4 курс / Дерматовенерология / Dermatologia_i_venerologia_KGMU_g_Simferopol_2012_g
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B 2KHp0Bb!X Ki\eTKax, rrpOAHcj:>epau:HH cyru:eCTBYIOW.HX a,ll,HITO- |
|
l (HTOB |
HAH 3a C'!eT IlO.SlBAeHH.SI HOBblX |
Me3eHXHMai\bHbIX He,ZI.Hcpcpe- |
peHll,HpOBaHHbIX Ki\eTOK. |
|
|
|
HepBHhIH annapaT KO)KH xapaKTepH3YCTC.Sl o6Hi\bHOH HH- |
|
HepBau:HeM c HaH60Abllldi: 11AOTHOCTbIO |
HepBOB H HX OKOH'!aHHj:i B |
|
o 6 AaCTH AHU:a, BepXHHX KOHe'!HOCTeHH reHHTaAHH. B KO)Ke pacnoAa- r aeTC:il .u.Ba HepBHbIX cfll\eTeHH.SI: rAy6oKoe - B rHno.uepMe H nose pxHOCTHoe - B COCO'!KOBOM CJ\OC ,zr:e pMbI. HMeIOTC.Sl HepBHbie MHeAHHO-
15
Bbie li 6e3MHeAHHOBbie BOAOKHa. KoHr.i;eBhie yqaCTKH <!YJ3CTBHTeAb H b!X BOAOKOH Ha3bIBaIOT KO:>KHbIMH HeHpopeu.er!TopaMH; B 3 aBHCH MOCT H OT THna pa3,a;paJKeHlli'!OHH ,a;eMITCSI Ha TepMopeu.enTOpbI, xeMopeu;enTO-
pbI, MeXaHopeu;en TOpbI H HOU.Hpeu.enTOpbI (6oAeBbie peu;enTOpbI ) .
Mop¢oAOrH'!CCKHpeu.enTopb! K02KH pa3,a;eMIIOTCSI Ha CBO).\H b !C H Kan-
CyA11posaHHbIC. CaMbIMH MHOrO'UiCAeHHbIMH H Ba2KHbIMH, BCTpe-
'!aIOII.\HMHC5I BO Bcex CA05IX ,u_epMbI, 5IBMIIOTC5I CB060AHbie HepBHble OKOH'IaHHSI, KOTOpbie Il03BOMIIOT BOCilpHHHMaTb 'IYJ3CTBO 6oAH . KanCYAHpoBaHHb ie HepBHbie OKOH'!amrn(TeAbu;a) HMeIOT CAem10rn;x-re pa3HOBH,ll.HOCTH: me.nb-z,ta MeilcHepa H MepKe.ll5l. (OTB e'IaIOTHa TaKTHAh - Hoe B03,a;ei1CTBHe), meJlblJa Py<jJ<jJUl-iU (OTBe'!aIOTHa TCIIAOBOe B03)l.CHCTBHe), 1COJl6bl Kpay3e (OTBe'IaIOTHa XOAO,ll.OBOe B03,l(CHCTBHe), menb-
!Ja <Pamepa-ITatitt.Ul-1.U (OTBe'!aIOTHa 'IYBCTBO,l(aBACHH5I H BH6pau;Hn).
Kpoeesocuaia: H AHMcj>aTH"ICCKaSI CHCTCM'.Ll KO:fitM. Ko2Ka
o6HAhHO saceyMipH30BaHa, HMeeT IIOBCpXHOCTHYIO ceTb, pacnoA02KCHHYIO Ha rp aHn:u;e CCT'!aToroH COCO'IKOBOroCAOeB ,l(epMbI, H rAy6oey10 CCTh, pacn0Ao:>Ke1-my10 Ha rpaHHIJ,e rnno,l(e pMbI H ,n.epMb I. KpoMe 3Toro HMeIOTCSI apTepHOBeH03Hhie aHaCTOM03bI, npHHHMaIOII.IHe yqacTHe B TepMoperyMlu;I-rH. K crreu;naAH3HposaHHhIM cocy,l(HCThIM TeAbI.l;aM OTHOC5IT rAOMYCbI , Heo6XOAHMhie AA5I ycHAeHIDI TOKa KpOBH B K02Ke, KOTopble qalu,e scero pacnoAar aIOTC5I Ha KOH'Y:HKax riaAbL\e B KHCTeH H CTOil H COCTO.HT H 3 BeH03Horo H apTepHaAbHOro cerMf'.HTOBH KOpOTKOro KamiAa, COeJ],HH$1IOII.Iero apTepHOAY H BeHyAy HaIIp5IMYIO, MHHY5I KanHAA5IpbI. J\aM¢aTH'IeCKHe cocy,l(bl. B K02Ke npe.n;cTaBAe.HhI
cocyAaMH MeAKOI'O KaAH6pa B ,l(CpMe H 3IIH,l(epMnce, 38.TeM |
AHMcpa |
aKKY1'.fYAHpyeTC5I B 6oAee KPYTIHbI X cocyJ.1.ax, IIOJ.1.XO,LI.HII.IHX K |
penrn- |
HapHbIM AHM¢aTH<teCKHM y 3 AaM. |
|
K npH.tt.aT:KaM KOJKH OTHOCHT BOAOCbI, HOITf{, ITOTOBbie H |
|
CaAhHhre :ace Ae3hI. |
|
BOJlOCbL IlOKpbIBaIOT B e eb K02KHhIH IIOKpOB, 3a'HCKAIO'leHHeM |
|
Aa,ll,OHe H:, IIOAOII.IB, KpacH OH KaHMbI ry6, l'OAOBKH IlOAOBOro |
opraHa. |
P a3AI·Pia1-0T ,l(AttHHhre (BOAOChI roAOBhI, 6opo,l(bI , ycoB), llJ.eTHHHCThie |
|
(BOAOChI 6 poBe H, p eCHHQ, YII.IHbIX H HOCOBbIX paKOBHH) H nymKOBbie BOAOCbl (secb OCTaAbHOH IlOKpOB TeAa). BOAOC . COC'I'OH11.. ld3 CTe p2KH.H ('IaCTb BOAOCa, BbICTynaIOII.Iero Ha,n IlOBepXHOCTblO KOJKH) H KOpH5I (BHYTPHAe pMaAhHbIH OT,l(eA BOll.Oca) . Ha KOHU.e KOpH5I HMeeTCSI AYKOBHU:a, o6e cne'IHB aromag pocT BOAOCa. K AYKOBHU:e nOJ],XOJJ:HT BOAOC.H- HOH COCO'!l c cocy ,ll,a MH H HepBaMH. BOAOC HaxO,l(HTC$1 B IlHTeAH- aAbHO-COe J.J:HHHTeAbHOTKill'IHOMMelllO"!Ke - ¢oAAHeyAe.
16
Hozmu npe,u.cTaBAflIOT co6oH: por oByIO II/\acnrney (HorreBrur
Il/\aCTHHKa) , i\e:lKauzyIO Ha 3IlHTe.!\HH KOHIJ,eBbIX cpMaHr IlMbU:eB pyx H HOr. HorreBrur IlJ\aCTHHKa COCTOHT H3 TeAa H KOpHSL Te/\O HOI'TII-
e ro BH.U.HMa51 qacTh. CKpbrTrur s HOITeBOM :lKeA06Ke npoKCHMMbHrur
qaCTb HOIT5I HBAf!eTC5I ero KOpHeM . HoITe Brur IlJ\aCTHHKa CHapY:lKff HMeeT r/\a,U.eyIO noBepXHOCTb, a H3HYTPH IlOK}JblTa rpe6elllKaMH H
6op0 3,ll.KaMH. 0Ha COCTOHT H3 Il/\OTHb!X porOBb!X 'IernyeK, HHor.u.a c OCTaTKa MH 51.U.ep, co.u.ep:lKaI.U;HX TBep,D.blH KepaTHH. /\e)KHT Ha HOITe-
BOM A O:lKe , KOTOpoe npe.u.cTaB.!\5IeT co6oH: TO/\CTb!H C/\OH 31lH,U.epMnca
6e3 porosoro C/\.051 (poroBOH C/\OH 3aMeH5IeT HOITeBrur Il.!\aCTHHKa).
Ilp o KCH MMbHO 3 IlH,U.epMH C HOITesoro /\O:>Ica npo.u.oA)f{aeTCn B M a TpH-
uy HOITH, COCTOHI.U;YIO H3 3IlHTe/\HaAbHbIX K.!\eTOK - OHaX06/\aCTOB . y
npOKCHMaAbHOH rpaHHU:bl HOITSI porosoii C/\OH 3IlH,U.epMHCa OKpy -
:lKaIOme'iiKO:lKH HaKJ\a,lf;bIBaeTCH Ha HOrOTb H npO'IHOK HeM)'rrpHKpeIl.!\5IeTC5I.. 3Ta 30Ha HOITH BMecTe c poroBblM CJ\OeM Ha3b!Ba eTCH Ha.u.-
HOrTeBOH KO:>!CHIJ,eH H.!\H 3IlOHHXHeM. 3a C"leT pa3MHO:lKeHH5I OHHX06-
J\a CTOB HOl'OTbpaCTeT B .Zl..!\HHY, a 3a C"leT pa3MHO:lKeHH5I. KJ\eTO K |
6 a- |
||
3 MbI-Wro CJ\OH HOITesoro i\O:lKa - |
B TOAmHHY |
|
|
llomoe&ie "*Ce.n.e3bL - |
npoCTb1e Tpy6qaTb1e Hepa3BeTBAeHHbie |
||
:>!<eAe3bl, B b 1pa6aTbrna10mRe |
H |
BhI,U.e.!\5IIOmwe noT. P acno11.o:lKeH b 1 |
n o - |
s ceM eCTHO 3a HCK.!\IO"leHHeM Kpa c H oii KaHMbl ry6, KO:lKH MaAbIX 110/\.0- Bb!X ry6 , K.!\H-i·opa, l'Oi\OBKHIlO/\OBOrO "li\eHa H KpaliHeii Il.!\OTH. 06mee "IHC/\O IlOTOBbIX :lKei\e 3 y 'Ie/\OBeKaOT 2 .u.o 5 MAH. IloTOBa51 ::>iCeAe3a
cocTOH T H3 ceKp emoptto20 omae.;ia (npe.u.CTaB.!\5IeT c o6oli c nHpaAbH03aKpyqeH HhIM KAy6o'Ie K , BbICTi\aHHblH O.U.HHM Ci\OeM 3 IlHTeAHMbHbIX
KAeTOK}, H2X0ll,SIUJ;eroc5I r Ay6oKO B CeT"laTOM CAOe .u.epMbI, H ebteoatto20
KOTOpblH npOXO,Zl.HT qep e3 .u.epM)'H 3IlH,ll.e pMHC nepne H ,D.H-
ey.!\5Ip HO K nosepXHOCTH KO:>!CH H OT KpbIBaeTCH B BH,U.e nopbl. |
B HOpMe |
B CYTK l1 BbI,Zl.eAf!eTC.H OT 0,5 .u.o 10 /\HTpOB IlOTa (npH KOMHan |
rofI TeM- |
n eparype qeAOBeK BhI,U.eAHeT 400-600 MA noTa s cyT KH) . IloT CO,ll.ep- |
|
)KY!T 9 8-99 % BO,Zl.bl, |
a30THCTbie semecTBa |
(MO'IeBHHa,- |
MO"leBasr |
KH- |
CAOTa, Kpea THHHH), |
aMMHaK, aMHHOKHC/\.OT bI, :lKHpHbie KHC/\OTbl , |
xo- |
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AeCTepHH, CO/\H H aTpHH H KMH5I, l'/\IOK 0 3y |
, BHTaMH HbJ, fornreHHb!e |
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a MHHJ,J. |
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B 3asHCHMOCTH OT MeXaHH3Ma ceKµeUHH pa3AH'IaIOT: |
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•MepoKpmiHbie IlOTOBble )KeJie3bl, CeKpeuMSl B KOTOpbIX np011CXOAHT 6e3 r116 enn c eKperopHblX KOMTIOHeHTOB K Jie'TKJll, OHW ttaqttHaIOT ¢YHK-
Ul10~-rl1pOBaTb c MOMeHTa po)f(,IJ;eHIDI;
17
•anoKpttHHbie IlOTOBbJe )l(eJie3bl: B MOMeHT ceKpeu;tttt KOTOpbIX rrpui1:'t-
XO)J,ITT'pa3pyrneHMe CeKpeTopHbIX KOMIIOHeHTOB KJieTKtt, OHM Ha'JttHaIOT cpyHKu;MOHttpoBaTb B rrep11op, nonOBOI'OC03peBaHWI.
CCVlbH.bLe -'Ke.Tle3bL - rrpoCThie ruu,aeoMipHhie JKeAe3hI c ro-
AOKpHHOBhIM THIIOM ceKpeU:HH, rrpH KOTOpOM ceKpeu;llil rrpOHCXO,ll;HT 3a c'!eTpa3pyrneHH.H co6CTBeHHhIX KAeToK. PacrroAmKem,r Ha aceM
rrpOTSDKeHHH KOJKHOI'O IlOKpOBa, 3a HCKAIO"l:eHHeM Aa,ll;OHdl: H rro-
,ll;OlllB. C aAhHbre JKeAe3hI 'Iall.l,eacero CBSI3aHhI co CTPYKTypaMH BOAo-
ca, HO |
HMeIOTCSI |
H CB060ll;Hble |
CaAbHbie JKeAe3bI |
(BOKpyr |
COCKOB MO- |
AO"l:HbIX )KeAe3, B |
061,aCTH MaAbIX IlOAOBblX ry6, Ha I'OAOBKeIIOAOBOI'O |
||||
"l:AeHa, |
Ha KpaHHeH IlAOTH). |
CaAbHbie )KeAe3bl |
HMeIOT |
AOAb'Ia Toe |
|
CTpoeHHe (12-18 CeKpeTOpHbIX AOAeK), no nepmpepHH pacIIOAQ}KeH CAOH 6a30cpHAbHblX KAeTOK, KOTOpbre rrpOH3BOA5JT ceKpeT (KO)KHOe CaAO), ceKpeTOpHblll OTAeA pacnoAaraeTC.H B ceT'!aTOM CAOe AepMbI. 3aaeyau:H.H KO)KHOI'O cat.a OCYll.l,eCTBAfieTC.H 'lepe3BbIBOAHOH npOTOK,
OTKpbIBaIOll.l,HHCSI B BOAOC.HHOH cjJoAAHeyA. |
CaAbHbie )KeAe3bI 3a cyrKH |
|
BbI,ll;eAfIIOT OKOAO 15-20 I'KO)KHOI'Ocat.a, |
KOTOpoe HMeeT CAeAYIQll.l,HH |
|
coCTaB: TpHI'AHIJ;epHHhl - 42 %, CB060,ll;Hbie 2KHpHbie |
KHCAOTbl - |
|
15 %, CAO)KHbie BOCKOBhie 3cjJHphl ·- 25 %, CKBaAeH - |
15 %, CAO:lK- |
|
Hbie 3CpHpbl XOAecTepnHa H XOAeCTepHH - |
3 %. PeryASIU:HJ'lcjJyHKU,HH |
|
CaAbHhIX )KeAe3 ocyw;eCTBAfleTCSI HeliporyMopaAhHhIM rryTeM, B OCHOBHOM rroAOBhIMM ropMOHaMH (TeCTOCTepoH, rrporecTepoH). Ha rrpoT>Ic :>KeHHH )KH3HH CaAhHbJe :lKeAe3bl HMeIQT pa3AH"l:HYIO cPYHKu,HOHaAbHYIO aKTHBHOCTb: MaKCHMfu\hHYIO B rrepHOA IlOAOBOI'O C03peBaHHSI H MH- :fIHMaAbHYIO y AHU, IIOJKHAOI'OB03pacTa.
Pa3AH'laIOT cAeeyrouwe «l>YHKilHH KOJKH:
1. 6apbeptto-3alll,T!ITHall.,
2. peu;emopHaH,
3. TepMoperyIDITopH~,
4. 11MM)!HOflOI'W'leCKall.,
5. ceKpeTopHM,
6. 3KCKpeTopHall.,
7. )J,bIXaTeJlbHall.,
8. yqacn1e Bo ncex B11)J.ax o6MeHa Be:m;ecTB,
9. 3H.ZWKp«HHaH (c mrreJ BJiITaMHHa D3),
10. pe3op6THBH~.
narorncronorHR KOJKH
BOAbUJHHCTBO KOJKHbIX 3a6oAeBaHHH HMeeT BOCIIaAHTCAbHbIH xapaKTep, BOCIIaAeHHe MOJKeT 6hITh OCTpbIM HAM xpOHH'iCCKHM. P a3-
18
AH'faIOTTPH BH,n;a BOCDaACHH5I: npoJtucjJepayusi - yseAH'!eHHeKOAH'ICCTBaKAeTOK H BHyTp11KAeTO'!HbIXCTPYKTYP nYTeM np.HMoro MAH Henp.HMOro ,n;eAeHH.H H .n:mpcpepeHU.HPOBKH, 3Kccyoayusi - H3MeHe - HH5I co CTOpOHbI cocy;:i;os (BbI)J;eAeHHe 113 cocy,n;oB 2KHAKOCTH R cpopMeHHbIX 3AeMeHTOB) H aJtbmepayust - np05IBAeHH5! TIOBpe2K,n:eHH.H T KaHeH.
IlpOAHcpepaTHBHbie naTOAOrH'leCKHe 1Xponecc1>1 pa3)l.e Afl-
IOTC5I CAe.ZJ:Yl:OT.l\HM o6pa30M '.
1.f u nepKepam03 - yTorrm;ettHe porosoro crro5l.
2.napaKepam03 - HeITOJIHOIJ,eHirne opOrOBeHtte, HaJll1'Ul.esi;ri:ep B KJle'J:'.KaX
porosor o CJI05l, OTCyTCTBHe 3epHHCToro CJI05l.
3.AKa1-1mo3 -- yTonm;eHHe IIIHDOBH)J,Horo CJI05l.
4.f pa1-1yAe3 - YTO./]m;eHHe 3epHHCTOI'OCJI05l.
5. Il05lBJieHHe B KJieTKax cTeKJlOBtt):J.-
HoJil, no.riynp03pa'IHOMcy6cTaHQIH1. IlJIOTHOM KOH CHCTeHQHH ·- JIHHa .
6.fpa1-1yA e.Ma - oqarOBa5l xpOHWieCK85l BOCilaJIHTeJibHa5l peaKQH5l Ha TKa-
HeBbie nospe»<,D,ett1 ;u1, conposo)i\p;a10Il\l1eC5l cKonnenweM w npoimcpe -
p au;ueti Jil1Mcpor.~HTOB, rHCTl1.0l\MTOB, MaKpocparoB.
7.1\!luKpoa6cijeCCbl - tte60JibIIIHe O'IaI'OBbieCKOIIJleHl15! KlleTOK B 3IIH,!J,ep-
|
MT1.Ce 1-1 p:epMe. |
|
8. |
!vlyKoua1we 1-1a6yxa1-1ue - |
HalJaJiblia5l cpa3a p:e3opraHw3aIJ,11M KormareHa 11. |
|
OCHOBHOrO sem;eCTBa p:epMbI. |
|
9. |
cPu6pwwumwe 1-1a6yxa1-1ue - cpa3a p:e3opraH11.3aI!MM coep:tttt11.TeJlbHoJ7! |
|
|
T K aHH, xapaKTep113y10II1;85lC5! na6yxaH tteM, roMorett113ail,11.eti H l1.3Mette- |
|
|
m1eM Tl1.HKTOPl1.aJibHbIX CBOMCTB KOJIJiaretta . |
|
.. 10. |
namtAAO.MGnl03 - pa3pacraH11.e COCO'IKOBOrO CJI05l )lepMbl. |
|
|
3Kccy.a;aTHBHl>re |
na'I'OAOrH'leCKHenponecchl xapaKTep11- |
3YJOTC5! CAC.ZJ:YIOl.U.HM o6pa3oM:
1.BaKyOAbHClfl oeze1-1epaiJWl - BHyTpl1.KIIeTO'IHbIMOTeK, napeHXl1.MaT03Hall
r~erettepal\H5l KJieToK xapaKTepi13yeTC5l noffilrre1111eM B npoTol1Jla3Me MaJibITtt:rl1.eBa CJI05! BaKyoneM:, pacnorraraIOII111.XCSI OKOJIO HJIH BOKpyr wi;pa H orreo-rn10m;11x 5Ip;po K rrep11cpepw11. 51,n;po rrptt 3TOM p:ecpopM11.- pyeTC5l, Ha6mo.o;aJOTCSI CHMilTOMbI Ill1KH03a (cMOplll,l1.BaH11.e 5lJJ:pa) .
2.Cno1-1zuo3 - Me)KKJieTo'IHhIMoTeK 3nt1)J,epM11.ca. '.3Kccyp:aTpa3}J,BHraeT
OT)J,eJibHbie 3 llMTeJil1aJibHbie KJieTKl1., paCT5lI'HBaeTMe)KKJieTO'IHhleMOC-
THK11. 3aKIIIO~IaeTC5! IlOJIHOM noTepett Me)KKJieTO'TifOM CBSI311. B pe3)'Jib-
T aTe npo11CXOAl1.T o6pa:mBaHl!!e 311HTeJIT1.aJibHOro Il)'3blpbKa.
3.baAAOHupylOU{Clfl ae2e11epaLfUJl - npe}J,CTaBJI5leT C060T<i CO'IeTaHl1.eBH)"rp11.
11 Me)!(KJieTO'IHOroOTeKa, l10Ml1.MO l13MeHeHl1.M B caMOM 3IIBTeJil1.aJibHOM
19
KJien::e, pa3pyrnaJOTOI Me)Kl()1eTO'!HbieMOCTHKM, B pe3yJI&TaTe 06pa3y-
eT<:.51 MHOrOIIOJIOCTHOM rry3orpb c neperopop;Ka.MM BHY'TPH·
K aA&TepaTHBHldM naTOAoruq:ecKHM npou.eccaM OTHOCSIT -
CSI CheJ.IYIO!WiC:
1.AKaH-mOAU3 - B illHIIOBl!l,D;HOM cnoe :irmp;epMHCa npowcxo.a;11:T p;ereHepau;lli'Il1 aTpocplim Me)f(K)"!eToqHbIX 3Ill1TeJI11aJibHbIX MOCTJllKOB, ocna6JieHMe H IlOJIHOe Hapymem-i:e CB.5l3M Me)l(,l];y KJieTKaMM; 3TO npi,reo.a;MT K o6pa3onaHHIO nHyTpr-i::irrttp,epMaJfbHbIX rry3b1pei1.
2.HyKAeu11.08aJ1 pea.x71wi - AereHepau;IBJ. B K.lleTKax 3rrttp,epM1'1:ca, 3aKmoqa10II1a.Hc.st B Ha6yxaH1'1:HMX .5l)J,pbIIIIKa, 'llTOCB.s!3bIBaIOT c B03AeMCTBtteM
=p;p yr11x areHroa TOI<cnqecKoro xapaKTepa.
Mop¢0Aorw1ecK11e 3AeMeHTh I K02KHOH ChIITH
Pa31UiqaroT nepBHqHbie 11 BTOp11qah1e Mop¢0AOI'a~1ecK.He 3AC-
MCHTbI.
IIepeuttH.bLJIUt M.optjJoJlozuttecicUMu 3JleM.eHmaMu c qH.TalOTCH TC, KOTOpbre B03HHKalOT KaK Herrocpe,n;CTBCHHbIH, nepBbIH pe3YhhTaT rraTOhOrl-P·ICCKOI'Orrpou.ecca B KO:»<:e.
BmoputtH.bte M.opcjJoJlozuttecx:ue 3JleM.eH.mbt - Te, KOTOpb1 e ITOSIBMilOTCSI H3 nepBHqHhIX, BCAC,ll;CTBHC HX CITOHTaHHOH 3B0Af-OU.HH Hi\H o6paTHOro pa3BHTI1SI.
K nepeuq:HhIM MopcJ.> oAOrH'leCKHM 3ACMCJITaM OTHOCJITCJI CA.e-
.Zl.YIOW.He npORBACHH.R.
1. U .nTHO (macula) - M3MeHeHHe a;seTa KO)KM Ha omeJibHOM y q aCTKe. flsrrHa He B03BbIIllaIOTC.51 Ha,IJ, ypoBHeM KOJKM, He OIIJYII~aroTC.51 rrpw rrarr&rrau;MM. BocnaJJMTeJibHb1e II.51TH<I. npM Ha,u.asm.rnaHMM scer.a;a MC'le3aJOT, He BOCilaJU1TeJibHbie - OCTaIOTC51. fip M pa3pemeHMM I151TJ-Ja MC'le3aIOT 6eccJie,!l;HO. 11.stTHa 6blBaIOT:
1)cocy,a;HCTbIMM:
•socnru111:TeJibH&1e --'- po3eorra, 3pMTeMa;
•He BOCilaJil1:TeJibHbie - 3MOIJ;MOHaJibHbie, 3aCTOMHbie, Terrea1-1rn- 3KTa3Hl1, pOAMMble Il.5lTHa;
2)reMopparwqecKMMM: rreTeXMM, nyprrypbl, 3KXMM03bl, BM6Mu;ec;
3)m1:rMeHTHb!Ml1 :
• p;errt1rMeHTau;M.st (o6iu;a!>l - aJib611HH3M, MeCTHa!'l - BMTMJltffO,
nei-i:Ko,a;epMa);
•TMnepnli!rMenTau,i-rn (o6iu;a.st - MenaHo,a;epMa, MeCTHa.si: - nHrMeHTH&Ie pOAMJibHbie Il.5lTtta);
4)apTlilcpHu;MaJibHb!Mlil - rpM6KOBO['Qnpoil1cxo)fQ];eHM.51, Ta'I}'lilpOBKa, neKapcTBeHHbie I151THa, OT yKyca smei1.
20