Tavi 5

saWmlis momnelebeli sistema

es Tavi Semdeg nawilebad iyofa:

1. Sesavali
2. anatomia da fiziologia

3. leqsikoni
4. Sedgenili formebi, Tandebulebi da cnebebi

5. saWmlis monelebeli organoebis paTologiebi

6. savarjiSoebi
7. samedicino Tavsatexi

8. savarjiSoTa pasuxebi

9. cnebebi da maTi mniSvnelobebi

da Tqven SegeZlebaT:

> daasaxeloT saWmlis momnelebeli sistemis organoebi da aRweroT rogorc maTi

mdebareoba, aseve funqciebi.
> aRweroT daavadebaTa procesebi da simptomebi, rac am organoebs axasiaTebs.
> ganmartoT am organoebTan dakavSirebuli Sedgenili formebi da Sesabamisi cnebebis
mniSvnelobebi sityvaTa am nawilebis gamoyenebiT.

Sesavali
--------------------------------------------------------------------------
saWmlis momnelebeli, anu kuW-nawlavis (gastroenteraluri) traqti iwyeba piriT, saidanac Sedis
sakvebi da mTavrdeba ukana taniT, saidanac sxeulidan gadamuSavebis Sedegad darCenili
nivTierebebi gamodis. am sistemis daniSnulebaa sakvebis moneleba, Sewova, da gamoyofa.

pirSi moxvedrili nairgvari sakvebis moneleba, anu _ meqanikurad da qimiurad daSla-

danawevreba mimdinareobs kuW-nawlavis traqtis dasawyisidanve. momnelebeli fermentebi
aCqareben qimiur reaqciebs da xels uwyoben rTuli Sedgenilobis nutrientebis (sakvebi
nivTierebebis) daSla-monelebas. rTuli cilebi ufro martiv aminomJavebad iSleba; aseve,
sxvadasxva tipis Saqari iseT martiv Semadgenlad iqceva, rogoricaa glukoza, xolo msxvili
cximovani anu lipiduri molekulebi (trigliceridebi) cximovan mJavebad da glicerolad
qucmacdebian.

Semdgom, Sewovis gziT, wvrili nawlavis kedlebis gavliT monelebuli sakvebi sisxlSi xvdeba da
aucilebeli nutrientebi (Saqari, cximovani mJavebi da aminomJavebi) organizmis yvela
ujredamde aRwevs. Tavad ujredebi ki axdenen nutrientebis katabolizms (dawvas) Jangbadis
zegavleniT _ sakvebSi arsebuli energiis gamosaTavisufleblad. ujredebi aseve iyeneben
aminomJavur nutrientebs im didi cilovani molekulebis anabolizmisaTvis (gamTlianebisaTvis),
romelnic organizmis zrda-ganviTarebisaTvisaa aucilebeli. marTalia, cximovan mJavebs da
glicerols wvrili nawlavis kedlebic iwovs, magram es nutrientebi ufro limfur sadinrebSi xvdebian,
vidre sisxlZarRvebSi. saboloo jamSi, monelebul-gadamuSavebuli cximebi sisxlSi aRmoCndeba
xolme, radgan gulmkerdis zeda areSi limfuri sadinarebi sisxlZarRvebs uerTdeba.

saWmlis momnelebeli sistemis daniSnulebaa im nivTierebebis gamoyofa, romelTa Sewovac

sisxls ar SeuZlia. fekalur masebad wodebuli es gadamuSavebuli nivTierebebi msxvil nawlavSi
iyris Tavs da bolos organizmidan ukana taniT gamodis.

anatomia da fiziologia
-------------------------------------------------------------------------

piris Rru
kuW-nawlavis traqti piris Rrudan iwyeba. am Rrus mTavari nawilebis Seswavlis Semdeg,
naxatze 5-1 saTanado cifrebs Sesabamisi cnebebi miuwereT.

ovaluri moyvanilobis piris Rrus kedlebs loyebi (1) qmnian, xolo am Rrus Riobs garss akravs
tuCebi (2).

magari sasa (3) piris Rrus “TaRis” zeda nawils warmoadgens, xolo kunTovani rbili sasa (4)
mis ukan mdebareobs. magari sasis zeda nawilis damfarav lorwovan garsze ganTavsebulia
uswormasworo naoWebi. uvula, anu _ naqi (5) rbili sasidan Camozrdili patara rbili qsoviluri
warmonaqmnia; igi xels uwyobs bgerebis warmoqmnas da metyvelebas.

ena (6) piris Rrus fskers mTlianad faravs da kunTebiTaa mimagrebuli qveda ybis Zvalze. is
amoZravebs sakvebs ReWvis (mastikulaciis) da ylapvis (deglutaciis) dros. papilebi (xaoebi)
amoSverili patara nawiburebia enaze, romlebic gemovnebis receptorebs Seicaven da
mgrZnobiareni arian sakvebis qimiuri bunebis mimarT. swored maTi meSveobiT xdeba enaze
moxvedrili saWmlis gansxvavebuli gemos aRqma.

Sedgenili formebi X 8
1. buk/o 9
2. Ceil/o, labi/o naoWebi
3. palat/o 3
4. palat/o 4
5. uvul/o 5
6. glos/o, lingv/o 7
7. tonzil/o 1
8. gingiv/o xaxa (farinqsi)
9. dent/I, odont/o 6
naqi
2

naxati 5-1 piris Rru.

nuSisebri jirkvlebi, anu _ tonzilebi (7), esaa lorwovani garsis RrmulebSi moTavsebuli limfuri
qsovilis masebi, romlebic orofarinqsis (pirTan axlo yelis nawilis) orsave mxares gvxvdeba. isini
erTgvari filtrebia, romlebic adamians mikroorganizmebis SeWrisagan icaven da amave dros,
gamoimuSaveben limfocitebs _ sisxlis TeTr ujredebs, romlebic daavadebebs ebrZvian.

RrZilebi (8) esaa kbilebis (9) budeebis garemomcveli qsovili. naxatze 5-2 naCvenebia dentaluri
rkali _ 16 mudmivi kbiliT (saerTod, mTel piris RruSi 32 mudmivi kbilia). saTanado adgilas
miuwereT naxats kbilebis qvemoT mocemuli saxelwodebebi:

wina saWreli [1] meore premolaruli (mcire saReWi) [5]

gverdiTa saWreli [2] pirveli molaruli (saReWi) [6]
eSvi [3] meore molaruli (saReWi) [7]
pirveli premolaruli [4] mesame molaruli (e.w. “sibrZnis kbili”) [8]

labialuri Sua xazi

(tuCis)

X 1
2
3
incizaluri (saWreli) kide 4
5
mezialuri (Sua) zedapiri sasa 6
7
distaluri (ukana) zedapiri 8

okluzaluri (bjenis) zedapiri

bukaluri lingvaluri (enis)

(loyis)

naxati 5-2 zeda mudmivi kbilebi dentalur rkalSi.

kbilis zedapiris dasaxasiaTeblad, kbilis eqimebi sagangebo cnebebs iyeneben (ix. nax. 5-2)
labialuri zedapiri (labi/o = tuCi) sakbeCi kbilisa da eSvis SemTxvevaSi, tuCebTan uaxloesia.
bukaluri zedapiri (buk/o = loyas) premolaruli da molaruli kbilebis SemTxvevaSi uaxloesia Sida
loyasTan, rogorc es naCvenebia naxatze 5-2. kbilis eqimebi orive am zedapirs facialur zedapirs
uwodeben (faci/o = saxe). facialuri zedapiris zustad mopirdapire mxares kbilze mdebareobs
lingvaluri zedapiri (lingv/o = enas). kbilis mezialuri zedapiri Suaxazidan yvelaze
axlomdebarea, xolo distaluri _ misgan Sors mdebareobs. premolarul da molarul kbilebs aqvT
damatebiTi okluzaluri (bjenis) zedapiri (okluzia = Caketva, daketva), romelic sapirispiro rkalis
Sesabamis kbilTan modis SexebaSi (anu _ xdeba zeda da qveda kbilebis dabjena). saWrel
kbilebsa da eSvebs aqvT mWreli incizaluri kide.

naxatze 5-3 naCvenebia kbilis Sida anatomia. qvemoT motanili aRrwerilobis wakiTxvis Semdeg
cifrebs saTanado mniSvnelobebi miuwereT:

kbili Sedgeba myari darbili qsovilebisgan. myari qsovilbia: minanqari anu emali, dentini,
cementi, rbili – pulpa. RrZilidan amozrdili nawils gvirgvini ewodeba [1] da kbilis Zvlovan
budeSi moTavsebuls - fesvi [2}. gvirgvinis gare damcavi safarveli, anu minanqari [3], kbils
dazianebisagan icavs. esaa mkvrivi TeTri nivTiereba _ yvelaze mtkice _ sxeulis Semadgenel
nivTierebaTa Soris. dentini [4] kbilis mTavari Semadgeneli nawili, minanqris qveS mdebareobs
da gvirgvinSic aRwevs. is yviTeli ferisaa da minanqarze ufro rbili, Zvlovani qsovilisagan
Sedgeba. cementi faravs, icavs da amagrebs dentins fesvs. periodentaluri apki garss akravs
cements da adgilze amagrebs kbils budeSi.

dentinis qveS mdebareobs pulpa [5], anu kbilis yvelaze rbili qsovilovani nawili, da is kbilis
Suaguls avsebs. mis arxSi, romelsac sxvanairad fesvis arxsac uwodeben, Tavmoyrilia
sisxlZarRvebi, nervuli daboloebebi, SemaerTebeli qsovili da limfuri sadinarebi. rodesac am
arxSi daavadeba Tu abscesi (Cirqis dagroveba) Cndeba, xSir SemTxvevaSi aucilebelia fesvis
arxis dabJena. eqimi zemodan xsnis kbils da asufTavebs arxs iq moxvedrili inficirebuli
qsovilisagan, nervebisagan da sisxlZarRvebisagan. Semdeg xdeba arxis dezinficireba da
Sesabamisi masaliT amovseba, ramac xeli unda SeuSalos kbilis damazianebeli
mikroorganizmebis SeRwevas.

piris Rrus garss akravs sanerwyve jirkvlebis sami wyvili (nax. 5-4). es egzokrinuli jirkvlebi
gamoyofen nerwyvs, romelic Tavis mxriv, Seicavs mniSvenelovan momnelebel fermentebs da
aseve, uaRresad aucilebel citokinebsa da cilebs. nerwyvi gamoiyofa parotiduli [1] (yursukana),
submandibularuli [2] (ybisqveSa) da sublingvaluri [3] (enisqveSa) jirkvalTa wyvilebis mier.
piris RruSi nerwyvi viwro milebiT xvdeba da dRe-RameSi xsenebuli jirkvlebi daaaxloebiT litr-
naxevar nerwyvs gamoyofen.

X
3 ------------------
4 ------------------- 1
5 ------------------
gingiva -------------
cementumi -----------------
fesvis arxi ----------------
periodontaluri apki ------------ 2
Zvali -------------------
sisxlZarRvebi da nervebi ----------------

naxati 5-3 kbilis anatomia

X
1
3
2

naxati 5-4 sanerwyve jirkvlebi

xaxa (farinqsi)

daxedeT naxats 5-5. farinqsi, anu xaxa _ esaa daaxloebiT 5 gojis sigrZis kunTovani mili,
romelsac Signidan lorwovani apki aqvs gamokruli. is savalia rogorc cxviridan (cxviris Rrudan)
sasuleSi mimavali haerisaTvis, aseve piris Rrudan saylapavisaken gadanacvlebuli sakvebisaTvis.
ylapvis dros epiglotisi _ qsovilovani wanazardi _ efareba traqeas, raTa sakvebi iq ar moxvdes da
ar gaiWedos (ix. nax 5-5, A,B). naxatze 5-6 ki naCvenebia saWmlis gza saylapavidan mTeli
kuW-nawlavis traqtis gavliT. Sesabamisi paragrafebis wakiTxvis Semdeg, cifrebis gaswvriv
dawereT saTanado cnebebi.

X X
cxviris Rru
cxviris Rru

xaxa xaxa

daReWili sakvebi

epiglotisi (daketili) epiglotisi (Ria)

larinqsi (xorxi) saylapavi

saylapavi

traqea (sasule) traqea (sasule)

daReWili sakvebi

A B
naxati 5-5 deglutacia (ylapva). A: epiglotisi sasules zemoT iketeba, roca daReWili sakvebi xaxidan saylapavSi
gadadis. B: epiglotisi ixsneba, sakvebi saylapavSi xvdeba da ufro qvemoT gadadis.

X
epiglotisi
farinqsi
larinqsi

traqea ----------- 1

filtvi
diafragma

4 -------------------- elenTa
5 ----------------
--------------- 2
RviZlis fleqsura elenTis fleqsura

3 -------------- ----------- 6
12 ----------------- ----------- 7
11 -----------
--------------- 13
ileocekaluri sarqveli --------------- 8
9 ------------
10 -------------------- ------------- 14

------------ 15
-------------- 16

naxati 5-6 kuW-nawlavis traqti

saylapavi (ezofagusi)

ezofagusi [1] 9-10 gojis sigrZis kunTovani milia, romelic xaxas kuWTan aerTebs. peristaltika _
esaa ezofagis kedlebSi (da kuW-nawlavis sxva organoebSi) kunTebis uneblie ganmeorebadi da
ritmuli gaSla-SekumSva, ris Sedegadac bolusi (sakvebis masa) kuWSi gadadis.

kuWi
saylapavidan sakvebi kuWSi [2] xvdeba. kuWi (nax. 5-7) sami ZiriTadi nawilisagan Sedgeba:
fundusi (zeda nawili), ZiriTadi nawili da antrumi (qveda nawili). kunTovani rkalebi _ e.w.
sfinqterebi akontroleben kuWSi Semaval da iqidan gamomaval Riobebs. qveda ezofagaluri
sfinqteri (e.w. kardia) dundeba da xels uwyobs sakvebis gadasvlas saylapavidan kuWSi.
piloruli sfinqteri saSualebas aZlevs sakvebs gadamuSavebis Semdeg kuWidan gamovides.
lorwovani apkis (mukoza) usormasworo zedapirs, romelic Signidan faravs kuWs, nakecebi
ewodeba. es nakecebi Seicaven momnelebel jirkvlebs, romlebic gamoyofen ferment pepsins
(cilebis monelebis dasawyebad) da maril mJavas.
kuWSi sakvebi wvril nawlavSi gadasasvlelad mzaddeba, xolo ukve iq xdeba misi moneleba da
sisxlSi gawova. kuWi akontrolebs sakvebis gadasvlas wvrili nawlavis dasawyisSi _ im
TvalsazrisiT, rom sakvebi qimiurad mzad iyos saamisod da Tan nawlavSi mcire ulufebiT
moxvdes. sakvebi kuWSi erTidan oTx saaTamde rCeba, an ufro didxansac _ imis mixedviT, Tu
ra raodenobisa da tipis sakvebi aqvs miRebuli adamians.

wvrili nawlavi
(gaarZeleT saTanado cnebebis Cawera naxatze 5-6).

wvrili nawlavi Svid metramde sigrZisaa da is piloriuli spinqteridan msxvili nawlavamde

grZeldeba. Tavad mas sami nawili aqvs: I monakveTi _ duodenumi [3] anu Tormetgoja
nawlavi sigrZiT mxolod 30 sm-ia. swored is iRebs rogorc sakvebs kuWidan, aseve naRvels
RviZlidan [4], naRvlis buStidan [5] da kidev, fermentebiT savse wvens pankreasidan [6].
fermentebi da naRveli xels uwyobs sakvebis monelebas, sanam igi wvrili nawlavis meore
nawilSi, e.w. mliv nawlavSi (ieiunumi) [7] moxvdeba da romlis sigrZec daaxloebiT 2,5 metria.
wvrili nawlavi mesame, sigrZiT daaxloebiT 4 metris ileumis – TeZos nawlavis [8] monakveTs
uerTdeba. swored ileumi ukavSirdeba msxvil nawlavs.

ezofagusi (saylapavi) fundusi

qveda ezofagaluri X
(kardialuri) sfinqteri ----------

didi moxriloba
mcire moxriloba

duodenumi piloruli sfinqteri

nakecebi

pilorusi ZiriTadi nawili

antrumi

naxati 5-7 kuWis nawilebi. fundusi da ZiriTadi nawili miRebuli sakvebis erTgvari rezervuaria, romelSic
kuWis wveni da pepsini gamoiyofa. antrumi ki SemkuSavi kunTis kameraa, romelsac sakvebi duodenumSi
gadaaqvs.

X xaoebi

wvrili nawlavis
ganivi Wrili
xao
X limfuri sadinari X
sisxlZarRvebi

naxati 5-8 xaoebi wvrili nawlavis Sida zedapirze

milionobiT pawawina mikroskopuli wanazardi, rasac “xaoebs” uwodeben, Signidan faravs wvrili
nawlavis kedlebs. TiToeuli maTganis SigniT mdebare uwvrilesi kapilarebi (sisxlis mikroskopuli
ZarRvebi) monelebul sakvebs sisxlSi da limfur sadinarebSi iwoven. naxatze 5-7 naCvenebia am
xaoebis sxvadasxva xedi _ wvrili nawlavis Sida garsze.

mxsvili nawlavi

(gaarZeleT saTanado cnebebis Cawera naxatze 5-6).

msxvili nawlavi ileumis bolodan iwyeba da ukana tanamde midis. igi Sedgeba:brma
nawlavisgan, kolinjisa da swori nawlavisgan. ganasxvaveben aRmaval, ganiv, daRmaval da
sigmoidur kolinjs.

brma nawlavi, anu cekumi [9] _ esaa sxeulis marjvena mxare mdebare nawlavi, romelic
ileocekalur sarqveliT (sfinqteriT) uerTdeba ileums.brma nawlavidan gamodis Wiayela danamati
apendiqsi [10]. apendiqsi rudimentuli organoa, Tumca arsebobs mosazreba, rom misi, rogorc
limfoiduri organos daniSnuleba Zalze mniSvnelovania. gadavsebis SemTxvevaSi igi SeiZleba
dasnebovdes da anTebiTi procesi daiwyos. daaxloebiT metrnaxevris sigrZis kolinjs 4 segmenti
aqvs: aswvrivi kolinji [11] brma nawlavidan RviZlis qveda zedapiramde midis, sadac marcxniv
uxvevs (RviZlis fleqsura) da ganivi kolinjad [12] iqceva. is horizontalurad miemarTeba
marcxniv, elenTisaken da Semdeg dabla eSveba (elenTis fleqsura) daswvriv kolinjad [13].
laTinuri S-is formis sigmoiduri kolinji [14] daswvrivi kolinjis distalur boloSi iwyeba da swor
nawlavamde, igive reqtumamde [15] midis. is ukana tanTan, kuW-nawlavis traqtis qveda
xvrelTan, anu _ anusTan [16] bolovdeba.

msxvil nawlavSi Tavs iyris monelebuli, Txevadi, gadamuSavebuli sakvebis narCenebi. msxvili
nawlavi am gadamuSavebul nivTierebebSi darCenili siTxis did nawils Seiwovs da sxeulidan
ukve myari fekaluri masebi (ganavali) gamodis. defekacia (kuWis moqmedeba) _ esaa ukana
tanidan ganavlis sxeulis gareT gamodevna. diarea, anu _ gaTxelebuli ganavlis gamoyofa, Tavs
iCens im SemTxvevaSi, rodesac msxvili nawlavis kedlebis gavliT sisxlSi siTxis Sewova
Semcirebulia.

RviZli, naRvlis buSti da pankreasi

saWmlis momnelebeli sistemis kidev sami umniSvnelovanesi organo _ RviZli, naRvlis buSti da
pankreasi _ gadamwyvet rols asrulebs sakvebis adeqvaturad monelebisa da Sewovis saqmeSi.
qvemoT motanili masalis Sewavlis Semdeg, saTanado cifrebs naxatze 5-9 Sesabamisi cnebebi
miuwereT:
muclis Rris zeda marjvena meoTxed wilSi mdebare RviZli [1] gamoimuSavebs sqel, ZiriTadad
monarinjisfro-moSavo, zogjer ki _ momwvano siTxes, romelsac naRveli ewodeba. naRveli
Seicavs qolesterins (cximovan nivTierebas), naRvelmJavebs da ramdenime saxis naRvlis
pigments. erT-erTi am pigmentTagani, bilirubini warmoiqmneba hemoglobinis daSliT
gamowveuli sisxlis wiTeli ujredebis ganadgurebisas. bilirubini sisxlis meSveobiT xvdeba
RviZlSi, sadac is sxva nivTierebebs uerTdeba da naRvels emateba. Sesabamisad, SekavSirebuli
bilirubini nawlavebSi gadadis naRvelTan erTad. kolinjSi moxvedrili bilirubins aq arsebuli
baqteriebis zegavleniT sxvadasxvagvar pigmentad iSleba, rac ganavals moyavisfro fers aZlevs.
bilirubinica da naRvelic sxeulidan ganavalTan erTad gamodis.

bilirubinis organizmidan gamosvla Tu Seferxda, is sisxlSi rCeba (hiperbilirubinemia) da

siyviTles iwvevs. am dros kani, Tvalis sklera da lorwovani apkebi yviTlad ifereba (iqteriulia).
naxatze 5-10 naCvenebia bilirubinis gza sisxlis wiTeli ujredebis daSlidan (hemolizi) naRvelTan
erTad ganavalSi moxvedramde.

(gaagrZeleT cnebebis Cawera naxatze 5-9)

RviZli mudmivad gamoyofs naRvels, romelic Semdeg RviZlis sadinaris gavliT Sardis sadinarSi
xvdeba. Sardis sadinari miemarTeba naRvlis buStisaken [2], RviZlis qveS mdebare msxlis
formis parkisaken, romelic agrovebs da inaxavs naRvels. Wamis Semdeg, kuWSi da
duodenumSi sakvebis moxvedris pasuxad, naRvlis buSti Sesabamisad reagirebs da naRvels
Sardsadinaridan naRvlis sadinarSi [3] gadaisvris. amasobaSi, pankreasi [4] gamoimuSavebs
pankreasis wvens (fermentebs) romlebic pankreasis sadinarSi xvdebian [5], is ki Tavis mxriv,
duodenumSi [6] Sesvlis adgilas uerTdeba naRvlis sadinars. Sesabamisad, duodenumi ukve
naRvlisa da pankreasis wvenis nazavs iRebs.

1 elenTa

X
2
RviZlis sadinari
Sardsadinari

3 kuWi

4 5

naxati 5-9 RviZli, naRvlis buSti da pankreasi

X
sisxlis wiTeli ujredebi
iSleba da gamoiyofa hemoglobini.
 bilirubini _ gadadis sisxlSi

gadadis RviZlSi

bilirubini da naRveli _ RviZlSi erTiandeba

duodenumi

bilirubuni da naRveli
(gadagvarebuli)

kolinji

bilirubuni da naRveli
oprganizmidan gamodis
ganavalTan erTad

naxati 5-10 bilirubinis gza sisxlidan ganavalSi gadasvlamde.

naRveli duodenumis cximebisagan gawmedis daniSnulebas asrulebs. emulgirebis procesSi

naRveli erTmaneTisagan acalkevebs cximis momsxo burTulebs da aTavisuflebs zedapiris met
nawils, raTa pankreasis fermentebma moaxerxon cximebis moneleba. naRvlis gareSe
organizmSi moxvedrili cximebis meti wili mounelebeli rCeba.

naRvlis warmoqmnis garda, RviZls kidev ramdenime sasicocxlod mniSvnelovani daniSnuleba

gaaCnia:

1. inarCunebs sisxlSi glukozis [Saqris) saTanado dones. RviZls Warbi glukoza sisxlidan
gamoaqvs da mas glikogenis saxiT inaxavs RviZlis ujredebSi. roca sisxlSi Saqris done
sagangaSod ecema, RviZli Senaxul glikogens kvlav glukozad aqcevs e.w. glikogenolizis
procesis meSveobiT. amasTanave, RviZls SeuZlia cilebi da cximebic aqcios glukozad, roca
organizms meti Saqari sWirdeba da am process glukoneogenezi ewodeba.

2. qmnis sisxlis cilebs, gansakuTrebiT – im tipis, rac sisxls SededebisTvisaa aucilebeli.

3. gamoaTavisuflebs bilirubins.

4. gamoaqvs sisxlidan toqsiuri nivTierebebi.

 pankreasi (kuWukana jirkvali)

sisxli _
ujredebSi insulini fermentebi duodenumSi
mosaneleblad
------------------------ ---------------------------------
endokrinuli funqcia egzokrinuli funqcia

naxati 5-11 pankreasi da misi funqciebi

portalur venas nawlavebidan miaqvs sisxli RviZlSi. monelebuli sakvebi portalur venaSi
uSualod sisxlSi Sewovis Semdeg gadadis _ wvrili nawlavidan da Sesabamisad, pirvel rigSi,
RviZls aZlevs SesaZleblobas, nutrientebiT (sakvebi nivTierebebiT) isargeblos.

pankreasi (nax. 5-11) erTdroulad egzokrinuli da endokrinuli organoa. rogorc egzokrinuli jirkvali,
is gamoimuSavebs fermentebs imgvari saxameblebis mosaneleblad, rogoricaa amilaza (amil/o =
saxamebels, -aza = ferments), iseTi cximebis mosaneleblad, rogoricaa lipaza (lip/o = cxims) da
imgvari cilebis mosaneleblad, rogoricaa proteaza (prote/o = cilas). Semdeg yvelaferi es
pankreasis sadinaris gavliT duodenumSi xvdeba.

rogorc endokrinuli jirkvali (romelic sisxlSi axdens sekrecias) pankreasi gamoimuSavebs

insulins. es hormoni aucilebelia sisxlidan Saqris gamoTavisuflebis xelSesawyobad, da
energiisaTvis saWiro glukozis sxeulis ujredebamde mimtanis daniSnulebas asrulebs.

naxatze 5-12 sqematuradaa naCvenebi, ra gzas gaivlis sakvebi kuW-nawlavis traqtSi.

saWmeli Cadis…

piris Rrunerwyvi sanerwyve jirkvlebi

xaxa

saylapavi

RviZli kuWi pankreasi

naRveli fermentebi
naRvlis buSti duodenumi

mlivi nawlavi

ileumi

brma nawlavi (cekumi)

aswvrivi kolinji

ganivi kolinji
 msxvili nawlavi

daswvrivi kolinji

sigmoiduri kolinji swori nawlavi

swori nawlavi

anusi (ukana tani)

ganavali gamodis organizmidan

naxati 5-12 sakvebis gza kuW-nawlavis traqtis gavliT

leqsikoni
absorbcia (Sewova) nivTierebaTa gadasvla sisxlSi _ wvrili
nawlavis kedlebis gavliT.
aminomJavebi rTuli cilebis monelebis Semdeg warmoqmnili
martivi cilebis erToblioba.
amilazi saxameblis mosaneleblad pankreasis mier
gamoyofili fermenti.
anusi (ukana tani) sxeulis gareT gamomavali, saWmlis
monelebeli traqtis damaboloebeli Riobi.
apendiqsi brma nawlavidan marjvena dabal meoTxed
wilSi CamoSvebuli wanazardi; sityva-sityviT:
raRacaze (ap-) dakiduli (pend/o).
naRveli sakvebis momnelebeli wveni, romelsac RviZli
gamoimuSavebs da naRvlis buSti inaxavs. es
wveni Slis cximis mozrdil burTulebs da
momwaro gemo dakravs. Sedgeba naRvlis
pigmentebisagan, qolesterolisa da naRvlis
marilebisagan.
bilirubini RviZlis mier naRvelSi gamoyofili pigmenti.
eSvi saWreli kbilebis momijnave, wverwamaxuli
kbili.
cekumi (brma nawlavi) msxvili nawlavis I nawili.
kolinji sqeli nawlavi, romelic Sedgeba brma
nawlavisagan, aRmavali, gardamavali da
daRmavali segmentebisagan; aseve, swori
nawlavisagan.
naRvlis sadinari RviZlidan da naRvlis buStidan naRveli
gadaaqvs duodenumSi.
defekacia fekaliis gamosvla momnelebeli traqtidan _
swori nawlavis gavliT.
deglutacia ylapva
dentini kbilis Semadgeneli mTvari qsovili, romelic
gvirgvinze minanqriTaa dafaruli, xolo
cementumis damcavi feniT _ kbilis fesvze.
moneleba mravalgvari sakvebis martiv formebad daSla.
duodenumi wvrili nawlavis I nawili.
gamoyofa sxeulidan nivTierebebis gamosvla.
emulgireba cximis mozrdili burTulebis ufro momcroebad
daSlis fizikuri procesi, rac zrdis moqmedebis
zedapirs, aadvilebs fermentebis mier cximebis
gardaqmnas.
minanqari kbilis zedapiris magari safari.
fermenti qimiuri warmonaqmni, romelic aCqarebs
reaqcias nivTierebaTa Soris. sakvebis
momnelebeli fermentebi rTuli Sedgenilobis
sakvebs ufro martiv substanciebad Slian.
fermentebSi dasaxeleba Tandebul az-iT
mTavrdeba.
ezofagusi (saylapavi) yelisa da kuWis SemaerTebeli mili. ezo =
SigniT; fag/o = ylapvas.
cximovani mJavebi cximebis monelebis Sedegad warmoqmnili
novTierebebi.
fekaluri masebi sakvebis gadamuSavebuli masa, ganavali.
naRvlis buSti RviZlis qvemoT mdebare patara parkuWi,
romelic naRvels inaxavs.
glukoza martivi Sedgenilobis Saqari.

glikogeni saxamebeli; glukoza RviZlis ujredebSi

glikogenis formoT inaxeba.
marilmJava kuWis mier gamoyofili, saWmlis
monelebisaTvis aucilebeli nivTiereba.
ileumi wvrili nawlavis III nawili; momdinareobs
berZnuli sityva eilosidan, rac “dagrexils”
niSnavs.
saWreli kbilebi wina oTxi kbili dentalur rkalze.
insulini pankreasis endokrinuli ujredebis mier
gamomuSavebuli hormoni. mas Saqari
sisxlidan ujredebSi gaadaqvs da xels uwyobs
RviZlis mier glikogenis warmoqmnas.
ieunumi – mlivi nawlavi wvrili nawlavis II nawili; misi laTinuri
dasaxeleba _ jejunus cariels niSnavs, radgan
gvamis daTvalierebis dros es nawili mudam
daclilia.
lipaza cximebis monelebisaTvis aucilebeli,
pankreasidan gamoyofili fermenti.
RviZli muclis Rrus marjvena zeda meoTxedSi
mdebare mozrdili organo. is gamoyofs
naRvels, inaxavs Saqars, rkinasa da
vitaminebs, warmoqmnis sisxlis cilebs da
anadgurebs sisxlis gacveTil wiTel ujredebs.
mozrdili adamianis janmrTeli RviZli
daaxloebiT
1,5-2 kg-s iwonis.
qveda ezofaguri sfinqteri kunTovani rgoli saylapavsa da kuWs Soris.
sxvagvarad “kardialur sfinqtersac” uwodeben.
mastikulacia ReWva.
molaruli (saReWi) kbilebi dentaluri rkalis Suidan meeqvse, meSvide da
merve kbilebi _ orsave mxares. molarulebis
 win mdebare meoTxe da mexuTe _
premolaruli kbilebia.
palati (sasa) piris Rrus TaRi. magari sasa rbili sasis zemoT
mdebareobs da mas zeda ybis Zvali (maqsila)
iWers. rbili sasa ukan mdebare qsovilovani
nawilia piris Rrusa da yels Soris.
pankreasi kuWqveS mdebare organo; gamoimuSavebs
insulins (Saqris ujredebSi misatanad) da
fermentebs (sakvebis mosaneleblad).
papila (papilebi) enaze mdebare umciresi xaoebi. nawiburovani,
wagrZelebuli formisa.
parotiduli jirkvali sanerwyve jirkvali loyis SigniT, zustad yurTan.
peristaltika kuW-nawlavis traqtisa da sxva milovani
struqturebis ritmuli kumSva-gaSla. peristaltikis
meSveobiT kuW-nawlavis traqtSi moxvedrili
nivTierebebi sxvadasxva siCqariT gadadis:
kuWs naxevaridan or saaTamde swirdeba,
wvril nawlavs _ oridan eqvsamde, xolo kolons
_ eqvsidan samocdaTormetamde.
farinqsi (xaxa) yeli; mTavari gasasvleli sakvebis kuWSi da
haerisaTvis _ filtvebSi mosaxvedrad.
portuli vena msxvili sisxlZarRvi, romelsac nawlavebidan
RviZlSi gadaaqvs sisxli.
proreazi cilebis momnelebeli fermenti.
pulpa rbili qsovili kbilis SigniT, sadac Tavmoyrilia
nervebi da sisxlZarRvebi.
piloruli sfinqteri kuWis boloSi, duodenumis maxloblad mdebare
kunTovani rgoli. momdinareobs berZnuli
sityva piloros-idan, rac “karis darajs” niSnavs.
Cveulebriv mdgomareobaSi Caketilia da
ixsneba mxolod peristalsis talRis gavleniT.
pilorusi kuWis distaluri are; Riobi duodenumisaken.
reqtumi (swori nawlavi) msxvili nawlavis bolo, kolinjis dasasrulisa da
ukana tanis SemaerTebeli monakveTi.
naoWebi amoburculi zedapiri magar sasaze da kuWis
kedlebze.
nerwyvi sanerwyve jirkvlebis mier gamomuSavebuli
momnelebeli wveni.
sanerwyve jirkvlebi yurukana, enisqveSa da ybisqveSa jirkvlebi.
sigmoiduri kolinji kolinjis IV da bolo, laTinuri S-is formis
monakveTi _ zed swor nawlavamde. icleba
swor nawlavSi.
sfinqteri rgolis formis kunTi, romelic ketavs bunebriv
Riobsa Tu gasasvlels.
kuWi kunTovani organo, sadac saylapavidan sakvebi
Cadis. misis nawilebia fundusi, ZiriTadi nawili
da antrumi.
trigliceridebi mozrdili cximovani molekulebi, romelTa sami
wili cximis mJavisagan, xolo erTi wili _
glicerolisagan Sedgeba.
uvula (naqi) rbili sasis Suidan Camozrdili rbili qsovili.
xaoebi mikroskopuli warmonaqmnebi wvrili nawlavis
Sida kedelze, romelnic nutrientebs
(mkvebavebs) sisxlSi iwoven.

------------------------
Sedgenili formebi, Tandebulebi da cnebebi
-------------------------

sxeulis nawilebi
Sedgenili forma mniSvneloba cneba/mniSvneloba
an/o anusi, ukana tani perianaluri -------------------
apend/o apendiqsi apendeqtomia -------------------
apendic/o apendiqsi apendiciti -----------------
buk/o loya bukaluri lorwo ------------

dacoba, gaWedva

X X X
A B C

naxati 5-13 apendicitis safexurebi. A: dacoba da baqteriuli infeqcia iwvevs apendiqsis gawiTlebas, Sesiebas da
anTebas; B: Cirqi da baqteriebi iWrebian apendiqsis kedelSi; C: Cirqi iwvevs apendiqsis kedlis perforirebas
(gaxvretas), rac peritonitis (peritoniumis anTebis) mizezi xdeba.

Sedgenili forma mniSvneloba cneba/mniSvneloba

cek/o cekumi (brma nawlavi) cekaluri ----------------------
celi/o muceli, muclis Rru celialuri -----------------
abdomin/o da lapar/o aseve
aRniSnavs muclis Rrus; roca
erTze meti Sedgenili forma igive
mniSvnelobis matarebelia,
aranairi wesiT ar ganimarteba,
romlis xmarebaa ufro swori, da
es Tavad unda gansazRvroT _
konteqstis mixedviT.
xeil/o tuCi xeilozi ----------------------
aseve “tuCs” aRniSnavs Ziri
labi/o.
qolecist/o naRvlis buSti qolecisteqtomia -------------
 ar agerioT “cist”-oSi, rac
“Sardis buSts” aRniSnavs.
qoledoq/o naRvlis sadinari qoledoqotomia --------------
kol/o koloni, msxvili nawlavi kolostomia -------------------
stoma niSnavs Riobs ama Tu im
organosa da sxeulis zedapirs
Soris (nax. 5-14).
kolon/o koloni kolonaluri ------------------
kolonoskopia ----------------
dent/i kbili dentibukaluri --------------
aseve “kbils” aRniSnavs
odont/o.
duoden/o duodenumi duodenaluri -----------------

X X ileostomiis
stoma
sigmoiduri kolostomia
A B

naxati 5-14 stomaTa gansxvavebuli tipebi. A: sigmoiduri kolostomia swori nawlavisa da sigmoiduri kolinjis
nawilis rezeqciis Semdgom. aq stoma muclis Rrus kedelze mimagrebuli kolinjis bolozea. B: ileostomia mTeli
kolonis rezeqciis Semdeg. aq ileumi muclis Rrus kedlis gareTaa gamotanili da stomas qmnis.

Sedgenili forma mniSvneloba cneba/mniSvneloba

enter/o nawlavebi, Cveulebriv _ wvrili enterokoliti ----------------
nawlavi roca kuW-nawlavis organoebTan
dakavSirebuli ori Sedgenili
forma erT cnebaSi gvxvdeba, jer
im organos dasaxeleba modis,
romelic piris RrusTan ufro axloa.
enterokolostomia ----------
mezenteri -------------------
peritoneumis ormagi fenis nawili,
romelic muclis Rrus organoebs
akravs da am organoebs adgilze
akavebs. is nawlavebis SuagulSi
mdebareobs apkis saxiT, romelic
nawlavebs muclis Rrus ukana
nawilis kunTovan kedelze
amagrebs (nax. 5-15 B)
parenteraluri -------------
ezofag/o saylapavi ezofagaluri ---------------
faci/o saxe facialuri -------------------
gastr/o kuWi gastrostomia --------------
gingiv/o RrZilebi gingiviti ---------------------
glos/o ena hipoglosaluri --------------
aseve enas niSnavs lingv/o
hepat/o RviZli hepatoma ---------------------
aseve uwodeben
 RviZlis ujredebis karcinomasac.
hepatomegalia --------------
ile/o ileumi ileocekaluri sfinqteri ---
sxvagvarad _ ileocekaluri
sarqveli.
ileiti -------------------------
ileostomia -------------------
ix. nax. 5-14 B.
labi/o tuCi labialuri ------------------
lapar/o muclis Rru laparoskopia -----------------
minimaluri qirurgiuli Carevis
forma. misi magaliTebia
laparoskopiuli qolecisteqtomia
da laparoskopiuli apendeqtomia.
lingv/o ena sublingvaluri -------------
mandibul/o qveda yba submandibulaluri -----------
odont/o kbili orTodonti -----------------
periodonti ------------------
endodonti ------------------
eqimi, romelic fesvis arxs
mkurnalobs.
or/o piri oraluri ----------------------
stomat/o aseve niSnavs “pirs”.
palat/o sasa palatoplastia --------------
e.w. “kurdRlis tuCisa” da “mglis
xaxis” qirurgiuli gasworeba.
pankreat/o pankreasi pankreatiti -----------------
peritone/o peritoneumi peritoniti -----------------
am cnebaSi fuZiseuli “o”
amovardnilia.
faring/o yeli, xaxa faringealuri ---------------
palatofaringoplastia -----
gamoiyeneba daxSuli yelisa Tu
cxviris mizeziT xvrinvis
problemebis mosagvareblad.
proqt/o anusi da swori nawlavi proqtologi ------------------
pilor/o piloriuli sfinqteri piloroplastia ------------
reqt/o swori nawlavi reqtocili ------------------
sialaden/o sanerwyve jirkvali sialadeniti ------------------
sigmoid/o sigmoiduri kolinji sigmoidoskopia ---------------
stomat/o piri, piris Rru stomatiti ---------------------
uvul/o uvula, naqi uvuleqtomia -----------------

anastomozi

X X
A B

bade-qoni (omentumi)
bolo boloze ganivi kolinji

bolo gverze mezokoloni

gverdi gverze daswvrivi kolinji

ieunumi

mezenteriumi

sigmoiduri kolinji

Sardis buSti

naxati 5-15 A: anastomozis sami saxeoba. B: mezenteri. omentumi da mezokoloni mezenteris Semadgeneli
nawilebia. am naxatze aweuli badeqoni - omentumi sinamdvileSi winsafariviTaa gadmofenili nawlavebze.

nivTierebebi
Sedgenili forma mniSvneloba cneba/mniSvneloba
amil/o saxamebeli amilaza -----------------------
Tandebuli –aza niSnavs
“ferments”.
bil/i naRveli biliaruli ----------------
biliaruli traqti moicavs
organoebs (RviZlsa da naRvlis
buSts) da sadinarebs (RviZlis,
Sardis, naRvlis) romlebic
gamoimuSaveben, inaxaven da
duodenumSi clian naRvels.
bilirubin/o bilirubini (naRvlis pigmenti) hiperbilirubinemia ----------
qol/e naRveli qoleliTiazi ----------------
qlorhidr/o hidroqloridis mJava aqlorhidria ----------------
gluk/o Saqari glukoneogenezi --------------
RviZlis ujredebi cximebisa da
cilebisagan xelaxla qmnian
Saqars.
glik/o Saqari hiperglikemia ----------------
glikogen/o glikogeni, cxoveluri saxamebeli glikogenolizi ---------------
RviZlis ujredebi glikogens kvlav
glukozad gardaqmnian, roca
sisxlSi Saqris Semcveloba
klebulobs.
lip/o cximi, cximgrova lipoma -----------------------
liT/o qva liTogenezi --------------------
prote/o cila proteaza ---------------------
sial/o nerwyvi, sanerwyve sialoliTi ------------------
steat/o cximi steatorea ------------------
 arasworad monelebuli cximebi
ganavals moyveba.

Tandebulebi
Tandebulebi mniSvneloba cneba/mniSvneloba
-azi fermenti lipaza ---------------------
fermentebi aCqareben qimiur
reaqciebs. lipaza ki xels uwyobs
cximebis monelebas.
-kezia defekacia, narCenebis gamoyofa hematokezia --------------------
sxeulidan ganavalSi Cndeba mkveTri
wiTeli feris sisxli.
-iazi aranormaluri mdgomareoba qoledoqoliTiazi -----------
-prandiali Wama, sakvebis miReba postprandiali ---------------
igivea rac post cibum, anu _
“Wamis Semdeg”.

saWmlis momnelebeli organoebis daavadebebi

-------------------------------------------------------------------------
Tavis am nawilSi warmodgenilia cnebebi, romlebic aRweren niSnebsa da simptomebs
@ (daavadebis klinikur gamoxatulebebs da kuW-nawlavis traqtis paTologiur mdgomareobebs.
yoveli ganmartebis Semdeg motanili winadadeba aRwers daavadebis etiologias (eti/o = mizezs)
da mkurnalobas. roca mizezi, anu _ etiologia gaugebaria, amboben rom mdgomareoba
idiopaTiuria (idi/o = ucnobs). 21-e Tavis bolos, ganakveTSi “farmakologia” Tqven naxavT im
wamlebis CamonaTvals, rac kuW-nawlavis daavadebebis samkurnalod gamoiyeneba.

simptomebi

anoreqsia umadoba (-oreqsia = madas).

anoreqsia xSirad avTvisebiani simsivnisa Tu RviZlis
daavadebis niSania. anoreqsia nevrozis dros madis dakargva
ukavSirdeba iseT emociur problemebs, rogoricaa gabrazeba,
mRelvareba da wonis momatebis gaucnobierebeli SiSi. is
gamoixateba uwesrigo kvebaSi da igive kategoriebis daavadebad
ganixileba, rogorc
22-e TavSi aRwerili bulemia nevroza.

asciti muclis RruSi siTxis anomaliuri dagroveba.

es mdgomareoba Tavs iCens, roca siTxe sisxlidan
gamoiyofa da peritoniumis RruSi grovdeba. is SeiZleba iyos
neoplazmis an muclis RruSi anTebiTi daavadebebis, RviZlis
daavadebiT (ciroziT) gamowveuli venuri hipertenziis (sisxlis
maRali wnevis) da gulis ukmarisobis simptomi (nax. 5-16). ascitis
mkurnaloba moicavs diurezuli (Sardmdeni) medikamentebis
daniSvnas da aseve, paracentezs _ muclis Rrudan siTxis
amosaRebad.
meteorizmi buybuyis xma, rasac muclis Rrus traqtSi gazebis, siTxis
an orives erTad gadaadgileba iwvevs.
meteorizmi, anu muclis gvrema, nawlavebis zedmetad aqtiuri
peristaltikis niSani _ xSirad vlindeba gastroenteritisa
da kuWis aSlilobis (diareas) dros.

X
naxati 5-16 asciti mamakacis muclis areSi. es foto gadaRebulia paracentezis (muclis Rrudan siTxis
amosaRebad Catarebuli punqciis) Semdeg. yuradReba miaqcieT pacientis ginekomastias (qalis msgavs mkerds); es
estrogenis siWarbis bralia, rac SesaZloa, Tan axldes cirozs _ gansakuTrebiT, roca is alkoholizmiTaa gamowveuli.

---------------------------------------------------------------------------------------------------------

@ niSnebi da simptpomebi
niSani, esaa obieqturi mocemuloba _ sicxe, gamonayari an gulmkerdis mosmenisas
gagonili xma _ rac eqimis mier danaxul daavadebis gamovlinebaze mianiSnebs; maSin roca
simptomi (qavili, tkivili, daRlilobis SegrZneba Tu gulisreva) _ es ukve pacientis janmrTelobis
mdgomareobis cvlilebis subieqturi aRqmaa. cxadia, erTi da igive monacemebi eqimmac
SeiZleba SeniSnos da pacientmac, rac maT erTdroulad rogorc niSnad, aseve simptomadac
aqcevs.
----------------------------------------------------------------------------------------------

konstipacia (yabzoba) kuWis moqmedebis gaZneleba.

peristaltika Senelebulia, ganavalic mSralia da
gamkvrivebuli. aseT dros uaRresad sasargebloa
xilis, bostneulisa da wylis dieta. ganavlis gamoyofis
gasaioleblad, agreTve gamoiyeneba laqtuloza da
sasaqmeblebi.

diarea (faRaraTi) gaTxelebuli, wyalwyala ganavlis xSiri

gamoyofa.
saWmlis miRebisTanave kuWis aSla kuW-
nawlavis traqtSi infeciis an toqsiuri nivTierebebis
moxvedraze miuTiTebs. mkurnalobis Catarebis
gareSe, mwvave diaream SeiZleba dehidratacia
gamoiwvios. am SemTxvevaSi, saWiroa kuWSi
Semkvreli da Semomgarseveli wamlebis miReba.

disfagia ylapvis gaZneleba.

yelze lukmis dadgomis SegrZneba im dros
Cndeba, roca gadaylapuli saWmeli Znelad midis
qvemoT _ an fizikuri winaRobis gamo (obstruqciuli
disfagia), anda imitom, rom motorikis
 problemebidan gamomdinare, saylapavis peristaltika
ara aris koordinirebuli (motoruli disfagia).
odinofagia is mdgomareobaa, rodesac ylapva
tkivilsac (odin/o) ki iwvevs.

eruqtacia (boyini) kuWis airebis piridan amosvla.

boyins damaxasiaTebeli xma axlavs da
sxvagvarad amoqarvebasac uwodeben.

flatusi (kuili) ukana tanidan airebis mkveTri gamoyofa.

flatulencia (Seberva) _ esaa Warbi airebis
dagroveba rogorc kuWSi, aseve nawlavebSic.

hematokezia swori nawlavidan sisxliT gasvla.

hematokeziis mizezebi, Cveulebriv, xdeba kolitiT
gamowveuli an msxvil nawlavsa Tu swor nawlavSi
gaCenili polipebiTa Tu wylulis gamoisobiT dawyebuli
sixldena.

iqteria (siyviTle) sisxlSi bilirubinis

siWarbiT (hiperbilirubinemiiT) gamowveuli
kanisa Tu Tvalis skleris moyviTalo-
narinjisfrad Seferva.
siyviTlem SesaZloa Tavi iCinos,
roca: 1. vTqvaT, hemolizis dros
eriTrocitebis Warbi ganadgureba sisxlSi bilirubinis
siWarbes ganapirobebs;
2. RviZlis daavadebaTa gamo misi ujredebis
(hepatocitebis) araswori funqcionireba xels uSlis
RviZls _ naRvelTan erTad gamoyos bilirubinic; 3.
qoledoqoliTiazis (naRvlis buStSi qvis) anda
simsivnis dros rTuldeba naRvlis gadineba, rac masSi
arsebul bilirubinis duodenumSi gadasvlas uSlis xels.

melena (nawlavuri sisxldena) Savi, blanti ganavali, roca fekaliebSi

sisxlia Sereuli.
es simptomi,Cveulebriv, im mdgomareobas
asaxavs, roca sisxlis koStebi mohyveba ganavals,
kuW-nawlavis traqtis zeda nawilSi dawyebuli
sisxldenis gamo (duodenaluri wyluli).

gulisreva usiamo SegrZneba kuWSi, rac Rebinebis

moTxovnasTan asocirdeba.
amis zogadi mizezebia e.w. “zRvis
avadmyofoba”; agreTve vlindeba xolme
fexmZimobis adreul periodSi. gulisreva da Rebineba
 SesaZloa muclis Rrus ama Tu im organos perforaciis
(kedlis gaxvretis), naRvlis sadinaris dacobisa Tu
mowamvlis simptomic iyos.

steatorea cximis Sereva ganavalSi, roca fekalur

masa qafiania da myrali suni dakravs.
araswori monelebisa Tu Sewovis Sedegad,
cximi SesaZloa, nawlavebSi darCes. Sedegad, Tavs
iCens pankreasis daavadeba (pankreatiti), roca veRar
xdeba pankreasis fermentebis gamoyofa. es
mdgomareoba aseve mianiSnebs nawlavur
daavadebazec, rac cximis araswori Sewovis Sedegia.

paTologiuri mdgomareobebi

piris Rru da kbilebi

aftozuri (wylulovani) stomatiti piris Rrus mcire, mtkivneuli

wylulebiT gamoxatuli anTeba.
zogadad, am tipis daavadebebs
gangrenozul wylulebad ixsenienen. maTi
gamomwvevi mizezi ucnobia.

dentaluri kariesi kbilis daSla (kariesi niSnavs

“daSlas”).
nadebi kbilze sakvebis, nerwyvSi
arsebuli cilebisa da kbilis minanqarze
nekrozuli nivTierebebis dagrovebis Sedegad
Cndeba. am nadebSi mravldebian baqteriebi
da iwveven im mJavis warmoqmnas, romelic
kbilis minanqris mTlianobas arRvevs da
aCens Rrus. Tuki baqteriuli infeqcia aRwevs
kbilis pulpamde (aCens pulpits) maSin
SesaZloa fesvis arxis Terapiac ki aucilebeli
gaxdes.

herpesuli stomatiti piris Rrus organoebis (RrZilebis,

tuCebis, sasisa da enis) anTeba
herpesvirusis infeqciis gamo.
am mdgomareobas axasiaTebs kansa
da lorwovan apkebze mtkivneuli, siTxiT
savse buStukebis gaCena, romelTac
Cveulebriv “cxelebis buStukebs” anda “civ
wylulebs” uwodeben. mas herpesuli virusi
HSV1 iwvevs. mkurnaloba simptomebis
Sesamsubuqebel medikamentTa daniSvnas
gulisxmobs. virusi HSV2-iT gamowveuli
 herpesi ki sasqeso organoebze Cndeba. orive
es daavadeba uaRresad gadamdebia.

oraluri (piris Rrus) leikoplakia moTeTro nadebi Tu laqebi piris

Rrus lorwovanze.
es avTvisebiani simsivnis
winapirobad miCneuli daavadeba SesaZloa
gamowveuli iyos Tambaqos qronikuli
moxmarebiT (Cibuxis weviTa Tu Tambaqos
ReWviT). simsivnis albaToba biofsiisTvis
qsovilis mikroskopuli gamokvleviT
dasturdeba.

periodontaluri daavadeba RrZilebis, kbilebisa da mimdebare

Zvlis anTeba da gadagvareba.
RrZilebis qronikuli anTeba (gingiviti)
Cndeba dentaluri nadebis, dentaluri qvebis
dagrovebis Sedegad. gingiveqtomiis dros,
roca liTonis iaraRebiT xdeba nadebisa da
qvebis kbilebidan mocileba, Cirqovani
parkebis amoReba axali qsovilis
Camoyalibebis SesaZleblobas iZleva,
lokalizebuli infeqciebis mkurnaloba ki
sistemuri antibiotikebiT xorcieldeba.

kuW-nawlavis traqtis zeda nawili

aqalazia saylapavis qveda sfinqteris kunTis

mudmivi daWimuloba.
aqalazia (-qalazia = modunebas)
Cndeba roca qveiTdeba peristalsi da sakvebs
ukve iolad aRar SeuZlia saylapavSi gavla.
rogorc xsenebuli kunTis modunebis unaris
Sesusteba, aseve peristalsis daqveiTebac
saylapavis zomaze metad gafarToebas
iwvevs (nax. 5-17 A). eqimebi aseT dros
pacients urCeven Txevadi sakvebis dietas da
saylapavis qveda sfinqteris gafarToebas
mimarTaven siptomebis Sesamsubuqeblad
(nax. 5-17 B).

saylapavis varikozi SeSupebuli, varikozuli venebi

saylapavis qveda boloze.
RviZlis daavadeba (rogoricaa cirozi
anda qronikuli hepatiti) RviZlis irgvliv
arsebul venebSi wnevis zrdas iwvevs
(portuli hipertenzia). Sesabamisad,
farTovdeba da deformacias ganicdis
saylapavis kedlebic, rac sisxlis Caqcevis
safrTxes aCens. mkurnaloba gulisxmobs
 medikamentur Terapias _ portuli hipertenziis
Sesamcireblad da aseve, saylapavis
SeSupebuli venebis gawmenda-gasufTavebas
(nax. 5-18 A).

X X
2 --------------- peristaltikis ararseboba

3 ---------------- saylapavis gafarToeba

saWmlis dacobis gamo

1 -------------- saylapavis qveda sfinqters

moduneba uWirs

A B

naxati 5-17 aqalazia. A: aqalaziis etapebi maTi gamovlinebis Tanmimdevrobis mixedviT. B: aqalaziis
mkurnalobis meTodi _ saylapavis qveda sfinqteris balonirebiT gafarToeba.

X X
-------- gafarToebuli venebi

A B

naxati 5-18 A: saylapavis varikozi. B: saylapavis varikozis endoskopiuri xedi.

gastruli karcinoma kuWis avTvisebiani simsivne

helicobacter pylori (baqteriul) infeqciasTan

dakavSirebuli qronikuli gastriti, gastruli
karcinomis Camoyalibebis mTavari risk-
faqtoria. am mdgomareobis diagnozireba
xerxdeba kuWis endoskopiisa da biofsiis
meSveobiT. mkurnaloba damokidebulia
 imaze, Tu ramdenad droulad gamovlindeba
daavadeba da drouladve moxerxdeba
simsivnuri qsovilis qirurgiuli gziT mocileba.

gastroezofaguri refluqsis daavadeba myari narCenebi da siTxe

kuWidan piris RruSi brundeba.

gulZmarva _ esaa wvis SegrZneba,

rasac marilmJavas kuWidan
saylapavSi amosvla iwvevs. saylapavis
lorwos qronikuli reaqcia kuWis
wvenTan da pepsinTan (cilis
momnelebel fermentTan) saylapavis
refluqss iwvevs. medikamenturi
mkurnaloba gulisxmobs antacidebis
(mJavianobis gamaneitralebeli)
wamlebis daniSvnas da procedurebs
ezofagis qveda sfinqteris tonusis
asamaRleblad.

Tiaqari Cveulebriv, damWeri kunTidan organosa

Tu misi romelime nawilis gamovardna.

hiataluri Tiaqari is SemTxvevaa, roca

kuWis zeda nawili zemoT adis _ diafragmis
gavliT (nax. 5-19 A). am mdgomareobam
SeiZleba gastroezofaguri refluqsis
daavadebac gamoiwvios.
inguinaluri Tiaqari Cndeba roca patara
nawlavi muclis Rrus qveda kunTis qsovilSi
gamodis (nax. 5-19B). am tipis
Tiaqaris qirurgiul mkurnalobas herniorafia
ewodeba
(-rafia = “nakeris dadebas” niSnavs).

peptikuri (kuWisa da Tormetgoja

nawlavis) wyluli kuWisa Tu duodenumis lorwovani apkis
Ria wyluli an dazianeba.

am daavadebis gamomwvevia baqteria H.

pylori. am baqteriebis Warbi mJavianobis
erToblioba Sida garsis epiTeliums azianebs.
medikamenturi mkurnaloba moicavs
antibiotikebs, antacidebs da sxva
saSualebebs, rac kuWisa da nawlavebis Sida
garss icavs.
kuW-nawlavis qveda traqti (wvrili da msxvili nawlavebi)

analuri fistula anomaliuri milisebri xvreli anusis (ukana

tanis) midamoSi.

xSirad fistulas aCens anusisa Tu

swori nawlavis kedelSi warmoqmnili
naxeTqi anda abscesi (arealis
dainficireba). nax. 5-20 A.

X X
saylapavi sazardulis arxi

Tiaqari pirdapiri
inguinaluri
diafragma Tiaqari arapirdapiri
inguinaluri
kuWi Tiaqari

A B

naxati 5-19 Tiaqari. A: hiataluri Tiaqari. B: inguinaluri (sazardulis) Tiaqari. pirdapiri inguinaluri Tiaqari
gamovardeba xolme muclis Rrus kedlis gavliT; arapirdapiri inguinaluri Tiaqari ki inguinaluri arxis gavliT
Camodis saTesle parkuWSi.

X X
saceciani polipi mizrdili polipi analuri fistula
(Reroze) (lorwovan apkze)

A B

naxati 5-20 analuri fistula da nawlavis polipebi. A: analuri fistula da polipebis ori saxeoba. B: msxvili
nawlavis mravlobiTi polipebi.
nawlavuri polipozi polipebi (keTilTvisebiani wanazardebi)
nawlavis lorwovan apkze Cndeba.

naxatze 5-20 A naCvenebia polipebis ori

saxeoba: saceciani (ReroTi mimagrebuli
apkze) da mizrdili (romelic uSualod zis
lorwovan apkze). naxatze 5-20 B naCvenebia
mravlobiTi polipebi nawlavze. xSirad xdeba
polipebis moSoreba (polipeqtomia)
biofsiisaTvis da maTi zrdis SeCerebisaTvis _
avTvisebian somsivneSi gadazrdis Tavidan
asacileblad.

koloreqtaluri simsivne kolonis (msxvili nawlavis) an swori

nawlavis adenokarcinoma cal-calke an _
erTdroulad.

koloreqtaluri simsivne (nax. 5-21) SesaZloa

gaCndes msxil nawlavsa Tu swori nawlavis
areSi warmoqmnili polipebisagan. diagnozi
dgindeba ganavalSi sisxlis SemCnevisa da
kolonoskopiis meSveobiT. prognozi
simsivnis fazazea damokidebuli da
gasaTvaliswineblia misi zomebi, gavrcelebisi
siRrme da limfuri kvanZebis CarTuloba.
qirurgiulma mkurnalobam SeiZleba
moiTxovos farTo rezeqcia kolostomiiT.
saWiroebis SemTxvevaSi iniSneba qimio da
radioTerapiac.

X
naxati 5-21 msxvili nawlavis adenokarcenoma. am simsivnem moicva kedlebica da wylulovani Sua nawilic.

X X
mezenteri

arteria

divertikulebi
A B
naxati 5-22 divertikulebi da divertikulozi. A: divertikuli yalibdeba, rodesac msxvili nawlavis Sida garsis
lorwovani apki kunTovan kedelSi gamoibereba. B: divertikulozis mizezi SesaZloa gaxdes ganavlovani masis
moxvedra/dagroveba divertikulebSi. kurkovani da CenCoiani sakvebisagan Tavis Sekaveba am daavadebis risks
amcirebs.

“kronis daavadeba” nawlavebis (ileumis bolosa da kolinjis)

qronikuli anTeba.

niSnebi da simptomebi moicavs kuWis

aSlilobas, mwvave tkivils muclis RruSi,
sicxes, anoreqsias, sisustesa da wonis klebas.
“kronis daavadebaca” da wylulovani kolitic
nawlavTa anTebiTi daavadebebis
formebia. mkurnaloba xdeba
medikamentebiT _ simptomTa mosaxsnelad,
anda qirurgiuli CareviT, roca nawlavis
dazianebuli nawilebi amoikveTeba da
tardeba darCenili nawilebis anastomozi.

divertikulozi nawlavis kedelze gaCenili anomaluri

gverdiTa parkuWebi.

divertikulebi (nax. 5-22 A) esaa jibisebri

gamonazardebi msxvili nawlavis kunTovani
kedlidan. rodesac ganavlovani masa maTSi
xvdeba, Tavs iCens divertikulozi. misi
simptomebia tkivili da sisxldena swori
nawlavidan. naxatze 5-22 B naCvenebia
sigmoiduri kolinjis diverkulozis magaliTi.

dizenteria nawlavebis anTeba da tkivili.

Cveulebriv, msxvili nawlavisaTvis

damaxasiaTebeli dizenteria Cndeba
baqteriebis (salmonelebisa Tu Sigelebis),
amebebis (erTujrediani organizmebis)
Semcveli sakvebisa Tu wylis miRebisas. misi
simptomebia sisxliani ganavali da tkivili
muclis areSi.

buasili SeSupebuli, Cagrexili, varikozuli venebi _

swori nawlavis areSi.

varikozuli venebi SeiZleba iyos rogorc

Sinagani (swori nawlavis SigniT) aseve
gareganic (analuri sfinqteris gareT).
fexmZimoba da qronikuli Sekruloba, rac
venebze wnevas zrdis, xSirad iwvevs am
daavadebas.
gauvaloba peristaltikis ararseboba, ris Sedegadac
xdeba nawlavebis gadavseba da
gauvaloba.

amis mizezi nawlavis meqanikuri dacoba

xdeba (simsivniT, qviT, anda _ nawiburiT).
qirurgiulma Carevam, travmam an
peritoniumis areSi baqteriulma
dasnebovnebam, SeiZleba paralizuri ileusi
(peristalsis mwvave, droebiTi gaqroba)
gamoiwvios.

X X
nawlavis CaWedva nawlavis CaxlarTva (valvulusi)

naxati 5-23 nawlavis CaWedva da nawlavis CaxlarTva.

nawlavis CaWedva nawlavebis Cakecva.

am SemTxvevaSi, nawlavis erTi segmenti

meore segmentis RiobSi Caikeceba (nax. 5-
23). es xSirad emarTebaT bavSvebs da
zogadad, ileocekalur areSi xdeba. SesaZloa
Tavi iCinos nawlavis dacobam, rasac Tan
axlavs xolme tkivili da Rebineba. viTarebis
gamosasworeblad, xSirad saWiro xdeba
dazianebuli segmentis amokveTa da
anastomozi.

kataruli koliti daZabulobasa da gaRizianebasTan

dakavSirebuli, kuW-nawlavis daavadebis
simptomTa erToblioba.

kuW-nawlavis simptomebia diarea, yabzoba,

Seberva da tkivili muclis qveda nawilSi.
damatebiTi gamokvlevebisas, nawlavebi
TiTqos normalur mdgomareobaSia, Tumca
simptomebi ar qreba. mkurnaloba
simptomuria. iniSneba dieta, rac kuWis
 moqmedebis mowesrigebas uwyobs xels.

wylulovani koliti msxili nawlavis qronikuli anTeba wylulis

arsebobis SemTxvevaSi.

es gaurkveveli warmomavlobis, qronikuli,

kuW-nawlavis ganmeorebadi aSlilobiT
gamoxatuli avadmyofoba (nawlavebis
anTebiTi daavadeba) xasiaTdeba tkiviliTa
da sisxldeniT swori nawlavidan. xSir
SemTxvevaSi, kolinjSi dawyebuli anTeba
swrafad vrceldeba da mTel msxvil nawlavs
moicavs. rekomendirebulia medikamenturi
mkurnaloba da sagangebo dieta. SesaZloa,
aucilebeli gaxdes daavadebuli nawlavis
rezeqciac _ ileostomiasTan erTad.
wylulovani kolitiT daavadebul pacientTaTvis
ufro maRalia msxvili nawlavis simsivnis
riski.

nawlavis CaxlarTva (valvulusi) erTi da imave nawlavis CaxlarTva.

am SemTxevvaSi xdeba nawlavis dacoba.

amis simptomebia mwvave tkivili, gulisreva,
Rebineba. qirurgiuli Careva aucilebelia
nawlavis segmentis danekrozebis Tavidan
asacileblad (ix. nax. 5-23).

X X
A B

naxati 5-24 A: naRvlis buStis qvebi. laparaskopiuli qolecisteqtomiis dros meqanikurma Carevam ramdenime
qvis daSla gamoiwvia da gamoaCina pigmentirebuli SigTavsi _ naRvlis pigmentebis zemoqmedebis kvali. naRvlis
buStis lorwovani SewiTlebulia da uswormasworo _ mwvave da qronikuli qolecistitis arsebobis Sedegad. B: ciroziT
daavadebuli alkoholikis RviZli. RviZlis janmrTeli ujredebis (hepatocitebis) adgilas gaCnda kvanZebi, romelTa
moyviTalo Seferilobas cximis maRali Semcveloba ganapirobebs.

RviZli, naRvlis buSti da pankreasi

qoleliTiazi qvebi naRvlis buStSi (nax. 5-24, A)
qvebi xels uSlis naRvels _ naRvlis buStidan
da sadinaridan gamosvlaSi (nax. 5-25).
Tumca, bevri pacienti aranair simptoms ar
avlens da ar saWiroebs mkurnalobas.
magram Tuki epizodurad Tavs iCens
biliaruli spazmi (sadinarebis Segubebis
Sedegad), mkurnaloba ukve aucilebeli xdeba.
amJamad laparaskopiuli Tu minimaluri
qirurgiuli Carevis sxva saSualebebiT
(laparoskopiuli qolecisteqtomia), xdeba
naRvlis buStisa da qvebis amoReba (nax. 5-
26).

X kuWi
B
A RviZlis sadinari
Sardis sadinari

C pankreasi
naRvlis buSti
D pankreasis sadinari

naRvlis sadinari
(qoledoqusi)

duodenumi

naxati 5-25 naRvlis buStis qvebis mdebareoba. A: Tavad naRvlis buStSi, rac SesaZloa, araviTar simptoms ar
iwvevdes; B: qva acobs Sardis sadinars da iwvevs tkivils; C: qva acobs naRvlis sadinars, iwvevs tkivils da
siyviTles; D: qva mdebareobs naRvlis sadinaris qveda bolosa da pankreasis sadinarSi, iwvevs tkivils, siyviTles da
pankreatits.

X 2
4

naxati 5-26 troakaris gamoyeneba laparskopiuli qolecisteqtomiis dros. troakarebi aucilebelia muclis Rrus
punqciisa da masSi SeRwevisaTvis. esaa liTonisxelsawyo, romelic Sedgeba futuro milisagan (kanula) da masSi
Tavsdeba dguSi (liTonisave moZravi xelsawyo, basri samkuTxa wveriT). igi gamoiyeneba sxeulis ama Tu im Rrus
kedelSi punqciis Casatareblad. dguSis amoRebis Semdeg, troakarSi SeiZleba SeviyvanoT endoskopi da sxva
xelsawyoebi _ laparaskopiuli operaciisaTvis. naxatze miTiTebuli cifrebi uCvenebs trokaris Seyvanis adgilebs: 1 _
esaa umbilikaluri, 10-11 mm troakari (troakaris maqsimaluri diametri 15mm-ia). 2 _ 10-11 mm troakari Tavsdeba
Sua xazze, xolo 3 da 4, diametriT 5 mm-iani troakarebi _ e.w. “gverdiT xazze”.
cirozi qronikuli daavadeba, rac
RviZlis gadagvarebas iwvevs.

zogadad, cirozi qronikuli

alkoholizmis Sedegia. misi gamomwvevi
xSirad SeiZleba iyos araswori kvebac da
hepatitic. RviZli fibrozuli qsoviliT ifareba,
misi ujredebi gadagvardeba da xdeba RviZlis
cximiT gajereba. cir/o moyviTalo-
narinjisfers niSnavs: swored am fers iZens
RviZli cximis dagrovebis Sedegad (ix. nax.
5-24 B). mkurnalobis forma gamomwvev
mizezzea damokidebuli.

pankreatiti pankreasis anTeba

sakvebis momnelebeli fermentebi “Tavs

esxmian” pankreasis qsovils da azianeben
jirkvals. sxva gamomwvev faqtorTa Soris
aRsaniSnavia qronikuli alkoholizmi,
medikamentozuri mowamvla, naRvlis
sadinaris qviT dacoba da virusuli infeqciebi.
mkurnaloba gulisxmobs medikamentebis
daniSvnas epigastruli tkivilis mosaxsnelad,
intravenul gadasxmebs da _ saWiroebis
SemTxvevaSi, pankreateqtomias.

virusuli hepatiti RviZlis virusiT gamowveuli anTeba

hepatiti A, esaa hepatitis A virusiT
(HAV) gamowveuli daavadeba. igi
SedarebiT msubuqi formaa, romlis
gavrcelebasac xels uwyobs dabinZurebuli
sakvebi an wyali da mas simptomTa dune
gamovlineba axasiaTebs. hepatit B-s B
virusi (HBV) iwvevs da is gadaicema sisxlis
gadasxmiT, sqesobrivi kavSiriTa Tu
dabinZurebuli samedicino xelsawyoebiT
(mag. nemsiT). mwvave inficirebam
SesaZloa gamoiwvios RviZlis ujredebis
daSla, cirozi da sikvdilic ki. arsebobs
Sesabamisi vaqcina, romelic imunitetis
gamomuSavebas uwyobs xels da
rekomendirebulia riskis qveS myofi
pirovnebebisaTvis. hepatit C-s hepatitis C
virusi (HCV) iwvevs da is gadaecema
inficirebuli sisxlis gadasxmiT da samedicino
xelsawyoebiT (mag. nemsiT), xSiria
narkotikebis momxmarebelTa Soris erTi da
igive nemsis gamoyenebis gamo. mwvave
 forma, SesaZloa, droTa ganmavlobaSi
qronikul hepatitad Camoyalibdes.

nebismieri hepatitis SemTxvevaSi, RviZlis

fermentebis donem SesaZloa aiwios, rac
RviZlis ujredebis dazianebis maCvenebelia.
niSnebi da simptomebi moicavs saerTo
sisustes, anoreqsias, RviZlis gadidebas,
siyviTles da tkivils muclis areSi.

savarjiSoebi

pasuxebi SeamowmeT 174-e gverdze.

A.

miuwereT saWmlis momnelebeli sistemis Semadgeneli Sesabamisi organos dasaxeleba

qvemoT motanil ganmartebebs:

anusi (ukana tani) ezofagi (saylapavi) RviZli

cekumi (brma nawlavi) naRvlis buSti pankreasi

kolinji ileumi farinqsi

12 goja nawlavi mlivi nawlavi sigmoiduri kolinji

1. msxvili nawlavi -----------------------------------------

2. mcire parkuWi RviZls qvemoT; inaxavs naRvels -------------------------
3. msxvili nawlavis pirveli nawili -------------------------------------
4. momnelebeli traqtis sxeulis gareT gamomavali naxvreti -------------
5. wvrili nawlavis II nawili --------------------------------------------
6. yelisa da kuWis SemaerTebeli mili -------------------------------------
7. wvrili nawlavis III nawili ---------------------------------------
8. marjvena zeda wilSi mdebare mozrdili organo; gamoyofs naRvels, inaxavs Saqars,
warmoqmnis sisxlis cilebs ----------------------------------------
9. yeli, sasa -------------------------------------------------------
10. kolinjis qveda nawili ---------------------------------------
11. wvrili nawlavis I nawili -------------------------------------
12. kuWTan axlos mdebare organo; gamoimuSavebs insulins da
momnelebel fermentebs -----------------------------------------------------

B. SemoxazeT is cneba, romelic pasuxobs mocemul ganmartebas; amave dros, danarCeni

cnebebis ganmartebac unda SegeZloT:

1. mikroskopuli warmonaqmnebi wvrili nawlavis kedlebze:

xaoebi (papilebi) xaoebi (vilebi) naoWebi (rugebi)

2. yurTan mdebare sanerwyve jirkvali:

ybisqveSa (submandibularuli) enisqveSa (sublingvaluri) ybayura

3. kunTovani rgoli kuWis qveda boloSi:

piloruli sfinqteri uvula saylapavis qveda sfinqteri

4. kbilis rbili Sida nawili:

dentini minanqari pulpa

5. qimiuri nivTiereba, rac aCqarebs reaqciebs da xels uwyobs sakvebis monelebas:

trigliceridi aminomJava fermenti

6. naRvelTan erTad gamoyofili pigmenti:

glikogeni bilirubini melena

7. pankreasis endokrinul ujredebis mier warmoqmnili hormoni:

insulini amilazi lipazi

8. kuW-nawlavis traqtis kedlis kunTebis ritmuli moZraoba:

degluticia mastikacia peristalsi

9. cximis mozrdili burTulebis daSla:

Sewova emulsifikacia anabolizmi

10. wvetiani kbili:

saReWi eSvi sakbeCi

C. daasruleT Semdegi winadadebebi:

1. labi/o da Ceil/o orive ---------------------- niSnavs

2. glos/o da lingv/o orive ------------------- niSnmavs
3. or/o da stomat/o orive --------------------- niSnavs
4. dent/i da odont/o orive -------------------- niSnavs
5. lapar/o da celi/o orive -------------------- nisnavs
6. gluk/o da glik/o orive --------------------- nisnavs
7. lip/o, staet/o da adip/o yvela ------------ nisnavs
8. Tandebulebi -iazi da -ozi orive ---------- nisnavs
9. qole/e da bil/i orive -------------------- niSnavs
10. rezeqcia da -eqtomia orive --------------- niSnavs

D. mocemul gansazRvrebebs miusadageT Sesabamisi cnebebi:

1. sanerwyve jirkvlis amokveTa ---------------------------

2. yelTan, xaxasTan dakavSirebuli ------------------------
3. swori nawlavis Tiaqari ----------------------------
4. RviZlis gadideba -----------------------------
5. piris Rrus TaRis qirurgiuli aRdgena -------------------
6. Wamis Semdeg daniSnuli --------------------------
7. analuri da reqtaluri areebis daTvaliereba --------------------
8. daavadebis mizezis Seswavla --------------------------------
9. naRvlis sadinaris gakveTa -----------------------------
10. kbilTan da loyasTan dakavSirebuli ---------------------------
11. wvrili nawlavis daavadeba zogadad --------------------
12. xelovnuri Riobi naRvlis sadinarsa da წვრილ nawlavs Soris ------------
13. anusis momdebare aresTan dakavSirebuli ------------------------
14. msxvili nawlavis gamotana sxeulis gareT ---------------
15. qveda ybis qveS mdebare aresTan dakavSirebuli ----------------------
16. saxesTan dakavSirebuli --------------------------

E. miusadageT eqimebi Tu dantistebi Sesabamis specialobebs:

koloreqtaluri qirurgi nefrologi periodonti

endodonti piris Rrus qirurgi proqtologi

gastroenterologi orTodonti urologi

1. axdens ukana tanisa da swori nawlavis daavadebaTa diagnozirebas da mkurnalobas:

-------------------------------
2. atarebs operaciebs Sardsadeni traqtis organoebze: -----------------------
3. asworebs kbilebs: ----------------------------------
4. atarebs fesvis arxis Terapias: ---------------------------------
5. atarebs piris Rrusa da kbilebis operaciebs -----------------------
6. svams diagnozs da niSnavs wamlebs Tirkmlis problemaTa samkurnalod -------
7. svams diagnozs da mkurnalobs kuW-nawlavis traqtis daavadebebs: -------------
8. mkurnalobs RrZilebis daavadebebs: ------------------------
9. atarebs operaciebs nawlavur traqtSi: -----------------------

F. qvemoCamoTvlil anTebebs miusadageT Sesabamisi saxelwodebebi:

1. apendiqsis anTeba -------------------------------
2. msxvili nawlavis anTeba --------------------------------
3. yelisa da kuWis SemaerTebeli milis anTeba ----------------------------
4. muclis Rrus garemomcveli apkis anTeba -------------------------
5. naRvlis buStis anTeba -----------------------------------
6. wvrili nawlavis III nawilis anTeba -------------------------
7. pankreasis anTeba ---------------------------------
8. RrZilebis anTeba -------------------------------
9. RviZlis anTeba -----------------------
10. piris Rrus anTeba ----------------------
11. sanerwyve jirkvlis anTeba -----------------------
12. wvrili da msxvili nawlavebis anTeba ----------------------

G. qvemoCamoTvlili cnebebi miusadageT maT mniSvnelobebs:

აnasტomozi glukoneogenezi mezenteri

biliaruli glikogenolizi mukoza
defekacia hiperbilirubinemia parenteraluli
qeiliti hiperglikemia portaluri vena

1. sisxlSi Saqris maRali Semcveloba -----------------------

2. tuCis anTeba ---------------------------------
3. nawlavuri traqtis gverdis avliT daniSnulebasTan dakavSirebuli mkurnaloba
------------------------------
4. lorwovani apki ---------------------------------
5. ukana tanidan ganavlis gamoyofa --------------------------------
6. cxoveluri saxameblis Saqrad gadaqceva ----------------------------
7. wvrili nawlavis muclis Rrus kedelTan SemaerTebeli apki --------------
8. msxvili sisxlZarRvi, romelsac sisxli nawlavebidan sisxlSi miaqvs ---------
9. manamde daukavSirebeli ori struqturisa Tu organos xelovnurad, qirurgiuli gziT
dakavSireba ----------------------
10. naRvlis sadinarebTan Tu organoebTan dakavSirebuli ---------------------
11. cximebisa da cilebisagan Saqris formirebis procesi -----------------------
12. sisxlSi naRvlis pigmentis maRali maCvenebeli -----------------------------

H. kuW-nawlavis daavadebaTa qvemoCamoTvlil simptomebs miuwereT Sesabamisi

saxelwodebebi:
1. swori nawlavidan wiTlad Seferili sisxlis gamoyofa ---------------------
2. umadoba --------------------------------------------
3. cximi ganavalSi --------------------------------------
4. moSavo, sisxlgareuli blanti ganavali ----------------------------
5. muclis RruSi siTxis anomaliuri dagroveba --------------------------
6. kuW-nawlavis traqtSi dagrovili airebis Sedegad gamocemuli xmebi ---------
7. ukana tanidan airebis gamoyofa -------------------------
8. usiamo SegrZneba kuWSi da gulzidva -------------------------
9. Txeli, wyalwyala ganavali -----------------------------
10. kuWis moqmedebis garTuleba -----------------------------
11. ylapvis gaZneleba ----------------------------------
12. tkivili ylapvis dros ------------------------------

I. miuwereT kiTxvebs swori pasuxebi:

1. ra aris siyviTle? ------------------

2. CamoTvaleT sami mizezi, romelTa gamoc pacients SeiZleba siyviTle aReniSnos:
a) ------------------
b) ----------------
c) ----------------
3. raze miaTiTebs daavadebis idiopaTiurad moxsenieba? -------------------

J. daavadebaTa simptomebs dausviT Sesabamisi diagnozi:

aqalazia koloreqtaluri simsivne herpesuli stomatiti

analuri fistula kronis daavadeba oraluri leikoplakia
aftozuri stomatiti kbilis kariesi periodontaluri daavadeba

1. q-ni jounzi ylapvisas tkivilebs uCioda. eqimma auxsna, rom mizezi qveda ezofagis
kunTebis daWimuloba iyo, romlebic ylapvisas modunebas ver axerxebdnen. diagnozi:
----------------------------------
2. b-n rozenis tkivilis mizezi ukana tanTan anomaliuri milisebri naxvretis gaCena gaxda.
eqimma es ambavi qirurgiuli CareviT gamoaswora. diagnozi: ---------------------
3. kbilis eqimma vinme bebes uTxra, rom mas baqteriebis warmomSobi mJavebis gavleniT,
sami kbilis minanqari hqonda dazianebuli. diagnozi: -----------------
4. simptomebma _ qronikulma diaream, muclis Wram da sicxem _ paolas eqims afiqrebina,
rom qals nawlavuri anTeba stanjavda, rac ileumis distalur nawilze axdenda gavlenas. eqimma
mas steroiduli medikamentebis miReba urCia. diagnozi: --------------
5. b-nma hartma Seityo, rom kolonoskopiam msxvili nawlavis lorwovan apkze patara,
keTilTvisebiani wanazardebis arseboba daadastura. diagnozi: -----------------------
6. gegmiuri Semowmebisas, dantistma fridmanma b-n longos loyis lorwovanze TeTri
nadebi SeniSna da pacients, gamousworebel mwevelsa da sasmelis did moyvaruls, urCia
saCqarod moeSorebina simsivnis riskis Semcveli es paTologia. diagnozi: ------------------------
7. samsaxurSi nebismieri stresuli viTarebis Semdeg, karls tuCze buStukebi uCndeboda _
adrindeli virusuli infeqcia umwvavdeboda. eqimis TqmiT, am problemis mogvarebis garantiis
momcemi mkurnaloba ar arsebobda. diagnozi: ----------------
8. b-n grins aswvrivi kolinjis biofsia Cautares. pasuxma simsivnis arseboba daadastura.
aucilebeli gaxda sruli koleqtomia da Semdgomi ileostomia. diagnozi: ------------------------
9. kbilebis metismetad gulmodgine gaxexvis Semdeg, daians RrZilebze usiamo da
mtkivneuli, pawia wylulebi gauCnda. diagnozi: ------------------------------
10. Saroni rigianad ver uvlida kbilebs, ver axerxebda nadebis droulad moSorebas, ramac
gingivitis Camoyalibeba gamoiwvia. eqimma mas im specialistTan misvla urCia, vinc am
problemis mogvarebaSi daexmareboda. diagnozi: ----------------

K. qvemoCamoTvlil paTologiaTa diagnozebi miusadageT Sesabamis ganmartebebs:

qolecistoliTiazi buasili pankreatiti

cirozi hiataluri Tiaqari peptikuri wyluli
divertikulozi ileusi wylulovani koliti
dizenteria nawlavis CaWedva virusuli hepatiti
saylapavis varikozi lorwovani koliti volvulusi

1. kuWis zeda nawilis gamosvla diafragmaSi: -------------------------------

2. baqteriuli infeqciis Sedegad nawlavebis mtkivneuli anTeba: -----------
3. SeSupebuli, CakvanZuli venebi _ swori nawlavis areSi: ---------------
4. Ria iara an wyluli kuWisa Tu duodenumis lorwovan apkze: -------------
5. peristalsis moSla nawlavTa dacobis TanxlebiT: -------------------------
6. erTi da igive nawlavis CaxlarTva: -----------------------------
7. SeSupebuli, varikozuli venebi saylapavis distalur nawilSi: ------------
8. anomaliuri gverdiTi jibeebi nawlavis kedelze: -----------------------
9. wylulovani msxvili nawlavis qronikuli anTeba: -----------------------
10. erTi nawlavis segmentebis erTmaneTSi Cakecva: ------------------------
11. A, B, Tu C tipis virusiT gamowveuli RviZlis anTeba: -------------
12. pankreasis anTeba: ---------------------------------
13. qvebi naRvlis damgrovebel parkuWSi: ----------------------------
14. qronikuli, RviZlis damSleli daavadeba, rasac alkoholizmi da araswori kveba iwvevs:
---------------------------------------------
15. simptomTa jgufi (kuWis aSliloba an Sekruloba, muclis tkivili, boyini) rac stressa da
daZabulobas kavSirdeba, magram uTuod nawlavebis anTebas ar gulisxmobas:
---------------------------------

L. mocemuli ganmartebebis Sesabamisad gaasruleT Semdegi cnebebi:

1. nawlavebis SemakavSirebeli apki: mez-----------------

2. naRvlis buStis amokveTa: ----------eqtomia
3. Savi an muqi yavisferi, sisxliT gajerebuli, blanti ganavali: mel-------
4. sisxlSi pigmentis maRali done (siyviTle): hiper------------
5. enisqveSa aresTan dakavSirebuli: sub----------------
6. nawlavis TaviTavSi CaxlarTva: vol-----------------------
7. kuWqveSa organo, romelic gamoimuSavebs insulins da monelebel fermentebs:
pan---------------------
8. umadoba, madis daqveiTeba: an-------------
9. SeSupebuli, dakvanZuli venebi swori nawlavis areSi: bua----------
10. manamde daukavSirebeli ori milis an sadinaris xelovnurad
dakavSireba: ana-------------
11. kuWSi mJavis ararseboba: a---------------------
12. sakvebis myari narCenebisa da siTxis kuWidan piris RruSi dabruneba: gastro----------
re--------------
13. piris Rrus TaRidan Camokiduli rbili qsovilis mocileba: ---------eqtomia
14. qvebis Camoyalibeba: ---------genezi.
samedicino Tavsatexi

areuli asoebi ise daalageT, rom miniSnebiT nakarnaxevi Sesabamisi cnebebi sworad Caiweros
Tavisufal grafebSi.

1. miniSneba: kanis yviTlad Seferva

________ terqiai

2. miniSneba: Txevadi ganavlis gamoyofa.

______ eradia

3. miniSneba: muclis RruSi siTxis dagroveba, wyalmanki.

______ sitaci

4. miniSneba: buybuyis xmebi kuW-nawlkavis traqtSi.

______ temeorizmi

savarjiSoTa pasuxebi

A
1. kolinji 5. mlivi nawlavi 9. farinqsi
2. naRvlis buSti 6. ezofagi (saylapavi) 10. sigmoiduri kolinji
3. brma nawlavi (cekumi) 7. ileumi 11. duodenumi
4. anusi (ukana tani) 8. RviZli 12. pankreasi

B
1. bususebi (vilebi)
2. parotiduli
3. piloriuli sfinqteri
4. pulpa
5. fermenti
6. bilirubini
7. insulini
8. peristaltika
9. emulsifikacia
10. eSvi

C
1. tuCi 5. muclis Rru 8. anomaliuri mdgomareoba
2. ena 6. Saqari 9. naRveli
3. piris Rru 7. cximi 10. amoReba/amokveTa
4. kbili

D
1. sialadeneqtomia 7. proqtoskopia 12. qoledoqoieiunostomia
2. faringaluri 8. etiologia 13. perianaluri
3. reqtocili 9. qoledoqotomia 14. kolostomia
4. hepatomegalia 10. dentibukaluri 15. submandibularuli
5. palatoplastika 11. enteropaTia 16. facialuri
6. postprandialuri

E
1. proqtologi 4. endodonti 7. gastroenterologi
2. urologi 5. piris Rrus qirurgi 8. periodonti
3. orTodonti 6. nefrologi 9. koloreqtaluri qirurgi

F
1. apendiciti 6. ileiti 11. sialadeniti
2. koliti 7. pankreatiti 12. enterokoliti
3. ezofagiti 8. gingiviti
4. peritoniti 9. hepatiti
5. qolecistiti 10. stomatiti

G
1. hiperglikemia 5. defekacia 9. anastomozi
2. qeiliti 6. glikogenolizi 10. biliaruli
3. parenteraluri 7. mezenteri 11. glukoneogenezi
4. mukoza 8. portaluri vena 12. hiperbilirubinemia

H
1. hematokezia 5. asciti 9. diarea
2. anoreqsia 6. meteorizmi (muclis gvrema) 10. konstipacia
3. steatorea 7. flatusi 11. disfagia
4. melena 8. gulirseva 12. odinofagia
I
1. kanisa da sxva qsovilebis moyviTalo-monarinjisfrod Seferva (hiperbilirubinemia)
2. a) RviZlis nebismieri daavadeba (iseTi hepaTopaTiebi, rogoricaa cirozi, hepatoma Tu hepatiti) roca
bilirubini ar ereva naRvelSi da ver gamodis ganavalTan erTad. b) naRvlis gadinebis Seferxeba, roca
naRveli da bilirubini ver gamoiyofa da sisxlSi grovdeba. g) mometebuli hemolizi, rac bilirubinis Warbad
warmoqmnasa da mis maRal dones iwvevs sisxlSi.
3. mizezi ucnobia.

J
1. aqalazia
2. analuri fistula
3. dentaluri kariesi
4. “kronis daavadeba”
5. nawlavuri polipozi 8. koloreqtaluri simsivne
6. oraluri leikoplakia 9. afTozuri stoamtiti
7. herpesuli stomatiti 10. periodontaluri
daavadeba

K
1. hiataluri Tiaqari 6. nawlavis CaxlarTva (valvulusi) 11. virusuli
2. dizenteria 7. ezofaguri varikozi hepatiti
3. buasili 8. divertikulozi 12. pankreatiti
4. peptikuri wyluli 9. wylulovani koliti 13. qolecistoliTiazi
5. ileusi 10. nawlavis CaWedva 14. cirozi
15. lorwovani koliti

L
1. mezenteri 6. valvulusi 11. aqlorhidria
2. qolecisteqtomia 7. pankreasi 12. gastroezofaguri refluqsi
3. melena 8. anoreqsia 13. uvuleqtomia
4. hiperbilirubinemia 9. buasili 14. liTogenezi
5. sublingvaluri 10. anastomozi

samedicino Tavsatexis pasuxebi.

1. iqteria 2. diarea 3. asciti 4. meteorizmi

sityvebi da cnebebi

(yovel cnebas Tavisi mniSvneloba miuwereT. Sesabamisi ricxvi im gverds

miuTiTebs, romelzec isaa gamoyenebuli. maTi sruli axsna SegiZliaT
saxelmZRvanelosaTvis darTul kompaqt-diskze moisminoT)
cneba mniSvneloba

absorbcia (Sewova) 148 -------------------------------

aqlorhidria 000 -------------------------------
amonomJavebi 000 ----------------------------
amilaza 000 ---------------------------
anastomozi 000 ------------------------------
anusi 000 ----------------------------
apendeqtomia 000 ---------------------------
apendiciti 000 ----------------------------
apendiqsi 000 ----------------------------
naRveli
biliaruli
bilirubini
bukaluri lorwo
eSvi
cekumi
qeiliti
qolecisteqtomia
qoledoqoliTiazi
qoledoqoieiunostomia
qoledoqtomia
qoleliTiazi
kolinji
kolonoskopia
kolostomia
naRvlis sadinari
defekacia
deglutacia
dentibukaluri
dentini
moneleba
duodenaluri
duodenumi
emulsifikacia
minanqari
endodonti
enterokoliti
enterokolostomia
fermenti
ezofaguri
ezofagusi
cximovani mJava
facialuri
fekalia
naRvlis buSti
kuW-nawlavis traqti
gastrojejunostomia
gastrostomia
gingiviti
glukoneogenezi
glukoza
glikogeni
glikogenolizi
hepatoma
hepatomegalia
marilmJava
hiperbilirubinemia
hiperglikemia
hipoglosaluri
ileiti
ileocekaluri sfinqteri
ileostomia
ileumi
saWreli kbili
insulini
mlivi nawlavi (ieiunumi)
labialuri
laparoskopia
lipazi
liTogenezi
RviZli
saylapavis qveda sfinqteri
mastikacia
mezenteri
saReWi kbili
oraluri
orTodonti
palati (sasa)
palatofaringoplastia
palatoplastia
pankreasi
pankreatiti
papilebi
parenteraluri
parotiduli jirkvali
perianaluri
periodonti
peritoniti
peristaltika
faringealuri
faringsi
portuli vena
postprandialuri
proqtologi
proteazi
pulpa
piloruli sfinqteri
piloroplastia
pilorusi
reqtocili
reqtumi (swori nawlavi)
rugebi
nerwyvi
sanerwyve jirkvlebi
sialadeniti
sialoliTi
sigmoiduri kolinji
sigmoidoskopia
sfinqteri
steatorea
kuWi
sublingvaluri
submandibularuli
trigliceridebi
uvula
uvuleqtomia

paTologiaTa terminologia

cneba mniSvneloba

aqalazia 000 ------------------------------

analuri fistula 000 ------------------------------
anoreqsia 000 -------------------------
afTozuri stomatiti 000 -------------------------------
asciti 000 ------------------------------
meteorizmi 000 -----------------------------
qoleriTiazi 000 ----------------------------
cirozi 000 -----------------------------
nawlavuri polipozi 000 ------------------------------
koloreqtaluri simsivne
konstipacia
kronis daavadeba
dentaluri kariesi
diarea
divertikulebi
divertikuliti
divertikulozi
dizenteria
disfagia
eruqtacia
ezofaguri varikozi
etiologia
flatusi
gastruli karcinoma
gastroezofaguri refluqsi
hematokezia
buasili
herpesuli stomatiti
hiataluri tiaqari
iqterusi
idiopaTiuri
ileusi
nawlavTa anTebiTi daavadeba
inguinaluri Tiaqari
nawlavis Cakecva
lorwovani koliti
siyviTle
melena
nauzea (gulzidva)
odinofagia
oraluri leikoplakia
pankreatiti
peptiuri wyluli
periodontaluri daavadeba
wylulovani koliti
virusuli hepatiti
volvulusi

am Tavis cnebebis Semadgenel nawilTa mimoxilva 6-e Tavis mimoxolvasTanaa gaerTianebuli

(ix. gv. 208).

@ damatebiTi savarjiSoebi ix. TandarTul CD-ze.