHoo p M a J r f i 3 o B a TOby H K q u t ox p o B o o 6 p a q e H r . { qI ' abrxaxrq, M€p nPelynpexaeHxq fi JrerreHar Bo3MoxHbrx HepBHbrx
a b t x a H r . i t . l o x e a a o . r l l o a a e , c rI n p a I r J I o a H a i r b r e 3 t I l : n e p e n o n e - n p H n a a K o Bn p l r p a c c € r r € H f i B KoxHoro noKpoBajHa"loxeHlrnlxBoB Ha
p a u f i e i r B n p o q e c c e o n € p a r l a r 6 0 , T r , H o M yH e o 6 x o A x M o B B o A x T b xoxy, pacceqeHlrH HepBHbrxBo,roKou. [IpsqnHeHne 6orft pa3nn'rHoft
BCnOMOrareJrL,Hbre ne(apcrBenrrbre npenaparH B yMeHbrxeHHbrx no cr€neHri x pa3apax€Hxe reepaoii Mo3roBofi o6o,roqKx y ocHoBaHlrt
cpaBHeHrb c MeALjKaMeHro3HoriaHecre3xeii Ao3ax. EbrBarcT ll cay- qepena Bbr3brBarcrro"roBHUe 6onr, TotxHoTy, pBoTy.
qax, KorAa onepaq{d He rpe6ylor nprMeHeHr.{q AononHrTe!'rbHbrx 6.Onepaqar Ha rna3ax:
x o n - K o Kr 4 C l r . r H h a ) l b T R ) H a o n F p H p y e v o f.ir o p u H p
a. npeMeaIKaqur. B K a q e c r B er p a H K B r r , l l { 3 a r o p oaBu, e - roaH-qyK (2V), Hrbr-xey (BHeMeprr{aHHas PC6, Ba cropoHe.
creTxKoB rlpljMeHtrcTct AonapraHi QeHepraH, aMfiHa3 H. B HexoTo- nporriBono"roxHon onepxpyeMoii) ;
pbrx ,re'{e6HHx yqpexAeHfisx xcnor63yrcr ro,rtxo ao,raprat (,la6o x o n - x o r ,( 4 C l ) . r r h a ) r 6 T R ) H a o n e p x p y e v o i ic l o p o H e .
a H a n o r r . j q H Hnep e n a p a r b r ) , a T a K x e c o q e r a H r r B r p o p M en r T f i , t e c K o - a y p r . { x y r r q p H HTeo ' r k n : r x a H M o H ( A P 5 5 ) , f l e q € H b ( c o c r o p o H b r ,r p o
ro xokreii,'rr, Henl€r 3a6brBarb, r]To aonapraH nporr{BonoKa3aH r r B o n o r o x s o i o r r e p x p y e M o )f t;
AertlM B Bo3pacre Mo"loxe I roAa u qro y B3pocr'rbrxc oc"1a6.,1eHHbr- xon-Kox (4Gl), Ho* xyaH (6MC) Ha onepspyeMoi cro-
Mr QyHKrrlrnMIt neqeH! fi norteK ero raKxe ci,reAyer 3aMeHrTr' (Pe poxe; ToqxI,{ no coceacTay c onepaqI,{oHHblM IloJIeM, TaKxe. Kar(
HepraHoM n,rfi aMr{Ha3uHoM. C qe,rbD noaag,reHaq cexperopHoi 3HoHr-6arb (l4VB), Hrbrxey (BUeMepfiAxaHHar PC6), rH-6arb
aetTenSHocT, cnloHHHx r{ noToBtix xene3, BepxHr,tx abJxaTe,qhHblx 1 2 E ) , T x b r a - K x a(nI E ) .
nyrex, xenyAKa L KrueqH[Ka ('{ro Heo6xo,AaMoArq coxpaHeHrt f l p s o n e p a u l l f l x H a r J r a 3 a x x e o 6 x o A r M o o 6 p a r r r r ' B H a M a H r eH a
npoxoAxMocr, AblxarenbHr,rx nyren) npaMeHqroT cpeAcrBa, npenqr,
. r B y | o L r r H eB b i r r n e H f i t u \ o n l l H a atponH ! cKonnJdvHH. 60,?bHbtM ec,'Ifi B Bexax r,{KoH'broHKTHBe coxpaHqeTcr qyBcTBITerbHocTb,
r,rayKoMoi nporrBonoKa3aH a-rponrH, no)KnrlbtM r IeTqM - cxofloJr- KpyroBaq MHruqa rJra3a paccnao,reHa HeAocTaroqHo fi npll l]pl,lKo-
cHoBeH[trx K rra3HbrM MHrrqaM 6o,,It,Hofi acnHTuBaer 6o"1b. fieo6-
6 . B c n o M o r a r e ' 1 L H r , r e n p e n a p a r H , n p [ M e H r e M b Br eo x o l l r M o 3 a K a n a T 6, ! l K a I r H :
B p e M gO n e p a q r r . u n p s H q H n e ,e c n r { B o B p e M r o n e p a u { ! y 6 o " r b H o r o Bo BpeMq oflepauna c,Ie,&yeTu36erarb c,uMy,'rrrul ,r fiMnyJlbc-
Bo3HdKali)r rHTeHcHBHbte60,reBbreoUlynleHr.trr,creAyeT nor63oBaTbcq HbIMTOKOMAO TAKOI CTeIIeHr, (OrAa KpyroBag Mblrx(a rla3a l,l rJIa3-
aHecTeTxKaMr.r HoBoKaIHOM,npOKarHOM X Ap,, BBOATlix B KaqeCT HbIe MbItuu6r HaqfiHarcr noaeprrBaTl,cr (B 3rlrx cnyqarx cneayeT
Be cpeac,Ba MecTHo| aHecre3lt! xnu 6noKaAbL npaocTaHoBIrTs noaaqy Toxa r,{!'1firloBhlcrrT6 ero qacToTy);
I l e p e a r e v x a k a o 3 a e i c r B o B a t b H a r o H b l l l o B b t L x e H H o iq y B L j . -- onepaqxx Ha rna3ax c npfiMeHeHrreMHrJroafianbre3r'firur\'teroT
Bxre,rbHocrrr (6prcufiHa, HaAxocrHr.tua) ,1fi6o npfl seo6xoA MocT,r nper{Myu(ecrBo nepeA o6H,rHbrM : oH& npoBoanrcr ycneuJHee, no
c M e u t e s f i qB H y l p e H H r xo p r a H o B B o B p e M s o n e p a r t B H o r o B M e u t a T e r l h c(orbKy npI,{ 60,]buei AocrynHocTfi onepaqxoHHoro none r,ra3HHe
c r B a , c n e A y e T3 a p a H e en p o [ 3 B e c r x 6 , t o K a A y y K a g a H H b l x3 o H . Mb[rrrlbr coxpaHrror B HopM€ cBor,rQyHKutr,6onbHofr cnoco6eH ABfi
l l p l r l l p f i M e H e H x xB c n o M o r a T e - n b H b(rpxa p M a K o , l o r r ' { e c K r xn p e n a r a r b r ! ' r a 3 H b r Mq 6 , ' t o K o M ,B b r D o , ' r H q sy K a 3 a H r r B p a q a ( H a n p u M e p ,
paroB c!'reAyer uMerh B BaAy o6qee npaBuno: qneHr,ronepaqHoHHoil IlpU Onepaqfia no ycTpaH€H!{ro afinnontl,r, np{ |r3MepeHrr coKpa
508 509
ruaeMocrl4 r"'Ia3Bbrx MbIlxq, rp'l oneparlor no nosoay Kocor.rra3firr xon-Kok (4 GI), Hoii KyaH (6 MC) c oAHoi cropoHbr;
H T . . [ . r . i J n o c J e o l l e p a u r ] o H H o Mn e p x o r l e o T M e q a e T c q M e H b u a 9 xon KoK (4 Cl), Hon-(yaH(6 MC) c oaHoiicropoHbr.aypr
ajTeqHocrb,oH npoTeKaer MeHee 60,re3HeHHo. (yirqpHbrer.rr{xlt:rxaH'MorrlAP 55), crMnarrqecKa roqxa;
B .O n e p a q n r B csq3n c xapytr|eH]iqM ,rlOP xon KoK (4GI), HoriKyaH (6,UC) c oaHoi cropoHH,rpy,
nor (18GI) c o6eax cropou-
On€parrxx B |ocoBoii x rafiMopoBoi nolocrfi: y 60,1bHbrxc rrneprpo@leii
SyHXIIr.r'|urHroB}raHox
xofl xox (4CI), rxy-raM'rx (l0GI) c o,,l oii cropoHbr, ]ryer Ao onepaqrr noHH3rrbocHoBHoii o6Mexao 30% HopManbHoro
rrreur-xuour (20GI) c o6exx cropoHi yBer'rr.{qnrbfl pertoneparrsoHHyro apr{orIlqecKyr,o
xofl xox (4GI). Hoft'KyaH(6MC) c o^Hoii croporiti; aypli
xy,lrpHue roqkai rxaH MoH (AP55) c B h r x o n o MH a c r ' r M n a T f i q e npfi onepaqrrx Ha uee xr,roaHaJlbre3re Aaer B o6nreM 6o"re€
cxyK) ror{xy, no"locrb Hoca. BbrcoxriiieQoexr rlo cpaBHeHaro c raIroBbrMnpr onepa!aqx Ha
Ooepauu,rB oo.nacrfiMriH,lanxH, ropraHH,rpaxer I nxLueBora: rrpyrHx .)6racrrx re.!4, u HapyueHue +n3no,loruqecxax OyHKruri:i
xon KoK (,{Gl), rxy-raM-rr ( 10cl) c o,inoii c.ropoxbl. MeHee3Harrnre!,rr,Hoe, oAHaKonpr o epaquqx Ha o6rrl{pHbrxy,rac.r-
.{xeMryeH (23VC); xax pe3y!'rbrarH xyxei qcM npn rfipeorl3KroMxll. O,rcnoeH"e l]6l]-
xon Kox (4Gl), rH Kay (6TR) c o,rHoiicropolH: aypxxy- noqKx 3o6a, ero pe3exurn ivorlr 3arpytHr.{rbAblxaHxe6oJr,Horo.
xqpHbre ror{Kn:roprlo,rxaH uoo (AP 55) c BbrxoAoM Ba cxMIaf!- e .O n e p a u u n H a r p y A H o i i n o J o c r l t .
O n e p a u r q o ) n a r r e h r | oo t r y r o r Hc r e H x r p ! L H o r xl . t e t x H ,p e
xorr Kox (4Gl), Hofi,xvaH(6.MC) c oArroi nnx c o6eux 3exttss pe6ep,yAarleHfie ao.rlr Hnfi BcerorelKoro: ron-KoK (4CI),
Hoit-xyaH(6MC). raM'3HoHrraK (8TR) c orrep(pyevoiicropo
fIps onepaqllflxB o6"1ac.r,{
JIOP-opfaHoBHeo6xolrMonoMHrrb HI'l, laM 3bloHr,rax (8TR) c BbrxoAoMHa Kxqr,,MoH (4MC)
c onep'jpyeMot cropoHl,l.
raxn€ onepau{u, xaK npaBfir'ro, conpoBoxaarcrcrrcxjlbHL,rM x. Onepauxr H a c e p a r l e : x o n K o x( 4 G l ) , H o i - ( y a H
xpoBoTeqeHneM! KolopoeMoxer npHBecrnl{ 3aKynopxe aDxare,lbHbrx (6 MC) c oneprpyeuoncroponu; ayp,xy;rapn
flyreri 1 A P 5 5 ) . , . r v n a r n , r e c x a1 qo ' r h a . e p n u e
B cayqarrx MecrHoii aHecre3ru ,reKapcrBeHHbriinpenapar Ilpu ecxpurar rp)'ABoii nonoc.rr He6xoAr.{Mo r{Merb B BaAy c,'re-
'rlroraaHeAoxoAxr!o rry6oKfix crroeBTr(aHU(xaK, HaflprMep,npt
y,rareBxr.rr"ry6o(oJexaursx r1o,1finoB) i 3rx onepauHrrpe6yrorMaficr.rMa,lhHoro aHa"lbrernqecKoro 3+-
aHecre3trl c noMorrlhRlrrJr aaer Bo3MoxHocrbr36exarb He- QeKra x Mep nporrB paccrpoicrB cucreMblxpoBoo6paqeHnrrr rbr-
npoxorrMocrr AbrxarexbHbrxnyreii ta,aa ckon,leHoHTaM Bbraenq11]- \aH e. . BrrjaHHbr\ c BcxpHrHevfpy,uHonnu,lu. 4,
ueicr c,,rroHbr, xax 3ro 6HBaer npfi npaMeHeHHx OapMaKo,rofrqe- !{r!'roaHa!'rbre3fifl
IlpH 3rrx onepaufiex oc,raB,,rsery 60,rbHoro
. x n i a H e c r e r H rn. o L a B . r e o r ! ppi ie o J r e h r o p h ) l| el ra x u H r or o p r a r , 1 . 60,'reBt'leouyueHut pa3Hoii creneHx, Bbt3brBaeMbre pacceqeHr.{et\l
lloc,le.nepaufioHHblt nelHoI nporpKaetr|eHee6oterppHHo,c vcyb- HaaKocrHLjtlbt u nreBpbt;
rt' nTeqHoc'bro. u4Haqn 3 npoIecceunepaufh 60,1bHoiBce-taK}] -- nps onepaq{qx Ha rpyalt Bo3MoxHoBo3HrKHoBeHre yqarueH
qyBcrByeT60rr., oco6eHUonpx onepaUasx B r,ry6oKxx c,roflx TXaHeri. Horo, noaepxHoc,Horo norBJreHxeqyBcTBapacn paHrf B
aLJxaHqrr.
r - O n e p a u f i a B q e r rr ) c r H o - , , H r { e Bo i i o 6 n a c T r . rpyAlr; npIr ocra6,'reHrr.r (oHraKra
OyHKurl.{,rerxrx, HapyrireHr.jtj
Onepaq{a Ha MtrKxx TKaHqx"lrua: xon-Kox (4cl), Hot KyaH 6()"rr,Horo c MearurHcKllMnepcoHaJoMr cHqxeHHr aHarsfer qe
(6MC) c onepfipyeMoii cTopoHu;ayp]rr(yrapHHe rorrxr: .Te.xoe. cxoro 3QQexTa oT BBeAeHlrrrr,t 6o,,tbHoi He cMoxer caMocTot
-re,rrbHo
cnpaBHTbctr c yxa3aHHbrMu HapytueHrrMl.l, qro nprBeaeTK
rle,rrccrHHeonepaunx:xorr koK (4CI), Hofi-Kyafl(6MC), xoHf- cMeqeHnoopraHoBcpenocr€Ht{rfi eqe 6o,,rbrxe 3aTpyaH[Tonepa-
roH (4RP), rxaii'xxe (3R). rav'au-:ao (6RP) c onepnpyeMoii qaro. IIpr 3Ha'rrre,rbHbrx cnaiiKax Ha yqacrxe HapyueHBeMerojr
cropoHH a,rl,lc o6erx cropoH. rr,roaH^arrbre3r crelyeT 3aMeHHTb apyrrM.
Heo6xoAnMosMerb B sxAy, qro onepaqr{! s sroi o6,racM co- 3.UnepaqI{r{sa 6prcurHoi no,'rocrn,
flpoBoxt/ta()rcq06rrrbHblMKpoBoreqeHHeM, nprBorl ur.rMx 3axynop- Unepaunx Ha xe.rlyAKe: ryK raM-rrr (36 E). rxbroHr,Khl xhr
(e a6rxare,rf,Hbrxnyrefi. (37E) - c orrHoii cropoHl,r,roqKB BAor'rb,'rr.rHfiflpa3pe3a (c o6efix
I,lr,'roaHanbre3rr rtpH ?rux onepauIrsx He AocrBrae, flo.qHoro cropoH);
o6e36o,rs'BaHxq, oco6exxo npN Bo3AeficrB[{ Ha nyrbfly 3y6a. Pe3€Kqle roHKofiKtrirKll ryx-raM-Jrr.{ (36E), xonrroa (4RP),
I. Onepaqnr Ha uree. xon-Kol{ (4GI). Hon kyaH (tiMC); aypur{yrrpHbre
Txpeoxr3KroMrir: MoH.(AP55) c oneprpyeMoicropolrbr.
Oy-AoT(l8GI) c o6€r.rxcropoHi AnneHn3xToMuqi
5t0 5
 ryx-raM-nr,(36E), raM-aM-3qo(6RP), roqKa anfleHrxxcai I-IeperflrHBaHve reMoppotAa,'IbHblxy3"roB: 6arb_xoaH_3y(30 V)
Ha Hore (c ofiepfipyeMoficmpoHbr); c o6e x cropoH; aypr.{KyJepHbre roqr(r: TXaH-MoH (AP55), ,rerxoe,
- ryx-raMrr.r (36 E), TaM-aM-3flo(6 Rp), nan-Kay (5 F); np'lMa'I KI,luxa.
rxaH-MoHlAP 55). Onepauxr Ha npoMexHocrH:raM-aM-3ro (6RP), rxafi-cyHr
ffpbixeceqeHreB 06,Ta.rH naxa: rlK-1aM-jn lJ6 E). ,1ai.xay (3 F) - c o6exx cropoH,rot{Kl,BAo,rbn{Hnx pa3p€a (c o6erx cro-
-
rD ri c onepfipyeMon cropoHbr:ayprK),repHHe ToqKH:crMnaTH'te poH).
cKar fiepBHat clrcTeMa,Ko"'IeHo c BbrxoAoMHa Toqxy xtBoT. Onepaqxn B o6,1acrfi Ta3oBoroaHa o6br,rHoH€6o,!bur[eH cpea-
unepawq rlo BoccraHoB,teHr,tro npoxoAxMocrr MaroqHoi Tpy6r,l: HIreDo c,lor{HocrH.onHaKo,nocfiorbx} Ta3oBoeaHo ooraaaer no-
- iyx-rau-,'ra (368), raM'aM-3;o (6RP) c o6erx crbpox; BbrureHHoiqyBcrBfiTe,lsHocrbro H Tpe6yer coorBercrBeHHo gQOeKrnB-
- ryx-raM-rrfi(36E), qyHr,Ao (6F) -c o6erx cropon; aypa- HOt aHecTe3rfi,BOnpOCO nOXa3aHHsXK Onepa{firM TaKOTOPOAa
KyncpHbre roqrs,: rxaH-Mox(AP55), qnqHxx. Heo6xoAr.rMo perxarb npfiMeHrrenbHox KoHKperHbrM ycroBljtM.
(ecapeBoceqeHHe: K -O n e o a l l n H H a x o H e q H o c r f l x .
T y K - r a M - n(x3 6 E ) , r a M - a M - 3 H(o6 R P ) .
aofi-uarr(26VB) Onepaqqlrnpl,l neperoMaxx!'rroqruiHofi-KyaH(6MC), Qy-aor
c o6erx cropoH; aypHKynqpHbre roqKr.r:rxaH,MoH (AP55) c Bbr- (l8Gl); ayprKy,rspHbre roqKH: rxaH-MoH(AP55), noaxopKa (xa
xoroM Ha cl,|MflarHqecKyro toqxy. nerKoe: o6erx cropoHax).
ryK-raM.,r, (36 E), ,ray-Kol<(7 RP) - c o.{Hoi cropoHbr,ro'{- BnpaBneHreBHBuxoBrrreqeBorocycraBa:xon I(oI<(4GI), KoHr-
K Bro,1b,rr.rHHH pa3pe3a(c o6erx ctopoHr. roH (aRP) c orHofi cropoHbr;aypfiKyrrpHbreroqxHi rxaH-MoH
y,aa,leHre MaTKnrnh ^pltalKa: ryi-rau-,rr (36 E). rav-aM-tflo (AP 55), cr.tMIarrrqecxafl Toq(a, noqxa,ner(oe.
l6 Rpr c oauoft. ropossr.roqx0 eno,lr,,lr.rHrnpa3pe3a(c o6exx fl,racrHqecKaronepaurr nneqeBorocycraBa: xon-KoK (4GI),
cropoH).l,ley-r) (2 VC). veH6MoH (4 VG). Hroai-KyaH (5TR), Kxyx q,' (llGl); ayprxy,rtpHbleTor{Kr:rxaH-
yAaneHfie(bonanxy,'roB flrqHr.rKa:ryK-raM-!'rH(36E), raM-aM-3ro MoH (AP 55), noqKa,JrerKoe.
(6 RP), nay-xoK (7 RP), aM-,raHr-ryeH(9 RP) c oneprpyeMoi ll,lacrfiqecxaflonepaurrrHa npernneq6e:hxJh qv lll CI) c Bbr
\ o a o , aH a r x r e y - x a f i( 3 4 ) . c r f b . q a r b ( 5 P r . \ o n . K o ( ( 4 C I ) : a l p l , |
Onepaqns no yAa,reHnloKaMHefil,l3 MoqeBorony3brpq,currBaHre KyrrpHHeroqKr,r; TxaH-Mos(AP55),
voqeBorony3hrpfl.co34aHHe oTBepcrr.tr ars oTBoaaMoqr.j: Onepaurs npr pa3pbrBecyxoxrn!fi ri no ycrpaHeHuro cnaeK:
- raM-aM-rro t6 RPt c o6elrr cropol. qyHr xuk t3 VC). rxreH-r'ri.rrt (6 Gl) ; aypI,lI(y,1tpHHe rorrKlr:rxaH-MoH(AP 55), nerxo€,
KyaH-HryeH (4 VC);
- ryx-raM-,1u(36E), raM-aM,3qo(6RP) c oABoficropo8br; Oflepaufifl Ha r{rornue: ryK-raM-nI,l (36 E), 3HoHr-raHr-ryeH
aypH|()ncpHHe roq({: voqeBotin}rHpb. nerKoe,rxaH-MoH{AP55). (34 VB), ya-qyHr (40 V) ; ayprxy,rrpnsreroqxr: rxax-uox (AP 55),
llpH onepaufif,xHa 6prcuHofi norocrl{ c srroaHar'tbfe3xefi pac. crMnarnrrecxat ToqKa.
crpoicrBo QxrfioiorHqecxrxS}HKul.ti He3HaqrtenbHoe, JatrepxKa lllrnoroBaHlre orlloMKoB Kocrr{: ryK-raM-nq (36 E), ooHr-noHr
Moqfi fi nape3 KHueqHrRa B nocneoflepaqroHHoMneprole Ha6,'rrc- (40 E) ; oy'3broHr(59 V) , Hroafi-ruay(36 VB) , raM-aM-3to(6 RP).
AaIOTC'peAko, tt cBt3r c TeM qTo aHecTe3lt c noMonlr,() rr,'I npr,l Kxay'I(xH(40VB), xaM-xoK(43 E).
grltx onepaurtx He o6ecneqfiBaerno,rrHoe noaaB,reHue 6oneBbrxouly- OnepaqHq no BnpaBreH!rc nepe,roMoBMa,ro6€pqoBoiifi 60,,rbIe
qeHuii r.r Heo6xoAxMoepacc,la6,,reHreMHlxu, onepaqtn c nr!'to- 6epqoBofiKocrefi: lxafi'cyHr (3F), aM-,laHr-ryeH(9RP), xrcer
aHa,lbresxefiHa 6ptouHofi noJrocfl{ 3Haqrrerr6HorpyrHee no cpaB- xafi (10 RP), yH 3broHr (39 V), xoaH-Kxfiey (30 VB), 6e'KyaH
HeHXTO C ApyrUMXOnepaqrrtMI,I C noMOLLIbIO Ill-IOaHa,'Ibre3Hr.
TeM He (31 E) - Ha Kopnyce;aypnxyrHpHbre roqKn: noa(opxa. rxaH'MoH
MeHeeBpaqr rryr Ha Hrx, yqn,rbrBarno,th3ya{,ri 3AopoBbr60rr,Horo (AP 55). DcqKa.
u o6rer,{eHrieelo cocrotHlts a noc,'reonepaqtounourIepuoAe,Tpe Onepaqua ra crynHe: raM-aM-3ro (6RP). rxafi cyHr (3F),
6yerct ,1l.x6 rroKaJ'rH3oBarh o,{ar 6one3Ht li, ec,!t Bo3MoxHo. Bb,l, rxai-Kxe (3 R).
Becrk nopaxeHH6ri oplaH (xe,'ryAox, l{n[rKy r r, A.) 3a npeAe.nH Onepaqfis Do BbrrsxesHro nqroqHoro (axu,rnoBa) cyxo)xtnxf,:
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rryr'rrqrx. (6MC); aypuxy,'rflpHble roqKH:crMnarrrqecKarrorrxa, neqeHb,noq-
r . O t r e p a u f i I ,B o 6 , 1a c r r r a 3 o B o r o A X a , 3 a A H e - Ka, rxaH-MoH(AP 55).
Ha!6onee pacnpocrpaBeHHHMr ao BberHaMel,r3onepaqxfi Ha
KoHeqHocrgx qBrnrorct cpoqH6IeonepaufiH B cB93H c 6oeBHMr
I Ornocrr.c x Mreroprr qoBdx rocex. Pa.nonoseHa rpaBVavx. a raxxe onepau l,l no )crpaHeHHro nocJeacrBxiiTaxrx
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512 5t3
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npoAoJrxaloT DorcKj 6o"ree ycnerrrHoro npxMeHeHxs MeToAa ur!,lo-
yKalrrbrBaHrr npB yKa3aHHr,rx onepauarx BBxly {x aKTya,rbHocTH c
roqKn 3pexue coxpar{eHHs 3AopoBbq 6onLHr,rx.
HaxoAqcb B co3xaHfir, ofleptpyeMbrri B cocrorHl. ] ABrrarb xo
H e q H o c r r M x ,r t T o o o r e r q a e r B p a q y o n p e A e r e H r j e n o B p e x t e H l r r c y -
x o x x , r r a , M [ , r u r u .K o H T p o n b3 a x o a o M o n e p a u f i ! , o 6 e c n e , { r 9 a e r e e
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cTe3kr nprqrHrrer aono"'rHr,nenbHr,re
cTpaaaHrs 6o,tbHoMy.
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Bo npevr onepauur (npH ,rrc6brx cpeacrBax MecrHoi g l)6qeii
aHecre3ux)aeicrBsq xqpypra Ao!'txHbr
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a r p a B M b lr K a H e t n H c T p y M e H , r a M r { .
rlocKo,rbxy nps onepaqxqx c nprMeHeHneM rrrroaHa!'lbre3l,lr,r
60,rbHoii HaxoA'rrcq B co3HaHrfi, AocrsrHyToe o6e36o,!rBaHqe oc-
TaeTc9 xeno?'IHbrM,Mbllllu6l B KaI(oI1,TOMepe HanptxeHHbIM x np{
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6oBaHxfl, npeAbrB,lqeMHe x{pypry B 3ToM cJyqaet oco6eHHo BH-
coKx. ne creayel norh3oBaTbcr xHpypf[qecKtM nrrHqeToM; Hoxr fi
cKarbneill AoJxHtit 66rrb xopolno HaToqeHbI. Orae,lefifie rKaHeii,
tccreAoBaHLie BHyrpeHHlrx opraHoB cneAyer npoH3BoAr,rTboco6eHHo
o c T o p o x H o , y M e f i o B a p b x p y q M a H H n y { ' r q q x x , , { ? o 6 bcra € c T x K M r H r -
MyMj npfiqaHn€MLr€ uMq pa3apaxeH tr,
llpHMeHeHue firr'r B xaqecrBe onepaqtoHHofi aHecre3xx rpe6yer
or xrpypra cfleqsaJrbHbrxycarrfi. Xopourafi xorraxr onepnpyl(lrre.o
Bpaqa c o-cranbHbrMnepcoHarroM onepaUtoHHoi 6pxra,qbl ll c onepx
pyeMr,lM ooJtbHbrMnpr,joopeTaer r'tct{rroqfirexbHoe 3HaqeHfie a,,rq yc
{ , N P E I { M Y U I E C I B AX H E A O C T A T K HM E T O A A I T J I O A d A N b T E 3 f i H
llp€I,ri{yuecTaa iieroAa. l. nps onepaqxrr c npfiMeHeHseM {rno,
aHan6re3fi, HapymeHne 0I,l3xo,rorrqecKrx OyHKrrafi cBoArrca K MM
nauyuy. l4r,royxa"runaHne, (poMe axa,rrreilqecxoro
3QQexra, cny,
xsr B AaHHoM cny'{ae I,l cpeAcTBoM perynrqrH Qr3ro,'lors,{ecKoji
AeflreJrbHoc,fi opraHrr3Ma, qro AaeT aogMoxfiocTb n36exarb cepbe3-
nr,rx HapyrueHrifi oyH(q&fi BaxHefiLIjrx opraHoB, noAlepxsBarb
s P r e p r a J b r r o e A a B J r e H r es n y n b c H a o r H o c r { T e r h H o H o p M a n 6 H o M
ypoBHe. braroaapfl nocToqHHoMy peryn&pytoxleMy BndqHxro mn
obrcTpo HopMarn3yroTcfl QyHXUlrfi, HapyueHHbre fi B rex c!'loxH6rx
onepaqrrx. KorAa 60,lr,HoMy npl,lxorurcr npsqxHerb nHTeHcrBHoe
pa3apa)+{eHxenpu cephe3Hbrx noBpexaeHrrx TXaHet, B Mec,rax cna-
eK a oqare HapyueHrr x T, a. l.l Koraa onepaqnq npoTeKaer c
514
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peaKqrefi opraHrr3Ma 60,'rLHoro, qTo6hr cBoeBpeMeHHo3aMeqaTh nn-
6bre orKnoHexsfl oT HopMbr ri cBoeBpeMexHo npxHrrMaTr, Heo6xoAr-
2 . f I p I M e H e H x e r r r o a s a r b r e 3 f i r l a e r B o 3 M o x H o c r b o f ie p t p o B a H ,
HoMy 6o,16HoMy 6brcTpo BoccTaHoBrirb crtr'rbr,Tar( Kax oH paHo Ha,
r{rHaef HopMar'lbHo nfiTaTbcq, Me bue tcDHTHBaeT nocneacTBrc
QapMa(o,lorqqec(oii aHecTe3Hx, qTo B KoHeqr{oM fiTore coKpaulaer
cpok nocrreonepaqroHHofo craqsofiapHoro neqeHxr.
3. Hr,'roaHanbre3nefi MoxHo Bocnorb3oBarbcr H B,r€x cr'ryqasx!
xoua 6orbHoMy Heo6xoArrMa onepaqtr, rro HMerorcq nporl.{Bono-
xa3aHsH K npHMeHeHxrc{papMaKonoruqecKori aHecr€3nB (npr xpo-
HrqecKnx 6o,,Ie3HHx, r.rcroureHr{8, HeAocraroqHoM nr.{TaHrrr, craDqe-
c x o i c , 1 a 6 o c r r . i(, ) 6 u e i i c r a 6 o c r r . i o p r a H l r 3 v a , a , r n e p r r a x u e a l r x a -
MeHTo3HbIM aHecrerl,tKaM,oc,ra6,teHHofi OysKqqn neqeHr.t,noqek, !'Ier-
xHx).
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croTa o6opyAoBaHrr: Hecxo,'rbKol,rr'r, rexepaTop uMnyrbcrJoro Toxa,
unpsuH, BaTa. cnnpT. \ ToMy xe crr'rMy!'rr lr.jro ToxoM MoxHo
3aMeHHTbnoocTbIM BDaUleHlleMtrr'l.
HeAocrarxa x cri6ue croporn MeroAa. l, l.l rnoaHa,rhr€ljq He B
cocToqHltt o6ecneqrr6 nonfioro o6e36o,ruBaHltq v Bcex 6onhHhlx.
l l p u a s e a e n r . l . rx r u B a x y n y H n r ) p H s r e r o q x H 6 o , 1 e ; o i i n o p o f n o B b r .
uiaeTct, oAHaKo 6o"1eBr,reoUynleEus norHocr6lo He xcrre3alor M B
Kar(t{e To MoMeHrbr onep{pyeMbrn Bce xe ficnbrrbrBaer 6oJrb.
2. He no"rnocrrro ycrpaHHercr r peaKquq BHyrpeBHrx opraBoB
H a p a r a p a x e H f i f l f l p H q r . r H n e v b rI reH c f p l M e H r o v B o B p e v e v a I x n y , l e -
I l l H r . rx n p y p r a . D o n b H o H c r p y a o M n e p e H o c H r p a r p e 3 n e f o q H o n
nJr€Bpbl-. y Hero norrB,lrroTcq TolxHora, 3aTpyaHeHHoe abrxaHqe
l, T. 4.
3- K HeAocrarKaM M€ToAa oraocurcfl r, HenonHoe pacc,la6"reHue
v s r r u u . f l p r o n e p a u q r B 6 p r c u H o i n o , l o c rr . 1a e n o , r x d e p a c c , r a 6 , r e -
r r x e o p r o u l H b r x M H t ! l ] c o r n a p l o n p e a e , l e H H H el p y a H o L r H n " , l q \ r -
PYPli.
! t e p e ' r r c r e H H b r eH e a o , c r a f K r n p o f l B r ' r r l o r c r B p a r H o i c r e n e H H B
p a J , l H q H H XO n e p a u H g \ . u 4 H a x o B U e " l O M6 0 , 1 h r ! H H C T BoOn e p a U X f i C
npHMeHexueMHr!'roaHaribre3r,lltlaeT cpaBHrrenLlHo xopoutlri pe3ynb-
'rar. cTpeMrrcr ycTpaHHTr, yr(a3ajrHHe HeaocTaTK{, yryqrua'I
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rrqecKr.rx npenapaToB r,t r. a,
TaKnM o6pa3oM, Merol r,rrnoaHarbre3,
x I r e , 1 6 H 6 i e .r a K I o r p l ] u a r e r b H b l e c r o p o H H , x a K B n p o , l e MH Q a p
r a k o r ' l o r H q e c K a f la H e c f e 3 H e .U t c r c l a B H 6 o p l o r o h 1 l . r , p y r o j o v e .
TOAa OnepaqnoHHot aH€cTesllH IOIXeH p€lxaTbcq B Xa)l{AOM KOH-
KperHoM_c!'tyqae nprMeHrTer'rbHo K 6o,rbHoMy I, xapaKrepy Hapy-
rxeHxq. lo,rbxo npx 9roM ycnoBnr rrroaHa!'rbresr,t' 6y!er ycneurHo
cnyxrTb BoccTaHoB"leHnro3Iopoabs 6onbHbrx,
f n a a a6 Hbrx paccrponcrB (B Bhrcoxoii creneHfi) r opraBnqecx'ix fiapynJ€-
tll Hfii (B orpaH{qerHoi creneHn).
nAIOI,|Orrn , lEl npr paHHeMo.6HapyxeH fi 3a6oneBaHrq (B crartrjn Sysxqro-
kalr6Horo paccTpotcTBa) cBoeBpeMeHHoenpjrMeHeHre Merola r,lrrro-
repanxx aaer 3xaq[Ter'16Ho6on€e 6raronpxrrHHij 3$Oekr, veM npr.{
ileqeHafi opraHrjqecKr.ix HapyLllI€Hr.{i,Tax, npa npaneueura ur,royxa-
.qHBaHHHB Haqa!'lbHoi craAr.lti rolttjoMser,rrjra (B craaxx Bocna,tt-
re"ibHoro npouecca) MoxHo lo6nTbca no!,tHoro 3"!erteHrs oT HeAyra,
r. CBEAEH]lt, HEOEXOAI{Mb|EBPA'{AM- B ro BpeMq Kar( np, noeBreHHs noc,leAc,rBfiii 6one3Hfi (KorAa no
I TJIOTEPANEBTAM paxeHHbre HepBrlbre rL[eTKfi HaqIHarcT pa3pytlJarbcq) 3roT MeToA
c n o c o 6 e H , l I u ] 6 o 6 , r e r q r j r b H e x o T o p b r ec f i M r r o M 6 r . I I o J r H o c T b r oB o c ,
. - a H o B r . i T bH a p y L x e H H b t{eb } H h u H r .oi H v x e 6 e c c H " 1 e H .
B p a q H , n p s c T y n a K r q n e x f l p a M e H e x f i I of i r n o y x a , r b r B a H B qc r e p a l l e B
S o r e y r o n e r c r q k f i r Q Q e n r . C o r , r a c i o r e o p Hx B o cI o q H o i M e r f iu f i
r qecKoH qer'rbrorao!'rxHbl ycBor.rrb:
-- M€XaHl,l3MTepafleBTnqecKoaoaeHcTBfi9 sr.ri; rrbr, <HenpoxoArMocrr, aHeprsI,{ nopoxlaeT 60,1b>. HapyuJeHl,le npo
yn!,tvocTr,|rHeprnH B (Hcteve MepnaraHoB npoflBJqeTcr
- ocHoBHbtenpaBxna !'IeqeHrq c noMoutbro {r,11 o6btqHo B
B { n e o o ' 1 l . 1B o n l e n e i l e f i H b t x } ' r a c t x a x H a n o B e p x H n c T ho p r a H f i t v a
M e T o A bB r o 3 A e a c r B x qH a a x y n y H K r y p H b r eT o q K { i
no!'Ior(eHfit 6onLHoro so BpeMfl cea coB Ilrlloyxa!'tHBaHLlq t roMHvo 60,1eiiB roHe ooaxeHurr.
l.{ Io3br Bo3aetcfBl,tt: Bo sropofi uacrl <Kuaru o nnyrpenneu> 3anucaro: <Bepfi 6(),
Jte3HeHHoeMecro B KaqecrBe roqKs l]|tg l{rrtovKa!,IhtBaHrjg> (B na,1b-
BpeMr npoBeaeHrq ceaHca r'reqeHfir;
rreilUev err loqKF nor)ql,1'Iu Harsadxe c60,1eBbtr, h,'rr .He6Fc-
a o 3 M o x H H eo c n o x g e H u s B o B p e M s f i r n o y K a n u B a H r j t I M e p r , t
H b r x ) ) - y x o n H B 6 o , ' r e B b rreo q x r r r o q K f i , l r e x a u l | l e H a M e p x A r a H a x ,
no 0x ycrpaHeH ro.
npoxoagulHx qepe3 yqacroK HapyureH{q, BoccTaHaB!1r.jBalornpoxo_
!r{Mocrb MepuIraHoB, HopMarrn3yroT roK 3Heprfifi, qeM Aocrxraercf
r . T E P A n E B T I t I € C ( O EI E n C T B I { E k f f O y ( A O 6 t B A I t U t n p r H U H n a' n p o \ o A H M o . r b, p e p rr H c h x v a e t 6 0 , 1 r , o .
bo, ey-oJqtouee aeicrBre Hr,1 Becbva rddeKrrsHo. la,ra.rvto
Bxparue 3ro aeficrB{e MoxHo cOopMy.rl.{poBarb cneay|oulxM 06pa d H a , l b f e r H q e c x r f ip e i l r b r a t n p o r B r q e t . n n a c r o , t s r , o6 u . r p o I a e H o .
JOM: OCI{OBHOX MeXaH}l3MT€pArleBTHqeCKOrO q T o n p x B o a l , t ' lB L 1 3 y M " ! e H H Hee C n e u f i a n r c T o B .
AeiCTBSH M€TOAafif,1O,
yxaffrBaHfiq r.j npxxxraHfir 3aKrr,o'{aercq B pery,rspoBaHfifi ufipKy llpa no,rr,:orarxx MeroroM r.irnoyKarrbrBaHrq oco6eHHo BaxHo
neqrr eHeprllfi (r- e. HopMan{3aurI QyHKqxii opraHl,3Ma). OaHaxo rroHaMar{HeMexaH!3Ma eao AeicrBrjfl. CocraBrB c€6e qerxoe npeA-
B K,rxHn,{ecKofi npaKrHXe 6o,tr,lnoe BHrMaHre yAenrrercrr Taxxe craBreHue o xapaKTepe 6o"ie3Hlt, cMero cBoeBp€MeHHonpllMeHr,tB
6 0 r t ' ! | o , 1 f l | o u r e v ) , r r o 6 e i 6 o . r I B a | o u . r e \D
ae' ticIBr|r) rro!hdnHBa r r , 1 b r .s p a . r n o 6 H B a e T c rvr a K c r M a , t b H o r or Q + e K t a o t v e t o l a K a h n p r
.'reqeHfifi 3a6o",reBaHr.rii! raK { B ocyuecrBreHfix npoor"1axrfi,{ecKoi
3o0e|(r perynrpoBaHre oBeprxx (Hopna,nl|3aqrx OyHKqxi). Bo uer .
B r o p o i q a c r x < K H H r n o B H y . r p e F H e M r>o B o p r r c q : < I Z r , r a M a n o n 6 -
3ylorcr, qro6br peryrxpoBa,rb gHeprtro>; <Baxsr,rM B npuMeHeHrs 2 , O C I | O B H U En P A B I J I A M E T O . q AI r . f l O y K A J t b t B A H l t t
) v e H H e p e t l r l H p o B a l bc o o t H o u e H H e H b r . 1) t H r . 3 r , fl flPltxl|rAH|lt
c , l o B a n o l q e p x s B a r o , , q T o o c H o B H a r U e n 6 B o 3 A e i i c r B ' , f lt i r x a M r s a -
rurorrse, crr B BoccTaHoBJIeHrsH IIoBhIrXeHrfi COnDOT{A.rltreMOC'fX OD- B c o o r B e T c T B x qc T e o p e T t q e c K r M s x o x q e n q u r r M f i B o c T o q H o i iM e A r -
r d H H l M a 6 o n e r H e T B o p n o i , H e p f r . 1 ,c r o , n o c o 6 i o c r r 'lroHerb eF Itr.rHbI Kaxlat 6oae3Hb B cBoeM npoflB!'leHrI rrMeeT xapaRfepxbre
Hapyxy. q e p T b r :r r o r ' r o x a r I r 3 a r l x l ,f l a p y t n e H r H ( B n o B e p x H o c T H H xT K a H q x ' r n f i
O c H o B b r B d t c bH a t i o v ( ) 6 u l e M n p h H U r n e v e x a H l l r v a q e x c l B r . l s a n y o o x o B H y T p s o p r a H | l 3 M a ) , n o x a p a K T e p y 3 a 6 o , ' r e B a H x e( o r H o -
fiI!'], Mbl lo"']xHbl ycBollTb, rtTo MeToa xrJ1oTepanIlj <,1eq[T 6o,,Ie3Hu cfiTct x <xoJoAy) I,t!'lt K <)Itap€>. <nycrore> IrJll{ <no,tHore>.3a6ore-
H a y q a ( I h a \ . n o x o t o p b r Mn p o r o a q l K a H a I b t . . 3 t o a a c t B o , v o x B a H I , I e< t H c x o e > x , r & < t H 6 c ( o e > ) . n o c r a A l , 3 a 6 o , 1 e B a H u t ( B H a -
Hocrb HariyqlrrrM o6pa3oM fi cno,rr,3oBarb MexaHfi3M peryrxpoBaHlls qa,rbHoi cTa!|,lr fi,rI,{6o,'re3Hr,xpoHrqecKar); no Bo3pacTy 60,'rr,Horo
3 H e p r x I , lr. l r r K B H 4 H p O B a rHba p ] u e H H e B K p a r q a r . t u H eI p o h H f,1aB (6onesH6 y B3poc,roro l,i,rr pe6eHKa),
H o e B H a ' r a , 1 6 H oH t r craAHt. qro6H no,lHee ucnor'rb3oBarb Bce npexMyqecrBa MeroAa, Bpaq
OnHr Aa,reKoro nporx{'roro, Kax I KrlHrqecKafl nparrfixa Hatrrtx 4 u , 1 , { e H\ o p o u r o ! c B U i r r b o c H o B H b l en p a B Ht a ( n p r H U H n b t ) h r n o y x a
Aret. noArBepxlaer HopManfi3yroqee Bo3AeficrBfie xrnoyKarrJBa- ,'16rBaHrg s n p f i x r r a H r e , c o o p M y J r r p o B a H H b rB e npoqecce MHoroBe
Hllt Ha OyHxqfirl opraHr3Ma npx pa3rfiqHr,rx BnAax QyH(uroHa,'r6-

516 517
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6 o K o . r o y x o , 1! o " 1 a e H 6 b r r b r , 1 ) 6 o x M E c , l n H a p y L x e H H o erHoc rcq
x r a n y < x o n o A ) , 6 o n e 3 s e r B o p H a q ? H e p r f i r t p o H r , i K J aI n y 6 o K o , B b r -
3Barb (gOOeKr firflbr> TpyaHee, yKor'r Ao"txeH 6HT6 rny6oxr.rM, n
To,rbKo norrBneAse <3ooexra xr,rbr> o6ecne'{!T TepaneBT{,tecKr{i
3 o o e x r . E c r l I 6 o , J e 3 H bo r H o c x r c q x r f i t r y < x a p a > , 6 o n e 3 H e r B o p H a q
3Hepafiq BHeApraacr, Hea,ry6oKo. y(o,1 Ao,rxeH 6blrr, Her,1y6oxIM,
BpeMe ocraB!'reH{q {rrrbr - HefipoAorxl,rre,lr,Hr,lM_Ec-nr 60"1e3Hbor
BocfiTcrr x <nycrore>, yKon ao{,rxeH 6bJTb yKpenrqrour]M (ToH|l3x-
pyr)uIUM); ec,]I,l 6o,1e3HbrlrDa <norflora], y(o,1 Ao,,txeH 6brTb pac-
cefiaa()ulr.rM (ceAaTHBHbIM).Ec,'rfi 60"1e3HborsocHrcs K <l.rHbcKoMy>
Txny, y(on lorxeH 66116 r",iy6oKtM, ec,r! K <flHcKoMy) Hefny6o
K I r M ,E c , ' r r 6 o n e 3 H bB n o s A H e i c ? a A x r ( x p o H r ' { e c K a q ) , c a a c r o i i f i b r ,
Ml,l tB'neHrtMl{ B MepnlrraHaxi 3Haqsr, 60re3HeTBopxar 9fieprfiH
npoH{K,'ra B MeprAraHH x Heo6xoArMbr yxonH c ManbrM KpoBony,
c K a H r e M ,q r o 6 H < p a 3 o r H a , b 3 a c r o n > , c H q T b 6 o , ' t b , , ' r r . { K B f i I l r p o B a r b
Bp€AHHe BeqecrBa, <orBecTt xapy). Ecn, opraHr.r3M y 6o,'rbHoro
KpenKxi{, Koxa r Mbruqbr 3iacTHqHbte, o,IoTHbte, To yKoJt AolrxeH
6brrb r,'ry6oKuM c noc,reryrcuxM ocraB!'reHfieM {rJtlt B TKaHtrx: ecr'Ili
6onbroi xyAoi, c,ra6blii, To yKo"r ,{o,uxer 6r,rrb Her,'ly6oKxM, He-
AonrnM. flpfi,reqeHHx AeTefi xr"rbl llo,'lxHbl 6btrr, roHxnM(, yxo,'rbr
IlpaBxna npHx[raErq, Ecns 6o,,re3fi6orHoo{rcfl x rtny <xo!'roA>,
aprxrralrlr€ Aoaxxo 6brTb corpeBaloulero Tfina, BoccraHaB!'tfiBaro-
uee npoxoarMocTb MeprrasaHoB, cTr,tMylrtrpyrculeenH-3Hepalrroc ue-
r'rbro x3rHarb 6o,re3HerBopHyro 3Heprrrc (xoJroaa>. flpt <nycrore>
rH-gHepr|jl,l npqxtIaHfie rMeeT ueJlblo <noaaepxaT6 3aIuuTHy,o
r H e p f r r o ,B o c n o r H F T rbr l c r o t l o { n y T e Mh o p r t a , l Hi a u H Hn r r a T e . l b H o i
r,{ 3aulsTHor.r9Heprjlfi , nonol'rHeHr'tfl3Heprrr{ BHy,rpeHHrx opraHoB),
Lj cryqaflx <nycToTbr r.iHr,-9xeprxI,i r npeo6naaaHxr rH,3Hepr x>
I l p r x a r a H r e n p o T l { B o n o ( a 3 a H of.l p r u n y c r o r e > s H e p r q ! { s H y r p e H H x
opfaHoB cleayeT npuMeBxTb np xrraHxe c qelrbro yxpenreHrt
yKa3aHHoii sHeprxx. Ec-na xa6,'rroAaerca no,repr q -3Heprrlfi, npll-
MeHqrcT6onr,noi:i no,lbrHUbriiKoHyc Ar're <ocTaHoB(fi yTeqKH> ll soc-
TIONgEHHg 3HEDTl,lI{.
3. CttocoE rlPElnEHEflfit rO{EK
noc,re onpeae.reHrerroKa.ra3a(fil,{6oxe3rrs (noBepxHocrHHer,'rr
ypoBHnopraHlr3Ma,
r,.ly6fiHHHe MepfiafiaB, opfaH), xa-
BHyTpeHHr.{i
(crtr4pou <xo,ro4a>rr'rs crHApoM<xapbr)), co
pa(repa 6o,'Ie3HL{
crorHr,rsopraHa3Ma(<nycrorar n,ru <no,rrora>),T. e. nocne ycra
HoBrextq oxoHqaTe.nbHoro ararHo3a! Har.{6o,reeBaxHLlii Bonpoc,
B(raourHfineper rr,lnTepaneBrov. ,ro Bonpoco cnnco6enpr\ae
lloHrrHo. qro rreM!,ryqrxecfloco6 nprMeHeHfirroqeK B npoqecce
neqeHlt rJLi npoOr,'raKTLtK,reM 6o,,rbue ruarcoB Ao6srr,cr Bbrco
5t8
Koro r€paneBrliqecKoro finl,l npoQfi,1axrr,{ecKoro 3O(DeKra. Anr ?ro
r o x r n o T e p a n e B TI o J X e H y c B o [ T b T p l , l o c H o B H b t xM o M e H T a :n o K a -
3aH{q K npr.{t\4eHeHr. o rorreK, npxHqHn Bn6opa ro,{e}( ll nprHuHn
coqeTauIrr Togex,
Jloxa3aHxc r( llprlMeHeBxx) pa3rxqEHx Bl,|Aoa roqeK (repaneBr{-
q e c K r i , o o e K r T o , r e ^ 1 .c y u l e c t B y r o r p a i J 1 r . l ' l H HBe H r b . r o q " r . , x a x -
abrt ,r3 KoropLrx fiMeer cBorc oco6eHHocrr,: anravtue rovxu (y-ruy)
B 06,'Iacrx BepxHr.{x x rrr,rxHrx xoHeqHocreri (To'{xa-HcroK, To,rKa-
p y q e t , T o q K a - p a 3 r r , r Br,o q K a 6 6 r c r p x H a a r o , r K a - y c r b e ) , r o , r l ( H - r | o -
co6Hxkr, cTa6u,1t,3ttpyrorufie roqxr (,'ro,nynxrsr), roqx,l-nlerH, llc-
nonb3yeMbre A,1r neqeHsfl 6orei flo xoly Mep{AfiaHoB, roqKr co,
npqr{{eHaq, o'rHocrllureca K 8 <'{yAecHbrM> MepHAnaHaM, coqyBcT-
B € H H H eT o q x l { c n f i H b r ( l o - n y H x T h r ) ,r o q l < r - r r a u a r a x B o 6 r a c r x x l { -
B o r a ( M o - n y H K T H ) . 8 T o , t e l <c o n p e x e H r q , 6 o n e B b r e r o , { x f i , T o q K r l
co cne(rogqecKLjMxno(a3aHHtMx.
f l q T b a H r l l q H H x r o q e K ( y - m y ) B o 6 n a c r u B e p x H r . t xf i H t x -
H r x x o H e ' r H o c T e tn p M e H r r o T c r r , r a B H H Mo 6 p a 3 o M n p n n e q e H H r 6 0 -
",re3Hei BHyrpeHH,rx opraHoB. B <Kunre rpyaHocrei> r,t3!'tararorct
n o K a J a H r q I ( n p r M e H e H H | oi t H ( t o q e x : H a t o q f i y . r ( r o | ( B o r l e i c T a y -
ror npn orUyueHdd crecHeHrr B o6"1acrfi nHr3y oT cepAUa, Toqkofi-
pyqeH r'leqaT Jlt XOpaAoqHbIeCoCTOtHllq, ToqXa-pa3IIB nOMOraeTnpH
o n y x a H r i a c y c T a B o B ,c t i ! ' I b H o n , r o M o r ea o B c e M T e , t e , T o q ( a , 6 H c r p u -
sa npfi acrMe, Marrepr,tr.j,rortKa ycrbe flpri ycrpeM!,rexur gHep-
rxr BBepxll npfi noHoce, HepeAr{o,xorla Heo6xoarMo nprrMeHriTb
P a C c e H B a r , U x l yl h o r . 3 \ 4 e c r o r o q x r . H c r o x a g o r A e i . t s t r o r H a r o q K v -
p ) ' r e i B o 2 i q a c r r " K u f i r r o B H y r p e H H e y a, a o r . q ' a o n o , 1 H a r e , 1 i -
H b r ec B e A e H u r :T o q x a - p y q e n n r o q r ( a - p a 3 ! r r { Bc " r y x a r r n a B H r , r Mo 6 p a -
3 o M ! , r r , l e q e H x n 6 o , r e 3 f i e j iH a c r a a r x M e p u A { a H o B ,a r o l r K a - v c r b e
x o f , q a 6 o , 1 e r H 6n p o H h K r d ! / h e e o e r l " p e r r l e o p r a u u r . B c e r r l c e e -
aeHr{fl orpaxaor onr,rr Ap€BHax Bpa,reri, Koropbti Ao!,lr(eH c,,ryxl.tr6
&ilt Hac aonorrHnTe.{bHLtM LtcroqHfixoM 3HaH{i n pyKoBoAcTBoM
x n p f i \ { e H e h r j o B x - ' I l l H t ' l e c x o Hn _6o,1e3HU
paKrrxe.
<ToqKa-noco6Hl,ll{ neqrr nsrH DrrorHbtx I txecrfi
norbrx opraHoB> (2-r qacrb <KHnl-fi o aryrpexxeu>). AaHHoe 3a,
KrroqeHxe noarBepxAaercs npaKrnxofi {rnorepaflHr,r, K ToMy xe B
nocneaHee BpeMq onpeAeneHfitt 3nexTptqecKoro conpoffiBIefiqt s
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orHoueHrrrMH o n o B e p x H o c f H o - B H ) r p e H H ef rhon,a . T a h , r o , { K a , t r e t .
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Krx, rlroxer 6blr6 Hcflo,,th3oBaHa nps Karxne (HHbcxsfi MepHAxaH
nerKrx), a raKxe np, roroBHbrt 6o,rrx (f,HcKr& MeprAraH Ton,
croi KrrlxKr.r,r.rueroulnfi <norepxnocrlro-Bt{)rpeHHUe> cB'l3H c r,tHL-
CKfiM MEDIjNfiAHOM ]'IEIKqX I.
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crynax 6o,rn B rpyax - Ha roq(y rqrrb-MoH (4 MC) (roqxy-ue,rb
r.iHbcKoroMepliafiaHa nepfiKapaa].
ToqKx conpexeHrre 8 <uyaecrux> MeprrAaHos sBnrrorca
TOqXaMll lllaBHbTX MepfiAItAHOBr COeAXHtrcnlXXCn C 6 <qyAecHbIMfl>,
On6rr npoHnoro cBraererbcrByer:
Maroqfificr Mepr.rAxaH)u Hok-KyaH (6MC)
x t l B d l o L ! l { t l M e p H A l 1 a H )r c n o r b r ) l o l c H npH,lPqeHHH Hap)ueHxt
o6nacrx rpyAx, cepAua,xe,qyrxa; Ha ro.rxn ryx-naM-Kxan(41 VB)
(onoecbrBarcqriMepxAaaH), Hroafi-xyaH(5TR) (uapyxnsrn noa
AepxrrBaroqrfiMepLtALtaH), a rar{xe roqr{, xay"xxe (3 IG) (3aAHe'
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MepxrraH) Bo3AefrcrByrcrnpa rJapyueHfiflx B crarr,rI,{ nopaxeHl,tt
noBepxHocrHbrx rKaHeii B o6,'Iacrfi nreqr cflltHbl,ueu, ro!'IoBbrr Ha-
pyureHnex B 6oKo8oi o6nacrx .pyAfi npa nopaxeHrl{ rny6oxo,']e-
xaurxx TXaHeii;roqKll r'rner-Kx|oer17 P) (nepeAHecpe.qrHHbri Mepx'
anaH) x rHey-xait (6 R) (BHyrpeHHriintroqHu* MepsaxaH)nc
no,rByrcrcr npa reqeHrx 6o,,re3HefinerKxx l,,'rfi AxaQparMbl.
a. Co,ryncroennuerovKr.{cnxnbr (ro-nyH(Tbr) ToqKH,,'rexanlfle
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BHyrpeHHxx oPraHoB.
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BxaToqeK,<npeacraBntrcurx>BHylpeHH{e opraHH Il nexaqr{x Ha
rlraBHbrxMepfilxaHax, npoxoAqulfix no 3Tofi 06,'racrfi.
floc,'reAHreABa B Aa ToqeK xMeror o6uyrc oco6eHHocrb oHu
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r xpoHrrqecKrxHapyrrleHr1i(cBorx> opraHoB,
rrplr !'rerreHfi
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,pQexroMB oTHorueHHr parJlH'{Hbr\ rKaHet opraHHrva:
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pyueHrqx norbrx opraHoB;roqKa 3r,roHr-raHr-TyeH (34 VB) npx-
MeHrercr npl, 3a6o,reBaHfirxcyxox!,,rl,lfi; roq(ofi Txafi-yeH (9P)
florb3yrcrct npfi 6one3HqxcocyAr.icroicrcreMLr,,roqxoi AaH-,ryHr
{l7VC) npfi 3a6oneBaHlrx,Bri3BaHHHx paccrpo;crBoMeHeprrr;
Toqxakarb-3y (l7V) rcrlo,Ib3ye.rca npri,reqeHrlr6one3HeixpoBx;
To,rkaraii-qbl (ll V) - npn ocreoaarrrr,ToqKaryer-Kor (BHeMepfi-
uranras) npH 6()).rerHrrho(tHoro \4oJra.
r. 6oneBHefuqhHrooeKrrBHhrnpH 60,1flx.
a. ToqKn co cneqsoq,{ecl(rM}{ o6,laaaror oco6brM
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l]6()6ulnrb B cBor{xpeKoMeHAa{firx,no{'Ie3Hblx t, cospeMet{HbrM Bpa.
roqra xon'xox (4Gl) ficnonb3yercqnpr neqeH{x Hapyue-
Hr.jiiB o6nacrfi ro!'loali r r'raqa,!'rrer (xroer (7 P) - npx Hapyue-
Hrjflx B o6,'racrrjurefi fi 3arbr!'rxa,qyHr (yaH (12 VC) B o6,,racrx
xxBora, yr]-qyHr(40 V) - B o6,1aci,cnrinH,raM-aM-sqo(6 RP)
520
npfi ,lerreHrx paccrpoxcTB MoqenolroBoi crcTeMH, fiyaxr-Mr,{Hr,
(37 VB) - rpn rra3Hr,rx 6one3Hrx, rxbroHr-rbrHb (23 VG) npr
KpoBoreqeHna n3 Hoca,e (PoHr117TR). rxrHb-(ynr (19 IG) DpH
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OoHr'MoH(l2V), xon-Kox (4 GI), KxyK-qr,(11 cl), rxHeyrxbroHr
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Hoii nonocrlr; Bo3AeficrBreHa 3Ty ro't(y rcnoxByercq l(ax ycnoxafi,
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llo M€pe pa3BlTxq MeroAa uricrrepanlls u o6orauleHHr onHTa
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onqecKnMnsOQexraMr.
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xa coceaHge c HI,iMI yqac,Kll. K HtM, B qaCTHOCTU, OTHOC'TC'TOqKll
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npanutna - yurnuaat, I(aK ,loKaJIt3aIIUrc 6o,1e3Ht orHocltre,lbHo
crrcr€Mbr MepnIfiaHOB, Tal( u cr{MnToMaTrr(y 3a6or',reBafir.lq_
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. o q _ r 5 7\ I , K o H . , 1 ori 6 , 0 \ r tueprarar /hr,tqHoro ,rlrblpflr. ,rofihlaH t6 MC), npr Oo,rri a o6,1acrHu(r Ha ru,rh\ ,lrer-hyro-
Lr c,ryqaer''ruxopaloqHbrx cocloflHrfi (06qee paccrpoficrBo) npfi e r t 7 P r H , l r \ a y - K x er 3 l c ) . f l p x v o q e n o J I o B H pa\ ccr!oiicrear
fiorl6opeToqekopftefirxpyo,rcs Ha ctunronraru<y. Ec,rir. crpynnlpo- Ha roqKyraM-aM-3ro(6 RP), npx 6onqx B 6oxy - Ha rduxy auoxr-
BaB caMnToMbr, Bpaq npaxoA,lT I< Br,rBoAy,qro 6o,1e3HbcBJ{3aHac r a H r - r y e H - r 3V 4 B , . - f l p H r o r o s o x p y x < e n uI k p s 6 x e r , r a r a x H a
M€pylnaHoM <aerxKrx rrg), To Ltroqxa oT6!DarcTtraBHr,rM ()6oa3oM roqxy rxar-cyHr (J r, 11r. a.
l r . q r o o r H o c rc s h y K a l a H H o Mv) e p x n H a H ) 0: o H r . v o H l l 2 V ) . JlpxHrlxll[t coqeraHtg Toqe(. BcreAcrBae pa3nxqrq B xapaKTepe
t r a t i - q b{ rl l V t . y r - v 1 r r r 4 0 V ) . e c " 1 H
x l e p H n r a H y. c B e f , l H i Fi H!. reqeHxq6o,re3HefiTepanesTHqecKriri 3QQeKror Bo3AeficTBHr Ha pa3-
ro rortxtl cooraercrBexHo 6yAyr: xxyK-qu (ll GI), xofi koK (4G]), ,rfiqHbre BHAT,IToqek oyleT llMeTb KaK cxoaHLie, Tax { pa3lllI,Iqatoulfie_
ryx-rau-,rr (36E), 3f,i-xxe (41E). "rtxub npr co6nrcreHq{3rorc) cs MotveHTbr,r.t Bpaqr, r{ro6H lo6HTL,cr Haxnyqurx pe3yrbTaTos,
ycroBr.rgr'reqeHse 6yaer aOoeKTfiBHhrM. o6HqHo cTpeMqrcq coqeTaThpa3!'lfiqHue,roqKt, co3AaBat cBoeo6-
npf 6o"lerHexrycraBoB lHanpxMep.apryanrrv,) u6brqHUno,rb- [ ' a 3 r { b r ep e u e r l r H r o q e h .l0qeqHbte nponricH,,
i ) H J r c a0 6 0 r v u p x H u h n a M hB. r a e r c u M o c r xo t v e D n . r H a Hxa ,0 6 - (,T Bpaqer npoLrroro fu Har ,oLx"fx c,]e/ryrcrxe nprHuHns co-
nacTr Koroporo orHocx,rcqHapyueHxe, Bbr6npaKlrfi ro,lKfi Bo3Aefi-
crBr.rs,o4HaKo Hapqay c 3rrM yqlTbrBaroT,r,tcxoar 3 cfiMnroMoBl a . C o q e , a H r e r o q e ( n o M e p r r a s a H a M3. T o r l l p u H u r . f l to c H o B a HH a
naToreHe3 6o"1e3HH(KakfiM naroreHxbrM QaKropoM- <BeTpa>. Bbr6ope roqeK. ,icxoAr xs Mepr,rAfiaHoB.HanpxMep, npr., 3y6Hoi 6onr{
(B,'IaXHOCTA), <xo,'IoAa>, OHa BIt3BaHa) L lono,tHfiTenbHo BO3Iei- MoxHo Bo3AeictBoBarb Ha roqK, B o6,1acrfi ,1oxa"rr3allltu 6onv -
c r B y p r H a r o ' r h r . c n o c o 6 H H ey c t p a H H T b 6 o , l e t H e r B o p H U i O a K T o p . 3 r n - c a ( 6 E ) x , r x x a - x y a H ( 7 E ) H r o q ( s B A a ? r no r H e e Hon-
ttce nepeqlrc,leHHbn t ep H H u r n u B H 6 o p a t o , r e h B p a B H o i c r e n e H x A u H 6 ( 4 4 E ) H ! ' r nx o n - x o x ( 4 G I ) ; n p s 6 o n r x B o 6 , r a c r r c n r H b r B o 3 -
Ba)Ksbl, AononHqloT Apyr Apyra I,r Ao,JxHbt 66rrr, B paBHoi cTeleHH l e t c T B y r o i H a l u q x y . , l e x a U y r c H e n o . p e l c T a e H H oB 0 6 , 1 a f l l , l H a p ) -
ycBoeaH rrrrorepa[eBToM. OAHaKo oco6eHHo xoporxo Bpaq AorxeH rueHLrfl. r),an-1y {2JV) H a r o q k y 8 6 , 1 H. i c e ixHa-0} (36V)
Bnanelb nprHuHnoM sH6opd toqeK no ueprarar.rav npHHutjlloM, B , '{ T o q x r B A a n ! { o r g T o i i o 6 n a c r - y f i - ' { y H r (40V), Txhra-coH
H a 1 1 6 0 , 1 exea p a x r e p H b t v a , r a u r , r o r e p a n t l . M o x H o g H q e , r u r r r p a ( 5 7 V ) , K o H - , r o H( 6 0 V ) .
K o d h p e r H b r cp a r F o B u n H o c r r r r o r o n p l , H t l x n a o r 6 o p a . 6. Co,{eraHfie coqyBcrBeHH6rx roqe( cnxFbr (ro-nyHXToB) c roq-
a . l o q x n B b l 6 H p a K , tH e n o c p e n c r B e H H o B 0 6 , 1 a c T Hn o h a , 1 { r a q f i r KaMx-rnauararMrI xr]Bora (Mo,nyHK,raMx) <coqeraHe ro,Mor.
HapyueHxq. Hanp{Mep, npfi 6o,r€3H! r,ra3 so3reicrByror Ha roqxfi B nprHqune nps,rn6brx xapyurelinx BxyrpeHHrx opraHoB Mo)xHo
.6ri6-vxHb (l V). ToaH-qlx (2 V,. Hf6r.Hc) (sHevepr,[fiaHHag Bocnon63oBarr,cs coqeTaHHeM rc,Mo. Tax. npt 6on€Hqx xe,1yA(a
P C 6 , . r \ a * - r H o H r t B H e M e p r a H a H H a f ,. P C ' g ) , f l p H r a 6 o , r e g a r l n x B o r n e i c T B l k r H a c o q y u c r B e H H ) r o r x y x e a ! a x a e o 6 , 1 a c r Hc r i H u b r
xe,lyrxa H a r o q ( y n b r o H r - M o H( 2 1 E ) , n p s H a p y r x e H l q x B 0 6 - Bn-3y (21 V) r, roqKy-r,lauarafi xe,ryrKa B o6,racrn x'rBora qyHr
nacrr nreq H a r o t r r { yx n e H - H f } H r( l 5 C I ) . n p x r y 6 e p K y , l e r e , 1 H M . ( y a H ( 1 2 V C ) ; n p n 3 a 6 o n e B a H u s xr o H x o f i K s l n K a u o : 4 e i c r a y r o i x a
q a r H q e c K l x ) r n o B n p r v e H r o r y K o r ' l v e x A ] c o c e n H f i M H" l H v O a t H q e _ coqyucrBeHHyro roqky cn8Hbr rbrey r{broHr,3y (27 V) n ro,rxy-r,raua
c K r M r ]j J , l a v r , n p l , t J o 6 e 'tah B o6nac'tu xr{Bora xyaH-HryeH (4VC)
]Korbt Boxpyf ro6a ft L n. l, r. !.
o . r o ' J x l . rB b i o x p a l o r p 9 4 o v c ) q a c t K o v H a p y r x e H r q . d a M e p H - B. UoqeraHne ToqeK,noco6HfixoB MepuAriaHa! c xoropbrM cBr3aHo
!fiaHe, nepeceKaroxleM yqacrox (o6HqHo B cnyqarx, KorAa yxorlhl HapyueHxe, r cTa6H"rx3rpyrcu{tx roqeK (no-nyHKroB) MepxAnaHai
HenocpeAcrBeHHoB o6riacrb r'ro(a,1I,l3aqrl,{ 6o,re3Hr.r nporrBonoxa- cBs3aHroro c npeabrayunMH orHolxeHHqM& <noBepxHocTHo-BHyTpeH,
3aHbI BBtiAy py6lroB, rpaBM x r. Ar- FIanpHMep, npll KpoBoreqeHslr H e r o >T { n a ( < c o q e r a H e n o c o 6 H H X , r o > ) . H a n p x M e p . n p x n a p y u r e -
' r 3 H o c a B o 3 A e i c r B y r o rr a - r o r x y r x u o n r - r u i l (23VG), npB naporn Hnri B MepnAxaHe roncrod Kurnfir Bo3AeficrBytor l{la rouxy-noco6uux
re HaToqKy 3r("roH (20TR) fi r r 3rol.o MepHAnaHa rxa;-yeH (9 P) l,l cra6xnH3xpypulyro roqKy Me,
rro3MoxHrrr c,ryqa, corteraHfir aByx yxa3aHHbrx Bbrrue (popM, T, e. pfiarraHa, cBt3aHHoro c npeahrayul,M'l oTHoueHrtMLl <noBepxHocT,
Bo3AencrBytor oAHoBpeMeHHofia rorrKfi B o6nacrE ,'IoKanH3auux Ha, H o - B H y r p e H H e r or>t n a ! r x u e H - r ' r l r r 6 ( 6 G l ) . S r o r n p H H u a n , B o o 6 l q e
pyneH&r r, roqxr sa o"rxxafiueM MeprArlaHe. TaK, B cnyqaflx 3a- roBopq! scnor|,3yeTcg Maro.
6 0 , r e B a H f i Fx p , l ) a x a B o 3 a e f i c r B l r o r H a r o q K ) r H o R r - v o H ( l J F r . r - L o q e T a H t e T o q € K n t T r , 3 r e M e H T O BM e p D A L j a H a C , KOTOpbTM
B . B H 6 l , | p a | o rr o , ] x u . , t e x a u t r l e g l a . r f i o r 0 6 , 1 a c r f i H a p y l ! e H l , t r . cBrraHo HapyrxeHfiF Ino npHHuHnav erarr,toorroueuuil voxal
Ho Ha MepxAHarre,nepeceKaroxleM 3Ty o6nacrr,_ B ,racrHocrr.t, 6epyr IrqTbIOfl,lOTHblMt,lOpraHaMt, ngTblo nor'rbrMIlopraHaMI, fi nflTbro 3ne-
Toq(lr Ha yqacTKe pyqHblx MeprauaHoB oT rroKTg t,l HHXe D HOXHTX MeHraMa). _HanpsMep, MepfiaHax neqeHfi npfiHaAvrexfiT K knaccy
MeplllrraHoB or Kor'reHa r.{ Hr]xe. TaK, rrDx ro!,roBHbrx 6onflx Bo3, <AepeBo>, t,cnr.i HapyueHre oTxofltTc9 K cr.tHApoMy <no,,lHorH' ne-
qeH{. Heo6\oar\4o.paccefisarbr neqens.Cor,tainu'etutpclqvrorLeMv
522
523
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npaBr,fiy, <np fieo6xoAxMo paccefiBarb cbrHa>, a ra(
x a K < c b r Ha e p e B a ) < o r o H b > ( < A e p e B on o p o x A a e T o r o H b > ) , r o B
aaHHoM c,lyvae Bo3aeficrByror Ha roq(y xaHh 3qH (2 F) (ro,rKy-py-
qea, orHocqUlylocr K xareroplrx <oroH[,>) MepIjIxaHa nerreHx.
Ecnr xe fiMelor reJro c cr.{HApoMoM<nycrorbl) neqeHr, To H€o6xo-
al.rMo Tor{r3r,rpoBarb neqeHbr corJacHo npaaljlly: <npl,l nycToTe yK-
p e n , ' r r T bM a T b > .r . {T a x K a K < M a T b a e p e B a >- < a o a a r { < B o a a o o p o -
? h t r a e Tn e p e B o , ) . 1 o B i r o M n o c n e a H e Mc J l l q a f c n e n y e i B o l 4 e t c T B o -
B a r b H a r o q K y K x y K - T y e H( 8 F ) ( r o q K y - y c r b e , o r H o c f u q y r c c q K x a -
Teropl,lfi <BoAa>) MepnAflaHa neqeHri.
!. CoqeraHre roqex-ue,1eii c 8 ro,{KaMn conprrxeHxi n,,rorHhlx
n nor6lx opraHoB, ?Heprrn, KpoBri, cyxoxn,rnii, xocreii, cocyAoB r.{
cnfiHHoro Mo3ra," r l p r.rMeHrerce, KaK npaBnno, npfi npficrynax ocT-
pblx 3aooIeBaHLjI,r,laK, B cnyqae npHcTyna cs,lbHoro Karxns, Koraa
6onbHoi 3aA6lxaeTct, Moxno Bo3AeiicTBoBaTb Ha ToqKy conpnxe-
H x q 3 H e p r r x A a H - q y H r ( 1 7 V C ) n r o q K y - r q e { ' r b} r H b c K o r oM e p r A r a } r a
,rerkrx (xoHr rofi (6P). flpx nprcrynax 6o,rH B xenyAxe Bo3Aefi-
croyror Ha roq(y conptxeHnr no!'rorooprasa ,ryHr-ryaH (12VC)
fi Toq(y-uen6 tHcKoro M€prAaaHa xe,'tyAKa ,IHoHr-xxay (34E).
npfi nprcrynar 6o,rfi B o6nacTn fleqeHr] xcno!'lh3yroT ToqKy conps-
xeHxr n,'rorHoro op.aHa rrioHr-MoH (13 F) r,| To'rKy-Lue,'rbnHbcKoro
M e p s A s a H an e q e H nv y H r - A o ( 6 F ) .
SOJlbHOfO 0O EPENI' CEAHCA rrJrOv(A.nHBAlrllt
4. noJloxEHxE
{ nPl|xrrAHrt. ao3A PA3aPAXEItl|t
nonox€Ht'e 6onbEoao.IIo3a 6onr,HoroBo Bp€Mqc€aHca drroyKa!']br-
BaHIrt lllt9 npl,lxfiraHxq Aor'lt(8a cooTBeTcTaoBaTb
cneqnQIx€ MeTo-
aa: npeaoxpaHrrb 6o,'rbHoroor naa€Hre s cnyqae Bo3Hl{KHoBeHrit
aKynyH(TypHorouroKa, o6ecneqrBarr, cBo6oaHbri aocryn K ToqKe,
6brrb yAo6HoftArt onpeAeneHxHnoKanfi3aur.{nH Bo3AeiicrBlrflsa
roqxy, ooecneq[Barb Ao,lroe npe6brBaHxe6onbHoro B oaHoM no!'ro-
6e3 yroM"leHlrt.HanpnMep,6onbHoMy,Bn€pBHenprueAueMy
x{eHr.ru
Ha ceaHcrr".loyl(arhIBaHItl,KoropoMyK ToMy xe npeacTol{TnyHXul.rt
B rovKy c c,{n6Hofi peaxqrerft Ha Bo3A€ficrBfie,Ka(, HanprMep,
roqKa xon-xot{ (4GI), ,ryvue npelr'roxxrb no3y nexa Bo t36exa-
xre arynyHKrypHoro rxoka. flpu nyHKqnqx B o6"racru rpyAlr, xr-
BOTa,ffoAfi4br, Cn{HhIOOBaXarbyqacToKyxora cl,reayeTrqaTelrh-
Ho x ao Heo6xoArMoiicTeneHr.j.PrA y,racrxoB nyHKqnn rpe6yer
crporo o[peAe,reHHoronorroxeHr,rr6onbHoro. yAo6Horo A,rt onpe-
aeleHtt !'toxa!'Ix3auxxTorrxs Lt Bbtno!'IHeHrtBpaqoMcyuecTByrcrqfix
l.rHcrpyKuxri. TaK, npr yxo,re B roqKy xxyx'qfi (ll Cl) 6onbHon
o6r3aH corHyrb pyKy B !ror(Te,a npr.r BosaefrcrBH}lHa rorrKy fiao
xoanr-ey (43V) oH ao,{xeH B3rrhcr oaHoi pyKoli 3a n{,re'{onporlr-
CTOpOHbr,TaK Kal{ TOTLkO npfi 3TOM AOCTyn X TOLIKe C,la-
BOflOTO)1{HOE
H€r yao6H6rM Anrr Bpaqa. npH yKo"re B roq(y xay-Kxe (3 IG) 60,16
Eoi aonxeH corHyrb Mn3fiHerr,a npr Bo3aeilcrBrr Ha roqKri cnfiHbr
eMy ,qyqrxe Bcero npfiHrrb cBo6oaHyo nexaqyrc no3y, qro 06,rerqfiT
Bpaqy noficK Toql(tt fi ToqHoe Bo3AeicrBHe Ha Hee,
524
Ao3a pa3Apaxexxc. Bo BpeMt ceaHca xrnoyl(anblBaHl'lt Bpaq
B 3aBrctMocrH or cocroqgxq 6oJbHoro oxa3blaaer Ha roqKy onpe-
aeJreHHoeBo3,[eicfare c uenblo pery!']r,rpoBaHHs3Hepr]lx opraHIl3Ma
a. 14rnoyKa,rr,IsaHfie. C y q e c r B y l o r r p , c r e n e H f ip a 3 A p a _
rKeHufl: <paccenBaloulee> (cll,1bHoe), <y(pen',]qrcuee) (nel'Ko,e).,
<flor'lypacceHBarox1ee nor''IyyKpenngrcuee> (cpeaHee). flp nrc6ofi
a3 Htrx o6r3are,rr,Ho AocrfixeHre oco6oro ouyqeHaq - <3Q(peKTa
a r r ' 1 N > a, T o , ' r b K on p n H a " r u q f i xe r o n p o x 3 B o a x T c a ,B 3 a B I t c I r M O c r n oT
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yxpenreHue>. bcna noc,le BBeaeHrt trr'Ibl yKa3aHsoe orilyIueHlte
y 6onLHoro He Bo3Hl{KIo, Heo6xoaxMo Aoxrarbcc ero. npoaorxafl
MaHIrnynrpoBaTr, tr,rol,
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MoMeHT npurrBa 3Heprxx. HrnorepafleBT, ocyurecrBnfiIoul}li nyHK_
ullrc, qyBcTByeT, KaK KOHeII fir"{bl <TtxereeT>, <Bq3HeT> B TKaHtX
(Aay XaH KxaHb <PyxoBoacrBono x.royKa,rblBaHnrc,').
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npx aocrfixeHrr (3QQeKfa rr,qbl> 6o,llHoi HcnblrhlBaer qyBcrBo
HanpqxeHHocTrj, pacnfipaHHfli TflxecTl,l B Mecre, y(ona, KoTopoe
Moxer pacnpocTpaHtrr,cq Do xoAy Mepl,IAriaHa. hexoropble Bpaqn
cr{Hralor, qTo TorbKo oqyueHae ?!'reKTpnqecKoro pa3ptaa npq no-
uaaaHxr{ qr,1br B ToqKy (I(aK npaBrro, aro noDaaaHLte B HepB)
o6ecneqnBaer sooexruBHocrb Bo3aeficrBl.rr. TepMnHoM (3oQexr trr-
nbr> rronb3yrorcr o6blvHo npr rny6oKr.rx BHyrpriMbruer{H6rx yKonax.
Koraa peql, IjAer o Ao3e pa3ApaxeHrrr, To noA pa3ApaxeHteM
He aMeercr B Br,r,(yrqlrb pa3apaxeHr,re c oqyueHxeM, xapaKTep_
HbrM anr <3Q$eKTa rrrbl>. B noHtrve AosLI pa3ApaxeHstl BxoAflr
TaKxe cr€neH6 r npoao!'rxurerLHocrh Bo3aeficrBfiq. tlro6H npa-
Bl,tr''IbHoonpeae,tl,trb Heo6xoAfiMylo creneHh fi npoAo,rxl{TerbHocrb
pa3ApaxeHHq roii finr rHofi nyHKqnn, cn€Ayer noMsHrr' IlpaBu,ro:
npr cIrHApoMe <nor'lHorhl> yxor'r .qonxeH 6brrL <pacceHBaloufiM>,
npr.j crHApoMe (nycrorbrr - <yl(pennflrcxrnMr; (oaAa 6ore3Hh or-
f l o c x r c r K c H H A p o M !c x a p H r , a 6 o , 1 e 3 H e l B o p n i r e r e p r r a n p o n t t x ' ' r a
nuur6 a floBepxHocrHylo rKaHb, yxo, ao,,rxeH 6nr6 noBepxHocrHLlM,
Hrrry npr.r 3ToM c{'reayer x3B!'reKaTb BcKope noc,re yKora; eclrlt xe
6one3Hb orsocxrcr K ct.{HApoMy<xo!'roaar, a 6o,'re3HerBopHaq3fiep
rfis npoHr,r(r'ra ffy6oKo fi <gOOeKT firnbr> Aocrxraercfl c rpyroM,
To xrny CneAyeT OCTaBT'IqTb B TKaHflX AO TeX nop. no(a He nOflBI'lTCg
yKa3aHH6rfi300ehr; xoraa 6o,1e3Hb <cxonr.racb> B xoriarepa"'IbH6rx
Mepr{AfiaHax.cJ'reayernpon3Becrt,l Maroe KpoBorrycKasre; npll 6one3
HHx qHckoro xapaxrepa yr(or'rbr ao,rxHH 6HTr, noBepxHocrHbIMx,
npaxH6cKr,x6ore3Hrx r,ryooxxMfi,
I,lraK, no noBoAy ao3br pa3apaxeHr,rr Moxr{o crerarr' c!'reaylo-
uee 0606ueHHe:
npl,' caHApoMe <nonHorbr> - y(o"r x aocrxxe8ne <39{p€K'
Ta ar!'rbr> - cl,tr'tbHoeBDauleHge grrhl lt ocTaBr'IeHte e€ B T(aHgx
BparueHr.reB nepHoA HaxoxaeHfit nr,,I6I B TI(aHtx qepe3 Kaxable
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K y n o p x B a H D r ro) T B e p c T { 9 :
npr cr,rHApoMe<nycToTr,l) - yKoa q AocTrxeHre <3oeekra
rrrbr> (IIpr oTcyTcTBuri noc,leaHero npox3Boafirb MHofoKpaTHoe
Bpaueflfie Ao ero norBlreHrrr) - nerxoe, MeareHHoe BpaqeHre
[r,IbI, ocTaa{'IeHte trru - MeaneHHoe.llocTeneHHoe I,l3Br'ret{eHrerr-
,ru c <3ar(ynopaBaHrreM>oTBepcr";
npl cuHApoMe <Hr.j rror'lHora, Hfi nycrora>
xeHxe <3Q(DeKa xrn6rr - Bpaqe8ne kfnH cpelHeii sHreHcHBHoc-
TL ocTaar'leH}reHrnbl - I,t3anelreHlrelir,'rbr co coenHei c(ooocTbto.
Bpeuc ooaa,reura ,rrrlbi B lxaxr\
noc"re yioaa onpeae,raercn
cocTotHfieM 6onbHoro, a,raxxe no ycMo,rpeHr.jroreqautero Bpaqa
(o6blqHo or l5 ao 30 MrrH). Hexoropbre apavu cuaranr eoo6ute
HeHyxHHM ocrasJrHrb llrrY.
<3ooexr rrabr, B o6blqxoM ero noHrMaHr,lt (ouyuleHxe 6onb,
Hbrv rlnon 6o"tr, HanpflxexHo.tx. raxerra;
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526
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527
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f l o c r o , r u x yB A a H H o vi : , T y , r a vee r o n a l l H K y - 2. T ;:e.1aqQopMa.npltHutln reqeHnrr:ocHoBHan Mepa (r1t{x-
",rorepafirr cJryxsr BcnoMorarenbxbJM cpe4crnou reornoxuori'nora6- Br1aaqxq BbIAe,'reHt{ii, yH{rlroxeHre xaptl>, Aonor'IH}lre!'lbHat -
B ae.lrueiuren AonxHH 6brT6 npfiMeHeHr,r I dpackpbrrve ofBepcTni1e,la.. BoccraHoBrleHxe norepeHHoitHeprxx
Iff, Apyrue MeToAr,l
3anarxoii MeAnusHLI j," pu4axa,ro"oro ,re"euua, To,rxr BoraeficrBHq: nnr-uyrr 126VC) HHreHclaHoe Bo3aeii'
::::::l"l !
KoTopoero{'Ibr{oI MoxeT o6ecneqljrr,coxpaHeHlje)Kr3H, Oorr6Horo. yH'
crBne; rxan-ryet{ (anevepa4raunar) , Kxyx_qarb (3 MC),
qyxr (40 V) (i uanurr'rxporonycxaHteM);6arb-xoii (20 VG).
CO.NHEqflHft YAAP Aono,'rH TenbHoBo3aeicrBylor Ha roq(t{:
nplj ror'roBol{pyxeH}r}r, rorxHore ryK raM_nr (36 E) I't Hofi_
ocltoBIbtE noJtoxEfi r.tt Kyan
' (6 MC);
np,{ cyaoporaxMblrxu 3broHr-,raHr'ryeH (34 VB);
- 9To HapyrneHr.je,
C.o,tx_e,{Hbui^JAap ,raqc Bcero Bcrpeqa&ueecs B &(fi_
nDIt ycr,r!'reHHoM noTooTAereHIIl.{, orcyTcTBl{s nyJbca
"pfl:..i:1,_.!pHpa6olenoaco,ruupv.
oco6iHronpr a,,rr. xaii (6 VC); rxas'Kxner (8 Vc) nprxrraHLe.
I,"?i,::
r14bHOv rpx3rqec|(oMnepeHanprXeHhH, Korra one/'(Aa nr'to{o T e p a n e B T a ' { e c K f t f i 3 O 0 e K T r o q e K : r o q K aA a l - T l o L
flponJcxaerren,lo (Te[noBoi yrap) rrr'1!(oraa reno
Ho or conHeqHhrx
rr!,loxo3aurrlue (14 VG) rcno,l63yercq a,lt nvKBltaauHfi(xapbl>, BoccraHoB"leHl'ifl
ayqeii (co,lHe,{HHiyAap). npoxolr,Moc'rx rH'rHeprrn,roqK, I(xyx'qr ( I I GI), xofl-KoK(a GI)
gTtOnOIXt fi [aIoIEltE3 A,1r !'rfiKBtuaqfifi6o'le3HeTBopHoro QaKropa <xapblt a Mepnanasax
<cBer,'rbritH>, ryK'raM',1I, (36 E) Are HopMa!'lIt3autileHepr I'j
oc,ra6neHrq xr{3H€HHo4 3Heprrx Ha(orrreHue xenylKa, OyK-,lbry (7 R) -- a'ra <a36aB,'reHlrq or xaxabr l{ yBrlax_
Il"^9:-:"_-:-u..g:.:(paKToloB
oore3HerBopHhrx <conHe,rHofixapu>, <iapu I cbrpocrH> HeHnf,cyxocrrr, Bofi-KyaH (6 MC) A,'ttr BoccraHoB!'IeHntnpoxo'
rrrMocrr gHeprar u KpoBti B o6,racrx rpyaHon x"lerKlj, a B coqeraHHlj
re,la. IIpu rsxe,tori 6opve raplueira ,axynopu
Baelcg-.(rorocoBoeoxso,, co:aaerci nenpoxoaruocro c ryK-raM,rH (36 E) 3ra roqKa eue 6onee 3OOeI{ruBHa s pe.y,ru-
en-eprla. ovroqeM Bo3AeficrBr.uj Ha xenyaox: ro'rK* 6arb-xon (20VG).
UI,pxy,rrpyKrulei_no MepxaraHaM,vro nptno4lr x l<oue,
cnrq,pouy iix-,rynr (26 VG), rxan_ry€H(BHeM€plagaHHaq) 06'1aAarcr cnoco6-
c. s34), xoraa Hapyurae.rcqan"p.".n"e.*oe pau,iosel
:jl"ll.r*-""!"" " 3Heprx' ycrpeMrse.rc, HocTblo"pacxpHBalb oIBepcInfl le"aa yHfiqTo/Aalbxap)t: ToqKx
:l" neepx.B c-nysaevpeiuepuoro h \ y K - , r a r b( J M L , , y q y r r r ( 4 0 V ) c n o , l b t ) k , r c nr ' ' I e , r H a H r F
rcrorrefifir co*os rera Bo3HrKaer cfir.rApoM<nycroru ; y;qxfir.
. x a p H $ H , h p o B t tH . ofi_xyaH ( 6 M C I B c u q e r a H H' r y K _ 1 a \ 4 _ ' 1 1 1
ctMnTo Arl|(A t36 E) Arle HUpvaJrraufir oyHt(unoHanbHoi nefiTerlbHocfU xe_
n Y n K a ,n p r r o u t r u r e .F l p t ' l x N
a Iu n e l o q e h h \ H x a i i t 6 V C ) l x aH-
Pai,1r.i,rator
nBe OopMH3a6oreBaHfi ,, xxrcer (8 VC) roHri3t{pyer xu3HeItfiy'o 3HeprBlo, npeAorBpaua€r
OopMa: roiosHae 6onb. roroBoKplxeHxe,pacflxpa e€ yreqKy.
....^,:
Hxe 1'11Lr"ro_rrrFoTa,
a rpyAr,r, xaxaa, BHcoKarr,reMneparypare,,ra,_ropn,ian
cyxir ycra,locrh,
6ecnoxoficrso,
arixorvoopr 6. Bo3Aef,crBreMeroAoM<ttB€renngt
+:.lri:i-()65a,
y:i:r:lTiifi.fJ',i1;
:1".i:"Xi%"""
T#Jiil:;i#l"f;_t,ii:tf"
HfixHrx- xoHeqHocrei,yqaLleHHoeaHxaHre, 6pen,
O 6 p a 6 o r K a n o 3 0 H a r b H o M yn p x H l r r n y .
l. npr ,rerKoftQopM€:
*orr, ;t;;;
o o n b L x o lnx o H 6 r ) .c K o , rr6H u r r ; { r o a r l . 6 b l c f p d j l ( c a | ( r . 30Ha OOt3aTe!'tbHOrOBO3AeLCTBliq;
ocHoBHat3oHa Bo3aeficrBfiq 3arbr,']oqHaq o6,1acrb;
rEPANl|' aonoflHxrenbHar roHa BoueficrBHe nepe4HeHap)aHat
cTopoHa npeAnreqbfl r roJIeHa, TLIrbHat cropoHa KI{CTH a cron$.
A. Hrnotepafirq 2. npr rcxe,loft QopMe:
- sarbr,,ro,rHano6nacrr; yvacrox ro'rxr 6arb-xofi (20 VG)
l:. j_",.I1i-O9f ", JIpHH(rin ne,{eHnn:rJraBHa, Mepa <nxKBrlla_ (Bo3aeficrBr.re
c,ra6ofi,HreHc BHocru); BHyrpeHHqH cropoHanp€a-
uflt sH4ereHfift.'xr,{roxefirexapbt.. Ionor'lfikrer6Hae nnelr6'l H roreHrr; naaoHb u noaorxBa; Ht3 xIlBoTa (Bo3aexcrBle
HopMajl,|
3aufie sHeprulrxerlyAKa. c,ra6ofi xHTeHclrBHocrfi ) .
536 537
 XapaK.rep Ct|MNIOIATTXA
o6pa6orRri. 3 o u a , p e x o n a e n 4 y c uxar ar
crpyKqset, ,{ 3aTbr"1or{Has
o6.racrb o6pa6arblBarcrcn co cpe4xeri
qHTeHCfiBpOCtbro. B pa3,rr'{Hbre nepfioad 6on€3Hb Moxer npoflB,lqrbcn ao pa3HoMy:
! , l a c l r \ H H a B O p I H H Xt H t l x H r x o H e q U . T r \
oollbluolr r,1H cperHet fiHredctBHoctbto. HrrJ , 1 f i 6 o B B h a e B b r c o K o i ir e M n e p a r y p 6 r r e " ! a , n o K p a c H e H t s , 1 l l { a , n p r '
xraufa rFr(o. '{eM y 6onbHoro Baqufiaer rpscrtic6 rorloBa, Apoxa,b KoHeqHocrt{,
haxnar ,lHHfin no l5 20 pa3. flpH orcyrcrBHr
3OO.j{ja npoton o H c T f i c K s B a e r3 y 6 5 r , y H e r o n o q B n t e r c t 6 e c n p l i , r x H H o e6 e c n o x o i
) h H r bo 6 p a 6 o r K ) , r a a o n l l n b a o u s i r c r o n b r : e c r H
r00exr ne aocrrr. crBo (He HaxoAlrr ce6e Mecra), ,rx6o flpu Aa,IbEeirxeM pa3Blrrl]x
il,l j.,:,:9:'..:9':::' acenz,'bubrp)*, *o,.'r.''; ;^; i;';^
rzu :rBarb
vur ,4o lcx non noka 6o,tbHoriHc nprAer 6o,,re3Hx Ha6,rroaarcrcq norepq co3HaHrtt, 3aKarHBaI{fie rra3. cyao-
cosfiafite. Ec",rx co,rfie,rHui s porr'r Bcero Ter'ra B Brae oraenbHbrx nprcrynoB t{nfi yqaqeHHoe
vaao co
npn,""n.o 4uno,nn,","";
;"j;;,i".;;iT"T#tiilf
";r*"ff;xTl a h r x a s x e , 3 a a e p x x a A e Q e K a I r a n ;n y J l b c r o B e p x H o c r l r b r i i( O y ) , 6 b t c r '
p b l i i ( c a K ) , r i n r H a I p q x e n H b l i i , 3 p a I { l { ' . rc y x e H b r l t n r p a c r u a p e H b I ,
cropoHy roneHn.
O 6 p a 6 o r x an o r o v e q H o M n a 6 " , r r c a a e r c ru f i a H o 3 x o H r l o B n a n b q e B p y x ,
tr"Xl
yKalaHHovy
1eq::1q """" loX'.,1;;"^,lltltl:
d . r ( o n o r-anixo_l,q:H
. o o r b H o t . H e L M o r p qH a n p f i H q r b , e lEPATI TI'
vepH, re npaxoaure
co3HaHfie,Heo6xorr.{Moro:At!ficreoaaiu rro,rbqarbrM
Mor'toroqkoM Ha
yqaLrKI Inqex 6atb-roit t20 VGr. HflH-,r)Hr A. Ilr,rorepanHc
rZe VCr..rro-xVni
1 8 M C ) . n p r " o | | u e " n o '.". a o p o , , r o 6 f a 6 o r a r ra . n o , r r , r , " . , i H o
y q a c r x xr o q e h x a y K - r r nprHqrn ! ' r € q e H t : o c E o B H a fM
l epa < l r n K B s a a u Hxqa p h l > l
_7{_3.lCt. r s r o n r ..rair1tr, (Jl VBl. ,\br;
x a r t b b v ) , r r b r a - c o H( 5 V). ocraHoBKa <Berpa>, AonoJIHfireJ'rbHat <pacKpblrlre oTBepcrlrl'{

B. AyprKy,lorepanrc To'{xx Bo3reficrBnq: H , r Hq y H r ( 2 6 V G ) , r x a n r y e H

( B l r e M e p n a l t a B H a q )( c M a n b I MK p o B o n y c ( a H I r e M )a, a n - r l o x ( 1 4 V G ) .
T u q h r .r t o a ' l l e x . a u r eB o { n e i c l s 1 4 t co f, l r ! u r . , r a r n o q c ! r H f K ! xorr-xoK (4 GI), rxaii cyHr (11F), 3broHr-naHr yeH (34 VB).
vur. rAr DJ,. ctvndtHqechdrl fiepsHa,
r\aH
c H C l t s V d .r a l b l J U K : n y H X U l , 1 ' T e p a n e BT r e c x r il 3QQeKr r o q e K : r o q K aH q H - q y H r
r \ranbrM hpoBonlcKaHHevro,rhu nr-rs,e, (26 VG) (<pacc€rBau$ftr yxon) cnyx{r Ant <pacKpblrllt orBep-
. cy,loporax ru"."epnarjrrnr")
llplr Mr,rulurpe6yercfl AorrorrHrrcJr,HoeBo3rlr,icTBseHa c r x i l T e n a > r { n p n B e A e H l q 6 o n b H o r o B c o 3 H a H x e .r x a n - T y e H ( B H e -
yqacrxx To'{ex: IIe,{eHb,xe,,r,rHbltiry3r,rp,o. vFpHrraHHdq) - A'1t !pacxpb||rq urBepcrxr.l lena', ,1r.1KBHAdaHl'l
- x a p b r ' . n a i j - r r o H{ l 4 V C t r x u n - h o x t 4 C I ) IIre nrhBHdauHr
( x a p l r > , r o q x a r x a t - c y H r ( 3 F ) n 3 b r o H r ' n a H rr y e H ( 3 4 V B ) a.IIH
BblcoKAt TE nEpATypA c cyaoporAln[
< H o p M a J r3f ai r r I ' I I O y H K q x o H a n b H o *r e q r e n b H o c r , n e r ] e H n > ,< o c r a H o s _
o6t{xE nonoxEl tt Kr Berpar, <pacc,'ra6,reHnq cyxo)(x,rnii>.,,rrKBraauur cyaopor.

CrHApoM,npr (oropoM 6o,'tl,Boi [r3 3a Br,rcoxofireMneparypH rer,ra 6. Bo3aeicrBse MeroAoM {qBer€Hue,

rcprer torHaHfie,npxqev no Bcelt! lFr) H.tHB oTtrerbHHr\ qafrex
, ro Haor,lro4a|otcq fienpepdBfiHeKUHBlnbc . Cl()na )he voxHo O 6 p a 6 o r K a n o 3 o H a r 'bl H 0 M y n P s B u r n Y :
orHecrl{ fi TaKre ctHApoMH BocroqHor}MerxqnHbl,KaIt xoHBy!,t6cl,rl, 30Ha o6t3are,lbHoro Bo3reicrBt'I;
o c H o B H a t l3 o H a : o 6 n a c r b 3 a r H ' ' l K a , y q a c r o x r o q x f i 6 a r b _ x o i i
)' le'rei (HepeaKoHa6.qrcrarcrcfly Aerei Monoxe 3 "rer). ( 2 0v G ) ;
Aono!'IHfirerbHae 30lla: BHyrpeHHqt cTopoHa npe,Anrleqbt x
STXOJTOTItI nATOrElE3 roneH .,1aaoH6 t noaolxBa.
fIpxqrHoi BbrcoKofireMneparypbrfena y Aerei, conposoxAarcIjreficr \ a p a K r e p o 6 p a 6 o l K H : n o c l y x H B a H r e ! 1 o , 1 o 1 o q K o \c4p t ' a H e x H ' l H
6o"rr,uiofi asrencagsocrH, 06pa6orxa Kaxaoii ''IxHnn ro l5*20 pa3.
xoHBynbcnqMl{, qBJrqeTcrro, q,ro B aeTc(oM BO3pac're OpaaHIi3M erqe O6pa6or(d n o r o q e q H U v ) n p r H u H n ! n p r Hur'l_n
He or(pe[,gHeprdn n KpoBbeue he y,rBeplsr]xcb,B cBr3x c qeM!eT,t
,.rerxonoaBeprarorcflBo3aeicrBr.{oruecrl{ 6o,Je3HerBopHbrx r e q e H H r a H a . l o f h { e H n p H B e a e H H o ! l }B b t u l e : H a K a x a y t o l o q K } H e o o
{afiropoB xoarMo no 50 yaapoB Mo,roroqKoM. Ecnll cyaopor, He Hcqe3alor,
" u* opraHX3Me6brcrpo aosuuxaroruxapa, a uoerep,,
l9l9Ayt
KOTOpbre Harpe_BaroT no6aB,rflror o6pa6orky roqeK xay-xxe (3lG), rxbla KaH (56V),
xltar(ocTn re,1at npeBpaulaq llx B MoKpoTy,
floc,reAgst, 3a6uBafl <ro,locoBoe oxr:or, sbl3llBaer cyaoporl.'Oria T r b r a - c o H( 5 7 \ r . l H o H r , 1 a H r r y e H ( 3 4 V B ) . f l p H f l o r e p c c o r H a H f i t
_ p r 6 ) e r c r n o n o , l H H r e l b H oBeo J n e i c t B H eq a r o , r K r6 c r b _ \ o i 11 2 0 V G )
Moayr Bo3HtKarbTar(xe B pe3yr,rbTareHapylUeHncpauHoHanbHoro
pet(fiil4 nfirassq,cKon,reHnq ,rao-xynr (8 MC), 3yrr-ryeH (l R).
<xapbr> ri Mol{porbr.
539
6)A
 B. Ayprxynorepanxe ToqKn Bo3AeicrBxq: Aaft-r'oa (14 VG), ,llrer'Kxoer (7 P),
Hroair-xyaH (5 TR): np Karlrre peKoveHnyerce !ol,nr1H'llenbHoc
lIplr Bhrco(ori reMneparype re,ra Bo3AeficrsoBarb Ha TorlKy HH-Tr,r€M Ha roqK)
( B H e M e p r a a a H H a f l )n; y H K U f i r rC M a J r L ' r M B o r A e i c rB H e H a r o r h y O e r y ( l J V ) . n p r H a . v o p h e
x p o B o n y c K a H r e M ;n p u c y ! o - rrrent-xuonr(20 Gl).
p o r a x - y K o , r L rB r o r l K x : c e p A u e . f l e q e H b !r x a H _ M o H ( A p 5 5 ) , x e - <ocrafloBKa
Ber_
,1y,qoK.
<Berep
2. Cr.{HApoM xapa>. Ilpaeurn "re'renaa:
'D a .D a c c e H B a HxHaep H .
ioqxH eoiaeircrarlq:SoH|rfi (20 VBr. aai TIo (14 VC) kxyh_
qr (ll CI), xon-xoK (4 GI). flpr aanopax peKoMeHAyercq aonor-
l . 1{HOEKUHOHHbt
E 6OJtE3n lt Hnrenr,HoeBo3AeficrBneHa rolrKt{ rxreH_Kxy (25 E) n ry(_raM_
"ru (36E).
rP}lnn I npocTyaHblE3ABOJ|
EBAHt,l' T e D a n e B l H , { e cK x i 3 O O e x l r o ' r e x : B o r 4 e H L l H Ba He
ocHoBBbtE ro,rx\ iafi-rroa t l4 VC, yKpen,lqe-raurHrHyto?HePrlo: BUraeii
nonoxEl {t . r B r c H a ' . q K y o o H r - q h( 2 0 V 8 ) ( p e . r c t B o r H a p l u r ( H r tB } t x
<HapyxHofi>(Haqa,rbHofi) craaxx, a npu coqeraHqt{ee c roqxaMx
flor npocryAul,tMs 3a6ll,leBaHqrMx rroHaMaelcr KarapanbHoe Bocna-
",rlei,rxroer (7 P) I, Hroafi,(yaH (5 TR) npr6aBnqercfl erlre lj
,'reHre BepxHxx !HxaTer6HHx nyTeri. fpsnn 3To l,lHoeKquoHHoe soccTaHoB!'reHrenpoxoafiMocrl,t 3Heprxr rerKxx; ToqKfi KXyX-qr
3a60.'reBaHUeBepxHr.{x46rxarenbHbrx nyrefi BnpycHoro nporcxoxae- <pacceHBarb
(ll GI) H xon-xoK (4 Gl) 06raaabr cnoco6Hocrbro
Hne, cnoco6Hoe Bbr3brBarb onureMsrc. Kax nilsoe, ,ai. a uropo" (25 E) n ryK raM-"In (36 E) {cno,rByrorcs npx
xapy), a rxneH'Kxy
3a6o.reBaHr.teMoryr Aasarb ocroxHeHur xa "reixne. fpxpn l npoc-
rtlHbre \a6o-npBaHrr
3anope.
I{acTbKl 3l1MOr1 ..scTpe,ra|o,Lnhpl|nbti to L. hu 6o,tbrxet
ll BecHot
5. BosAeicrBxe eroaont <ItB€reH[c,
STlonOrXq I nATOTEt|E3
O 6 p a 6 o r K a n o 3 o H a ! ' I b H o M yn p n H I r f n
i y:
npocryAHHe 3a6o,reBaHr.js Bo3Hr,rKarcr B pe3yrrrr,rare cnfixeHfig 3l]Ha ()6q3are,lbHof o Bo3AeicTBxt;
conpoTltBr'tteMocTr opIaHI,t3Ma t flpoHtiKHoBeHfinB Hero naToreHHHx ocHoBHas3oHa 3arbt,toqHaqo6"racrb;
(paKTopoB <Berep-xonoA), qTo co3laeT HenpoxoAr.rMocTb3Heprufi cTopoHa npeAn'eqb'{'
Aonor''lHtjTeJIbHag30Ha HapyxHag
,rerKxx. Ilpx pe3KoM n3MeHeHHr Froro!Hbrx yc,roBsii nosg,rqircs XaDaKTeD fi ao3a ao3aeicrButl
'npr
<6one3fierBopHas 3HeprHtr>, ycfinrrBaercrr Bpeao!ocxaq <xapa>, io,roerofi 6o,1t: aoflorHltre'r6Has o6pa6or(a BrcoqHoli
o H r i n p o H r r ( a l o r B J e r K H e , c o c o 6 c r B y q B o 3 H y K E o B e H r r or p r n n a . o6racr!.{;
npx HacMopKe: AononHfiTerbHas 06pa6o1(a 06,'lacrl'{ Hoca
c l.r,t,tnToitAT t{ KA 3oHy 06r3arenr,Horo BosaeftcrBl.rt 06pa6arblBarb co _cpeAHet
f l H T e H C r B H o c r b r o .c H o B h y t o r . 1a o n o r l H u r P n b Hr)o , o s t r _ c 6 o ' r s u e f r
CyqecrByror rBe OopMht yKa3aHH6rx 6o,'te3Hei: oo \ o , t t h ] 6 n o l 5 - 2 0 p a 3 . o a H H
r H T e H c H B H o c r b r oK. a r { ! y l o " 1 r . 1 H L tnt p
t, Lr.jrapoM <Berep xo,rioA): ro,roBHar 6on6, noBbrlxeHHanreMne_
p a r y p a , o s H o 6 , c y x a q K o x a , 3 a r o x e H H o c r b H o c a , H a c M o p x ,r o H x r i i
O 6 p a 6 o r K a n o M e p n a x a H H o M yn p s H u u n y :
6 e n H r i r l a " l e r H a n 3 H h e . n l r b c n o s e p r H o c r H b r i rt d ) ) . yracTok MepnanaHa MoqeBoro ny3blpt oT roqxn ToaH-LlyK
z L n H A p o v . B e T e p . x a p a r : r u n o B H a q 6 0 , 1 b H o L ! ) L r l e He H d n p q .
(2 V) Ao ro.rxx rxfiex-qy (10 V);
xeHHocrr{ B ro,1oBe, 6o,'lt B rop"le, Kaueib c rycrofi xe,rroii MoKpo y q a c r o K M e p H A H a H a" , I e r K L xo r r o r { K , r x s e y _ T x b l o H r ( l l P )
Tor,rjHeBr,rcoKaflTeMneparypa, 3q6xocrb, He6o,rbruoe noroorAereHlle,
roMora B TeJre, cyxocTr. Bo ply, roHx|jft xe"rrblfi HaneT Ha r3brxe; ao roqKs cnrb-qarb (5 P) ua npean,reure.
XapaKTep n ao3a Bo3AeicrBaq: Ka)KAyo,rrHllro npo)(oallrb no
n y n b c n o B e p x H o c . r H b r(iO y ) , 6 b r c r p H n ( c a l { ) .
2 0 p a 3 B H a n p a B , 1 e H f i x0,6 p a r H o M x o a y M e p r A f i a H a ; n p x H a p y u j e H x u
OyHKufiI, n,lorHoro opraHa D3 3a <nycrorri> tH-3HepraH npocryA-
IEPAN|{' Horo ra6o,leBaHre HapyxHofo npor.xoxncHHq soraeHcrBoBal!
c se6o,rbrxoi HTeHctBHocrbo B HanpaB,reHul'l no xoAy MepH
A. I'lrrorepanrt araHa, ao6aBxB yqac,oK HoxHoro MepuAxaHaxerqyAxa or roqKfl
ryKraM-nx (36E) ao ro'rKlr 3tfi-Kxe (41 E), no l-2 ceaHca B
L CnHApoM <Berep-xo!'roA). IlplrHqnn ,eqeHfir: Mepbr flpoTliB
< H a p y x H o r l >c r a A d a 6 o , r e 3 H r .

5{0' 541
 B. Aypnxy.rorepanxr
pacxpbrrsx prat nepexeBbrBaHna n{uq 60,rbHofi l,|cnsrrt'rBa€r 60"'Ib.
Bo3Ae$crBoBarr, Ha roqxq: nerKr{e, MoqeBoi ny3r,rp6 (npl, 60,reBbrx H o p M a , ' r b H a rs ! ' r H l r e M H o r o D o B b r u r e H H a r e M n e p a r y p a , 3 a r p y a H c H '
olq)'u{eH0tx Ha yrlacrKax srtix Toqex npolr3Botxrl, nyHXUHr,o B r{brar np eM Iltrulx; ncaxfiqecKoe cocToqHxe HopMa,'lbHoei roHKt}r
6o"reBbreMecra, flpfi oTcyrcrBtill B ro,rKfi). 6e,1brfH i ane, Ha r3brxe; nynbc noBcpxHocrHdft(0y).
yqacrKn roqeKr ropJro a ropraHb, HapyxHbtii Hoc, 2- THxe,lar (bopMa 3a6oreBaHrr, 3Haqqre,'rbHar nprnyx,!ocrb
,npoBep|lrb
.qo6, ruer.3arbrnorl. flpfi Ha"raq{r 6o,reeurx roqex Hr,r( Toqex c noBlr, u rBepaocrb ueK, npn HaaaBn{BaHrfi 6onbHoi licnt'lrllBaer 6o,'Ib,
rueHHon tr'ieKTporIpoBoAfiMocrbto Heo6xoILlMo lra3HaqHTb aonor'rHH- 3arpyaHeHHoe rno,aHxe, noBbruesl,re TeMneparypbl rena, o3Ho6,
ro,'roBHae6o,'rb, xaxaa, cyxoc,r, Bo pry, xenratt Moqa, floKpacHeHIte
C nporlnraxruuecxofi (e!,rlro MoxHo npnr""nro nyr*q'ru ,nn 'l3brxs. xe,rrbrii Ha,rer sa q3r,IKe; ny,rbc cKonb3flxrrfi (xoar). 6brcr'
, { H A e K U r xB r r a M u H o BB r r x , . r r B I s r o q x r : c e , r e 3 e H ( ax, e n y a o K 3 p a 3 a p b r n ( c a K ) . B o c o 6 o r t x e , r H x c , r y q a f l n - x o H r p a K r y p a M b r r x u3 a r b l n '
B H F l e , ' r r c f. l O O n H O V y) h o r y B r ( a x n y o t u q K ) , K i j , n o r e p r c o 3 H a H n s ,c y a . J p o r { ( 0 p x o c n o x { B e H n s xB O o p M eM e H n B r t { _
ttpoOHraxlhKa f p f i n n a . B u B p e y f rl n r r c v H r l p n n a ra. 3Hueoalu,a uno Mxcnrra).
v o x f l o n p r v e H q T h v e t o a b t l { r r 1 o ) K a r t . | B a H x fHl l t p f i ^ { h f a H H r c n p o
Q x r a K r n r r t c K o t D e , 1 b x ) ,q r o 6 b J r p e n o r B p a r r r b r a 6 o n p B a H e . y K p e rEPAnl|t.
nBrL xrBHeHHyro (3anrfi,rHyro) 3Heprrrc naufieHroB. A,rs gToro Bo
BpeMe 3nsaeMDx creayeT npo|,r3BotfiTb nyHr(urr, npl,lxrraHfie, A. Hr,lorepannt
flpr(naaHBaTb n!'tacTr pb c <rnrpoBoii> Ma3r,ro lrru ocytqecTB!,lsTb
T o q e q H H rv a c c a x l H a L a B ' l r B a H r ec B p ! u , r f l , r e M ) r o ' r f i l , |r y K - r a v - r r L , t l e r x a s O o p M a 3 a 6 o n e s a H U ' I .f l p t i H r l r n , l e q e H u q : < p a c c e s B a H I r e
( 3 6 t ) p a e a H e 8 H oB r p q F H r c3 5 r F ; i i n o I 2 p a r a s a e r s a a p b r , ! H H ' r r o ) h e H H eB p e t r H o r r H e p r H h ,
Toqxr eo,aeiicrgHs F SoHr (17 TRr. rHn-.a r6 E). rH xa!
(6 TR), xon-KoK (a GI) < p a c c e x B a l o r q H e >y K o r I r I .
3nr,[EMltqEcKIn nAPOTI|T 2, T' xetaa (popMa 3a6oneBaHlt. npt{Hqun neqeHxe: <paccer-
B a H x e x a p b l , y H n r { T o x e H r e B p e A H o f ig H e p r x t > . M e p H , c n o c o 6 c r B y n
ocdoBlruEnonoxEHll ulne paccacblBaBDlo npxllyxnocTIr.
Toqxa Bo3aeiicrBr.rr: re xe, qro I npl,l nerKoi +opMe. [IpH opxu-
3nrAeMUqecKti napo,rr.jr ocrpoe rHQeKutoHHoe3a6o,reBaH{e Te peKoMeHAyercq AoflorHtjTerbHoe Bo3AetcrBl.{o Ha ToqK xaHL'_
BxpycHoronpoIcxoxaeHrr,coflpoBoxaaeMo€ noBbrrxeHfieM
TeMnepa- srx (2 F), vyur'ao (6 F), raM-aM'3to (6 RP).
rypbrTena,nprflyxr'locrbro
yuHHx xe{1e3,opxrToM,a raKxe nDorB, T e p a n e Br u q e c K l ,i i , Q Q e x r r o q e K : r o q K He - O o H i
,leHXflMfi HapyrueHui HepBHoficqcreMH. flaporarou (cBrrHKofi) o6brq
tl7 IR, lr 1fln-ca (6 E) .,1y)har s (aqecrBe nepBnrhofr vepH n'ls
H o 6 o n e o t a e r r B B o , p a c l e u r 3 a o 1 5 , l e t . a H H o r 4 ah B r p o c J H e . BOCCTaHOB!'Ie rt MeCTHOIinpOXOAt{MOCTg3Heptl,ll,{ t I(pOBX; TOq(Il
q a l r l e B c p r o B . 1 v H eB e c r H f i r i e p H o a , B v e c f a x
D o , r e t H bB o r H H K a e T rx-xay (6 TR) r xon'KoK (4 GI) cnoco6crByror paccacHBaHlr()
c Br,rcol<otn,'roTuocTtrc Hace,reHfit. npl{ny)\rloclH v c p a ( c e B a l o l x a p } ' B M e p r n r l a H a \! v a n b l H t H , x
<cBer,'rr,rii rHr; Bo3aeficrBre Ha rorrKfi xaH6 3rH (2 F) u qyHr-ao
3TIOnOrl{t l{ nATOrEflE3 t6 f) cayxrr n e p B r H b r r r c p e n c r B o 1 4. p a c c e B a H H f l c K o n , l e H r r u r ' 1
9 H e p r H t l .B M e p r 4 H a H e . x o H e u H t ! : l o q h a l a M - a v - . r g o i o K t . I
nprqHnoi 3a6o-"reBaHfi r .16biqHoc,!yxar upocryAa r npoHHKHoBcHne cnoco6crByer I'rrKBxaaul,fi <xapbr> B KpoBlr.
oone3HerBoprror.{ sHeprxn <rerra) I,'rx naroreHHoro 4a(ropa (serpa_
n p u o 6 e q x O o p M a x 3 a 6 o , r e B a H x tM o x H o n p H M e H e r bn p { x r { t a n f i e
xapH> B MepfiAlaHbl <Ma,tbti flH> H <cBerrHfi qH) a coqeraHuu c
(c nouourrroouir,rq or (epocr.rHoBofi
naM'rLr)rbvxa sax-rou (20 TR).
Moxporo, B coclorHfifi <orHr> BHyrpr.{opraHr,3Ma, Bce 3rr, BpeaHr,re
paxroprrr c(anrxBarcTcs a c,qloHHhtxxere3ax, ll ec,.Ifi 6one3HerBop_ 3axxeHHbrM OurHneM, nponnraHH6rM apaxrcoBblM Mac!'IoM,xacaror-
ci 3Toii ioqKa raK, qro6ti OIrTnnb 3arpeuan o norac- J Tepa neBTr{-
Har (xapa, x3 Mepslr{aHa <Manbri qH> npoHl{KreT B MepfiafiaH ,recxrfi 3oQeKT Aocrliraerct noc"re l-2
/ x o H e u n H q , t o M o a e T B o T H H X H ) 1CbH H r p o v. f i r H b h y e r ! ( c x , l b o e raKrx lrpfixuraH ii,
B o , 6 ) x a e H H e u e H r p a n b H o f ir e p s l l o i i , r c r e u s r . 5, Bo3reicrBxe MeroAoM (uBereHt,|c,
Qyixuroaa.rrrne
paccrpoxcrBo 3Heprnn lr KpoB,l. - Ilpuuea. nep.) AnA opxr.t.
O6pa6orKa no 3oHanbHoMy npnHuHny: 3arbtlroq_
CTMNTOMATIIKA Har o6nacr6; ueqHat I cKynoBat o6nacrfi; nepeaHqq cropoHa

l. ,tlerKar oopMa 3a6(),leBaHrr. OaHocropoHHrr x,, .r rBycropoHHqq O6pa6orKa rro Mep!rAnar{uoMn y p r r H u r n. {y :

- yqacro( MepxAqana xeryAKa oT roqKr aay-3|lrr.r(8 E) ao
npxnyxnocr6 x 6o",tr B o6"racT[ yruHbrx xe!re3, npH HaAaBlrrBaHr{n,
roqxa rxHa-rbroHr(24 VC);
542
543
 y q a c r o K M e p f i a E a H a , r o H K o r {K n l r r K l , to T , r o v K g 2. CxHApoM <c"ra6ocr6 rHb-neqeHn n nHb-noqKr>: arpoQr{t
(l9lG) qepe3 roqKy KyeH-ruey (18 IC) I,j ao ro,rxr
MHrurt, npnao,tfluafl K ,leoopMarrrx x ocraroqHbrM rrB"qeHasM-
lTrG);
- lBa yqacrKa MepxaraHaxerqHoro ny3btpr or roqx[ rrso
TEPANX'
KxoHr (19 VB) ao roqxa kreH rbrHb (21 VB);
yqacrox Meprar{aHa ,ro"lcrot Kliu]Kr.l oT roqKr xon_Kox A. ]|rnor€panrc
(4 CI) ro ro'rxa Kxyt(-qlr(ll CI).
XapaKrep Bo3Aeiic,rBrfl : ABa rrepBhlxy,tacTKa o6pa6aT6rBarorcr nprHrrfln reqeHI,rt. f " r a B H a r M e p a p e r y , ' r g u 0 qg H e p r a s
MeroaoM (paccefiBaHfifl) {nr <Ilo,tyyxp€n,,reHI]r nonypaccerBa- Mepr,q{aHoB. flpr napa,ir.j'{e BepxHxx xoHeqHocrefi Bo3AeiicrByror
Hr.19).l\axlyro !'raHr,
o clrelyer npoxoaarb no 20 pa3, exeaHesHono r { a r o q K , p y q H o r o M e p { A a a H a < c B e r , , r H f ir { H > , n p l r n a p a n r q e H { x -
H a r o ' r x l t H o x H o r o v e l H n H a H ao c B e l , l b r t9 H ! .
ToqhH Boraenc rBHr. Ha plK(: nai ro,r {14 VC).
k H e H , r r l H (r l 5 C I , . x ( j K , r H ( l l U I , . r \ ] f a v - , 1 H( 1 0 C l , . \ o n - K o K
B. Ayprxynorepanfie
( 4 G I ) , 3 t r o s r x x € ( 5 G I ) , 6 a r - r a ( B r r € M e p x a H a r r u a q ) ':r a n o r e :
ToqKn Bo3aeiicrBr.rn:
ckyna (ur€xa) (6oJreBbre ro,rxn yqacrxaj ecJ,ra M e H b - M o H( 4 V G ) , 6 e x y a H 1 3 1 E ) . O y K r x o ( 3 2 E ) , , ' r b r o H xr x a y
raxoBbreaMero,rcs)xJrtl ro,'rcrarr Krlnxa, rpr] ,{ac,rr rynos,ltra. flpl,l (3a E), ryK-raM-,rl, (36 E), srii xxe (41 E), 6ar OoHr (BHeMepH
ocrroxHcHrir'r
B Baaeopxxra peKoMeHAye,rcr,rorrorHxrerbHa'l nyHKrruu rHaHHas).
f i p r o r H A p o M c< x a p a n e r K x x , : c x r b q a r b ( 5 P ) . 0 e 3 y ( 1 3 V ) .
npr csHApoMe <c,ra60crr, rHb-neqeHx x HHb'noqKnr: I(aH-3y
n oJt ]{oM t'tEJt}t T ( 1 8 V ) , r x a H - 3 y ( 2 3 V ) , x r o e H - ' r r o H r( 3 s V B ) , 3 b r o H r , r a H r - r y e H
ocfloBt|btE nonoxEHltt ( 3 4' V
I B).
c p a I e B I H q p c x r . l i l1 O 0 e h r l o q e r : . . B e r n H iqi H ,
no"rooMne"tr.{r r.{HOeKrruorrHa'l6oJe3nb rI!/leMnqecKoro rnx f l B , l r e r r ' Hv e p a , r a H n M . 6 o r a r b l v, H e p r H e f li r K p o B b r oH
, x rovy xe
r H n e v n q e c K o xr oa p a h l e p a .B 6 r r d B a e v a oq l p e r e . t e H H b tBvr p l c o t l o H . u r B e ' r a e f o r a B a x H e r l I r r e r ' )\ o x r l r 4 e . r r o , r o ) B o r r e n c r s e
XapaxrepHoiioco6eHHocrbro ,aHHor.i60,1erHuse,laercs an,THi,na rra roqxr :,roro MeplaraHa ckrh qarr (5 P). Oe 3y (13 V).
pa"rfiq, cBr3aHHbrtc nopaxeHfieM Kr'reroxnepeAHeropora ceporo r r p n M e H r e T c qc q e n r r r o y c T p a H e H r r c n H A p o M a < x a p b r ! ' r e r K r { x > .
BeqecrBa cnsHHoro Mo3ra. qaure rcero na6,rrc4aerca y aerdi s Ilpl,r oc,ra6,resrq oyHxqsfi neqeHr.r l,l xH6-noqKfi nx crxMynapylor
Bo3pacreo'r 3 ao 7 ner, o,lgako cryqaerca n y B3pocrrblx.ilocroqsaq c r r o M o r u l , r cr o r r e x x a H - 3 y ( 1 8 V ) x r x a H - 3 y ( 2 3 V ) . t l o c x o , r r x y
MeIfiq{Ha oTHocfir norrrIloMneixr x ,trc"1y oIacHHx 60,1e3Hei. rreqesb <3aBenyer> cyxoxlr!'rr,rrrMn, ar'r9 x yKpeflneHrrr no!'rb3yroTct
cTrMynupyrculrM yr{orroM B roqKy conprxeHdr cyxoxa!'rxH -
3T{OJlOtttl l{ nAIOTEHE3 ,bloFf {'Iadr ryeH i34 VB). a r,4t }hpenrleHHt xr,cretr Bo,reir(rByr'r
Ha roq(y corrpFxeHrt l,(ocrHoro Mo3ra-- xI{)cH-rroHr (39 VB).
B 6 o , r b u r o H c r B ec n y q a e B 6 o n c a f l b flpoHrxHoBeHxeM
B nerxfie 6oJre3HeTBopHbrx (BeTpa AocroxeHHe repaneBrfiqecKoro ?oQeKTa B rroM c,lyqae rpe6yer
QaKTopoB xapbr> x Bo3BxKHo anflTerbtlblx ycfiras.
BeHHeM<Xapbt> !1erxrxj TaK xax ltcTouleHIe nHb-r,IerKsx npIlBoa T
K noTepe 3racrrqHocrr cyxoxa,lrd fi cocyloB, qTo nopoxAaer 5. Bo3AeficrBne MeroAoM <uBereHfigt

3aTqxroi xapaKT€p 3a6o.rreBaHrfl oc,1a6,!rer 38eprrIo fleqeHtl { O 6 p a 6 o r K a n o 3 o H a , ' r b H o M yn p n H q r j n y :

noqeK, qro eqe 6orrr,ue yxyArxaer rpoQHKy cyxoxx,,Il{i x cocyAoB, 3 0 H a 0 6 q 1 a l e , l b H o t o B o r n e i r c tB , l q ;
Bbr3l,rBaeT arporpxrc MHrxrl, 3arpyaHre,l BoccTaHoBlreHre aBrlra- ocnoBHar 3oua orrte!'t cnrHbl MexAy lto3BoHka^4fi Llr fi
re,lbHoi OyHKurx napa,'lr,r3oBaHHbrx
xoHeqHocrei.
S';
- A o n o r l H r T e J l b H a3f lo H a t , o k a r ' l b H o B o 6 , l a c T l B e p x H u x x H t x
Ht{x KoHeqHocTer.
CIMNIOMATI{KA
C n o c o 6 o 6 p a 6 o ' r K r i : B o 3 a e i i c r B n e c p e a H e n x H r e H c x B H o c T n ,n o
Pa3,lrqaror aoe Qopnu 3a6o,reBaHxq. 20 yaapoB Ha Kaxryftr ,rlrHlrro, qepe3 rerb; xypc ,reqeHHq 20 ceaH'
l. CfiHApoM <xapa Jerxsx>: noBbrueHfie reMneparyp6r re,'la, coB, Mexay KypcaMr nay3a l0 ,aHen.
Kaure,rb, 6ecnoxolicrBo. xaxAa, Moqa cxyAHar, KpacHoBaroro or-
B. Ayp|xyrorepan{fi
r e H K a ; e 3 b r KK p a c H b t ac x e r l r b r M H a n e r o M ; n y n b c r o H x n i i ( . r 3 ) , 6 r , r c r
pbrii (caK); B AanbHeirlneM c , ' r r 6 o c r bx o H e q H o c r e i ,n o c r e n e H H o ey c l , l i, AyprKy,lqpHbre roqKr,r,coorBercrByrorqre nopaxeHlitlrM yrracrr(aM
BepxHsx 'r Hxxrrflx xoHeqHocrei. Bo3aef,crBre cna6oe.
544
 2. Aypaxy,rrprrneror{xx, coo.rBercrByortxe
pa3rrqBbrMyr{acr c MnTontAr[(A
K a M B C p X H S XA S A ' K H T X K O H e r r H O C T eBa C O q e T a H r . {C
X' r o ' t x a M q : T O J ' I C -
Tas (I,IlD|(a (npx napa,rrqe BepxHHx (oHeqHocrefi), xenyroK (npx L TfinrqHat QopMai ()3Ho6, noBbroreHre ,reMneparypu, noro
n a p a l r r q e H s x H r ' r xK o H e q H o c T e t ) .
npq cr'rHApoMe <xapbr nerKxx> Bo3AeiicrByroT AojtoJtHfiTeJlbHo 2 - O o p M a c n p e o 6 . r a a a H l I e Mr x x o p a l o q H o . o c o c r o q H t i f l : n o B b l _
H a T O q K y! ' I e r K l , l e . r o e H r e r e M n € p a r y p b rr e r a , ( ) 3 H 0 6 ( c , r a 6 0 8 b l p a x e H H b l i ) .
llpx ocna6,leHtt rpyHKqafi ne,reHn I,l ,db-rro,{xr Aono,,rHnre,rb- 3. frneprepMx'recKas QopMa (6e3 o3Ho6a).
H O eB O 3 A e ' C T B XHea T O q X U :O e q e H b r, r o q K a . 4. frnorepMn,{ec(as QopMa (c rIpeo6,laAaHneM o3Ho6a)-
Aypxxy,rorepanrei nor''r*yltrrcfl n AaflHoM c,lyqae B correraHr.ra 5. 3xaei,raqecxaqOopMa (xapaxrepHaq ant ropHbrx panoHoB)
c lr!'royKa.'rbrBaHeM Kopnopar,6Hblx ToqeK. 6. flprcryn Marspnfi npfi Qa3svecKot neperpy3Ke
7 O o p v a c B b r p a ) h e H H o.i in n e , r o v e r a , l f e f i .
f. IlpHMeqaEx€
IEPAlrX'
L B6lrxe nepeqrcneHH rraBHbre roqKx Bo3AericTBBr. B KaxAoM
xoHXpeTHoMcJyqae noi'IlioMreJItTa B 3aBr{caMocT{ oT "{oKaJa3arlsa A. I,lr,norepannt
Hapyu€Hrs no!6rparcrcH AononHlr, errr,Hbre!'roKa!'rbHbreroqKx Bo3-
L tlpa ocrpon oopMe. npeaynpexAeHHe nplcryna Marqpxa.
AeicTBfie Art noBbluefixe repaneBrrrrecKoro ?OoeK,ra. Bo3AeicrBne
flpr,lrqun ,']eqeHfiei HopManu3aqxq coorxo[reBrtr rHr,- r,l rH-
sHeprxu B opraHIr3Me,,ruKBHAaur.rfl 60,le3reTBopHoi gHeprrri,
2 . q e M p a f i b u e H a q a r o r e q e H n e , T e M 6 o " 1 h r x eu a H c o B H a n o r , r H o e
npe4)npe/{aeHre npHcrvna varlqpHx: .parceHBaloull.iri, )xo,t 3a
Bl,r3AopoB!'reHre.IIpH norB"reHxx npr.r3HaxoBnapan qa Heo6xoafiMo
I--2 q ao npacryna.
Bo3AetcTBoBaTb HenocpeAcrBeHHo Ha ro'{Kl, nopaxeHHoi KoHe'{
ToqI(a B o 3 A e i i c T B n q : r a o - r a o ( 1 3 V G ) B , r r A a i ir r o r
H o c r f . E c , 1 Hr a 6 o J e B a H u en e p p r u J t oH a . r a n n I o u c r a r o q H b J xq B , 1 e H H f i .
(la VG), xay-xxe (3 IC), 3qH-cH (5 MC). Ilp norepe 6onbHbrM
reqeHl,le !'tfiutb qacrfi qHo o6,ter,taer cocroqHr.re 6l]"!brroro, Haaexabr
Ha no!1HoeI3IeqeHIle HeMHoto. co3rraxur Bo3reicTBy HqH,ryHf (26 VG), xon'Kor
( a G I ) , K y a r - c y r r r( l T R ) .
2. npfi peMrjrrxpyrorilei +opMe.
MAJI'PI'' n p l i H u t n n e , r e H t t : H o p M a n r 3 a q q q c o o r H o [ I e H r t I , l H b -I , ' q H - 3 H e p -
fdfi, <pa3MqrqaTb TBepaocT6, pacceHBaTb cKonr''IeHl,tt>,
o6t{HE noJ|oxEH|lt
To ql(fi Bo3Aeicr B r i s . O 6 b r q H oK 3 T o M yB p e M e H !n p r M a -
Ma,lflpHe 6o,TerHL. Bbt3Hsaevafl vaiFpyitHbtvr nJaivo4r.jrr l. Jqpfis Bo3HrrxaeTcn!'IeHoMeral'rss, no3ToMy I( nepeq[c{'IeHHblM86rlxe
p a c n p o c r p a H f l e M b r MKr io M a p a M xx 3 p o a a A n o p h e l e s . A , 1 q n p f i c r y n o B roqxaM Bo3Aeicrsxq rpu6asaercr eqe aBe: rnoHr-MoH (13 F) n 6x-
Ma{'rqpsfi xapaKrepHbr 03Ho6 c nocneayroulrM noBHrxeHfieM reM- K a H ( B H e M e p u A I r a H H a r rE)c. , 1 r H a n p n B e A e H H b rBeb r u r er o , { K r B o s A e * -
neparyp,br x nepeA oxoHqaHHeM np cryna o60rbHoe noroorAe- crByn rnaMfi, ro Ha 3Tr aBe nprxxraHaeM.
,reHfie. J rroles, nocrorHHo npoxuBarcunx B ropHbrx paioHax, TepaneBrxqecKxfi 3OSeKr roqex: Aao-Aao
6orarbrx 6one3HersopHofi 3Heprfie, (3HreMr.jqHhrx.- npu.ta. ped,). (13 VG) x aan ro ( 1 4 V G ) n p r M e H f l o r c a a , r q y K p e n " r e H l , no p r a -
6 o , r e 3 n hB o 3 H x x a e , n e 3 a B r c r M o o r B p e M e H rri o _ 4 a .B A p y r l l x p a i o - H r 3 M a , , r l r K B n a a u a r 6 o n c a H e r B o p H b r x+ a x r o p o B , n p e l o r B p a u e n x q
Hax 6ore3Hb qaqe Ha6nroAae,rcr ,leroM x oceHblo, T. e. B nepHoA nprcrynoB Manflprn. ToqKa xay'Kxe (13 IG) cnoco6crByer cnHx(e-
sX' rnBHOt !e'TeJ6HOCTU KOMapOB. H r r o r e M n e p a r y p b r ,y $ p a H r e r , r o M o r y B T e , r e ;r o q x a 3 q H - c H ( 5 M C )
npeaHa3HaqeHa cneqsanbHo rns,,reqesuq MarqpBs. ssg-qyH.
3Tr.roJtot'ltt I nAforEfl E3 (26 VG) A,re <pacKpblufl oTBepc,ai re,ra>, ron Ko( (4 GI)
f l p r q f i H a M I r 6 0 , 1 e r H 0 6 H q H o e B , 1 q r c t c q6 0 , l e r H e r B o p H b r e6 a x r o p b l ! , r r c H x x e H r f l r e M n e p a r y p b rr e n a , K y a s ' c y s r ( l T R ) A r ' r r rJ r n K a
.Berpar. {xapd, 4 a u H r c H H A p o M a . x a d p H iB q H c x o v v e p H n n a H er p e r q a c r e r . fr ) , 1 o
6u,rerns npnrr;r.aer e gfiula.
c p c a H l r e( . n o , l ) n o B (p \ H o c I H b j e n u r l B H y r p c H H e , r , ra . r x o p r a HH ,
v a . r n e o o , ' r e r H e t a o p H a qh r a u l l H a A r H c p r H q B c r y n a r o r B 6 o p h 6 )
,qpya c rpyroM, B pe3ylrbrare qero Bo3HfiKaer 6o,,re3Hb.Ecnll nporxB 6. Bo3AeficrBle MeroAo <qBereHflqt
6o,'re3HHHe flprrHxMarcTcrr Heo6xoAxMHe Mepbl, ro rra nporrxeHr! O 6 p a 6 o r K a n o 3 o H a , t b H o M yn p r H q r n y i
IO,'rroro BpeMeH,l 3Heprxr x KpoBb noaBeprarorcs flaTo!,rofr.jqecKoMy - r u H a u 6 q . a r e , l b H o f oB o r A e i c l B r r ,
Bo3AeicrBr.{lo, a 6o,re3HerBopHas 3Heprus, cxarraBarrcb, Bbr3HBaer - o c H o B H a t 3 o H a : y q a c T o K n o 3 B o H o q H t K aM e x a y n o 3 B o H K a M f i
Thvrrr L,,.
546 547
 lononHxre,rbHat 3i][ra: HapyxHafl x B H y T p e ] t H q qc r o p o H t r lsopHofo (,axropa <xapbr> sa6nrcAarcrcs rnnepeM,lr nxua, ry6,
Bs3Kaq MO(pora, xenrbtt HaJrer Ha H3brKe, fly!'rhc noBepxHocT,
O6pa6orxa no roqeqHoMy npr,tHqnny: Te )Ke H H t r 0 y ) . 6 H L r p b r i ir c a x ) .
roqKfi. qro s npu rieqex!{n Mfixpofir.qaMx, o6pa6oTKa cpeAHeri H B c n y ' { a e n p € o 6 n a r a H x q 6 o n e 3 n e r B o p } r o r oo a K r o p a < x o r o A a >
reHcrBHocrn, Ha xaxayro roqxy no 50 y4apoB. rra6rroAarorcq no6neaHerrue,rr.jqa, cna6oe BHAereHfic MoKDorbr.
O6pa6orxa no xo!y MepxAxaHoB; o e ' l H n H a r e r H a e 3 H h e , I y r h c n o B e p \ H o c lH b t i i t O ] , . n p r a ' 1 h a K h
qerHpe yqacrxa MepxAtaHa MoqeBoro ny3brpr B o6,racra ohrrrpofo nynbca (caK, oTclrcrayrcT.
flpoMexyroqHaq craafiq (Ao 3 6 HeA): xauer,rb nocren€HHo
* A B a y q a c , K a M e p x A q a H ar p e x q a c r e i rynoBfixra Ha npeA- ycdJr{BaeTcr, nors!'tqroTct npxcfynLr KauJlt npfi cnacTHqecKoM no-
r 1 o ) h e H H HB c p x r r H x r . 1 H H / { H H r h u H e q H o c T e i . n u h p a c H e H , r r , r I U a ,
ABa yqacTxa Mepsar,raHaxer'rriHoro ny3brprr Ha Horc. o6r",rbBoM c,'re3oTeqeHfiIjx BbrAereHnHx |l3 Hoca; Bo BpeMrr npucTyna
L n o c o 6 { ) 6 p a 6 l ) r K r : ( ) 6 p a 6 0 r h a c p e [ H e i r H H T e s c H B H o c r rH. ia. x a x - KaUlI",rH6o,rr,Hofi ctfi6aercq B noHcHuIIe, (alljleJrb colooBoxlaeTct
,'lbrfi yqacrox no 20 yaapoB, sa I 2 q Ao HacrynreHr.rq npqcryna. cneryuurHbrv! npHrByKov B rop"re. Ha6rrclaerce roruiota c euae-
ieHIreM MoxpoTbr, lHorAa c ocraTKaM c,r,eaeHHoi nuuI, ,1fi6o
B. Aypflxy,lorepan{e BHAeneHte MoKpoTbt c npxMecbrc fipoBH; oTMeqaIoTcrI xaxaa,
rxnep€Mxq e3brKa, ToBXrt Ha"reT Ha r3nxe; nynbc 6llcrpbri x,'tlt
T o , r K y F o J r p f i c l B H f l :r x a u u o r t A P 5 5 ) , x e " l e r u B H ) f p e H H e i c e x - cKo"rb3sruni {xoar).
p e u s r { , H a A n o q e q H r i K( o 6 p a r x r t B H s M a H u eH a , r o K a , l r . t 3 a q u K6) 0 , ' r H ) , KoHe,rHafl c.raArre (2 3 Her)t qacrora nprcrynoB
n o n o n H r r e , l b H o M o , h H oB o l n e i c r B o B a T b H a T o ' t h h x e , 1 , t H H f in y 3 b t p b , npoaonxsTenr,fiocTb nocTeneHHo yMeHbuatoTcq, MoKpora Tepser
rps qac,s ry,roBr.llqa (B BepxHeii flo,loBrHe MexKo3enKoBoi Br,r, Brr3xocrb, Kauer,r6 Ae!'raercq c,ra6ee, 6onr,Hoii xyreer, ry6H npx06pe-
pe3Kx). raror 6neAHrifi orrexoK; Ha6'rrcAaercr norepr anneryra, np& npl{,
Hrrfia flqrla noroorAer.reHxe. noHoc, q3HK 6reaHHi; ny,rbc nyc,
KOKJIIOIU rofi (xr,').
o6ulIe noJroxEHllt
TEPANNfl
K o x , T r o r u H H o c K u r o H H o er a 6 o , t e B a H r e a b r \ a t e , l b H b r r n l r e k . , r a r l l e
Bcero Bcrpeqarculeecq y rereii. O6brqHo notBnqercr B 3,{MHe, A. l'lrnor€parlxfl
Dec€rssi neplror. HaqHHae,cr c Karapanl,Horo BocnaneHfir rbr,
xare.flbHbrx flyrefi,3areM HacrynarcT npr,tcrynH Kaullrlrr c xapaKTep flpr.rHurn B H a , r a , l b H oci rr a r r : v e r o r L i , n p f i M e -
HLIM cnerlurHHH\,r, npH3Byhov. orqero B BoctoqHoI vp!ltUfiHe HteMHe A,re <HapyxHoi> craAfiri (noToroHHhre), nrkBlAarll,ir cr,tfiA.
xoylnlorx nonyqHr'r Ha3BaHIre<nerylxr.rHbri (alxe,Ih). poMa <xapbr> r"{l.r r'roxa,lq3aqfiq 6o,re3HerBopHHx +akropoB <BeT-
p a r , . p a c c e r B a H H e , 6 o , l e 3 H e t B o p H o r oQ a r , r o p a n r o , r o l a , .
3Tl.to,'loaht I nATotEHE3 b npoMex)ToqHol, cTanrH: Jl.jxBl,taauHt cxH4poMa aaapHr,
Mepbr, cnoco6crByroufle yMeHr,rueHrrro Mo(porLt, fipexpaqeHHr{)
B pe3y,rbTaTenpocTyA6r r AertrcrBxs naroreHHbtx eaKTopoB <Berpa> (aljlrq,
r . 1. , f i a p H , n o p a x a r c r c F n e f K r e . M o k p o t a c H l r x a e 1 I p o r o a n M o c r L B (oHeqHoii craAr,ra: noaqepxaHHe OyHI<ql,l "1erkfix, aKTfiBr.t3rj-
abrxaTenbfibII nyl.el{ u MeuiaeT npoABIlxeHfi ro Bltr.t39Heprtfi r'lerkl,tx, poBaHge Iefl le!1LHocTu cel're3eHKt.
B pey"rbrare qero Bo3Hfixaer 6o,resHl. C reueuaeu rpeuenl 6ones- ToqKfi BoiaeicrBr.lH: B l ] a q a , l b H o ui n o o M e x v l o q H o i i
H e H H o ec o c r o r H r e H a p y u i a e r O y H X q x o H f i p o B a H r en o n e p e q H H xM e p r i - c r a n H H r c H l b - q a T bi 5 P t . H r b r - r , ( l P ) . H o nn l o n 1 6 l ' , t C ; ,
AnaHoB !'letxHx, qTo MoxeT npr{BecT, K BbrAeIeHtlt,o npx xarx,re xon-KoK (a CI), rafi rrcu (14 VG).
MoxPoTbIc XpoBLb.
Aono",rHnre,'rbHoe Bo3AeficrBx€: npu floqBrieHr.l cneAoB KpoBn
B Moxpore Ha ToqKy KxoHr-roii (6 P): npr ,{poBon3rnqHM s
TETIEHI,IE6OJIE3HII o6,'Iacr[ rna3 H a r o q r y r b r H b - M a H b( l V ) ; n p s o 6 r n b H o i i M o K p o "
re Ha ToqKy ooHr',roHr (a0 E).
Eo,re3Hb fiMeer Tpl] craAr{r{: HaqarbHyro, trpoMexyro,{Hyru fi (oHeq- B KoHeqHofi craArn so3AeficrBxe Ha rorrKfi r.{rraM! HnIj MeroaoM
Hy'o. r r p H x , ' r a H r { s n p o r l r B o r o K a 3 a H o .l Z c n o , ' t b 3 y r o r c c , ' I r l l u b , , r e K a p c r B e H -
HaqarbHar craata' (l 2 H e A ) : H e 6 o , , r b r u a3
r r6xocrh, He3Ha.rH- Hbrenpenaparb| (BberxaMcKrre, xrrraficKue a,'rH3anaAHbre). B npoMe-
TenbHoe troBHureHre TeMneparypbt Te-na, 3a,'IoxeHHocTh Hoca, xyToqHot cTaafi!1 lrnoy(anbrBaHIte Taxxe cneAyeT coLr€TaTL c
yaylxbe, HacMopK, prfi operr, xalne,'rr]; npI,r npeo6,'raAaHLtr.j6o"re3He-
fi EKADCTBCHHHMII CDE.[CTB Mfi .
548
549
 T e p a f l e B r l r , re c k l , f i e O S € K r roi{eK: roq(d clr-r6- tlroHcKt n SHuEoA.[]lT TXIIA 6
,rarb (5P) x HIH-T3 (l0P) a c n o " , r b 3 y r r r c , ar n ' B o c c r a H o B . r e H "
aBxxeHrrr 3Heprljfi rerKxxj r, {xBrraaufiIl cxHApoMa <xapbr>, npeK- ocHoaflbrE noJroxEHtlt
paqeHrn xarrJrq: Aan,rron (l4VG) noBbruaer conporuBrrreMocrh
.rpraHx3Ma, nsxBr'rAr.jpyer crHApoM <xapbr); Ha roql(y Hoi-KyaH Do,ie3Hh Bhl3HBaercr HerfiporponHbrMBr,tpycoM, nopaxarcUlnM nopy
(6MC) Bo3IeicrByror c qer'rbro HopMar''tr.r3au!fiaBaxeHtr 3HeprxH ronoBHoro Mo3ra, 6enoe Beulecrso nonyuaprfi, M03roByro o6o,toqxy
n l(poBn B rpyAHoii 06,racrn; .roql{a xon,KoK (4GI), npnHaane- i hocIHbrfi MUrr. IIues,letofcs cHMnrovH paccrpoiicrBa ueHfpa,lb-
xauar MeprAxaHy rorrcToI xsllrKlr, aMeoqer: <noBepxHoc,rHo- H o i H e p B H o i c l r c r e M b rr 1 M e H n H r e a n s u u nc a n a p o u . H a n 6 o " r e eq i c r u
RHyrpeHHne> cBs3a c nerKriMx, c,!yxar !"rtfl fi3rfiaHnr 6o"re3- MU noc]reAcrBrqMr 6one3Hg qB"rrrrorcq pa3nrrqHbrM oopMbr pac
H e T B O p H o r {3 H € p r r u H B o c c r a H o B r e H r r a B r . { x e H n q 3 H e p f x E B crDoiicrBa HeoBHo;ctlcreMH-
Bo BLerHaMe 3IIl,lAeMHr gToro 3a6o,leBaH|,lq Ha6,']roAarorca
o6d'rHo neroM, flpxqeM nepexocquKoM6o,1e3H, c,ryxrjr KoMap, a
ecrecrBeHHbrM pe3epByapoM - onpeAer''leHHar nopoAa nrlrq- t-lanle
6. Bo3AeficrB[e M€ToAoM<qBereflflr,
3a6o,1eBalor Aeta. B eocrounoi MeAr.tqfiHe rnoHcKuii gHqeoa,rnr
rHna B orHocfircn K pa3pqay cr.rHApoMoB<rennar.
O6pa6orKa no 3oHanbHoMy pr.jHrrrnyi
- 3oHa ()6fl3areJlbHoro Bo3reiicrBr.jr; Srrororl|x r nArofEltE3
- o c H o B H a s3 o l a : y q a c r o K n o a g o s o q r u x a T h r Thu;
-- aonorHr{TerbHar 3oHa: rpyAHar o6nacTb x nepeAHqr 06- Eone3Hb Bo3Hrrxae, B pe3y,'rbTaTe npoHtiKHoBeHxn B opraHH3M
,racrr, ureH; nepeAHsr o6nacrb npeAn"leqbq. q e n o B e K a6 o , r e 3 H e . r B o p H osnH e p r u u ( B o B p e M q 3 n r i a e M l r n ) n a
OoHe
O6pa6oTI(a no xoAy MeptIraHoB: n c , l a 6 , 1 e H r r x r . i 3 H e H x o i i , H e p rr r . i . 1 . e . c o n p o r H B n r r e v o c r H o p r a .
yqacTKa M€pna{aHa i4or{eBoro ny3brpr or ror{Kl, rxreH- H H I M a P a J B H I l , l ef a O O J e B a Ht n p o H c \ o ! H L K a x n p a B U J o . c f l e l y r c -
-aBa
.ry (l0V) !o roqKn4e-3y (l3V); qnM o6pa3oM. BoneHerBopHr,lfi (baKTop nopaxaer npexAe Bcero
yqacrxa MepnafiaHa nerxfix or rorlx| rx ey-,rxbrorr IrMMyHHyro crcreMy (noBbrrxaercn reMnepaTypa Te!'la, norrB,1firoTcfl
._ _ . ABa
(l I P) Ao roqkracxrr-varr (5 P); o3Ho6, ro,loBHaq 6o,1b,6onb B ropne n Ap.),3areM oH 6brcrpo ne
oafiH y'{acroK nepeAHecpeafiHrloro MepxauaHa oT rorrxr pexolxr Ha 3Heprerrrrecxylo cl.{creMy (TeMnepaTypa noBbrueHa)
Txaes
Aor (22 VC) ao roqxr qyHr-xyaH (12 VC). notBrfltorct xaxAa, ocTpat ro,'loBHaq 6onL, TolljHora. cDagM
C n o c o 6 o 6 p a 6 o r x r. 3oua o6i:are,rinoro Bo3aefic.rBqq MbI[q B o6,racrx lxefi, 3aTHnKa Ir Ap.), Aa,tee oH nopaxaer na-
o6pa6arHBaercq co cpelHefi fiHreHcrBHocTr,lo. OcEoBHar fi lonon- TarenbHyro cy6craHqHlo H KpoBb (sbrcrynaer cbrn6, Ha6,,1nAaerct
Hrjre,lhHae 3oHbr Bo3Aeic,rBr,trnpn cr.jHApoMax(xaphr> fi <no!,rHoTbr> K o M a , K o H B y , r b c f i Hn , pn Trxerbrx QopMax -- ficroqeH e rH-3Hep-
o6pa6arbrBarcrcr c 6o,rnuoi qxiexo{gH_o.to., npn cxHApoMax <nyc- rfik), Mea,,resHoe rr,'ru 6brcrpoe pa3Bnrle 60,'le3Hrr. TrrxeJrar anI,{
ro,br> r.i <xonola> co cna6ofi rHreHcr.rBHocrbrl; Ha KaxAbrfi nerKan QopMa 3a6o",reBar!, r l , ln o p a x < e H B e6 { )
yqacrox no 20 yAapoB. n e 3 x e r B o p H o f i3 H e p r r e i , T a x { o r c o c r o r r H x r x x 3 H e H H o i 3 H e p r r l {
n p r c n H A p o M a x < x a p H > x < n o r l H o r b r >o 6 p a 6 o r x a n y q K o B b r M 6o,,!bHoro,
Mo!'roToqxoM fiMeeT <paccerBarouIDi) xapaKrep x npor,t3Bolr,rrcq
npo,fia xoaa_ MepriAnaHoB, np, cr.rHApoMax <flycrorbl> r.t <xoroaa> TE{EHI{E 6OJIE3HIf
xapaKrep o6pa6orxn yxpcn,rarcrrrril, orra npolr3Boarrcs no xo-
Ay MepxAxaHoB. Ha Kaxrbrft y'{acro( no 20 y4apoB Mo,ro B x,runrqecxoi npakrtKe 6one3Hb o6br.rso roApa3Aenror Ha rpfl

Haqan6Hat craAHe noc"le HHh)6auHUHHiJlo (pHona. nponu'l-

B. Aypx{yrorepanrt
B Haqa,rbHoi x npoMexyroqHoii craAxqx 6one3H, BosAeicTByroT
Ha TOqXfi: ierKlte, To,'rcTat KfiuIXa, ropJrot ropTaHb, Tpaxeqj TxaH
M o H ( A P 5 5 ) , c x M n a r r . { q e c x a ru{e p o a a i c r c r e J a ( o 6 p a r r r r e u r v a ,
HIle Ha 6o,reBHe To'JX]r),
B KoHeqHoi cTaA{Il aonojHrrer]bHo Bo3reiicrByror Ha roqKy
. e J e { e H h a ( c u c n a 6 n f i { H t c H c H s H o cbl r o , .
550
/ K a t o u l e r o c t D - o n H e n . n o g B J I n r c t c Fc H M n T o v b t , c B l I A e T e j b c t B \ t o -
u r e o n o p a x e H H H H M M y H H o i ru r H e p r F T [ q e c k o r . ci r { c r e M : s u c o i a q
T e M n e p a r y p a ,r o , r o B H a s 6 o n b , T o t x H o r a , p B o r a . c f l a 3 M , H a n p r x e H k e
Ctagua paerapa 6one3Hr. Bone3HeTBopHhrti Qa(Top k aroMy
BpeMeHx npoHr{KaeT r"1y6xe ll 3arparHBaeT nr.trarenbHyto cy6craH-
rlrirc r.r KpoBr, (Bbrcoxar TeMnepa,rypa, 6peAoBoe cocrorHHe, crpax,
a q n o c T r , .3 a T e M H e H H o e , . o 3 H a H l lCe ], , n O p Or , n a p a " l H q h o H e q f l o c t e f)i.
L r a a n s p e M H c . H H . F o r n a ) r a e r c q B o L c r a H o Br H b xr rkeHHyru
3Heprfirc 6on6Horo, <3ac, aBllTh orcrynr|rb> 6o,IBH€TBopHbri QaK- T e p a n e Br r e c x a n ? + 0 e K r r o q e K. flpx Bl,lcoxori
rop, Hacrynaer craAxtl peMucljll. OAHaxo B p$y"1bTare 3Haqnre.rb- rer{neparype Bo3AeicrByror Ha roqKr'r Aafi-rrofl (14 VG), xon-xox
Horo )uep6a. HaHercHHoro 6 o , 1 e f H b on H r a r e , t b H o f t, H e p r H HI K p o B H , ( 4 G I ) , K x y x - , ? I ,( l l G I ) , Q o H r ' O y ( l 6 V G ) , r x a n - r y e H ( B H e M e p x -
oc,la6neHrt cBt3oK Lr cocyAoB BcrreAcTBneToro, qTo <oKHa Te.ra> a n a H H a r ) B K a q € c r B e M e p b r, ' r l ] x B H A a r l l r xH a p y r u e f i H i B ' { x < R a p y x -
oTxphlrtr He nonHocrbro, y 6onhHoro fla6Jro,tarcTcr noc,'reAcrBlrs Hofi> craAr.rn n cxHApoMa <xapH>. flpH cyloporax Bo3leficrBynr
6 o , 1 e 3 H x n: a p a , l a . r , H a p y l r e H n r n c r t x t { K 8 . I l a r o q K I , x o n - K o K ( 4 G I ) , K x y K - , { r . {( l l C I ) x a K c p e . q c r B on p o r n B
6 o n $ H € T B o p r { o r oO a K T o p a < x a p b l > . < P a c c e x B a ! o u f i f i > y x o r B r o q K y
TEPANI' 3 b r o H r - " r a H r T y e H( 3 4 V B ) ( r o q x a c o n p q x e H H s c y x o x H , l r i ) n p r M e -
srror c rrelrbro pacc"ra6rrb cBr3Ka- Bo3AeficrBue Ha roqxfi rxaii-
A. I'lrnorepanre cynr (3 F) { 6arr-xofi (20 VG) noMoraer HopMa,rfi3oBarb AerrenL-
aocrb nerreHH.ocraHosrrb 6o.r$rrerBopHbrii Qa(Top <Berpa>. ToqKfi
npBHuan ! r e q e H H r r . B H a q a , r b H oci ir a r a ! n p H H r M a | i )M r epbr rxa'r MoH (7 C) Hoii KyaH (6 Mi) sryxaf lurr Bo3spaureHnn
f l p o r a B H a p y o r e H r { i B x x < H a p y M H o i i >c r a l l r a ( l o r o r e H s b l e c p e A 6o",rbBoMycnoKoiiHoro cocrorrHrr. llpl,l KoMe Bo3AeicrByor Ha ror{-
crBa).,'rxKBxAaqut cxHIpoMa xapbr. xy HHU-qyHr(26VG),,rro < p a c x p b r B a e ro r B e p c r r i q r e ! r a > , B o 3 B p a -
B craAfix pa3rapa 6o,1e3HU: ox,1axleHfie kpoBu. Ae3xHToK- rllaer 6(),rbHoMy co3HaHr.re. To.rxa 3yHr-ryeH (l R) c,'ryxrr a"rs
c f i K a q r r q , r n ( B x a a q s 6 o n e 3 H e r B o p H H x0 a K r o p o B < B e r p a ) , p a c K p b l - o R a 3 a H x 9 H e o T , r o x ( H o rn{ o M o n l a e T g M n D n 9 n x r l e n T u q e c K r x n p f i ,
T x e o r B e p c r r r i r e r a , n p x B e A e H H e6 o , 1 h H o r oB c o 3 H a H H e , na[xa\. yHo,rb] B ruqxq rr eH-Aur (22 VC) H "luev-r]eH r2J VCI
B craavH peMrccar: AonorHfiTerbHHe Mepl.l no yKperrneHrro BoccraHaBr'rrBalor npoxoAfiMocrb 3Heprnr{ Il noMoraroT npn AricQa-
uHbcKoi sHeplsfi opraHu3Ma, rnlt. To,rKn 6arb-xoi:i (20 VG), a voa (15 VG),,aan,rK)r (14 VG),
To,rxri Bo3aeicrBflr. B 3 a B n c r M o c , foi r c r M n , o M o B r x a H - . r y ( 1 2 V C ) , K a r ' ' c y K ( 8 V G ) s M e H bM o H ( a V G )
MO)KHOBO3AeHC' TBOBaTb Ha Cnelyorq e TOqKn: c r o q l t a M l t! a i ' , r b r ( l l V ) , O o H r , r y ( 2 0 V 8 ) , r x a H - 3 y ( 2 3 V ) I l y n -
npn Br,rcoKorftreMneparype - rafi-r|ou ( l4 VG), xon-xoK 'ryHf (40 V) noMoraror npr'r pr.jrraHoc,n Mbrxu 3arH,'rKa x !nuHbj,
(4 GI), ooHr-oy ( 16VG), xxyx-vn ( I I GI), rxan-cyHr (3 F), BHJTTRHoI npoH,rr{HoBeHxeM6onesHerBopHofi 3Hepr B 3Tr o6,1ac,
(34VB). r)(aH'Morr
3HoHr-!'rasr-ryeH (7 C)i T f i . | | , K O T O p b TnMp o ) ( O n r r r a r H e c p e n x H H b t t M e p x n r a H h M F p l r a H
n p x K o M e . -H s H - q y H(r2 6 V G ) . 3 y H f , r y e H (l R); v o q e B o r on y i H p e . B o , a e f i c r s f i er a r o v x r v y n r i J a H ( 1 2 V L J . T r a i i
npr aricoarun lxneH Aor (22 VC), ,rneM-ryeH(23 VC): cyHr (3F), ryr('raM'r'r{ (36E) n Hofi-KyaH (6MC) BoccraHaB,,rx,
npx pfirHAHocrti MbIlIlrI 3arr,lr'lKa. u cnxHbr 6aTb-xoi B a e r n p o x o a r . l r r o c r b, H e p r H H . H U p v a r l H r l e T Q l H K u r r . l x e n l a k a . n o .
(20VG), a MoH (l5VG), aai-flon (l4VG), rxau'vy (12VG), ivoraq reM caMbrM npu rorxHore l,i pBore. K Toq(e HrH,qyHr (26 VG)
(aH cy( (8 VG), MeHb'MoH (4 VG), Aai,qH 1l I V), yn,qyHr (40 V), rlpfi6era|()r B c,lyqarx HeorroxHoi noMoulfi, a ror{Ka xon,au (l VC)
SoHr'qI, {20 VB), rxaH'3y (23V); yKpeflr'1rrer3Hepr lo opraHr.r3Ma_
n p r r o u J H o r ex p B o r e q y H r - h l a H ( 1 2 V C ) , r l h - r a M , t r i
1 3 6L l , H o f ik y a H ( 6 M C ) , r x a i i - c y H f( 3 I ) : 5. Bo3A€ficrBxe ireroAoM <qBereHtqt
- npt 3aTpyaHeHHoM abrxaHrrr, B6r3BaHHoM scrouIeHfieMrHep- (B Ka,{€crBe EcnoMorar€nbHoi MepH)
flni, HqH'qyHr(26 VG), rxan cyHr (3 F)-
Aono,,rHrrenLHbre roqxr Bo3AeiicrBnr &rrr r,rnKBrtauxx nocneA, O6pa6orKa no roqeqHoMy np{Hqnny: roqxrBo3-
crBHfi 6one3Hn: aeicTBl,tq Te xe, qTo a nDt nvHKlllsfx.
c,1a6oyMl.rr,BbrsBaHHoroocna6neHfieMyMcrBeHHr.txcll,1, Cnoco6 o6pa6orxx - g sisrcl{Moclj or OopMu re'{eHfiq sa6o,
6arL'xofi (20VG), aH-AbroHr (BHeMeprrAraHHaq), xon-Kox (4 GI), , 1 . 8 a ) rf l . H a x a x n ) n r o q K l n o i 0 y l a p o B
Hof,-KyaH (6 MC), rxaH-MoH(7 C); O 6 p a 6 o r K a n o 3 o H a J r L H o M yn p r H { f i n y :
a Q o H l J n a - M o H( l 5 V G ) , r a i - T r c u ( 1 4 V G ) , r x o H r - , r (x5 C ) . ' JoHa 06erarenbHoro Boi!er.icrB t
,rneMryeH (23 VC); - ocHoBHafl 3oHa o6,'racrb 3arlrnKa:
napar'lnrra,raueBofo xepBa ara TxbroHr (4 E), 3rn-ca - AoDo!'IH Te!.I6Haq3oHa reMeH|aq o6,racTb, BllyTpeHrrrr cro-
(6E), xonxox (4GI), e'4osr (17TR); pora npeanreqbru ror€sn.
napa!'rxrra BepxHnxxoneqsocrei Aari-rror (l4Vc), xfieH- Cnoco6 o6pa6o,rr: Ha xa)|rayr,o nr{HUrcno 15.-20 yaapoB.
Hcynr ( 15 GI), xxyK qn ( I i GI), rxy-raM-,rl,l ( l0 GI), uroan- B ocrpoft crairnn paarrlrua 6o,r6suu rurencxerocrr o6ia66rxu
ryaH (5 TR), xon kol< (4 GI); cpeAHrfl, B cTaArju ocraroqHHl sB,reHai c,1a6ae.B ocrpoii cra-
napa,rxqaHr.rxHr{x KoHeqHocrefi MeHbMo (4 VG), xoaH, an!{ 6o,re3xr'r KaxAbri AeHL no oAHoMy ceaHcy, B craann ocraroq-
Kxxey (30VB), ooHr-rxr (31 VB), xon-,rox (60V), 3HoHr-,1anr' r{brx aB"leHHt - no oArroMy ceaHcy rrepe3 aeHb_
ryex (34 VB), rxua-cox (57 V). AononHxTe,,t,Hbre 06,'racrr.{ Bo3AeiicTBrq:
552 553
 n p n B b r c o K o lrre v n e p a r l p e - H a r b r J b H y ! oc f o p o H y A r c r e r i . 3rxoJrorrt I nAtofE[E3
cTon, Ha iaaoHr ll noaorxBH Hor; Bo3Hl.{KrroBeHfieHeBpanraIr ceaanxurHoro HepBa cBe3brBaror o6r,rqHo
npa cyAoporax -- Ha na,rbrlbr Hor rj pyK BoKpyr Meata,lbHblx
c npoHxKHoBeHxeM 6o,'re3HerBopHbrx OaKTopoB <Berep xoJroa>,
fl JrarepanbHbrxnotHxeK; . B F I e p ) | ( a p a , 1 1 H . C b r p u c r b x a p a ' B q H c h H H! r e p H n H a Hv o -
npn yrpare peqx He nepeAHroroo6,1ricrb rner; qeBoro ny3ripe r,,rH B eHcxrl, MepxAqaHxeJqHoro ny3brpq B Mo-
- np onyrreHnx yrra pra Ha o6,1acr6 pra r.r cKy,roByro M e H T ,K o r A a p a c K p b l T Hn o p L l K o x n . 3 a 6 o , ' r e B a H l l eM o x e r B o 3 H r , r K H y r b
o6nac,bi
raKxe B pe3y!'IbTaTe cKonn€Hr'rrrKpoBH B yKa3aHHbrx MepxafiaHax.
n p a n a p a ! ' r n q eK o H e q H o c T e t i H a n o p s x e H l r y t o K o H e q H o c T b . b pe3y!1brare 3aTpyaHqercr r.{nx Aaxe Hapyuaercrr uHpxynqqxfl
B. AypxKyrorepanxe sHepftll{ lr (poBr.{ B MepxaraHax MoqeBoro l{ xe,'tqHoro ny3brper,
qro npaBoaHr B aetc-rBre npaBn!'ro:<raM, rae HapyuaeTcf npo-
Alprh),loIepanrq np veHFercr B co'letdHr.lh. so ueil.TBr FM Ha xajlrMocrl, Bo3Hukaer 6o,rb>; ecJ[ 3To naroJroraqecKoe cocTorrgHe
coMaTl,lqecxl,leTortKr{. 3 a T f l r H B a e T C 9O, H OO K a 3 b l B a es' ,r l r s E U e H a n e q e H b x n o q K r , { .
l l p r I I o F H I r e H H or ie v n e p a r ) p r Bo'api.rB e
c e p , { q e .r o r c , a q x r m x a , r x a H M o H ( A P 5 5 ) , r r n o Q s 3 ( M o 3 r ) , c I r M ' cfiitflTorurx(A
s e p B H a qc r c T e M a .
npr cyaoporax, KoMe rononHureJbHoe Bo3/reiicrBr.{eHa roqKr.,: L IIenpppHBHat 6i),1b H,1H 6u.r" B BHAe npHcrlnoB no xoa)
! l c p r . 1 t r r a H o BI l p v r l q o a d r r B n o e ( H r l u e , h a U | 1 e . q r x a H b . . n p o A o n
o e q e H b !x e l r q H b r i n y 3 b r p b ,n o q x a .
xxre,rbHoi xoab6e 6onb ycrunBaercr Ir xppaAr.fl{pyer BHr3 or
n p x B o 3 H n K H o B e H n nn o c , r e A c r u x i i B o 3 A e i i c r B n e H a r o q x n :
c n B H b r K K o H e q H o c r q M .X a p a x r e p 6 o , 1 n r y n o i i ( n p r q t H A p o M e
r x n o Q a 3 ( M o 3 r ) , r x a H - M o H ( A P 5 5 ) ( n p r . , 3 a r e M H e H H o Mc o 3 H a H r . r n ,
<xo!roA cbrpocrbr), Konrounii n,rr'r pexyurl,jii (np{ cKon,reHltr
MaHr'raxar'rbHo Mc r o r H r ' r I , {3rn x n e n r u q e c K x x r l p t n a a K a x ) : H a r o q K x
co
KpoBr'r). B KavecrBe 6(]"reBbrx BHcryraror roqkr: rtafi-qbroHr-3y
coorBercrByrou e qac e\4 sep\HH! y urxr'ux r'oreqxocrefi, nopa
(25 V). xoaH-Kxsey (30 VB), rxbra-4'y (36 V), ys-qy r (a0 V).
xer{Hbrx napar'IxqoM.
r r 6 r a c o H ( 5 7 V ) , K o H , r o H ( 6 0 V ) , 3 b r o s r , r a H r - r y e H( 3 a V B ) .
II p x M e q a fi a e: npx Apyrrx 3Hue(pa,lonarrrqx fi raKfix 6o,te3 qro6L,r yMeHl,rxxrb orqyrqeHlle 60"rrr, 6o,1brr9i crapaercr coxpaHqrb
,rfl\. Kah rHuFoa,l r 3xouovo A, fHoitHbtii MeHrHfxT. cepniHbri
MeHxHlrir. Ty6epxyne3Hbrii MeHxxl'r.rr, ocrpbri gHqe(panI]TxqecKni , { a r 6 o J r e ey r 0 6 H o e , . n f l p e r o n o ' 1 o x . H r . 1 c .
OqyrqeHr'rg Ha HapyxHofi cropoHe roneHx x rH,rbHoi cropoHe
cnHApor\,t,MoxHo Bocnor'Ilf oBaTbcs TeM xe MeToaoM l1eqeHxfl, qTo
Ir npr'r 3sqeQa,'rfiTe, Bbr3BaHHoMsefiporponH6lM BxpycoM, KaI( cpea, c r o n h l n f i 6 o M o r y T 6 t r T b r H n e p c e H c r 6 u n x 3 n p o B a H H b l M r { , , 1 { 6 0H a
6 n o A a e r c t q y a c T B o o H e M e H H r -f l e p e A s u x e H H e 6 o J t b H o r o 3 a r p y A
cTBori nporr{B x'roexunoHHbrx Il MeHfiHro3Hqe(Fanfirr.,qecK{xcnHA-
HeHO, MLitlTUL BAO!'Ib nOpaxeHHblx HepBHr,rX nyTex HanptxeHbI.
H r , ' l o y k a , 1 H B a H l l eI ] n p r x I { r a H r e i B , l e l o r c q H e c n e u x o t . r e c x r M Orcrcaa Bo3HrKHoBeHre 6()rn npa ABnxeHrqx, BKr'rroqarculrx B
MeToAoM ner{egrt, I B cr'tyqaflx oxa3aHxrr seoTJloxHoi noMoqlr a € x c T B r e r a n p r x e H H H e M b r r u q b r',r r o B e a e r K o r p a r r a q e s x ' o n o a B a ) ( -
Heo6xollrMo co'{erarb Bo3AericTBre Ha rorrxfi co cneufiolr.recxtMrt a B o ) { r e H n n( c r ' r M n r o MJ l a c e r a o o , r o x ( H r e , r b 8 b)r.f i
2. Bosnoxlra aMliorpoorfl eroAlru ,r HllxHr,rx KoHeqHocrefi,
repaneBrtr{ecKIIM c p e r c , B a M n . n p r , { e M n p n H a p y l U e H a q xo . xoropbrx
l1Aer peqb, qeM paHbure 6yter npxMeHeH MeroA rrnoyKa,rbrBaHnq, c H r x e H H e r n } r c q . J H o B e H u ea x u , l , l o B a p e + , l e , { ( a n p H H o p v a , r b H o v
'feM Bbrue repaneBrr'r,{ecxnii ?o+eKr x reM ierqe 6yAyr noc,leA- Ko,'reHHoM,(B cBq3x c <nycrorofi, nerreHli a noqeK oHr He B cocroH-
Hfir.j o6ecDeqxft, Heo6xoArMoe nr.{raHre cyxoxfinrii).
B HXxHrx KoHeqHocrex Moryr Ha6noaarr,ci ollyqeHfir xo!'ro!a
fi"q{ xapa.
IV. HEPBHbIE6OJTE3Htl
TEPAN||'
HEAPAJII'Tq
CEAAJIXUHOTO
HEPBA A. I'lrnorepanxc
o6ulfiE IIOJ|OXEHllt flpasurn n e r r e H n q r B o c c r a a o B n enHproex o a x M o cMr e p u -
HeBpanrrr cela"lI,ll]lHot-o HepBa npeAcraBJrer co6oji cr.{HApoM. AraHoBMoqeBorox xre"lqHo.ony3Hpea.
a p x K o r o p o r t o L r r y u r a e l c r r6 0 " 1 r . B 4 o n b c e r a , l h L r H o r o H p D B a . b o n b ToqKx so3aeiicrBxq:xoaHxxxey (30 VB), OoHr-rxr.{(31 VB).
,r a n-opa)hFHreM " 1 1 1 6 (H) e p B a . , 1 k 6 o H e p s H r . t \ i < o p e u h o B 3HoHrnaHr ryeH (34 VB), rxafi'cyHr (3 F), ,aafi-qbronr-3y (25 V),
^BHlBaHa
t t B o f l u q H o [ v e n r ] u H H eB o c n a r e f l H eL e n a J H U l H O | O H C p B an t H O ,f l l rxHa-Qy (36 V), y!-qyHr (40 V), rxbra-coH(57 V), KoH-,IoH (60 V).
B c q B v f p e d H e v y ' . n H n p o M y( K H a p \u r F H r . i r rBrH 4 y r p e H H xo\ p r a H o B J . Cro(o6 B o r n e r , r B H e . B K a , i . A o cMe a H c B
Forapfic-Bo-
D O J e r H 6t r a c o o t B e r c t B \ e !H c B p d r l f h fc e 4 a J l y t x d o t oq p p s a BaTL Ha 3 5 Toqe(. Heo6xoAr.{MoB xaxAoii ToqKe {o6xrbca
< 3 Q o e x r a r r , l b l > , K o r o p H n A o , l x e H , p p a A x x p o B a r b B H q 3 .T a K , n p s
B o J ^ e H c r B HHHa r o q H y \ o a H - K \ r e y ( 3 0 V B ) c n p u H + H q e c x ooeu y .
ureHHe (c3QQel(r trfrblr) Aor,txHo ur ?Toji to,rKH cfllctHf6cn h
roq(e ytl'qyHr (40V), npu nyHKuxri xe 3roi roqxn oqyureaue
p a c n p o c r p a H q e r c f ie q e H s x e , R r o s ( e r x u a , c o f i ( 5 7 V ) f i r , n .
l l p H ) o r " 1 e H f i r .6r0 , 1 e i r3 r M o i i H , t u B H o q H o e s p e M s H e o 6 { o r r v u
oTAaTb rrpelnoqTeHfie npqxl,lraHHIo, yt\{eHbtuxB lo3y Bo3aetcrBfiff
I,lrJlaMll,
Ec,'ix 6o,'rb ,loKa,1fi3yercr B Kaxofi-,rlj6o oaHofi roqxe - o66rqHo
9To xoaH-Kxlrej (30V8), peKoMeFAyercr coqerarb yKon c 6aHKofi
Han BrIoIt jl{oo rlpllMcHrrb n}HHurto c ltoAorpeBu\4 r,1bI.
TepaneBruqecKrfi ?ddexr roqex:
Ha nepeqr,lc,reHHhre rovxfi nogao"riei HopMarrr3oBarb npoxoanMocrb
3Heprfill B MepuAI]aHax, cHl{3xrb 6o,,reBHe oDIyueHse B Hoxr{brx
tHcKIlx MepIlIIraHax_
6. Bo3AeicrBu€ MeroAoM <qB€reHrct
O 6 p a 6 o r x a n o 3 o H a ! ' r b H o M yn p r H r l n y :
3oHa o6t3ale,16fioro Bo3AeiicrBnq;
ocHoBHafl 3oHa Bo3AefrcrBrr: 6oxoBat croDoHa rv,loBnlua.
r d A H s f lc T o p o H d6 e A p a H r o , l e H .
O6pa6orka no uepl4raxnoMy npnHrrany:
qeTHpe yqacrKa MepdAraHa Moqeaoro ny36rpr B ()6",racrn
cnu br a oalrH yqacroK Ha 3aaHet cTopoHe roneHx;
oarjH yqacroK MeplrafiaHa xe!'lqHoro ny3blpr Ha rcr'reHa,
C n o c o 6 o 6 p a 6 o r I( q. 3oHa o6ssare,riHoro Bo3aeficrBrq
o6pa6aTblBaercfl co cpeAHefi yHTeHcrBHocrblp; qeM Bhrrre 6one3-
HeHHocrb 3oHr,r r,rn Mepxlrasa, TeM Bbrue AoJrxHa 6brTr, r.rHreH-
craBocrb Bo3AeficrBr.js- Ha xaxryrc ,rr.rsgrc no l5 20 yaapoB,
ceaHcbr qepe3 aeEb. rJo BpeMq nepBoro Kypca J'reqeH!r Bo3aetcrBte
Moxer 6brrb exeaHeBHbrM, Ha xypc 15 20 ceaHcoB.
B. Aypxkynorepanl,lq
Oco6oe sH[MaHue o6parurL Ha 6o,reBbte ro,{xr, Bo3AerficrBoBarb
Ha TOqKIT:CeAantI{Hnn HepB, notcHl,tqHH& oTAen no3BoHoqHrxa,
xpecTlloBhltt oTAeI no3BoHoqHfiKa, troal(a, Hora, HaanoqerlHrx,
rxaH-MoH(AP 55).
n p x M e q a H n e. MeroA rjr,loyKa,rtbrsaHHnue ycTpaHqeT B AaH,
HoM cnyqae npxqrH HapyueHr.tr (cMeqeHfie MeHr.jcKa, MuenoMy,
KOC1HHeHapOCr6r), a ,rfimb o6"lerqaeT 60,1r,, ,lfikBHAapyeT Bocna,lr{-
ren6HHl npoqecc.
H E B P A . I I ft , I f l I I I E X P E S E P H b I X H E P B O B
ocdoBHbrEnonoxEfll{t
lleBpalrrr Mexpe6epHbrx HepBoB nporBnserce B Br.rle 6(),1D B
Hecxor'rb(lrxMexpe6epbflx; Bo BpeMr rrptcryloB 60,1b oco6eHHo
556
yclr'rnBaercq. BocroqHat Mea q Ha. orHocllr ?To 3a6o"'IeBaHxe K
o a H r M r e p M r H o M : < 6 ( ) , 1 nB 6 o K y ) ,
H a p y u r e H f i r M ,f i M e H y e M b I M
STI,tOJtOrflt ll nATOtEHE3
b o r e 3 H b c B r 3 a H a c H a p y l x e H f i r M HB M e p x a f i a H a x n e q e H Hu x e , r q B o
ro ny3brpr, IIpxcrynbl tpocrrr,3no6br. cxonneHlte B opraHu3Me
cnx3fi r,r Moxpo,br, HapyureHHe xopManr,Hot urlp|{yr'lfqtu xpoBll
co3Aaror npenr,crBre a,rt cBoCoAHoro npoxoxaeHl{fl 9Heprall B
Mhltxqax, Bbt3r,rBaroTHenpoxollrMocTb B M€pfiallaHax, 3acTo! 3Hep-
r fi. qro Bener K 6o",Ie3HLt.
B o r a c ir iB( x e
c lt M ft TortAT l,lxA
no cBoeMy xapaxrepy 6(),,16 B Mexpe6epL,flx HanoM'lHae, yxo,rr,r
fir!'rot anr nope3bl HoxoM, nprqeM Bo BpeMr npficTynoB oulyqeHye
6onr Hapacraer raK xei Kar{ npH xaru!'re. qsxaHbe, 6o,'lb o6blvHo
oTAaeTct B o6,racTb cflr.{Hbl, a lHorAa npBcTynri 6o,'tr Bo3Hl.{xaor
r.r B o6,racTH rpyAl.r.
npfi oulytHBaHI,lE MoxHo onpele!'[rTb rxnepceHcx6H.'rH3rpoBar-
HbIfi yqacTo(, a 6o,reBHe Toqxu, nponBrqrorqxecrr npr HaAaB!'tH-
B a H I I t , C O B n a A a I OC
T C O q y B C T B e H H b TTM OXq K a M LCj n I r H H , , l e x a t l l r M H
B coorBercrByrcUIrx Mexpe6epbfl x.
Bo3Hr.rxHoBeHre6onfi, cBg3aHHoe c nprrcrynaMr rHeBa. npr,t Ha-
n p r x e n H o M ( x r o e H ) n y , r b c e o 6 y c , r o B n e B oB o 3 B p a r H h t MA B x x e H t e M
3Heprnr neqeHn- Crporo noxanu3oBaHHaq 6on6, Ho.*,rc 6onee rxreH
c u B H a q , q e M ! H e M , n p x H e p o B H o M( c a n ) n y n b c e B b I 3 B a H a3 a c r o e M
KpoBr. npxcrynH 60,rn nplt cxaroM (KxaH) ny"rbce eB,1qrcrcq pe3y,rb-
TaroM IpoHxxHoBeHHq B opraHH3M 6one3HerBopHoro (paxropa
TFPANU'
A. l'lr,ror€Danxe
n p x H rr fi n n e q e H I,rt. f,raBfibrM o6pa3oM BoccraHosreHre npo-
xoatrMocr{ Mepl,raraHoB neqeHn r xelrqHoro ny3r,rpH.
To qK Bo3AeficrBIl r : 6 o , r e B b rreo q K r ( K a K n p a B r i a o 3
, To
coqyBcrBeHH6reroqKr cnrrHbr DopaxeHHbrx Mexpe6epHHx HepBoB),
ru-xay (6TR), 3broHr'naHf-ryeH (34VB), rxaii-cyHr (3F), Hofi
KyaH (6 MC).
Cnoco6 Bo3AeficrBr.rr. n p r B o 3 A e i c r B r i uH a 6 o , r e B b l e
To,rxn B o6nacrx cnrHbr Heo6xoariMo o6parnr6 oco6oe BHrrMaHfie
Ha r,ry6nHy yxo,roe. B xax4ou KoHKperxoM c,'ryqae r,!y6rHa yKo,ra
onpeAe!'rqerct B 3aBl,rclrMocrr,ror KoMn,reKqqt 60,rrI'Horo (xyAofi, non-
Hbri, ro,,ruluHa MhlueqHoro MaccrrBa Ha cnrjHe), npuqeM M€pqnoM
Heo6xoAHMofi r"ly6ltHbl Mo)Ker c,ryxrrb MoMeHr BxoxAeHsH nr,'I6I B
MHue'rHbrfi cnofi. HIl B xoeM c!'ryqae He cneayer BBoAlirb xrny Ha
6o,'Ir,uylo rny6 Hy, Li6o 3To,{peBaro npoKo!'roM,rrerKux. lloc,re BBe-
neHHg l,rr'tbl cnealer npotrBecrfi aKTrBXoe BpaueHue ee. qro6br
557
 Bri3Barb fiHreHcr.rBHr,rfi
llQoexr fir"ru>. B.re,{eHne Bcero llepfioaa oKa3blBaeTAaB!'reHre Ha flHcxHe MepraxaHbr B 3roM yqacTKe t npr-
ocraBreHhnrl"lH {15 20 vHHt npoH,rBo4r.ltb aoBtopHble Bpajlrehfie Boar{r K saaepxKe raM 3Heprrn r xpoBr- ApyrHMr nprql{HaMltcqr-
qepel KaxnHe J-5 MHH. r a o r c r r T a K x e c n H A p o M< n o ! ' r H o T a - x a p a >n e q e H x r x e r y a K a , < n y c -
q e c K r i i 3 O O e K r r o q e K . B o 3 A e f i c r BHr a
- T e p aTn e s r n .je T o r a > x H r . - 3 H e p r x l ,x n p e o 6 r a A a s r e < o r H r > , y c r p e M n e H x e< n y c r o r o
oo,'IeBble oqKri BoccTaHaBInBaeT r'Io(ar'lbHO npOXOA'{MOCTb gHeprfir. orHq> BBepr, K rolroBe fi r,rrqy.
ToqKxr!-Kay (6TR) a :uoxr-,raxr,ryeH(34VB) ucno,rrsy'orcr
Art BoccraxoBreH{n flpoxoalrMocrr] Meprranala <Ma,1bIItrgHr_ Bo3- C|,|MNTOMATIIKA
AetcrBne Ha roqKr rxai-cyHr (3F) l, Hon-xyaH (6MC) noMoraer
HOpManLr3OBaTr, q'rpkynnuxrc 3Heprllr1 B MeprAnaHe <koHeq fiHs>. npucrynH xryqefi 6(),'rll, B pesynbrare Koropbrx MbrruuH nriua co
ar{TrB!3rpyeT 3Heprtlo x KpoBr,, BoccTaHaB"laBaeTncfixtqec(oe paB- KpaqaroTcr, xaK oT yKo!'IoB r,roi, noKpacH€Hfie Koxlr !'Isua, cr're3o'
r e q e R r e , c , , r I o H oeTq e n n e . n p o a o , r x r r r e , r b H o c r b n p H c r y n o B l - 2 MUH.
B re,reH e lHq Ha6,rrcraercq no nec(o,rbKy npnclyfloB. pxcTynbr
6. Bo3A€f,crBre MeroAoM <qBerenrD Bo3Hl,lxaror oco6eHHo or np]rKocHoBeHfirr k HeKoropr,rM 6o,'re3HeHHbrM
O 6 p a 6 o r K a n o 3 o H a , 1r , H o M y n p x H q a r r l : r o q K a M x H a r ' r H { e :3 l t o H r 6 a r b ( 1 4 V B ) , r b r - 6 a r b ( 2 E ) , H r e H b - x b l o H r
ocHoBHafl 3oHa Bo3Aeicrar.{q yqacTor( Ha ypoBHe cnrHbr; (20 GI), .(ira-rxbroHr(4E), rxbra-rbroHr (24VC).
AonorHrTerhHaq soHa Bo3aeicTBrr o6,racrfi pe6ep no o6e-
r , r Mc r o p o H a MT ) r ' l o 8 H u a . H a p y x H a e c T o p o H a r u r e H r . TEPANl,l'
O 6 p a 6 o rh a n o M e p r a r a r i o v ) n p r h u H n ) :
qerbrpe yqacrKa Mepr.{AnaHa MoqeBoro ny3Hpq B ()6,1acr0 A. l,lrnorepanxc

nprHufin neqeHtg, f"raBHhIM o 6 p a 3 o MB o c c r a H o B r e H l ne p o -

- ABa yqacTxa MeprrAraHa neqeHr B o6,'tacTll pe6ep, or ro,lxl.l
xoal{MocTn x aKTaBa3aulr9 AetTenbHocTll Mep!{araHoB.
x r L - M o r r( 1 4 F ) A o r o q ( H r r o H r M o H ( 1 3 F ) ; Bo3aeficrBdr. B o " r e B H er o q ( r ( K a K n p a B r n o . I r 3
To,rxfi
o A r H y q a c l o K H a r o J r e H r ,o r r o q K n x a H b 3 f l H ( 2 F ) a o r o , r x x r brure), e'QoHr (l7TR) H,In ooHr qu
r e x , x o r o p b r € n e p e q [ c r ' r e H bB
Kxyx ryeH (8 F); (20 VB), xon'koK (4 GI).
o A [ H y q a c r o x M e p r a r ] a H ax e ! ' r q H o r of l y 3 b r p r , o r ? o ' l K n 3 H o H r - Cnoco6 Bo3AeiicrB!i. llyHKqntB Hax6o,'re 6eone3HeH-
,laHITleH (J4 VBI no loqxh h\Hey-dv I ll VBj. Hyro x3 6o,reBbrx roqeK c nocneaybnlHM rrHreHcHBHbIMBpaqeHreM
Cnoco6 o6pa6or K r . H a B c e \ y q a c l A a xo 6 p a 6 u r h a . p e ! . Hrnbr, Ec,rr 6onb He cHfixaercr, nyHKqxe npofi3Boaurcs Bo Bropyro
Hei ,HreHcrBHocrfi, Ha xaxablii yqacro( no 20 yrapoB. 6o"reByro roqKy fi T. A. CeaHc6r xrnoyKa,'rbrBaHfit npoBoAtrcn qepe3
B. Aypr{Kyrorepanxe AeHr,.Ilpr orcyrcrBrifi repanearruecxoro :$QeKTa Bo3AeicrBqe rr,ra-
Mr MoxHo 3aMeHr'rrbnolKoxHbrMI,l tH'bexutqMLi no 0,1 M,1ALtcrx,T,'It-
Oco6oe BHHMaHxe H . o 6 x o a r M o y n e n n T b . d o n e s b l vv e c r a M B t o q K a x : poBaHHoii Boar.l s oaHy 6oreByr,o rovxy. Pexru r.jHleKqri ror xe.
rpy!b, neqeHb,r(€rqHbtti ny3brp6, cr.rMnaTfiqecxarrHepBHarrcxcreMa, '{ro H pe)xfiM ftrr'royKa!'rbrBaHfir, qepe3 IeHb.
r x a H - M o H( A P 5 5 ) . TepaneBr ,recKnfi 3O0exr r o q e x . B o e A e f i c r suxae
6oneBHe Toq(fi BoccTaHaBJ-llBaeTnpoxoaHMocTb gHeprrn B Mepljal'I
H E B P A J I T I , I ' T P O NH T q H O T O f l E P A A aHax, nopaxeHHr,Ix 6o,,Ie3HerBopHofi3Heprxefi, { rorAa Bcrynaer B
AeficrBfie 3aKoHoMepHocft,, HaiaeHHar ApeBHeBocroqH6lMtl MeA[Ka
oo[-tlE noJ|oxEHtq Mai <npoxoAuMocTb xcx,'Ircqaer 60,'rb>-
ToqKx e-OoHr (17 TR), OoHr-qx (20 VB), xon"KoI((4 GI) acno,rr
yxa3aHHaq 6one3Hb rrporB!'rrercs 3yrcTcq KaK cpeacrso nporxB HapyueHfi* B nx <HapyxHofi) craAnfi,
B BrAe npficTynoB pe3xoii 6o,1fi
B o6,iacTI, HHepBxpyeMoi rpofiHfi,rH6rM HcpBoM, 4 orHocxrcs B cpeAcrBo lrnKBn,laqxx 6o,re3HerBopHr.rx (paKTopoB <Berpa) H <i(o
BOCTOqHOfiMeAHrlrHe K <BOCrraJteHL l) cycTaBoB oT BpeaoHocHoro roAa>.

6. Bo3aef,crBxe M€mAoM (qBererrr)

STt|OIOr{,| lt nATOfEHE3 O 6 p a 6 o r x a n o 3 o H a r ' rb H o M y n p a H q r . {n y : o 6 , r a c r b3 a -

Tbr.jrKa,ToqKa 6ar6-xofi (20 VC), BncoqHafl 06,1acrb, yurHble paKoBn-
f . r a B H u i i n p n r u H o i t B o r H r . i K H o a e H ktr, , B l a t f r T p o r . i H r q H o r oH c l B a HL,l.o6,'racrx rr'ra3Hxu6r, Hoca, ueK, pra, cky,loBarr o6,'racrb, Hapyx
tBr'rrercq IpoHfixHoBeHre 6(),rBHerBopHbrx 0afiTopoB <BeTep_xo,,roA) Har cTopoHanpean,reqbn.
B rpfi qHcxfix MeprAxaHa rrnu cxonlreHfie xpoBu s i]6,1acTl,l,rrqa, qTo O6pa6oTXa no M e p H A { a H H o M yn p n H u n n y :
558 559
 ABa yqacrxa MepxAaaHa xer'lqHoro ny3blpn B o6nacru ro_ TEPAN'|'
roBbr, or ro'rhr nuir,rH-,lre' (l VB) no toqK
+oHr.qH r20 VB.,
t B o r n c r c T B r e c p e A H F nx H r e H c H s r l o c r u ) l , 1o ! H H y , l a c t o x H a r o , l e H r ; A. llrnorepanxg
oAxH yqacrox MeprusaHa roHKoi xrluxfi B o6,,racrn,r{ua, oT
roqxr rxnHL,KyHr (l9lG) ao ro,rKu rxrj€H-3yHr (l7lc) x oAr.rH Il p n n q x llr e c e H r q . B o c c r a H o B n e H u er r p o x o A a M o c r x n a K r u
yqacToK Ha npetn,'reqbe (cTeneH6 sxTeHcxBHocTa onpeae,rH€TCHcno Br{3arlnrr aesTe!'LHocT, nopaxeHHl,lx MeDrranaHoB.
c u 6 H o c r b n 6 0 , 1 b H o r un e p e H U . ' rbr B o l a e i ( r B H e H a r o M p r rlHoM To'{xn Bo3Aeilc aipxnrx xogeuuocrxx
yqacrxe). x o x ( 4 G l ) , H o n ' x y a H( 6 M C ) , K a r b - 3 y ( 1 7 V ) , r x a H M o H 1 7 C ) ; H a
Cnoco6 o6pa6orxx, Bosaeicrole no 3oHa!,lhHoM n yp l l - H r x g r x x o H e r r H o c r r x x o u ' , r o n ( 6 0 V ) , 3 b r o H r - r r a g r - r y e H( 3 4 V B ) ,
3Ha(y npofi3BoAfiTcrr co cpelHei Hna cna6ofi aHTeHcuBHocrbro B 3ei-Kxe (41 E), rarv-aM-3so (6 RP). xroer-xafi (10 RP).
3aBrclrMocrx oT peaKqru 6o,rr,Horo ua KaxAoM KoH(perHoM yqacTKe. C n o c o 6 B o 3 A e fi c r s r q, 9ro6br x36exaTb ycfi,reH.n 60-
JreBblx orqyureHHfi,6o,'rbHoMy npou3BoAqr nyHKunr BHaqar'reHa 3ao-
8. Aypxrynorepannr poBoft cTopoHe, noc,'Ie BBeAeHr.rHHr,Ibr Heo6xoAr.{Monpon3Becrr ee
Oco6oe BHriMaHueyAe,rxTb 6o,,reBr,rMMecraM B Toqxax: 1106. Bepx, BpauleHHe 3HaqHTe!'rbHoiiIInl,l cpeAHei HHTeHcr,tBHocrr,t, Henpepr,rBHo€
Hrrq qeJlocTb, HHxH'I' qe,IIOCTb,Cr.rMDaTHr{ecxa'] B TeqeHxe l5 30 MqH, Ec"lri lrMeercr coorBercrBytouar annapary-
HepsHa'I clrcTeMs, p a . v o x H o B o 3 n e i c t B o B a r b r , r M n ) r h c H H 1 4t o H U v c M a K . x M a , l f , H o i
r l a B . M O H( A P 5 b ) ,
creneHin uHreHcaBHocTa, KaKyro cnoco6eH BHAepxaTb 6o,rr,Hoii-
I(orAa 6onh yMeHburrjrcr (o6brqHo noc,le I 2 ceaHcoB), MoxHo
npos3BoAarb rrr'loyKarbrBaHHe Ha nopaxeHrrofi cropoHe. nyHKuuK)
npor3BoAqr l--2 pa3a B AeHb,
c f i H A P O M ( B O 3 T O P Ar i l l t O r H t r U XfytlEtl 6 O J I l l ( K A y 3 A J rr H , ) g Q Q e K r r o q e x . H a r o q r uT
TepaneBruqecxrfi t xaH-
M o H ( 7 C ) , x o n - ( o K ( 4 G I ) n H o f i k y a H ( 6 M C ) B o 3 A e i i c r B y r o rc
o6l{HE nofloxEflr,tt q€,'rbro r{acTfirrHofi HopMaJ'Ir{3auljI'tnpoxoa}rMocTr, }rHbcKrrx fi gHcKI{x
MepnArraHoB BepxHux KoHeqHocreil. Toqx! KoH-,'roH (60 V), 36roHr'
<Bo3ropaHne orHq> ecTb oAHo g3 cqMnarxqecKrx paccrpoiicrB, cBt "raHr-ryeH (34 VB), 3f,fi-xxe (41 E) x rarv-arv-rro (6 RP) c,ryxar
3 a H H O eC n o p a x € H r e M n e p x Q e p s q e c K a xH e p B o B ( c p e a x H H o r o ,r o r ( ,
a,rn qacruqHoro qspKy,rqqnr 3Hepruu B nHr,cKxx
reBoro, lrryqeBoro,ceAarrurHoro, Ma,'io6epuoBoro Il ap.). Bocro'{Hat
r t H c x l x M e P r A H a H a xB x x H I t x x o H e q H o c l e i .
MeaHrlrHa oTHoclrT eto k <BocnaIeHato cycTaBoB oT BpeloHocHofo
T o , { x } t ( a r 6 - 3 y ( 1 7 V ) x x r o e r - x a f i ( 1 0 R P ) c n y x a r a . r r ea K r n B r i -
3arrru KpoBfi, nrrKBrraarlna <xapHr fi aocnarxTe,'rbHoro npoqecca.

sTuOl.Ortit tt nATorEHE3 6. Bo3AeficrBxe u€ToAoM .IIB€TeHtt!

3a6oneBaHre, xaK npaB no, ffB!'rqerctr pe3ynhraroM npoHfiKHoBeHr'rs O 6 p a 6 o r K a n o 3 o H a r ' r b H o M yn p u H r r r n y :
B MeprAfiaHU 60,re3Her8opHbrx OaKTopoB <uerep-xapa>, qTo Bbr3br- - 3oHa o6n3are"lbHoro Bo3AeficrBdr lo6pa6orKa cpeAHeii nH-
Baer Irx HeflpoxolrrMocTb a BeAeT B AaJrlHeiiureM n Bo3HI]xHoBeHIro
c H H I p O M a< O r O H b > . - ocHoBHar 3oHa Bo3AeicTsl.tr:npr{ nopaxeHs, BepxHlx Ko-
BeqHocrei o6pa6arHBaor yqacrox cn Hn Ha ypoBHe no3BoHKoB
IEqEHI E 6OJIE3HI,I Thr - Thvrr; ec,'Il nopaxeHr,I Hl,lxHIle xoHeqHocTx, npol,t3soAsT Bo3-
Aeic,Bue Ha yqacroK no3BoHo'tHur{a Lrrr - Sr;
Prr,rrqa|or nBe Sopvbr reqehHe 6orerrH - AonorrHHTe,,rt,Haq 3oHa Bo3AeicrBxq: ,'roKanbHo, BepxHre ,l"rt
Tn,rrnaq Qopva. Ouryuerrre rd-' HrrreHrrBHoi.xrvqeir HrxHue KoxeqHocTr.
6o,'Ix. croBHo K Tery np{noxxJ'lt1 pac(a"!e}r brn yro!'t6, xoxa cyxat O6pa6orKa no M e p r r a r . r a H H o M yn p r H q r n y :
H TaI(at roptqatL qlo rpe6yeTcr nuctuflHHo npl,|K,laabrBath Hefi - o'IlnH yqacToK nopaxeHHoro MepxllraHa Ha B€pxHrx r,'rr Hnx-
xo,'toAHblenptlMoqxlr, CBeroBHe x 3ByKoBble pa3apaxeHrr ycl]rt,lBa- HHX KOHEqHOCT'IX:
IOT 00r'16.DOJIbIIOIjCTpeMr.rTCsyeAI{HUThCr B T€MHO' KOMHaTe,A3- o n f i H y q a c r o x M e p l , t n } 1 a H ac, B r , 1 a H H b l l {o t H o u e H t t v H ? l o
6eraer (oHTaxroa c ,rloa6Mn. BepxHocrHo-BHyrpeHHero> Tfina c nopaxeHHr,lM Mepr1afiafioM Ha
"rlerKat oopMa. Oqyqeure xixeHxfl Ha xoxe c,1a6oe. flprMov- BepxHnx fi,'Ili HaxHrx xoHeqHocTqx.
Kr rpe6yrcrca IIpr pe3Koii cMeHe reMneparypbr Bo3nyxa, fi ,1ur1t6 Cnoco6 o6pa6orKL. O c H o B H y rno A o n o r ' r H u r e n b H 3 y rocH b r
crrrr,H6rt lxyM noBrnrxaer orqyDleHr.re60,,rH. Bo3teicTBnq o6pa6arHBaroT co cpeAseii x,1fi 3HaqtTe",rr.Hofir.rHreH-
560 501
${tsrrocrbrc(B 3aBrrcxMocrxor peaKrrrx 6o,,rbHoro)_O6pa6orKy no
yePsAuaHHoMy flp{Hqnnynpol3Eoaflr or xapaK.repa
cooapoMa(<xor'Ioa),<xapa>, nycrora>,(nonrora>).
- no 20 yAapoB. Bo BpeMq nepBoro Kypca
Ha xaxAyro r-r,rHrirc
.leqeHfit Bosael{cTBn€ exeaHeBHoeno oaHoMyceaHcyB aeHb,BTo
poro 0 Tperbero rrepe3AeHL. KaxAbrfi xypc !'req€Hsscocrorjr ,13
l5 20 ceaHcoB.
B. AyprKy,rorepanxc
AypxKy,rqpHbre-Toqxn, cooraercrByroulre nopaxeHHnM MecraM:
rxaH-MoH(AP55). cxMnarrqecxaesepBr{arcrcreMa.
TIAPAIITI VII qEPENHOTOflEPBA,BbI3AATHHN
n EPEOXJIAXJIEHIl Eilt (Jlfi{EBAt TEm1|IIJIETt|t)
oclroBHHEnonoxEHt{t
Ha06o,ree'racroeHapyuieHreVII qepenHoroHepBa. Bo3HtiKaer
BHe3anHo, nponBrne,cr B OopMe,lxqeBoi reMfiDr''rerxfi,
KorAa 6onb
'roi He B cocroeHr.fl.l
laKpbtTbt,'taJ Fa nopaxeHHoilcropoHe.
B Bocro,rHoiMeArrrfiHe3ra 6o,1e3HbHa3hrBaercq<rcxaxaloqeii
r"ra3a rt por B pey,rbrare npoH]lxsoBeHrir6o,re3HerBopHHx Saxro-
9IllOIOrl|t l| nATOrEtE3
Bo"!e3HbnporcxoAr'rTB pe3y!'tb?are BTopxeHur 60,le3HeTBopHbrx
oaxropoB <Berpa> x <xonoAa> a xor'rr'rareparbHdeBerBu rpex rH-
cKl.jxMepr,rAfiaHoB
B o6nacrr'r"1fiqa. Hapyuraercr HopMar'lbHaf,
r!,ip-
Kyiflqur ?Heprsrno MepHAr.raHaM,3Heprxq fi KpoabB sToMyqaclKe
He peryr'rr,rpyrcTcr,
HapylIjIae,lcrrpoQHXa cyxoxxr'lbHoMbrueqHbrx
Mepr.radaHoB a Hacrynaernapan q nrqeBbrxMnrxq.
Cl'MNTOMATII(A
MHrxubrnapa,'rrr3oBaHHofi cropoHblnfiqa HaqrHarorcrerxa orBrcarr,,
craHoBrrce Hocory6Haflr.j,'106HaqcKnaaKn.Ha-
pyuiaercrecrecrB€HHaq MfiMxxanpx y,lbr6Ke,
Haq nonoBxHa ry6 ocTaerc' HenolBlrxHori, BeKr.rHa nopaxeHHoi
cropoHe"rx6o coBceMHe 3aKpbrBarcTcq,,'ru6o
Ho, r"!a3 c,'re3xTcr,6o,'tbHoiHe B cocToqHr.ts cABt{Hyr66poBfi, 3aAyTb
oroHb, FoptvalrbHo nfiTb BoAy,r.icKaxaeTcrpe.jb.3arpyAHeHos npu-
IqT e rrur. Koropar iacrpeBaetBo pTy Ha nopa.{eHHofi
H d q i b i K pr o H H r i6 e n H rH
i a , l e ra. l n r , cn o B e p xo c r H b r i{rd v r . c x a r d i i
562
Tak xak napanu3oBaH-
3a(p6rBarcrcfiHennor-
cropoHe
IEPANT'I
A, Ilrnorepansq
npr'rHufin ne'reH e . B o c H o s H o MB o c c r a H o B ! ' r e Hnf p i eo x o A n -
Mocrl.{ 3Heprxa B MepflAfiaHax, aKTrBr3arIHr l(o,rrrarepa,rbHbrx Ber-
Beii B o6,'racrr nfilla.
T o,r K fi Bo 3 Ae i c T B ll fl: Txai-3HoHr (BHeMepxAfiaHHar),
r o a H - . r y x r 2 \ ) c B b r x o a o vr \ o H x a H f , r b rB r o q h ] r s r r o - v r n u t l \ ,
(B ()6,racr, ,rnua), ara-rxbroHr (4 E), 3Hn-ca (6 E) (Ha qeKe),
H q H - , { y H r( 2 6 V G ) , r x b r a - r b r o H r ( 2 a V C ) ( B o 6 , r a c r x p r a ) , x o n - K o x
(a GI) (Aa,rbHqe ro'rKa). npx myMe B yurax c,'reAyer Aono!'rHnrelrb-
rro Bo3leiicrBoBarbHa ToqKy e goxr (17 TR).
Cnoc06 s o 3 A e r t r c r B n q . t s o B p e M nK a x A o r oc e a H c aB o 3
AeicrBoB6r6 Ha I 2 To'rKri n3 rpynn Toqek, pacno,ioxeHHbrx B ()6-
"lacrx r,ra3, qeK, pra, a raKxe fia aanbHrolo roqxy. BH6op ro,rek
onpeAe,rrercr cnMnroMarxKoii. TexHrxa nyHxufix c BbrxoloM Ha co-
ceAHIoo rorrxy: npolr3Becrr{ yKon, 406arbcr <3QQexra Hrnu>,3areM.
HaKnoHrra Hr,rry, npoaonxfiTb yKon noaKoxHo ao Bsrioaa Ha Heo6-
xoanMyro roqKy. TaK, ecnr Heo6xoArrMa nyHxqre B rorrxy AHa rxbroHr
( a E ) , n o c r y n a r o r c n e a y m u , . r Mo 6 p a 3 o M : B B o a r r x r n y , a o 6 u B a b r c a
<9QQeKra xrnrrr> x npoAo!'rxaror yxorr noaxoxHo c BhrxoaoM Ha
r o q x y 3 q n - c a ( 6 E ) ; n p n n y H K r rr B T o q K y 3 r n - c a ( 6 E ) B B o a e r
ur',ry, A06qBarcrcq <300et<ra rr,rbr> x npoAo{'rxaror yxolrr noAKoxHo
c BbrxoAorliHa roqKy lna-rxHoHr (4 E) 'raK, qro6H Kor{ubr aByx Hrn
Bcrpern!'rncr, B 3rofi roqxe. fipn nyHKqr.{x B roqKy roaH-qyx (2 V) c
BbrxoroM Ha roqKy rbrHb-Mr.rHh(l V) se oleayer npoH3Bolsrb Bpa-
UleHxr rir,rbr, Tax KaK Mo)KHo noBpeAriTb r,,Ia3Hoe s6,'loKo.
B HaqanbHori craAxx 3a6oneBaHrn Bo3AeficTBytoT r,,raBHblM()6-
pa3oM noKanbHo Ha cooTBeTcrByroulre ToqKx nopaxeHHot cTopoHbr
r{ Ha A}rcTar'rbHHero,rxn 3AopoBoii cTopoHbr. noc,re pa3ApaxeHHr
ur,raMfi cpeAHei r{HreHcfiBHocrn Bo3AeficTByrcT roKar'rbHo npx)t{ara-
HfieM Ha rolrKrr nopaxeHxofi cropoHbr. Ec,'tr 10 l5 ceaHcoB Bo3-
AeacrBrr He aaror repaneBrrqecxoro 3Qoer{Ta, npfiMeHqroT xH,bex-
u x r c n o 2 0 0 M K r H a 2 M , B r r r a M x H aB 1 2 B T o ' r ( x A f t a - r x b r o H r ( 4 E ) ,
iin-ca {b L} x rHoHf-6arbrl4 VBr fia nopaxeHHoicTnpoHe.
TepaneBrrqecKxfi 300eKT T o q e x . B o 3 A e f i c r BHr ae
roqxx B 3oHe HapyLLreHHqcnoco6crByeT r,'laBHbrMo6pa3oM BoccTa-
HoB,r€HfironpoxoarMocrx MepfilrraHoB nopaxeHHoi cropofibr. Toq(a
xon-KoK (4 GI) xcnolirlsyercfl .{!'rr BoccraHoBneHfis npoxoAl{Mocr|
M e p x A x a H a< c B e r , , r b r q i H>, B cnyqae noqBreHr]r txyMa B yuax npr
M e H q r o r! r ! ' r o y K a r , r b r B a H Bx er o q K y e - Q o H r ( 1 7 T R ) , , { r o o a H o B p e M e H ,
so n Aaer gOoeKT, aHa.lorn,rHbrri TaKoBoMy coceaHHx rorleK, u cno
c o 6 c r B ) e r . , , r n K B L r n a , r r re e r p a , p a c c e u e a n i r o \ o , 1 o a a r .
6, O6pa6orxa MeroAoM <qBere8tgt
O 6 p a 6 o r K a Ir o 3 o H a,r b H o M y n p fi H q x n y: 3arur'roqHaq
o6,racrb, o6,,racrr, pra. qenrccrBo-!'r|ueBar o6nacrb, nepeAHes cro
poHa npeAn!'reqr,H.
 O6pa6orI(a no M e p s A l i a H H o M y n p t HIrtlny: TEPANT'
- oariH yqacroK MepfiAxaHa xe!'ryAr(a B o6nacrfi ,,rlrua
r r u a - x x a n - ( l F ) . , r e p e 3r o q x ! r x b l a r b r o H r t 2 4 V C ) H A. Urnorepanxq
- oAnHyqacTot{MepriA[aHaro!']cTot r(riruxriB o6!,racT|jrr{Ua or n p r.tH q x n !'r e q e H s q. BoccraHoB,leHfle poxoarMoclil, aKTD-
ruqxHfireHb-xbro-Hr (20 Cl). qeper roqh} rxoh-Kay t26 VCr H ao BIr3aqHfl AeqTer'IbHocTI{MepttAIiaHoB, noABeptrx{xcr EapyrxeHtlo,
roLrxH Qy.[or I lU Ul I H eue onHHy'racroKor roqKHxon-hox(4 C I ) T o q K x B o 3 a e i i c r B l r e ir x e v - x a i ( 3 C ) . r x a s r ' . r i a s t ( 2 C ) . x a y -
a o r o q K xK \ y " - q r ( l l C I ) xxe (3 IG), Hroaii-xyaH (5 TR); suosr'qx (a TR), qyHr-rbu (3 TR),
C no co6 o 6 p a 6or K ri. O6pa6orKa<no!,rycrxMy, {pyloulero- x o f l - K o x ( 4 G I ) . , I a o - R y H r ( 8 M C ) , 6 a r - r a ( B H e M e pA ' { a H H a q
nolrypacceraaDurero,Ieic,rBnq. Ha KaxAyro nfiHHrono 20 ylapos PC 107).
Morororr(oM.B AeHr,no oaHoMyceaHcy. Ha orrH xypc 20 ceaHcoB. Cnoco6 Bo3AeficrBfit, f l p u B o 3 r e i t c r B u xH a n e p e r l H c -
JreHHhreToq(It <3QQeKT IjrrbI>, I(aK npaBxlro. aocrxfaeTcn c TpyAoM'
B. Aypxxynorepanlc nogroMy rpe6yerct riHTeHcHBHoea 6o,r€e npoAonxnreJbHoe Bpaue_
qe,l|ocrb.
B o r a e i c r e r eH a r u q h H :r r a r a , H a p ] ) h t h r ;H o c .B e p x p q H Hfie ,r,,rbr (6o,1ee npoAolrxlrre!'IbHoe, qeM IIpl, orcyrcrBt, napanr_
,ra), T. e. Bn,rorr, Ao roflBreHxq E€o6xo,4tMoro cieqro{qecxol'o
Hrx{tt qeJ()cr6.
noc,re nyHKurjB ocraB,rsror trny Ha l5 20 MnH, B reqeHxe Koro-
NAPAOXqJIOKTEBOI-O
HEPBA pbrx npofi3BoAtr oaHoKparHoe BpalqeHfie KaxAbIe 5 l0 MtH
T e p a n e B r L tq e c K I l f i 3 O Q e K T r o . r e K , B o c H o B H o M
Bo3_
OCHOAHUE NOTOXEHI,I' Ha Bce nepeqnclteHHbIe Br,Ilne ToqKfi nprMeHqercq c qe!'lr,lo
aeicrBue
HapyueHrr B o6,racr ,tol(Tq x 3anrcrbr (c ,'roKreBoi cropoHbr): BoccTaHoBfiTlr HopMalrbHyro UapKylr'{qfiIo 9HeprxH B nopaxeHHblx
rrepe!'roMH
MeAfiarhHoro HaAMHUler'rKa
(c,1eBoi c,ropoHH)ln,reqeBoi Mepr.,axaHax.
xocTx, BbIBI{x}t B .loKTeBoM CyCTaBe, flptMoe CAaBntBaHUe JTOKTq
B pe3ynbTaTeHeyaooHorono,roxeHr.irrerra 3o RpeMr HapKo3aunfi 6. O6pa6orxa MeroAolr <rtB€TeHlet
B cocTorrHrrlr
onhrHeH4s,HeBprTbr(qacro Ha6,rroaaeMHe npk Hapy
tlreHxrx. B6r3BaHH6rx O6pa6orxa n o 3 o H a ! ' r b H o M yn p x H I r f in y :
6o,te3He,rBopH6rM OaKTopoM<Berpa>) - Bce - soHa 0613arenbHoro Bo3AeicrBnfl;
3'ro Moxel cryxur6 nprqnHon napaJ ,'{a roxTeBoro HepBa,Haxoarr'
LlefocrrrraaHbrvo6paroMB npelerar p),rHHxvepHAxaHoB oMa,1Hfi o c H o B H a r 3 o H a B o 3 a € f i c r B H r :T h r - T h v r ;
H H b r r r ! B e I L l i { tl i t H r . H o . n o v H V o 9 1 o r u , 6 o I e t H L o h a J H B a e I c s o e aonoJHriTenbHat 30Ha Bo3aerlcTBltn: 3aaHtfl BHyTpeHHqt q
BosneficrBfie n Ha coc€lHxe MepxAsaHbr: 3aaHsfl HapyxHat cropoHa n,reqa fi npeanneq6g.
O6pa6orKa no MepxaraHHoMy npHHqnny:
TJTItOJIOt'ltt |,| nATOtEfl E3 oAnH yqacror( MeprrafiaHa ToHKot Kr.rurkl,lor roqKli Txxey-
qacr6 (l IG) ao roqKr, IrfieH-qrH6(9 lG);
6 o r e r H b B o r H H X a e lB p e l y r ' l b r a T e n p o x r K H o B e H x q6 o n e l H e t B o p H b r \ oAnH yqacroK MeprarraHa cepAua oT roq(x TxaHb-,rrH6 (2 C)
q a K l o p o B . B e T e px o r ' l o n o r n f i . x a p a , B p l r t H b t e v f p r n r a H L j " v a . ao r o q Kr rxrey-cyHf (9 C).
<Bernriri rH>, B pe3yjhrare qero Hapyurarcrci rpooH_ C noco6 o6pa6orx - B o 3 a e f i c r B [ en p l j o 6 p a 6 o r K ef i o M e _
qecKre (pyHxur,r 3Heprsr ll I{poBIl B 3oHax, cBr3aBHbrx c 3,rllMfi Me- prAlratHoMy npnu{rny Beaerct co cpeaHei unt c,ra6ofi xHTeHcI'B-
PI,IAI,JAHAMI'. nocrro. flpa cH,rLHEIX60,1sx riHreHcI,rBHocrbo6pa6orKlr 3Haqltre,'Ib-
Har. Ha Kaxayro ,trrHxro - no 20 yaapoB. Bo BpeMq nepBoro Kypca
CII M II TOMATI' KA o6pa6orKa exeAHeBHaq, BToporo r{ Tpelbero qepe3,eeHb. Kypc co-
cron, 13 l5 20 ceaficoB.
ilapylneHrie xBaTaTe,tbHr,rxSyHKrrsi narbu€B: nor,lsoe ficqe3HoBe-
lroe Hr''Ir.r cHnxeHre qyBcTBlTen6sOCTHHa nOIOBHHe XUCTrj pyxn C B. Ayp ryiotepanrt
. i o x r e B o r ic r o p o H b r .B o 3 M o ) K H a M r o r p o Q x q M e x K o c r H b l xM b l l u u ,n o x -
reBoro crx6are.rre 3aftrc.fbe l{ r,ly6oKoro crr6are"lr na.qrrueB qa Bo3AeicrBlre Ha ayprryntpHble roqr{li, coorBercrByrorq[e nopaxeH'
. n o K r e B o i ci r o p o H e . K u c r b n p r s M a e r x a p a x r e p { y n Q o p v ) , , K o r r a s B e p x H x xK o s e q H o c T e i H
, a r o q K r : c e p a q e ,r o H K a t l { t r x K a -
pe3yrbrareHapyueHr.tr
rpoerxn cyxoxn"rrii n uuuu IV x V na,rs- IIpriMeqaHIe: n p u r B n e H r r a M r j o r p o Q f i ns a e Q o p M a q u r
ubr craHoBqrcr cxploqefiHr,rMll Tax, qro 6oxbHoi He B cocrotHrn KXCTI nplrMeHtTb _ B CoqeTaHl,lt eXeAHeBHr,Ifi MaCCaX MbtlIq fi
rsMHacTtKy na,lbueabrx cycTaBoB,
56{
 I l p I , 1 r a p a n x , { e n o x r e B o r o H e p B a 6 e 3 r p a s M B H e u r H e r on p o l r c
xoAl.{Mo6oree x8reHcrBHoe r 6o,!ee npoaorxfirelrbHoe BpaqeHHe
xoxAeHxe 60,'rr,Horo crreAyer noxa3a16 cneusar'lrrc,ry HeBponaro rr,Tbr (6onee npoaon)fit{re,lbHoe. qeM npx orcyrcrBHHnaparHqa),
.rory. Ecnu 6o,re3Hb He Bbr3BaHa6(rre3Hersopn""
( B e r p a > , n e q s r h e e M o x H o o a H n M , 1 r u r b M e r o a o M ' , l r6njonyr ox p o" r, e. Bn,'rorbao notar'IeHrt 3Toro cneqrorqecl(oro oqyqefiaq. I4r,1y
arrbl ocraB!'lrror Ha l5 20 MuH c noBTopHHMBpaueulteM I{epB xaxable
5 l0 urs.
nAPAnfi q cEAAIIttldoro T e p a n e B T n , r e c K r . f{ t 3 Q O e K T T o . r e K . B o 3 a e i c r B l {Hea
HEPBA roqKr 36roHrraHr-ryeH(34 VB) , ryK-raM-nu(36 E), 3flfi-I(xe(41 E),
o6lllrE nonoxE||flt ryx-naM'Kxan (41 VB), rxai-cyH. (3 F) npl,lMeHterctc ue,rbrc!
BOCCTAHOBICHNq fl POXOATIMOCTt,l I' AKTI'BI{3AIIfi I, MEP}IANAHOB (CBET

B rou vecre. rae "rr,rfi qH> r'r <Ma,'rbrfisH,. Toqxr, 3HoHr-,'raHr-ryeH(34 VB) n ryK
_ c e n a r r u r F U i H e p B c r a n H e i i . . r o p o H b t H o f r . i ,0 6 ( ) . raM-Kxan(41 VB) c,ryxar a,rq npeaynpexreHnrarpoQtn nepeaHeli
f H l B u e r i x y v a , l o 6 e p u o B o r .ti( o c T r . jB, b t x o A h r H a n e p e a H | o r oo. H H a f i .
6o,ree yr3BriM Anr{ pa3r' rqHoro pora rpaBM npx yul6ax, nepe,ro 6o,rLuie6epuoBoiMr,lrxqbr.yKon B roqxy 3efi-Kxe (41 E) no3Bonqer
vax ureiiK{ Ma,ro6epuoBoi xocru ,u6o upuclo npl1 caaB,,rnBaH,,tn cnoco6Hocrb6onbHoro orrn6arb BBepx crynHIo,
eroro ytlacrxa (fipn &'lrTenbHoM crAeHr.tx rra Koproq(ax nx6o Bo a B ro.rKy 6ar Oosr (BHeMeprrAfiaqFas) - orrx6arh BBepxnarlbqbl
BpeMq Hapxo3a ,1s axecre3xx npl, cnruxoM sbrcoko noaHrrToi

NATOTEHE3 6. Bo3A€ficrB{€ MeroaoM <qBereHrc}

I "1aBHofi npsqfiHofi, Br,r3brBaroqei 3a6onesaBae, rBnre,rcq Hapyrne- O 6 p a 6 o r l ( a n o 3 o H a r ' r L H o M yn p B H U r i n y :

- 60KoBaq 06,1acTb xl.iBora;
Hne npoxoAHMocr, MepfiAqaHoB<Ma,tbrfi rH> x <cBer",rbri qH>, xoraa
- noAKo!'reHHat tMKa;
9Hepraq r KpoBb lie B cocrorHIa o6ecneqxrb nt,laH{e Bfi)KHeIi qacrfi
o p r a H r . j 3 M a(. B o K u u r e o B r { y r p e H H e M )c h a 3 a H o : < . . . e c ! , r xx p o B b H e HapyxHaq cropoHa roreHfi r,rrbrrrbHarr
flonEriMaeTcq BBepx x rna3aMr oHu He Bk!r,r, ecjH oHa He onycTr,tT_ O6pa6orKa no M e p f i A r a H H oM y npr'rHrr{nyl
c s B H a 3 ,x H o r a M ,o H x H e l r A y T > ) . aBa yqacrKa MepraraHa MorreBoro ny3brpq Ha 6oKoBoi 06-
JacTn xxBora oT TorrKr, ,rxbroHr-!'trrey (31 V) Ao ToqKr.{xoi-3bloHr
cllMnToMATltKA (35V) u or roqxlt 6aHr-KyaHr-3y (28V) ao roq(x 6arb-xoaH-3y
( 3 0v ) ;
llpfi napa"lx,{e ceAarrnlHoro HepBa cTyrrHI,jHor caHcaK)r enfis, 6o,,la- )!racroK MepHnHaHa )+{e'lqHoro n}rHpq B 06,1acrr ro"leHr o'
Hori He a cocrorrHufi pa3BepHyTb crony Hapyxy, oTorHy,rrr nanbqrrr r o q x r . u o s r - , r a r r j r l e Ht J 4 v B r t r o r o v r , r i r r e y a v r l l V B t :
sor xBepxy, rlpn xoab6e oH Bo!'rorrrr Hor{. rlyBcrBtre,,]6Hocrb Ha
- ' y q a c r o ( M e p x , q x a Hx a e n y a l ( ao r T o , i K n T y x r a M ' 1 r ,( 3 6 E )
s s e u r H e f ic T o p o H er o " r e H r ,r , r b u b H o d c r o p o H e c r o n H M o x e r 6 H r b ao ro,rxs Hofi rrHb (44 E).
B cnyqarx AnnrenbHoii 6one3Hx Moxer Hacrynxrb C n o c o 6 o 6 p a 6 o r K r . O 6 p a 6 o r x ac p e r H e friH , r e H c n B H o c r x ,
arpoorfl neperHei 60,rbuie6epuoBofi Mbrurrrbr. Ha Kaxayro,l,lHrrono 20 yaapoB.B Te,reHae nepBoroxypca- Bo3
aeiicrBreexeaHeBHoe, BToporon rperbero qepe3aeHb.Kypc co-
crorir 3 l5 20 ceaBcoB.
TEPANT'
B. Aypfixyror"epantq
A. Hruorepanrr Bo3aeficrsreHa yqacrKn yuHon paxoBfiHhr. no
coorBe,crByroru[e
p a x e H H b r Mq a c T f l MH U x H r i x K o H e ' { H o c T e a . Toqx8: xeaq
IIpruqfin J r e q e H f i r . B o c x o s H o M B o c c r a H o B n e H xnep o x o - Hbril fly3brpb, xe"ryAoK.
AIMOCTT'Ir axTlrArr3arlHt letTerrr,HocTl,r MeprauaHoa <Manbtii,H, x
'[oqxH NA PA II.II ETfi '
Bo \4eicrBHr: J b t o H t - n a H r . t V( 3e 4HV B l . t \ K -
r a M - , 1 r _ ( 3 6 E ) .| r f i - h x e r 4 l E r . r ) x - , t a M - h x a ni + t \ S r . r x a l c y n r
( J r r , o a r - q o H f ( B H e M e p r a r a H H)a. H ocHoBHbrE noJloxEHtrt
Cfloco6 Bo3aeicrafis. O 6 u q x o l l p l , nl y H K u r r r yx x a 3 a H npotBrtlorcn B no,epe noaBl{xHocrx a qyBcrBn_
3rx HapyUJeHfiH
HHx roqek cneq&(p,rqecKoeoqyuleHne, xapar(TepHoe Anr <gOOeKTa
TeJbxocTr norroBtHbt,'Irqa, no"'toB H6l rynoBl,tua, oaHol t3 BepxHllx
rrr'lr,rr, Bo3Hrxaer He cpa3y (BnnrHrre napanxqa), nogToMy Heo6
fi oAsoi rr3 H{xHl,lx (oHe.]Hocrefi. PaccrpoiicrBo aBrrare,'Ir,Hoi
566
OyHI(qxtl, Dorepq qyBcrBarenbHocrHtrpor.jcxoArrrlt3,3a flopaxeHrt
rrripdyunHofonlqKa, OcHoBHo;npfi'{uHoi napan,'rerflrrBJqercq
flopaxeHle (poBeHocHbIxcocyaoB ror'loBHofoMo3ra,
B Bocro,rxoriMeAxurBe 3Ty naro,rorfio Ha3brBarDT <nopaxer e
Sll,roJrorxfl x naTofEHE3
Kax rpaBnno,+aKropaM!, BH3nBamunMusapydeHxe,nBnr|o.rca:
- BHelxHreQaKropbr:6o,'re3xerBopHbril
0ax.rop <Berpa>,oKa36r-
BaloxlHriBHe3anHoe
Bo3AeficrBxeHa MepftAnaHHx BHyTp€HHreop,
- BrryrpelrHneQaKropl,l: Bo3o6,raAaHre<orHr> (B pe3y,lbrar€
}rcroUleHxrrnoqeK, cl]rbHoro yc.rpeM",reHfir
BBepx <orHq> ceplqa
B 3Tnx cJlyqaqx6o,1e3Hb cqsraercr cepAeqHorourI,t noqeqHoroDpo,
ficxoxAeHrq)icr.iHApoM BnyTpeHHero <BeTpa>(B pe3yn6raTe (nycro,
TH> r,rHr,-noqKrj
H Bo3o6",raAaH{tqH-neqelr 6one3fih neqeHoqHoro
x,r{ noqeqHoro npoxcxoxAeHlr); cfiHApoM <Moxporbr xapbr> (B pe
3y!'rbrare BiaxHocrr,r, nopoxAarour€fi Moxpory, r{oropar, cKanrfi-
Barc[,, BeleT x cdHlpoMy <xap6r>, a noc,leAtqrr,Bo3o6naaaB,pox-
nael cBelep, 6onerHbB ,Iov cJyqae cartlaHac ceJtejeHKoii H",II
IIaroreH€ napan"r€rrr npercraBlrrercrr r(aK HapyueHse paBHo
Beckrr{Hb- a rH-3HeprrrH,
nycrora nHr,-noqxH, qH ne
B03()6,1aAaHue
qeHsa 3aKyfloprBaHxe Moxporo! <oKHacepAqa>.
TEITEHTIE
EOJIE3TIII
O6brvHopa3,rfiqarorABe crarry reqe!fir 6o,resHa:craA!rc nopaxe-
Hr.{q.
BHJrpeHHsxopraHoB }i cTaaqronopaxeH 9 MepraraHoB_
l. LTaAnr nopaxeHr{rBHyTpeHHr.jx opraHoB(rqxenaq QopMa)
B cBoro oqepeAl. noApa3Ae"']cercrHa crrHApoM<3anep,rocTg(ne
peflo,lHeIrnq) 3Heprnnr Ir clrrrApoM {tcroueHks (yreqxs) ?Hep
Cfix.{poM<3aneprocTn>:Herny6oKaqkoMa, nnorHo cxaTbrfi por,
rxnepeMfiflflrqa, xxcrx pyK cyaopoxHo cxaTH B KyJraKr,yqaqeH'
noe nbr\aHe. napaJlrLnoIoBHHbt J ua, TyrloBHLla u KoheqHocTeF
c B. JIe,{eH e a 3aprpnx, Kofirpaxrypbr MHnlq r3brKa: Bo3Aeficr-
oAlroi cropor{br:nynr,c cKo"lb3qnllrii(xoar), no,1HHil(rxbrK).
Cauapou <xcroqenxn>: rny6oKae KoMa, por u r!'ra3a orKpbrrbr,
KOHeqHOCrlr xorloaH6re,pyKlr cyaopoxHo sbrnprM!'reHbr,abrxaHfic
xptlnlloe, noT, napalllq nor'IoBltHblJr qa, Tyr'loBnlqa fi KoHeqfiocTet c
oAHofr cropoHbl, Henpofi3BorbHHe MoqexcnycKaHr,{e B A€oeKarue;
nyn6c roHKufi (r3), €ABa y,ro8xMbrii-
2. Cralfiq nopaxeHtr MepfiAraHos (,lerxaq OopMa): napa,rrq
floroBlrHbr rHrla, TyroBxua fi (clHeqHocreri c oAHofi cropoHH, 6€3
flpr3HaKoB (oM6t.
flpl{ flapan,lerrr B craArjll rropaxeHxr BHyrpeHHflx opraHoB
fipeAno,laraerca x nopaxeHae Mepl{AxaHoB. OAHaKo Bo3MoxHa fla-
pafl!'Ier|,lq c lropaxeH{eM To!']bxo Meprr'laasoB,
568
lEPANl|'
A. l,lrnorepanxf,
L CTarrrr nopax€HUt BHyrpeHHItx opraHoB.
IlprrHrl n neqeHlrt. a. flptr ctHApoMe<3anep,oc,t> (Her'1y6oxaq
K o M a ) : < p a c K p b r r r r eo r B e p c r n i r e , I a > , , ' r I r K BA a u r i s < x a p H r , n p u B e _
r € f i r e 6 0 , r b H o r o B c o 3 H a H q e ,o c r a f i o a K a 6 o n e 3 H e r B o p s o r oQ a K r o p a
T o q K r B o 3 . q e f i c ' r B l r cH: f l H q y H r ( 2 6 V C ) , r x a n r y e H ( B H e M e p t '
anaHHar). 6arL-xoii (20VG); 3areM Bo3aeficrBoBa,bHa roqKH:
e a n - c a( 6 E ) , s y u r r y e H ( l R ) . O o H f - r o H r ( 4 0 E ) , r x u e H - a o r( 2 2 V C ) .
6. npr cr.rHApoMe<tcroulexttt> (r,'Iy6oKaf, KoMa): BoccraHoBne
Hfie ),TeptHHot 3HeprHn;
rbqx_n soa,qeicrsus: rxaH-xxoe, (8VC), xyaH'HryeH (4VC)
Kxn-xaft (6 Vc).
B . " 1 ) q a e H e B o r v o x H o c r H T o q H o o n p e n e r ' l f i T t ' .K a K o [ r 1 A B y ]
cnHApoMoB xMeer Mecro (<3aneprocrhr ,,1I, <|lcroureHfie>), cne_
ryer npo!3Becrn nyBKqlfio roqKn ryx'raM-"lfi (36 E) c qe"lblo Hop'
Manr3oBaTb unpKyJrturrc 9Heprfifi B MepHAIraHax Ir, noAoxaaB'
noKa He cTaHer tceH cfiHApoM, Bo3aeacfBoBaTb Ha coorBeTcTByrclllre
2. CTaAHfl nopaxeHaq MepljafiaHoB.
f I p f i H q n n , l e q e H f l H - B o c c r a H o B , r e H u en p o x o a n M o c r t t x a K r f i B I r 3 a -
uxq aerrerLHocTfi MepfiaralroB, HopMaJH3aqfit qrpKy!'IqqnM ?Heprxt
n xpoBr.{.
a- ,rleqeHfie napan rra ,lnu€Bbrx Mbllxq: Bo3AeicrBoBarh Ila roqKl't
snn'ca (6 E), Ara-rx6loHr (4 E), roaH-qyx (2 V), xon'l(oK (4 GI),
rxat cyHr (3 F).
6 . J l e q e H r e n a p a " r r q a n o r o B u l t H r y n o B n u r a : B o 3 A e i c r B o B a 1 bH a
r o q K : l ( r e s - H r y H r( 1 5 G I ) , x x y x - q { ( l l C I ) , x o n - K o x ( 4 G I ) , 6 a r -
ra (BHeMepHrrarlHat), Oyt( rxo (32E), ryx-raM-,1, (36E), 3qft
Kxe (41 E), 6ar-QoHr (BHeMepHAHaHHar).
cpeAcrBa BO3AelC'tBOBarL Ha TOq-
B KaqecrBeaono!'urHre,/rbHoro
(ri Kues-nney(14 TR), Hroafi'KyaH(5 TR). ,ryHr-rbhl(3 TR), xoaH-
xxuey (30 VB), 3broHr-"raHr-ryeH
(34V8).
BoBarb Ba roqKlr: a-MoH (l5VG), ,rneM-ryeH (23 VC), rxoHr-,rlt
( 5C ) .
C n o co 6 B o 3 ae ii c r B r t, B cnyqatx oxa3aHlrt HeornoxHoii
noMouln nyHXrlxq aon)KHa conpoBoxaarbcn xHreHcrBHbIM Bpaue_
flreM rfrbr, rHTeHcxBHblMpa3apaxeHreM c qer'r6lo <pacxpblT f oT-
Bepcrxi rena>, npsB€leHHr 6onr,Horo B co3HaHrre.
flpx ,leqeHl,{x noc,r€rcrBni (B craara nopaxeHrrn Mepxa{aHoB)
Taxxe rpe6yrorcfl nHreHcnBHoe pa3ApaxeHqe Ir nocroffHHoe Bo3-
l e f i c r B H e r , l a M r . q e M p a H b u e H a q a r o . r r € q e H q er,e M o H o g Q O e x r H B -
see. PeKoMeHAyercn coqerarb nr!'rorepanuro c aBnrare!'IbHblMr{ yn-
paxHeHutMlr r{ caMoMaccaxeM 6onbHoro, TaK KaK axrrBHHe aBIl
rareibHHe ynpaxHer{xt noBbrrra()r ero lxaHcbr Ha BbI3AopoB,reHI,Ie.
569
 flpruevaure: ecn, y 6o"rbHoro r M e r c r c qn p a 3 H a K H cxuApo
Ma <Berpa>, Heo6xoarMo 6e3or,rara,re,lbHo npr,tHr-lb coorBercrBy,o
u r H eM e p H ( c v . H H x e , u n p o o r , l a K t H h e a a H H o r o c r i H n p o M a r ,
T e p a f le B I H ' rc c x r f i , 0 O e K r roqrK. npr cHHApove
< 3 a r r e p r o c r x3 H e p r r r , : r o q x a r x a n - r y € s r n K B t i A n p y e r< x a p y ) x ( 3 a -
n e p r o c r b , , r o q K a H q H' { y H r ( 2 6 V G ) < p a c K p b r B a eor r B e p c r r r q r e , r a } ,
npr.rBorrr 6o",rbHoroB co3HaHr{e;.ro,rKa 6arb-xoi (20 VG) HopMans-
3 y e r n e q e H bo , c r a s a B n r r B a e r< B e r e p ) ; r o q x x 3 r b c a ( 6 E ) I , x o n - K o K
( a G I ) H o p M a n r 3 y r o ru a p K y n q u H b ? H e p r r r i B M e p u r r a H e < c B € r , l H i
t H ) i r o q i { a 3 y H r - T y e H( l R ) H o p M a r n 3 y e r3 H e p r u r on o q I < f i ,< c a y c x a e r
oroHr,> BHx3; roql(Ii (poHr-,roHr (40 E) r rxxeH Aor (22 VC) onycKa-
| o 1 y c r p e M n e H H y rB o B e p xl H e p r n o . ) v e H b u a r c r M o h p o t y .
l l p x c r H A p o M e q y T e ' r x h , ? H e p r r r . 1 :r o ' r x a T x a H . K x | o e r ( 8 V C ,
HOpMan 3yer rH-3Heprxro noc"re ee naronorsqecxorc ycTpeMneHnt
sBepx; rovKr.r ryaH-HryeH (4 VC) r xxx-xaii (6 VC) yKpennqror
, H e p r f i r o p i a H r r v a , n o M o r a r c ct o x p a H e H x rxox J H e H H o ifil H - 3 H e p f H H .
llp nopaxeHllfi MeprA[aHoB 6orsHerBopHHM Qa(ropoM <B€r-
p a > c r e A y e r B o 3 A e t c r B o B a r br , l a B H H M o 6 p a 3 o M H a r o q f i x n x q a l {
KOHeqHOCTelt C qelhlo HopMaIu3aur.ir SHeprl,ll,tB Mepra{aHax <cBeT
n H f i s H > r < M a , 1 b r frtH , ; r o q x n x o n - K o K ( 4 G l ) r r x a n , c y H r ( 3 F )
HCnor'rb3yroTcaa!'IrI HopMaax3allrll SHeprlrr Bo BceM opraHIl3Me;
roqxna-MoH(l5VG), "rreuryea (23VC), rxovr-,rx (5C) ane
BOCcraHoB,'rexsq
ncfixrqecKoro pasHoBecfin, <pacKpbrTr.rrokHa cepa-
f. npooxnaKrx(a napannern!
I I p x n o r B , l e H a n f l p f i 3 H a K o B( n o p a x e H { t B e r p o M > ( o H e M e H a en a n h
u e B p y h , r o ' ' ] o B o K p ) ) r \ e H f i eB, H e r a n H a t n r 3 d p I p H f l l M o x H o q p x
t3l \Br'
r " * , i i n r n * u n o i r i q e x :o a r s - x o l ( 2 0 V C ) . O o H r - r x H
KxyK'.'n(ll GI), ryK raM-nr (36 E), rxafi-cyHr(3 F), xon Kox
(4 Gl), (oropbre <HopMan{3ylor neqeHr,t, <ocraHaB"'IfiBalor Berep>,
pery,'rrpylor ulrpKyntul,lrc ?HeprH]r no BceMy opraH13My, He ao_
nvcKar reM caMbIM 3a6o,reBaHfi'r or 6one3HerBopHHx OaKropoB
"ierpa,.
XEBPACTEr|T'
oBullE no4oxEHllt
HeBpacreHr.tt tBnqercq paccrpoficrBoM QyHKutri Kopbl ronoBHoro
M 0 3 r an p n n c f i x o e M o q r . r o H a n b HnoeMp e H a n p e x e f i r f i ,B p e 3 y n b Ta r e q e f o
oc,'ra6,,rrerct npouecc BHyrpeHHero ropMoxeHI,ls. a ocna6,leHte rop-
MOXefifir B K,leTXaX TO,TOAXOTO MO3ra ntlr1aeT qeroBe(a rorHoqeH-
HOro oT!5lxa nocne rpyAoBoro aHt.
TaKae cr.tMnroMr,l, xax 6eccoHHxqa, cepaqe6IleHHe, HanptxeH
Bocrri, rolroBHat 60,'rb, oc,'Ia6,'reHre naMtfx. o6uee yroM,rreHlre, na_
Tonorl,qecxHe nOJlIrlIO(Itx,MOI'yT C"IyxrT6, nO npeICTaBIeHHqM BOC_
TOqHOt Me.(nrlriHbl, noxa3aTe!'IsMl.{HeapacTeHtH.

6. Bo3A€fcrBr€ MeToAoM<uaeT€Hxq, glltoJtotl|t r narolEllE3

O 6 p a 6 o r K a n o 3 o H a , r b H o M yn p n H u l n y : H a n 6 o , i e e p a c n p o c r p a H e H H o fni p r ' { r H o f i H e B p a c r e H s nr B r q l o r c q 6 0 -
| | n e q e H r en a p a r l r q a' 1 r J e B H l v b l l x u . ne3HerBopHbr€Oa(ropbr ncrxuqecKoro nopflaKa. Cpear.r H,rx qp€3-
06,racTb 3aTHn(a, 06,1acrb p,ra, 06.'racr6 BepxHet:i ry6br, ne, MepHo TpeBoxHoe cocTorrHUen , € q a n b , H a B n 3 q H Be M 5 l c r ' I g .r x e B ,
peAHqs cTopoHa foneHrr; c T p a x , l l o M H M o 3 T o f o , H e B p a c T e H r gM o x e r p a s B H T b c qB p € y ! ' I b T a r e
z) neqeH{e napaJlkqa no,'IoBuH6rTyr'IoBr,{ula: pa3{'rfiqHbrxxpoHfiqec(ax 3a6oneBafiflii, oc,1a6,rqrcqHx raKxe BHyr-
3oHa 06'{3aTeJ,rbHoroBo3AeficrBtir; peHHr{eopraHH, KaK cepaqe, fleqeH[,, noq(H, cere3eHKa-
- BHyTpeHHr{rfi HapyxHaq cfopoHbr npean!'ieq6rr fi ronefi{ oo- Bocro.r-
MexaHx3M B03Hr.rKHoBeHfitHeBpacreHl,ll.ro66qcHterct
paxeHHot cropoxbr; rroii MeArulrHofi c!'IeAyloqnM o6pa3oM: 3acroi 9Hepr8fi B neqeHt{
3 ) n e , { e H r eA r c a p r p u u , ( o H r p a K r y p b t M b l x q r r 3 H x a : Bbr3brBaer cocToqHne <orHr>. qTo cKa3HBaeTcr Ha nHb noqKe, 86l-
3oHa o6t3are"rbxoro Bo3aeficrBlrt j 3brBaq €e <fiycrory> H Bo3o6,'raAaHneqH-neqeHx. <llycrora> noqKH
o6,1acr6 sarHnxa, nepeaHfle o6,racrh ruefij BHyrpeHHrq cro- r naccnBHocTb ce{'r$eHxn nopoxaaroT <nyc,ory, cepaua H KpoBx.
poHa npeanreqbr. qro Bbr3brBaer6o,'Ie3Hb.
Cnoco6 o6pa6oTkt. H a B c e xy q a c r x a xo 6 p a 6 o r K a
cpea-
Het asreHclrBHocrr, Ha xaxAyro nrHHro no l5 20 yAapoB, |lep,
cttnnto arr(A
Bbrl ()pc oaHH ceaHc-B reHb. Bropui I Tperfiri KypcH qepel
aeHb. KvDc cocTorT 3 zu ceaHcos O6HqHo pa3alqaror rpri KnIjH t{ecKfi€ OopMbl HeBpacreHn[.
l . < f l y c r o r a > n H b ' n o q K n , n p e o 6 n a , q a H n eq H n e r l e H r : r o n o B o x p y _
B. AyprKynor€panrc ) K € H x e ,r r x e c r b . H a n p q x e H H o c r b , u r y M B y m a x , p t 6 b B r , r a 3 a x .
o c n a 6 n e H r e n a M s r a , p a 3 a p a x r r e , r b H o c , b , 6 e c c o H H r . { q ar,n f l e p e M n e
AypxKy,'rorepanfl nprM€Hqercr B corterafir,rfic rpyrnMx r€paneB- q3brKa; fly,rrbc xanpqxeHHbri (xrceH).
rxqecxfiMr MeToIaMfi.Bo3AeiicrBxe Ha ToqKri cepaue,noqxa, rx- 2 . O c , r a 6 n e H u er H e p r I u n o q e K : r o , ' ] o B H a r6 o , ' r b , 6 e c c o H H I u a .I r M -
noQr3 (Mo3r),3aTbr,roK.rxaH-noH (AP55). noreHqI,ls, npexaeBpeMeHHaH esKyr''rqarq, naTo!'roraq€cKfie nonn10

570 571
 ufis, 60,,llr B o6,Jacru cnrHH. noxonoraHre KoHeqHocrei, rofoBo, O6pa6orKa no M e p l , l A s a H H o M yn p u H q r n y :
KplxeHue, p-F6bB i"1a3ax. 06uee )tovJeHle: ny,rbc r,ly6oKHi I - '{erbrpe yqacr(a MepuAnaHa MoqeBoro ny3r,rpq B o6Jracrfi

3. <nycroia> cepaua n ce!'re3eHKx:6eccoHHuqa, ro,,roBfia,60,,lb. - oAsH yqacror( MepnArraHaroqex B 06,14cru npeafl{reqr,r;

'racTHe cHoBttA€Hl,lq,6e3oTqe,rHoeBorHeHrie, noHr.rxeHHhlfi - npx 6ontx B o6nacrq reMeHr AononHrrre,'rbHar
anneTfiT, o6pa6orKa
yqanleHHoe Ar,rxaHre, o6qee yToM,,refite, Haner Ha ,3brKe. Ilv,,tbc nBv) ,rr.rHr.1i MeprnraHa voqeaoro nv3blpr B 06racrr ronoBbrlr1
roHKsn (r3), rny6oxsi 6 oqeHb Ma,rHi (Bt). r o u x Hr o a n - v 1 xt 2 V t ! o r o q x r r x u e n , r y ( 1 0 V ) l , |y q a c r o kr a a H e -
cpearHHoro Mepr,rAraHaor roqxu rxr,roHr-TbrHb(23VG) ,qo roqxH
lEPANl{' O o H r - O y( 1 6 V C r .
A. ltrnorepafxq
npn reMuKpaHr{r.r, 6onrx B Brrcxax nporBBo,qqrrononHdrenbByro
o6pa6orxy y.racrKa MepsaiaHa xenqHoro ny3r,rpe B o6,racrfi ro-
n p H H u'1 n !,te q e H Il 'I_ HopMa,,rt3autq neqeH't, cHtxeHxe aK,
rxBHocTll rH-sHeprxa; ycrnesfie rjHr,_sHeprx{, r'ltrKBxaaq,lq <orfir>: C n o c o 6 o 6 p , a 6 0 r K q . H a K a x A y r o" ' ] u H x rnoo 2 0 y A a p o B ,
<yxpenreHr€> noqex Hnu cepaqa, cene3exl<r{; HopMa!,rr3auHe o6pa6oTr{a,'rt,'60 ToHri3}ipyroqar, nx6o <nonyroHfi3r.rpyrcuraq
ae- no,lypaccerBaroruaq>B 3aBlrcr,rMocrxor xapaKTepa 3a6oneBaHufl.
rtrerllrHocT! HepBHoi cl,lcleMbt,
ToqKH Bo3AeficrBfifl. llepBbrii (ypc no o4HoMy ceaHcy B reH6, Bropoft fi lperni Kyp-
f l p q < n y c , r o T er)H r , - n o q k r ,n. p e o 6
,laaaHtI tri^-JlerteHl]npxMeHgrcIcH . paccefi Baoufi e o Korb| B roqxt : cbr no oAHoMyceaHcyqepe3AeHb.Kypc cocrorr ag l5 20 cean-
)
6 ^ a r br o f i ( 2 0 V G ) . n o i r x l a r { 6 M C ) , T x a f i . c y H f{ 3 F r . r \ a f t K x e
IJ RI
np o ( , T a 6 , 1 e H x x3 H e p r r { n o ' r e K n p o r r B U r F t c r t T o H H r r p y r c u { e B. AypxKyrorepanxc
yxo-nH B ro'rhr.i: 6arL--\oi r20 VC), rxau-ry
123 V;, veirt vor Bo3aeficrBxe Ha roql(fi:rxaH-Mox(AP55), cuMnaruqecKar HepBHag
r + v u , , x y a H . H r y e Ht 4 v L ) T O H H 3 r p y r c u r ne pe f i x H r a H x e .
i r p r a n y c t o T e l c e p ! u a x c e j e J e H X Hn p h v e H q l o t c , l o H H f t j D v r o . cHcreMa,x{er'1e3Ll
BHyTpeHHen cexp€ur.rH.
flp|l <nycrore> rBb-noqKrj, npeo6nal(asl,lr'reH-rreqeHxpeKoMeH-
u e J { o - n t B r o q h x :6 a r b - x o f i t 2 0 V G l , H o i i . K y a H1 6 M C , . r l x . r l v _
ayercn aononHxrenbHat nyHKqrrq fieqeHb;npll ocna6-
, r' r ( 3 6 E ) , r a M - a M - r e o{ 6 R P ) .
neHfifi 3Heprfit floqeK noq(a.
floMyMo nepeqficneHH6rx roqex, peKoM€HAyercr r,roKarLHoe pa3
flp,t <nycrore> cepAqa r{ cen€eHKfi AononHxrerbHoeBo3Aeft
a p a x e H f i e a o f l o i H r r e r b H u x T o ' { e K ,H a n p H v e p , f l p H l q x e c r u H H a crBrre Ha ToqKr{:cepAqe,cene3eHKa,xenyaoK.
npsxeHxr B o6,1acfr rna I BoueicrBytoj aa rbqxj russ-vxnt (l V),
f l p x l x y M eh r r x e . r n B ' r x a x Ha toqxy e-QoHrt17 TRl.
! e p a n e B T H ' l e c K x r i ? $ 0 e A I r o q e x . T o , t K 6x a r b - x o i UCTEPN9
( 2 0 V G ) ,r x a i - c y r r ( 3 F ) , u o n - i y a x( 6 M C ) I r x a i i - x x e( 3 R ) a c -
n o , l b 3 y t o T9f , t r 1 t l o H H 3 H p O B a H r gn o q e h . H o p v a J l r l a u f iH n e , t e H f i B o c - o6uIUEnOJ|OXEHt{t
,
c r a H o B i e H H Hn c H x f i ' { e c K o r op a B H o B e c l ] t .y c n o K o e H l , tH s e p B H o i cl r c r e . Hcreprr Ha6nroAaercffnp€rMyqecrBeHHo B MonoAoM x cpeAHeM
vbr:rolrKH.rxaH r y ( 2 3 V ) . v c H b - v o H{ 4 V G ) K } a HH i } e H t 4 V C , Bo3pacTe. qarue y xeHurxH. KaK npasu,rro.60,1e3HbpalBfiBseTca
c r ' r y x aI a , l e c r n M y n r r u x u3 H e p f , r Hn o q e l < :f i a t o , r | ( r 6 a t h - x o i { 2 0 V G ) , Bcre,rrcrBreocrxHqec|(o;rpaBvH. XapaKrepHbrn,,re 6o,tbHHxHe-
H o n - K l a H1 6 M C ) . r l K - r a v - r H r 3 6 E ) x r a M - a M . 3 r o ypaBHoBelrexHocTb
16 Rp; eoe- ncHxlqecKoro cocroqHrir, .'IerKa! BHyuaeMocrb,
n e l r c r B l K ) r c u e L l b l ot o H H 3 u p o a a H I t c e p ! u a f i c e j e j e H X r .
B Bocro,{Hofi Meaur{rHe ficreprir onpeAer''lqercflxax <cyxocrL>
6. Bb:4efcraxe M€mroM <(Ber€xflgt
rrr'rorHbrxopraHoB n oTHocr,rTcrI{ pa3pfiAy criMnroMoB <Henpoxo-
O6pa6orx,a no 3oHaJr,HoMy npfiHllrny: anMocTH>ri <noxonoaaHxflBcex (oHeqHocTei).
- 3oHa o6H3are,tbHoro aosaeicrstrq:
o c H o B H a q t o H a B o 3 4 e i C T B l t t : y q a c r o x n o 3 B o H o q H r K aL I u _ Stro.notrt r nATorElrE3
^
) \ ' B O O , l a C TS r aTHIXa:
- AonorHI{Te,'IbHat3oHa BosleicrBat: Bcq DoBepxHocrb roroaH. OcHoBHofinpsqHfiofi so3Hnr(HoBeHxrrlcrepxr{ cqrrarcrcr 6o,re3He-
BHyTpeHHrecropoxbr Ipeanne,{br H ro!,reHr.t. TBOpHbre9axTopbr flcrxnqecKofo nopeaKa npfi ca'rrrxxoM HreficrB
| |pn nno,)\oM a r r n e r xI F p e h o M e H t r y ec ta 4 o n o , 1 H r . j T e , 1 6 H( )a6qp a 6 0t - rloM 3MoqloHar'rbHoM Bo36yxreHrx, nprrBoAqureMK nci,txrqec(oMy
K a n e p e a H e rc l 0 p o H H n p e n l n e q b r . n p f i n a 1 0 , 1 0 r { q e c h H xn o r J t o q r r r paccTponcTBy.
y MyxqsH fi oenrx y xeHurfiH - xr3a xdsora. qpe3MepHbrfirHeB,o6rAa, qyBcrBo xar']ocrx paccrpaI,lBarorHop-

572
MaibHyrc urpKylrqurX) 3fieprrr B Mrfinqax! co3AaroT 3acrot, r{Horaa OqyqeBxe <3ooeKra urnH> Ir BHylxeHne Bpaqa 6o,rbHoMy rec-
r,{ Henpoxoar,rMocTbgHeprrr. zlHoraa HapyueHxe qnpxyrrrrrrfi 3tlep- IJo cBr3aHbr Mexay co6ofi x B3auMo3aBl,rcxMbr.qeM no,,rHeeBocno,lb-
fHx abl3brBaeTcrrTeM, qTo ee oxBaThIBa€T cocTorrHxe <orHr>. B De- 3 y e r c q B p a q s r n M M e x a H D 3 M o MT, e M B b r u e 6 y a e l r e p a f l e B T r q e c K n f i
3y!'rbrare qero Bo3HDKaer6ecnoxoicrBo. L,lcrepxq Moxer 6brrb rax- '0oeKr.
xe BH3BaHa B CIyqaflX, KorAa sHeprxfl <ycrpeMnqeTca BBepx> r T € p a o e B r H , re c x I , ft i e 0 0 e x r ro.rex. Toqk, Hoi,
BMecTe c MoKpoTori <3a6kBaeT> MepxAraHbl, 3aKynoprBaeT <ro!'ro- Kyas (6 MC) t rxaH-MoH17 C) xcnon6yrorcrrKaKycnoxaxBarolqer
cpe,lcrBo; Bo3AeicrBr'reHa roqKy xay-xxe (3 IG) pacceloaer cxon
reHxq eHeprxft;roqKnHrH-,ryHr(26 VG), 6arb,xoii (20 Vc) ll rxan
CltMNTONTAIIIK^ cyHr (3 F) cnyxar A,rH <pacKpbrr|s orBepcrHi rena>, rlrrxauAaurr
<xapHr, paccenBaHxe <orHer; rortKaryK-raM-na (36 E) HopManr.j
y 6o,1bHoro BpeMq or BpeMeHx Bo3HnKaroT npricrynbr 6ypHorc Be- 3yeT OyHxrrfiIoxe"ryaxa. Bo:qeficrrae Ha 3,rn ToqKHnpox3BoAuTct
c e , r b q , 6 e c n p H ' { ! H H b r xc r e 3 , o H M o x e T k p L j q a r 6 , n r t c a T b , H o n o c qer'lbrocrrMnToMarfirrecKoro Jr€qeHfirann perynHpoBaHnqufipKy
o H o H q a H x Hn p H c l ) n a B H o a b B e n p r c e 6 e h a K H o p \ a a , 1 b H H iq e , l o B e x . lflUur ?HepfxfiHa ) qaclx3\ dap)uleHr),
\ c t M n T o M a Mx c r e p n n o r H o c u r c s r a K x e c l l B r x x o M n p o A o ! ' r x s , e r b
Hbrri coH, Borr,Hofi Moxer yJreqbcr cnarb B Heo6brqHoMMecre, npr- 6. BeAetcrBre nreroAox <tlB€relret
qeM He or3blBaeTct Ha ox,rs(, y HeKoropbrx 6o"rbHbrx Ha6",rroAaroTct
raJeHrjq naparuqa urr, Ha060por, floBbrueHHaq noABrxHocrb, O 6 p a 6 o r x a n o 3 o H a , 1 6 H o M yn p r . . H r rof yl :
Ipoxhi cyaoporll. J apyrxx BHe3anHo nponaaarcT 3peHHe, peqb r,']s roHd 06r {dren6Ho_o BoraeiclsHq
cnyx, y rpeTbax norar'rrercrr oulyueHre nocTopoHHero npe,4MeTa B o c H o B H areo d dB o r l e f i . r B h ql :u a c r o r .n o r e o r o u n r x aT h , . .
,
ropr're, xor9 oocneaoBaHfieM orqyUleHxe He noaTBepxaaercr.
B { ) 6 u l e Mc r M n r o M a r l i K a r c r e p n s B e c b M ap a 3 H o o 6 p a 3 H a n , pr{,leM Aonor'rHrTe,rbHaq3(]Ha ao3AeiicrBnq: BHlrpeHHne cTopoHbi
Ha6,1rclarcrca 3Haqrre,rbHhre pa3axqfiq y pa3Hbrx 60,'rb:rbrx. npeAr",r€qr,q
r.jro,reHx,6oKoBHecropoHbrrpyAHoiiK"rerxr, BrryrpeHHqt
s fiapyxHaq clopoHbrnpeanneqr,rr roreHri.
TEPANT'
O 6 p a 6 o r x a n o M e p n a x a H H o M ny p r H u n n y :
- yqacroK Mepl,lAxaHaxerqHoro ny3hrpHB o6nacrn pe6ep or
A. llrnoT€pantg roqKn Hrr-Hryer (24 VB) qo roqxr.r xusl,uon (25 VB) x eure oAnH
yqacTox 3roro MepuAHaHaHa ror'reHr.t;
flpnHuun ! ' r e q e H a r . B o c n o a H o -n a o c c r a yqacToK MepxAtaHa neqeHx B pe6epHoii o6,racrfi or To,lKr
c x o r o p a B H o B e c r . t rH. o p v a r , t xi a u H r n e r r e j b H o c T l { H e p B H o i c x c r e M H . Kx-MoH(14 F) Ao roqKi.rrroxr-uox (13 F) x yqacroK r{epHAsaH,
,qrKBHIaul,lq c H H n p o v a {. / K a p H r . o n ! c h a H n e B H l ,i . M} r H o f r 3 H e p jHH . . neqeHH Ha ror'IeHl,l;
. y c n o K o e H f i e !{ p y H X U H rnl e ' t e H r H x e , l } a K a . - KpoMe Toro, AoironHsTer'lLHoeBo3AericrBxe npfi ro,,roBHbrx60
I oqhH BorneicfBxq: H o ; - K y a (H6 M C ) , r x a H' r o x ( 7 C ) . rrx * xa MepxAqaH xenvHoro ny3brpr B o6,,racrfi ronoBl,ti
HqH-,ryHr(26VG), xay-Kxe (3 lc), riarr-io* lZOVGy, rxai,cyir - n p x 6 e c c o H H n r r -e- H a M e p x A U a Hc e p A q a B o 6 n a c r x n p e A -
(3 F), ryK raM-"rr (36 E).
floMr.rMo eroro,Annne,{esnsHexoropHx HapyueHHfi peKoMeHAyer npq ro!'roBor(pyxexfi{ u pq6fi B rra3ax - Ha MepnAnaH no-
cs Bo3AetcrBoBarb Ha roqKH:fipx napar'rHqe KxeH-HryHrl5 GJ), qex B o6nacrr.r npeAnner{br;
KxyK.,r{(ll cr). xon.KoK(4 crJ, Qyi.rxo (32 E), suoir-,raxr,ryen - npH cHxxeHlr{ aflnerrTa H a M e p a A s a Hx e , l y A K a B o 6 n a c r r . {
( 3 4 V B ) , 3 q f tK x e( 4 1E ) , n p n y r e p e c " r y x a e o o H r ( t 7 T R ) , r x x H b -
xyHr (19 IG), npr,yrepe 3peHrin rbrHb,MrrHb (l V), 6onr,qr Cnoco6 o6pa6orxr.r. B c e y q a c r x r . {o 6 p a 6 a r r ' l B a r c r c n
ao
(20V8), KyaHr-MnHb (37V8), npuonryqeHxrnocropoHne.o npeaMe- n p r r H r r n n y< n o r ' l y y x p e n r e H { r n o n y p a c c e r { B a H x e ) .H a x a x A y K , n n
r a B r o p n e- T x H e H - a o r( 2 2 V C ) , r a H - q y H r( 1 7 V C ) , 0 e - 3 y ( 1 3 V ) . H u r c n o 2 0 _ y a a p o B .f l e p B H i x y p c no oaHoM! ceaHc) fia)hnHi
C f l o c o 6 B o 3 A e f i c T B f i t r . I I p , l n y H K u r e xH e o 6 x o l x M A o o- aeHb. aropoH H rperHH hlpcbt no oaHovy ceaHc) qepel aeH6
SHsarbcr cr.j,lbHorocneuHoxqecxoro ouyuleHrrH <3Ooekra rrr,ru>, Kypc cocrorir s3 l5 20 ceaHcoB.
arrs qero c!'reAyeT npeaBaprTe,1hHo pa3brrcHurr.6onbHoMyxapa(rep
sToro oqyueHnq (qyBcrBo HanprxexHocT,, rgxecrn r,rr'lr,t ouyqe- B. Aypaxyoorepanxr
Hlie cpalpf4oJ ToKa!. Koropoevorlr pacnpoctpaHslhcrno xoA)
v F p H n H a H al lll.H X U r r or l y q u ec o n p o B o x A a tHbe o 6 x u a H v H \)aKra 3 a - B o u e i c r B H e H a r o ' r K r . c e p a u e .n o q x a . r f i n o O H 3( v o 1 | t . T x a H - M o H
Hnrrrt 6o,1hHoMyo ToM, riro oH aonx€H !e,'tarb, qro6bl noMoqb lAP55),r H a y q a c r h r . r ) r ! H o i p a K U B r H b r .c o o r B e r c r B )t o u l f i e n o
Bpa'{y. p a x e H H b r Mq a c T q Mo p r a r r r 3 M a .

571
 npIMeqaHfle: n p r , r e q e H r xr i c r e p r r jB a x x y r op o . r r b
rrpaer 2. C{HApoM<nycrorbr'. npr (nycrore} 3Hepfr{q(o6qeft cra
ficr,rxorepanur;Heo6xoAxMoyae,rxrb gToMy MeroAy Aorx8oe BHx- 6oc1{): rono8Hat 6onb (nepro/raMa),ycr,reHxeee npn HanpexeH
MafiHer, ?(pOeKTrBHo npsMeHr,bero B 6opb6ec yxa3aHHHrlt Ha- rofi yMcrBeHHoipa6ore, yroMJtneMocr6janarxr, yqauleHHoe lbrxa-
pyueH}leM. rrre; ny,rbcnycroii (xH).
npx (nycrorc' rpoBn opoAo,rxsre,rbHarHoK)lrlaqronoBHaq
6onb, conpoBoxla11)uancqcepaue6rreHHeM.TpeBoroi: nynbc roHKrii
roJtoaHAg 60JIb (re).

o6ttll{E noJtoxEHHt
TEPANT'
fo,loBHat 60,16 oaHH l,tr Ha160,1ee pacnpocrpaHeHHHr rr\4nro
Mo6. olHocqL[Hxcsx cavblM parrrrqHHv ia6o"leBaHHeM. CrMaioM A. l,lrnor€parnc
3'ror K roMy xe nMeer cy6texrnBHbrt xapaxrep.
B 3aBxcl.rMocrfior ocxoBHofi6o,1e3Ht ro"roBsble6onlj 6brBaror llpaMeHtTb c"leAyeTxax cnMnroMarrqecKoe,TaK I,' naToreH€rriqecxoe
pa3r'r[qHbrM,IIo xapaxTepy, no ror(aJrll3auxx fi no conpoBoxAaro- r'reqeHlie,CrMnroMarxqecxoenelreHaenpr qBHoBbrpaxeHHr,rx ronoa-
UII,M CE CIMflTOMAM. Hbtx 6o,,1txrMeer cBoa AocrorrHcrBa.
C"reAye,rpa3nn.rarb ocrpyro ro,rosHyro 60,1b (c,lHIpoM <no,rHo.rbr>) l. [laroreHers,recKoe!']eqeHxe.flp, flpocryAe BHeuH€ro npdfic-
r{ xpoHfiqecxyrc ronoBHyro 6(),1b(cxrrapoM <nor'rHorbl>r,tcxHApor{ <nyc xoxAeHsq"peKoM eHAyercr npr{MeHerbcxeMy ,rerleHlrq60,re3HefiB lix
<Hapy)KHoH> craarrx-
Toqxa aosaeficrnuq:ooHr-qr (20VB), xon,Kox (4GI), Hroafi-
3TllOJrOt't{t H nATOTEH[3 xyau (5TR).
flpfi cKonneHlrrMoKpoTH,npeo6,raAaHr,tx <norHoTbr)!'relreHle
Ha 6o,ree pacnpocrpaHeHHbrMr nprqxHaMr, Bbrsl,rBaroulrMr roroB- 3axJroqaeTct B nuKaxlaqlll,l cKon!'leHI,
t Mot(poTbl.
HyIo 6onh, gBntlorct npocTyla BHemHero npoHcxoxAeHns, Br,r3BaH- ToqKn Bo3AericrBrr:vyxr-xyan (12VC), ryK raM-nx (36E),
Haq 60,le3HerBopHofi 3Heprlefi <Berpa>, cxonreHfie <norHorbr>, ooHr-,roHr(40 E).
ycTpeMreHueBBepx 3Heprfir neqesr, (craHApoM<no,rHoTH>) fi,1fi qpe3- flpfi ycTpeMneHn[sBepx 38eprqx neqeHl reqeHne cocTotT B
MepHat yToMrteMocrb, oc,ra6,'teHfie3Heprfirt fi xpoBfi (crHApoM <nyc- HOpMarn3aur,rn neqeHv.ocraHosxerPeprl,|H.ycrpeM,lercurelrcflBBepx.
To,rKr.rBoi.leicrBrr: rxafi-cyHr (3F). ryK-,1aM.xxan(41 VB),
6o,'IBHerBopHat 3Heprxr (Berpa) Broprae,rcr B o6nacrb reM€Hfi, 6arL'xofi (20VG).
Toxrr3upytoqee
npt,l (nycrore) gHeprrrfiHeo6xoruMo,'ieqeHr{e,
flpoHnfiaeT llo Mep{A}taHaM B ro!']oBHofi Mo3r u, oc,raBatcb raM, BEI,
3r,rBaer roroBHyro 6onb, <Xapa>, Ha(onMBoaqcr B xenyaKe, nnfi 3Heprr{rc.
<oroHb>, Bo3o6,1aAaBrxfifiB neqeHr, xe,lqHoM ny3brpe, ycrpeMrBrrrrch ToqKx BosAeicrB[q: AaH-qyHr (l7VC). xyax-nryen (4VC),
BBepx,3arpyAHser tlnpKyrrqxro 3HeprxI B 06,racrt ronoBHoro Mo3ra xxr'xan (6 VC).
fi TaKxe Mo)xer BH3Barb ro,'roBHyro6onb. nptqfiHofi rorroBHoi 6onfi - llp,{ (nycToTe> KpoBx npyMeHrroT!'reqesre, ToHr.3xpyloqee
M o x e T n o c r l y x r - l 6 t r p e 3 M e p H ayqc r a n o c Tb , 3 a r p y a H e r o u a q f l o c r y n n e ,
Hrre tH-3Heprfir B o6,racrb ronos-bt. ToqKfi Bo3AeicrBfifl:KaH-3y(l8V), xarb-3y (l7V), ryK-raM-,Itt
( 3 6E ) .
CTMNTOMATI{KA 2. CxMnToMaTuqecKoe ne.ieHr€. Bo3AeicTByroTHa roqxt:
- IJpr,6onfi B nepeAHefiqacrr.rro,roBbr aH-AbroHr(sHeMepLtAt{-
par,r{qaor nBe aHHaq) c Ma,rb'M KpoBonycKar.rxeM, rlay-3roll (8 E), 3fli-xx€
OodvH aaHHoroHap}u,eHxe
l LnHnpoM .no!'rHoIti, llrpocrylla B,leuHefo nporcxoxaeHfir. (41 E) c uenb'o npoxoAnMocr,MeprAHaHa <cBer-
B b r 3 B a x x a s6 o r e 3 H e r B o p H o f3i H e p r f i e i < B e r p a > ) : n o B h r e H H er e M n e -
parypbr rena, 03806 n!'rfi 3a,loxeHHocrb Hoca, xarxenb, xp nH, nyr6c - npt 6ontx a 3aAHei qacrfi ronoBb|- (DoHr-rrH(20VB), xay-
xxe (3 IG), 6arb-xoi (20 VG). KoH-,roH(60 V) c {enr,n BoccraHoBne-
f I p H c h o n " T e ' r H\H
a ) , H o i t v u h p o r H , s b t r B a H H o i r a c t o e Mn r u l r : T o l l l . Hut npoxoAxMocTH MeprAnaHoB<BenrrKnfirH>, <ManHfiHH, ri 3aAte-
Hora, oluyqesse norHoTH n rrxecrx B xHsore, xxcr'laqorpbrxKa; cpeafiHBoro MepsaIaHa;
n y n b c H a n p q x e u s h r f t ( x r o e H ) ,c K o n b 3 r r r x n ( x o a r ) . - np, reMLrkpaHLIx - QoHr-qu (20VB), rxafi-3broHr(BHeMepr-
f l p s y c r p e M , r e H n lB, {B e p xe H e p r r E n e q e H H :6 o n , B o 6 n a c r x p e 6 e p . AraHHat), 36IoHr'Oy (38 VB), ryK-naM'Kxan(41 VB) c qerr,roBoc.
r o , r o B H a r6 o n b , p q 6 b B . n a 3 a x ; n y n b c H a n p q x e H H d t ( x o e H ) . craHoD,leHnq flpoxorl \rocrx Mep[aHaHa. ManHfieHrl
576 577
 npr 6oflj s reMeHHofio6nacrfi 6arb,xofi (20VG), rbr
(BHeMepaA
TxaH-TxoHr aHHaq),THH-xoti\22VGl Mfl BoccraHoBJre- aTno!'loaltt { nATorEHE3
HHr npoxoAlrMocTrrMep{arara neqeHr,rl{ 3aAHecpear,rHHoroMeprr-
nprq[Horl Bo3HxKHoReHr AaHHoro HapyureHur ,Bl,rfleTcq qaxle Bcero
AfiAHA,
cnaoocrb 3HeprHs noqeK, qro MeDae,r DtTare,,rr,Hofi gHeDrllx noll-
H v d r b c g B B c p x . h f o J o B e r t s p o x l l e H H o eH a p y u e H x e , , r r 6 b e r o p x e .
MeroAoM<{BereHrrt
6. Bo3Aeficrsr,r€ rrr're H3BHe 60,r€3HerBopnoi aneprtl, 3aKylloprBaronletl <ro,,tocoBoe
oKHo. fi Haplurarcuer.t ero HopManbHoe
O 6 p a 6 o r K an o 3 o H a n b H o M f! l p x H u r n y ' Q l H x I l l H o H H p o B a H r e( n o _
' r e r c r B f ie , r H O e | ( u x o H H oor r a 6 o , t e B a H H r ) .
3oHa o6q3are,'tbHoroBo3AeicTBxfl ;
- ocHoBHan3olra ao3AeficrBuq:3aTbltoqHat 06,'IacTb;
- 3OHa IOnOJrHrTerlbHOfOBO3AeiCTBItfl. Cl,MNTOMATI,iXA
KpoMe Toro, aonorHnrer'lbHo Bo3AeicrByror: yrpaTa c,ryxa { peqr-.Llpyrux crMnroMoB
B o p r a H e c , r y x a o 6 b r , t H oH e
- npr 6onri B reM€HHoi o6nacrfi - Ha BsyTpeHHrorofloBepxHocrb r a 6 , 1 r o r a c r c a .y h e x o r o p b r \ a c r e r l o r p a n r q e i a n o r s x x H U c r r , r r b r x d
roneHI{ Irnt frpealrneqhf,; 3Br'rny Bpox,4elrHon vKopo'teHHocTll y3aeqKx q3L,Il{a_
- npx oAfiocTopoHHet r.trr.t ABycropoHHei ronoBHofi 6o,,rs
Ha nepeaHroronoBepxHocTf, npeAnneqbr r{ roneHx; TEPANT'
- npfi 6onx B 3aaHei qacrr ronosbr Ha 3aAHnro cropoHy ro-
A. l,lrnoTepantf,
C n o c o 6 o 6 p a 6 o r K rr. 3oHa o6r3are,'rbHoro Bo3aeficrBne
o6pa6arbrBaercq co cpeAfiefi fi HreHc:rBHocrbro, Mecra lroKa,r|l3aur. r npnsuxn B o c c r a H o B n € x g en p o x o l n M o c r g M € p r j
6o,rei - co qra6oii xHTexcr,tBHocrbto.l,lnreHclrBnocTr, 06pa6orKl 3oH a u a H o B , n o a x o a s u r l r i K y u a M , q 3 u x y ; . r o H t r s x p o B a H n e3 H e p f u H
ocHoBHoro r Aonor'IHnre,'Ir,HoroBogAeicTBrrq onpeAeJIfleTcflcocrof, Hri-
eM 6o,r€3Hr. Ha Kaxayrc nljfixrc no 20 yAapoB. B req€Hne nepBoro Tovxx eo:AericrBrr: r x r ] H b , x y q r( l g I G ) . r x r H b - x o , i
Kypca exe4HeBHo no oaHoMy ceaHcy, B TeqeHr{eBToporo x rperbero r 2 V B t , e ' Q u H rt l 7 T R , . a - M o Hr l S V G ) . n | e v - T y e H( 2 3 \ C ) . 6 a 1 b .
y o n l 2 0 V C ) , r x a H - { )( 2 3 V ) . " \ H - \ a n ( 6 \ C j .
KypcoB - qepe3 !eH6 no ceaHcy- Kypc cocror.rr H3 l5 ceaHcoB. Mexay irodirh)aH (StRl.
KypcaMr, - nepepHB I HeA. qyHr-rhu (3 TR).
Cnoco6 Bol.ae-ftrrarn. tlpr ocna6,leHrH , H e p f H nn o q e K
F O l I e t C T B O B a r bH a I 2 t o q h u B r o H e H a p l u l e H r l t t i H a r o q K l rT x a H , !
B. AypxKynor€panrn (23 V), xxx'xafi (6 VC).
B c , l y q a r x r n y x o H e M o r b rK a K n o c r e A c r B 6 q q H d e x u r r o H H o i 6 0 -
Bo3AeicrBteHa 6oreBueMecraHa yqacrxax roqeK: ro,'toBa,no6, , l e r H H s o l a e i c r s o s a r h H a I 2 r o q i { Hs , o u e u a p v u i H H q H a o n o n a r -
r e r l b H oH a l o q x H : H r o a i - K y a Hr 5 t R r . r y u r - r r i i ( 3 T R , 6 a r b x o n
Aono,lHxreft,Ho Bo3AeicrByor Ha roql(ll: (20vG)
npt,l 3aKynopxe Mokporbr, npeo6,'raAaHrl,l <norHoTbr> - xe,ry- Tepa n€Briqecx rfi 3O q e K _I I y H K u rBrr o q x ,
AOK; Txxlb-xyHr (l9lc) n Hr-MoH(2i O e K r r o
iR) noaso,,ueraoccraHoBrrsnpo-
npll cxoll{'IeHfi, 3,{eprxr neqeHtl fleqeHb; yolr,rMocrb)HeprHHB vepraHaHe "Bc,1HKfijifljr.. ToqK
e doHr
npx <nycToTe, 9Heprrfi - nerKxej l l 7 T R ) . r r h H b - \ o rn2 V B i . H r o a i - x y a (Hb T R , x q l H f - r b b(l 3 T R )
npn <nycToT€> KpoBU - fleqeHb, cepAue, cen€3eHKa. ' i c f l o n b t y l o r c r l a j 9 H o p M a n x r a u h x l o K a ? H e D f l ] l l B M e D 1 4 f i a H e( M a , t H f i
qH!. To,txlrrraH-r) {23V1 H K\r-\ai t6VC, coy.i<ara,r; rorl:r.l
poBaHnqnoqeK,yxpelneHrr sHepixH.Toqxa 6arb_xoi (20VG) uc-
TTYXOHEMOTA nor'lb3)eTcr npfi Heu6xoAr.ivocrrj HanpaBrthsHeprqrcBsep\, a roqxH
O C H O B H H EN O J I O X E B f i q a . M o H{ l 5 V C ) n , r r e v r y e H t 2 3 V C t p e r l r r r p l r u rn u r r y n n r H r e
?Hep.
I Hr.rl< MbluuaMtrHKa
f . q y x o H e M o r aB c r p e q a e r c qq a u r e B c e r o y A e r e i i . 3 r o H a p y u e H x e q s - I I p H M e q a r l . . e . f , r y r o n e r a u roat H o c H r c qk p a 3 p r n ) r p y l H o
rqerca p€3ynbraroM 3apaxeHug Bo BpeMf poaoB finll B neproa, H3"reqriMbrx 6o,1e3Heft, rpe6yrcrurlxH or Bpaqa, r or 6'o,rrioro O6,irruo-
K o r A a H e p B H a rc u c r e M a y p e 6 e H K an o n f i o c T b t oB e p a 3 B u n a c b .B p e - fo repneHfie. JleqeHte lor'lxHo 6HTr, O6panleHo npexae Bcero Ha
3ynbrare nalororxrrecKo.o Bo3ne[crBxff H3 ronoBHoi Mo3r y pe6eHKa !crpaHeHHe r,1yxorH.Kax ro,,rtxonoqsarci neoBhre nDr3Haxr.j Boccra-
c T p a A a e rc n y J ( ,q r o r B n s e r c r o p e n f l r c r B r . { e!M
,rr pasaurnr pevx. Cpe- roBrleHrrc,lyxa. ueHrp rqxecv repanesrr,ricxux nepexo
''r(r Ha pa3BHr )cx,lxi
Afi 60,1bHbrxpa3rfiqarcrcs oorHocrbto r{ qacrsqHo rryxoHeMbre. Hepeqfi.ti npuuecce,re,reH{r Hrvorbrc,tea}ero6parxrh
Ma(crMyMBHfiMaHdrr Ha O6yqeHHe pe6eHXaycTHoi peqfi.
578
l9'
v. 6oJrE3HlrnlllEBAPl{TEJtbHOACrlCTEMb| 2. flocneAcrBHe (B.'raxHortrMoKporLrr: xaK npaBxno, oqynreHxe
pacnfipaHle B rpyAl.t,To[rHora c BbrAe!,reH{eM c.nllgtcrori MoxDorbr.
TOTIIIIOTA.
PBOTA cepnue6HeHHe.6e,1Hfi Harel Ha e3HXe.[lvnbc cxo,l$eurrft lxbart.
noroxEHxt 3. []ocjeacrBre HenpaBr,1bHoro pexavi nurarnn: s3tryrre,flepe
ocHoBHbrE norHeHHocrbx 6orb B xgBore, ycfi;rBarcquecr c npxHrr,rlreM nrur,
B K , l ' r H f i q e c x o i n p a K r l { x e r o n 8 o r a x p B o T a a o B o , l r , B op a c n p o _
3aAepxKa r€OeKaqxlr,Bs3KI,l*xe,rrbrfi Ha,,rerHa r36rKe:ny],tbccKor'tb
1qurfr (\oar). florrHHii(r\bix).
c r p a H e H H H ec u M n r o M b l ,n p a c y u f i e M H o r x M 3 a 6 o n e B a H L ' M , f l o 3 r o '
r i u p u " a o , r * e n , c o a H o i c r o p o H H , B b r n B x r Lo c H o s H o e3 a 6 o n e B a H s e 4. flocneAcTB"enepeBo36yxAeHfirnctxxxr{ (o6r.tAa,rHes): 3Heo_
t i r o B u n o o s e c r x f l a r o r e u e r n q e c ( o er e l { e H a e ) , a c a p y r o f i
- nocra_ fHfl neqeHrB 9Tov crlqae ycrpeMjrercr BBepx.?Hepfrg xe,rylxa ie
t{36aBI,rTb 60''IbHOrO or rouIHorbl (cl,lMnToMart'{ec(oe B COCfOqHT,lriOnycTtiT6cs, LITO BhISbrBaeT pBoTy ocTaTKaML ntuk
DaTbcr 6Hcrpee c
ire'rer{r.{e). Kr,rcrhrM3anaxoM, 6onb B noApe6epHoii o6,racia; ny,r* HanprxeH_
Hbrft lxroeHL
3TtOnOrEt
" nerorines 5, noc,,reAcTBte <nycTorbr>, ocna6JreHu, gHeprfio xenyA(ai He-
npepbrBHaqpBoTa, noHrixeHHbri anreTfiT, rro!,ryxHAr(HencnpaxHeHfi ,,
MexaH!l3M Bo3HtiKHoBeHr.rr rotxHorbri pBorbr npeAcraB,'Iterct c!'l€_ ToHXLii cnr3Hcrhli Ha,,Ier Ha t3brKe; vrotltrreMocrb:
AyrolqsMo6pa3oM. n y , 1 6 cn ) c l o f i ( x b l ) .
Bo,r$HerBopHbre OaKTopH <Berep-xorroa>, <xapa-Bnax-
fiocrD, npoHrKae B xeryaor(, Hapyrxarcr HopMa{,rbHoe rupkynfipo' TEPANI,''I
BaHxerHeprufi B o6nacrr.rxe"lyAKa, Bhr36raaqroluHory, pBory,
Xfia(ocru opraHfi3Ma (B BrraeMoKporbr <B,raxHocrHr) Hapy. A. llr,roTepanne
uaroT npoxoasMocTbB cpeaHenqacTr,rfyr'loBUqa, qTo npentTcTByeT
onycxaHrro3seprfiu xe!'ryAKa,3acraBnrr ee ycTpeMnrbcgBBepx,BbI- fl p fi H u 1l fl !r e q e.H lr s. Hopva,rlsaqun
3HBarTeMCaMbrM TOuHoTy,pBOTy.HenpaBrnbHHii pexrM nIrTaHHt eyHKqir, )KenyAKa, ony-
cxaHfie ycrpeMxBuletcr BBepx 3HeDrr,tlt
np BoAr,rTK paccrpotcrBy nuqeBapeHr,rr,qTo oKa3uBaer Blt}rtHxe Toqxu Bor4eicrera: v y n r - x v a t t l 2 V C t , T V kr a M - , 1 r
Hacnoco6lrocTb sHeprfi xe!'ryaxa nepeMeqaTbcrBBepx-BHIr3ll npn- ( 3 6 E ) ,r o f r - x y a u{ 6 M C j . K o H r - r o (t 4 R p ) .
aoafiT x Tol[HoTe, pBoTe, npn 3Morlr{oHa,/rbHoM n€peBo36yxAeHB}l llononHHrerbxoeBolAefictBHeHa roqKH:
3Heprrr neqeHHTerrerBcnrrTb,a sfieprrq xenyAKa, He 6yayqt B co- npr crxApoMe(xapbr> xon-Kol((4GI), xofi-ArHb(44E);
cTorrHflronycTHTbcraHx3,Bbr3brBaeT Tol[HoTy,pBory. lrprr <nycToTe>, n p r l c H H A p o M e c r o r o r- a ' B x , y ( 2 1V , . r x H o H r . K y a tH3 \ ' B ) ,
cra6ocTr{cene3€HXxH xenyAKa paccTpasBaeTcsnfiueBaplrTerbHHi oflycTr,rB loqxy KoHr-ToH(,1RP),
flpoqecc, nrua (3acTarrBaeTcc>, qTo npr,rBoaHTx forlrHoTe, pBoTe. IIpH cxHApoMe.MoKpora B'1ara, (cKonneHue,hH4Kocleri
nepeqrc,'rexHHeOaKropH Hapyuaror cnoco6Hocrb3Heprlrricp€A- r e , l a l ! a H r - , r y H r { l 7 V C r , O o H r - , r o H rt 4 0 E r . o n y c r x s r o q K y
Hei, qacrE TynoBxura nepeAsrrarbcs BHx3 u BBepx. B p€3ynbrare KoHr-roH(4 RP):
gTofo sHeprrHxenyaKa ycTpeMnceTcrBBepx.qro cnyx'rr npHqxHon npu HenpaBIrJItHoMnfiTaHfiI,t,BH3BaBlxeM3ACIOUnr{rIH
y x} a
BO3Ht,lXHOBeH l t 3 a H H O r oH a p y m e H H q . x a - K y a H( 7 E ) ;
npll nepeBo36yxAes!! ncrxxKri (o6rla. rHes) _ 3broHr_
ooPMbt HAPyutEHflt n a H r - r y e H1 3 4V B ) . r x a i i - c y H r( 3 F ) ;
np (rrycJore> ,{ cJra6ocrr 3HeprHI,xe,,ryAKa r6rj3y (20 V),
O6HqHo pasrfiqalor ntr6 QopM HapyrreHr{q. r H o H r - M o lHl 3 F ) .
l. flocneacrBl,le npocryaHbrx 3a6oneBaHxfi, cBs3aHHbrxc 6one3He- C n o c o 6 Bo 3 ae fi c r B x qr npr cnHApoMe <xo,,roaa>
rsopHr{Mu (pa(TopaMll (Berep-xonoar, <xapa-B!']axHocTb>, fIpfi cn€Ayer
nprjMeHrTbyxonH c oc,raB,'reH[eM nr!,] ]r npqxriraHHe; npr{ qiH4poMe
npoHr(HoBeHfill 6o,,re3HeTBopHoroQaKropa <xoroA> B xenyaoK: <xapbr> IfJrH t3BneKaoTcrrcpa3y noc{,rey(ora, npHxuraHUeHe npH_
pBora c BbraeJreHUeM np€pa'{Hoi xraKocrfl l,nr cr'rr.{3xcro[ Maccbl, MeHqroT;Koraa 3xeprflt neqeHl oxa3bIBaeTOTDtllafer'l,HoeBo3aeli
rorrHora cnycTr A,lrjTerbHoe BpeMc noc?re npxHrTlrq nHUlt, 6enhlfi crBae Ha xenyloK, nprrMeHrrcr <paccerBarou[e) yKonrrr B Totrxr.j
HaJrer Ha rl3brxe. flynbc Mea,1enH6rfi(,{r). HapyueHre qacio conpo- M€pfiAHaHaxenylKa, np& <nycroTe> 3Heplrifl xelryAKa - roHH3Itr
BOXAaeTCTnpo3paqSOi MOqOfil{rX >Kr,rAr(r.rMr,r l,IcnpaxHeHutMl.r, pyloull,IeyKorbr.
nprr cxpbrroM nprcyrcrBr,r, 6one3HerBopHoft gHepr H <xapL > TepaneBTHqecxufi gOOe(r roqef_ Bo3AeficrH
BHyTp{ OpraHr3Ma TOUHOTaqaIUe BCefO notBrf,eTcq Cpa3y Xe |IOCre
B rae
r o ' r x r q l H r - k J a H{ l 2 v _ c j . B x - 1 } r i l V t , x o n - x o xt 4 c l , , r y K - r a M , 1 f i
npnHqrnH nnqr, pBorfiar Macca ltMeer Kltc,lblfi 3noBoHHbIi 3anax; ( 3 6 E ) _ r i . h o H r - r ot H4 R P ) o n y c K a e r H e p r H Kx)e j l n K a . T 6 q x aa a s .
Ha6nloAa|orct 3anop, xe,,rrbrfi Ha,'rerHa r3br(e, ny,lbc 6Lrcrpblfi (caK). q y H r{ l 7 V C ) n ( p o H r . n o H{ 4r 0 8 r c , I y ) k a I a . r ' l' 1 x K B x a a u rcrx H n p o v a
580 581

<MOXpOTa-BJraxHOCT6r,KoTopbrn OpUBOAHTX OulyqeH |{) pacnUpa-
Hlre B rpyari. ToqKa xa-KyaH (7 E) c,lyxHr A,lq reqeHHt npI clisApoMe
<c(onreHue norHoTbIr. a <pacceaBarcr{ri> yr{on a roqKfi 36roHr'naHr-
ryeH (34 VB) l, rxafi-cy8r (3 F) no3Bo,lqer EopManx3oBar6 cocrotnae
fle'refin u 3HeprnI Bo BHyrpeHHrrxc,'rorx opraHx3Ma- loHfl3l,rpyrcuaq
n y x K l t r { er n l l n p r x l l r a H B e r o q e K T b r - 3 y ( 2 0 V ) n r f l o H r - M o H ( 1 3 F )
yKpenncer 3Heprflro ce,re3eHKr, ycrpaHre, <nycrory> r <c,ra6ocrb
3Heprrfir xenyaKa.
B. Bo3Aclcraxe x€ro.4oM <uacr€xrq,
( ) 6 p a 6 o r l { a n o 3 0 H a , r b H o M yn p x H u x n y :
- 30Ha o6t3aTerbHoro Bo3reic, Br.rr:
BepxHtfl qacTb x,Bora;
- nepeaHrf cTopoBa rorreHv_
Cnoco6 (:)6pa6orxrr: Bce yqacrKl{ o6pa6arbrBaror co cpeaHeii I,rH-
reHcMBHocrbro.no 15-20 yAapoB Ha KaxAyro r'rr,rHurc,
oaHoMy ceaHcy.
06pa6oTXa no roqeqHoMy npxHurrny. CxeMa,le
q e H a ea H a a o r r q H ay K a 3 a H H o rBi b r u r eH
. a KaxayroToqKy no 50 yAapoB:
Bo3reficrBxe cpeAHet rrHreHcxBBocTlr,erreaHeBHo no orHoMy ceaHcy.
EOJI1I B XEJIYA(E
ocHoBltbtE atoJtoxEdltt
Bonfl - a,1aBHr,lficxMnToM 6one3Hefi opraHoB 6protxHofi no,tocrfi:
Bocna!'leHqfl cnH3t{cTofi o60no'{KH a nsar,t xe,ryaxa, H3BH ABeHaaIla
l r n e p c T H o a r { r u l K H .o n l u r e H H q x e J l l a x a , p a K a x e n l a K a . p a c c T p o i
crBa HepBHo[crclevH. rHHelBHp]tourei xer'lyaoK I r !.
STgOJtOfht ll nATorEHE3
Hafi6o,'ree pacnpocrpaHeHH6rMs nprqxHaMr.t 6onefi B x€nyAxe rBnr,
rcrcH <nycToTa xonoa> cere3eHKr,rx xenyAr(a, <xapar xenyAKa,
HenpoxoAr.rMocrb3Heprtx; 3acrofi 3Heprfli neqeH,r 1rxenyal<a; 3acroi
nfiufi; <MoKpora - Marar, 3acrofi xpoBfi, Bce gTu rBneHfir Hapyuaror
oyHKufirc xenyAxa, cnoco6Hocrt ero 3Hepr-rr nollrHMar6cq r onvc-
^ a r 6 c r . ' r r o H n p r B o n r r x 6 o n q r u . O a x a x o e x . l r . r x r u e c x o r ni p a x r r . t x e
exeaHeBHo no qaule Bcero BcTpeqarorcq ABe
QopMbr Hapylx€fiIlr: B cBs3fi c orprrqa-
Te,rbHbrMBo3aeHcTaIeM Ha xenylox SHeprHH neqeHI I,t c cHHApoMoM
<nycToTbr xoJloaa) cerr€3eHKl fi XeJlyAXa.
CI,'M NTOMATI,I|(A

B. Aypx(yrorepanx{ Pa3nsqaror aBe OopMbr HapyrreHHr.

l. bo,'Ifi B cBq3ri c oTpuUaTe,'lbHbIMBo3AeficTBteM Ha xe!,Mox
nps Bcex OopMax6one3HllBo3AeficrBoBarL
Ha roqKH: xe,ryaox, s H e p f H t n e ' r e H H :6 e 3 o r q e t H a t l p e B o r a , B H e 3 a n H a r Ig c n u , l s q H e o c r s .
T x a H - M o f i( A P 5 5 ) , c l , t M n a r f i q e c K aH
r e p B H a rc r c r e M a , f l p u n c x x l v e - 60,rI, B xe,lyaKe n3-3a Henpoxo4lraocra ereprrn, Hapyuarorqefi OyHK
cxoM nepeBo36yxteHfir (rHeB, o6rAa) AonorHr{renbHo Bo3aeficr- rlHro fleqeHr, 3Heprur Koropon, ycTpeMnrrcb BcnrTs, oxa36rBaer
BoBarb8a -roqxy: neqeHb. orpHqaren6Hoe BosaetcrBre Ha xe,ryAoK, 3arpyAHcc
eyHkurroHnpo_
B a H x ee r o 9 H e p f f i r : o u t y u e H x e B 3 n ) " r r q I n e p e n o , l f i e H H o c Tsx B e p xH e i
' { a c r } ) | ( H B o f a . 6 0 , 1 n . o T A a n u f i e B n o a p e 6 e p H y r co 6 , , r a ( r L : K ; c , t a f l
t{ KOTA orp-brxxa {na oTpbrxxa c BbrxoAoM Bo3ayxa.
HKoTa xal( clrMnroM Bo3HI{KaerB pe3yrbrare cKonneHaq 6o,te3HerBop_ z. bonll B cBn3r c cnHApoMoM <nycfoTH,xojoaa, ceJe3eHx, x
xenyAKa. Tynaq 6onb B BepxHei,racT, xrBora, pBora c BHAeneHxeM
Hofi gHeprrx B cpeAHefi qacrfi MepraraHa rpex qacrefi TyJoBfirrla t{nfi
Ipo3paqHoi xaAKoclli, 316koc,rb; npfi HaAaB,,r,rBanrfi60,1b cHfixaer_
x o r a a n p f i q p e 3 M e p H o Mq y B c r B e 0 6 n A H , p a 3 a p a x e H t q ? H e p r t t
y c , p e M r ' r r e r c r B B e p x , B H 3 H B a r H e n p o x o a r . r M o c T? b8 e p r @ x e n y a x a . c q : y r o v r l f l e v o c r b . ! n a a o x c r . i r 1n: ) , 1 b c n y c r o i ( r H ) , M H r K r i
L x M n T O M b r H e n p e p b l B H a qn p o a o n x r T e r b H a q a x o T a ; e c , I ' I uaHHat QoI'va oTHocHrcq h crHApovy ,n\cforbJ _ xoro,aa,.
lKora Bo3HI{(aeTxeoxfiAaHHo, caMa no ce6e, To ltHofAa caMa no ce6e
I npoxoArrr; npH 3arsxHofi nKore rpe6yercfl !'reqeHse- TEPANI'
n p r x u I,l n n e q e H n r: peryrlpoBaHr.re aHeprlrfi xer'ryAKa,
BoccraHoBJeHse npoxolsMocrlj sHeprrl,l B o6nacrr AraoparMbI. A. firroreoanuf,
Toqxr Bo3aefi crBrr: H o f i - K y a H( 6 M C ) , r y ( - r a M - , r l r
( 3 6 E ) ,x u - x x | o e(r1 4 V C ) ,x a r r - a y( l 7 V ) . l. 60,,rfiB cBf,3trc oTpr.jqarenbHr,rM
Bo3AeicrBreMHa )xer,ryAor(
3Heprrfi
A y p r n y , o r e p a n r q: Bo3aeicrBoBarb HaroqKx:araopar-
M a , f l e q e H b ,x e r y r o K , r x a H - M o H ( A P 5 5 ) , c r M f l a r n q e c x a q H e p B H a f l n p s H u r n r ' r e q e s r r : y p e r y n x p o B a HOxyeH K u r n r xe q e x x I ,
xenya(4,
q q . q y H r - K l a H( l 2 V C , . K r l . M o (H1 4 F ) .
npxMe'raHse. H K o r a f l p a r q x € n o n o o p M e 6 o n e 3 H nM o x e r - T o x f i - Bo ^ 3A e i c r B n
yxa3blaaTb Ha r'reTarrtHHfiicxoa,,lerreHrre ee B 3Tax c!'Iyqaflx o6HqHo fion-KlaH (6MC). ryx.raM.r'llr t36E), .ruronr-,raxr.ryeH{34 VB)
He aaeT gooeK,a fi npIMeHrTb fif,royKanHBaHfie He pexoMeHAyerct. tyxonbr <paccerBaroqero>neficrBxr).

5lt2 583
 2. Do,rr.{ B cBs3r c cBHApoMoM <nycrorbr- xorola> ce,,r$eHxr{
u xe.rryaxa. B. Aypr{Kynorepantlt
Il p n H rrfi n neqe H ri q: (corpeBaHe> fi roHl,r3xposaHte cere npr 6onqx B cBtrsu c oTpsuarerrbHbrM Bo3AeicrBteM 3Heprfil, ner{eHfl
3eHKr.r l{ xenyaxa xax ocHoBHoecpeacrBo. H a x e n y a o x n p r M e H H e T c qn y H K q x r B , r o q K x : x e n y l o x , n e q e H s ,c l r M
T o ' { K x B o 3 a e i c r B n u r r b r ' 3 (y 2 0 V ) , B x - 3(y2 1V ) , q y s . - [ a r q q e c K a r H e p B H a r cr a c r e M a , r x a a - u o x ( A P 5 5 ) .
K y a H ( l 2 V C ) , r l , l o H r - M o(Hl 3 F ) , x o i i - K y a H( 6 M C ) , r y K r a M , I I l npa 6o,rflx B cBrr3x c crHApoMoM <nycrorhr
yKolru arl, nprxnraHae)- xoroAa> ce,le3eHKq
(36E) (roHB3xpyrcurl,le ll xe!'lya(a nyHKrILtt B TortKt: xer'lyaoK. ce!'Ie3eHKa,c{MnlaTfiqecKaq
T e p a n e B r t { , re c x I , fl i 3 + 0 e K r ror{ex: rorrKaqyHr H e p s H a qc r c r e M a , r x a H - M o H ( A P 5 5 ) .
xyaH (12 VC) Bcno!'rLryercrr !t1e reqeHre npr HapyrrreHr.rrx B ()6rracru
xeiyAKa, roqK, ryx-raM-!,r,r (36E) x Hofi-KyaH (6MC) o6,raAaror PACCTPOACTBAN]IUIEBAPEHX' Y AETEA
oco6brM,'reqe6HHM3O0exroM r.{, Kar{ npaBrno, npr.{MeHrrrorcfl npr
paccrpoiiclsax nuueBapnre,lbHoiOyHKrrfir opraHr3Ma- 8006ue ocHoaHbtE noJloxEl ,tt
yKa3aHHHeTpx roqKr{ cocraBrrror npfiBbl,rHbliiHa6op roqe,rHbrfi
p e u e n Tr .c n o " r b r l e v Hni p HH a p y u e H u snxr u e B a p H r e , r b H oci r c T e M H , yxa3aHHyro 6o"re3HbHa3blBaror raxxe 3arsxHoi !xapeeir. OHa
BH3BaHFHX pacc' rpoficrsoM 3Heprt xe"rryaKa. ToqKXKr MoH (14 F) , { p e 3 B b r , { a f i Hpoa c f l p o c r p a H e f l ac p e A n l e r e f i . C } r M r r o M r , r in o H o c c A e -
'r 3HoHr-{'raHr-ryeH (34VB) npdMeHrrcrcq a,,rqBoccraHoBneHxr npo- O e h a u H F f in o J 4 p a l a B , , H b . n o H H , { c H H b rai n n e r r . B , a y l r e
xoAxMocrx3Heprnnner{eHr,a qyHr xyaH (12VC) , B{ 3y (21V)
arr{ <corpeBaHae}l,roHlr3fi poBaHarr cere3eHXa fi xe!'ryaKa,
f TttoJtoa]t, I nAlof EHE3
(,6blqH. IprqrHaM,r. BbrrbrBatuurvH
Iiar.rpuiic'Bo nrurcBapeHrt
5. Bo3reicrBn€ M€Toaom<uBereBrrt ) aeTeri. sB,leroTcr atotpHr{b|e Odxtopbl .xapr" BnaxHoc .l,.
BorAeicrB!rortHe Ha Aerei B ,letHrri x oceHH ir nepHoa. .Berep
O 6 p a 6 o r K a n o 3 o H a n b H o M yn p f l H q n y i xo,,roA> 3HMofi. a Taxxe HerpaBHnbHo€ nrraHre, HapyueHl,le rfirte,
30Ha o6q3are,'rt,HoroBo3neicrBsn: ynorpe6"teHHe rpyrHoy.BaHBaeMoit nllLtt lMoxHo
ocHoBHat 3oHa Bo3aencrBrq Ha vqaaroK no3BoHor{Hfixa , q l r l a r b 3 r o o c H o B H o Hn p r q H H o n , n o c K u r ' l b K )A e r H H e ! M e | o T e u e
Thvrrr- Lrr: pa36fiparbcr s eI€), c,ta6ocrb sHeprlrk B cpeAHei rracT[ Mepx-
IOnOJBXTerbHar 3OHa BO3AeIICTBA'i BepXHtt qaCTb XrBOTat anaHa rpex qacrei rynoBaqa nr6o <nycrora, flH, nopoxAarorque
nepeAHrr cropoHa rolreHx. c r H n p o M . \ o n o A a . . y x a r a H H H e n p r q r H b t B b t 3 b j B a r opra C c r p o i c r B o
O 6 p a 6 o r K a n o M e p u A r a H H o M yn p n H q x n y : oyHKqroHanbHo; aeq, €rrr,Hocrfi ce,'re3eHx,{I,lxe,ryAxa. B pe3y!'rbrare
- qerHpe yqacTKa MepfiauaHa MoqeBoro ny3brps B o6racTlr qero oqrlqeHHHe u HeoqruIeHHHe SKclpaxTbr H€ MOryT HOpMalrbHO
D e p e M e u a r b c f ,B B e p x r B H H 3n o o p r a H U 3 M y .
oafiH yqacTox n€peaHecpea HHoro MeprAxaHa r{ aBa yqacTKa
MepruvaHa xe!'ryAxa a BepxHet qacrri xaBora; Cl{MNTOMATI,IKA
o n r H y q a c l o K M e p l n u a H a x e r ' l y t k a B o 6 , ' ] a c T Hr o , l e H r .
O6pa6orxa no roqeqHoMy t I l t o y : T o q K tB o 3
n p I ,H P a 3 J r r ' { a r c r A B e 0 o p M b r x a p y L u e H n r : c K o n n e H s e ,3 a c r o i i < B n a x H o c
AeficrBrrt re xe, qTo r npu neqeHr,rHnoBepxHocrHblMHyxonaMx c no .r -- xapb'> x cl{rrapoM <nycrorbr xoJtoaa _ BnaxHocrfi> cere-
MoqLro MlrKponrr, Ha xaxAyro roqKy no 50 yAapoB. 3eHXU.
C n o c o 6 o 6 p a 6 o r x r, O6pa6orKy 3oHH o6r3are{'rr,Horo
Bo3AelcrBut cneAyeT npoBoA[Tb co cpeAHet fiHreHc{BHocTbro,rHTeH TEPAN|'|'
ctiBHocrb o6pa6orKs ocHoBHoriIl AononHllrenhHoi 3()H (<pacceaBaro-
qero> ltnfi roHa3ljpyrcuero aeicrBnfl ) onpeAejqercr crMnroMarHKofi . A. l,lrnorepannr
flpr, Bo3aeficrBrx no MepraraHxoMy npxHurrny yvrirbrBaror, K KaKoMy
l. flpr, paccrpoficrBenfi[reBapeHr.rfi
B csr3u co cKonrelueM fi
cuHApoMy orHocl,tTct Hapyuex[e: K c[HApoMy (nonHorbr )KapH> -
3 a c , o e M < B J A ) I { H O C T I-I XapH>.
Bo3AeicrBxe <paccenBaloUlee>,npoTltB xoAa MeprtAgaHoB;K cxHApoMy
nprHusn reqeHrq: "'DtxBxaau< r sB n a x H o c r u x a p b r > ,
<nycTorbl-xoJroAa) ao3aercTBre ToHx3Hpyrorqee, no xoay Mepr- pcrynupoBaHxece!'re3eHXr{ t{ xeryaKa.
akaHoB, DCIL oole3Hb no ee xapaxTepy HeJtb3t oTHecTI H'r x <no!'IHo- T o , ? h H B o 3 n e i i c I B r r r : r ) x - r a M , 1t r3 6 L ) , a a i - q H o H r - 3 y
re>, HI,t K <xonoAy>, Bo3AeicTBrje AoJrxHo 6brrL <nonyToHxsxpyl(}-
qee - norrypacceuBarculeer, KaK no xoAy, Tax x npoT[B xoAa Mepr- r 2 5 V l . , r y H r - ' ( y a {Hl 2 V r ) . r r n e ; - x x } t 2 5 E r . x o n - K o xr 4 c t i .
llpx rourHore, pBorc, DOno.lHHTerlbHo Bo1!eictBoBafb Ha roqh)
axanog. Ha KaxAyro r'rsHxro no l5 yAapoB. Hoft-KyaH(6 MC).
584
585
 np,Ir paccrpoicrBe B cBq3fi c cr.rHApoMoM<nycrorH - xor'roaa]
2. flpr paccrpoficrBenrqeBapeHnq B cB13x c cIrHApoMoM
BO3Ae'CTBUeHa TOqK!: Ce,'Ie3eHKa,XenyAOK, CnMnaTnq€CKat HepB-
<nycToTbr xoJola - BJtaxHocTfi> cerrle3eHxn.
Har crcreMa, rxaH-MoH (AP 55).
l l p I l x q ' , l n r ' re q e H r r : < c o r p e B a H s e > T , o H f i 3 l p o B a H x ec e ! ' r e -
flpflMeqaHne. flocxorbKy Aerr He yMeror caMocrotreJlhHo
3 e H K r iI , x e r y a x a ! " r r r k B x A a q E qa x o n o l a B ? r a x H o c r x > . pa36riparr,cq B eae, Bonpoc 06 rx nfiTaHrn npro6peraer oco6yro
Toqxfi Bo3AeicTBrr: T o H t r 3 x p y r c q an
q y H K r r f i fBl r o r r x f i BaxHoc ,. Ec"qu nocr'le Bbl3aopoB!'IeHricpe6e8Ka pexnM eto nBTaHllq
r y K - ' r a M ' n( 3r 6E ) r , r y r r r y a n ( 1 2 V C ) 6yre_r no-npexHeMy He HopMan!3oBaH, oH,'rerKo 3a6o,1eer noBTop-
I I p x f i f a H H eB r o q r ( H r x x e H - x x ) ( 2 5 E , . k l a H - H r l e Ht 4 \ C t
xo_ balKHo HopMar}r3oBaTb pexrM nrTaHnq yxe B npoqecce neqe-
h rxaH.Kxrcer{8VC). npu HenpeKla[raoulevcqnoHoce,noxo,t{J- Hq9, TaX KaK B npOTr{AHOMCnyqae OHO MOXeT 3aTtHyTbcfl Ha npo-
AaHr,rl,KoHeqfiocrefr,noBepxHocrHoM(Qy), oqeHb Ma,IoM (sa) lr CPOK.
AOJIXITfe,/ILrHbIt
nycToM {xHJ nynbc€ crreAyeTHeMea"'reHHo HaqaT6nprxuraHte ro-
qe( rxneH-kxy(25E), KyaH,HryeH(4VC), rxaH-Kxroer(8VC) Ao
Tex nop, noxa H€ noTennercT(oHerrxocTa'l He npexpaTtTcrl noHoc. vt. BoJtE3Hlt cllcTEMbt JlbtxAHl{rl
Heo6xoAxMocoqeralb BocToqHble x ianarHHe vetotrH JeqeHuq.
T e p a n e B r s q e c I( r, 3 O O e K r r o q e xr roqKr|ryK-raM- DPOHXI,IT
,1I, (36 E), Aafi-qHoH.3y(25 V), qyHr-xyaH(12 VC) x rxneH'Kxy
(25 E) c,ryxar Arq yperynnpoBaHr.rs QyBxrrst )(ejyaxa n ro,rcron oclloBHhlE noJloxEHltt
xon-xox (4 GI) anr nrKBxAaqr.js olHApoMa<xa-
phr>l.{oAHoBpeMeHHo Ar''rrypery!'rnpoBaHxrOyHKqtifiro,tcroi Kl.tLuxr.j. 6poHxHT qaclo Bcrpe'rarcuarcr 6one3Hb aHrare.r6HHx n),Tefi c
Bo3reicrBre Ha ro,rKyHoi-xyaH (6MC) raer xopouiuii3+QeKr H(bexqrioHHbrMBocnaneHreM c,rfl3rjcrofi 6poHxoB. Pa3r qapr ABe
npr {,reqeHssor rolrrtorbr, a Ha roqKfi KyaH-Hryex (4VC) |,{ TxaH oopMbr 6poHxrra - ocrpbrir fi xpoHsqecl{trft, OcHoBHoir cHMnroM
Kxroer (8 VC) rroMoraeTr'UrKBrArpoBarb Karx€nb c BhraeIeHfieM MoKpoTbr. ljocToqHafl MeAI{qHHa oTHocxT
cunApoM<xoroAar, <co
6 p o H x H r h c t r H r p o M y ( ( a u e " T b c M o x p o T o i r H f l . i H , E p o M y. c r ' r . r 3 H
t.
rperb> o6,'racrbcpeAHefir.{ xrxHeil ,lacrei MepfiaxaHarpex qacreji
9TUOJtOttt U nATOTEHE3
6. Bo3AeficrBxeMeroAoM<qaereHr{,
Kauen6 Moxer 6LITb BH3BaH KaK BHeuHefi 6one3HerBopxofi gHep-
O 6 p a 6 o TK a n o 3 o H a r ' r b H o Mn yp x H q x n y : rriefi, Tax q BHyrpeHHnMx HapyueHsflMH B opraH{3Me. K BHenlIHrM
- 3oHa o6rcarenbHoro Bo3r€iicrBHr; 6on€3HerBopHLrM(Da(ropaM orHocqrcq <uiecrb BpeAHbrx notoaH6rx
- ocHoBxae3oHa Bo3Aef,crBfir;yvacrox Thirrr Lr:; 3Eeprlrfi) (qaue Bcero <aerep), <xonoA)), (oropbre npli <nycro-
AonorrHnTerrbBaq 30Ha Bo3AeicTBxt: BepxHtfi qacT6 xIBora, Te> xr3HeEHOn 3HeprfiIt BTopraroTc' B IIOBePXHOCTHbT€ C!'|OXOpra-
rICDEAHflq CTODOHA TONCHfi, Br3Ma r B nerF{e. BHyrpeHHeil npl,lqrHofi 6poHxrTa Moxer c.rryxr.rrb
O6pa6orxa no Mepr.rrr{aHHoM n py r H u r n y : HapylreHre HopMar'rbHofo cocroqHllq sHeprftfi nJroTsbrx opraHoB
- 4 yqac,xa MeprluaHa MotreBoro ny3blpes o6rtacTxcnaHd; (nocKonhKy <Bce nffTb nr'lorHbrx opraHoB MoryT cnyxrrT6 npHqxHoi
- oar.rH yqacrox r€persecpelxHHoro MepxaaaHa n ABa yqacrKa 6on$Hefir), rraBHbIM o6pa3oM rerxrx, cere3eHKn, aoqex. Koraa
MepsaxaHa xenyAxa B BepxHea tlacrx )KaBorai 3Hepflre nerKux TepqeT cnoco6Hocib onycKaTbcq BHn3, <nycTaq,
- oAuH yrracrox MepuAraHaxenyAxa B o6"1acruro,reHr. ce,le3eHxa Bbr3brBaeTcrHApoM <MoKpoTbr B.naxHocTH,, a flor{xr He
Cnoco6 o6pa6orKr. f l p f i B o 3 A e f i c . r Bnr !o 3 o H a M- MOry'l aKr(yMy.rspoBar
o6pa6orKa co cpeaHeii '{rx c,ra6ofi xHreHcsBHocrbrc,np Bo3
, c i c r B H n n o M e p H A n a H a t c( o ! p e n H e f i H T e H B c H o r t b r cK a K n o
xoAy, raK x nportrB xoAa Mep0llxaHoB"1n6o co cra6oii xHrerrcrB CtlMNTOMATN(A
Hocrbp no xoAy MepulfiaHoB, Ha xax4yro ,rxHrro no l5 yAapoB.
Ilpr.r Bo3AeficrBrrx no roqKaM cnoco6 Tor xe, qro onqcaH Bbrue; Pa3nrrqarcTcfl aBe QopMbr 6poHxl.{ra.
Ha fiaxryro roqr{yno 50 }napoB: Bo3neficrBre L HapyrxeH're B pe3yrl6rare Bo3aeicrBqr BHeurHlrx 6o!'re3H€-
co cpenHei}rrr cJa.
6oi fiHTegc'BHocrblo. rBopHbrx Oa(TopoB: cyxoi r.j xprrnnHfi xallreJrr, r',rr6o Kaue.ft, c MoK-
p o l o l i , r I o B H l n e H H a tr e M n e p a r y p a r e J l a . o 3 H o 6 , r o n o B H a q 6 o n b , H o c
B. Ayplxy,rorepanrc 3anoxeH, rqxecrb B Te!'re, ToHKnfi 6erbri (xrr xenrbli) saner Ha
q s H K e , n y n s c n o B e p x H o c r H b r i(l 0 y ) n , 1 u 6 b r c r p b r f i ( c a K ) .
np{ paccrpoicTBe B cBr3n co cKonr'leHfieM
r.{ 3acToeM<BrlaxHoc 2. HapylueHxe B pe3yrbrare BHyrpeHH{x npr,rrH: He npeKpa
rr xapH> Bo3aeltcrB[e Ha roqKH: xeJyaox, To,,]crag xrrxxa,
Uarcurficfl IHeBxoi I'I,ro Ho'{Hoi Kam€nr,, K yTpy o6qar cra6oc,r,,
rllMaarrrqecxat
HepBHaflcscTeMa,rxaH-MoH(AP55).
586
froHl,txeHHblli anneTtr, qaiToe oTxapxr{BaItfie, MoKpoTa Bq3xat, ToHH3rpoBarb gHeprrrcl,l Kposb,a roqKfi TaoHr-MoH(13 F) t ryK-
K,lefikaq rfi6o npo3paqHaq, sarpy4neinoe AbrxaHfie, 046rlrrKa, oDry- raM-,rll (36E) aKrl,lBfi3ripoBarbOyHxuroranbHyro aetrer'rbHocrl'
rueHxe pacDr{paHfiff B rpyAr,l, rcnpaxHeHfrr To ooopMr€H8bte, To cene3eHKH r.r ,{er1ynKa.luHH3HpoBar6?Hepfrro B cpPlr+retqaclr
xnArfie ns6o Bce BpeMfi xnlKrie; rghrx 6neAHHfi, c rycrbrM c!,rr.t- Mepr{araHa rpex qacrei rynoBsua. Tpr nocneaHreToqxljo6naaall)r
l t i c l b i M H a r e T o M ln y , l b c r , t y 6 o K H i ( q a M ) . r o H K l , l f tt r r t , o q e H b M a n H i cnoco6HocT6royxpenlrqT6 nr'ro,Hbre BHyTpeHHxeopraHH, al(rnBfl3u
r B { l : r o p r q H e , ' l a l l o H r .li, | n o ] l o l x B b t .c y x o c r b B r o p , D e f i o r c } T c r B r e poBaT6 cerre3eHKy.ntKarafipoBarb <BraxHocTb>, crtMy"'InpoBaTf,
MoI(porH (,Tr60 crenH xposk B MoKpore).; xciyaarae, iyr,ocrs npouecc o6pa3oBaHHrrMoKporbr,ToHrB'rpoBaTbsxepr[ro n xpoBb.
KOXX, ynyqueHne caMoqyBcTBxs AHeM no cpaBHeHr,rrcc HoqHbrM: Bo3Aefic,B eM Ha Hfix ,eqar cxHrpoM <nycrorbl). flpfixfiraHreM
rrnepeMHi q3HXa c cyxtrM HarreroM: roHxljfi (r3), 6brcrpHfi (caK) ToqKn MeHbMoH(4 VG) nonb3y'orcqc qenbro <corPeBaHuqrH
nynbc sce 3ro cBfiaelenbcTByer o cr,lHApoMe<nycToTbr r,tHb>. nono'lHeHfirrHeprHefiBHyrpeHHr.{x opranoo. lonr:apylourfi 1xo,r
B roqKy raM-aM-3qo(6 RP) ycltr'lxBaerrHh'3Heprfirc,"!eqsr crrHApoM
TEPAN|{9
B. Bo3a€ficrsneM€ToAoM<uBer€rrs,
A. l,lrnorepanrt
O 6 p a 6 o r x a n o 3 o H a r ' r b H o Mnyp r H q r n y :
npr{Huxn reqesxq. n p r H a p y u r e H x nB p € 3 y , r b r a r eB o 3 a e i - 3oHa o6H3aren6HofoBo3aeficrBHt
c r B i l f l B H e l x H U ) \6 0 , l e r H e r B o p H b r xO a x r o p o B o6,rerqeuHe aura. - ocHoBlat 3ola Bo3AeficrBnr: yuacrox nosronoranxa Thr
renbHon OyHXrrfifi JerKnx, M€pH IIo reqeHHro 60,re3Hr.tB ee <noBepx
Th\'I B o6,lacrt cnIrHHi
HocTHoi, craAnH. npu cl.rHApoMe <BeTpa XoJroIa) - <paccex- AonorHnrenbHat 3oHa Bo3AeicrBxq: o6nacrr, rpyAx, nepea
BaHrrer 6onesHerBopHoft aneprua "xo,ro4a>, IIpeKpaueHue xau!,rr.
Hqr o6,'racrb lxer, nepeAHgr cropoHa Dp€rnneqbt- llpl' noBblueH-
llplr curlapoMe (Berpa xapbr, - r'rr.rxBriaarlxr (xapu>, npexpa- Hoi revneparype - aononHfirerbHoe aorrencrBxeHa BHyrpeHH|oro
UTEHHE I€lxJlg.
cTopoHynpean,rleqbc,npfi o6rnhHoi MoKpore- Ha nepeAxrorccro-
nprt HapylxeHfifi B pe3y,rbrare BHyrpeHxlx nptqrrH - B cr,ryqae poHy rorreHr.
<nycroTH> 3Heprrr rrerKrjx cJeaye,r frpoH3Boal.tlh roHx3npoBaHne 06pa60rxI,l.
Cnoco6 B 3 o H eo 6 r 3 a r e . 4 b H oB
r oo 3 r e n c r -
9Heprrs, o6J,rerqeHxe lbrxarenbHofi oyHKuu! nerKrlx; B cnyqae B ocHoB-
Bfiq o6pa6oTKaflpoBoarircq co cpeaHefi rHTeHcfiBHocrbro,
<nycrorbr> cere3eH(u It,'Ienkfix Heo6xoltMbr o6,retqeHge nhlxarenb-
noi x Aono,'rHure,,rbHblx 3oHax c 6orbruori. Ha Ka)KryIo nrHfito
{ofi oyHxqlilr !']erKrx, yMeHbuexre MoKpord, aKrrBH3aqnr rpyHK- no 20 yAapoB Mo!'rorolrKor\4.flpx ocrpoM xapaxrep€ HapyrneHflt
u H o H a n b H o xr e s r e r b H o c r H c e J l e 3 e H X Hc, H H l t ( e H r e a H e * . s , , t a x .
o6pa6orKa ex€aHeBHac, no onHoMy cearcy B AeHb, npfi xponr{-
HocTr{r. llpr! yrep€ noqr(aMr.rcfioco6HocTr,raKXyMynnpoBaTb aHeprfir,o qecKoi oopMe 3a6oreBaHl,rt- '{epca rcHb no oaHoMyc€aHcy-
rpe6yeTcr <corpeBaHxe> noqex, qro6br oHr.jr'ryque axKyMyntpoBarfi
e H e p r s r c ;n p s . n y c r o T e ) y c E n e H n eH H 6 , 3 H e p r r r , < I l r a H x € > n € r -
KHx, yMeH6ueHr{e MoKpoTbr, B. Aypxxynorepante
Toq(a so3Aeicrsrrfl. np, Hapynl€Hxl,'
Bo3aeicrBrrr BHelnHrix6on8HersopsHx rbax,ropoB:O e ' 3 y ( 1 3 V ) ,
qyHr-Qy (l P), aaH-qynr (l7VC), nxer-xxrcer (7 P), aaft'rror Bo3AeicrBxe Ha rorrxx:6poHxx. rpaxeq, nerKoe, noqxa, cere3eBKa,
( 1 4v G ) . e x e A H e B H o ex n x q e p e 3 a e H L n o o A H o M y c e a H c y . 3 a c e a H c n y H X q H s
l l p l , lH
. apyueHrH B p er y r b r a r eB H y t p e H H H e I 2 roqxx c ocraBneHreM nrnbr Ha BpeMs or 30 MIH ao I q.
n xp H q n Hr: l { o H r - M o H
t l 3 F ) . k a o . x o a H f - rry4 3 V ) , r y x - r a v - " 1 t( 3 b E r . M e H b - v o (H4 V G ) ,
raM-aM-3ro(6 RP). 6POHXXA.IIbHA' ACTMA
T e p a n e B r,l q e c x H i ? O O e K r t o'r e x. Bo3AeficrBHe Ha
roqKr 0e Jy tl3 V) ft qyHr-Q) i l P) cnocoocrByerHop{aaHraul,tH ocfioBHbtE noJtox€Hut
3seprr, JrerKlrx; roqKa AaH-'{yHr(17VC) npsMeHqercrA,IH ToHx-
3rpoBaHtfl 3Heprrx Bcero opraHll3Ma y oIHoBpeMeHHO A!'tA BOC- 6poHxHan6Haq acrMa - alrr'reprrrrecKoe 3a6o,teBaH e c neprroAaMH
craHoB!'reHrqnpoxoAr,rMoc,rfi MeprAr.raxoBB o6nacrl rpyAu; ro.rxa p e M r c o r r r . ro 6 o c r p e H r q - K e e c u u n r o v a u o r H o c r r c a : 3 a r p y a H € H -
!'raer-(xner (7 P) c'ryx,rr Alrr r'rHKBxAaqtx6o,te38erBooHofi3fieo- Hoe AbrxaHHec xapaxTepHbtM cBrcroM, 06Luar{ cna6ocrb, nprcTynH,
rrfi B noBep\Hoc?Hbrx rr{aHrx opfaHHlMa.To,{Kalaft T|,on(14 VC, 3acTaarflrculfie 6onbHoro npxnoaHfiMa,bcr c nocre!'Ix x nptHfiMarb
acno!'rb3yercfiIne crl.tMy,rqqrfi HH-MepqafiaHoBr.t Arr 6opb66r c cfiAqqyrc no3y. B BocroqHoi MeArquHe 6one3Hb uMeer HasBaHHe
60,'re3HerBopHof, eHeprrefi. ToqKa xaojxoanr,gv (43V) no6eo,,rser <npqcrynH yAyrxbf,>.
56E
589
3TI{OJIOTI{fl E TIATOTEHE3
upoBaHfie sseprlrx, <corpeBaHrrerB 30Hecpeal{eftqacrn Mepxa,'aHa
<npdcrynbr yAy rbt> B 3Haqrre,lbHoi Mepe csr3aHbr c raKHM, rpex qacret TynoBrrula.
nnoTfiblMLl BHyTpeHHI,IMA OpraHaMI,t, KaK nerl(fie, Cer'Ie3eHKa,nOqKX, To,{ KI Bo3AeicrBnq: B o B p e M fn, p x c T y n aB o 3 A e i c T B y I o r
nocKor''l[,Kyl1er(fie <oTBeTcTBeHHbL3a 3HeprXrc; <nyCTO'ra] Cene3eH- Fa ro'{(y, peryrlpyrcrqyo abrxaHrie (ayplrKy'lqpfiyto AP3l), rol Kt'l
Kl,l nopoxaaef cr,rHApoM<Mor(poTa- Bnara>, a noqxs aKKyMynx- rxxen'aor (22VC), qyBr-Sy (l P), xxyK''ru (ll GI), Qonr-,ronr
pyroT 3Heprfi|(), <llycToTa) nr''rofHbrxBHyrpeHHxx opraHoB B coqera- (40 E), ryK'raM-nx (36 E).
Hr.il{ c BTopxeHreM B opraHfi3M oone3H€rBopHoi 3HeprnH <Be,rpa>, Bo BpeMr peMxccl.il,-- aononHfire,rbHoeBo3AeicrBne Ha roqKx
c H e n p a B l , t i b H b r rn4f i r a H l r e v . n c f i x H ' r e c x o n x e l p a s H o B c u l e H H o c t b t o O € ' 3 y ( l 3 V ) , r b r - 3 y( 2 0 V ) , r x a x - e y ( 2 3 V ) .
Br,r3r,rBaeT 3acTor{ MoKporsr r gHeprrn, qro B cBoro oqepeab npfiBoari,r Cnoco6 Bo3aeficrBfit- f l p r a c r M e ,o r x o c ' { x l e n cKf l
x 3aTpyAHeHsoMy AbIxaH&ro, yTepe cnoco6HocTr{ gxeprr{t ,rerKrx crHlpoMy <xo!'Ioaar, rpfixIrraHlre oraenhHo n16() B corleraHalr
n o A H H M a T b c o n y c r { a r b c r ( n o M e p r a n a H a M ) , B p e 3 y J b , r a , r eq e r c c nyHKrlHefi, npfi acrMe, oTHocrueficr K cxHlpoMy <xapbl>,
Bo3rruKar)T npncTynH yaylnbq. rorrhxo nyHKurH B coqeraHqq c cooTBercrByroqxM pexxMoM nr-
raHrr, oTAbrxoM, rpeHrpoBKon.
CTMNTOMAfIIKA 6aHKH c AfiaMerpoMorBepcrrq 50 MM rrocr'refi3BlreqeHssIrrrhl
c r a B r r H a r o q K n q y H r - o y ( l P ) , A a n - q y H r( l 7 V C ) , + e - 3 y ( l 3 V )
g OCTABT'IOT HA 5 Ml,H.
npli HacrynneHan npnclyna 6()rbHofi He HaxoArr ce6e Mec.ra,
norrBnrro:rcr qrixaHr,e, 3aroxeHHocrb Hoca. 3yA B 06racTr{ r!'Ia3, MoxHo craBrrb 6aHKIr H npl, Hacrynr'reHfirinp cryrra. Ecrl.{ B
Hoca, cTecxeHrre B rpyAr.j,3a KoTopbrM cr'reayor npficryn yay1rr69" pe3yrbTaTeBo3aeicrBfig Ha yKa3aHfibreroqxx npficryn He npexpa
r a T p y a H p H H o el H x a H e c \ a l a K T e p H h t M c B r . l c t o M ,6 0 , 1 6 H o ; n H U r t ua€Tcg, Heo6xoaHMoBocnor'Ib3oBaTbcq roqxaMl,|Tbl-
aono!'IHaTerbHo
p r o v . f I p H r q x e , r o f i O o p M e 3 a 6 o " i e B a H r nn x u o 6 o n r . H o r o 6 , r e a H e p t 3y (20V), Kao-xoaHr (43V) B 06racrr.r cnHHbr.EaHKx c,reayer
ars cifieer, noKpbrBaercs noroM, B nepfio.q peMrrcclr yKa3aHHbre npaMeHqrb",lt'lull)npt acTMe,oTHocflUle}lcsK cltHApoMy<xor'1oAa>
cxMtITdMr,rxcqe3atoT. T e p a n e B r n . re c K n i 3 O 0 e x r roqeK. Aypn(ynqpHae
6poHxranr,Has acrMa o6brqHo aeryrcq Ha ABe QopMbl. ro,iKa AP3l, peryrltpyrcqat auxaHre, rcnor'lh3yercqcneqxanbHo
l. AcTMa, oTHocquatcq K cxfiApoMy <xo!'loAar: oTcyrcrByer Arr !'reqeHxracrMH.Toq(a qyHr-oy (l P) cnyxfir Arfl BoccraHoB_
xaxAa, Ha6,UoAaerct osHo6, noHoc, xo!,toAHbreKoHeqHocrn, rI3HK rle8nr npoxo,4nMocrr.r Ir peryrrrpoBafisq 3Heprtt B nerKnx- roqxa
6,1eAeH, noKpblr roHKnM 6e,1hrM HaneToM; ny!'rbc HanprxesHblfi rxxes'aor (22 VC) flo3Bor'rrernqKBr.ralrpoBarb MoKpory I{ BoccraHo_
l r r c e H ) , r o H K r . r i ih 3 ) x n r c x a r H f i ( K x o H ) , c x o , ' t b 3 q u ' l H i i( x o a r j . BxTb npoxoaHMoc,b3HePri.rHB {'rerxrix. TpI, nepeqrc,leHHbIero,{Kfi
2 . A c r M a , o r H o c q i [ a q c f l c c r . 1 H l p o v y. x a p b l r ' 6 0 , r b H o i H J 6 e r a e r Bceraa xcfrorb3yror a.[r{ !'reqeHxq6poHxfia,rr,HoiiacrMbl Bo3aefi
xapu, npeAnoqmaer npoxnaAy, qacTo pa3ApaxeH, noKpbrr o6s,rb- crByr Ha roqKy KxyK-qn (ll GI), ,ruxararpyrcr 6oneHerBopHylo
H6rM noroM, cTpaAaer or xaxAu (flpeAnoqmaeT xonoAHyro BoAy); 3Heprnrc, a roqK! (boHr-,roHr (40 E) I,lryx-raM-na (36 E) noMorarcr
voqa rxlaHafl, KpacHoro otlcHXa, ,anop: poloBHfi H r xerrbti nHKBHAnpOBarb VOKpoTyH Onycrrrb ycfpeMrsLll!$cfl BBePr tHep-
c,,rH3rcrr,ri Ha,rer Ha 13br(e; fly,rbc cKoJrb3rtuafi (xoaT), 6brc,rpbrn rH|lr. Bo Bpevr peMrccHHBorneicrByror Ha roqK) +e-3y rl3V)
(cax). B coqeraHrr c roqxaMr rxxeH-aor (22VC) t,j qyHr-Sy (l P) c
U€nblo BOcCTaHOB!'IeHIrt npOXOAl,lMOCTI,i3Heprlt IerKaX. 14cnorrrb3yloT
raKx€ roqKy rbr-3y (20 v) B coqeraHr.r{ c roqKaM}r 'ryK'raM-na
TEPANgI (36 E) r OoHr-"'roHr'(40 E) anq crIMyrflrrHr] oyHKunoHa,lbHoi
aetrerrbfiocTH cer'Ie3eHXr,yMeHbueHMt Mol(poTbt r,r JriKBaaaqrt{
A. llrnorepanng <B,raxHocrl.i).Toqxa rxaH'3y (23 V) B coqeraHr.tac ,ryHr-Oy (1 P)
cnyxrrr a,lq ycTpaHeHrerBreHri9, Kofaa <ycrpeM[Blunecq Bcnf,Tb
npxHrrrn " q e q e H H r . f l p n a c r M eo, r H o c r r q € f iK
c qc H H A p o M y xfiaKocrfi opraHn3Mapoxaaror Moxpory>, a raxxe aJe <corpeBa-
( x o r ' r o a a r : < c o r p e B a H f i e )n e r x t x , r l t i x B s A a u l l t c u H A p o M a < x o j o a a > ,
M o K p o T bsr n p f i c r y n a a c r M H ,
Hr'rfl>not{eK,coaeqcTBr'rs
aKKyMy,rrul,llrrMr{ 3Heprr!.
flps acrMe, orHocrueicr K orHApoMy <xapblr: <oxnaxaeHr{€>
l r e r K r x , < p a c c e n B a H r r e< > x a p H > , c n o c o 6 c r B o B a H x en p o q e c c y ( ) 6 p a ,
3 o B a H n r M o K p o T H ,n p e x p a L r l e H & n ep H c T y n a a c r M H . 6. Bo3a€ficrs € MeroAoM <qBereHrflt
borbHbrM npex!'roHHoro Bo3pacTa c crrHApoMotlr<oroHb - nycro-
O 6 p a 6 o r K a n o 3 o H a n b H o M yn P L t H q n x y:
ra> xeo6xoArMo <corpesaHre> o6nacrfi noqeK. Ilpx <flycrore> , 1 o H ao 6 t , a t e , ' I b f i o f o B o r , 0 e i L I B H f;l
cen€3eHKs, BblpaxeHHoM c,tHApoMe <Mor(pora BnaxHocTb> Heo6
xoAl.rMbIaKfIrBIr3arlrt ce!'Ie3eHKd,r'rr{xBHAaIlaq <BnaxHocTI>, ToHLi o c H o B E a q3 o H a B o 3 r e f i c r B l r q ry v a c r o x T h r Thvrtrs o6,'lacrr

590 59r
 Aono?lHrreJrr,Haq3oHa Bo3AeicrBxr: o6nacrb rpyAH, nepeA- paBHoBecae-IIpsqnHoi noBHrxeHfiq aprepl{anbHoro AaB!'reHsqMoryr
Hqq_o6iacrb ueH, lepcAHqq .fupoHd npenn,teqbq. cnyxrrb l.j HapyueHlre nc!{xssecfiotl ypaBHoBelxeHHocrl.{,cHHApoM6r
j r p f i o o n r H l J M o K p o r b t l l o r o , T H r r e r , r b H a0e6 p a 6 o r h a n e p e a H r . i i . r , r o h p o r aB " 1 a ) h H o c r h i. .v o K p o r a o r o H b r , . B H ) l p e H H H f rB e l e p r . a
cropoHU rcneHH:npx pacctpoicfBe cnoco6HorrH nouex axxyvl.rr_ raKxe sacroi KpoBlj, t{ro eue 6o,1ee oc",IoxHqer 6oJ1e3xb.
poaar6 3H€prHro aono,tHfirerbHan 06pa6orxa Hu3a xIBora fi
Bs).TpeHHencropoHbr rorleHH. Ec,lr fiMeeTCr 6orb[roe xo,lrjqecTBo
CllMNIO ATI,t|(A
laHHbrx, cBxaere,'rr,crByroulxx o roM, qro 6boHxxanbHar acrMa or-
Hocr{Tcr K cHHApoMy <xoJrora>, To noc,re o6pa6orru HrorbqarHM CyqecrBylor rpfi QopMbl reqeHrr 6o",re3Hx.
MO,1ototrxoM cJlen)el nonorfixrerbHo flporrsect jr npr{xHfaHHe To- l . n p o q B e r a H r e < r H - n e q e H u > : r o " r o B H b r e6 o J t r , p a 3 A p l < B T e J r b -
q e K , o e - r{yI 3 V ) H , r }H r - o y( | P ) . F o c r b . B c n H r l b q r B o . r b , 6 u " r b H o r .H
i e .HaxoqHr ce6e uecran; rnnepe-
Unoco6 o6pa6ork . 3 o H a o 6 e j a l e , l b H o rB ooraelcTarn r r , r t ' l r i u a , r r a r . c l x o c r b B o p r y , ' a n o p , / x e L ' l r b [ ,H
r aieT Ha fl1brxe.
()6pa6arbrBaeTcq co cpeAHei uHreHcrBHoc.rbru. ocHoBHafl },l
aonor, nyrbc HanpqxeHHhri (xrceH) I,lnaHanprxeHHbrii (xroeH) a 6brcrpbr;
Hrre,1bHat 3oxbr B 3aBrctiMocrl, o,r xaDar(Teoa reqeHfit 6o",re3Hr.
H a r a x a y o n H H o n o 2 0 ) n a p o o . n p H n p o a o i x a r o u r a r c nn p r c r y - 2. <nycrora> rH6, npouBeraHfie qH: ro!'roBoKpyxeHr.re, uryM B
no oAdoMy ceaHcy exeAHeBHo, nocne o6r,rerqeH , qepe3 yuax, 6e3orqerHoe 6ecnoxoicreo, 6eccoHHrua, He6or'rblroe oHeMeHfie
KoHe,rHocren n rynoBr{nra. po3oBblfi Ha,1eTHa r3HXe; nynLc Hanpq
xeHHHi (xloeH), rorrKHfi (r3) 6blcrpbri (caK).
B. AyplKynor€panfie 3. <IycroTa> [ |,{Hb,rr rH: ronoBoKpyxeHre, lxyM B yrxar, 6onb
B HxxHrrx (oHeqHocrnx, noMora B Ko"'IeHflx,6eccoHHrqa
Bo BpeMr npEcryna c,re4yer eo:qeicrsosa,rb co 3Haqnre,16Hoi pbl Bo cr{e, 6"reAHocrb rIua, oHeMeHlle KoHeqHoc,refi,no,,InaKfiypsr,
sHTeHCr,tBHOC' rbrO Ha BaH6o,lee qyBcTBxTer,IbHL,Ie yqacTKfi yutHoi pa, no,rrHxxTyprq, naTo!'rorIqecKfie DorJI|oqr!, xMno,reHqafl, 6,']eAHr,ri
xoBrH,bl,coqe,as 9To c nvHkUxei B l-2 ll3 cneAyoqHx To'{eK: acr H a r e r H a s 3 r , r ( e ; n y " t 6 c f " r y 6 o K r . r i i( q a M ) , r o H K r ; ( r 3 ) .
M a ( 6 p o g x o , r f i r r r r { e c K arqo q K a ) , n e r K o e , c n M n a r n q e c K a , H e p B H a s
crcreMa, xer're3br BHyrpeHHei ce(peqHH, noAKopr{a (XVI 3oHa),
cer're3esxa, noaxer'ryAoqHaq xe,re3a, novxa_ nyHkur.jr.i c ocraBJe- TEPANI,,|
H H e v H r r u H a B p e v e o t 3 0 v r . j H, q o I , r .
A. Itrnorepanrt
VII, BOJIE3H}I CIICTEMbIKPOBOOBPAIIIEH]I9 f l p L { H u r n r ' te q e f i H q - [ I p t , l n p o q B e r a H x r ,< q u - n e q e H f i > < H o p ,
Ma!'rx3aN,rq neqera, TyueHfie rH); npx (nycToTe l,|Hb x npouBera
rI nEPTOflttt Htlll tH) <nflTallae gHb, TyueHlle 9H>; npx <nycToTe L H6, r{
gH> < n f i T a H l e r r H l , ,n o M o u l b q H r .
o6urE noJroxEflxfl Toql(H Bo3AeicrBHs: A a y - 3 l o u( 8 E ) , c y a r - K o K( 8 V B ) ,
funepronaa orHocxrcrrx paccrpoficrBaMc negcHoi srao,roraeii ooHr-qn ( 2 0 V B ) , 6 a r b - x o n ( 2 0 V G ) , a H - A b r o H r( B H e M e p n A , { a H H a r ) .
(nepBxqHo) r.{B To xe BpeMf, HB!'rqercqc{MnroMoM MHorrx 6one3Hefi T X a f i - 3 b l o H r( B H e M e p r A r a f i H a r- P C 3 ) , B o 3 M o x H o A o n o n H [ T e r b H o e
(BTopl,IqHo). OCHoBHHMnoxa3arereM paccrpoficrBa cnyxrrr noBbr- B o 3 A e i c r B r . r eH a r o r r K n : r a H r ' - 3 q x ( 2 F ) , r { a H , 3 y ( l 8 V ) , rxafi-Kxe
rxeHHoe apTepxanbHoe aaB,leHrre. no xapaxTepy 3a6o,,reBaHuq Boc- (3R), xyaH-HryeH (4VC), rxaH-3y (23V), ryx,rar'r-a (368),
ToqHafl MeatrrfiHa orHocHT ttneproHttto x <roroBHtIM 6onrM, co- QoHr-,ioHr (40E), rc(r'xafi (6VC), rxaH,MoH (7C), raM,aM,3ro
flpoBoxaaroufiMcq roroBoxpyxeHreMr, ( 6 R P ) . B o A r j H c e a H c€ o 3 A e i c r B y r o r H a 4 - 5 r o q e K .
ctrHApoMy (Berpa, neq€Hfii
rrapyuier{l,r,orH-neqeHr. \ T e p a f l e B r x ! r e c n h i j 3 S + e K r l o q e K . T o q h xQ o H r - , r h
r 2 0 V B ) . c y a r l < o h( 8 V B , . a a y r r o n 1 8 t ) H 6 a 1 b - x o f i( 2 0 ! C ) r c -
n o r b t y r o r A r t ( p a c c e f i B a H H qx a p H ! , n o A | ( o x H b t i y K o J c \ 4 a , l b i v
3TrO.[Oat|t r{ ItATOTEHE3 h p o B o n y c h a H r e MB o B H e v e p H l t u a H H HTeo q K Ha H - a H o H f H r \ a f i - J b i o H l
qaqe Bcero rxneproHrrr Bo3Hl.{KaerB pe3yrrbrare . r p o x l B o a t r r u e f l b r o , 1 x k B r i a a u H H6 0 , l e r H e r a o p H o r l f l H - s H e p f H H :
Hapyureuriq r{Hb- .paccerBaroulrir yho,l B ro'tKy \aHb-rrH (2 F) HopvanHrler 4e-
qH-paBHoBeclr neqefir, noqefi. np{ cxHApoMe <nycro,r6r> rrH6-neqe-
q r e r b H o c f b n e , { e H x .T o H H l n p y l o u r x i y t ( o , 1 B T o q x y K a H - 3 y ( 1 8 V ,
Hlr Bo3H[Kaer [peo6,raaaHte flH-neqeHx, x no Mepe HapacraHris -
? T O r On p e o o n a a a H H r n p o H c x o a t r B c e 6 0 , l b u l e e r c I o L [ e H f i e H H b - n e - [B coqeraHruc rouxaur r'xla,sy (i3V) r xyai-uryeu (+ VC)]
q e H H .. l l y c r o r a r x H b - n e q e H B , p a c c r a 6 , 1 r enr ,e ' r e H h
a ,. p a c c e B a o u H f i "y K o r B r r y x e l o q x y
n b t 3 H B a e t c rea K x e . n y c r o r o f i. H H b -
noqxs, qTo He MoxeT He BJtflrITbHa tH noriKy. yxyauat lB coqeraHrr c roqxofi \aHb-rrH (2 F)l no3Bo,lqer HopManh3oBarb
tx rjH6-tH- aprlFrbHocrb neqelH To,rKa 11x rarv-"rr (36 E) c"1!xHi n,le yKpen-
592 59ll
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Ha rpex qacrei rynoBrrua fi ycrrreHxH rH-aHeprrlj [B co,r€TaHrfi c
r o q x a M x T x a F - 3 y( 2 3 V ) r K x s - x a n ( 6 V C ) l ; s 6 o b n a n o g g o r n e r O c n a 6 n e H H a s Q y H K q q q r H c e r r e 3 e H x xn o p o x A a e r < M l r H y r o M o K p o -
yKpensrb Oyfixqqrc xenyAxa u !'rnxBualrpoBarb <BraxHocrb, Ty>, a cHI,I){(eHfiea(Tl{BHOCTXnH-CepArla npHBOAI{Tk 3aCTO'M KpOSH.
qeraHrrc ro'tKoii IB co- H ro. l,{ npyroe rarpyaHFer aeercnbHocrb cepneqHo.cocyaHcrori
o o H ' - n o H r { 4 0 E ) 1 . B o 3 a e f i c r B HHe a r o q ( y O o H r - crcreMbr, yxyauaeT ur,rpLynnq rc rH-gHeprHx B rpyal, Bbl3brBat
, l o H r t 4 0 E ) c n o c o 6 c r B y e Ty r u e t u r u e H a r ov o x p o T b t ,r r . t r { B f i a a u H 'v] y T -
6 ( ) , r r B 3 r o f t 0 6 , 1 a c r r . H e c , 1 Hr r p r H a i H q { H } k a 3 a H H u x H a p y r x e H r , r i
Hon xnAxocTrj B opraH!3Me. To,{Ka xxfi-xai (6 VC) cryxrT .anfl
y K p e n j e r r x ex H J H e H H o i s H e p r r x . a T o q x l , rl \ a l t - M o H B O B H y r p e H H H eO p r a H L Jn p o H x K a e r 6 0 , r e 3 H e T B o p H arFH e p r , r < x o n o
\7 q k rau-aM- Aa> (KoHqeHrpnpyrcr, B rpyAHoi o6nacrfi), y 6orbHoro Bo3HriKalor
3ffo (6 RP) Ar'rrrBoccraHoBreHfiq AyoeBHot-o cfioxoficrBrr. ocrpeiur e 6or'1fi B cepaue.
5. Bo3AeicTsle MeroAox <qDerefi[f,,
ChMNTOMATI,I|(A
3oHa o6nsare"ruHoro so:leiicrsrq.
BHe3arIHaH ocrpaq, np crynoo6pa3Har 60,rrb 3a rpyal.{Hoi aaBquerc
O c H o B H a e 3 0 H a B o 3 A e f i c r B r e : v , r a c r o x n o 3 B o H o , r H f i x aL
xapaxrepa c oTAaqet a noAMHueqfiyrc o6nacTb, cntHy, rxerc, r,reBoe
Ly; o6,racrl 3aTdnxa I,r o6racrb xlx,roBxnHoi xe,re3br x n,leqo, BAoL,lb n o s H l t p e H H e i c T o p o H en e B o i p y x x r { K r c T H H , l r n o
ropna.
BHyrpeHxefi cropoue o6erx. pyK. flprcryn ocriol 6onl Bbr3brBaer y
A o o o , r n n r e , r l n a r 3 0 r r a B o 3 a e i c r B H q : s H v r D e g H e f fc r o D o H a r o , r € , oonr,Horo cTpax, oH xBaraercr 3a rpyAb, ocTaeTcq HenoABrrxHbtM,
HH H nolousa rronH npr onyulenrr yr"ra pra aononnnt"no. llprrcTyn npoAorxaercq o6brqHo or HecKo,,rbrctxceKyHA Ao HecKorr,
H a F o 6 p a 6 o r K au e q H o f t H c x ) , l o s o i o 6 , r a . r e f i . n o p a x e H H o i . r o -
Kfix MfiHyr, noc,re qero 6onb ocra6€Baer H 6Hcrpo npoxoAnr.
p o H H . l l p f l n a p d r x q e B e p \ H e i r " 1 H H H x n e i i n o H e q H o c r e i_i A o n o , 1
qnre,,rbHar 06pa6oTKa HapyxHofi c,ropoHr,l KoHeqHocT", Pa3,t|,taK)t rpr OopMhtcTeHoxapArH.
| . L r . r H A p o Mc n l c T o T b t r r H i n p e o 6 , r a n a H { e x o r ' 1 o n a . :n e p f i o t r f i q e c K r
Cnoco6 o6pa6orKri B o 3 l e i c T B f i ce p e A H e i s r r T e H c u B -
BosHrrKaronreeouryuleHre crecHeHHocrx, pacnfi paHrrr B rpyarr, 6ec-
Hocrx, sa KaxAyro ,usarc no 15 20 yAapoB; ceaHcbl qepe3 AeHb.
noKoicrBo, ocna6neHHoe AbrxaHlre, 3a6(ocTb, floxo,roAaHHe KoHeq-
fiocret, cHrxeHqe aflnerrTa, noHoc,6neAHblfi c 6enblM c,rI,BHcr6rM
B. Aypxxyrorepanxt HaneToM q3brK; nyrbc r,,ry6oKrfi, MeA[eHHbr* (qaM-,rl,l) fi,rr 3aM€p-
raoulHfi (Ker'Aafi).
Bo3A€ic,rBre ga ToqKn: cHlxaIoulaq aprepxa,lbHoe AaBneHre. 2. CHHApoM (3acrofiHocrr, flopoxAefiHo& MyrHoi Moxporoi';
H a a n o q e q H r . r xn ,o a K o p x a ( X V I 3 o H a ) , r x a H - M o H ( A p 5 5 ) , n e , r e x r , ouyrueHne pacnrpaHr,rq, crecHeHHocr[ B rpy.tti, 60rr,, orAaloqaq
B cnHHy, ocra6r'reHHoe, 3arpy4HeHHoe AhrxaHxe, ronoBoKpyxeHue,
O A H o s p c M e H H afrl y H K u x q H e c x o n b x x x 1 . o e e K BO3Ae'CTBxe
, cp€n BraxHHi Kauenb c Moxporofi. rycToi cnr.r3xcTHi Ha!'re,rHa q3brKe;
Het THTeHCfiSHOCTX, I,t3BrleqeHfiexfIH cpa3y noc,le oxotvaH!{'I nyrbc cKonBturHfi (xoar).
nyHXrlllr. C sacryn{'reHr,reMyryqrueHfirr ceaHcr,r npoBoaLrr6 qepe3 3. Crnapou <3acroq 3Heprnll fi KpoBx>: ocrpbre. nprcrynoo6pa3-
HbI€ 6onx xoJ,Ircnlero xapaKTepa B o6nacTx rpyAlll cepAUa, oTAa-
Ioxlre B [!'reqo. cnnHy; oc,ra6,reHHoe Abrxafine, cepHfi Har'teTHa fl3br
h e . H a K o H q H f i eH n o k p a q M f l b t K a H a 6 , t | o 4 a l o T c ay q a c l k r l a c T o q
CTEHO(APAN' K p o B H : ,n y , ' r b c (.raM), HepoBHbri (can) {n}t <3aMep3aro-
"fny6oK{ri
xlxx> (KeT-aaH,.
ocHoaHbtEnonoxDHLt
Crenoxapaur flporrBnrerch B Blae npr.jcrynoo6pa3Hoft6o,,rn B 06- TEPANH'
Jlacrr.r
cepAua,BcBnJ, c BHcaanHHM yxyArtleHHeM rpoorKfi .epAeq
HOr,r i'aoIOAaeTCt qatue B.efo y JlHu lroxxjofo Bo3pacTa.
MbILUUbr. A. llruorepanrn
cTaplKo^B,npeHMyuecrBeHHu y MydqHH.! pa60rHrKoB)MCrBeHHoto
rpyna. uprlcrln6roorlt BolHHXa|or06blqHonpr Harrpf,.{exxH. Ilpsfiqqn neqeHsfl. flpr cHEApoM< e n y c r o . r Hs H r , n p e o 6 r a -
cl.lJb
HoM)MounoHanbHoM Bor6yxleH x rnH nepeoxnaxlreHHH opraHxlva. aaHrll <xoroaa> ToHr.rsr,rpoBaHnerH-9seprxI,l ar'lr yKpenneHr,tt
llprcTynH 60rr a 06,1acTH cep!ua. A,Telurecqno '/? v, norao,rnrcr cepAIIa, ToHu3lrpoBaHrr€ flg-noqKx, Haxoatul€icc B cocTotHllt <ot
npennor'rararb aHQap{t Mxohapaa H fpe6}|or cootBFtcrBytolultx Hrr. npH cr.rHApoMe<3acrofiHocrt, nopoxAeriHofi M)'rHoi MoKpo-
. B O e B p e r t e H H bM
t ye D , L t o c T o r t H a f\l4 e n H U
H H a Or H O C l t TCr e H O K a p l l r t oh TO8>, BOCrTaHOBreHr.re npoxo4flMocTl.t 3Heprrfi ar'lq yMeHhoeHrt
MOKpOTbL rrpx <3acroe ?Heprfir Ir KpoBt{} - a(TnBH3arlur Tot{a

594 595
3HeprrH, cTr,rMyrru,rrKpoBr.r!BoccraHoBr'reHre npoxoAxMocT{ Mepr,t- l,BreHcfiBHOCrn, tsXeAHeBHonO OAHOMy CeaHCyBO BpeMqnprrcTyna.
Ir{aHoB fi cocyAoB. Bo3aeficrBxe3HaqHTe,rIbHofi riHTeHcIrBHocTlr Ha ayprKyJrrpHbr€TorrKt
Toqxfi Bo3AeicrBrr: r x a H , a a o( l l V C ) , T x a H - A b r o H r aaer BHcoxfift aHanbre3rp)rcurHfi ?(poexr,
r 4 4 V ) , n a H . ' r l H r l l V C t . x x n r 6 M o Ht 4 M C ) . H o i - x y a H( 6 M C , . [ 1 p H M e q a H r e . B r e q e H x 6e o , l e r H n p H c T y n H
6oir{s ceptrue
,{onycrxMo aononHfiTenbHoeBo3aeficrBre Ha roq(Il MeHb-MoH Moryr nocreIIeHHo nptrynnrrbcr (craHoBnrbcr MeHee ocrpblMr)
(4VG), rhr xoa (sHeMepnAHaHHar), ryx-raM,r'1ll (36E) D QoHr,,roHr ,r1160,Hao6opor,Aena|orcq6o,'reerfixe,iHMx- Becr,MaqacrbrMxr.rcxo-
t 4 0F ) aaMr creHoKapAnxsBnq|orcr o6nxrepaqrn apr€pnfi cepaqa r BFe-
C n o c o 6 B o 3 A e f i c T s f i H .B o B p e M H r a c r y n n e Hnxpr r c r y n a
Heo6xoA&MonprMeHcrb r.rHreHcrBXoeBosAeficrBxe Ha 9 nepBbrx I,la cxasaHHoro qcHo, qro 6onbHoMyco creHoKapafiefiHeo6xo-
x3 nepeqxs,reHHbrx ToqeKAo r€x nop, lloxa y oonbHoro He norBr.trct AlrMo 6epeq6ct, He nepeHanpqraTr,cr,,{36erarr, fiepeoxlraxAeHut
cneus(pfi'recKoeouIyuIeHfie ((9QQeI<T {rnhrr), qro66r yMeHbrx}rrr. (or xo,'roAHoi Boa6r, Berpa), fi36erarb 3MorlHoHarbHoronepeBo3-
nprcryn 6o,,rH,EorbHotiao,'rxeH noqyBcrBoBarl,o6.lerqeH&eB 06- 6yxAeHuq, 3aHrMar6cr Abrxarenr,Hofir MHacrrrKofi.
.rlacTqrpyAu. flpox3BoAtr nyHxrll.{rcc ocraBneHreMxrnri Ha 30 M H
c BparrreHneM qepe3 xaxaHe l0 MrrH.Mexay npucrynaMn yKonbr
lorxHbl 6HTb cpeAHefifiHTeHcr.tBHocru perynxpyronlero AeicrBrrr- XPOHTqECKAgCEP,UEII
HA' HEIOCTATOITHOCTb
TepaneBrfiqecKnn 3QSeKr roqeK. Bo3AeicrBne
Ha roqKr B o6,,racrfi cnrHbr, coceaHr,tec rovxoii rav-ay (15V), ocHoBHuE noJloxEHl,tt
rxaH-Aao (llVG) 1I rxaH-AHoHr(44V), <pacKpbrBaer orBepcrxt
Terrar, 9occTaHaBn'lBaeT ncHxfiqecKoepaBHoBecre,yxpennH€Tcepa- XpoH[,{ec(at cepAeqHac HeaocraroqHocrb, Ha3bIBaeMaqraxxe
ue. BoccraHaB,lrsaer npoxonnMoclbMepHrHaHoB. ToqKa aaH-qyHr KnaccHqecxofifieaocraroqHocrtlo (poaoo6PaqeHH9, tB,Iltercc no_
{ l l VC) cnyxlrui,1e aKT BH3aulHToKa rHeprrlt c ue,lbrocHflrrq cJeAcrBxeMBcex 6on*Hefi ceparla, HapyueElrH neroqHot apfepHs
orqyuleHrfl TsxecTlr B o6nacrn rpya . fi prAa Apyrnx 3a6oneaaBlrfi (6qne3Hb no,rek, 3HAoxpI{HHHe,tH-
(beKqroHrGre 3a6o,1eBaHlrt,roxct(o3 Ha OoHeoc"'Ia6'1eHfiqopraHfi3-
ToqKHxxr,b-MoH (4 MC) r Hon-I{yaH(6 MC) ncrorb3yrorct
,I!1rr BOCCTaHOBTeHnq npOXOAr.rMOCT'i MeptAUaHOB;BO3AenCTBfie Ha Ma). Bce c,ryqar xpoHxqec(oft cepAeqHofiHeaocraroqBocrricBtsaHbl
c IByMr ocHoBHbrMIt npnqxHaMlr:yMeHbrueHrieM o6reMa KpoBooopa'
Hl,lxno3Bo!'lHer JltKalrArpoBarb3acroigble ts,leHlit B cepAue.ToqKa
ueHrc B cepAqe fi 3acToftHL,IMI,r tB!'IeHIiqMIrB nepfiQeplqecKoi
MeHb-MoH(4 VG) cfloco6crByer yxperrreHr,trcqH-3Heprur, crr.tMyrr-
U H HB c e f oo p f a H r r M ari h r - \ o a ( B H e M e p f i a f l a H Hk H
n eeH , r r r t H Hl 7 V cncreMe xPoB006parqeHI,It.
I l 9 V ) p e r y " r r p y e ar n e p r r r o ,n u r a e i K p o B r :r y K - r a v - , 1 H{ 3 6 E 1 ,rler{eEnrcxpoBfiqecr€t cepaeqHat HeaocraroqHocrbno&qaerct c
cr'lyxxT Arr ToHr,r3rpoBaHHq gHeprrr,tB cpeAHet qacrt MepfiAxaHa TpyAoM.d,nr HeexapaxTepHhrTtxe,lbre npncrynli H neptoabr peMric-
Tpex qacTei ryroBltrqa, nprqeM oco6eHHoo8a gOOeKrfiBHaB coqe, cnH, He rax aaBHo 6bl4a HafiAeHaBo3MoxHocrhc noMoulblo llr"Io-
yxaJrHBaurr ynyquaTb cepAeqHyloAeflT€r'IbHocTb u cloco6cTBoBarb
raHy{ c roqKoft AaH',ryHr (ll VC); HaKoHeu,roqKa OoHr-noHr
(40E) nprrMeHeercH Tev CaMblMrreqeHl'lloyXa3aHHOll OO!'Ie3Hl
Ans onycKaHnrycrpeMxsrueficq BBepx3HeprHH,
yMeH6rxeHxrMoKporhr.
3TTONOTT' T NATOI'EHE3
6, Bo3A€ficrsle M€mAoM(qBer€xllq,
fnaBHofi ItpnqnHofi Bo3HnxHoBeHlrt xpofiriqecxoi cepAeqHofi HeAo_
3oHa 0613are,lbHoroBo3aeficrBr,tr, craToqHocTu gBrtgtcfl ocr'la6r1eHle flH-3Heprlill cepaua I noqex
OcHoBHat3oHa Bo3aericrBflr:yqacroK no3BoHoqHHKa Thr Thvrr. HeaocrareqHocr6 tH-SHeprrt cepaua BbI3bIBaer3acroll B KpoBoroke,
Aono,rHrrerbHar 3oHa BosAeficrBl.rr:o6nacrb cnHHbtr pe6eDHat a rH-3sePrul' noqek cHrxeHfie rx cnoco6HocT, aK(yMyr'lllpoBaTb
06,1acrh,BHyfpeHHtt cropoHanpe!nreqbq. 3Hepasro, HapyrxeHHe oyHKulir.{ 3Heprnx,3acToll xttaxocTet B opra_
C n o c o 6 o 6 p a 6 o T K f i B o t a e r l c r Bcxoe c p e a H efii H r e H c , l s - Hr3Me, qTO npfiBoalrT K oreqHocTl.l lI crlyxHT nprqHHor notBneHxfl
Hocr6ro;Ha (axAyro ir.rHHrono l5 yAapoB; exeAHeBHono oAHoMy y 60rbHoro rpeBoxHoto cocrotHfiq.

CllMNTOMATI{KA
B. Aypr(ynorepa[fic B Bocro,rHoi MeaxrlfiHe pa3nr.rqarcT aBe QopMbI xpoHtqecKoi cep_
neqfior He,(ocTaTorrHocT.
Bo3aeicrBxeHa ro'rl(Ir:cepAqe,rxar-uou (AP55), cuMnarrrqecKae 1. CnHApoM <oc,1a6neHfir rH-cepArrar: noBbrueHHat Bo36yaH-
HepBHar crrcreMa, noAKopKa (XVI aota). BosAeficraue cpeAnefi MOcr6 Cepaqa, oulyqeflre cTecHeHnfl, pacnlpaHlrf B rpyAn, ncE-

596 5C7
xrqecKat ycTajlocrb, anarnr, 6reAHocTb I(oxHHl no(poBoB,Il{qa,
no6r'lenHeHte Hoftei, Jt6Kocrb, noxoJIoAaHte l{oHeqHocrei, qacrbre HacrynneHfir yny{ueBus Bo3AeficrBnenpoaonxanr Bo 2 3 ceafica
ronoBo(pyxeHr{r, TpeBoxHbrfi coH, cHrxeHte annernra, 6enbrfi
B HeAerrrc:flyr|(qfin B roqKu Hoi-KyaH (6 MC) r ry( raM JIri
(36 E).
xa!'rer. Ha t36IKe; nyrLc ronKlri (r3), rny6oxri fi oqeHb Ma.rrLi
Tepa reBrnqecKri 3 O O e K r T o q e x - T o q x tr x u e y - o y
2. CrHApoM (gacroc gHeprflu u xpoBfi)i noBLrrxeHHar Bo36yAr.r-
(8C) fi raM-3y (l5V) cnyxar Anr yxpenneBriq ceprqa, yJIyqIxeH{H
MOCTbCepArIa, oljlynleHre clecHeHfiq, pacflopaHrir 3 rpyll{,3aTpyA- npoxoAriMocrHKpoBeHocHbrx cocyAoB.Toqxa Hofi-KyaH(6 MC) TaKxe
HeHHoeAblxaHle, noxo!'IoAaHte xoHeqHocrefi, cfiHrotll8[ri uBer Hot" rcnoJlb3yeTcg c uenbropeflJ9uHx KpoBoToxa. a B coqeTaHfih c ToqKot
refi, ry6, Hanera Ha q3brKe; nynr,c rny6oKufi (,{aM), roHr(fi* (T3), raM-aM3flo (6RP) osa cnyxrr A!'rr ycfloKoeHrq,BoccraHoB,qeHut
HepoBHL.fi (can) I,lrtr <3aMepsalor]lnfi) (Ker-Aafi ) nc xuqecxoro paBHoBecnt. tlTo6br aKTlBr.r3r.rpoBaTb utpr{yr'ltll}rrc
qH-)HeprrI B 06,lacrHrp]!1.1x B rrH.cepnue. rrpHMeHrlor nyHX(xrc
B roqKyKhr-xxrcer t14VC). a Bo3neicrBxe Ha mqKyKxmb-MoH (4 MC)
BoccraHaB,lHBaer npoxoar.lvocrbvepHrxaHoB. To,rha xao-xoaHi
(43 V) cny)KnrArq aKTfiBrBaqnxoyHxqrrr ce,'res€Hxr,r r xe.ryAxa, Toq-
TEPANTq Kr.r(yax-HryeH (4 VC) Ir (xn-xafr (6 VC) Arq <corpeBaHfit, r.rroHx-
3r,rpoBaHnF nepBopoaHofisHeprrr, a B coqeTaHl,lnc roq(ofi Klou-nai
A. ]lrnorepall fi (29 E) Aaer Bo3MoxHocrr,aKTfiB13HpoBarb gHeprfiIoB HxxHeft qacrx
MepruflaHa Tpex qacleff ryJoBHrua. rfiKBri4Hpoaarb raxoe paccTpon-
npIHqrn .reqeHufl, fnaBHbrM o6pa3oM 9ro (noAAepxKa
crBo, Kar(B3A)'TrexfiBora. IIpu xpoHflqecxoficepaerrHoiHeaocraroq-
nepBopoaHofigHeprnlrr, <yKpenneHreayxoBHbrxcfin>. Ilpr oablurxe
HOCrxO6brqHo HapyuaeTct npoqecc[riqeBapeHHr,Lrm B caorcoqepea6
r o6fi,rbfiofi MoKporeHeo6xoAuMbr MepH c qenblo
Aonor'lfir{TeJrbHbre ycyry6nger paccrpoficrBo trH-cepAua.B 3Tnx c{ryqafl Bpaqr npx6e-
<HOpMa,l13allllrAbrxaHnR,onyuleHxr ycTpeMnBureffcrBBepx gHep-
raroT I( Bo3AeficrBr.rrc Ha roqKn qyHr-xyaH (l2VC), TyK-raM-nfi
xalllnr r MoxporH, npr cqHApoMe<3acror sHepr|i!
rfitl), JIl.rKBriAarIsu
(36E) lr Kxx-\afi {6C) r uenbp (roHr.r3Hposalb cpenHrcrcqacrb
r.r (poBu> r yBenrqeHre neqeHs Heo6xoaqMo(yc[nHTb 3Heprno,
qro6r,r BoccraHoBqrbee npoxoauMocrbr, a Dpx oreqHocrl{ u ortry- vepx[HaHaTpex qaclei r]roBxua. qTo6d noMo'rb9HeprIx,, npx
prn * <BoccTasoBl.rTb fieaocTaToqHocTl.l <neBoro cepaua) cneAyeTBo3AetcTBoBaTb Ha ner
npoxoarMocT6rH-gHeprrifi, qro6br yJyqufirE
KUE, TPTMEH'' IJH 9TOTO AOflOJIHHTEJIbHONYHKI.IllU B TPYAHHE TOqKIi
Ha o6eux cropoHax rena: B roqKr.r3y'Qy (27R), qro6br ycrnurb aK-
II p ri M e q a H u e. B c,lyqae sHoeKqnoHHoro3a6o,'reBaHHtIrJrI{
KyMyrflufircsHeprrr, B TorrKuAaH-qyHr(llVC) Anq ro8u3ltpo-
ToKcrKo3a,pesynhraroM Koropbrx rBrnocb ocna6neHre cepAerr8ofi
BaHr,rr?Heprljn,B rortxx xon-KoK (4GI) B co,reraHHnc rxaH-Aao
aeqTeJrtHocT!,Heo6xoauMonp€xae Bcero nprfirTb Mepbl no nuKBu- (ll VG) -anr ycrrrreBfisrH'3sepru}r,B roqKu oyK'nily (7 R)
Aaurl, yKasaHHhrx Hapy eHrri. EcnI| HapyrueHfiecepAeqHofiaetrenb-
I Txrou-TyeH (5 R) - a.'lq rosa3spoBaHrq noqeK t y,ryvlleHut
HOCTr.r BO3HI{KJTO B p$yn6raTe peBMaTr{3Ma, HyXHOnpnHqr6 AOnO,1-
HHT€!']bHHe MepbrnpoTI,tB3Toro 3a6oreBaHfit.
T o q x r B o 3 A e f i c r B l r f l : r p y n n al : H o | l - f i y a( 6HM C ) , r a M - 3 y
(l5V), rxney-Sy (8C); rpynna II: xu'xxroer (l4VC), Kxrrb-Mo{
(4 MC), Kao-xoanr(43V). 6. 8o3r€icrBxe MeloaoM <qBer€Hxe,
MoxHo npnMeHnrbAono,'rHflTe,'lbfioe Bo3reficrBie Ha roqxri: KyaH- O 6 p a 6 o r x a f l o 3 o H a r b H o M yn p n H u r n y :
H r y e s( 4 V C ) , K x u - x a i( 6 V C ) , K r o n ' , 1 a( 2
i 9 E ) , q y H r - K y a(Hl 2 V C ) , - 3oHa o6q3areJbHoroBo3aeicrBrrt;
f y K - r a M - n l{r3 6 E ) , n r e r s - v o n( 4 V G r . n a n - q y H r( l l V C ) . 3 y - Q y - ocHoBHag 3oHa_ Bo3aeicrBn9 - yqacrox no3BoHoqHnKa
{ 2 7 R ) . x o n - K o K( 4 G I ) , r x a H n a o ( I I V G ) . 0 } K - , 1 b r{y7 R ) , r x r o x - ln' ln\r:
ryeH (5 R), raM-aM-3ro'(6 RP). - aonoJrHfiTeJlbHat 3oHa Bo3aeficrBrq o6nacrr, cnfiHbl, BHyr-
C n o c o 6 B o 3 A e ii c r B x rr. Kak npaBano, Bo3AeicrBylor peHHqr cTopoHanpeanneqhq,nepeaHrrr cTopoHaro!'reHu.
nooqepeAHo Ha roqK! I fi II rpynnH. B 3aBnclrMocrr,t or reqeHHq60- C n o c o 6 o 6 p a 6 o r K H. 3oHy o6r3arerL,Horo Bo3AeficrBxq
ne3Ht,l()16llparoreue 2*4 ToqxfiAnr aoaonHfirer'r6Horo Bo3AeficrBrc. cneAyer o6pa6arHBarb co cpeAHefi rHTeHcuBHocrbro,ocHoBHyIot
bHaqare pa3ApaxeHrreoT yKor'loBr'terKoe,Ho nocTeneHHo oHn Ael'Ia- Aono{'IHnreJI6HHe 3oHbI co c,'Ia6ofi nHTeHcIrB Hocrt Io. Ha KaxAyto
IOTCq UHTeHCriBHeeIl npOAOIXlTer'lLHee, n, Har(OHeq, I,rny BbIBOA'T. ,rrjHurono l5-20 yAapoB,Bo3AeiicrBneexeAHeBHoeIr!'rnqepe3AeHb,
Bo3AeficrBfieex€AHeBHoe,no oAHoMyceaHcya Aexs. B 3aBrcrlMocrt no oaHoMyceaHcy.Ha xypc !'reqeHfiff l5 ceaHcoB,nepepr,rB Mexly nep-
or 6o,1e3Hltfi KoHKperHbIxyc,roBfii qacrora ceaHcoBMoxer 6bITb sblMH aTOpbrM xypcoM- I Hea,
yMefibueHa oar{H ceaHc B 2-3 \tIA, Kypc ,rereurn cocror,rTlr3
7 l0 ceaHcoB.MexAy KypcaMxaeraror nay3y B 4 5 aHefi. nocne
598
599
 o6nacrb notcHt{qbl;
v r. 60JIE3HllMOqEnOJtOEonC]tCTEMbl HTI3 XI'BOTA;
- Mear{ar'rbHat cropoHa npeanneqL,fl.
NOqEqHA' KOJIfiKA O 6 p a 6 o r K a n o M e p f i A x a H H o M y n p f i H I l an y :
- qeTbrpe yqacrKa MepuafiaHa MoqeBoro ny3blpfl B
ocHoBHbrEnoJloxEHt{t

flp,r\rln noqe'rHoi Ko'lfihI BoiHHxaet B peiynbtare ) ulelrJeHHr He. yqacroK MepfiafiaHa Moq€Boro ny3brpt Ha Hofe, or roqK,
6o,lbltroro xaMuq, cnycKaouerocfl no MoqeroqHnKy, rrro Br,r3brBaer y l - r - q y H r( 4 0 V ) A o r o , i K n x o H - , ' I o H( 6 0 V ) ;
H a p y u e ! r s e y p o a x H a M s K B .n p x c r y n b r B o 3 H x x a | ( ) ro 6 b r , r H o H a o a aBa yqacTKa MepnaraHa noqex B Hl{xHet rIacTIl xl'lBoTa, oT
Hofi cropoHe I y MyxqrH Ha6noAarcrcfl qarl(e, qeM y xesulxH. roqKl xoaHr-3y (16R) ao rovxr xoaHL-Kor (ll R).
B B o c r o ' { H o *M e a x u r r H 3
€ r o H a p y u e H r e o . r r o c B r c i {x 6 o , 1 e 3 H f l M
<xaMHl{ 06pa601Ka no roqeqHnv) npfiHurn): cxevB a or-
aeicrBuq a H a ' l o r r q H a n p r B e A e H H o i B b l u e , H a K a r { a } I o l o ' r K y n o bu
(l,j 6o,1ee) y,(apos MororoqKoM B 3aBxcltMocrl,l or cocroqHHs 60_
3TXOJ|OTllt l| nATOrEflE3
Cnoco6 o6pa6orKt, C x e M a l : o 6 p a 6 o r K a3 o H b o
I 6t3a-
CrHApoM <BraxHocrx xapbr> x npoaorrxHTerbHbre 3acrorHHe qB Te,'rbHoroBo3AeficrBltt Lr BHyrpeHnefi cTopoHbI rorleHI,I npoIBBoaI'lTcf
neHse B MoqeBoMny3brpe l] ,roExorl xHru(e Beayr K 06pa3oBaHnrir KaM- co cpeaHei xHTeHctlBHocTtlo,notcHl,lubl l.t HIl3a xfiBora - co 3Haql,|-
H e n ,q T o p a c c r p a t B a e TS y H X U n I ,3' H e p r a x , H a p y m a e TM o q e H c n y c K a H H e
fl BHsHBaer ocrprie 6onfi B xjtBore, orAatoque B cIIrHy, C x e M a 2 : 0 6 p a 6 o r K a M e p f i A l r a B aM o q e B o r on y 3 b l p t B o 6 n a c r x c n
Hbr r MepHA aHa noqel( B HIixHefi qacT xIjBoTa aonxHa 6bITt <pac-
CTMNTOMATI{KA cefiBarcnlero) xapaxTepa, MeptaxaH MoqeBoro ny3blpt B o6nacrx
roneEH cneayeT o6pa6arblBaT6 co cpeaHei vHreHchaHocTblo: Ha Kax-
B H e 3 a n H a f lo c r p a r c x B a r k o o 6 p a 3 H a q6 o , i b p e x y q e r o x a p a K T e p a B ayro nHHr.rrcno 20 l,l 6onee ylapoB.
HDxHex qacTfi xtaora, oTAa$ular B o6JracT6 cnrrHbl I,r tppaAuHpylo_
lqarr BAonb BHyTpeHHenIOBepXHOCTU 6eApa, a raKx€ ocTpar 6o,,rb B B. AyprKynorcpanl|c
MoqerorrHyxe, HapylxeHIle MoqercnycxaHar npx n03brBax; fio6neAHe-
Hne xoxHbrx noxpoBoa {'It{qa, noToo,rle,1eHfie, TotuHoTa l,lr'1l,lpBo,ra. Bo3aeficrBn€ rr'raMl Ha 6oreBble roqKlt B 3oHe, cooraercrByroqeff
b o 3 M o x H a n o T e p t c o 3 H a Hr . H a p y e H H o M yo p r a s y n o q K a M t f i H a a y p H K y n q p H b l eT o q l ( t r M o q e -
TOrrHLtkt{JIr noqKa (ecrln HeT 60,'IeBblx ToqeK), clMnaTnqecKafl HepB-
TEPANl,|'
Aono,lHxrenr,Hoe Bo3aeicrBle Ha ro,rxlr: MoqeBox ny3blpb, ToHxag
A. l{raorepanar Kr.rlxKa,xe,/re3br BHyrpeHHet ceKpeqxB,
npnHurn r ' re q e H f i r . , r l x K B s A a q r c x H A p o M a < B n a x H o c [
xapbr>, BoccraHoBlireHe npoxoaxMocTfi 3HeprIu, ycTpaHeHxe 6oJr{, ocTPbtn ulncT1|T
Tovxn Bo3!eic.rBxfl: rxaH-3y (23V). 6aHf,KyaHr-3y
(28V),,{yHr-K6rx (3VC), aM xox (l0R). yK;"lbr upacceruaiure.oi ocHQBlrbrEnonoxEllllt
rr'rl{ <nonvroHs3rrpyrcuero-rroJrypaccesBanurero> aeic,f Blrr.
Ocrpbrfi qrcrxr npercraBnter co6oi fiHQexqlroHHoe3a6oneBaHHe
T.paneB i,00eq B.iaeicrBHa c opraHoB MoqeBbraeJleHrh,BhI3HBaeMoeB 6on6uLlHcTBe cnyqaeB
r o q ( r 6 a H r - R y a H f3 y ( 2 8 V ) ' i , { y H r - K b r K( 3 V C ) n p { M e H q e r c s
c u e r ' r h rp
l rP f y , l x p o B a H H f,lH e p t H M H r l l U M O q e B o t on \ r b t o e , H a T o q h \
E, coli. 6o,'lBHb qaue acrpeqaercey xeH fiH. no onpeae-neHxrc
ao{'
roqxofi verl{uHHbrocrpbtft u crnr orHocHTcex pa3pca] 6oierHen
lxaH t t23 V) B coqera r c aM.xox t lO Rt - aro "dpmaon:auail
<nfTt Br,rAoB noqerlHtix KaMHei).
v b l u J e q H o t ) H e p f t t l n o ' { e K H O p M a I f i J O B a BM b t U l e ' { H } t O
s H e p r H r cn O -
qeK s MoqeBoro ny3blps, BoccTaHaBr'ttiBaroTnpoxoal{MocTL
Moqx. STXOJIOTX'T NATOTEHE3
ycTpaHrror crrHApoM <BJraxHocrl,{ xapbr> B MoqeBoM ny36rpe.
flpxqsHoi ra6o,leBaHHe cJyxrr senpoxo,4tlMocrb ?HeprltHMLIuru
6. Bos4eicraxe MeroAoM (rlBereHtnt Bep\Hefi qacrx MepxllfiaHaTpex qacTei Tynosfiua 60re3HerBop
l,tnfi
O6pa6orxa Io 3oHanbHoMy rrpaHurrry: xue rpaxropu <a,raxuocTH xapbl>, onycTlrBmltecflt3 o6nacTlrcpea
3oHa o6s3aTe,,IbHoroBo3AeficTB{ri
Hefi qaclx Mepnafiara rpex qacrei TynoBrnra I,i cKonltB recq B Mo_
601
600
q€BoMny3Npe, rAe oHx nopoxAabr <xapyr. Eone3Hb Moxer no-
re,'rbHoro Bo3aeficTBMt L BHyrpeHHei cTopoHbl roneHH npoH3Bo,ql'lTcH
eBlr,bcfl raxxe B pe3yrbra,re nopaxefilrn MepHAsaHa <BenEKfifi -
tH> 6o,'rBHerBopHofi sHeprrei (xonoAa), npoHr.rKuefi B opraH!3M co coellHefi lHTeHctBHocTbn, nogcHllIlH tl HIrsa xHBOTa (no(a"lbHo,
co 3;aqrrenbHoti, qro6bl ao6HTr,cll <paccenBalouero> eQQeKTa ll 'rfit<_
u3BHe fi AOCTITU]eUMOqeBolo ny3Hpq.
BfiAaqx 6oneBblx oulyueHlti.
Cx€Ma 2: o6pa6o y qerHpex yqacrKoB MepfialtaHa MoqeBoro
c|,lMnroitATlt(A
ny3brpH B o6nacTir cnrHbl r yqacr(oB gToro 'Xe MeplrAfiaHa Ha ror€_
OcHoBHbrMr ctMnToMaMa ocrporo rlr.rcrtra tBncorct nix o6er.u nor c.IleAyer npott3Boa,{Tb co cpeax€i I'lBreuctBHocrblo'
6o,rle3HeHHoe t r B V r \ q a c T K o B v e p H A H a H an o q e ( B H l l x H e i q a c T H x l l B o T a c Bblco_
MoqeficDycKaHreri no!'t,raxrypnr, floMriMo aToro, Ha6nlolarcrcr 6orx q ' r o 6 H c H t l r b 6 u , 1 e B H o
e u ) ueHrf,'
r.oii rir cpeaxei n x r e H c f i e H o c r s o .
tl qyBcTBo nepenonHeHHocrriB I{l.DKHei qaaTIJ xHBofa, 60,r& B notc,
gsue. BpeMeHaMLiHe6oJbllloe noBbtueHlie TeM[epaTypbr Te,,ra, 3fl6-
B. AypxxyrorePanur
Bo3AeficrsxexiraMx Ha 6oreBHe aypHx)''ttpHHe loqKx: Mo'reBoi
TEPATII,'' opraHhl l,tnn Ha 06€ 3Ttl ToqKH (ec"lt
ny3Hpb, HapyxHbre IIotoBHe
6 0 , r e B H eM e c r a H e o 6 H a p y x e H r , l ) .
A. llrnoftpanrn Bo3AeicrBte Ha y(a3aHHble BbIUe Mecra u aono!'tHl'lreJlbHo Ha
f l p r H q s n , e q e H r : B o c c r a H o B ! ' r e H rnr e TOqKn: noqKa, xeJlyaol(-
p o x o a r , t M o c r r3, H e p r f i r . r
Mr,[xII, rnKBaaaqr{r caHApoMa <BnaxfiocTH-xapH}.
ToqKH Bo3Aefi crBar: q y B r - K b r (( 3 V C ) , 6 a f i r , K y a H r - 3 y HOqhOfi 3HYPE3 I'I HEAEPXAHI{E MOqlt
(28V), raM-rbrey.sy(22V), yn-qyHi.(4OV).'
TepaneBrrqechHi rOOeKr toqeK. Bo3aeicrBfie oBuIsE noJloxEIl'tt
Ha roqxr qyHr xHi {3VCl u Oari-iyarr-ry (28V) (co,ryBcrBeHHaf,
TorrKacn[Hbr r roqRa- amarafi) nprueHcercq c uerhro peryr'rr,tpoBa- Ho,{Hofi sHype3 - Henpot3BoJlLHoe Moqeficnyc(aHUe Bo BpeMi cHa'
Hxs 3Heprflr B HrxHel.r vacrs MepfianaHarpex qacrefi Tynosfiqa I floa HeAepxaHfieM Moqt noHtMaerct B AaHHoM cJlyqae ro cocrotHEe'
(BnaxHocr -xapH>, Toqxa-ycrhe yrr-3HoBr (orAa 6o,'r:,Hofi He MoxeT yAepxaTb aKT Moq€gcnycKaH[t AHeM
,rrKBnAaur{r.rcr{HApoMa
(39 V) cryxrlr a,ri pery,,rxpoaauaaoneprirr vbnxu, nioreKaroqefi no H o ' { H b r Ma H y p e t o Mc r p a l l a o T B 6 o n h t l l } l H c l B ec J I y q a e BA e I 9 . H e a e p x a -
Mepr{Ar{aHy Tpex qacTefirynoBrula, fi BoccTaHoBrefirrnpoxoAl{MocTlt Hl|ev voql,t rlollr npecTaperoro Bo3pacra lqxero6on6Hble Oorb_
H L J eC p e 3 K o o c , l a 6 n e H H b l M opraHHsMoM
Mo'{eBHBOATIIUUX nyTet,
Bocloqxaq uealrqana orHocxr o6a Hapylxeuttt ( <HeAepxaBHIo
6. Bo3Aefi€rBxeireroAoM <qBeres rt
O6p a 6 o r x a n o 3 o H a J l r , H o Mnyp r H u u n y : SlttoJtoruq It nATO[EHE3
- 3oHa o6q3are,'E,Horo so3AeficrBHr;
- ocHoBxaq3oHa Bo3aeicTBtt o6nacTb noqcHuqlr; PaccrDoicrBa Moqet{cnyc(aHrq nocBrttorctl s pe3ynbrare oc-JIa6!re_
qacret ryno_
- aonorHrreJbHae3oHaBo3reficrBlr-Hx3 xnBora, BH)"rpeHHrt HI,lr ?;reDrlrx noqeK fi HIrxHefi qacrfi MepaAraHa rpex
B llla. napyuieHt{t coKpaTaTe.JltHoi cnoco6 ocTa MoqeBofo ny3blpH-
O 6 p a 6 o r x a n o M e p r A q a H H o M yn p n H r r n n y :
- qerbrpe yqacTxa Mepr.{Ar{axaMoqeBoro ny3brpr B o6,tacru CHMNTOMATII(A
INI'HH; a
no olHovy yqacrKy MepxnraHaMoqeBofony3r.iprrHa toneH, H e n D o r 3 B o r b H o eM o q e f l c n y c K a H n eB o B p e M t c H a ' 3 a H o q b l - 2 ,
o 6 e f i \H o r- o r r o q K r y f i - q ) H r| 4 0 V , a o r o q x HH o H - ; o H HHoina n ao 3-4 pa3. O6blqxo Ha6r'IloAaercff y aerei' cr'ryqaerct
(60V):
l.r y B3pocntix.
ABa yqacrxa M€p}lAriaHa no'reKor roqxr xoasr 3y (16 R) ,[o
r o q x x x o a H b - K o( rl l R ) .
O 6 p a 6 o r K a n o r o q e q H o M y n p r . r H q r i n y c: x e M a TEPAnXt
BoJleicraxt aHa,'lorHqHa npHBeleHHoisbttuel Ha KaxAyto To'{Ky
rro cu fi ooJleeyaapoB Mo,'toloqxova JaslcHMocTtof cocTotHHt A. hr,torepanxc
6one3Hn,
C n o c o 6 o 6 p a 6 o r I ( I , l . C x e M a1 : o 6 p a 6 o r K a3 o H b o
ri yxpelnefiLe3Heprufi
n p r H u n n J e q e Hr'Itl. Pery,rfipoBaHse
r 6r3a-
Mblrru floqel<t,. 3HeprfiIl MepHIsaHa Tpex qacTet TynoBnllla.
602 603
 -T,o,{Kx Bo3AeicrBke: 6 a H r - K y a H r - 3(y2 g V ) . q y H r - x b t k 3TXOIOr|{q I{ nATOfEHE3
(3 VC), raM-rHey-3y(22Y) . npu orHocrrenbHoM Her€pxaHrrj Mo-
qn-aororu renbgoe BosaetcrBseHa ro'rxr: TxaH_3y (23 V), O c H o B H 6 r M rn. rp a q f i H a M q q l x y p r i t ' B r t l o r c q paccrpogcrBo eHeprul
MeHb'MoE(4 VG). A.rg Bcex roqek-yxorH novex. flcTouIeHIte nuTaTerLHoro SKcTpaxTa t,l xpoBl'i, cocrotHl'Ie
roHr3{pyioqero
aeucTBltt. <orHe> fl cra6ocrn, B pe3ynbrare q€ro HapyruaeTct oyHKII'{t 3HeprIjH
p a n e B T r q - e . c xj ( i r O O e k I MoqeBofo [y3brpq. flp qltHoi nlnypriH raKxe MoryT noc,lyxllTb 6oJIe3-
^ - 'vr
l.,e ToqeK: 6aHr-KyaHr,t)
rzo fi qyHr.KbrktJ vLl cjyxar anr perynrpoBaHH, HerBopHbre{paKTopH <B,raxHocrx - xapu, a cpeaHei qacrx MepuAx_
coKpaueHfif,
voqeBoronyrhlp9. toqKa taM THe'-3y (22V) ficnoaByeTc,rj, cTra- aHa rpex qacTei TynoBnua, fIpoHnKHoBeHfie 6one3HerBopHEIX(pax_
vyr9urn eyHKltr.ir.i sHeprrHvepsaraHarpexqacjei TyroBxu(a. TopoB BHr,rs,B MOq€BOiny3brpb H 3aTpyaH9er QyHKuxL sHeprlrx MbIruq
ncF Tpt nepeqrcreHHbje ToqKHMoryT 6brrL xcno,lbloBaHHflpl.r nocneafiero, Bbr3brBatr,{rxypfiro. 3aaepxxa MoqIt 6blBaer faxxe c]'Iea_
H€OOXOAI,IMOCTT
HOpMalIIr3OBaTr, COXpaUIeHIte MrjlUU cTBxeM rpaBMbr MoqeBoro ny3brpt npll onepaqtI,l.
MOqeBOTO ny,

CXMNTONATl{XA
6. Bo3AeftcrBx€[eroAox rqBer€dxrt
B socroqHofi MeAarruHe pa3rHqaror rpll QopMbr 3aaepxxl{ Moqfi.
O 6 p a 6 o r K an o r o H a n b H o v ! j r p x H I r n y : L flpl, HeAocraroqHocrI,l ?HepaDUnoqeK: norrlaKr.rypxtr, afi3ypr.tt,
- oolacT6 no9cH Htlbti pe3(arr cra6ocTb Mhlluq MoqeBoro ny3brpfl. 6reAHocTL,KoxHbIx nokpo-
- Hg3 XITBOTa; BOBr'rl,lUa,anaTre,6onr, B o6JacTrj cepaua, cra6ocTb B Kor{eqHocTtx,
AOrrolltfifeir6Ho - BHyfpeHHrf, CTOpOHarO!'reHU. 6enLrfi Harer Ha fl3brKe; lynbc r,ry6okrjfi (qaM), roHKxfi (r3), B ny,1b
O 6 p a 6 o r K a n o M e p r . r A r r a H H o M ny p f i H q s n y : r n y 6 o x r r l H o q e H L v a J r L , r i( H H o x ) .
coBoftToqke .cxrb)
ABa yqacrxa MepuafiaHa MoqeBoro ny3Hpq B o6nacrrl norcHx- 2 . f l p l , t o n ] c K aH l , | n6 o r e 3 H e r B o p H o i 3 H e p r u r . i. B J r a x H o cI r - t ( a .
q b r , o r r o r r K r i r a M - r b r e y - 3 y ( 2 2 V ) A o r o q k ! 6 a H r - r r y a H r _ 3 y( 2 g V ) ;
pLl> B MOqeBOtny3blpb: nonna(I,lyprr, au3ypnr, Moqa xe,rrat c xpac-
ABa yqacTxa MepnAnaHa floqeK B o6racrt xrrBoTa, or Tor{Kn H O B a I H M O T T e H X O VB , J A I T U e g H a n p f l X e H H O C t bB H H ) K H e i q a C l I , t
xoanr-xor(ll R) ao rovrr xoaHr-3y(16R). xqBoTa, xaxAa, xe"qrbli I KpacHoaaTbig Ha,'IeT Ha fl3brKe; ny,]rbc
O 6 p a 6 o r x a n o r o v e v x 6 u y I p l . t H q x n y s: o 3 A e i c r - cKonBrqrifi (xoar), 6brcrpbri (caK).
Bte Ha Te xe Toqkfi, KoTopHeficnolth3yroTcffB cnyqae npHMeHeHr,' 3. noc,reacrBne rpasMrpoBaHrrr {,rr'Il{onepaurl Ha MoqeBoM ny
MrrKpor.rrn,
tla Kaxlyro Toqxy no 50 yAapoBMo,roro,{KoM.BosAeicrBfie . . b r p e :a r 3 y p H q . H | x l p x c , B r a y r r e , x a n p r r x e H H o c r b B H r r x B e t q a c T x
cpeaHeuIrHT eHcfiBHocTIr_ xI,lBoTa.
Cnoco6 o6pa6orr{r,t: nocxeMaM I u 2 aoaqeficraanepoue-
BoAl.rrcrco cpe4xeii aurexclauocrbro, npr.j HeaepxaHr,tr,r
Moqx - co TEPAN1l'
cna6oi.
A. nrnor€panxt
B. AypxKynor€palxfl
fl p H q x n r e q e H fi rr, PerynlpoBaHre3Heprqr,BoccraHoBJreHre
Bo3AeficTBxe
Haro,rKHtMo,{eBoiny3btpb,HapyxHHenoJroBHe oprafihi, npoBoanMocrnMoqeBbrBoAcrlqxnyTefi. npl,l HeaocTaToqHocTn 9Hep-
cxMnarHqecxarfiepBHaHcrcreMa, rxax-uon (Ap5E). IIpr xe_ rvx noqeK- ToHn3rpoBaHse3HeprHr. flpH onycKasrx 6o,re3HerBop-
lepxaHHt Moqx- aonorHrireJlbHoeBo3a€ficrBte Ha roqKri: noqka, HbrxQaKropoB(Br'raxHocrs )Kapbrr B MoqeBoftny3brpb- aononHH-
rrnoor3 (Mo3r). MepH no rrrKBIjAaqrr 3rrx OaKropoB. flpr rpaBMxpoBaHIrLr
Tei'rr,HHe
MOqeBOTO ny3Erpt.- <aKrxBr.r3upoBaTbKpoBb, BoccTaHoBtrbnpoxo-
Al,lMOCTT, KAHANOB),
Toq Kn Bo3AeicrB r r (arrBceirpexOopM3a6oneBaHuq):
II IIJYPI,I'
6aHr-KyaHr-3y(28V), qyHr-KbrK(3VC), rau-ruey \22V), yt-
qyxr (40 V).
ocHoDltbtEnonoxEHltt T e p a r I e B T r . r e c ( s f t g 0 Q e K T T o q e K . C o q e r a H xqt e r b l -
pex nepeqrcneHH6rx Toqex opManu3ylor, ycilnuBarcTsHeprrrc Moqe-
npr rruypl.rH nponcxoAnr 3aAepxKa Moqr B MoqeBoM [y36rpe BOrOny3brpgH MeplraxaHarpex qacrei rynoBtnla, BoccTaHaBntBalor
BCneacTBfi
e HeBo3MOXHOCTXCaMOCTOqTejSHOTO MOqericnycKanrr.
npoxoAriMocrbMor{eBr,lBoarulux nyrefi. B 3aBr.rcr.rMocTrj oT xapaxrepa
B BocToqfiofl MeAtusHe raxoe HapyureHfie Ha3L,lBaercq3aAepxxoft 3a6o!reBaHfir.qonorHrrrenr,Ho Bo3AeicrByrorHa roqKu rxaH-3y (23 V)
r Kxr-xafi (6VC), qro6ll ycnnrrrr, OyHxqxn sHeprxr noqeK. ToqKIr

604 005
r a M - a M 3 q o ( 6 R P ) r { a M - n a H r - r y e H( 9 R P ) c n y x a r & 1 r a K r x B n 3 a q r n B. Ayp (ynor€panxc
ce,1e3eHXX, cnoco6crByrcT BbrBoAyxfia(ocrI x3 oprarrl,l3Ma, rllxBliaa, Bo3AeficrBHe Ha 6oneBHe Mecra B pafioHe roqeK: MoqeBoi ny3brpb,
q{l,{ 6ore3HerBopHHx (FaKropoB <BraxHocrll - xapbr>. Toqxfi xrcer-
HapyxHhre nonoBbre opraHbr, cgMnaTfiqecKat HepBHa'| cl{cTeMa.
x a f i ( 1 0 R P ) l , i r a M - a M - 3 r o ( 6 R P ) c n y x a r l , r q a K r k B r r 3 a u H Hx p o B r . { ,
KpoMe roro, Heo6xoanMo Aoflo,rHr{TerrbHoeBo3aeftcrBue: npr <nyc-
< p a c c e l i B a H t 9 r3 a c T o g .
TOTe) noqeK B mqKy IIOqXa,np|,l cqHApoMe(Br'laxHocTl xapbl>
B T O q I ( 0 : X e , l y A O K . C e n e 3 e H K an, p x r p a B M a x M o q € B o r o n y 3 b r p q-
B. Bo3Aef,crBx€ ireroAoM <{Ber€Eltet B T o q x n : f l e q e H b ,r H n o o r 3 ( M o 3 r ) .
O 6 p a 6 o r l { - an o r o H a n b H o r r y n p r H u H n ) (,!l!'rr Bcex
rp€\ rpopMraooreBaHflr,: I| ATOJ|O t-l,|q ECK l.rE rroJr.I|lOUfit,|, IIMflOTEHUt{t
3olla o6t3arerbHoro Bo3Ae&crBrfl:
- ocnoBHarr 3C)naBo3AettrcrBur: o6nac,rb florcHr.rqbr; ocdoBHbtE noJloxEH||fl
- rono!'rxrrrei'rbear 3oHa Bo3reficrBr.re: Hr,r3xaBora, BHyrpeHHne
noA flaro,torHqecxrMI ltor?'tlolllttMr tMe€Tct s B{Ay H€npor.r3sonbHoe
()6pa60rKa no MepxAIraHHoMy nptH{Hny (A,rq ceMtr3BepxeHr€ Bo DpeMq cHa llllII npfi cHoBI,IAeHrtx cexcyanbHoro
Bcex rpex $opM 3a6o,reBaHHr): coAepxaHHt.
- qerHpe yqacTxa Mepr,tAl,laHa MoqeBoro ny3brpr B o6,racrfi cnx- HMnoreHqris - nonoBoe 6eccu,rl,le, o6yc,toBneHfioe HeBo3Mox-
HOCTbTO gpeKUnU flOnOBOTO q,'IeHa.
HH,or loqxH raM-lHey 1) {22V1 4o roqhr 6arb xoaH.t} t30\). I
o r r o l r K r x o a H r - M o H( 5 1 V ) A o r o e x r j q a r - 6 H e H ( 5 4 V ) ; B BocroqHofi MearrrrxHe norlIloutlt, cBttgaHHble c ceKcyanbH6tMl{
aBa yqacTxa Meprrar{aHa noqeK B HxxHen rrac,rH xfiBoTa, oT c H o B x a e H n q M r , H a 3 b r B a l o r c Hc c e M q x 3 B e p x e H n e Mo r c e K c y a n b H o r o
roqxn xoaHb-xo, (ll R) Ao roqKr xoaHr-3y (16 R); cHoBxaeHnr', a no,Inrcqfir, c ceKcyanbHbrM cHoM, -
y q a c l o x n e p e l l H e c p e a x H H o r o\ 4 e p H A x a H ao t t o q h l , l h \ ) x - x o T < H e r p o r 3 a o n b H b r M c e M q H 3 B e p x e H r r e M , ;r r M n o r e H r r n f l
( 2 V C ) A o r o q x l ra M 3 r o { 7 V C ) <ycTar'IbrMqneHoM).
O6pa6orKa no roq€qHoMy npr.tHqrny: noA6op
roq€K Tor xe. qro x y(a3aBHr,ri BHrte; Ha KaxAyro ro,{Kv no 50 a, .r tTltoJtoal,tt ll llaToaEHE3
6oJee yaapoB Mororoqko\,r.
{noco6 o6pa6orKn r Bo3reficrBrr, CeMnr3BepxeHHe or ceKcyat'IbHoro cHoafiAeHaa Bo3HrKaer B 60,1b
Ao3a
a. llo 3oRaibHoMy nprHrlrny: B 3onax o6H3aTe,t6Horo Bo3leiicrBuH rnrrHcrBecnyqaeB B pe3ynbrare qpe3MepHoro pa3pacranxH <60rrhuioro
npxMexrercr o6pa6orKa co cperHefi HreHcxBHocrLro.npfi <nycrore, o r H q > , q r o n p r i B o a x TB p a c c r p o l l c r B o ( a B o p e u c n c p M H > ,a r a K x e r 3 -
eHeprHn lloqelt o6pa6arbrBarorcq co cra6ori HHTeHcfiBHocrbloocr{oB- 3a npeo6naAaHHq cHHApoMa <orHF> B rH-cepAqe, qro orpllllare.rbHo
Has s AorrorHrTe,tbHarr3oHH- flpr onycxaHxx BHr.G60,resHerBopHbrx c K a 3 b r B a e r c eH a u H b - n o q K e .H M e r o r c r r H A p y r r e I p f i q r x H : q p e 3 M e p -
goe ncrxriqecKoe HanprrxeHr.re c oTpHqaTeJISH6lMnocneAcTBfieM A!'tq
QaKropoB <BnaxHocTH - xapH> Bce 3oHbr o6pa6aTblBabrcr co 3Ha-
qnre,lbHoi rgreHcllBHocrbro (3a ucK,lbveHseM 30H6r ()613are,'IbHoro cepAqa ri KpoBri, qpe3MepHoe flo.roBoe Bo3AepxaHue, oc,ra6flBuee
BosIeicTBrr, B oTHouleHanKoropoi nprMeHseTcr cpeAHrH tiHTeHcfiB- rHb-floqKy. l lepeqncneHHhrerpl,lquHbr npr{Boarr l{ cekcyanbBoMy pac-
c r p o H C T B yn. o p o x I l a r c l l l e M y c e M e H 3 B e p x e H r rBeo B p e M r c f i a c e x c y a r L , -
B c , r y q a f l x . x o r l a n p H , r H o i p a c c f p o r i c T B aM o q e x c n y c K a H f i fsl B . H O r OC o l l e p X a H f i F .n e n p o l l 3 B O n b H OHeO q H OC e e M t H l B e p X e H H eH, e C B 9 -
!rt|orcr rpaBMH MoqeBoro ny3Hpr, fipxMeHH€TcrrBo3AeilcrBre cpeA, l a H H o e c n o , r o B b r vB o J 6 ! x n e H x e v , e B , l r e T c r 6 o r e e c e p L , e 3 H H M Hapy-
HEX I'HTCHCIIBHOCTI{. ueHHeM, BEBBaHH6TMyrepei noqKaMrl cnoco6Hocrlt yAepxrBarb
6 . f l o M e p l j A u a H H o Mnyp r ] r q r n y : M e p H A a a HM o q e B o r on y 3 b r p r {( ) 6 cnepMy, KoTopac x Bbnexaer caMonporl3Bo,rbHo.
pa6arHBaercr co cpeAH€i yHreHcfiBHocrbroI| flo xoAy E nporus xoAa HMnoreHunfi B rcHolxecKoM so3pacTe cB,'ItreTct c!'teAcTBseMnx6o
MepHA[ana, MepnA&aH noqeK l,l nepelHecpeAriHHlifi MepHAuaH o6pa Macryp6aufir, nfi6o a,rrre,'rbHoro noJroBoro ao3AepxaHxq, qro npr-
6alHBaroTca m,rr,Ko no xoAy r.rco cna6oi flHfeHcr,tBHocTblo. BOlr.{T t H e p r E o n o q e KB c o c , o f l H r { e< o r H t r , t H e p r n r c c n e p M b rB c o c T o q -
B, llo roqeqHoMy npsH!{ny: Ha KaxAyr,o roqKy llo 50 s 6o,1ee Hr{e flcrouleHxt. flpx,{rHoi r.rMooTeHur B 3,roM Bo3pacre Moxer
y,4apoB Monom'{koM B 3aBHcaMocrr or xapaKrepa 3a6oreBaHltq. floclryxfiTr' raKxe cepbe3Hoe nopaxeHre noqe(.
llpl cnycrorer novex B o l A e r c r B H ec n a 6 o e , n p s o n v c x a n u l , l o r r :
6 o , 1 e 3 H e T B o p H 6QI ra x r o p o B . B , l a x H o c r H Cl|MNTOMATI,I(A
xaphJ, c , . t , ' r b H o en.p r
rpaBMax Moqeroro ny3Lrpr cpeaHee, npl,l 6onn I,l outyueHtr.r pac-
O6uqnue crunrouu HoqHhrx ceMrrfl3BepxeHr.rfiBo BpeMr cHoB ceKcy-
fir{paHgt l{HTeHcItBHocTbBo3AeacrBl,ti raKxe ao,rxHa 6HTb 3fia.rx,
anbHoro coaepxafirt MeprlaHl,leB fna3ax, ronoBo(pyxeHre, ycTa-

606
607
 rocrb, anardn, 60,1r,B o6"rac,rr cnsHH, rnyM B yrUax_flps Henpox3_
BolrbHoM ceMtd3BepxeHI{t,He cBs3aHHoM O6pa6orKa no 3oHarbHoMy nptrHur.rny:
c cexcya,rbHr,lM
Bo36yxAe, 3l]ga o6q3are,rbHoro ao3neicrBtIt,
HfieNl,OTMeqatOTCq, Kak npaBLjJo, qyBcTBo yToMjeHrlt B xoHeqHocTffxj
oc,ra6reHre IIaMsrH, 06uaq yroMnseMoc,rb. anarlrr, MepuaHrje B rra- ocHoBHas 30Ba so3reficrBr'rfl : ()6,'lacrb tlogcHHubl:
3ax, rcroBoKpyxeHue, 6o,rs B o6r'tacrx cnHHbl. ura6oc,rb B fiorax: aono"lHxTe!'lbHar 30Ha Bo3aelcTBljti Hl13xl,tBoTa, BHyTpeHHrfl
n ) , 1 b cT o H h l { f ri r r ) , r r y 6 o h r f i l r o q e H b v a , r b t i t r H r o K l . q r b t K r r p h o
( p a c H b r i c 6 e , 1 b i vq a . t e tu M . O6pa6orKa no MepfiA aHfioMynprHqxny:
yrracTox nepeaHecpea|jHHoro MepraraHa or ToqKx Kxyx-Kor
(2 VC) ao nynxal
TEPAIII,I'T
aBa yqac,Ka Mepfi.(I,'aHa froqeK B BlrxHeii qacrlr xriBoTa, or
A. llruorepantt roqKr xoaH-Kor (12 VB) Ao roqkfi xoaHr'3y (16 R);
- yqacTox Mepr{afiaHa noqek Ha ror'leHa, oT Toqx,l Txal{-Kxe
nptHunn reqeH{s. f l p x c e v a a : e e p x e r a rs o B p e M xc e x c v (3 R) ao roqKa aM-KoK (10 R).
a " r h H o r oc H o B x A e H x r < y c f i n e H r r el l o , r e x , r l x r a l ] f i e n e q e H u ] . < x a j a flpr Heflpolr3BonbHoMceMqu3BepxeHfi fi He3aBrcr.rMoor noJoBoro
xxBaHrje cBr3u Mexly c€prqeM x novxaMu>.flpr HenpoH3BonblroM Bo36yxAeHur x xMnoreHrlxr nprMeHrercrr o6pa6orKa Mo,,roTorrKoM
ceM9l,l3BepxeHLjri fi€3aBficlrMoor no!,IoBoro Bo36vxaeHrq _ <ToH13L1 cra6i)ii rjHTeHcxBBocrx (ToHn3npyKlqee Bo3aeficrBre). Ha KaxayrlJ
poBah,rn e o q e h y. h p t ' n r e H r ec n e p v b r , .u p r r v n " r e H u f i h ,corpeBa nrrHu() no 20 yaapoB. floKa3aHa raKxe aononHrrerbHas 06pa6o,Xa
H s e q r o H s 3 x p o s a H H e s H , f l o q K f i r i < y K p e f l n e H x es H n o q K x i H a x o - yqacrxa MepfiAr'raHaxe,ryAKa or roqx! ryk raM "1r.{(36 E) ro roqxtr
n n u e r c r B c o c to f l H n no i H r r . 3 e n - K x e ( 4 1 E ) . I l p r c e M f , r r 3 B e p x e H f i as o B p e M r rc H a c e x c y a r b H o r o
To'rx g o ^ 3a e r l c r B r . sr : k y a H - H r y e H (aVC),rxaH-3y (23V) coaepxaHnt Bo3aeacTaIre MHot'oaroIbqaTbIM MorroTortxoM Ao!'lxHo
T a M a M - 3 r r o(. 6B
R P ) . B K a ' { e c r B ea o n o r s l r e n b r r H x r o q e x : 6r,rrb cpeAHefi l,HreHcfiBHocrr.i.IIoKa3aHa AonolrHlTer'tLHae 06pa6oTKa
n p r _c F v f lH r s c p x < e h H HB o B p e M r rc e K c )a r b H o ro c H o B r r e H r q y q a c r K a M e p r A r a H a f i e q e H r o T T o q K r ' rx x y l ( T y e u ( 8 F ) a o r o v x r x a r r -
r a v . . ! ( 1 5 V ) . T r a H - v o Hr 7 C ) . x a H 6 - r e H - ( 2 Fr: tflH (2 f) 'r )tracrha vepHAraHacepnud or ro'rhr ri\aH MoB (7 C) tro
fl pr Henpor3BorbHoM ceMrx3BepxeHtI,r He3aBfic]{Moor nor,roBo roqH rqel-xai (8 IC).
ro Bo36yxaeHflr rxan-Kxe (3 R), rr-rxar {S2 V)i
- f i p f i u M r o r e H q a r {- M e r b - M o H( 4 V G ) ,
rt_rxar (S2 V) . B. AlpxKynorepanHq
lJ cryqae ceMr!{3BepxeHllfi Bo BpeMr ceKcya,l6Horo cxoB AeHs, -
< n o n y r o r r r r 3 a u n s f i o n y p a c c e r . { B a H s e >n; p r s e n p o H 3 B o r b H o M c e B o 3 A e i i c r B r e H a r o q K a : n o q x a , M o q e B o i in y 3 6 t p l , ,H a p y x H b r en o n o B H €
Mrrr3BepxeHxIH , l e 3 a B r c E M oo r n o j o B o r o B o 3 6 y x A e H x , c r r M y r e q a q
nor{eK AorlxHa 6Hrb rnaBHbrM Bo3I€icT6ueM ,,rx6o KaK roHrj3uovro flpfi ceMtr3BepxeHd, Bo BpeMq ce(cyavlbHoro cHoBxAeHrH
uree HrrloyKaiHBaHHen . H60 kax npx)RrraHre npr rvnoreiirll Aono?rHxrenhHoeBo3leficrBfie Ha ToqKr,t:cep!ue, net{eHb. npq Henpo-
rcno,rb3yroT x xrnoyxar''rnBaHHeia npsxuraHre, Bo3AeiicTBfie roHl.r3H- a3Bo!,rbHoM ceMta3BepxeHHx, He cBfl3aHHoMc nor''roBblMBo36yx<neHn-
pyrcqero xapaxrepa. e M , - A o n o n H r r e n b H o eB o 3 A e f i c T B r { eHa Toq(n: rxaH-MoH lAP55),
T i p a n e s . r i , r r c K H i ? e + e | {r t o q e K . [ l ] H K U r qs r o q h ) rrnool,{3 (Mo3r). flpfi rMnoreHullr.r AonorH|rer'lbHoe Bo3AerrcrBfie
r v a r - r r y e x ( 4 V C t J . H i H B a e r r H e p f H r on o r e x . T o u x r i x a r . r y H a r o q x r : c u M n a r q e c x a q H e p B H a rc | l c T e M a ,r a n o Q f i 3 ( M o 3 r r .
123 \ i
{6 RPr .n}xar a,rr 1xper",.rrn xaK xHb, rax H qH.
f l o q K n .A o n o l r H H r e r b H o eB o 3 r e f i c r B x eH a . r o q r ( r r a M , 3 y ( 1 5 V ) , r x a H -
H E P E I - Y J T ' P H O C T bM E H C T P Y A J Ib H O T O U X K J I A
MoH (7 C) I, rH-rxar (52 V) npruexrercr rnr oora6neHrq HaKon-
r ' ' r e H H o r(oo r H r , , r r a J r a x n B a Hs c B q 3 x M e x a y c e p l q e M x n o q x a M r . { . ocltoBHblE noJtoxEHt,|{
Co,rerasnei{
roqex ^reHb-MoH
(4 VG) n ru-riar lE2 Vy no,r*yrcic"
aJIg noaAepxaHx-r xu4xbcrl, yxpen,reulr eH-3Hepffifi , ToHu3r.lpoBa- flpfi aaHHoM HapyuieHfix MeHcrpyaJrbHrJfiqrKn Moxer 6HTb Kopo.ra
Bus nepBopoAHofr3H€pr[ri, y(penlreHar noqex, HopManbHoro, A,llrHHee HopMarbHoro na6o ro Kopoqet To A{'rrHHee,
nprt{eM f3MeHrrroTcr TaKxe I1BeT, cocTaB I KonrqecTBo BbrAelreHxn.
5. BosAeicrBxe neroaoM <[BereHtrt. Croaa He orHocI,lTcq Merpopparfir.
O 6 p a 6 o T & a n o T o q e q H o M y n p H H u f i n y .T a x e c x e M a
B o r r e f i c r B l r q .q r o I n p H B e r e H H a rB b r u e . H a x a x n v o r o , { x \ n o 5 0 v n a . sTr.roJtotl{tx nATorEHE3
p o B . T e x H x x a B o r a e i c T B r r sa H a , l o r x q H a r o i . ( o i o D a r n " o n M e n q i r c s
npn r'leqeHHH MxkpoxrJavH, MoxHo s Kaqecrse aono,rnrre,rssoro Hepery,'rflpHocrr, M€ucrpya!'rbHoro q Kna Bbl36rBaercrrrnaBHbrM ()6pa-
B o r n e f i c r B H fnl p r . j v e H x r bn p x x x r a H r e H e o 6 x 0 4 r . r M b t o 3OM<nyCTOTou>noqeK, qro Beaer ( ar.jcrapMoHxI rrepeAHecp€ariHHoro
r qek.
0 <noAH,rMarourerocfl) MepfiAraHoB- flprqrHofi aaHHoro HapylxeHrq
608
 - npr'r 3aaepxxe MeHcrpyaqxii: rxaex-xxy (25 E), xrca-,rari
MOXeT nocr'IyxrTb Ta(){(e <nyCTOTa>neqeHt,l,A pe3ynLTaTe qero oHa {29 Ft):
<He B COCTO9HTILj BMeUaTb KpOBb), l{rr <nyCTOTa>Ce"'Ie3eHxx.Kol'aa n p H H e o l p e a e i e H H o v M e H c r D v a r b H o Mt l , . l K , 1 el xt a H . t \ t 2 3 V l .
oHa He Moxer Bblnor'lHtrb cBoro kpoBerBopHyro oyHXqx|o t KorAa 06- r f l o - r H Ht 8 R r : r H r ) { 2 0 \ L r y i - i a v - , r H r 3 6 E r .
pa3yeTcr 3acTof, xpoBrj. Ha MeHcrpyarbHbli I(ax,'I MoxeT oxa3arb Cnoco6 Bo3!eicrBfi r . f i p r n p e x A e B p e M e H HHoaMc r y n -
Br1r.{tHten nctilxl|qec(aq rpaaMa- " r e s H nM € H c T p y a q H t H a p y m e H a n ,o r H o c H u e M c r r r o c B o e M yx a p a k -
flpexaeBpeMeHHue M€Hcrpyausfi - HapyureHIre, Bo3HHKarc[lee B repy K cxHlpoMy <xapbr), nprMefirloTcr <pacce{Baroulrer yKorbt
60rr,rurHcrBe c,lyqaeB x3-3a,4!'rxr€rbHoro rpeBoxHot'o cocrotHHfl , 6 e 3 n p x ) K n r a H r q , a K c s r { A p o M y< n y c r o r b r - x a p b r , <nonypacce
KoIAa npoAo,'lxlrTenblloe cxonJleH e eHeprxH BbI3HBaer crHIpoM /BaroLrlre noryroHxrrpyrour{e. yxo,ru. Ilpr raaepxKe veHrrpya.
o o f H r r H i H c x H n p o Mq x a p H 3 a c r o t r B 0 6 , 1 a c r rM a r x H . uxfi u i paccTpoucTBe MeHcTpya,'tHoro ur,xJla npaMeHHlo,rcr Kax
3aaepx(a MeHcrpyaqxx Bo3HxKaer B pe3y,rbrare npoHriKHoBeHI'1fl nrloyxa!'IblBaHte, TaK It npxxfi raHfi e.
6o,re3HerBopHoigHeprsx <xoroAa> s Marxy. qro 3arpyaHser KpoBoo6 T e p a n e B r x ,re c K x ri 3SdeKr roqex: roqxfi xxfi,xafi
paqeHr{e B 3rofi o6nacTn. ( 6 V C ) f i r 3 M a M - 3 f l o ( 6 R P ) n p r . r u e x n r o r c ac u e ! , r r , t p oerynlpoBaHrr{
HeonpeAe,leHHHi MeHcrpyanL,xHi qrx,! 06brqHo Ha6,'Iloaaercfl y nepeaHecpearlrfioro fi <ltoanHMaroolefoc', MepHAsaHos, aj9 perynx-
MHoropoxaBrrfix xeHnlaH. nocre MHoroxparHoi norepn KpoBH. nps p o B a H H qs H e p r H . H o p r r a n H < a I x l K , poBy,. .PacceHBaoulrit] ]xo.l
qxHaMHaaHHor{oopMbr HapyuieHIJt MoryT c,'Iyxxrbral(xe a{'IxrenhHoe
B r u , r K ) r x a f i . c y H f{ 3 f ) . r o c o 6 c f B } e r . r H \ B r I i u l t H q r k a p Hn e ' r e H f i r .
Ilonosoe Bo3aepxaHqe, c,ra6ocTL,ce,'re3eHKsx xe"ryIKa, orpl{uaTerlbHo d q n o r l r o H r . r . r H p y l o u r e e n o n y p a c c e f i B a l 1 r u r e pF!o r t e i c r B r e H a t o , r x )
B,lr.rrrrcuar Ha neqeHb r'r noqKut paccTpol.{c,Bo ncpelHecpealrHHoro rxai Kxe (3 R) (HopMarx3yer eyHl(urrrc noq€K, perynxpyer MeH,
l j < o J l r { x M a r o 4 e f o c t )M e p a A r a H o B<, n y c T o T a >s H e p r r t { I K p o s l l . c r p y a u l , l r r . n p x ) K x r a H H e Mr o l r e K r x , i e H - K x y ( 2 5 E ) , r x l o r . t - , 1 a (n2 9 E )
. r u 6 h B a K ' r c qa c o rp e B a o u e r o . 3 o + e h r a . l o q x H r x a H . ] y ( 2 3 V ) q 1 { o .
C|l M NTOMATI'IXA , b i H ( 8 R ) c , l y x a r a . ' q T o H r . l r f i p o B a H r r. {r , f i H e H , , o i , H e p r H r . a r b t r }
( 2 0 V ) x r y K - r a M - , r H( 3 6 E ) - 4 , r a c r r M y r r p o 6 a H , ' j n c p r r u B c p e a -
I l p e x l e B p e M e H i { u eM e | c r p y a u f i} r : M e H c r p y a q q BM o r y r n o g B r t r b c q a o He rracru MepHAraHa Tpex qacTet TynoBrula, yKp€nr'rrq ,rev caMbrM
n B y x p a 3 B M e c , { u ,K p o B b a n a r , ' r x 6 o c Q f t o n e r o B b I M o T r e H K o My, 6 o , ' I b _ l.{croqHr{KMera6o"rr3Ma.
Irot oqyxleH0e xap3, qyBcTBo c qTeHr.rr, cyxocrr, Bo pTy, xaxaa
(npelnoqfiraer xoroaHyrc BoAy); q3brx xpacHHil c xe,lTHM Ha!'IeroM;
B. Bo3AelcrDxe remAoM <uBer€xtc,
flynbc 6brcrpbli (cax).
3aaepx(u MeHcrpyaurrr: MeHcrpyanbBHii qfi K!'r Moxer 3arqrlj- O6pa6orKa no roqeqHoMy n p n H u l r n y . n p H f i r r r rr on r
Barbcr ao 40 50 ,qHeii,KpoBb 6o,ree xxaKaq, 6,1eafiee!l,1H,Hao6opor, xe, qrol' npfi Bo3AeftcrBnHHa rorrKI, c noMoulr,ro Mrxpo,rrn. Ha Kax-
T e M H e eo 6 b l q H o r o ,3 q 6 K o c r 6 ; c a b I K6 n e a H H i ; n y r ' r b cM e A r e H H b I i (i q l r ) .
Ayrc Toq(y no 50 yAapoB. TexHuM Ta xe. qro l,l B pa6ore c Maxpo,
H e o n n e , [ e n e H f l b rvee H c r p l a , r 6 H u e u H K n b r :K o r u q e c r B o B b t , n e r e H x i rrr''laMI,t,
6onbue ri,'rl,{Me8blxe o66rqHoro, qBer - oro,leroBr,Ifi Irnlt 6r'1eaHo_ O6pa6orKa no 3oHanhHoMy np,rHqxnyi
l o H a ( ) 6 q l a T e , l h H oor B o 3 n e f i r r B H s ;
ocl{oBHafl 3oHa Bo3AeficrBut: o6,tacrb floqcHIublt
lEPAN|{9 AonorHItTerl6Hat 30Ha Bo3AedcrBxr: Hlj3 xrjBoTa, BHyrpeHHfit
cTopoHa toreHI,t.
A. llrrorepanxs O6pa6orxa no MepHAfa i HHoMy npnHusny:
) q a c r o h a F p F 4 H f c p e ! H H H o rt o , | r p t r l r a H ao r T o q x H K x y K . K o T
flp x Hq|,jn "r eqeH fi rl. Pery"rqqdt ^,,^
QyHkurinepeaHecpealrHHoro { z v L , a o n } nh a ;
d <noaHrjMaoqeroct> Mepgal,taHoB, a fakxe 3Heprltl{ x (poBL Kax aBa yqacrKa MepaaxaHa noqeK a HfixHe, qacTx xxBo,la B oallH
fraBHar TepaneBTrqecxbs Mepa,npfi npexAeBpeMeHHhIx MeHcrpya- y q a c r o r { r o r o ) h e M e p l n x a H a H a B X y T p e H H e cnr o p o H e r o r e H H .
ur{qx <n Ka}raarlar xapbrrr{opMrurH3aurf KpoBrr.I lpa 3allepxKax C noco6 o6pa6o f h H . n p r n p e ) f i n e B p e v e H H bMi xe H c r p y a -
MeHcrpyaqat,l <ToHr€ripoBaHHe 3reprfifl. Ir{TaHre KpoBH>.fIpL 3a- unqx o 6 p a 6 o r K a B b r c o x o i H " r Hc p e n H e f i r H r e H c l r B H o c T Hn, p H 3 a -
croqx Kpoafifi <IIorr{oTe>9HeprtB <aoccTaHoBLl€Hre npoxoAHMocrt{ Aepxke Meficrpyaql]fi - c,ra6oi, a npI] HeonpeAereHHoMMeHc,rpyarh-
eHeprrr.j,aKTsBri3auHe KpoBu>,IIpr HeonpeA€!'reHHbrx MeHcTpyan6Hblx HoM rlxK"le - c,1a6of, a,rH cpeAHeiftfixreBcfiBHocrr. Ha Kaxayrc nxHr.rro
rluK,lax <p€rynxpoBaxxen ToHr{3rpoBaHre sHeprfia ll KpoBn>. no l5 20 vnaDoB Mo,roroqkoM
T o q ( x B o 3 A e i c r B I r : K x r { - x a (* 6 V C ) , r a M - a M - 3 t o
(6 RP). tlpa o6p'a6<irxe no ueprrAxaHHoMy nprHurrny B cnyqae npexaeBpe-
Aono,rHnr€n6HoeBo3AeficrsxeHa roqKfi: MeHHbIxMeficTpyaqrfi 406aBfiTh Bo3AeficTBre BHcoKofi r.rHreHcnBHocrH
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ce!'Ie3eHxlrr noqeK B o6,lacTx ro,,r€Hx.
B. Aypxlynorepannt
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n p H n p e , ( a e B p e M e H H b rvxe H c r p l a u f i r x ! o f i o r ' r H r r e r r h H o ea o l n e i -
c T B H eH a r o q K f i : n e q e H b ,n o q h r { : n p x 3 a a e p x K e M e H c r p y a u t l
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qaxre - Ha Toqxr: ce.Jle3eHI(4, noql<fi,
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noclre I{ Bo BDeMsMeHCTDVarlrsOTHOC'TC9K O6},1,{HblM Lt He
orHoctrct x narorrorru.'oAxaKo ec,rn 3T 60rl, HacToJ'ILXocl,t!'lbHbl,
q - o B n q r c TH a r p l a o B y K ) n e t r e " l b H o c r b , r op e q r , f i l l e r y x e o 6 o r e l H e H _
r { b l x M e H c T p y a u H f l xT,, e . 0 6 a n b r o a f i c M e H o p € e . 3 r oH a p y u e H d e n p o _
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ro,bl), ral( r.jx cxHApoMy <rronHorbl). B cnyqae cuHApoMa <norxor6l>
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nfi6o, HaI(oHeq,ncnxxqecKoi TpaBMofi, Koraa Bo-3nIrxaer Henpoxoal,t_
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qaule Bcero cBt3aH c acTeHuqecKrrMcocTotHIreM opraHfi3Ma, HeIocTa_
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He nor'lyqaer Heo6xoaxMoIo 0t raHLtt,
CI,IM IIIOMAT It (A
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npr csHr,poMe<flo,IHorbl>: B cr'lyqae 3acrofl xpoBll Ha6nroaalorct
60,'rI,B HfixHef, ,{acTr.,xrBoTa fiepea MeHcTpyaulreirurlt Bo BpeMt Hee,
npxqeM Maccax He cHrMaeT 60rb; TeMHbrecrycrKH KpoBr|, no Bblxoae
Koropbrx 6o,1byMeHr,lxaercq; rry,,rbcrny6oKfii (,{aM); B c,ryqae 3acrot
3Heprrx c,1a6br€6onl, BHrl3y xrBora, oqyqeHxe cl.lJlbHoroHanpt_
xeHl,lfl B xHBOre,'1H6O qyBcrBO HanptxeHl,rf Li pacntpaH,js B
r p y A q r o 6 n a c r p e 6 e p ,T o r H o r a ; n y r r b cH a n p t x e H H b l f i ( K x r c e H ) ,
npa crHApoMe <nycrorH': npoAor'lxrre,lbHHe 6o,rx a xrrBore
612
noc,re MeHcTpyaUs!, Mflrl<Ijt Hn3 xnBoTa, Maccax o6r'tetqaeT 6or'16,
He6or'lhLxoe d{HAkfl\BHAe,leHHScBe,Ijo.KDacHofouBera.
q y B c l B o y r o M n e H r H , 6 o n b B c f l f i H e .c x u x e x a e a n n e r a r a . r o , r o s o x p y
xeHfie, 6ecnoKoicrBo, q3HK 6,reaHbri; nyrbc roHlrrfi (13), r,1y6o(rli fi
M a n b r f t( H x o K ) .
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II p k n uu n ,,1e qe H H q, flpri cuHApoMe <fionHorbr> <at<Tr,tBrr3a-
qxn 3Heprrq H (poBn, !'rrr(Buraqt,lr 3acroiHhrx cBneH]rfir. IIpr.i cltHA-
poMe (nycrorbr> - <corpeBaHxe> q roHfi3xpoBaHne 3HeprHn B HuxHefi
q a c r r v e p f i [ { a H a r p e } ' { a c t e i 1 } , 1 0 8 f i u r a .p e r y r g u x f l n e p e l f i e c p e ] l , t H -
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o aHeH Io Haqana MeHcTovallris.
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r a \ 4 - a v . 3 e o( b l < P l . l l p r c H H 4 p o M e . n o " l x o T Ha. o a o j H H r bT o q K a M H :
xrcer-xafi ( 10 (P) - B cny'{ae 3acror xpoBr.r,Kxn-xa* (6 VC) n qra-
xo (8 RP) - np}l 3acroe eneprxl. flpu iun4poMe <nycrorbD Aonor-
F H r br o q K a M r . K r :l a H - H r y e H( 4 V C ) l , r l K - 1 a M - n l t( J 6 t t .
p a n e B I H ' r e c x r t i 3 O Q e | (r r o v e L T o u r . a q y x r - x u x
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noMorulj MoqeBoMy ny3brpro, axTHBlj3arlfiIj gHepr]rH B H xHefi qacrr.l
Mepr'rADaHarpex qacret TyrroBr.rqa, rB,lqercr oco6o aeOeKTHBHoi
rorrKor: npr 6o,leHeHRoi MeHcrpyaws. ToqKa rxH,,1sey (32 V) rax-
xe sQOe(rrBHa flpH 6o,rqx B xr,tBore. cBfl3aHHbrx c MeHcrpyaqqefi.
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HOX(pyHxqlrfi, gcnor'lb3yeTcHB r HeKor'IOrnI C qenblo ToHlr3fipoBaHfig
cene3eHKx, y!'lyqueHllfl 06MeHa BeutecTB. aKTLiBt3aIItll 3fieprru B
H H ) h H e fq i acrx MepHlkaHa rpex qacrei ryroBrura, BoccraHoBrleHHt
npoxoAHMocIr MeplranaHoB, TaKrrM 06pa3oM, rpl nepeutc,rennue
TorIKt perynfipyloT nepeAHecpeAr.tHHbrfi r.r<noAHrrMarorqricrr MepnAn-
aHbr. axTuBH3rpyror 3HeprH|.o fi xpoB6, nfiKBrAnpyroT cr.rHApoM
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Toqex npu neqegsfi yKa3aHHoro HapyrteHfir
He3aBHcl.tMooT roro,
o r x o c H T c r r! ' r f l o H o n f l . r H A p o M y{ n o r H o T b t , t j r H c r . l H A p o v }( n y c r o T h t , .
K r o q x a M x r o e l - x a i { 1 0 R P ) . K x H - x a f it 6 \ C ) ; a ; a - x d ( 8 R P )
npxMeHrIoT <paccer6a|olllHii> yKo,'l npx fieo6xoArrMocrs aKTriB!3I,r-
I ' o B a T l ,u r p K y r ' l n u r r c 9 H e p r H l , I K p o B , l l p l x u r a n r e v roqeK KyaH-
HfyeH (4 VC) r y h - r a v - , 1 1 i .( 3 6 E ) . c o r p e B a I o r ! 1 1r o H r 1 r H p ' r o 1x H 3 -
HeHHyrogHepraro B HrxHex '{acrH Mep AxaHa rp€x qacrefi Ty,roarula,
YrYqrllaror (pyHKqulo gHepr n.
6. BGAeftcrBx€ MeroAoM <uBererrrr,
06pa6()rxa no roqeqHoMy npfiHqfiny. flpxHunB n o3-
reicrBl,tt ror )Ke, qro I,l onricaHHHfi aurue. Ha xaxayro rouxy no
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ctlBHOCrH,npfi CITHApOMe <nycToTbl c'ra6oi.
xpaiHee <BbrcbrxaHre> k p o B e r B o p H o r on a , r a , n aa o p r a x u s u e . A u e u o -
O 6 p a 6 o r K a I I o 3 o H a ! ' i b H o M yn p o H u a n y : pefi MoxeT 6brTb pe3ynbTaToM Bo3AeficrBrrq 6o,,re3HeTBopHbrx
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ocHoBHat{3oHa Bo3aeftcTBlle o6,Iacrb [oecHfiuri;
- Ht'{3 xltBo-ta, BHyTpeH- 3y!'rbTaTe qero <xonoa> npoHHKaeT B MarKy, ti,rl, nocneacrBxeM
aonorrH[Te!']bHat 3oHa Bo3AeicrBtlt
n c u x r q e c K o HT p a B M b r(,o r a a B 3 H e p r x q t B K p o B t n o t B n t r c T c t 3 a c f o n
' l q n C I o P o H ar o " ' l e H q
( ) 6 p a 6 o r K a n o M e p x a f ia H H o M y n p a H u n n y :
'laclH ,{H_ K a M e f i o p e eH e I M e e r o r H o r x e H n qo r c y r c r B r e M e H c r p y a u r x y 6 e p e
! q a c r o x n e p e n H e c p e , 4 x H H ovr oe p H 4 f i a H aB H f i x H e f i M e H H b r xx e H u I H H r x o p M q u r x M a T e D e t
B o r a , o r r o , r x Hx x y h K o r ( 2 VC) ro nynha:
a B a y q a c T x a v e p l a f i a H a n o q e K B H r ' l , h H e fqi a c r r a H B o l a . o l
r o , r h ar o a H i . x o r { l l R ) t r o r o , t K } t\ o a H r - r } l l 6 R l n o a H H ) ! r a c I o K Ct'MNTOMATIIKA
MepHAraHa fioqeK Ha ro"'IeHti.
Pa3rxqarcT ABe OopMH aMeHopea.
Cnu(o6 o6pa6orKl.j. f l p r o 6 p a 6 o r K_en o r o H a n l H o Mh!
\ r e p H , l I a H H o v yn p H u r n a M H a K a x t r ] l o , l H H r . l lnoo l b y 4 a p o B I t c r ' l y q a P l. AMeHoper B cBqsu c <cyxocrr.|1)) KpoB|,l. nocrle onpeAeneHHoro
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B 6o,rbulrHcTBe cnyqaeB aMeHoper conpoBoxAaeTcr yxyAueHHeM
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Ha nfiuI€BapeHr.{e,xxAXsM Ka"1oM,HeAocraro,rHofi Tpooxxofi, no6,reAHe
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HHev r)6 lr Horrei. ro,loBoKplxeuteu, c"paue6rienuev, anarreir.
nepelH'oro cTopoxy ro,'IeHx c BblcoKoi l'tHTeHcsBHocTbrc,npfi 6ontx ycra,rocrbro; q3brx 6,reAHblt; ny,Ibc roHKHfi (r3).
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flp{ o6pa6orxe no M€pH,lxaHHoMyIIpfiHunfly: B cnyqae cnxapoMa
x r B o r s n p o l u y n H B a l o r c r x o M o q K r , 3 a n o p , c y x o c . r bB o p ? y , q 3 H K r e M ,
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x e H H t n i ( x l o e H ) , H e p o B H H f i( c a n ) .
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oSusE rronoxEHxt a n o A X H M a r o r u e r o c rM
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TEPANIC
METPOPE'
A. l'lrnorepanrn
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c T H M y ! ' r e q x xp o a o a .
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3Hep paHo nocre poroB npxc,ynx"lx l< pa6ore.
fl{fl r1KpoBx>,npx cr,rHApot!{e <nonHorbl> <BoccraHoBjeHMe npoxo
axMocTr{ 3HepruH MHrxll>,<oxnaxAeHl,rexapf,l,, nnxBraaurn Henpo- STI,IOJOTT' g NATOfEHE3

To q x n B o 3 A e i c r a fi r: HI()-KaH (18 E), AaH-,ryHr(17 VC), OcHoBnoi npHqnHofi, Bhi3brBaroDrefi BHrraAeHtle Marxx, tlBnterct
rxxey-.rarb (l IG); npr cxHApoMe <nycrorrrr> Aonor'rHnrenbqoe o c r a 6 r ' r e H r eo p r a H r r 3 M a ,K o r A a g H e p r r r s x p o B b , a r a x x e o 6 q e e c o
Bo3aeicrBne Ha roqxn ru-sy (20 V) r ryK-raM-xx(36 E); np| 6esa- crosHrie 3AopoBbt poxeHxqbr B nocnepoAoBofi nepnoA eue He Boccra-
porre .nonHorbrt AonoJlH{tei1hHoc Bor,nerictR c Ha roqhr xfi voH soBr'reHbr,a oHa BllHyxaeHa BepsyTbcr x rqxe,'roMy os3xqecKoMy
( 14 F) s Hofi-AHHb (44 E) . TpyAy. 3ro fiopoxAaer <nycrory> gHeprxr, Koropaq yxe He B cocrot-
T e p a n e B r r . ,{1e c x x i i s O S e k r r o q e x . T o , r f i aH r c - K a f i Hsu o6ecneqarl coxpaHeHx€ H o p M a n b H o Mn o n o ) K e H f i I r .
(18 E) c,lyxnr 4,rs Boccranos,leinenpoxoarMocr.!jHep*r B Mep14-
araHe <cBeT,'titflH>a npoxoArMocrr.{M,leqHblxnpoToKoB.ToqKaaaH- Ct,|MNTO AT II KA
! ) q r { l 7 V C ) . n p r v e H e e T ccf l u e r b r op e r } r H u r r J H F p r r Ha. r o q h a
rxHey-qa.TbI I rur are Bo.craHoB,leHrq npoxorrlvocrr.l MreqHHx B H n a a e H r e M a I X t l . , r i c t r q H U t ' x , l h u e n r x o v . r a n p e , a e , t Hn o " l o B o f i
nporoxoB.TaxtM o6pa3oM,BcenepeqscneHHbre Toqxr cnoco6crByroT Uler'rI,B Brae I<oMa6neaxo-po3oBoro uBera Be-nnqxHoi c KypflHoe fliqo,
BoccraHoB{'reHnro HopManr,Hoi,laxTaqray poxeHHrlbr.nps cIHApoMe onlyrleHle TrxecTH, pacn[paHrrc B HrixHer,l rracrx x,rBoTa; oo.rrfi B
cfly.rorH, pexoMeH,4yelcs rurror'rHllTerhHoe roH{rxpyX)ueeBolrertr. cnxHe, arrarr,ir, cHr{xeflre annerrra: 6enbrfi fi3br(; nynbc <nycrofi)
rH l) (20Vr H rlx-rav.rH t36 Er n,rr !rlqLxeHftt ( x b r ) . r , , i y 6 o x r f i s o q e H b M a , r b r f i( H r r o K ) .
na^1auur. llpv cHHrpove .norlHorbr' aono,lHrTe,lbHoe Boraeit
cTBr_e <paccexBaroqero, rr{na Ha rorrxr,rKH-MoH(14 F) r Hofi,axHb TEPANfi'
(44 E) anfl naxBrAaq{r.<xapbr>}r 3acrofiHbrx rB.leHfiii.
A. Hrnorepanxq
5. Bo3A€ic?sx€fiemao .qs€Te{rc>
n p a H q r n n e q e H Ir tr. <floaBnrse rrH-3Heprx!), <yxpenieHlre
O 6 p a 6 o r x a f l o 3 o H a r b H o M yn p u B q r n y :
3OHaO6s3are,'tbHoro so:aeficraatl To,{xHBo3Aef,crBrqr 6arb-xofi(20 VG), qyHr-xyau(12 VC), uyxr-
ocHoBHat3oxa Bo3AefiCTBltt: Bepxgfq qacTrrcnLrHLr; (6
KbrK VC), KxH-xai VC), aoi-Mar6 (26 VB).
(3
Aono?.rHure,1bHar{ 3oHa Bo3aeiicrBljq: MonoqHaqxene3a (no- Cnoco6 Bo3aeicrBun: Ha roqxx 6arr'xoi (20VG),
xa,rl,Ho), nepeaser cropoEa roneHr.{,BHyrpeHqq cropoHa npen- uyxr-xyar (l2VC) ll aofi'Marr, (26VB) Bo3aeficrByror roHfi3xpy-
rcrrxMriyxo,raM{.ToqKr.{ xxrr-xaii (6VC) x ,ryHr'Ki,rK(3VC) peKo-
C n.r c o 6 o 6 p a 6 o r x r. 3oHa o6r3a,re,rr,HoroBo3reicrBr.te MeHAyeTCr npfixrraTb.
o6pa6ar6lBaeTcq co cpeAHeirrr{reHcrBHocTblJ,a ocHoBHaq{ AonorHr.t
623
622
 6. Bo3AeficrBxe fieroAoM <qBereHrrt pa3orperbrfi pa6orofi, DoTHbrfi qerroBeK HeocTopoxHo caAkrcfl orAbr
O6pa6orKa xarb B npoayBaeMoM Mecre llnr ecrrfi oH noclre rop'Iqero aytrra nonaaa-
no roqeqHoMy fiprHurnyi n p r r H q rJn, t e ' r e
Hqfl onl,lcaH-Bbrue; Ha KaxAylo roqKy no 50 x 6onee yaapoB Mo!,]oroq- er noA xonoAHlrfi Berep. PeBMark3M Moxer 6brrl, creAcrBteM npo-
KOM C.IAOOT fi HTEHCI,IBHOCTI,{. aolxlrTenbHoro HaxoxaeHxs B cHpoM, BnaxHoM MecTe, B pe3ylbTaTe
qero 6one3HerBopHaq 3HeprHs <BeTpa), <xo,'roAa>. <B!'raxHocTx,,
O 6 p a 6 o _ r x a n o 3 o H a r ' ' r b H o M yI p n H q r n y :
< n y c T a e > n o c B o e M y x a p a K T e p y , I I p o H r K a e T B o p r a H r { 3 M ,B n 3 H B a e
roHa 06q rare,lbHoto BojtreficrBHq
o c H o B H a 9r o H a B o J A e t i . t a n s HenpoxoaHMocTb MepltaxaHoB, qTo BeAeT K IIOqB!'IeHl,{|opeBMaTIqe-
0 6 , 1 a c T bn o q c H k u H , T e M e p H d t
()6"1ac15ronoBHi c x r . 1 xc H H A p o M o Bc B e T p a r , . x o J o n a ! . c B n a x H o c T r , , E c , ' r r o p f a H r 3 v
KpenKxri, npoHxKHoBeHfie6o"re3HeTBopHofisHeprriu <BeTpa>j <xono,
AononHHTe!'IbHat3(Jga so3aeicrBfi, _ H
O6pa6orKa no MepkAraHHoMy np Hq ny: a a ) . < B r a x f i o c T r ' r 3 a c ' r o I H H er s n e H n r o r Q a K r o p a < x a p b r > M o r y r
y ' { a c r o x n e p e ! H e c p e n r H H o fvoe p r a H a H a o r l o q K f i x x ) x - K n r npfiBecTri x ocTpoMy cycraBHoMy peBMarri3My, oTHocrruleMycrrx cr,tHA-
^..^
( z v L ) a o r o q K r K 6 r y . B x( l 5 V C ) i
yqacroK 3aAHecpeAr.tHHoroMepxAXaHa oT ro.lKa Iai_rror.r
(14VG) ao rouxu6ari-xofi (20VG). CTMNTOi'TATI,I
XA
- y q a c T o K< o n o q c H B a r o u e l o >M e p H A r a H a ,p a f i o H f l y n K a .
n o c o 6 o 6 p a 6 o r x t 1 . O 6 p a 6 o r K a 3 o H b ro 6 q 3 a r e n b H o r oB o 3 O6uvuo pas,uuarcr ABe OopMH peBMaTrqec(oi 6o,te3Hr.
_C l , P e B M a r r , r 3 Mo, r H o c r u u r l c r K c x H A p o M a M < B e r p a > , < x o J o A a > ,
AencTBrjs nporr3BoAr{Tcg co cpelHei &HTeHcaBHocT6lo,a ocHoBHoti
AonorHirTe,lbnoi' 3oH co c.na6oi r,lHreHcxBHocTr,ro . B ! ' r a x H o c r l . r r .B o c n a , n e n r e n 6 o , n t e o a i o M x , ' r . i M H o r r x c y c r a B a x ,
roHll3apyrcIIIero
AcficrB r. Ha xaxlyto rhHxlo nu 20 yAapuBMUruto,r,{oM. HapyueHHe 4nrrerbr{oro xapaKrepa c peufiat{BaMx:
06pa6()rKa MepHnxaHos npor.rioarircr co .,Ta6ofi HHreHcrB H'rxH0e fi BepxHfie r{oHeqHocrll corxyrbr B cycraBax ru6o orMeqalorcg
H o c r b r c ,n o r x x o A y , H a x a x a y l o , r { H a r o n o 2 0 y a a p o B . E x e A H e B H o 6onq, onyxnocrb r ranepeMsrr E o6nacrH cycraBoB; noABlxHocrb
n o o a H o M yc e a H c y . cycraBoB orpa8tqeHa. B 3aBacuMocrH or creneHfi npoHI'(HoBeHI,tt
B o p r a H H r M 6 o , l e 3 H e r B o p H b i xQ a K r o p o B . B e r p a t . n r , o , n o a a n L t a
<B,taxHocrl{> npeo6naaaror re rrnl,t HHbre c}lMnfoML,I 3a6oneBaHlrq.
B. Aypr{ynorepan{t
OrcroAa r pa3Hble HasBaHllr peBMarr,t3Ma B BocroqHoft MeArqu,
BosaeilcrsueHa roqxt: MarKa,noqKa. H e : < p e B M a r n 3 MB e T p a ) . < p e B M a r r . r 3 M xorloaa>, <peBMarr3M Bnax-

(PeBMaru3M BeTpa>: ocHoBHod cuMnroM 60rll HenocroqH-

HOi JIOI(a'1t3aUfifi, IHOfAa rroabrrrreHre TeMnepaTypLl Tena, 3q6-
lx. 60Jt$Hl,| KocTHO-Mbt[rEqHofi cr{cTEMbt KocTb, xerfblfi cnr3r.rcrbli Haner Ha q3brKe, ny,16c noBepxHocr-
HHn (O) L
PEAMATlI3M <PesMarr3M xorrola>: Horcrqne 60,'Ir Bo BceM Ter'le rr'L MecrHble,
nocrotHHoi noKatrgaurrr. Tenno cHHxaer, a xonoa ycunuBaer 6on6,
6 e , 1 b r iHi a n e r H a r 3 H K e ; n y a b c H a n p r x e H H b r t i ( x r o e H ) ,6 b r c r p u f i ( c a k ) ,
O C H O B H H EN O J I O X E H X '
<PesMarlrgM ar'laxHocrlr>: ocHoBHoi cl{MnroM
Pesr,{arrel{ 3a6oneBaHre, nporBnroueeca B onyxaHxr r, 6o"trx HOrO flOKpOBa,HOIOtlla' 6OJIr,I,I TtX€CTb B CyCTaSaXBepXHITXl{ HLrX
B cycraBax. BL,r3BaHHoe_6ore3HerBopsbrMH (paKropaMu <xonoAa>,
<BrraxxocT!>, <xapbr>, ttonI Mory,r HabnrcIarbcq B oAHoM r!,Ir MHo_ H'rx xoHeqHocrefi; 60,rk nocrorHHori noxanl,l3auHrr, nplj chrpofi, Brrax,
rxx cycTaBax; oHr MoryT.6brrb ocrpblMn ,1'{6()xporlvecxaun. Ocrpui Hofi floroAe o6blqHo ieuaAuBljpylort .ny,ruc nonepxiocrnxfi x oqens
p e B M a T r 3 M tX a l ( n p a B f i r o , c o n p o B o x A a e T c q n o B b r u J e H { e M Ma,rblii(Hrc), 3ana3Al^Barcuafi (xoaH), Ha Bbrke 6enHi cn!3&crufi
TeMnepa_ HA!1ET.
rypbr Tena, o3fio6oM; qacro 6o,1$Hb Aaer oclroxHeHre Ha ceplqe.
XapaI(TepHbrpeunruBbr. 2- <peBMarrj3M xapbrr. [1o cBoeMy xapafirepy HB,'rrercr nepBnq
I I b I M o c r p h r M p e B M a r f i 3 M o M , r l j 6 0 H a n o M r H a e To 6 o c r p e H , { ex p o H n q e ,
cKoro pesMar[3Ma. b cycTaBax orM€qaroTcr ocrpar 60,rh, onyxnocrh,
9TroJlorfit r naToIEflD3
rfinepeMfi9. noreps noABHxHocrH. y 60rbHoto petxo noBbtuleHa
I I a x 6 0 " r e e p a c n p o c r p a H e H H o fni p r , r H o i p e B V a ? H 3 v af l B , , t q e r c e6 . c TeMneparypa, o3Ho6, 3anopbr, Morra xerToro UBera, xaxAa, 6o,i,
n o p q n o q H b l l oj _ o p a la H r H h , r ( o r t r ao p r a H H r M L ' c n a 6 , 1 e H. K HerrocTotHHoli noKar'rfi3arlslj B oaltoM 'tIL, Bo MHOTr,iXCyCTaBaX, Ha
. oxa fl,lo\o g36IKe xerrrHi rycrofi Ha,ler; ny,'rbc cKo"lb3rrlfii
3AUIXUIACT>. PCBMATI'3M MOXET
(xoar), 6brcrpbrn
6HTb BbI3BAH CXBO3I''KAMI{, XOTAA
tcaxt.
624
625
TEPANll'
r1fi3aUrfl.{rx o6pauleHxq B opraBq3Me, pery,rnuar n Tare,'lt'Hou Ii 3a_
xlxrHoii 3Heprlir.jrroBbrlxeHHfl conporxBnt€Mocrx opraHt3Ma fl yKpen_
A. Hrnor€pan{g
Toqxx irafi-rrca ( 14 VG). KxyK-qa I I I Gl) n xon-xoK (4 GI) c'ly"-
flpr H qnn JreqeHIr fl. <,tlfixBraaqxq B e r p a ,p a c c e B a E Y ex o J l r ) _ a a r r r e . o x , l a x n o H r q ) l a a P H ,r t n e q e H H H H e a l f a H a e r o q a p J X H n x
Ia>, <yMeHbrxeHle Br'la)xHOCTll>, BoccTaHOBIeHne npOXoAHMOCTII c r / ! H l r ! . l e q e H r t 4 p e B M a T H 3 M) ar ( a p H , . l o q K u h a l b - 3 ) ( l / v r x
MepsAkaHoB. x l o e r x a f i ( l 0 R P ) c r y x a r A r s a I ( r H B n 3 a u l r nK P o B H n , e r r e H r q< p e B M a -
To,{xx Bo3AeicTB H'l { a r o r r K Hr x b r o H r - x x a y ( 5 R P )
r n 3 M a B e r p a > . B o s A e f i c r e l r e NH ryK_
- npfi 6onnx B oieiHoii o6nacrt -- xrceH'rloHr (39 VB), K',eH-
rav',ra (36 E) y(peDrqkrr (pyHKrllrlo ce,,re3eHxH,rrro6bl aKr Bl'l3r'rpo-
r u n r ( 2 1V B ) : BATb O6parlleHre opraHrqecKsx xaar{ocrefi B opraHH3Me, {3re'{fiBat
nDlt 60'1ex B o6r1acr,1nreqcBolo cYcraaa KreH_HryHr r e M c a M b r M < p e B M a r v 3 MB , r a x x o c r n ) . f l p r x o r a H l l e M r o l { e K K y a H _
t l 5 C l t , x u e nn H e ){ 1 4 t P r . x r e H - t H Hrb2 l V B r . t r o J y r l 0 l C l : H r y e H ( 4 V C ) x r x a { - 3 y ( 2 3 V ) c n o c o 6 c TB y ' o r O a x r o p y < o r H q > .
n p r 6 o . r q xi o 6 ' 1 a c rnnn x r e B o r co l c r a B a x \ v h q r t l l C I ) yxpeII,rHrcT rrH-sHeprxrc, <paccerBa|1)r 60,1e3HerBopHyrc3Hepraro xo_
x a e r r - r s r i tr2, l V B ) , T b r . H l (o1 4 C l ) ,
npu 60,1fl\B 06,1aLlr {dntcrbe rbruHrq i4 lR) rbloHf_
h x e 1 5C l ) . H r o a i - K y a H (5 TR);
n o l l 6 o J t x s n o l B o H o q H H_K el \ i o r ' x a Y l 2 6 V G ) . l x a H q ) <qBereExet
5. Bo3AeicrB[e MetoAo
t l 2 \ C i , r s r o v r - r . y(aJxV G t . v e n t - v o n( 4 V G r . O o H rv o H r l 2 \ r :
npH6o,,rrxB 6oKax rxbr ,Ixey (32 V), xbr-nfiey(3 E), xoaH-
Kxuey (30 VB), qar-6reH (54 V), ys qyHr (40 V) ; O6pa6orKa no roqeqHoMy npsHqnny. flpxHqxn
npl,l 6o,,iflx B o6nacr{ 6eApa 6e'KyaH (31 E), 'rbloHr'Kxay r'reqeHxq onrcaH Bbrlne. Ha KaxAyro roqxy no 50 yaapoB.
(3,1E). ooHr'rxs (31 VB), rxNa 0y (36 V) i O6pa6orxa n o 3 o H a , ' r b H o M yn p n H u n n y : 3 o H a
rpH 6onqx B KoneHqx xrcer xaii (10 RP), rar sHoHr-xyaH, 06r3arenL,Horo Bo3AeicrBtq; aono?rHrrenbsatl 30Ha Bo3aencrBut;
aM-,ra'{n'ryeH (9 RP) i
npl, 60,1qxB roneHocronHoM cycraBe n B o6nacrl,t,']oablxl(It O 6 p a 6 o r K a n o M e p f l a r j a H H o M y n p r . { H q x r I y :B o 3
3qfi-Kxe(41 E). r<xay-<xu(40VB), KoH-,roH (60 V), rxan-Kxe (3 R); l e i c r B r . { e f i a M e p r ] l B a H H .n p o x o a t q a e n o 6 o i e B H M y q a c r K a M ( B o c
npIl 6o"'rqx B o6,'Iacrl flpeanneqbq 'rxy'raM nn (10 GI), HoBr{oMB o6r'racrfi KoHeqHocrei r.r cnxHbr).
r r x y x ' , r n( l l G I ) , H r o a n - K y a(n5 T R ) ; C n o c o 6 o 6 p a 6 o r K r i . I l p n g t H A p o M e< n y c r o r b r xonora>
-- np 6or'lqxB o6racrlr to,'IeHa ryK-raM-rrrl,l(36 E), xa_Kbr_xbr Bo3aeticrBae c,ra6oi aHreHcfiBHocra, npfi cl,tHApoMe <nolrHorbr
(39 E), 36ronr-Qy(38 VB). xapbrr Br,rcoKorl MHreHcrrBHocrr, Ho He rrprql,tHttrouee 6o,IbHoMy
AononHrr're,'rr,Ho ficDo!'rr€yrcT ToqKB: c,rxrxKoM 6o"'re3HeHHblxoulyxt€Hl,ri; npx cHHApoMe <He nor'rHorbl
- np,r <peBMaTrr3Me B€rpa> Karh-3y (17 v), xrcer-xan rr€ nycrofbr> cpeAHei HHreHcr.rBHocrrr. oaHaxo npfi ocTpblx flptrcry
( 1 0R P ) ; nax 6{),rr MoxBo ycfi,rnrb l.{HTeHcrBHocrbBo3aeiicrBltfl, qro6bl <[oAa
npl, <peBMarx3Me xo{'roAa> rxaH-3y (23 V), xyaH-HryeH
(4 VC); flpx o6pa6orxe no 3oHaM Ha xaxayro r'rr.{Hrrrcno 20 yaapoB,
flptr <peBMaTn3Me cbrpocrx> ryr(-raM-rn (36E), rxuour DpoaonbHHe,1xxrn 0 6 p a 6 a r b r B s T bc B € p x y B H r , 3 ,n o n e p e q H b l e- - a o 6 e
xxay (s RP); cropoHbr, JoxanbHo no cllrpanfi.
. npfi <peBMarr3Me BraxHocrr.{> aai-rrori (14 VG), Kxyx-qt B c,ryqae roHrr3rjpyroruero Bo3aeicrBxe no Mepra,raHaM c,reryer
( l I G I ) , x o n - K o x( 4 G I ) . npor3Boaxrrr 06pa6oTxy co c,,ra6oi l,tHTexcrBHocrbrc no xoay Mepfi-
C floc o 6 Bo3ae &cr Bx q. np, <peBMarx3B Meer p a >x ( p e B - !'raHoB, B cnyqae <paccerBarcqeto> Bo3AeficrBl,re- c BLIcoKoi I'rH-
Mara3Mexapbr> nprMeHr€TcqMeToA<paccelrBaroul€ro,yKa,!bIBaHrt reHcr{BHocrl,Io, npoTIrB xoAa Mep0al,taHoB, <nonyToHlr3ljpylonrero
,1160 06pa6orKa roqex Ero!'rbqarHMMororoqxoM: npfi <peBMarn3Me noiypacceriBaloqero> co cpeAHefi fiHTeHcLrBHocrbto,B o6e cropoHbl
xonoaa) qaule (cno?'rb3yeTcr nprxrraHfie; npfi <peBMaflr3MeBlrax- ( n o r o p x 3 o H r a n f ix t r o B e p r x K a n x ) n o y ' { a c r K y M e p H A H a H a ,
HOCTII> BHaqa,lenpoH3BoaxTcaBo3aetcTBre llr!'IaMr, 3areM npr-
xlrraHfie r|!lI,l<corp€Baroqxe>yxonbl; MoxHo TaKxe Bo3aeiicfBoBarb 6OJr lt B CIII'tHE (JllOM6A10)
MeroloM <qBeTeHfit>.
T e p a n e B r r e c KI, fi 9 0 Q e K r T o q e x. Bce nepe'{xc,'IeH- ocHoBS6tE nOnOXEHl,ltl
Hrie ro'{xs vcno,lb3yrcTcranr <nrKBraaurD BeTpa>,<paccelrBaHfit pacflpocrpalleHHoe 3a6o,1eBafiIte y nloaeii, 3aHqrblx Ox_
"rlrcM6a,'o
xo!'roaa>,BoccraBoBreHrJrnpoxoaxMocr, 3HeprsI,'n KpoBH,HopMa rpyaoM. flpotB'rterca o6blqHo B Baae 6o"'lei B notcHl'{qe
3HqecxrM
626 627
ar'rx no3BoHoqHrKe,npuqeM 6o,'re3fib Moxer rMerb ocrpyro l.r xpoHH- r x H - , r r e y ( 3 2 V ) . 3 b r o H r - n a s r - T y e H( 3 4 V B ) i n p x 3 a c r o t x , K p o B t -
qecxyro OopMy. a r x s ( 6 o n e B a t ) , r | l K a y ( 6 T R ) , 3 b r o H r ' n a H rr y e n ( 3 4 V B ) , y x -
qyi{r (40 V).
3TTIOJIOTI,I'E NATOTEHE3 TepaneBTl,lqecI(Irfi 900eKr r o q e I ( . B o 3 a e f i c r B tf ei a
foqKy rxaH-3y (23 V) MeroAoM nr,royKa,'ItiBaHrq x flpxxrraHllt ToHH_
n p t , { r H o i i 6 o n e f i B n o q c H n u ed c n r H e e B ! ' r r e r c ! B o c H o B H o M< j r y c . o r a > 3rpyer noqxfi, ruKBHAnpy€T .4oKaJrbHo 6o,lesHeTBopHhle QaxTopbl
rroqex, npoHfiKHoBeHfieB opraHu3M 6o,'le3HeTBopHLu(paxTopoB <BeT- <xoroaa) n
pa), <xonoaa), <B,,raxHocTl.t>,xorla naToreHfiaf, 3Heprxr HaKanr'IIl, npuxHraHH€ (4 VG) I, KyaH'HfyeH(4 VC) ro
Baercrr B MeprnrraHax. 6onlr Moryr Bo3H]tKHyrb raKxe B pe3ynbrare Hn3apyer qH-noqKy. ToqKa rrr-rxar (52 V) B coqeraH I c roq
DaAeHfiq. noAHtTxt rcxecTet, pacTqxeHfit cyxoxx,rfii, 3acToq K o i r x a H - 3 y ( 2 3 V ) x c n o n b 3 y e r c r a n t r o H x 3 r r p o B a H r { tn u r a r e r b
KpoBrr_
Toqxa Hey-3HoHr-KyaH cnyxllr Ar'rt BoccraHoBneHllt npoxorx-
( TMNTOMAII,I(A MOc'rI,l3Hepfrr, B nepelHecpeAlrHHoM MepHAfiaHe, yM-qyHr (40v) -
a,/rr r'reqeHr,trr rroM6aro. 14rnoyKa,,rbrBaHHe c Mar'lLIMl(poBonycKaHfieM
P a : , r u ' r a o r r p a Q o p M b rH ap y u r e HH r : <DaccerBaeT) 3acTori. o6e3BpexgBaeT flAbr, coqeTaHqe c Bo3Aeicr-
l . 6 0 r H B c f l r H e _ o r 6 o r e r H e r B o p H h t IS a K r o p o B ( B e T p a . , . x o , 1 o - aier,,r na rouxy Karb-3y (l7V) eBnqercq 3OOennBHbIM cpe,(crBoM
4a>, <BnaxHocTr,rr. llpl{ cr.{HApoMe<BeTpa-xor'loaa): ocTpbre 60,rfi, r'IeqeHlrg r'1loM6aro, BrrSBaHHoro 3acToqMr{ KpoBx. Touxx rxu-,rr.rey
KoHrpaKrypa Mbtruu. llpri caHApoMe<xonoaa B,raxHocTlt>: gorculrle (32 V) u 3hroHr-,'raHr-ryex (34 VB) cnyxar !,'re n KBLIAaUIH6o're3-
o o n r i r a T f l x H o r o x a p a K T e p a ,) c l . t J l B a i o l r r I e c r n p H r l M e H e H H Hn o r o a b l HerBopHbrx (paKTopoB <BeTpa>, <xo!'roAa, H <BnaxHocTtj>, a raKxe
2 . b o r u B c n f i H eo r . n y c r o r b r t n o q e x . H o r c q r e 6 0 , 1 r .Jj a t r x H o f o 4 ' 1 r B o c c r a H o a J e H t q n p o x o a H M o c r r .?t H e p r n H B v e p l r ! H a H a x . . P a c _
xapaxTepa, He npexpauraK)lUHecr Hri AHeM,Hr,tHoq6ro,c,,ra6ocTaB Hrx- cefiBaroqrfi> yKor'r s Toqxri rx-xay (6 TR) t{ 3bIoHr-.rIaHr-TyeH
HIX KOHeqHOCTqX, ttCr'rr B aOno,,IHeHIrex nepeqrc,IeHHhrMctrMIrToMaM (34VB) aKTxBlr3upyer roK ?Heprrr, nxxBurnpyer 3acroiHble tBre_
Ha6nrcIa|oTcfl analnt, noxor'roAaH&e KoHeqHoc,refi.naro!,Ioafiqecx[e Hrr I BMecre c Toqxo]i yl,l-qyHr (40V) npxMeHtercfl A,rIq neqeHllt
n o n i l o u x r , c B e T r a r M o q a . n ' r ' l b c T o H h H f i{ T j ) . t , 1 y 6 o K H i l i o , { e H bM a - 6 o n e i B c n H H e .B b r 3 B a H H b rpxa c r e x e H l r e M r y x o x r . 1 , ' l r n .
n H t ( H r o x ) , T o J a 6 o n e B a H r eB b l J B a H .on y c r o t o i l , q H - n o q K HE. c , l H
xei noMfiMo cr,tHApoMa<nycloTrir>. I,lMel()TMecToCocTofHI,lepac,repcH-
6. Bo3reicrBle MemAoM <qBer€Hxet
Hocrri, xerTar Moqa, ny"'rbc 6HcTpHi (cal{), r3hrK KpacHhrir,ro 6oJ,tI,
B c n H H eB H 3 B a H H a n y c T o r o i i rH H b . n o q h x .
3 . 6 0 , 1 r . iB c n h H e o r r a c l o f l K p o B H .6 0 , 1 H K o n o u r e f o \ a p a h r e p a , O6pa6orKa n o 3 o H a , J I b H o M yn p l r H u l r n y :
rocrorHHofi rloxarfiJaurlt: ny,tbc HepoBHbti1can1. tlpa aiaxeirr l o H a 0 6 f l J a r e J b H o r o B o 3 A e i c r B l . t,f
6 0 , ra B c n s H e y c B r u B a r o r c s , - ocHoBHafl 3oHa Bo3AeicTBI,It O6JIaCTbIIOHCSIIUbI;
- aonor'lHuTeJLHar 3oHa Bo3AeicTBHfl - noAXO,leHHaq06,'laCTb.
TEPANX' O6pa6orI<a no Mepr,raxaHHoMyDpIrHuIny:
- qerHpe 'qacTKa MepHltIaHa MoqeBoro nyJbrpt B o6iacrH
A. ltrnor€panfic
- yqacTol< 3aAHecpeAHHsoro MepfiAuaHa B o6nacr no3Bofioq-
Ilplnuun !reqeHHq. flpu <flycrore, noqeK <yKpenr']exrie
- y'{acro( MepuArlaHa noqeK B o6,/Iacra npean,r€qht or rorIKIt
OyHK{xti no'{ex, aKTriBI,l3arlxr3Heprllfi B nonepeqHHx I(aHa,']ax>.IIpt
npoHaxHoBessr{ 6o,'r$4erBopHbrx (paKTopoB <Berpa), <xo,roaar. rxaft r<xe (3 R) ao roqKr aM {ox (10 R);
<Brax ocrrr, - <flixBltaauss Belpa, paccefiBaHrie xoJroaa, yMeHb- yyacrox MePnAIraHa MoqeBorc nysblpt B o6.4acrfi roreHH oT
ueHr{e BnaxHocrr>- llpfi 3acroe KpoBl < a K r r r B r r 3 a u x fol 6 p a q e - roqKn yx-qyHr (40V) ao roqxa (ol-,loH (60V).
Hrl 3Heprru x hpoorr. npu pacrexexxx cy\or{rnHi .alt BAta- O6a npHHrrnna rcnoJlb3yrorct arq Bcex qerblpex OopM,rrcM6aro.
I l x s o o p a r u e H t t t H e p f H r . r ,B o c c t a H o B J e H f i ef l p o x o l H v o f r H K a H a , l o B . Ha KaxAyro nHHslo flo 20 yaapoB Mororoq(oM.
paccexBaHse 3acrofi fi Hx eB,telrrfi >. C n o co 6 o 6 p a 6 o r K rr. B 3aBlrcfiMocrx or cocrotHltt 6o'le3-
To,{ xl,l Bo3AeiicrB n r : n p r < n y c r o r e r r , r H b - n o q e K, r x a H - HU BO3AeiCTBxe MOXer 6hlrh rOHrr3XpyrcqKM, <paCCeIrBaloull'rM).
3 y ( 2 3 V ) , M e H b - M o H( 4 V G ) , y r - q y H r ( + O V ; ; n p r < r y c r o r e , a H - <nor'ryToHr3upy|onIxM - norypaccerlBaloDllrM r.
nor{Kr - ronoJlHrre,lbgo€ Bo3neilcrBrie Ha ?oq(r{ Ttl,rxar (52V), O6pa6orKa no roqeqHoMy npLrHIlLny: npxHqxn
_
l<yaHHryeH (4 VC); npn npofirlxHoBeHnIj 6on€3HerBopHbrxOa(ropoB ,reqeHrr onrcaH Bblue; Ha l<axAyro roq(y no 50 fi 6onee yaapoB B 3aB
< B e r p a > ,< x o , r o A a r ,< B r ' r a M f i o c r n -) r x a H - 3 y ( 2 3 V ) , y r , q y H r ( 4 0 V ) , cltMocTll or cocrotH t 60Jr€3Hri-

628 629
 -
B. AypxKy,lor€panrt a e l l H e x p o B n , o 6 e 3 s p e x l r B a H I t eq A o B > . n p f i 3 a n o p a x cna6xrenb-

Bo3AeicrBdq Ha 6o,1eB6re roqKfi. coorBercrByrl)ulxe nopaxeHHHM ToqKr Bo3AeIicrBtq: x x y K - , { n( l l C l ) , xrcer_xan

o p r a H a M ,a r a K x e a y p f i x y J r r p H b r er o q x r : r x a H - M o H ( A P 5 5 ) , H a a n o - (l0RP), Aafi-rtott (l4VG). B xaqecrBe aonor'lHlrer6Hllx MoxHo
x c n o , l b 3 o B a r br o r { x f i : H o f i - K y a H( 6 M C ) , r a M - a M - 3 r o ( 6 R P ) , r y x _ r a M _
A o n o J H r r T e n b B o eB o 3 a e i c r B r e : n p , i 6 o r r x B c n x x e o r < B e r p a r , nH (36 E), rxaH-Marb (62 V).
Cnoco6 Bo3Aeftc1Bqq, y K o , ' I bBl r p t t o c x o B u b l reo q K l
<xoJoAa>, <B,raxHocTl.{r - fleqeH6r noqka ]i,!t cere3eHxa; npH <nyc-
ToTe, qfi-noqxr{ - MoqeBot ny3brp6, xe,te3hr BHy,rpeHHet cexpeqxfi; Ao!'rxHH 6biTb (paccexBaloqero) AeficrBHq. flpu I(panxaHlqe oT <Ber
npl,j <nycror€) r.{Hb-noqKr noqKa; npB 3acroe KpoBI, cepaqe, pa>, <xo,'Ioaa>. <B"raxHocTr) c,'Ieaye, npuMeHtTb nplixftraHlre rpex
Toqxy TyK_TaM-!'ll,l
fr'taB[brx ToqeK B coqeTaHfifi c Bo3A€icrBxeM Ha
( 3 6E ) .
T e p a n e BT 'rq e c x t i 9O0eKT ToqeK. <PacceHBa-
x. BoJrE3Hlt KO'(h n [ r H e ' ] K o n b rB r o q K Ht r a f t - r r c Hr l 4 V G ) H H x ] K q H l l l _ G I ) c ' l y x a r
4 i q . J H K B T A a u H HB e r p a H 6 o n e 3 H e r B o p H h l(I p a x t o p o B , . l o q K a x l o e l '
(PANIBHIIIIA xan (10 RP) flcnor''Ib3yercq Ar''Iq<oxnaxaeHI,q KpoBH, o6e3BpexhBa
Hrr raoBr; roqKa Hon-KyaH (6 MC) c,'ryxrr .DtIt <oxnaxaeHss cepa_
o6uxE noJloxEHt|, r r a l , K p o B n > ,r o q x a r a M - a M - 3 e o ( 6 R P ) - a . n gy x p e n n e H l ' r fxl H b _ 3 H e p _
KpaIIHB riqa - KoxHoe ar'rreprrqecxoe 3a6o,reBaHHe, Bhl3brBaeMoe rrIr, <!'txKBnAaIltlr xapbl>, <yKpenneH t ceJleseHKtlr, <ox.4axaeHljt
p a 3 r ' ' I { q H b I Mnt tp H q x H a M n , H a 6 0 r e e p a c n p o c T p a H e H H 6 l 1
e3 H l . { x , K p o B H > , < C H U ) X e H l l gB I a : K H O C T I I )B O p r a H U 3 M e ;T O q ( a T X a H - M a T b
HaxoAqllrect B MqrKax rKaHflx 6one3He,rBopHbre (baKTopLr<xonola - (62 V) cnoco6crByer MoqeBbrr€"{eHxrc, <yMeHbuIeHnro B,'IaxHocrn>;
BraxHocTL nrlr cl(onreHse 0axTopa <xapbr> B xe,ryAoqHo-xttrnerl- roqKa ryK-raM'r[r (36E) c,ryxrr a,]rt <yKpen'reH t x€'lyaKa>'
HoM TpaKTe, I( xoTopblM npy6aBrrrrcrcr upoHrKruxe B opraHngM Ha- <yMeHbuleHrrnB,!axHocrll>.
pyxHble 6one3HeTBopHHe QakTop6r (Be,rpa xonoAa>, <Berpa-
BraxHocTa> I!1II <BeTpa xapbt). 6. Bo3AelcrBs€ MemAoM <uaer€Hst,

CTMNTOMATII(A O 6 p a 6 o r x a n o 3 o H a n b H o M y n p r H . u f in y :
- 3oHa o6r3arenbHoro Bo3aeicrBnn;
6onee anx M€Heeo6rxrpHbr€ BbrcblnaHrq Ha xoxe, Bbt3Hgaroulse cxnb- o c H o B H a s3 0 H a B o 3 l e i c T B f i r : B H y r p e H H r cc r o p o H a n p e a n n e q b t
Hbri 3y.q.flponaaarclr nkrn6 qepe3 HecKo"1r.xoaHeii nx Here,rb. O6brq-
Ho pa3lrnqaror aBe sopMbr. aono!'lHnTer'rLHafl3oHa Bo3aeic, Bxn: 3aIHtlq cTopoHa ro,reHH
L KpaquBHrrra or 6on€HerBopdHx +axropoB <Berpa xo!'roAa>, Ir no!(oreHHar rMKa.
< B n a x H o c r r r : 6 e n H e r r x p o 3 o B a r H e B H c 6 r n a H r e ,o u l y u e H a e r q x e c - C n o c o 6 o 6 p a 6 o r K I,. 3oHa o6H3arenbHoro Bo3reicrBl,Iq
T x B o B c e Mr e n e , M o r r a6 e n a q , n p o 3 p a q H a r r { n f i H e M H o r oM y T H a e ,H a 116pa6arbrBaerca co cpeaHefi x HTeHcnBHoc rbro, ocHoBHa'{ x aononHft_
Te!.lbHaq3oHbr c BSrcoKoi tfiTeHcfiBHocTbro. Ha Kaxaylo auHlllo no
rr3Hxe rycroi 6enHri c,1 3r.rcrbri Haner,
2 . K p a n r B B s q a o r 6 o n e 3 H € T B o p H b rOxa x r o p o B < B e r p a x a p b l ) i l 5 - 2 0 y a a p o B M o , r o r o q K o ME
. x e a H e B H o n o o a H o M yc e a H c y ,
BbrcbrnaHdt po3oBoro uBera, cyxocrb Bo pry, xaxaa, apeMeHaML{
o 4 y r q e H H ex a p a B ! ' r u u e ,M o q a x e n , o r o q B € T a ,B o 3 M o x H b rB p e M e H r b r e B. Ayp rynorepa[xc
3anopbr, xenrbrfi Ha!'rer Ha 13HKe; nyr'rbc noBepxHocrHbrft (0y),
6Hcrpuii (caK). Bo3AeficrBfie Ha ToqKrl xpaIIxBHnqa, xer'r€36r BHyrpefiH€ii cekpeqxltt
Jrerfioe, [oAXopKa. Bo3aeficrBue co cpe.qHefi nHreHcr,rBl]ocrblo,ocraB_
r'reHr{efirr'r Ha I q. ExeaaesHo no oAHoMy ceaHcy, MoxHo ocTaB"IqTh
IEPANI'
firnbrHa3 4 aHtl.
A. Hrrorcpanxs
BEBPOTEHHbIN AEPMATllT
flpfiHurrn neqeHne. B o c H o B H o- M < p a c c e l r B a l r B
r ee r p a > .
flpfi xpansBHx(€ or 6one3HerBopHbrx rpa(ropoB <xonoAa Rlrax- O C H O B H b I EN O J I O X E H H '
Hocrr, Ao6aB,rrercr rrprHrlrfi <paccenBaHfiexonoAa, r'rrKBnAaqrr
HapyueHfie, BbBEIaaeMoeOyHX{rroHanbH6rM paccrpoicrBoM xepBoB,
BraxHocTr> B correraHnnc <yKpenneHr.reM xenyaKa, ynyqueHneM
flps xpanr]BHEue oxnax- rHHepBfipyronrHx xoxHblfi noKpoB. xapaKTepHbI qacrble peulAlrBl>l.
MoqeabrAe!'reHrs>, or <Berpa-xapbr>
631
630
B B o c T o q H o nM e A f l q H I r eo T H o c q r e r o H a p y u l e H x ex 3 a 6 o n e B a H , . t M . rr.{KB0Arpyror 6o,qe3HeT BopHble QaKTopbl qTo6bl yc}Innrh <o3aopo_
MeHy€Mb'M <(Or(a 6yiBo,ra>, <Koxa Kpo'rxxa>. BATe!'IbHoe> Bo3aeficTBlteHa KpoBb, noarinrcqarcT aono!'lH[Ter'It'HOTOq_
K v r a M - a M 3 ' r o ( 6 R P ) , a a n q 6 0 , 1 e el i H r e H c f i s H o ir ' r { I ( B f i A a I I n x< B i 1 a x _
nircrn, r o q K ) a M _ , 1 a H I _ r l et H 9 R P ) n p x r d n o p e/ l o 6 a B i t r o l B o r _
aTxoJtorutrl nAToaEHE3
a e i c l B r e H a I o L I K yH H _ r q H( 2 G l ) . c n y , { a u r y l o 0 6 H ' r H o r ' 1 q H o p \ 4 a ' ' l r i _
pacnpocrpaHeHHoi
Har6o,1ee npuqHHori
HeBporeHHoro
aepMarr.jra : a q f i a x a r a , , l l , r x g r a a q x x 6 o , ' r e 3 H e T B o p H 60IaxK T O p O B . ' r l o x a n b H B o o3-
q B n r r o , c q 6 o " r e 3 H e r s o p H b lO nr,laMx c Ma,'IbIM KpoBonycKaHHeM na I 2 roqKfi B lla_
eaKropbr <BeTpa xapH,. flarorcHHat AeficrBy'or
e x e p r r { e , n p o H x r ( H y BB x o x H 6 r a n o x p o B , 3 a r p y r H t e r u x p K y n f l q x r c !6o"ree rooa)KeBHblx YqacrKax,
eHeprnn u KpoBr. B pe3y,tbrare <xapa> Hapyuaer
HopManbHyrT op o 0 x K y K o x x .
6. Bo3reficraxe MeroAoM <qBetefirc,
CT M NTOMATI'IXA BHaqa,'re peKoMeHnyerct ()6pa6orKa cpeas€i llHTeHctlBHocrIl' 3a
reM -- ctr!1L,Hatl, ao notBIeHIq KanerreKKpoar' B lleHrpe nopaxeHH6Ix
,\,loxHo Br,rae,1!Tr,ABe OopMbr HeBporeHHoro aepMa, sTa- yqacrKoB x 'lo qerblpeM KpatM !'{x. flo o(oH']aHxIr o6pa6orKfi Mo''roroq_
L OopMa. orHocqqarcrr K cl{HApoMy <xapbr Berpa Br'1ax- ioM noosecrx flpuxxraHfie c noMotublo nonblHHblx clraper Ha Bcex
Hocrr>: nopaxeHHHe yqaclxn xoxI rrpko-po3oBoao rlBera c MHoro f l o o a x e H H r , I xy q a c , K a x , e x e a H e B H o n o o n H o M y c e a H c y
qnc,leHHbrMr,6e,,rblMr veuyiiKaMfi, noA (oTopHMB nocne lljeryueHlle
B a A H aH e x H a n p o 3 o B a qx o x ( a c M e n K n M sr o q e q H H M f lK p o B o t l 3 r l . j e u n q -
x ; r 3 b r K p o 3 o B b r i ci x e , l r H M H a , r e r o M in y n b c 6 b r c r p d f i ( c a ( ) .
2. OopMa, orHocquaqcq x cr.rHApoMy<flycrorH KpoBr.r>or 6one3-
uerBopHHxOaKropoB <Berpa)I, <cyxocrn>: nopaxeHHHe yqacrKt XI. 6OJIE3HH OPTAHOB qYBCTB
6e,1bre"1x6o. po3oBes, IpeBparqarcrcrr B xpacHo-cepbre, c,Ia60 [re,ry-
rxaultect. orpaHr{qeHHbreno nnotllaat, lrHoraa l,cqe3atoT, ocTaBnrfl KO H1,lO fl KT l'l B ltT
nocne ce6q 6eryro cHnb: nxraHre { BHAenfire,rbHHenpoueccbr B Hop-
M c ; r s b r K 6 r e a H b r i i : n y n b c r o H x r ] i i ( 1 3 ) , H e M H o r oy c x o p e H H H i ( c a K ) .
ocHoBHt'rE noJloxEHrtl
TEPAN|{' O6bIJHo 3Ta 6o,1e3Hb Ha3HBaercq <rrra3Hoii xpacHyxou>' nocxont'Ky
nDH sroM Ha6rtroaarcrca flpqnyxnocrb x noKpacHeHqe rra3' '1rl
A. llrnorepanrt <i,rasuofi aerpnxxoi>, Tax (aI( B Berpetylo noroAy u3 rra3 Texyr
o6xn6Hble cne3H I,l BbIAe,'IeHltfl Har6o,1e€ pacnpocrpaHeBa B r'IerHl'lt
[ l I p x H r l l , n n e q e H r t - f , l a B H b r Mo 6 p a 3 o M < p a c c e H B a H [ eB e r p a r . nepr.{oA. Bone3Hb 3apa3Haq; ecr'Ix B ocTpoi craAlllr ee pa3Bl'lrl'lq He
n p s n e p B o i + o p M e B K a ' r e c , B eA o n o , r H s r e , r b s o i iM e p H <oxrlax-
nolrxnru cgoegpeuennHe Mepbl no no!1HoMy Ir3Ieq€HI'llo, oHa nepexo_
Aexre KpoBH>, o6e3BpexxBaH e qaoB, <lrsxBxaaqrt B'laxHocrl'{}.
l i r r a x p o u r u e c x y r c c r a , q n r c .B B o c T o r { H o iM e a r t l x H e o H a r a x
Ha3bI_
n p a B r o p o f t ( p o p M e ,B A o n o n H e H r . ,xe o c H o B H o M yn p l i B q x n y , <noa
Baercr < r n a 3 H o i i ( p a c H y x o i t > ( < n o K p a c H e H u e I ' r a 3 ' B t i 3 a a H H o eH e _
x f e n " r e H s eK p o B r , r x x B u a a u a r B e r p a > . 6oM').
To,{x Bo3aeicrBri,r: KXyx'{0 (llCI), x r J e rx a f t
( l o R P ) f i T o q k r H a y q a c r K a x n o p a x e H r . i r ; B K a q e c r B er o n o n H l f i e , l b -
s b r x r o q e x : a M n a n r - r y e H ( 9 R P ) , H f l ' 3 f l H( 2 G I ) , r a M - a M - 3 f l o( 6 R P ) . 3Tl,toJtorr'I lt nATOTEHE3
Cnoco6 Bo3aeicrBrr. n y H K q r s e x e a H e B Hnon n q e p e 3
aeHb no oAHoMy ceaHcyl l5 20 ceaHcos cocraBnrrb, xypc neqeH|rq. KoHbrosKTnBa cK,r€pbl (6enKl, r,!a3) cBe3aHa c rerK MI'{,a KpoBeHoc_
flpfi B'ropori rpopMeHeBporeHHoroaepMarara MoxHo nprMeHgrh npx- Hblecocyari B yrnax rna3 c cepaueM. Koraa B,'IerKrlx Ha6r'ltoaaercq
x x r a H r e [ l o , r H H H b l M cl jd r a p e T a M r T o q e K H a n o p a x e H H b r x y r l a c T K a x cnHApoM <xapH>, Aa K roMy xe ryAa npoHI'lKarcTt3BHe 6on€HerBop-
npoao!'rxnre,rbHocrblo l0-20 Ml,lH. n s r * b a x r o o u i n g e r p a - x i p u o , o u n c x a n r l l l a a e c b .B b l r H s a l o r 6 0 r b
T e p a n e Br s q e c x l, ii 3O+eKr r o q e K . T o q K a( x y K _ q t o n y x i H x e . i o h p a c H e H H er , 1 a i a . l ' { e c ' l H n a r o r e H H a f l , H e p r f i t ' x a p b r '
( l l C I ) c " r y x x r a , ' r t < p a c c e r B a H r t B e r p a ) . C K a 3 a H o :< q r o 6 b l r ' 1 x K _ He r'lrrKaHAr,rDoBaHa,6one3Hb flpHo6peraef xpoHxqecKylo QopMy.
Br,rAIrpoBarbBerep, HyxHo cHarlana BHneqrrb KpoBb>, nosroMy Bo3- 3,roynorpe6,renae a!'lxoroneM, pa3ApaxHTenbHocrb, BcnHr'lbqIrBocrb,
aeicrsyror Ha ro'rKy xKler-xafi (l0RP) y(o,laMlj roHx3xpylc'Ulero B o 3 a e f i c i B r i eH a r n a 3 a n p K o r o c B e r a . o c n a 6 n e f i x e l , H b _ 3 r r € p r u xA, n q _
- Bce 3ro cno-
I e i i c T B r r c q e n b l o< n o l x p e n " r € H x 9 >K p o B r , a K r r B r 3 a u x I { € e $ y H ( u , 1 f i ; r e l r b H a t 6 e c c o H H H I I ay, T O M l l t r o q a s o p r a H b l 3 p e H { q '
yKo!'rbr<pacceaBarouefo> aetcrBrr B 3ry roqxy <oxflaxaaror xpoBb>, co6cTBver Bo3HI,rKHoBeHrlo xpoHltqec(oro xoH!ll)HXT fiBrra'

632
 mT co c,!a6oir xHTeHcxBHocTtllo. yqacTxll
fia ocTa!'lr,Hble co cpeaHefi
CTIMflTOMATTiXA Ha Kaxayro "rrHlrro no l5 20 yAapoB Mo'roro.lKoM.ExeaHeBHono
Pa3,lrqaror rBe OopMhl xoH,h|oHKrr,tBra.
l . @ o p M a ,c B t 3 a H H a nc B o 3 A e f i c r B a e M 6 o n e 3 H e r B o p H b l0x a x r o p o B
<Berpa
B. AypH(ynorepanxc
xapbl> Ha rerKr{e (coorBercrByer ocrpoii craatfi). E6rcr-
p o e p a 3 B r r x e 6 o n e 3 H I , rt ,r n e p e M p o B a H H a tc x , r e p a ,o n y x a H r e , o 6 l r n b ' Bo3reicrBfle Ha roqKfl: rnasa, neqeHb.Bo3aeicrBlre BblcoKoiitiHTeH'
H b t eB H A e J e H r r . c B e r o 6 o r 3 H b , caBHocTr{,c ocraB,rreH(eM r"1 Ha 20 30 MnH.
2 . O o p M a , c B q 3 a H H a qc c x H r p o t l t o M< x a p u > c e p A u a ! , r e r x s x ( c o -
oTseTcT8yer xpoHfiqecKoii cTaAfia) : ynr'toTHeHrexoH6r,oHKTaBblH pac-
L X q p e H { ek p o B e H o c H b r cx o c y a o B c K n e p b r ,3 y ! , x x e H u e , r a n e p e M a f , ATPOOX' 3PIITE.IIbHOTO HEPBA ( fEMEPANON X')
cyxocrb rna3, cBero6os3Hh, nps oTKpbrrlix rrrla3ax ronoBoKpy-
O C H O B H b I ET I O J I O X E H X I

HapylIjIeHfie saxrrorraercs B a€aeHepaufix 3prrrenbHoro HepBa. fna3,

TEPANE' BHeulHeHI{qeMHe OT,'IUqarcUI|,lnctOT HOpMa,']bHOtO, nonHOCTbIO' repter
cnoco6Hocrb aHAerb "'rl,160cMyrHo pa3!rqqaer flperMerH (co BpeMe-
A. llrnorepanxc reM 3ra cnoco6HocTb norHocThb yTpaqnBaercq) - B BocroqHofi Meafi-
{ r H e H a p y r u e H a eH a 3 H B a e r c f l< x y p s H a f l c ! , r € n o T a > .
| I p u H U x n n e q e H f i q . B K a q e c T B ef n a B H o i M e p b l < p a c c e f i B a " -
H H e B e r p a > , r " 1 s x B l . { a a u r n< x a p N } , B K a q e c , r B ea o n o r H x T e , r b H o r r
MepH <oxnaxAeu{e !'Ier(r.{x> (B fiaqanbHoi c,ralrfl) nlx (ox,rax- 3TI4OTOT[' T NATOTEHE3
a€Hxe cepaua Il ,terxlrx) (B noc,leayroulrtx cra,qxsx).
K a K f l p a B u n o , 6 o n e 3 s b c B e 3 a H ac < n y c r o r o t > f i H b - n e q e H sa f i H b n o t l
To,rxx Bo3AericrBfirr: T b r H h - M H H(bl V ) , a o n r - T b r - , r r e y l<fi. HeaocTaToqHocTtlo nxTaT€,rbHoro 3xcTpaKTa B KpoBl{,.a TaKxe
( l V B ) , r x a r i - 3 b i o H r( B H e M e p l r A r a H H a*e P C - 9 ) ' r , r Ha H , A r i o H : ' ( B H e -
c <nycrorofir cene3€Hlo.{x xenylKa, rrro Meulaer nlrarenbfioa 3Hef]rtfi
NrepoAxaHHaq pC 3), KxyK qr{ (ll cl) a,rn xon-KoK (4 GI)- noAifiMarbct BBepx n o6€cneqtBarb OyHKIrxto opraHoB 3peHt'r. fJra3.
ilono,,iHr.{re.'IbH Boo s A e i c r B y r c l H a r o q K u : O e - 3 y ( 1 3 V ) , r x a s - Jr.rll]exHufi Heo6xolfiMblx eMy 3Hepffifi a xpoBtr, T€pge-r cnoco6HocTb
MoH(7 C). rx xay (6 TR). 9CHO B AeTb OKpy)Kaoqxe npeaMeTbr, npfiqeM co apeMes€M 3peHl' te
T e p a n e s I x ! re c h H i r r 0 O , x 1 r o ' t e h luqhH rbrHb- BCe 60,rblxe yxy,rluaerca.
' ' n h i l V r n , 4 o H | r b rn H . )
t l V B i c , r l x a r n n r o p a . c e H B a H x sB c r p a
h ,{{apH>. IIyHKqaq BHeMepaAraHHbrxro,rex rxafi-3r,roHr r aH-,qrioEr
c Nra"lbrM KpoBonycKaHtleM CEMNTOMATIiXA
n p r r M e H g e r c sA n r c H x x e x x r r x n e p e n u r {
B | n a s H H x y r , , r a x .T o , { K r K x y k q t , l ( l l G I ) a x o n - K o x ( 4 G I ) n p f l ] y e H e - MoxHo BbraenfiTb aBe QopMbr HapylxeHltg.
rorcH c ueJrbo {nrKBHnauFF Belpa H oxJlaxleHrfl xaDbi!, a loqKa l. Ar?aiQfir 3pnrenbHoro HepBa, BH3BaHHas (nycroroii, 3seprfin
Oe-ty I l3 V) a"qgnox,laxaeHirq H paccerBaHHr6o;erHerBopnoi li xpoBH: cHrxeHxe ocrporbr 3peHl,tt, yxyA[IeHte aflneTqra, yToM-
3Heprfix, HaxoAeqericq B cocroqHHr no,lHoTH>. B MepflafiaHe rerKxx. rlreMocr6, no6relHeHre KoxHbrx floKpdBoB, cna6oe abtxaHlte; t3bl(
B <IroBepxHocTHoi> cTaALM 3a6o,,reBaH0q. <Paccefiaarcufie> yKo"lbl 6neAHbrfi;nynbc roHxrrfi ('r3), r,ry6oKxfi s oqeHb Manblfi (HxoK)
B T o q x y 1 x a H - M o H ( 7 C ) n p r M e H s r o r A r e < o x r r a > K l e H x r rc e p a { a > , 2. Arpo$ur 3plrre-'IbHoro HepBa, BbI3BaHHaq<nycrorofi fiHb neq€_
Haxoarluerocr B cocrorrHntl <xrapbrr. npfi xpoHr{qecKoii craas, H 6 u l l H L ' - n o q x r > :n o q r r ' [ o r ' I H a s y r p a r a 3 p e H r t r ,c y x o c r b x o x r ' n o , r _
KoH' brcHk,tlrBI,tTagO3AelCTBytO' rAOnOJHATe!'IbIlOHa TOqXy Tfi-Kay raxuypr,rr, cyxocTL Bo pTy, )Kaxaa, rxyM B yuax, rnyxora, cJla6ocTb
( 6 T R ) A n q < p a c c e r a a H r t H l r s K B x A a u r u x a p b r , B M e p r A l r a H er p e x B KoneHrrx, nlroxoii anneTlrT, paccTpoficrBo cHa.
,lacTefi Ty,'IoBl.iua, fiaioatqeMca B cocTotHIl.l <otHn>, nocxo!'Ibl(y
9TOT MEPXAITAH CB93AH N O B C P X H O C T H OB H Y T P E H H I T M A O T H O I r I C H f i g M I , 1
c M e p H l s a H o Mn e p r K a p A s , TEPANU'I

A. llrnorepafl t
6. BosA€ficTBx€ M€roAoM <qBeT€Hxgt
npxHqfin ,reqeHlIt. n p x < n y c r o r e r 3 H e p r [ t {l I K p o B I -t < T o _
O6pa6orxa no 3oHa,rbHoMy nptlHuxny: o6racrr> Hr3lrpoBaHfie 3seprsfi fi l(poBll>, Ilpx <nycrore> tHb_neqeHl'l I, l'lHb_
3arbr!'rKa, BrcoqHarr 06,lacrh, yqacrxx Bor{pyr rlra3, nepe,aHeHapyx- noqI(n - <ToH[3ripoBa]llte net{eHU fi noqKLl>.
Has cTopoHa npeAn!'reqbq. T o'r K x s o 3 a e ii c r B x n: rHHb-MnHb ( l V ) , O o H . - q x( 2 0 V B ) ,
Cnoco6 o6pa6orxH: H a y ' r a c f x BHo ( p l rf n a i B o r a e i c r B ) -
635
634
 KyaHr-MnHb (37 VB), Kx-MoH(14 F). B xaqecrBeaonorHrrer'rhH,,rx: 3apa3Har{, Aarouafl qacrble p€Illrrr.{BbL Bocna,leHlte ca"'IL'Hoi xe''re3br
rH xoa (B{eMeprar.rasHbre, raeHrrrrr.rbrero.rxaMl7 V a l9 V), rxaii_ BeKa npoxoatir 6blcrpee, qeM Bocna,reHre xere3bl xpqLla BeKa
Kxe (3 R), 'ryK-raMnx (36 E).
C n o c o 6 B o 3 A e i i c r B r H , n p s n y H K q t r xB T o q K r pr ,a c n o , 3TIIOJIOTT'I l| NATOfEHE3
roxeHHHe B r"ra3Hrrle,firrH Heo6xoAttMo016rparr, oco6eHHorura,
reabHo. I4cno,rb3yrornpcMbrerrrr'rbrc poanuu ixa,tou. BBoAltrr, tjx n p r , r h H o i s q v e H r 9 B , 1 f l e r c qB i a r v o r e t i ( T B H e 6 o r e r H e r B o p H b r rO a K _
cneayeTrry6oKo B aHo rna3H,qbr.6es ipaqexru, rax xax npx 3ToM ropoB <Berpa> H <xapLl>, Btl3HBalouee HapyueHfie B 06"lacrH Beka,
,erKo BH3BaTbKpoBol{3nqflHte.Bo3aeficrBle Ha ocranbHbreroqk, nx6o roprqar nrura, 3acraBrtroqat 6o,le3HerBopHylo <xapy> Mepr-
Io'r]xHo 6tjrb Tonl'3lrpyrculfiM,c ocTaBneHIreM nr,r sa l0 15 r,un., axaHa <cBer"lr,Ii eHt noaHtrbcfl BBepx, K BeKy t Bbl3BaTbBocnarleHl{e
qepe3aeH6no oAHoMy ceaHcy.Kypc ,reqeHrrcocro&rrc l0 lS ceaH, xele3br xpgula Be(4.

T e p a n e B r - I ,q e c x x f t 3 O O e K r r o ' r e K . T o q K Hk a y - x a y CTMNTOMATTXA
r| rbrHb-MrrHb (l V) nprrMeHflrorcq Atq BoccraHoBneHnq rpoxoar.tMocrrr
rHeprkfl r KpoBr_H?^yqac.rKe HapyujleHHe. ro,rK +oHr-qu l20VB, Bocfla,leHxe canhHoi ) | . i e n e 3 r , IB e K a . B H a , r a nxep a *
{ x } a H f - v r H bl J / v L l ) c i y x a r ( n e u x a b H on n H J l e , l e H Ht jqa j H h r \ Bexa sa6yxacr, { ) 6 p a 3 y q y r o n n r e H n e , H a n o M n H a r c n l e ep r c o B o e 3 e p -
6one3Hefi;Bo3AeiicrBreHa roqrs (r.r-MoH(14 F) a rxafi xxe (3 R) H h l x r { o , K o r o p o e c n e f x a 3 y l n r . l l o c r e n e H l l o y r o , r U l e H x e3 a M e T H op a 3 -
c roqKavh I b l - x o a ( B H e v e p n A r a H H b j e c, o o t B e . l c I B \ r o . l p a c r a e r c q , K p a c H c e r . - n p l r n e r K o i i O o p M e o H o M o } l ( e r H c q e 3 H v : 6y ) + ( e
r o , r x a vl 7 V u l 9 V i I r y K . r a v - n t { 3 6 E i n p x \ a e H n |co ur . , r s r c, o n a . q e p e 3 H e c K o , , r b KaoH e n , f l p x r q x e n o a flpeBpaxlaerct B rHoxHt'lrloK,
3rpoBaHxq?Hepr{fi,xpoBas opraHoB(neqeHb,no,rxr). K o T o p i 3 a r e M n o n a e r c f f ,A o c r a , o q H o r r u a r e r b l t o o q t u r a r r ' n o p a x e s _
H b r f iy q a c r o K o T r H o q , n p a f i K a 3 a x u B a e r c a M a c o 6 o f i . B o c n a , l e H n eB
6. Bo3A€ficrsx€MeToAotn
{qaereHr,tct naHIov cJllqae rvo.l ocrpHn \apahr.p. nohanrrauHe rHorirqxa
H e r , r ) 6 0 k a e B c a n b H o i , ( e . r e , eB P K a .
O 6 p a 6 o r K _ an o r o H a r r b H o v ] I p H H u H n y : BocnaneHae xene3H xptqa Bexa. ha BeKeraKxe
3 o H a o o f l 3 a T ( i J b H o t oB o l A e i c t B t l g ; norBrreTcr yror'Iuext{e B B}lae He6orrluloro TBepaoro npblxl Ka 6e3
- ocHoBHat 3oHa Bo3AeicTBI,tg:o6,tacTb 3aTbL,I(a; f i 3 M e H e H r ru HB e r a , r f i 6 o c p o 3 o B a r H M o r r e H ( o M , n p r t { e M c e p a q e B f i H a
aono!'lHI]TeJ6Harr30Ha Bo3aeiicrBIrq: yqacrl(x, pacno!,Ioxe&HbIe e r o , B H e a p x B l r 1 a cB b rKaH6 xpnqa, npoAorxaeT pa3pacTarbct ltoc_
s O K p y r r r a 3 a t H a p y x s a r r c T o p o H an p e a n n e q b q ,B H y r p e H H q Hc T o p o H a rraneHve r{MeeT nolocrpblt xapaKrep.

Cnoco6 fi Ao3a Bo3AeficrBfiq. 3oHao6s3aTenbHoro TEPANTI

Bo3Aerlc' rBnex lpyrre 30Hbr 06pa6aTHBarcTcr co cpeaHefi sHTeHcuB
Hocrl,ro,-a yqacrKr, BoKpyr rna3 - co c,1a6oft. Ha xaxayro ,rlaurc nprHuHn ,,reqeHHe. npl,l Bocfla'leHrH c a n b H o i l) h t ' , ' l e r HB e _
n o l 5 2 0 y n a p o B . B o r n e f i c r B f i e q e p e r a e H bn o o A H o v \ c e ; H c v . K \ o c Ka <,'rlrKBnaauHqBerpa xap6rt. x npfi Bocna?'IeH![ xer'Ie3H xpqula
. r e ' r e H H fcl o c r o l i r H , 2 0 c e a H C o B n. o c , I e l 0 c e a H c o Bn p ' o r r e e c i u o a i o Be(a <nnKBItAauIte xapH t BpeaoHocHblx OaKTopoB).
M a l r o eK p o B o n y c K a H sBe r o q x e H x - T b r e M( B H e M e pa r a H H a q ) . Toqxu a cnoco6 Bo3reftcrBxe H c x o a ql r 3n p a K T x q e _
cKoro onbrra, MoxHo penoMeHAoBart crleayrcu(Hfi cnoco6 neqeHxH.
B. Aypfixyrorepanxe Ecnu qqMeHb Ha npaBoM rna3y, ro 6onbHofi, coMI(Hys flanbuH reBoi
raaoHI,t, aoJrxeH 3aHecrlt ee 3a npaBoe nJleqo Kax MoxHo aarbue 3a
Bo3leficrBfie Ha roqKn: r,!a3a, nerreHb,noAKopka. pa3apaxeHte cpea, c r r r { H y ,T a x , . r r o 6 b l n o A 6 o p o A o Ky r x u y , r c a a ' r o K T e B o i c r x 6 . 3 a r € M
Hei fiHTeHcrBHocru, yxonbr c ocraBreHreM r,lr,1Ha 20-30 M H. Bo3- c p e a H I { Mn a , l b u e v J e B o . i p } x H o H n u ' l ) h e Hx o c H y T b c qn o J B o H o q H I , l K a
Ieic,Bfie qep€ AeHbno.oAHoMycearJcy_Kypc coc,royr x3 lS 20 ceaH- M e c r o h a c a H H t r r 6 ) t r e r l o q K o f i ) x o n a . B p a q , t r o n x e H H e c K o n b l ( op a 1 .
oqeHh rulare,'IbHonpoAe3uHoxu poBarb yl{acrox xoxx Mexay roq_
Koii KueH'rl,rHL (21 VB) n roqKoi yxona r, flo''Ib3ysc!, rpexrpaH
qqMEHb nofi nr"roi (npx orcyrcrsrx ee o6blqHo& uBefiHofi urrofi), HaHecrL
noBepxHocTH;fi yxo!'I c Ma.'IbIM KpoBonyc(aHLteM. 3Ty npoueAypy
ocHoBHbtE noJoxEHt,lt noBroprrcT l-2 pa3a fia c,r€AyrcuHfi aeHb ,"1Ir qepe3 AeHb. Lcrx yxo-
JrH He aaayT TepaneBTuqecKoro 3QOeKra, cr''leAye,npofi3Becrlt aoflon-
t l q _ l i e H bf lB , t s e r c r , T 1 6 0 o c I p 6 r M B o c r r a j e HH e v c a , 1 b H o i , ( e r e ] H B e K a . HHTe.nbHyrc noBepxHocTHyrcnyHKqrin c MaJIbItrlKpoBonycKaHIr€MB TOq_
, ' t x o o . B o c n a , l e H r e)Mh e J ei H x p q u r a B e k a ( n p o r e x a r c u r r M B M e H e eo c t - Ky,,rrrer Kxroe, (7 P) Ir,ra rxsey-rxr,loHr (l I P) c uenblo <,rlxBaAalrlrt
pon qopMe, B pe3yn6rare nx fiH$nqupoBaHrr. tqMeHb 6oneHb Berpa I xapbr,.

636 637
 flp, Bocna,'reHH xe,re3H xpflua BeKa AononxureJrbHo Bo3Aeiicr,
B y r l r H a r o q K y r u - s y ( 2 0 V ) l , l n l , lB q - 3 y ( 2 1 V ) I ' r q < , l r { K E r u a q x n
T e p a n e B r I i q e c l (r i i i 3 + Q e ( r r o q e x . T o q x as n n c a
(6 E) ,Meer ,,roKanbH6rri 3oQexr, c"lyxlrr Ane nxKBraaulrs <xapu>
x a p 6 r , B M e p u a r a H e< c B e T r L l ! q u ) .
fl nprnyx!'roc,n.llyHxq]tt c MarblMKpoBonycKaHx€M B ToqKyrxley
Ec"ll' yTo,llrreHse Ha BeKe craro MrrrKfiM, BqrbrM, 3Haqr,rTB HeM
rxr,loHr(ll P) npfiMeHsercq c qensb <.rrHl{BllAaulrrxapH> B Mepn
Haxonrncq rHoi, xoropbrri Heo6xoAuMo yAa?rxrb, BcKphrBrHofiHnqoK_
npx 3roM c,,reAyero6parrrrb BHuMaHre Ha rruare,rrnyro Aeaaa<Fexrrrrc araHe,rerxnx.ToqKaMrxon koK (4 GI) s (xyK-qH( I I GI) no'rb3ylor
xrr'lH x nopaxeHHoro yqacrxa. noc,le BcKp6rTxr npoBecTx !'reqexHe cr Anq <nH(B Aaq{x xapbl> B MepraaaHe<cBerrbrieH}. nps Kau,Ie
AononHfiT€,'rbHo Bo3aeficTByror Ha ToqKyrreT-Kxroer (7 P) c rroMoul6lo
Bllue coocoooM
<paccerBax)qero, yKona- npH 3anope x )K€irofi Moqe npon3Boatr
OCTPbIN TOH3XJIJIXT riyHKqr.rrca B roqKy rxfieH-Kxy(25 E), xoropan noMoraerHopMarH-
3OBATb Bri,4er'rriT?r'r6Hblenpoqeccbr.
ocBoBHttE noJloxEHttq
6. Bo3aef,crBx€ emaoM .llBereHr{,
Ocrpbrfi roH3H,'rntT AoBorrbHopacnpocTpaHeHHoe3a6()rreBaHIe, Bbt-
i H B a e \ o e c r p e nr o k o r { h o v .q a u r e B c e r uo H o B rI p c ' t a e tc f l y , u e T e fri M o O6pa6orxa no 3oHa,rbnoMynpxHIlluny:
,roAbrx "1roaef,.Anr ocrpol'o roH3rJlr'rs,ra xapaxrepHbr qacrbre peuB- r o H a ( ) 6 f l r a re , rb H U r u B o r a e i c r B H q i
o c H o B H a s3 ( ) H a B o 3 a e i i c r B r q : 0 6 , ' r a c r b 3 a r 6 r n K a ;
f)rrpeae,reHre oc,poro roH3r{"rrr'raraHe cJroxHo, o!Haxo npr flocra, Aorro,,rFsre,rbHat 3oHa Bo3aeficrBsfl : o6nacrb [epeAHei cropo
H o B X rA H a r H o 3 aH e o 6 x o , t r . r Mnop o q B n r b M a K c s M y MB H ' i M a H H eq, T o 6 b r lrbl txefi fi Hr.{xHer qenrocTb, nePeAHqq cropo}ra npeanreqb'r.
Arr+Q€peHulipoBarb €ro c Afi+repaeii, Bo B36exafire cepbe3Hbrx IIo- C n o c o 6 o 6 p a 6 o r x H. O6pa6orxa 3oHLi o6tr3ar€nbHoro
Bo3aeicrBr{s xpox3Boa rcq co cperHeri r.rHr€IlcuBHocrbK).ocrroBHori
r{ aono,'rrrHTe,'rbuoi:i 3crH c Bbrcoxoi. Ha Kaxayo nnHtlrc no 20 yaa-
3TltoJtofxt r nATorEHE3 p o B M o r r o T o q x o Mq. e p e 3 J r e u b n o o I H o M y c e a H c y -

E o n € H € r B o p H H eO a x r o p H < B e r p a ) x < x a p b r > , H a x o n n B r u r . r csbr o p J r e , B. Aypxrynorepanxtl

<pa3orpeBarcr> coKr rena, npeEpaqafl rx s Mokpory. [Ioc.rreAHHe,
6yayqfi B cocrotHnl, <orHq> r 83axMoAeicrByr c 3acroiHoii <xapoi> Bo3aeircrB e Ha rolrKu: nerKoe, xenyaoK, MHHAaIIHH, roprlo fi rop
B nerKfix r, )Ke,,ryaKe, a raxxe c 6o"re3BerBopHEJMtQaxropaMr <Berpa> TaHb, chMnarr{qeckan HepBHaq cficreMa; 6l],reable ,toqKx.
r { < ) l ( a p b r > n, p o H s x r l j } r M rB' r o p r a H H 3 M jB b t 3 b t s a e ro c r p o e B o c n a n e t x e Cnoco6 Bo3Ae*crBrr: pa3apaxeHxe cpeaHei HHreHcrBHocrt,
BpaqeHae qrrbr 2- 3 MkH; Hr,ra ocras,lqerci Ha 20 50 MnH. Exe_
a H e B H on o o n H o M y c e a H c y .
CI,I,[NTOMATII KA

nps ocMo,pe rop,ra rcHo Bl{Ir{br rsnepeM}lr { flp[ny;,'rocTb oAHoi

o , r x o 6 e r r xM r H A a " l B H 6 e " r b r M xT o q ( a M l 1 ,K o r o p H e M o ,
ryr orAensrbcq ,rerxo x 6€cxpoBxo. ,Ilpyrae carvnror,ru
60"rH B aopre, 3aTpyrHe'{Hoe, 6one3HeHHoer,loraHre, Bbrcoxar reMne-
parypa Te!ra, o3Ho6, ro"losHar 6orb, yroM,lreMocrb, KpacHHi no
KpaflM s3brK c 6erblM (tBorla BnepeMeuKy c xe",rrr,rM) Ha,'reroM;
n y , r b c n o B e p x B o crTi b r i ( O y ) , 6 b r c r p b r i i ( c a K ) .
TEPANT'
A. Iirnorepanrfl
llp!HuIn
J r e q e H f i f l . < J l u k B r a a q u qB e r p a I x a p n > , y c r p a H e -
H6e npsnyxrocT'r.
T o q K n B o 3 4 e f i c r B x q : 3 r n - c a ( 6 E ) , r x f i e y - r x b r o H(rl I P ) ,
xon-KoK (4 Gl), Kxyk'ql, (l I cl), ,rHer-Kxner (7 P), rxneH-Kxy
( 2 5E ) .
638
noTEPt ro.flocA (AooHltt)
O C H O B H t T InEO J I O X E H t ' l t
ocrpbre
HapyureHre cocrolrr B roM, qro nponaaaer 3ByqHocrb ror',roca (6e3-
rracfie), npoq3lroqiMHe 3ByKx Ae.nsro,cr HeqeTIOlMli, notBr'Ite,ctl
xpsnnocrb. flpx 3ToM, HecMoTpqHa aesopMaqtrrc 3ByKoB, cMHcn p€qlr
n o H q r e x . f l p x q n H a M x , ' B b I 3 I ' I B a r c U l r i My xK a 3 a H H o ep a c c r p o f f c r B o , M o -
r y T c a y x l i r r , n p o c T y A a , H a p y l x e H H q3 K s o l e H H o r oI 9 H A o r e H s o r o x a -
p a k T e p a ( H a p y u e E x ' { B K p o B e r o c H b r xc o c y a a x M o 3 t a . n c H x l , l q e c x f i e
noTpqceHst). Ha6nroaaroTcf TaKxe qBrreHx9, Koraa roJoc <caarlTct>
B pe3y!'rbrare !rpe3MepHoro HanpqxeHn'r ronocosbrx cBftoK (n€Htr€,
pa3roBop, Kpt l{).
3TXOnOfIt r nATOTEHE3
fonoc rrMeer cBr3b c ntrblo n,rorHbrMl{ oprafiaMI,t, Ho rraBHblM o6pa
3 O M c , r e r ( H M 9 t n o q x a M f i : < n e r K H e- n p e a a B e p H en p o l j 3 H o [ I e H r t ,
639
 noqxr ero rrcTor<r). KorAa naroreHHa, gHeprxq <BeTpa, npoHfixaeT
ll:)qetcr Ha coKax Tera, - <Bo3poxAeHte coKoB T€r,Ia,yalaxHeHte
B nerKse, cKonrrauJrltcr B Htix <oroHb> Taxxe noaql{MaeTcfl, BH3bIBag
nerxrx>. flps a$oulu, nrraeanuofi <nycrorofi> q 06 uei- c,,ta6oclhro,
3acron gHeprlis ref(ux, 3axp6lsaq <roltocoBoe okHo). pa3,lljqalor
nary6Ho orpaxarcurMficq Ha HHb3Heprrr, <yxpenreHre nHr,-
aeoqnro, B6138aHfiyro(cyxocrr,ro>,IerKfix, paccrpoficrBoM
oyHkqu 3HeprxI, paccetBaH,|e orHt,.
coKoB Tena, r{ a$oHfilo B pe:y,rr1are oc,ra6,ieurq noqex n un'viroro,,
Toqxq Bo3AeficrBHq: a-MoH (15VG), ,lreM-ryeH
H b -r H e p rr r . r ,, r r o n o p o x n a e l , B H l r p e H H | o r ox u p y , u . n l c , o r o . n g . .
i (23 VC), HrH-HreHb(9 E). B Ka,recrseaono!'[ trer'lbHbrxuorvr 6urr
a 3TO B CBOrOOqepeAb oTp[uaTe,]bHo cxa3hBaeTc, Ha <rorocoBoM
r o q K r ' Q o H r ' M o HI l 2 V ) . x o n - x o x ( 4 C I ) , K H H b . K b{ 8r P , , i r z H - r \
oKHe, ll <ro!'IocoBHx nyTtx> fi BeAel K noTepe ro!,Ioca. ( 2 3 V ) . 3 y Q y ( 2 7 R , . S y x - , r h i yr 7 R ) , O o H r . , 1 o H( r4 0 E J .
C n o c o 6 B o l a e i c t B H q y x o , l bBt T o q x va M o H{ 1 5 V C t
C'i M NTOMATI,IKA r"4e4yeT IIporrjso.4tlr, C 6o,tbruofi ocropoxxocrrir, BBoAxrb IrrV
pa3ryqaror nocreneHHo, Ha r,1y6HHy 0.5- I uyns,ocrple rrau nanpae,rnrsa cro'-
lBe OopMH aQoHrs: o.rHocrrqyrucr j{ cxHApoMy <norHo_ poHy noA6opoAKa.BHa,rare BpaqefiI,lerrJrbr cpeaHefii.inreucr.raxocru.
rbr) fi orHocrrqymcq K crxApoMy <nycrorbl>. B nepBoM c",ryqaenaro,
resHbrM qraxTopoM c,'tyxrr 6o,,re3HerBopHa, efieprrrr, npoHxr{aK)nlae
3areM, nocrefl€HHoerc ycrntBalor Ao 3Haqtrei,rbHoro.Xopouo, ec,rLj
yAaercr 406fiTbcaotqyueHrr fianpqxeHHocrn, pacnfipaHriqB Mecre
B o p r a H H r Mr . i r B H ea, a o B T o p o v o H a s o . r H r x a e r B p e r t " r i r a r e n . v x o c -
yxo,'ra.npfi nyHxullx B ro'rxy,rlev-ryeu (23 VC)-ocrpie rr,ru xyxno
T U oJ l e r x r r lt l . n y c l o l b t , H H b - ? H e p r H
HanpaBJiflbB cropoHyKopHse3HXa.nepea 'xoJoM B rortxy HeH
l| A0oHrq, orHocrrjtarcs ! cuHApoMy <nonHo-
HreHbty E r cieayel aaBneHfievnaJrbuaoroaBHHlTbB cropoHycoH.
r br). Korya 6one3HerBopHbreQaKTopbr <Berpa, n <xo,toaa> gogaefi-
Hyro apTepfi|o, yxon npon3BoAr.rrr,nprMoi, nocne npoxolra xoxll
crBylrfr Ha rerKxe, Ha6"1rcAarcTcfl:xprn,rocru ro,roca, cyxori Kaure-,rb.
qyBc,Bo paclrpaHnr B rpylll. roroBHHe HaK'IOHI,ITb ItrJIy B CTOpOlty topTaHt, npon3B€cTucgaqala lterKoeBpa-
6ona, reMnepaTypa,3s6- rueHre, nocreneHHoycr,rrriBar ero, 406{Baqcb <gOOexTarirnHr.
kocrb, 6 e i H i H a " 1 e rH a r r r h r K e ln y n r , c n o o e p x n o c r r i i i t q y ; .
"roHxlii T e p a n e s r f i q e c K H i 3 O O e K r r o q i x . T o q x ra - u o x
c}harbrn {xxaH): Korrd )he trH 6o,lerHerBopHble
Qairopsr fl,an,rrlia- ( 15 VC) n nreM-ryeH (23VC) acnoasayrurcncneqna{rbHoar'rr,leqe-
IOTCfl,Bbr3HBat <OrOtb>, oTMeqaoTcq xpsn!,IocTh, olbrrrKa. xerrTa,
HHsa(pa3r{rirl HeMoTbr, a roqxa HrH-HreHb(9 E) Ha nepeAHefio6nacTu
vur{pola, c}xocrb..Bo pry 60rb B fop"le. xe,ljhlli HarFT Ha flrbtKe;
f l y r 1 6 cc r ( o 4 b r r U l r . l t { x o a l ) . 6 b t L r p H i i ( c a h L
uex- B coqeTaHrH c aByMnllpenH4yurlrM]r. &1r .oTxpblrlrqoTBep-
crrn Terar, <pacceHBaHrr 6oJe3HerBopHoii 9HeprHfi, BoccraHoBneHHt
z A q o H x H , o T H o c F L ! a f l C qh c l i H A p o M y a n ) . l o -
r br>. Koua <cyxocrD "'rerr(rlx orpHrlarerbHo BJ,rfieer Ha coxs rera
npoxoAliMocrlrMeplAraHoB>.ToqKs QoHr,MoH(12V) l, xon-Kox
(4 CI) c,ryxar xax ,4,rr ,ruxgrlauan 6o,'iegnerBopHoisrieprfit,t,nonaB-
{xHb 3Heprrrc), Ha6,'rK)aarorcr xpnn!,tocrb ronoca, aeeoDMaur, 3Bv uef, r,r3BleB opraHH3M, rak x arr ycrpaHeH{sHapyuei i Oyut<ufix
h o B . o n H L x K a , r y x o c r b B r o p , l e u n u ^ . , a f i < x a ,r r n e p e u r n a r u r x i ;
ropTaBr fi ropia. llyHKurieFB ToqK) kxHb-Kbt(8P) BoccraHasnH-
nlnbc roHKHt{r}1.6br.rpblli (faxr. Korqa cn\crord. H cna6ocrb
aaror (npoxoasMoc, b 3HeprriunerKnx>.ToqKgrxaH-3y (23 V), 3y-Oy
o p r a ' r H r M an a r y 6 H o o r l a x a k r r c r u a a r u - , r e p i u r , H v e r , T c e \ D x n -
(27 R) B OyK'nbIy (7 R) c-'ryxar Anr <aKrxB 3a(!'
. . u c r b i o r o c a . r e Q o p v a u H e i B l K o B .u n H L u h an p , p u r , o " o p " . y , o ,
(rHb-3Hepr fi), <ycfineHrf, xnAxocTei opraHr.€Ma>, <ocJra6.rreHrt
n r e M o c r b , c y x o c r b x o x t , n o H U x e H H H r ia I I n e r f i T , 6 e c c o H H { u a . n o H r
xeHHoe 3peHne, uyM B y ax, rroMora B cnfiHe, c,,ra6ocr6 B sr.txHrx
orHrr. To,rxo* 0oHr-noHr t40 E, no,rtryorcn arr <paccerBaHfit
x o H e ' l H o . l 9 xn, o ( t e n e H H o )i c r l e H H e \ p H n J l o c l r r o , l o c a ; F 3 b t KK p a . -
cl<on"ieHri MoKporbr>,<!'trKBxAaqsI MyrHofi gHeprrlr>,
H b r r .o r e f l q u u r l n ) n b c t o H K H i ( 1 3 ) , 6 b | f l p h j ; { c a K t ,
6. Bo3Aef,crBre €mAoii .uBerarrqt
TEPAN
Uq O 6 p a 6 o r l { a n o 3 o H a , r1 , H o M yn p r H q n n y :
- ToHa o6caare-nl,Hdro Bo3AeficTBxr,
A. llrnorepanEt - octoBHat golta Bo3AeficrBrq:o6.rlacrb3arhl,rkal
- aononHlrrejrhHar3oHa Bo3AeficrBl.tt:DepeAHtt o6r'tacr6 ueu,
I l p I , ' H u u n , 1 e q e H x r . < B o c c r a H o s n e H x en D o x o l r , t M o c T lar a K T l ] ,
Cnoco6 o6pa6orKr. H a K a x A y b , r l n a rnc o 1 5 - 2 0 y a a -
B n t d u H f lO y H X U r r s r o p H q b r , \v e p H t r { a H o n rr.p a c x p u r u e o r r e p r r r f i
pos Mo!'roToqxoM; 06pa6aTbtBaTbco cpeAHefiIrHreHcrBHocTr,ro. Exe-
a O o H r r i . B b [ B a H H oj i n p o H r ] x H o B e H r e v6 o , r e r n e re o p H brl
i "aj 1K' tr o pIol B
p p "_ c p a ,
Bel
aHeBHO(!nri qepe3 IeHr,) no oaHoMy ceaficy_
H .\orloaa! B J,lefxHe, .paccerBaHfie BeTpa h
xo"1oaar, npx aQoHrifi, Bbr3BasHoiict<on,,rexlleMdo,resneraooHr,rxbat<-
I O p O Bd B e l p a , x . r o n u a a , H n p e B p a u e H H e vf i x B . o r o H b ! , . n , 1 r . l i s x . B. Ayprxynorepanflt
I a u H f l c K o n r e H B i , p a c c F H B a H } eo f H r i . . . p a c c e H B a H r e B e r p a , r x o j o .
B o 3 a e i c r B x e H a r o ' r K H : r o p n o H r o p T a H b . r l e r K o e , n o q x a . noaxopI(4,
4 a , . l l p r a Q { r H H HB.h r J B a H H oc fci} x o c t b t o , , 1 e r h f i xn, a l } 6 H o o t p a x a -
Ha Ka,{aHft .eaHc yl<orbrB 2-J ro,rKr, BorAeficrBxe
640
641
n H r e c u B H o c r b r o .h r " r b r o c r a B r q r b H a l 0 l 5 M ' ' r B E ) K e A f i e s H on o TepaneBrrqecKxi 300ekr r o q e ( . I l y H K u xBr r o q -
o a H o M yc e a H c y . M o x s o o c r a B n t r b u r n b l - x H o n(llHa 7 aHe,, a Ha c,'Ie- Ky HreH;-xbroHr (20GI) npuveuaerca xu(arbHo ar'rn <pacxpbrrxt
Toqxx. urBepclrrr reJar. .pa.ceHsaHHqIa]ofeHHoi rHepfxx,: xon-Kox
A y r o u e i H e a e , r ea o 3 A e i r c r B o B a r bH a a p y r n e
l4 CII roqKa 06urero AefictsHr. (.,1'aHr rdhlhr ,rfl .paccexBa-
HfiH naToreHHot rHeprrx> npx HapyrxeHxqx B l)6racfl,r ro,,toBbr,
ocTpbtn I xPoHllqEcKl{ffPll HllT lrnqar B MecTair <oTBepcrl.ti (oxoH) Tena>. IlyHxur.tr c MarbrM KpoBo-
OCtlOBHlrlE nOI1OXEHttrl n y c K a H H e MB i o _ ' r k ea H - a H o H r l B H e v e p h n H a H H a P C J t c " 1 ! x r r ! , 1 t
\ p a c c e r B a H l r r o o ' ' ] ei H c r B o p H o t ? H e p r r l , lB c T p a , . \ c r p a H q e t r o , l o B H H e
Pfi Hur ts,,Iqerca ocrpblM x!'t|,rxporrrqecKxM BocnalreHt{eMcrx3xc, oi 6 u , 1 H f. l p H x p o H r q e c K o f rO o p M e p H f i t 1 a B U 3 a e i c r B y r o rA o n o , ? H r l e , r b H o
()6onoqKj Hoca fiH(pexuroHHoro tnt anneprfiqecl(oro npoHcxoxaeH{9 Ha roqxH rxoHr-rx,reH (7 V) n rx{eH,qy ( l0 V), qro noMoraer <Boc-
craHaBr[Barb npoxoAriMocrr, n al{TfiBI,'3r.rpoBarf,KaHa,!hr]. To,rKv
3Tfi OJtotl,tt r nATotEHE3 r x o H f T x H e H r 7 \ t x c n o , l L l y r o T T a K , l { e a r l f l , 1 l j h B r A a u H Hf o , r o s H o i l
6 0 , 1 H T o q f i a r \ l { e H - q ] ( l U V , n p H M e H q e r c f lK a x A . t r n e q e d F 3 a 6 o -
H o c c , q y x r . r r< o x H o M ,a , ' r s , l e r x s x , D o r e s H e r B o p H a t3 H e p r a s ( B e r p a > . , r e B a H f i tr o p r a a r o p r a s H , r a K r 4 r l r y c r p a H e H l r r o n y x a H a r 6o,tefi
BHeApttcb B opraHl,t3M,oKa3bIBaeToTpIrqaTeIr,Hoe B!'Il{9HfieHa SHep_
rBxr I'rerKrrx, ToKcrrqecKle aeqecTBa' o6pa3yloul[ecq B opraHr3Me
npa npocTyAsblx 3a6oreBaHxtx, Kopn, orpaBreHxx ar'lKororeM (B c,'Iy_ 6. Bo3leficrBne M€TotroM .uBeleHrrt
qarx cacreMarxqec(oro 3,'roynorpe6,,reHLttIIM), a raKxe npH 3aflope..
- O6pa6orKa 3arbr,rxa Ha yqacrxe Cr -
nopoxaafl Bpe.4oHocHyIo<xapy>. Bbl3HBalor BocnareHlie c!'Ilt3l'tcTol Cyi no3BoH(oB.
O6pa6orKa co cpeAHefi HHTeHcxBHocrbroyqacTkoB, rexaLqfix
x B f i f i 3 o r H o c a j H a A J l r , t H r i r M uq e q H o r y 6 r r b r x c l ( , t a l o x .
CllMNTOMAlIIKA E x e a r : e B r o n o o a n o M y c e a H c y . n o o x o H q a H f i r lu d a l e l c r u u o i p o
BoArrrb Maccax pykot BAo"tb nHHl,lfi o6pa6orKu ro noren,,reHa'I Kox_
I Ilps ocrpoM plrHl.{re,conpoBoxAaloqeMct npocryAoii, B HaqalrrbHoit H o r o n o k p o B a y x a 3 a H H b t xv , { a c T K o B .
cTanrr{ 3a6o{'IeBaHqfiHa6'lloaaloTcq H€6onburoe IIoBbllrleHfieTeMIIepa-
Typbi re,'ra,3yI s Hocyr BbI3bIBaIoqrt qlxaHbe; cflycrt HecKoJb(o
qacoB nnt{ I 2 aHt 3a,IIoxe8HocT6 HOCa, ItaCMOpK, BblAer'IeHI{e B. Ayprxyoorepannn
c r ' ' r n 3 x c r o r coe x p e , a . K o r a a n p o c , y a H o e 3 a 6 o r e B a s s e c r u x a e r , q e p e 3
qBer, Ae'rarcrct{ B o 3 A e i i c r B x es a H a H 6 o n € eq y B c , r B s r e r b H H eM e c r a H a y q a c r k a x r o q e K :
3 4 AHq BbrAe,leHfierycrelor, npl1o6peralor xenrtli
no!'IocTb Hoca,..,rerKoe,HaAnoqer{Hr.{K.npx ocTpoM prHxT€ Bo3Aefi,
BCe MeHbue fl qepe3 HeaeIIo npeKpaqaloTcs.
crBre BhrcoKor.rrHTeHcHBHocrr. npr xpoHrqecKoM - cpeAHei. llpll
2. flpfi xpoHEqecKoMpfiHtrre ocHoBHHMcxMnroMoM tlB!'Iterct sa
Bo speMt cHa. flplr pfiHocKon ,{ o c r p o M p f i H x ' r en p o A o n x x r e r b H o c r b o c r a B r e H r q r i r , 1 I q. nDfi.xDo-
roxeHHocr| Hoca. ycrntBa'oulatcg
. Ec,,rx B p€3ynbTaTe H ! ' { e c K o M- a o I Hen,
oTMeqaroTcr frnepTpoont, oTeqHocrb c.' lIl3IrcToft
3aKanbrBaHl,rfl0,lo/o pacrBopa aApeHan Ha oTeqxocTb noqrx IIor-
Hocrbro rcqe3aer, ro 3ro 3Ha'rfiT.qro y 6onbHoro npocroil xpoHrqecxri aocfl AJtEHUEoKoJtoHocoBbtxIIA3yx
puHnT. ( IIAPAHA3AJtbHbt
n ClrHyctlT)
TEPANhI o6ultE noJ'loxEHltt
J a n n o e x a p y u e n r t 0 6 l r q H o r H e F x u H o H H o r o r r H a r , t j e p rh q e c x o r o
A. Jlr,ror€pante r r p o f l c \ o M A e H H trt.p r \ p o H H q e c h o ir b o p v eH v p t o T c qo 6 a n a t o t c H H b t \
- < p a c c e f i B an
n p x H q n n ! ' re q e H L t . n p o c r p o ioi o p M e Hax_e f a h r u p a , n D q . { e v B o c n a r l frir r r b H b t i i n p o r r e " c . x a x n p a B h r 1 o .o x B ar b j .
roreHHbr)( QaxropoB), <o6,1err{eHre ablxaTeulbrroi QyfiKq t{ nerl(lix>. B a c r H e c K o J b hnoa J l x . L t B o . T o q H o iv e q r u r H c n r n a H a l a l l 6 H b tci tH H \ .
(pacxpbrTfie oTBepcrl.rii Tena>. npr xpoHlqecxoft +opM€ <BoccTa_ clrTlr pnHrT He orlrr(pQepeHur.{poBaHH.
floBneHre npoxoatrMocrH x aK,lxBLi3aul.tt{ 0yHxusfi {a a anoB >, .<o6'1er-
qeHfte IHxaTenbHofi (pyHKul.jr ner(fix>, <pacKpblrlre oTBepcrl,lt Tena> 3Ttlo.,|of Nt lt ItAtoIEltE3
T o q ( I l B o 3 a e i i c r B ! i t . I l p H o c r p o i O o p M e- H r e H b _ x b r o H r
ynorpe6JreH,te roprqeii, ropbKofi, xaperofr nsqr,
(20G1), aH-AbroHr (oaeuepIraaanxaa PC-3), xon-xox (4GI) alir(oroJ,lqi cKon-
[ I D , r \ p o h f l , { e c K o i ir b o p v e a o n o r H r ] T e J l b H oBc o l a e n c r B f i e H a r o \ K y n e H x e < x a p b r > B M e p x / l x a H ex e r q H o r o n y 3 6 l p s a n p o H n x B o B e H x e e
( 7 V ) ; i x r e Hq ) ( 1 0V ) .
rxbnr-ixren B 0 6 , r a c , b H o c a , n p o H r x H o B e H n eB r r e r x a e 6 o , r e e n e r s b p u o r x
$axropos

642 ri4J
<Berpa, fi <xonoaa, fi yrept LrML<oqHcrrre,'rbHofi> OyHKufiu, <cKon_ nycxaHHeMnor'lByroTcc A,It <OXIa)KAeHfiqt ,lrxBfiAaqfiIj xapbrr,
,leHne 6on$HerBopHofi ?Heprsfi Berpa r,lxapbl B o6racrx Hoca) Bce ycrpaHeHnq ronoBHbrx6orefi. C noMoubro roqK[ xon-KoK (4 GI)
oxor'roHocoBblx[a3yx.
3TOMOXer tBI{TbC9 npl,lqfiHot Bocfla.JIeHI'1fl cpacceHBarcT 6one3HeTaopHyro )Heprr.jro
xoJlolar r .pacKpHaaroToT
BepcrHfl rerar B 06racrH Hoca.[lpH BbrcoKoi revneoarvoere,ra.osHo.
Cl,|MNTOMATI,IKA 6e npH6era|orx rouxe nroai.xyar t5 TR). Toqxfi Oo;r-qr (20 VB,
tr Kxliey-aM( I I VB) cryxar Arr (oxrraxaelrrr orHr xerqHoro ny3br-
pa3nri'{a|or cnMnroMhl MecrHoro fi 06uero r(apaxrepa. p9r. a To'{KarxoHf.T,(neH {7 V) HCnO,163yeTCC OnHOspeveHHo H ]rre
l. CaMnroMr,r MecrHoro xapaKTepa: npx ocMorp€ npI't3HaKI', <BOCCTaHOBIeHtl'npOXOA&MOCTrl I{ aKTIBH3aIlI,lI,lXaHa,rroB)Lt Ar'Iq r'3-
BOCnar'rfi,lerbHoronpoqecca oKorollocoBot naSyxu; npx HaAaBnriBa_ 6aBreHrfl or ronoBfiofi 6o,1fi. To,rKa qyHr-Tbbr (3 TR) nprrMeHflercq
Hxx Ha Hoc 6onh, rppaafifipyroqac B cTopoHy rna3xfiIl6l, nepeHoct_ c {eJrbro <ox,laxaeHur xaphrr B MepfianaHe <Manhrf, cHr. IIpfi npo-
qbr aaree Ko n6y; 6orb ycttl{BaeTct nprl qTeHxa, npx cocpeAoToqeH_ sl.txHoBeHfiHB ,Ierx{e n3BHe 6o,le3fieTBopHOfi 3Heprqr, BH3bIBarOqefi
H O M p a 3 M H t u n e H r r r r3;a " l o x e H H o c r b H o c a , n o g r r x e H H o e B o c n p a t r e K a u e r b . B o 3 a e n c r B y l o Tl . t r , l a M HH a r o q K y Q e . t y l l 3 V ) . q T o 6 H c p a c -
3anaxoB r.{fionHat yTept o6oHflHris; npo3paqHHe ll!1fi xenrHe BHIer'Ie- c e F T bB H e l U H I OOI OO n e 3 H e I B O p H yttHOe p r H | o ! , ( B o c c T a H o a H T nb p o x o a H .
, I n o B o H H H M3 a _
H r . i t l . t \ H o c a , x \ l ] a x H e l , i n B n r x o i x o H c H c T e H u l . l cl l o MOCTb3Heprat nerxfix>,

2, CriMnroMLI 06uero xapaKTepa: noBbllneHlreleMneparypbl Te{'Ia, 5. BGAeftcrBxe Meroao <uaererlc>

ronoBxaq 6on6, BHyrpeHfixi AtcKoMoopr. Clnrnrouarrixa saaacur or
O o p M H n a p a H a 3 a n h H o r oc H H y c r r a . P a s , r u q a r o r r p r + o p M H H a p l u l e _ O6pa6orKa B npoAonb8oM HanpaBrteHri, 6o(oBLrx cropoH Hoca or
H x n : a ) c o n p o B o x a a e v o e n p o c r ) ! o i . c B n J a H H o *c 6 o n e 3 H e r B o p H b J v H n e p e H o c r u h lK K p b r r b r M . n o 7 l 0 ' 4 a p o B c x a x a o f i c T o p o H b l
OaxropaMr (Berpa> Ir <xonoaa>; npo3pa'{Hue BbIAe"'IeHHtl'13Hoca, O6pa6orxa B rroflepeqHoM H a n p a B r e H H fo
i r e x e u e p r q r . r a t u o f ir o u
noBbtuleHxe reMnepaTypbl TeJIa, Kaul€,,tl,, 6e,!Hi Harer Ha s3HKe: Kj aH-abroHr no HaA6poBHoMy(paro x BrcoqfioMy Kpap, no S 7 yAa-
n y r b c n o B e p x H o c r H b I(f O i y ) , c x a r H f t ( x x a H ) ; 6 ) c B c a a H H o ec c t H A p o _ poB c KaxAot cTopoHsr.
r , r o M. x a p H r e r K H x , : c l x o c T b B o p l y l , r o p J r e .x e r r d e B b r , t r e ' ' ] e Hxl l3t O 6 p a 6 o r K a o 6 e x x c r o p o H 3 a r H . n K a jo r r o q K n O o H r - q n ( 9 0 V B )
H o c a , x a u e , l b , , ( e ' l r o B a l H i H a i e r H a e 3 H x e : n y J I b c6 H c r p b l n { c a l < ) l K ro'{xe Oe Jy (13 V), no l0 yaapoB c xaxaofi cropoHH. Bo3neicrBre
B) CBfl3aHHOe C CrsApoMOM <Xapbr Xer'lqHOrOny3Hpqr: xer'lTble B'{3- cpeAHei rHTeflcrlBHocrr, c oay3ofi B nec(onbKo AHei Mexlv c€aHcaMr.t.
l < t e B H A e , r e H Hxf l, H o c a c o 3 r o B o H H H M3 a n a x o M , f o p e q b B o p r y , 6 o i r Klpc ,reqeHlir co.rolr r.t3l0 ceaHcoB.
Ha 6oxoBblx cropoHax ryroBt{ua, roroBHat 60rb; nynbc HanprxeH_
fiHi lxrceH), 66rcrpblfi(cax)- B, Alpx(yrorepaI|st

TEPANT' Bo3AeficrBre Ha fo,rkn: no,'Iocr6 Hoca, ,erxoe, HaAnoqeqHHfi,JIo6, xe-

ne3br BHyTpeHHegceKpeufifi .
A. llrrorepaflrc llplj ocrpofi QopMe Bo3AeicrBr.reBbrcoKoi rjHr€Hcr.rBHocrrj,c oc-
TaBreHIreM r,rrr'rna 15 30 urH; exeaHeBno no oaHoMy ceagcy.
IIp&Huxn neqeHfit, n p r f l . r H y c l i r a xc, o n p o B o x a a e M b lfxl p o - np xpoHrqecxoi QopM€ Bo3aeicrBre cpeaHefi rHTeHc;BHocrn.
c T y A o * .c B f l J a H H o fci 6 o J e 3 H e T a o p H b l M( px a K r o p a M 0( B e l p a t i l . x o n o - _ c o c r a B r e H q e Mr { r , r H a 1 5 - 3 0 M k H .
[a,. - .pacceHBaHxe Betpd H xo,']olat. .pacKPHrxe oIBepcrHIl
TeJar, <BoccraHoMeHHn e p o x o a l ] M o c T H? H e p r H Hr e f K H x ! . l l p H c H H y
cxrax, cBt3aHH6Ix C CIIHApOMOM<)Kapbl r'IerKI,tX),- <r1I'lxBl{Aallnt foJIo BoKPyxE H1{E (BECTltEyJttpHHnCn HApOM)
xapbl nerKfix>. flpfi cfiHycrrax, cBt3aHHbIx c ct HApoMoM <xapu
xenqHoro fiy3blpt], i <rtl,lKBIAauHtl cxon"I€Hl'{i, ox''IaxaeHte orHt. ocdoBHbtE
noJtoxE|ll{t
xerqHoro ny3Hp'{r-
T o q K n B o 3 A e i i c r B I , rt : H r e H b - x b r o H r( 2 0 G I ) , a H - a h l o H r fo,loBoKplxeHrekax cy66eKTxBHoe oLuyueHxeMoxer nponBjrr6cq
{ B H e M e D n A I r a H H3a t
p C ) , x o n - x o x ( 4 G I ) . B K a ' I e c r B eA o B roM, qTooKpyxarcure npeIMeTHKax6br.nnHByT)no ropr3oxrarrH.
noro n6saeicreaq - uroafi-xyax (5 TR), QoHr-qx (20 VB), rxosf- KonHurarcfaBep)\ BHxJ.xax npri Kopa6enbHoixaqxe.rl.t6o KDv_
rxxeH(7 V), Qe-3y(13V), vynr-rru (3 TRi, Kxl,ley-aM ( l l VB) xafcs. c"'roBHo s 6ecnopraoqxoMranie. hHorra r(MoBoKDtx{ei;e
T e p a n e B T r , {e c K L f i 3 S Q e x r r o q e ( . H r e H b ' x H o H r conpoaoxtra-ercr rourHoroi, pBoroi, noloortreJreHreM: ny,rii Osrcr-
(20CI). Toqxa ,loxan6Horo reficra,rt, c'IyxHl nr'lt .pacKpHTxq pHfi (caK), Ha6,rroAaloTcr rajroxexuocrs yurei r] utyM B yua\, oco-
oTsepcrHfi eJar. (paccerBaHIt 60,leJHeTBopliblx_(paxTopoB
T I l ,y H X _ 6eHHos HaqanbHbrfi nepnoA3a6oneBaHflrie reqeHae6,ruxafilnfix tue-
u l r e f t B o B H e M e pa H a H H y l oT o q K y a H - a b l o H r ( J P L ) c M a r b l M h p o s o cflqeB 3Tu ou.lyuIeHl,ttMoryr nocrerreHHoocra6eBarh.

644
 f oroBoKpyxeH{e orHocnrct BocroqHofi Meaxlll'rHoi R 6on€HsM, T E P ANI '
c B r 3 a H H H MC < n y c r o T o i > x p o B H .H e c n o c o 6 H o i rB c B e 3 x c a T r M o 6 e c
n e q l r T bn r T a H a e M( f o ! ' r o c o B o eo T B e P c r d e ( o x f i o ) > . A. Ilrnorepannc
n p l a H u n n r r e q e H I l r . f l p a c a a q p o v <e B e T pnae q e H f i r * < H o p -
STXOJTOTII' X TiATOTEHE3
Ma,113arI,{q neqeHfi,HaxoAsqeicq B cocTorHr,lrtBeTpa>_Ec,1aOopMa
n a H H o e H a p y r x e H t eo 6 b l q H o c B e 3 a H o c c l r H A p o M o M< o r H t n e q e x > ' 3a6oreBaHrf, rrxe"rac, Tpe6yercfl aonor'D{rrerbHo<yKpenneHreno-
IlepexoaflrliM B ct{HApoM <BeTep neqeH{), B <KHrre o BHyrpeHHeM> qek>.npfi cr.rHApoMe <nycrorbrKpoBr>- <n{TaH,{el(poBt{,n{KBt{aa-
cKa3a'ro: <Bo,'re3Huxo!1oAa, ronoBoxpyxer{lre cBq3aHH c neqexblot
F . o r a a . , M y r H a t M o K p o r a , c K a n n I 1 B a s c bn, o p o x A a e r , , o r o H l , . . . K o r o _ T o q K r.r B o 3 r e i c r B r.{e: cyar,xox (8 VB), e-Qotr (17 TR),
p b r i i M e u a e r ' r I , l c T o itiH _ 3 H e p r f l nn o a H l { M a r b c t B B e p x ,a M y r H o i t H b _ Hofi'KyaH(6 MC).
To B K a q e c r s en o n o r H H r e r l b H-b rO
i r e p r r n - o n y c x a r l c a B H t t 3 . 3 r o r a K x e M o x e r B b I 3 B a r br o r r o B o _ x o H r - q M( 2 0 V B r . \ a H 6 - r e H
t 2 [ : t . r y a , h r e { J R r . S o H .n o H r t 4 UE ) . j r r i K x e ( 4 t E r . x o e r . \ a i
B r c , o , { H ( a x n D o u r , ' r o r or o B o p f l r c q r < E c n o r c y r c r B y e r M o K p o _ (10RP), rnoHr-MoH ( 1 3F ) .
r a . r o H € B o 3 r l r l r r a eri o i o o o x p y x e H s e > B o T n o q e M y < I r y c , o r a ) x p o _ Cnoco6 Bo3AeicrBaq- f l p s n y H k r t r r rao q K s e - ( b o n r
B r , H e c n o c o 6 H o i n u r a r b < t o " I o c o B o eo r B e p c r H e ( o x H o ) > , M o x e r ( l7 TR) H€o6xoafiMo Bri3Barb oco6oe ouyqeBre, fippaar.Lrpybrle€
B b r 3 n B a T bf o r o B o K p y x e H r e B yua,x, Il6lr ro,rbKo opl,l 3roM MoxHo paccqxrbrBarbr{a repaneBrs-
qecxur,r3QQem.
T e p - an e s r H q e c x r i i 3 Q + e h r roqeK T o q K f ci y a r .
K o r ( 8 V B I H e - Q o H rr l T l R , c , r y x i a rc n e u a a , r u rdo, l q y c r p a H e H H n
uyMa B yuax a roroBoKpyxeHfir, BoccraHoBreHHrcnyxa. Toqxofi
CI,!U.NTOMATT,IKA ,rro6bryMeprr.rbOyHKtIHricpeAHe*qac-
Hoi-xyaH (6 MC) no,'rb3ytorcB,
TX MepXIhaHarpex qacTetiry"!oBr,lqa, BoccraHoBuT6AyrreBHoepaB-
BHe3anHoe nosB"l€Hre rxyMa B ylnax c nocJleaytoqaM rcJoBoxpyxe_ HOBeCrre n yKpenxTbBo!'lro,a TaKxe anr pery!'lrLllfl{3Heprrfi xe!,rylKa
Hx€Mj MeprlaHueMB r!'Ia3ax, oluyqeHl{e,
qTo oRpyx,a|oqfie flpeaMeTbl c qerbro npeKpaureHrirrorlHorr,r. <PaccehBaroutrMl.{> yKo,taM,{B Toq
.nonjru,rir, e xpyroaou BpaureHtx, qro 3acraBneer 5onbnoro 3aKphrrb xfi QoHr-qr (20 VB) H xaHb-3sH(2 F) HopMa,rx3yror neqeHb, onycKa
qaUle Bcero
r,ra"a u npaxnii 'Texuqee no'roxesae ls 6oq3H ynacrl' ror ycrpeMneHHyoBBepxsHeprHro.To'rKarxafi-Kxe (3 R) cnyxrr Art
raxoe ro,r_oaoxpyxeuae conpoBoxlaerc9 roulxoroi, pBoroii, no6nel_ roHr.r3rrpoBaH!{fl no,leK. To.rxri OoHr,toHr (40 E) I ari-xxe (41 E)
HeHfieMrxua, 06I,l,T bHbIMnoroorae!'IeHxeM. l'lBoraa nplcTynbl ro''IoBo- l{crro!'rb3yrorcrc rle!,rbro<yKpenlreHrrrxer'ryaKa, JrsxB{Aaqrin Baax -
KDv)KeHaflr/rttrcg HecKo!'Ibl(oMrlloBeHqii, a rHoraa oHx 3artrxBaorct Hocrr,r>, <ycrpaHeHrsMoKporl'l,onycKaHrr ycrpeMreHHofiBBepx?Hep,
lta Hecxo,,Ir,KoqacoB a Aaxe aHeii rlrfir. ToqKa xroer-xafi (10 RP) cnoco6crByer roHll3llpoBaHr,tro Kpo
O6uuuo pa:,ruvarcr rp'{ (popMbr roJoBoxpyxeHue Bri a rsoHr-MoH(13 F) <yKpen,lseraH6,3Heprurc, nrira€r xpoBb).
l . f o " r o n o K p y x e n a e . c B f l 3 a H H o ec c t H A p o M o M < B e r p a n e q e H f i t .
K D o M ec t M a r o M o s , o n H c a H b l x B b l u e , H a 6 n l o A a l o , c ar o p e q b B o p r y , 6. Bo3Aef,crBrieMemAoM{uBere{rs,
cvxocrr s rop,le,6o'1n g 60Ky, npn pa3apaxeHx 60'1e3rrbycyry6nser
, , i r .u u . t o ' e c i , o u n a e g n " .s 3 b I XK p a c H b r i if-l v " r b c H a f l p q x e s H b r f t( x t o e H ) O 6 p d 6 o r h , a o r o H a n b H o r , r ry p H H u x n ) :
r o H K r j i i T 3 ) u H e M H o r o6 b r c r p H i i ( c a K ) ' . l o H a o o H J a T e ' l b H o f oB o r t r e t c l B H h ,
2. fonoBoxpyxeHxe, cBtBaHHoe c c!'lHApoMoM <Mo(porbl x3-34 - ocHoBHar3oHa Bo3AeiicrBtlq o6,,racrb
3arH"!Ka;
rraroreHlroi BnaxHocrl'tr, floqB,'Iqorcq topraHHocrb peqt{' rorxxora. - AononHtrenLHai 3oHa Bo3leicTBlir: yqacrKH
BoKpyr yuHoii
HenpxtrHoe qyBcTBo pacnfipaHrq B rpyar, 6ecnoKoiicrBo' coHnt{Bocrbl paKoBfiHbli BticoqHarr ()6"racrb, HapyxHar c,ropoHa npeAnrjeqbrur ro-
n,roioi annerlr. cKonneHfie Bo pTy MoKporb{ (no yrpaM), cnfi3acrblt
h $ 1 e l H a q t b r K e .[ l y , l 6 c c K o ' l b r t u r H i l x o a l ] . -Cnoco6 0 _ 6 p a 6 o r x H . E x € A H e B d or o o A H o M yc e a H c y ,B o 3
J . f o , l o B o K p y x e H H e .c B f l r a H H o cc { n y c r o l o i , x p o B } r ' l l l l , L o e a r AetcrBre cpeaaet rHreHcfiBrrocli, aa xax4yro,laulrc nb l5_i0 yna-
HrroTcf, 6neAB6aTb,Ilt{qa, {HorAa c orreHKoM xerlTt3Hbl. 6ecnoRoi' poB Mor'ro,oqKoM.
c r B o . \ r o M L l g e v o c T b , r a 6 H s q x B o \ T b 6 e c c o H H u a . n " l o x o r ' 1a n n e r l T '
n o r e p i B K y c o B b t xo u r l L u e H f i t t rt:r H X 6 , 1 e n H U f ic o c ' 1 a 6 t i M H a " l e r o v B. AypsKyrorepanxq
y xeHUrIlH -
nv,ric rosi<rfi (r:), r.iy6oxui u oqexb Mardfi (HfioK)
o " r u r o m e a o p e rc H e H o p M a n b H b I MBxH I e n e H n q M x ;n o c n e M e H c ,pl y a q d t { B o r a e f tc r s _ r _ e
H a I o q x h : i t e q p H b . , { F r q H b r t n ) r b tp b . c e r l e 3 e H K aT, x aH .
qacro 6brBarcT 60'14 B xfiBore. v o H r A l - b r r , n n ' l h a . x e J l e { b t B H y r p e H H e f ci e K p e u H H .H a a n o q e q H f i { .

6116
 C n o c o 6 B o 3 A e f i c r B l r t , B o B p e M xt a x A o r oc e a H c ca n e - rEPANt|'
aye, xcnonBoBar6 2-4 Toqkl,-Hr,Ibl HyxHo BpauaTb qepe3xaxaue
i0 MHH.Bo3AeficrBrecpeaHefi[HTeHcrBHocTI,r c ocraBL'IeHfleM xrr Ha
A. Hraorepanxn
30 MnH.MoxHo ocraanflTbI,trnbl-KHonl(l,l Ha Heae,rrc,a sa cneAyloulyrJ
Heae,rrcso3Aefic,BoBarbHa apyrxe Toqxn. fI p fi H q,,l n ,r e q e H H r. OcHoBHoii nprrHrlrn _ (',rHxBllraur,rg
orHc) Ha 6o"'re3HeHHoMyqacTKe. flpu ctnlpove <orH, B cocTorHa!
n o r ' l H o T b t t . o ) \ J a x A e H r e , { e n y A x a H x t u l o K r . c p a c c e B a H u ec K o n .
3y6HAt 50Jlb n e H t f i o r f i t , . r r p H c H H I p o M e< O r H eB C O C t O e H f inr jy c l o r H , .yKpen
, ' I e H t e f H - 3 H e p f f i | , j ,p a c c e x B a H r e o f H f l r ,
o6uItrE lloJroxEHxt To,rxfi so3reicrBl.re: x a - x l a H( 7 E ) , r r n c a { 6 E , , x o n
nprqrHoft 3y6Hofi6onr qaute BcerorB{'rflercr Kaprecay6oB.Bo BpeMq hoh,(4 Ut), Hoi-!HHb f44 E). rxai-K\e (3 R,.
npsHrrnr ropnq€fi r,1x xo,ro4Hoi, Kricnofir craaxoi nrulr 60rrbycfi- Bo_lieficrBHr nph nyH(uHeB x r o q x H3 e n - c a
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r'rfiBaeTcr.aerraerct eqe ocTpee. HrnoyxanHBaHxeM3y6Hyto 6onL ro E, x xa xyaH l/ L, ocTpxe HrJH crlelyer HanpaBrqTb B clopoHy
MoxHo o6!'rerqrrb,oaHaxo3Tor MeroAHeo6xoAsMo coqerarb c,{pyrtM 60,1b oro ry6a. yKo,lH nportBorHrb ao apeua aoirrxroaeHra Ooalr.
JIEqCHfiH 3Y6OB. 6 o 3 n e f l c r B H el o n r { H o 6 H r r , B b t c o K o j it H T e H c H B H o c f f it n D l , | c l . j H n o o v e
.METOIOM . n o " l H o r b i r ) r , ' t r c , r a 6 o f i , j Ht e H c r B H o c T r .(rn p r c a n a p o v e . n y c r o i u r , ) .
l4r,lbr ocraB,'tqr6 Ha 20-30 MuH, Bo3AeficrBoBarr, sna,ra,,ri xa 6,1u-
sfHOnOrrt I nATorEfic3 xailllfie roqKIl, 3areM Ha Aa,rhHte, nprqeM Ha AanhHlle _ c 60r,Ibruefi
IiHTeUCIiBHOCTblo. yMeHbU€Htlt 60,1fi MOXHOrlHOtIa
IO6HTI Cg I{aAaB-
nfiBaHIleM nanbqeM c noc!'leayloulxM BpaUIeHteM Ha frlaBHbl€ r.{3yKa,
3y6br rrMeror HenocpeacrBeHHylocBq36 c AByMfl MepriAlraHaMfi <cBer_
,rbri qH> - roncrofi Krrrxn H xe,'ryAKa- OaxH x3 yqacrKoB MepuAlra-
Ha xenyAxa npoxoAfiT x 3y6aM Bepxfien qenlocrr, a Ha oaHoM Ii3 Tepanee^rj,rec|(rfi ?eOeKr r o q e x . T o q K Hx a - K y a H
-
csonx y'{acrxoB MepllAIaH Torlcrot nuIjlIKH noAxoAItT K Hn)KHeL | / E ' . 3 f , n - C a t b E t l , r o n . k o x l 4 c l ) c _ n y x a ra n e . r ' l 1 (. B H ! a l l r x B e f -
p a r x a p r , i ! . l l y H h u t e r . tB r o ' { x f l x a . K y a H ( 7 E t H 3 e n . c a ( 6 E ) v o x H o
npnquHoii oc,poi 3y6soi 6onu Moxer nocnyxir6 cKoDrlesue TaKXe AO6IrTbCq BOCCTaHOBT'reHrt npoxoallMocTx MeDItarraHoB Ha
<xapbr> B MepnaraHax <cBernHi ffsr. flpu cxon,reHlrr BHyrpexBei nopaxeHHoM yqacTKe. Toqxa Hofi.ArrHb 144 E) cnyxfiT A;c <,tHXBHna,
< x a p 6 r ) B o p r a B r 3 M € B c o r r e r a H f i f ic l l p o r s x u r u M l r T y a a . 6 o , ' I e 3 H e _ r.llr|HorHr) B MepxAriaH€ xeJryAr{a, a roqKa rxafi-Kxe (3 R) ,,nA
rBopHHMr oarffopaMr (Berpa) <xapH) rcBHe 3y6HaH 6o'1b ycl'rru- T O H I t 3 U p O B a H snsO q e ( .
Baercr eule 6orbue. <3y6H, - yrBepxaapT MeaHXn npo ,loro,
?TO AOnOJIBgTeJIbtIbre HapOCThtKOCTen, a 3a KOC' tt OTBeTCTBeHHHe 6. Bo3Aef,crBxe r,teroAoM <rlB€TeHrflt
noqKH'. B cnyqae ocra6n€Hlis noqeR BblnaAanr 3y6H. a <nycrorat
l r < x a p a , n o q e ( n p r B o A q r K p a c u a r b r B a H r I o3 y 6 o B . K 3 y 6 x o i 6 o n E . O 6 p a 6 o r K a n o 3 o H a n b H o M y n p } r H rI l n y: o6JracT6
3aTblrka, nleqHar r,i cKyr'lqBar o6nacrr; nepe,4HrflcTopoHa roIeHL

nTor$lH(A
C n o c o 6 o 6 p a 6 o Tr{fi: Ha KaxAyto n}rHarono 20 yAapoB
cl
MoJIoToqKoM; Bo3AetrcTBHe cpeaHeHIlHTeHcHBHocrH,xaxAHi AeHbnu
oAHOMyCeaHCy.
3y6Har 6o,!b Moxer no cBoeMy xapa(repy orHocr,rrbcr K cnHApoMy
(no!'rHorr,r) nJllr cxHApoMy <nycrorbrr. CrEApoM (norHorbl) cBtsaH
c <orHeM a cocfotllllt flonHo,br>, a cnHIpoM <nycToTH) - c <orHcM B. Aypxrynorepaflxt
B COCTOTHTII flycfoTblr.
B o 3 a e f i c r B r e H a r o q x t : s e p x H s r q e r l l o c r b ,H H x H f , q e J r c c r b ,x e r \ A o K .
3y6Haq 6onh npli ctHApoMe <orHr B cocrorHrH norrHorbl B Mept-
n o ' i x a , t i o 3 a c i c r B H e c p e a x e i H H T e H . r s H O C r rh. lr., r u o c r a e , r q K ) rH ' aI q
aI,IaHe<cBeT!'16Iff 'tH>i flOTOOTAeT'IeHHe,
3anop, noBbrrXeHHatTeMnepafy-
pa) xenrbrfi xane, Ha IB6IK€, cyxocrb Bo pry. xaxaa; ny,rbc 66lcrpbtfi
lcaKr.
3y6Hafl6onhnpt cxnapoMe
<orBflB cocrorHnnnycrorbl>:cyxocrb
KOXI,I, CyXOCTb BO pry, nCriXfiqeCKAfl yTOM.4qeMOCTt, noxpacHeHfie
Kpaes fi3brxa;[yn5c - rny6oKri (qaM), roHKnfi (r3), 6HCrpHft
(caKl.

64E
 TA6JIllqH ToqEK
KJlACCllOrlKAul,loHllblE
AKYNYHKTYPbI 'IX NO TftNAM
l| CI,ICTEMAT]13AII1'I' Meptr!uaHn. npr.oelrHqre4ke.R xoroPHM npRcoenk
K nrHHoMy vePrnralr- Heercr larHdi Meputran

l. Tafu{qt ro'{c( B €trax flpxcoaAx|tcB{i

€praxa{oa apyr x apyry
MeDuHaud x Koropb{ oPscoelE
M€p!!f aHd, rPrcoeA(u'oure.e
k laHtsoMy MeprlreHy
VB

1 5V B )

( 4E ) (9 E)

9yp" I ( 3 7E )
( 3 ?E ) (3e El

ll5 (]ll ( 1 2l O ) (r4vB)

( 1 6G r ) l
(20Gl) (21vB)"
l
:".", O"*
{ 1 4v B )

( 1 2v c )
t24 VC)

( 1 4v G ) ( r 3v c )

{20vG) ( 2 4V C )

( 2 6V O ) ( r 4v G )

(l E) (20GI) (20vc)
(1V)
1 2 6V C )
( 2 9V B )
(28VC)
( 4E )

650 651
 MepNnMHrj nprcoelrrrb{recq M€prlr,tsE. K xoropuM oprcoe!tr dep!!traHH, nprcoetuxrnqrect KoroPrr npsco€rx
( laH{ory flepraHsdy sqer.r !aHH!' repklrar
K l a H H D m yM € p n l r a H y Hrercr raHHEi MepN!'aH

g y H r ' O y( l P )
(6RP) (20TR)
(24VB)
(22TR)
1 1 2R P )

{l vB)
(3VC)

{r5 RP) (r2vc)

(r6RP)
(4 VC)
(l3vc)

rr7 vc)

H e c o e a r H n e r . qc ! p ) r r M r M e p r r H a { a M { ( 1 4v c )

1r0l(l)
(20vG)

( r 2r G ) (lv)
( 3 9E )

(v)
( ?V B )
( l 8r G ) Ian-qd (r l v)
(8 VB)
( 1 9r c )
(9VB)

1 l lV ) (r0vB)
( r 2v ) (lrvB)
( r 2v B )
652 653
 [ePr,1k3nu, !p!.oelrH'b(tre.t fleprruaHlj K xoropnM npr.oe!tr.
x raHsofly nePrntrahy {cDtr!,aH,, nprcoe!rHraqrccr xotopHM trptrco.r!.
rr.rcr !!RHHit nepnllatr x !aH{oMy xeprlraHy Bqercr !aHHdr {epuraH

(5ev) ll5 vB)

( r 8R )
(61v) RI

(02v) { 2 0R )
R)
(63 V) (23 VB) ( rv c )

(30vB) ll Mc)
(33V)

( 1 3v G )
( r 4v G ) ( r 3r R ) (l2lG)

( r 5T R )
( 1 6v G )

(r7vc) (l7TR) ( 1 8r c )
(20vc) ( 2 0T R ) (i9 la)

1 2 4V G ) ( 1 9T R ) ( | lv )

(6RP)
( rv B )
( 3V C )

(3Vts)
(ll R)

( 4V B )
( r 2R )
{ r 3R ) ( 4V C ) ( 5V B )
T H M a n{ 1 4 R )

(6VB)

(11vB)

( r 7R ) ( r 7v c ) i 2 0v B t
654
 MepHAraHs, nprcoelrHrf urecq KoropuM trDrcoe!{
MeputrshE, nprcoerrHrDurecr MeprAraH', x xoiopNr npHcoenr x lakHoMyMePrasaHy Hqercr !aHHUi Mep'^,aH
x l a t s H o M yr e p H l r : s y H q e r c Rr a F H U n x e p t r a l a H

{ lr v B ) ( rM c )
(21vB)
( r 2v B )
{ l 3v B ) ( r 5T R )
(r2vc)
( 1 4v B ) ( r 7T R )
(20TR)
0 7v c )

( r 5v B ) (22TR)
(r.rvc)

(20vG) 06 vB) { r 3F )
( 1 7v B ) (r vc)
xa Ryau(7 E)
(l vB)
Aay.3os(8 E) ( 1.8vB)
(3 VB) ( l9 vB) ( 1 4v G )
(eE) (20vB)
(4 VB) ( r 2I O ) (20vG)
(21vB)
( 5V B )
( 1 9l c )
(6 VB)
(23 VB)
(llv)
(24VB)
( 7V B )
( 8V B )
(evB) (33V) 1 2 6V B )
( 1 0v B ) \27 VB)
656
 seprxraHU, nprcoe!rtsqrureca ruepRnFaHU.K KoropHM rprcoep !!eptrrtraHbri rprro.!HHqbureca KoropNn nPncot!r
x r a n n o M yM e p 4 r a H x {rer.r ra{RHr Mep!!r:H x naHHoMy xcpr)rrluy

(28VB) ( 4V C )
(29VB)

{ 3 0v B )
( 3 5V B )

(r2vc)
( 1 3F ) (fj RP)
( 1 4F l
{ r3v c )
( 1 2R P )
( 1 3R P ) (r7vc)

( 3 3V )
(22 VC)

( rM c ) ( 2 3V C )
(24 VC)

{?YC)
(3 VC)
(1 VG) ( 1 2v )
(l vc)
( 4V C )
( 1 3v G )
( 1 4v G ) 124VC)
(rvc) (1E)

( 1 6v c )

(2VC) { 2 8V G )
( 3V C ) {r 7 vG)

658 659
 Mepra"aHH, .npscoelrnr!,.cq M.p{asaDs, x noropHn nprcopnr
x laHHoxy xepxlraHy Biercr AaHru, xeptrdatr

K a B . 3 y( l 8 V l K x - M o H( 1 4 F ) F)
(20vc) K N y - B n( 1 5 V C )

( 2 4V G )
(l vc)
( 2 6V G )
(35VB)
( 2 8V G ) (eR)

{5sv)
Coriacx. Apy x xeDrrxaHoM rarolrrcs
(8R)
" B {crocHrRax orcyrobyor coelrHeur c trot roqxot
Apyrd a.HHo* rpynnu

2. Ta6nxua coqyrcra€HlLrx roqex c||tHH (Io-nysxroB),

Toq€X-rJrauara€tr(iro-nyHrms), ro'tcx-qenen
I cra6xnrGxpyroqxx ro{€r (ro-oyt|(mB},
oTxocrullrxcr r( octroanllx r <qyaecsHM, uepxa{a|ra

o H . n d y( 7 G I )
t25V) (22E) (6Or)
Bu.3y
(2t V)
( r 2v c ) (34 E) ( 4 0E )
Td-3y(20V) ns.'Ko (8 RP)
( r 3F ) (4 RP)
T a M3 y ( l 5 V )
( r 4v c ) (6 C) ( 5c )
T{ 0E!(7 IG)
(n vl (4 VC) (6rG)
(28V) ( 3V C I (tsv) (5EV)
(25V8) (5R) (4R)
(14v) 0 7v c ) ( 4M C ) { 6M C )

122v) ( 5V C ) (7 rR) ( 5T R )

( 1 9v ) {24V8) (36VB) {37VB)

060
 5. Ta6nxqa loqex ncrfi gJ€MCI|Toa
xa rlccrr| <lll6crxx, raprAranax

E3 E E v,

(lrP) ( 1 0P ) (9P) (8Pl ( 5P )

= E
(r RP) ( 2R P ) (3RP) (5RP) ryeH(9 RP)

(ec) (8C) l7 c) ( 4c ) {3C)

(l R) (2R) ll]R) (7R) 1 r 0R )
a H_q
( 8M C ) ( ?M C ) (5,41C (3MC)
(9 nlc) )

1t F) (2F) (3 F) (8F)
F-a F a ! :

- : i :
i q
6, Ta6JrxIa rocc|( ntTlt gr€refiToa a ruac,tx .iicrxxt ilc9a'{ia ax
Et9

a3
T E 9
ia ( | lc r )
( 2C l ) (3Gl) ( 4C I ) ( 5G l )
(1Gr)
I CyHL
(45E) 144E) (43E) (41E) n r ( 3 6E )
142E)
I : s
(2 lo) 0lo) ( 4 1r G ) (5rc) (8lG)
(l rG)
{67V) (65V) ( 6 4V ) (60v1
: ; i :
I n!: I {2TR) (3TR) ( 4T R ) (6rR)
a F r e S (rTR) ( r 0T R )
I aM (44V8) (43VB) ( 4 0v B ) (38VB)
(41vB) ( 3 4V B )
9:

9e a
F E : A
E::

i i E
€
?
;F-
-,!

662
 AJIOABI.ITHbIN
CNICOK TOqEK AKYNYHKTYPbI

42VB
l5 vc 4E
38E
Uwa"" 27 VC
l?no* 26 VB
l T V C Ay-uy
]l el'."
RP
Iy 6u 35E
l9v
IVB
luE
I IRP
t 7 TR Tpex cacreil ryroBBua
PC3
37y zTR
3y 0y uly 0y 27R
1 3V B I R
IIax .ya{-uy 28V t4vB
53V 35 VB
l ! rE tts-ry 5rc
PC r07
33VB
3VG
PC 137 5GI
PC 30
30v 34 VB
20vc 6tc
PC 163 qn'4v 38VB
3tE 4TR lpex cacr€t ryioB,ura
PC 66 28 VB
t2lG 4lE
22R 20 TR Tpex cacret ryioB,nra
6tv 5 ilc
2P 8R
6E
B, 3y A5i uy 2rv
s0v
2I RP 45V
Aa ay 2RP Ley 3y
Aa !yx6 I F PC 74
PC t00 1 8v
27E
7MC 8VC
5E 43V
I4VG t2F
4R
l2R fr .yan!
I5RP
25y nvc
lTvc I4 TR Ipei cdcrn ryroB{ura
l3 vG l4 tc
8E t5Gl
l5 vB 2l vB
8RP 9tc

664 865
 7RP
Il3tHb uy PC 127 45E
I5IG 23 VC
63V
PC 20 I OV G
64V 4C
24R
u3{H ,1oii I8 P I 9T R Tp€x qa.ren ryio8nua
2 5V B
I 1R P Xtryn{a
2lE
4RP pc tsl
26R
ryarFM3Hb I 22E
26V
lTR Tpex racft'ft rtrioBrru! I6VB
3 7V B
1 8t ( i
1 4v I 9V B
40VB l7vG
I8TR Tpex cacren rynoBrua 2 8V G
q, -, lll 20(]r
30E 5TR
PC 59 36 VB
26E
24V
4" *v 13E
1 3R
PC 20

llvB 2 7V B
lMC
!1r+", l4t'
PC t57
1 3t c PC6
2VC l0P
PC It4
?VB 2Cl
8 F iP 'rsr 2I TR Tpex qacren ryioBnoa
3MC
llGl 2R
t2E 44F
I6QI 6MC neprkapaa
l4vc
2SVB
3 L.l t0lc
l c
X"'vo* l 8E
l8 vc I3TR Tpex qacrefi rlnoBrr(a
l5vc t7li
29E Xr{b rH 9E
26VG
2 4V B
8
1 5L
ri Mc 7CI

666
667
 I

I8RP
5P 25E
lllyan ry 8VB 1 5T R Tpex cacrn ryioBrua
42E 6Cl
I2RP l6lc
PC 5l 25E
9VB
6RP ll lc
l5v 2MC
8TR IOTR Tpex qagen rynoBuUla
3Ar
22V tMc
9C
9VC ll P
6TR Tpex qacren ryroBrn(a 8C
7IG 3C
52V l t c
6R l9 lG
I 7V B 2VB
1 3F div
2 5V G 20R
2t vc 5C
Uyantsqi, 2V
llloy-y.rn l3cl
44VB I OG I
.II VB tlly ry 65V
3{i Il 32V
23E 56V
3RP
PC9 I E
3 R 1 8V B
3F 20E
9P 57V
ll vG 21yC
24VC 36V
I7RP
23V lcl
3VB
62y t3vc
7C 5RP
25R l 7R
23R 37E
l2 vc 9Gl
IITR Tpex qacret ryxou,na 3lv
2C t3 vc
PC 86 2l vc
1 8R 28E
5VC tllyii-ry t 0E
l?cl 26 VC
22 VC 5R
I 6T R TFx qacren rynoB{ua 9VC
1 7I G 2E

668 669
 Tp€x qa.reii ryioBrura 43E
2F
3tc
+3b ryH
PC 85
I 9G I
2 2T R TI)er q..ren ryroBrlra
." "^"lt " 23TR Tper qa.rei ryiourrr. 2ti R
I2VB
2tc 3 0V B
PC 102 16R
1 2T R Tpcx qacren ryroBr lla 5l v
8rc 1 1 R
2T! 21E
22 VA lVC
6VC 7TR Tpex qacren rlx060rua
2 0R P
2IR
22 VB 4Cl
.! lG I9RP
39V 5VC
6VB
5VB
42v 3t vB
1 OR P
40E
2 3V B
CR
t6vG l6vc
20 vB
l0vB 3 2V B
I 8G I 1 2v c
59V
38V
I3RP :lxljH.F{
33V
I 6R P
I4RP qxtH qyH 9MC
7 R
32E 3fR Tpex qacret r,vioBnqa
8GI 15R
3 I P
'/4EV lvc
1 2C I
l0vc pc I24
311ti
l{i u
PC 156

670
 PyKoBoAcrBo
TIOYKAJIbIBAIIIIE

3as. peaarurei B. C, 3|rclcxre

Peaamopuloax Cya{ Meoy, A. B, (mycrxi
PeaamopnslrrsrcrBa T. B. Or{xrflrxon
XyAoxarEeHHdipela{'op A. JI. oxc.ro
XyloxrnK lt. T, Xr(yrxxx
Ilepenne xyaoxrxRaA. E. fpr.opEr.
Tex{{cecRBiperaRropfl. |(. Ilapola
KoppenopI. a. X!o!r'x.
l|6 .t 463?
CaaBo s ra6op 09-07.87.noatrxcaBo ( necart
0{.12.87.rDop*af 6ydar. 60X90'/s. byMara ooc.
Ib I xMn. fapsmypa nnrepatypHat.necat6 ooce-
rsr. ys. neq.n. 42,0.ycr. kp.-m. 84,25.yc.-rcA.r.
44,3?.Tr9ax.l000O 5re. 3aes ?55.U€na l0 p.
ODletraTlt,aomro KpacHoro3Ha"eHr hftrer*rm
. M e l r u r H 6 ' . 1 0 1 0 0 0 ,M o . x B a , I l t r p o B e p cr rr r f i
nep.,6/8.
t D o q a B c h r f rt q r r e a o k o H 6 B H aCr o b s n @ H r P a o n p o _
M; npr foc'lapcmeH{oMKoMNr* CCCP no lqaY
rraarubcrB, nMrrpaouN t $rxrot rcP,oMx
150014, 9pocraub. yr. Cso6o,!u.97

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