2 курс / Нормальная физиология / Торшин 2014
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Ɋɢɫ. 3.9. ɉɪɢɧɰɢɩ ɨɛɳɟɝɨ ɤɨɧɟɱɧɨɝɨ ɩɭɬɢ. Ʉɨɧɜɟɪɝɟɧɰɢɹ ɢɦɩɭɥɶɫɨɜ, ɩɪɢɯɨɞɹɳɢɯ ɢɡ ɪɚɡɧɵɯ ɪɟɰɟɩɬɢɜɧɵɯ ɡɨɧ
ɤɨɞɧɨɦɭ ɦɨɬɨɧɟɣɪɨɧɭ (Ⱥ.ȼ. Ʉɨɪɨɛɤɨɜ, ɋ.Ⱥ. ɑɟɫɧɨɤɨɜɚ, 1986)
3.ɉɪɢɧɰɢɩ ɞɨɦɢɧɚɧɬɵ (ɪɢɫ. 3.10). Ȼɵɥ ɨɬɤɪɵɬ Ⱥ.Ⱥ. ɍɯ-
ɬɨɦɫɤɢɦ, ɤɨɬɨɪɵɣ ɨɛɧɚɪɭɠɢɥ, ɱɬɨ ɪɚɡɞɪɚɠɟɧɢɟ ɚɮɮɟɪɟɧɬɧɨɝɨ ɧɟɪɜɚ (ɢɥɢ ɤɨɪɤɨɜɨɝɨ ɰɟɧɬɪɚ), ɜɟɞɭɳɟɝɨ ɤ ɫɨɤɪɚɳɟɧɢɸ ɦɵɲɰ ɤɨɧɟɱɧɨɫɬɟɣ ɩɪɢ ɩɟɪɟɩɨɥɧɟɧɢɢ ɭ ɠɢɜɨɬɧɨɝɨ ɤɢɲɟɱɧɢɤɚ, ɩɪɢɜɨɞɢɬ ɤ ɚɤɬɭ ɞɟɮɟɤɚɰɢɢ. ȼ ɞɚɧɧɨɣ ɫɢɬɭɚɰɢɢ ɪɟɮɥɟɤɬɨɪɧɨɟ ɜɨɡɛɭɠɞɟɧɢɟ ɰɟɧɬɪɚ ɞɟɮɟɤɚɰɢɢ ɩɨɞɚɜɥɹɟɬ, ɬɨɪɦɨɡɢɬ ɞɜɢɝɚɬɟɥɶɧɵɟ ɰɟɧɬɪɵ, ɚ ɰɟɧɬɪ ɞɟɮɟɤɚɰɢɢ ɧɚɱɢɧɚɟɬ ɪɟɚɝɢɪɨɜɚɬɶ ɧɚ ɩɨɫɬɨɪɨɧɧɢɟ ɞɥɹ ɧɟɝɨ ɫɢɝɧɚɥɵ. Ⱥ.Ⱥ. ɍɯɬɨɦɫɤɢɣ
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Ɋɢɫ. 3.10. ɉɪɢɧɰɢɩ ɞɨɦɢɧɚɧɬɵ (ɩɨ Ⱥ.Ⱥ. ɍɯɬɨɦɫɤɨɦɭ, 1923):
ɚ – ɞɨɦɢɧɢɪɭɸɳɢɣ ɰɟɧɬɪ ɫɝɢɛɚɬɟɥɟɣ ɩɟɪɟɞɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ (ɩɨɫɥɟ ɚɩɩɥɢɤɚɰɢɢ ɫɬɪɢɯɧɢɧɚ); ɛ, ɜ, ɝ – ɪɟɰɟɩɬɢɜɧɵɟ ɩɨɥɹ, ɪɚɡɞɪɚɠɟɧɢɟ ɤɨɬɨɪɵɯ ɜ ɧɨɪɦɟ ɜɵɡɵɜɚɟɬ ɫɝɢɛɚɧɢɟ ɡɚɞɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ, ɚ ɩɨɫɥɟ ɜɨɡɧɢɤɧɨɜɟɧɢɹ ɞɨɦɢɧɚɧɬɵ ɩɪɢɜɨɞɢɬ ɤ ɫɝɢɛɚɧɢɸ ɩɟɪɟɞɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ ɥɹɝɭɲɤɢ (Ⱥ.ȼ. Ʉɨɪɨɛɤɨɜ, ɋ.Ⱥ. ɑɟɫɧɨɤɨɜɚ, 1986)
ɫɱɢɬɚɥ, ɱɬɨ ɜ ɤɚɠɞɵɣ ɞɚɧɧɵɣ ɦɨɦɟɧɬ ɠɢɡɧɢ ɜɨɡɧɢɤɚɟɬ ɨɩɪɟɞɟɥɹɸɳɢɣ (ɞɨɦɢɧɚɧɬɧɵɣ) ɨɱɚɝ ɜɨɡɛɭɠɞɟɧɢɹ, ɩɨɞɱɢɧɹɸɳɢɣ ɫɟɛɟ ɞɟɹɬɟɥɶɧɨɫɬɶ ɜɫɟɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɢ ɨɩɪɟɞɟɥɹɸɳɢɣ
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ɯɚɪɚɤɬɟɪ ɩɪɢɫɩɨɫɨɛɢɬɟɥɶɧɨɣ ɪɟɚɤɰɢɢ. Ʉ ɞɨɦɢɧɚɧɬɧɨɦɭ ɨɱɚɝɭ ɤɨɧɜɟɪɝɢɪɭɸɬ ɜɨɡɛɭɠɞɟɧɢɹ ɢɡ ɪɚɡɥɢɱɧɵɯ ɨɛɥɚɫɬɟɣ ɐɇɋ, ɚ ɫɩɨɫɨɛɧɨɫɬɶ ɞɪɭɝɢɯ ɰɟɧɬɪɨɜ ɪɟɚɝɢɪɨɜɚɬɶ ɧɚ ɫɢɝɧɚɥɵ, ɩɪɢɯɨɞɹɳɢɟ ɤ ɧɢɦ, ɡɚɬɨɪɦɚɠɢɜɚɟɬɫɹ. Ȼɥɚɝɨɞɚɪɹ ɷɬɨɦɭ ɫɨɡɞɚɸɬɫɹ ɭɫɥɨɜɢɹ ɞɥɹ ɮɨɪɦɢɪɨɜɚɧɢɹ ɨɩɪɟɞɟɥɟɧɧɨɣ ɪɟɚɤɰɢɢ ɨɪɝɚɧɢɡɦɚ ɧɚ ɪɚɡɞɪɚɠɢɬɟɥɶ, ɢɦɟɸɳɢɣ ɧɚɢɛɨɥɶɲɟɟ ɛɢɨɥɨɝɢɱɟɫɤɨɟ ɡɧɚɱɟɧɢɟ, ɬ.ɟ. ɭɞɨɜɥɟɬɜɨɪɹɸɳɢɣ ɠɢɡɧɟɧɧɨ ɜɚɠɧɭɸ ɩɨɬɪɟɛɧɨɫɬɶ. ȼ ɟɫɬɟɫɬɜɟɧɧɵɯ ɭɫɥɨɜɢɹɯ ɫɭɳɟɫɬɜɨɜɚɧɢɹ ɞɨɦɢɧɢɪɭɸɳɟɟ ɜɨɡɛɭɠɞɟɧɢɟ ɦɨɠɟɬ ɨɯɜɚɬɵɜɚɬɶ ɰɟɥɵɟ ɫɢɫɬɟɦɵ ɪɟɮɥɟɤɫɨɜ, ɜ ɪɟɡɭɥɶɬɚɬɟ ɜɨɡɧɢɤɚɸɬ ɩɢɳɟɜɚɹ, ɨɛɨɪɨɧɢɬɟɥɶɧɚɹ, ɩɨɥɨɜɚɹ ɢ ɞɪɭɝɢɟ ɮɨɪɦɵ ɞɟɹɬɟɥɶɧɨɫɬɢ.
Ⱦɨɦɢɧɚɧɬɧɵɣ ɰɟɧɬɪ ɜɨɡɛɭɠɞɟɧɢɹ ɨɛɥɚɞɚɟɬ ɪɹɞɨɦ ɫɜɨɣɫɬɜ: 1) ɞɥɹ ɟɝɨ ɧɟɣɪɨɧɨɜ ɯɚɪɚɤɬɟɪɧɚ ɜɵɫɨɤɚɹ ɜɨɡɛɭɞɢɦɨɫɬɶ, ɱɬɨ ɫɩɨɫɨɛɫɬɜɭɟɬ ɤɨɧɜɟɪɝɟɧɰɢɢ ɤ ɧɢɦ ɜɨɡɛɭɠɞɟɧɢɣ ɢɡ ɞɪɭɝɢɯ ɰɟɧɬɪɨɜ; 2) ɟɝɨ ɧɟɣɪɨɧɵ ɫɩɨɫɨɛɧɵ ɫɭɦɦɢɪɨɜɚɬɶ ɩɪɢɯɨɞɹɳɢɟ ɜɨɡɛɭɠɞɟɧɢɹ; 3) ɜɨɡɛɭɠɞɟɧɢɟ ɯɚɪɚɤɬɟɪɢɡɭɟɬɫɹ ɫɬɨɣɤɨɫɬɶɸ ɢ ɢɧɟɪɬɧɨɫɬɶɸ, ɬ.ɟ. ɫɩɨɫɨɛɧɨɫɬɶɸ ɫɨɯɪɚɧɹɬɶɫɹ ɞɚɠɟ ɬɨɝɞɚ, ɤɨɝɞɚ ɫɬɢɦɭɥ, ɜɵɡɜɚɜɲɢɣ ɨɛɪɚɡɨɜɚɧɢɟ ɞɨɦɢɧɚɧɬɵ, ɩɪɟɤɪɚɬɢɥ ɞɟɣɫɬɜɢɟ.
ɇɟɫɦɨɬɪɹ ɧɚ ɨɬɧɨɫɢɬɟɥɶɧɭɸ ɫɬɨɣɤɨɫɬɶ ɢ ɢɧɟɪɬɧɨɫɬɶ ɜɨɡɛɭɠɞɟɧɢɹ ɜ ɞɨɦɢɧɚɧɬɧɨɦ ɨɱɚɝɟ, ɞɟɹɬɟɥɶɧɨɫɬɶ ɐɇɋ ɜ ɧɨɪɦɚɥɶɧɵɯ ɭɫɥɨɜɢɹɯ ɫɭɳɟɫɬɜɨɜɚɧɢɹ ɜɟɫɶɦɚ ɞɢɧɚɦɢɱɧɚ ɢ ɢɡɦɟɧɱɢɜɚ. ɐɇɋ ɨɛɥɚɞɚɟɬ ɫɩɨɫɨɛɧɨɫɬɶɸ ɤ ɩɟɪɟɫɬɪɨɣɤɟ ɞɨɦɢɧɚɧɬɧɵɯ ɨɬɧɨɲɟɧɢɣ ɜ ɫɨɨɬɜɟɬɫɬɜɢɢ ɫ ɢɡɦɟɧɹɸɳɢɦɢɫɹ ɩɨɬɪɟɛɧɨɫɬɹɦɢ ɨɪɝɚɧɢɡɦɚ. ɍɱɟɧɢɟ ɨ ɞɨɦɢɧɚɧɬɟ ɧɚɲɥɨ ɲɢɪɨɤɨɟ ɩɪɢɦɟɧɟɧɢɟ ɜ ɩɫɢɯɨɥɨɝɢɢ, ɩɟɞɚɝɨɝɢɤɟ, ɮɢɡɢɨɥɨɝɢɢ ɭɦɫɬɜɟɧɧɨɝɨ ɢ ɮɢɡɢɱɟɫɤɨɝɨ ɬɪɭɞɚ, ɫɩɨɪɬɟ.
4. ɉɪɢɧɰɢɩ ɨɛɪɚɬɧɨɣ ɫɜɹɡɢ. ɉɪɨɰɟɫɫɵ, ɩɪɨɢɫɯɨɞɹɳɢɟ ɜ ɐɇɋ, ɧɟɜɨɡɦɨɠɧɨ ɤɨɨɪɞɢɧɢɪɨɜɚɬɶ, ɟɫɥɢ ɨɬɫɭɬɫɬɜɭɟɬ ɨɛɪɚɬɧɚɹ ɫɜɹɡɶ, ɬ.ɟ. ɞɚɧɧɵɟ ɨ ɪɟɡɭɥɶɬɚɬɚɯ ɭɩɪɚɜɥɟɧɢɹ ɮɭɧɤɰɢɹɦɢ. Ɉɛɪɚɬɧɚɹ ɫɜɹɡɶ ɩɨɡɜɨɥɹɟɬ ɫɨɨɬɧɟɫɬɢ ɜɵɪɚɠɟɧɧɨɫɬɶ ɢɡɦɟɧɟɧɢɣ ɩɚɪɚɦɟɬɪɨɜ ɫɢɫɬɟɦɵ ɫ ɟɟ ɪɚɛɨɬɨɣ. ɋɜɹɡɶ ɜɵɯɨɞɚ ɫɢɫɬɟɦɵ ɫ ɟɟ ɜɯɨɞɨɦ ɫ ɩɨɥɨɠɢɬɟɥɶɧɵɦ ɤɨɷɮɮɢɰɢɟɧɬɨɦ ɭɫɢɥɟɧɢɹ ɧɚɡɵɜɚɟɬɫɹ ɩɨɥɨɠɢɬɟɥɶɧɨɣ ɨɛɪɚɬɧɨɣ ɫɜɹɡɶɸ, ɚ ɫ ɨɬɪɢɰɚɬɟɥɶɧɵɦ ɤɨɷɮɮɢɰɢɟɧɬɨɦ – ɨɬɪɢɰɚɬɟɥɶɧɨɣ ɨɛɪɚɬɧɨɣ ɫɜɹɡɶɸ. ɉɨɥɨɠɢɬɟɥɶɧɚɹ ɨɛɪɚɬɧɚɹ ɫɜɹɡɶ ɜ ɨɫɧɨɜɧɨɦ ɯɚɪɚɤɬɟɪɧɚ ɞɥɹ ɩɚɬɨɥɨɝɢɱɟɫɤɢɯ ɫɢɬɭɚɰɢɣ. Ɉɬɪɢɰɚɬɟɥɶɧɚɹ ɨɛɪɚɬɧɚɹ ɫɜɹɡɶ ɨɛɟɫ-
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ɩɟɱɢɜɚɟɬ ɭɫɬɨɣɱɢɜɨɫɬɶ ɫɢɫɬɟɦɵ (ɟɟ ɫɩɨɫɨɛɧɨɫɬɶ ɜɨɡɜɪɚɳɚɬɶɫɹ ɤ ɢɫɯɨɞɧɨɦɭ ɫɨɫɬɨɹɧɢɸ ɩɨɫɥɟ ɩɪɟɤɪɚɳɟɧɢɹ ɜɥɢɹɧɢɹ ɜɨɡɦɭɳɚɸɳɢɯ ɮɚɤɬɨɪɨɜ). Ɋɚɡɥɢɱɚɸɬ ɛɵɫɬɪɵɟ (ɧɟɪɜɧɵɟ) ɢ ɦɟɞɥɟɧɧɵɟ (ɝɭɦɨɪɚɥɶɧɵɟ) ɨɛɪɚɬɧɵɟ ɫɜɹɡɢ. Ɇɟɯɚɧɢɡɦɵ ɨɛɪɚɬɧɨɣ ɫɜɹɡɢ ɨɛɟɫɩɟɱɢɜɚɸɬ ɩɨɞɞɟɪɠɚɧɢɟ ɜɫɟɯ ɤɨɧɫɬɚɧɬ ɝɨɦɟɨɫɬɚɡɚ. ɇɚɩɪɢɦɟɪ, ɫɨɯɪɚɧɟɧɢɟ ɧɨɪɦɚɥɶɧɨɝɨ ɭɪɨɜɧɹ ɤɪɨɜɹɧɨɝɨ ɞɚɜɥɟɧɢɹ ɨɫɭɳɟɫɬɜɥɹɟɬɫɹ ɡɚ ɫɱɟɬ ɢɡɦɟɧɟɧɢɹ ɢɦɩɭɥɶɫɧɨɣ ɚɤɬɢɜɧɨɫɬɢ ɛɚɪɨɪɟɰɟɩɬɨɪɨɜ ɫɨɫɭɞɢɫɬɵɯ ɪɟɮɥɟɤɫɨɝɟɧɧɵɯ ɡɨɧ, ɤɨɬɨɪɵɟ ɢɡɦɟɧɹɸɬ ɬɨɧɭɫ ɜɚɝɭɫɚ ɢ ɜɚɡɨɦɨɬɨɪɧɵɯ ɫɢɦɩɚɬɢɱɟɫɤɢɯ ɧɟɪɜɨɜ.
5.ɉɪɢɧɰɢɩ ɪɟɰɢɩɪɨɤɧɨɫɬɢ. Ɉɧ ɨɬɪɚɠɚɟɬ ɯɚɪɚɤɬɟɪ ɨɬ-
ɧɨɲɟɧɢɣ ɦɟɠɞɭ ɰɟɧɬɪɚɦɢ, ɨɬɜɟɬɫɬɜɟɧɧɵɦɢ ɡɚ ɨɫɭɳɟɫɬɜɥɟɧɢɟ ɩɪɨɬɢɜɨɩɨɥɨɠɧɵɯ ɮɭɧɤɰɢɣ (ɜɞɨɯɚ ɢ ɜɵɞɨɯɚ, ɫɝɢɛɚɧɢɹ ɢ ɪɚɡɝɢɛɚɧɢɹ ɤɨɧɟɱɧɨɫɬɟɣ), ɢ ɡɚɤɥɸɱɚɟɬɫɹ ɜ ɬɨɦ, ɱɬɨ ɧɟɣɪɨɧɵ ɨɞɧɨɝɨ ɰɟɧɬɪɚ, ɜɨɡɛɭɠɞɚɹɫɶ ɬɨɪɦɨɡɹɬ ɧɟɣɪɨɧɵ ɞɪɭɝɨɝɨ, ɢ ɧɚɨɛɨɪɨɬ.
6.ɉɪɢɧɰɢɩ ɫɭɛɨɪɞɢɧɚɰɢɢ (ɫɨɩɨɞɱɢɧɟɧɢɹ). Ɉɫɧɨɜɧɚɹ ɬɟɧɞɟɧɰɢɹ ɜ ɷɜɨɥɸɰɢɢ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ ɩɪɨɹɜɥɹɟɬɫɹ ɜ ɫɨɫɪɟɞɨɬɨɱɟɧɢɢ ɮɭɧɤɰɢɣ ɪɟɝɭɥɹɰɢɢ ɢ ɤɨɨɪɞɢɧɚɰɢɢ ɜ ɜɵɫɲɢɯ ɨɬɞɟɥɚɯ ɐɇɋ – ɰɟɮɚɥɢɡɚɰɢɹ ɮɭɧɤɰɢɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ. ȼ ɐɇɋ ɢɦɟɸɬɫɹ ɢɟɪɚɪɯɢɱɟɫɤɢɟ ɜɡɚɢɦɨɨɬɧɨɲɟɧɢɹ – ɜɵɫɲɢɦ ɰɟɧɬɪɨɦ ɪɟɝɭɥɹɰɢɢ ɹɜɥɹɟɬɫɹ ɤɨɪɚ ɛɨɥɶɲɢɯ ɩɨɥɭɲɚɪɢɣ; ɛɚɡɚɥɶɧɵɟ ɝɚɧɝɥɢɢ, ɫɪɟɞɧɢɣ, ɩɪɨɞɨɥɝɨɜɚɬɵɣ ɢ ɫɩɢɧɧɨɣ ɦɨɡɝ ɩɨɞɱɢɧɹɸɬɫɹ ɟɟ ɤɨɦɚɧɞɚɦ.
7.ɉɪɢɧɰɢɩ ɤɨɦɩɟɧɫɚɰɢɢ ɮɭɧɤɰɢɣ. ɐɇɋ ɨɛɥɚɞɚɟɬ ɨɝ-
ɪɨɦɧɨɣ ɤɨɦɩɟɧɫɚɬɨɪɧɨɣ ɫɩɨɫɨɛɧɨɫɬɶɸ, ɬ.ɟ. ɦɨɠɟɬ ɜɨɫɫɬɚɧɚɜɥɢɜɚɬɶ ɧɟɤɨɬɨɪɵɟ ɮɭɧɤɰɢɢ ɞɚɠɟ ɩɨɫɥɟ ɪɚɡɪɭɲɟɧɢɹ ɡɧɚɱɢɬɟɥɶɧɨɣ ɱɚɫɬɢ ɧɟɣɪɨɧɨɜ, ɨɛɪɚɡɭɸɳɢɯ ɧɟɪɜɧɵɣ ɰɟɧɬɪ (ɫɦ. ɩɥɚɫɬɢɱɧɨɫɬɶ ɧɟɪɜɧɵɯ ɰɟɧɬɪɨɜ). ɉɪɢ ɩɨɜɪɟɠɞɟɧɢɢ ɨɬɞɟɥɶɧɵɯ ɰɟɧɬɪɨɜ ɢɯ ɮɭɧɤɰɢɢ ɦɨɝɭɬ ɩɟɪɟɣɬɢ ɤ ɞɪɭɝɢɦ ɫɬɪɭɤɬɭɪɚɦ ɦɨɡɝɚ, ɱɬɨ ɨɫɭɳɟɫɬɜɥɹɟɬɫɹ ɩɪɢ ɨɛɹɡɚɬɟɥɶɧɨɦ ɭɱɚɫɬɢɢ ɤɨɪɵ ɛɨɥɶɲɢɯ ɩɨɥɭɲɚɪɢɣ. ɍ ɠɢɜɨɬɧɵɯ, ɤɨɬɨɪɵɦ ɩɨɫɥɟ ɜɨɫɫɬɚɧɨɜɥɟɧɢɹ ɭɬɪɚɱɟɧɧɵɯ ɮɭɧɤɰɢɣ ɭɞɚɥɹɥɢ ɤɨɪɭ, ɜɧɨɜɶ ɩɪɨɢɫɯɨɞɢɥɚ ɢɯ ɭɬɪɚɬɚ.
ɉɪɢ ɥɨɤɚɥɶɧɨɣ ɧɟɞɨɫɬɚɬɨɱɧɨɫɬɢ ɬɨɪɦɨɡɧɵɯ ɦɟɯɚɧɢɡɦɨɜ ɢɥɢ ɩɪɢ ɱɪɟɡɦɟɪɧɨɦ ɭɫɢɥɟɧɢɢ ɩɪɨɰɟɫɫɨɜ ɜɨɡɛɭɠɞɟɧɢɹ ɜ ɬɨɦ ɢɥɢ ɢɧɨɦ ɧɟɪɜɧɨɦ ɰɟɧɬɪɟ ɨɩɪɟɞɟɥɟɧɧɚɹ ɫɨɜɨɤɭɩɧɨɫɬɶ
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ɧɟɣɪɨɧɨɜ ɧɚɱɢɧɚɟɬ ɚɜɬɨɧɨɦɧɨ ɝɟɧɟɪɢɪɨɜɚɬɶ ɩɚɬɨɥɨɝɢɱɟɫɤɢ ɭɫɢɥɟɧɧɨɟ ɜɨɡɛɭɠɞɟɧɢɟ – ɮɨɪɦɢɪɭɟɬɫɹ ɝɟɧɟɪɚɬɨɪ ɩɚɬɨɥɨɝɢɱɟɫɤɢ ɭɫɢɥɟɧɧɨɝɨ ɜɨɡɛɭɠɞɟɧɢɹ. ɉɪɢ ɜɵɫɨɤɨɣ ɦɨɳɧɨɫɬɢ ɝɟɧɟɪɚɬɨɪɚ ɜɨɡɧɢɤɚɟɬ ɰɟɥɚɹ ɫɢɫɬɟɦɚ ɮɭɧɤɰɢɨɧɢɪɭɸɳɢɯ ɜ ɟɞɢɧɨɦ ɪɟɠɢɦɟ ɧɟɣɪɨɧɚɥɶɧɵɯ ɨɛɪɚɡɨɜɚɧɢɣ, ɱɬɨ ɨɬɪɚɠɚɟɬ ɤɚɱɟɫɬɜɟɧɧɨ ɧɨɜɵɣ ɷɬɚɩ ɜ ɪɚɡɜɢɬɢɢ ɡɚɛɨɥɟɜɚɧɢɹ. ɀɟɫɬɤɢɟ ɫɜɹɡɢ ɦɟɠɞɭ ɨɬɞɟɥɶɧɵɦɢ ɫɨɫɬɚɜɧɵɦɢ ɷɥɟɦɟɧɬɚɦɢ ɬɚɤɨɣ ɩɚɬɨɥɨɝɢɱɟɫɤɨɣ ɫɢɫɬɟɦɵ ɥɟɠɚɬ ɜ ɨɫɧɨɜɟ ɟɟ ɭɫɬɨɣɱɢɜɨɫɬɢ ɤ ɪɚɡɥɢɱɧɵɦ ɥɟɱɟɛɧɵɦ ɜɨɡɞɟɣɫɬɜɢɹɦ. ɂɡɭɱɟɧɢɟ ɩɪɢɪɨɞɵ ɷɬɢɯ ɫɜɹɡɟɣ ɩɨɡɜɨɥɢɥɨ Ƚ.ɇ. Ʉɪɵɠɚɧɨɜɫɤɨɦɭ ɨɛɧɚɪɭɠɢɬɶ ɧɨɜɭɸ ɮɨɪɦɭ ɜɧɭɬɪɢɰɟɧɬɪɚɥɶɧɵɯ ɨɬɧɨɲɟɧɢɣ ɢ ɢɧɬɟɝɪɚɬɢɜɧɨɣ ɞɟɹɬɟɥɶɧɨɫɬɢ ɐɇɋ – ɩɪɢɧɰɢɩ ɞɟɬɟɪɦɢɧɚɧɬɵ. ɋɭɬɶ ɷɬɨɝɨ ɩɪɢɧɰɢɩɚ ɫɨɫɬɨɢɬ ɜ ɬɨɦ, ɱɬɨ ɫɬɪɭɤɬɭɪɚ ɐɇɋ, ɮɨɪɦɢɪɭɸɳɚɹ ɮɭɧɤɰɢɨɧɚɥɶɧɭɸ ɩɨɫɵɥɤɭ, ɩɨɞɱɢɧɹɟɬ ɫɟɛɟ ɬɟ ɨɬɞɟɥɵ ɐɇɋ, ɤ ɤɨɬɨɪɵɦ ɨɧɚ ɚɞɪɟɫɨɜɚɧɚ, ɢ ɨɛɪɚɡɭɟɬ ɜɦɟɫɬɟ ɫ ɧɢɦɢ ɩɚɬɨɥɨɝɢɱɟɫɤɭɸ ɫɢɫɬɟɦɭ, ɨɩɪɟɞɟɥɹɹ ɯɚɪɚɤɬɟɪ ɟɟ ɞɟɹɬɟɥɶɧɨɫɬɢ. Ⱦɥɹ ɬɚɤɨɣ ɫɢɫɬɟɦɵ ɯɚɪɚɤɬɟɪɧɵ ɨɬɫɭɬɫɬɜɢɟ ɚɞɚɩɬɚɬɢɜɧɨɝɨ ɡɧɚɱɟɧɢɹ, ɩɨɫɬɨɹɧɫɬɜɨ ɢ ɧɟɚɞɟɤɜɚɬɧɨɫɬɶ ɮɭɧɤɰɢɨɧɚɥɶɧɵɯ ɩɨɫɵɥɨɤ, ɬ.ɟ. ɬɚɤɚɹ ɫɢɫɬɟɦɚ ɹɜɥɹɟɬɫɹ ɛɢɨɥɨɝɢɱɟɫɤɢ ɨɬɪɢɰɚɬɟɥɶɧɨɣ. ȿɫɥɢ ɜ ɫɢɥɭ ɬɟɯ ɢɥɢ ɢɧɵɯ ɩɪɢɱɢɧ ɩɚɬɨɥɨɝɢɱɟɫɤɚɹ ɫɢɫɬɟɦɚ ɢɫɱɟɡɚɟɬ, ɬɨ ɨɛɪɚɡɨɜɚɧɢɟ ɐɇɋ, ɢɝɪɚɜɲɟɟ ɪɨɥɶ ɞɟɬɟɪɦɢɧɚɧɬɵ ɷɬɨɣ ɫɢɫɬɟɦɵ, ɬɟɪɹɟɬ ɫɜɨɟ ɞɟɬɟɪɦɢɧɚɧɬɧɨɟ ɡɧɚɱɟɧɢɟ.
ɑȺɋɌɇȺə ɎɂɁɂɈɅɈȽɂə ɐȿɇɌɊȺɅɖɇɈɃ ɇȿɊȼɇɈɃ ɋɂɋɌȿɆɕ
ɋɩɢɧɧɨɣ ɦɨɡɝ
ɋɩɢɧɧɨɣ ɦɨɡɝ ɪɚɫɩɨɥɚɝɚɟɬɫɹ ɜ ɩɨɡɜɨɧɨɱɧɨɦ ɤɚɧɚɥɟ. Ɉɫɧɨɜɧɚɹ ɨɫɨɛɟɧɧɨɫɬɶ ɫɬɪɨɟɧɢɹ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ – ɫɟɝɦɟɧɬɚɪɧɨɫɬɶ. ɋɩɢɧɧɨɣ ɦɨɡɝ ɱɟɥɨɜɟɤɚ ɢɦɟɟɬ 31–33 ɫɟɝɦɟɧɬɚ ɢ ɩɨ ɮɭɧɤɰɢɨɧɚɥɶɧɨɦɭ ɩɪɢɧɰɢɩɭ ɞɟɥɢɬɫɹ ɧɚ 8 ɲɟɣɧɵɯ (ɋ1–ɋ8), 12 ɝɪɭɞɧɵɯ (Th1–Th12), 5 ɩɨɹɫɧɢɱɧɵɯ (L1–L5), 5 ɤɪɟɫɬɰɨɜɵɯ (S1–S5) ɢ 1–3 ɤɨɩɱɢɤɨɜɵɯ (Cɨ1–Cɨ3) ɫɟɝɦɟɧɬɨɜ. ɂɡ ɨɞɧɨɝɨ ɫɟɝɦɟɧɬɚ ɢɧɧɟɪɜɢɪɭɟɬɫɹ 3 ɦɟɬɚɦɟɪɚ ɬɟɥɚ – ɫɜɨɣ ɢ ɞɜɚ ɩɪɢɥɟɠɚɳɢɯ ɤ ɧɟɦɭ ɫɨɫɟɞɧɢɯ ɦɟɬɚɦɟɪɚ. ɉɨɷɬɨɦɭ ɩɨɪɚɠɟɧɢɟ ɢɥɢ ɩɟɪɟɪɟɡɤɚ ɤɨɪɟɲɤɨɜ ɫɩɢɧɧɨɦɨɡɝɨɜɨɝɨ ɧɟɪɜɚ, ɨɬɯɨɞɹɳɟɝɨ ɨɬ ɨɞ-
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ɧɨɝɨ ɫɟɝɦɟɧɬɚ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ, ɧɟ ɩɪɢɜɨɞɢɬ ɤ ɩɨɥɧɨɣ ɩɨɬɟɪɟ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɢ ɢ ɞɜɢɠɟɧɢɹ ɜ ɫɨɨɬɜɟɬɫɬɜɭɸɳɟɦ ɦɟɬɚɦɟɪɟ ɬɟɥɚ, ɚ ɥɢɲɶ ɤ ɨɫɥɚɛɥɟɧɢɸ ɷɬɢɯ ɮɭɧɤɰɢɣ.
Ʉɚɠɞɵɣ ɫɟɝɦɟɧɬ ɢɦɟɟɬ ɚɮɮɟɪɟɧɬɧɵɟ ɜɯɨɞɵ ɜ ɜɢɞɟ ɡɚɞɧɢɯ ɤɨɪɟɲɤɨɜ ɫɩɢɧɧɨɦɨɡɝɨɜɨɝɨ ɧɟɪɜɚ, ɤɥɟɬɨɱɧɭɸ ɦɚɫɫɭ ɧɟɪɜɧɵɯ ɤɥɟɬɨɤ (ɫɟɪɨɟ ɜɟɳɟɫɬɜɨ) ɢ ɷɮɮɟɪɟɧɬɧɵɟ ɜɵɯɨɞɵ ɜ ɫɨɫɬɚɜɟ ɩɟɪɟɞɧɢɯ ɤɨɪɟɲɤɨɜ ɫɩɢɧɧɨɦɨɡɝɨɜɨɝɨ ɧɟɪɜɚ. ȼ ɡɚɞɧɢɯ ɤɨɪɟɲɤɚɯ ɩɪɨɯɨɞɹɬ ɱɭɜɫɬɜɢɬɟɥɶɧɵɟ ɰɟɧɬɪɨɫɬɪɟɦɢɬɟɥɶɧɵɟ ɧɟɪɜɧɵɟ ɜɨɥɨɤɧɚ ɨɬ ɪɟɰɟɩɬɨɪɨɜ ɤɨɠɢ (ɛɨɥɟɜɵɟ, ɬɟɦɩɟɪɚɬɭɪɧɵɟ, ɬɚɤɬɢɥɶɧɵɟ ɢ ɞɚɜɥɟɧɢɹ) – ɷɬɨ ɤɨɠɧɚɹ ɪɟɰɟɩɬɢɪɭɸɳɚɹ ɫɢɫɬɟɦɚ, ɚ ɨɬ ɪɟɰɟɩɬɨɪɨɜ ɦɵɲɰ, ɫɭɯɨɠɢɥɢɣ, ɫɭɫɬɚɜɨɜ – ɷɬɨ ɩɪɨɩɪɢɨɰɟɩɬɢɜɧɚɹ ɫɢɫɬɟɦɚ. ɂ, ɧɚɤɨɧɟɰ, ɨɬ ɪɟɰɟɩɬɨɪɨɜ ɜɧɭɬɪɟɧɧɢɯ ɨɪɝɚɧɨɜ – ɷɬɨ ɜɢɫɰɟɪɨɰɟɩɬɢɜɧɚɹ ɫɢɫɬɟɦɚ. ɉɟɪɟɞɧɢɟ ɤɨɪɟɲɤɢ ɫɩɢɧɧɨɦɨɡɝɨɜɵɯ ɧɟɪɜɨɜ ɹɜɥɹɸɬɫɹ ɞɜɢɝɚɬɟɥɶɧɵɦɢ ɰɟɬɪɨɛɟɠɧɵɦɢ (ɡɚɤɨɧ Ȼɟɥɥɚ – Ɇɚɠɚɧɞɢ).
ȿɫɥɢ ɜ ɨɩɵɬɟ ɧɚ ɥɹɝɭɲɤɟ ɜ ɨɛɥɚɫɬɢ ɩɨɹɫɧɢɱɧɨɤɪɟɫɬɰɨɜɵɯ ɫɟɝɦɟɧɬɨɜ ɫɩɪɚɜɚ ɩɟɪɟɪɟɡɚɬɶ ɜɫɟ ɡɚɞɧɢɟ ɤɨɪɟɲɤɢ ɫɩɢɧɧɨɦɨɡɝɨɜɵɯ ɧɟɪɜɨɜ, ɚ ɫɥɟɜɚ – ɜɫɟ ɩɟɪɟɞɧɢɟ, ɬɨ ɩɪɚɜɚɹ ɤɨɧɟɱɧɨɫɬɶ ɬɟɪɹɟɬ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɶ, ɧɨ ɫɩɨɫɨɛɧɚ ɤ ɞɜɢɠɟɧɢɸ, ɚ ɥɟɜɚɹ, ɧɚɨɛɨɪɨɬ, ɫɨɯɪɚɧɹɟɬ ɱɭɜɫɬɜɢɬɟɥɶɧɨɫɬɶ, ɧɨ ɧɟ ɦɨɠɟɬ ɫɨɜɟɪɲɚɬɶ ɞɜɢɠɟɧɢɹ.
ɋɟɪɨɟ ɜɟɳɟɫɬɜɨ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ, ɫɨɫɬɨɹɳɟɟ ɢɡ ɧɟɣɪɨɧɨɜ, ɨɛɪɚɡɭɟɬ ɞɜɚ ɩɟɪɟɞɧɢɯ ɢ ɞɜɚ ɡɚɞɧɢɯ ɪɨɝɚ ɢ ɧɚ ɩɨɩɟɪɟɱɧɨɦ ɪɚɡɪɟɡɟ ɢɦɟɟɬ ɜɢɞ ɛɭɤɜɵ ɇ. Ɂɚɞɧɢɟ ɪɨɝɚ ɜɵɩɨɥɧɹɸɬ ɫɟɧɫɨɪɧɵɟ ɮɭɧɤɰɢɢ, ɩɟɪɟɞɧɢɟ –ɞɜɢɝɚɬɟɥɶɧɵɟ.
ȼ ɝɪɭɞɧɵɯ ɢ ɜɟɪɯɧɢɯ ɩɨɹɫɧɢɱɧɵɯ ɫɟɝɦɟɧɬɚɯ ɩɨɦɢɦɨ ɡɚɞɧɢɯ ɢ ɩɟɪɟɞɧɢɯ ɪɨɝɨɜ ɟɫɬɶ ɟɳɟ ɢ ɛɨɤɨɜɵɟ, ɜ ɤɨɬɨɪɵɯ ɪɚɫɩɨɥɚɝɚɸɬɫɹ ɧɟɣɪɨɧɵ ɫɢɦɩɚɬɢɱɟɫɤɨɝɨ, ɚ ɜ ɤɪɟɫɬɰɨɜɵɯ – ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɨɝɨ ɨɬɞɟɥɨɜ ɜɟɝɟɬɚɬɢɜɧɨɣ ɧɟɪɜɧɨɣ ɫɢɫɬɟɦɵ.
ɉɪɢ ɩɨɪɚɠɟɧɢɢ ɛɨɤɨɜɵɯ ɪɨɝɨɜ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɜɨɡɧɢɤɚɟɬ ɰɟɥɵɣ ɪɹɞ ɜɟɝɟɬɚɬɢɜɧɵɯ ɪɚɫɫɬɪɨɣɫɬɜ: ɧɚɪɭɲɚɸɬɫɹ ɤɨɠɧɵɟ ɫɨɫɭɞɢɫɬɵɟ ɪɟɮɥɟɤɫɵ, ɩɨɬɨɨɬɞɟɥɟɧɢɟ, ɧɚɛɥɸɞɚɸɬɫɹ ɬɪɨɮɢɱɟɫɤɢɟ ɢɡɦɟɧɟɧɢɹ ɤɨɠɢ ɢ ɧɨɝɬɟɣ.
ɇɟɣɪɨɧɵ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɋɭɳɟɫɬɜɭɟɬ ɮɭɧɤɰɢɨɧɚɥɶɧɨɟ ɞɟɥɟɧɢɟ ɧɟɣɪɨɧɨɜ ɧɚ 4 ɝɪɭɩɩɵ. ȼ ɩɟɪɜɭɸ ɝɪɭɩɩɭ ɜɯɨɞɹɬ ɦɨɬɨɧɟɣɪɨɧɵ, ɢɥɢ ɞɜɢɝɚɬɟɥɶɧɵɟ ɧɟɣɪɨɧɵ, ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɜ ɩɟɪɟɞɧɢɯ ɪɨɝɚɯ, ɚ ɢɯ ɚɤɫɨɧɵ ɨɛɪɚɡɭɸɬ ɩɟɪɟɞɧɢɟ ɤɨɪɟɲɤɢ
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ɫɩɢɧɧɨɦɨɡɝɨɜɵɯ ɧɟɪɜɨɜ. ȼɬɨɪɭɸ ɝɪɭɩɩɭ ɫɨɫɬɚɜɥɹɸɬ ɢɧɬɟɪɧɟɣɪɨɧɵ – ɩɪɨɦɟɠɭɬɨɱɧɵɟ ɧɟɣɪɨɧɵ, ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɜ ɡɚɞɧɢɯ ɪɨɝɚɯ ɢ ɩɨɥɭɱɚɸɳɢɟ ɢɧɮɨɪɦɚɰɢɸ ɨɬ ɱɭɜɫɬɜɢɬɟɥɶɧɵɯ ɫɩɢɧɧɨɦɨɡɝɨɜɵɯ ɝɚɧɝɥɢɟɜ. Ɉɧɢ ɪɟɚɝɢɪɭɸɬ ɧɚ ɛɨɥɟɜɵɟ, ɬɟɦɩɟɪɚɬɭɪɧɵɟ, ɬɚɤɬɢɥɶɧɵɟ ɢ ɩɪɨɩɪɢɨɰɟɩɬɢɜɧɵɟ ɪɚɡɞɪɚɠɢɬɟɥɢ. ɂɧɬɟɪɧɟɣɪɨɧɵ ɨɬɜɟɱɚɸɬ ɡɚ ɜɢɫɰɟɪɨɦɨɬɨɪɧɵɟ ɪɟɮɥɟɤɫɵ. Ʉɪɨɦɟ ɬɨɝɨ, ɨɧɢ ɨɛɟɫɩɟɱɢɜɚɸɬ ɜɨɫɯɨɞɹɳɢɟ ɢ ɧɢɫɯɨɞɹɳɢɟ ɬɨɪɦɨɡɧɵɟ ɢ ɜɨɡɛɭɠɞɚɸɳɢɟ ɜɥɢɹɧɢɹ ɧɚ ɤɥɟɬɤɢ ɜɵɲɟ- ɢ ɧɢɠɟɥɟɠɚɳɢɯ ɫɬɪɭɤɬɭɪ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɂɧɬɟɪɧɟɣɪɨɧɵ ɭɱɚɫɬɜɭɸɬ ɜ ɪɟɰɢɩɪɨɤɧɨɦ ɬɨɪɦɨɠɟɧɢɢ.
Ɍɪɟɬɶɹ ɝɪɭɩɩɚ ɧɟɣɪɨɧɨɜ – ɷɬɨ ɫɢɦɩɚɬɢɱɟɫɤɢɟ ɢ ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɢɟ ɧɟɣɪɨɧɵ, ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɜ ɛɨɤɨɜɵɯ ɪɨɝɚɯ. Ⱥɤɫɨɧɵ ɷɬɢɯ ɤɥɟɬɨɤ ɜɵɯɨɞɹɬ ɢɡ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɜ ɫɨɫɬɚɜɟ ɩɟɪɟɞɧɢɯ ɤɨɪɟɲɤɨɜ ɫɩɢɧɧɨɦɨɡɝɨɜɵɯ ɧɟɪɜɨɜ. Ɋɚɡɪɹɞɵ ɫɢɦɩɚɬɢɱɟɫɤɢɯ ɧɟɣɪɨɧɨɜ ɫɢɧɯɪɨɧɢɡɢɪɭɸɬɫɹ ɫ ɤɨɥɟɛɚɧɢɹɦɢ ɚɪɬɟɪɢɚɥɶɧɨɝɨ ɞɚɜɥɟɧɢɹ.
Ʉ ɱɟɬɜɟɪɬɨɣ ɝɪɭɩɩɟ ɨɬɧɨɫɹɬ ɚɫɫɨɰɢɚɬɢɜɧɵɟ ɧɟɣɪɨɧɵ, ɨɛɟɫɩɟɱɢɜɚɸɳɢɟ ɜɧɭɬɪɢ- ɢ ɦɟɠɫɟɝɦɟɧɬɚɪɧɵɟ ɫɜɹɡɢ.
ȼ ɫɪɟɞɧɟɣ ɱɚɫɬɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɧɚɯɨɞɢɬɫɹ ɩɪɨɦɟɠɭɬɨɱɧɨɟ ɹɞɪɨ, ɫɨɞɟɪɠɚɳɟɟ ɧɟɣɪɨɧɵ, ɚɤɫɨɧɵ ɤɨɬɨɪɵɯ ɨɛɪɚɡɭɸɬ ɫɟɬɶ – ɫɬɭɞɟɧɢɫɬɨɟ ɜɟɳɟɫɬɜɨ (ɠɟɥɚɬɢɧɨɡɧɭɸ ɫɭɛɫɬɚɧɰɢɸ Ɋɨɥɚɧɞɚ), ɢɥɢ ɪɟɬɢɤɭɥɹɪɧɭɸ ɮɨɪɦɚɰɢɸ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ.
Ɇɨɬɨɧɟɣɪɨɧɵ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɞɟɥɹɬ ɧɚ ɚɥɶɮɚ- ɢ ɝɚɦɦɚ- ɧɟɣɪɨɧɵ. Ⱥɥɶɮɚ-ɦɨɬɨɧɟɣɪɨɧɵ ɢɧɧɟɪɜɢɪɭɸɬ ɷɤɫɬɪɚɮɭɡɚɥɶɧɵɟ ɦɵɲɟɱɧɵɟ ɜɨɥɨɤɧɚ, ɨɛɟɫɩɟɱɢɜɚɹ ɦɵɲɟɱɧɨɟ ɫɨɤɪɚɳɟɧɢɟ. ɇɚ ɞɟɧɞɪɢɬɚɯ ɷɬɢɯ ɤɥɟɬɨɤ ɪɚɫɩɨɥɚɝɚɟɬɫɹ ɨɤɨɥɨ 20 ɬɵɫɹɱ ɫɢɧɚɩɫɨɜ. Ⱥɥɶɮɚ-ɦɨɬɨɧɟɣɪɨɧɵ ɨɛɥɚɞɚɸɬ ɧɢɡɤɨɣ ɱɚɫɬɨɬɨɣ ɢɦɩɭɥɶɫɚɰɢɢ (10–20 ɢɦɩ/ɫ). Ƚɚɦɦɚ-ɦɨɬɨɧɟɣɪɨɧɵ ɢɧɧɟɪɜɢɪɭɸɬ
ɢɧɬɪɚɮɭɡɚɥɶɧɵɟ ɦɵɲɟɱɧɵɟ ɜɨɥɨɤɧɚ ɦɵɲɟɱɧɨɝɨ ɜɟɪɟɬɟɧɚ.
Ɉɧɢ ɨɛɥɚɞɚɸɬ ɜɵɫɨɤɨɣ ɱɚɫɬɨɬɨɣ ɢɦɩɭɥɶɫɚɰɢɢ (ɞɨ 200 ɢɦɩ/ɫ). Ƚɥɚɜɧɚɹ ɮɭɧɤɰɢɹ ɝɚɦɦɚ-ɦɨɬɨɧɟɣɪɨɧɨɜ ɫɨɫɬɨɢɬ ɜ ɩɪɟɞɨɬɜɪɚɳɟɧɢɢ ɜɨ ɜɪɟɦɹ ɫɨɤɪɚɳɟɧɢɹ ɷɤɫɬɪɚɮɭɡɚɥɶɧɵɯ ɜɨɥɨɤɨɧ ɪɚɫɫɥɚɛɥɟɧɢɹ ɦɵɲɟɱɧɵɯ ɜɟɪɟɬɟɧ. ȼɨɡɛɭɠɞɟɧɢɟ ɝɚɦɦɚ-ɦɨɬɨɧɟɣ- ɪɨɧɨɜ ɫɩɨɫɨɛɫɬɜɭɟɬ ɪɚɡɜɢɬɢɸ ɧɚɱɚɜɲɟɝɨɫɹ ɞɜɢɠɟɧɢɹ ɢ ɢɫɩɨɥɶɡɭɟɬɫɹ ɞɥɹ ɜɵɩɨɥɧɟɧɢɹ ɨɫɨɛɟɧɧɨ ɬɨɧɤɢɯ ɢ ɦɟɥɤɢɯ ɞɜɢɠɟɧɢɣ. ɗɬɨ ɫɟɪɜɨɦɟɯɚɧɢɡɦ ɞɥɹ ɨɩɬɢɦɢɡɚɰɢɢ ɞɜɢɠɟɧɢɣ.
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ɋɨɛɫɬɜɟɧɧɵɟ ɮɭɧɤɰɢɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɨɫɭɳɟɫɬɜɥɹɸɬ-
ɫɹ ɡɚ ɫɱɟɬ ɫɟɝɦɟɧɬɚɪɧɵɯ ɪɟɮɥɟɤɬɨɪɧɵɯ ɞɭɝ (ɦɨɧɨ- ɢ ɩɨɥɢɫɢɧɚɩɬɢɱɟɫɤɢɯ). ɒɟɣɧɵɟ ɫɟɝɦɟɧɬɵ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɋ3–ɋ5 ɢɧɧɟɪɜɢɪɭɸɬ ɞɢɚɮɪɚɝɦɭ, Ɍh1–Ɍh12 – ɧɚɪɭɠɧɵɟ ɢ ɜɧɭɬɪɟɧɧɢɟ ɦɟɠɪɟɛɟɪɧɵɟ ɦɵɲɰɵ, ɋ5–ɋ8 ɢ Ɍh1–Ɍh2 – ɰɟɧɬɪɵ ɞɜɢɠɟɧɢɹ ɜɟɪɯɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ, L2–L4 ɢ S1–S2 – ɰɟɧɬɪɵ ɞɜɢɠɟɧɢɹ ɡɚɞɧɢɯ ɢɥɢ ɧɢɠɧɢɯ ɤɨɧɟɱɧɨɫɬɟɣ. Ⱥɥɶɮɚ- ɢ ɝɚɦɦɚ-ɦɨɬɨɧɟɣɪɨɧɵ ɩɨɞɞɟɪɠɢɜɚɸɬ ɬɨɧɭɫ ɬɟɥɚ ɢ ɨɛɟɫɩɟɱɢɜɚɸɬ ɪɟɮɥɟɤɫɵ ɫɝɢɛɚ-
ɧɢɹ ɢ ɪɚɡɝɢɛɚɧɢɹ – ɦɢɨɫɬɚɬɢɱɟɫɤɢɟ ɪɟɮɥɟɤɫɵ, ɢɥɢ ɪɟɮɥɟɤɫɵ ɧɚ ɪɚɫɬɹɠɟɧɢɟ ɦɵɲɰɵ. Ɇɟɯɚɧɢɱɟɫɤɢɣ ɭɞɚɪ ɧɟɜɪɨɥɨɝɢɱɟɫɤɢɦ ɦɨɥɨɬɨɱɤɨɦ ɩɨ ɫɭɯɨɠɢɥɢɸ ɦɵɲɰɵ ɩɪɢɜɨɞɢɬ ɤ ɛɵɫɬɪɨɦɭ ɟɟ ɪɚɫɬɹɠɟɧɢɸ ɜɫɟɝɨ ɧɚ ɧɟɫɤɨɥɶɤɨ ɦɢɥɥɢɦɟɬɪɨɜ, ɚ ɡɚɬɟɦ ɫɨɤɪɚɳɟɧɢɸ ɜɫɟɣ ɦɵɲɰɵ ɢ ɩɨɹɜɥɟɧɢɸ ɨɬɜɟɬɧɨɣ ɪɟɚɤɰɢɢ. Ʉ ɬɚɤɢɦ ɪɟɮɥɟɤɫɚɦ ɨɬɧɨɫɹɬɫɹ: ɤɨɥɟɧɧɵɣ, ɚɯɢɥɥɨɜ, ɩɨɞɨɲɜɟɧɧɵɣ, ɫɝɢɛɚɬɟɥɶɧɵɣ ɢ ɪɚɡɝɢɛɚɬɟɥɶɧɵɣ ɪɟɮɥɟɤɫɵ ɩɪɟɞɩɥɟɱɶɹ.
Ʉɨɥɟɧɧɵɣ ɪɟɮɥɟɤɫ ɜɵɡɵɜɚɟɬɫɹ ɭɞɚɪɨɦ ɦɨɥɨɬɨɱɤɚ ɩɨ ɫɭɯɨɠɢɥɢɸ ɱɟɬɵɪɟɯɝɥɚɜɨɣ ɦɵɲɰɵ ɛɟɞɪɚ ɧɢɠɟ ɤɨɥɟɧɧɨɣ ɱɚɲɟɱɤɢ, ɩɪɨɹɜɥɹɟɬɫɹ ɪɚɡɝɢɛɚɧɢɟɦ ɝɨɥɟɧɢ ɜ ɤɨɥɟɧɧɨɦ ɫɭɫɬɚɜɟ ɢ ɫɨɤɪɚɳɟɧɢɟɦ ɦɵɲɰ ɛɟɞɪɚ. ɇɟɣɪɨɧɵ, ɭɱɚɫɬɜɭɸɳɢɟ ɜ ɷɬɨɦ ɪɟɮɥɟɤɫɟ, ɥɨɤɚɥɢɡɨɜɚɧɵ ɜ 2–4-ɦ ɩɨɹɫɧɢɱɧɵɯ ɫɟɝɦɟɧɬɚɯ (L2–L4) ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ.
Ⱥɯɢɥɥɨɜ ɪɟɮɥɟɤɫ. ɍɞɚɪ ɩɨ ɚɯɢɥɥɨɜɭ ɫɭɯɨɠɢɥɢɸ ɜɵɡɵɜɚɟɬ ɩɨɞɨɲɜɟɧɧɨɟ ɫɝɢɛɚɧɢɟ ɫɬɨɩɵ. Ⱦɭɝɚ ɷɬɨɝɨ ɪɟɮɥɟɤɫɚ ɡɚɦɵɤɚɟɬɫɹ ɧɚ ɭɪɨɜɧɟ 1–2-ɝɨ ɤɪɟɫɬɰɨɜɨɝɨ ɫɟɝɦɟɧɬɚ (S1–S2) ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ.
ɉɨɞɨɲɜɟɧɧɵɣ ɪɟɮɥɟɤɫ. ɒɬɪɢɯɨɜɨɟ ɪɚɡɞɪɚɠɟɧɢɟ ɩɨɞɨɲɜɵ ɜ ɧɚɪɭɠɧɨɦ ɟɟ ɨɬɞɟɥɟ ɩɪɢɜɨɞɢɬ ɤ ɫɝɢɛɚɧɢɸ ɩɚɥɶɰɟɜ ɢ ɫɬɨɩɵ. ȼɨɫɩɪɨɢɡɜɨɞɢɬɫɹ ɪɟɮɥɟɤɫ ɫ ɭɱɚɫɬɢɟɦ 1–2-ɝɨ ɤɪɟɫɬɰɨɜɨɝɨ ɫɟɝɦɟɧɬɚ (S1–S2) ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ.
ɋɝɢɛɚɬɟɥɶɧɵɣ ɪɟɮɥɟɤɫ ɩɪɟɞɩɥɟɱɶɹ (ɛɢɰɟɩɫ-ɪɟɮɥɟɤɫ).
ɍɞɚɪ ɦɨɥɨɬɨɱɤɨɦ ɩɨ ɫɭɯɨɠɢɥɢɸ ɞɜɭɝɥɚɜɨɣ ɦɵɲɰɵ (ɪɭɤɚ ɩɨɥɭɫɨɝɧɭɬɚ ɜ ɥɨɤɬɟɜɨɦ ɫɭɫɬɚɜɟ ɢ ɥɟɠɢɬ ɧɚ ɪɭɤɟ ɢɫɫɥɟɞɭɸɳɟɝɨ) ɜɟɞɟɬ ɤ ɫɝɢɛɚɧɢɸ ɩɪɟɞɩɥɟɱɶɹ. Ɋɟɮɥɟɤɬɨɪɧɚɹ ɞɭɝɚ ɡɚɦɵɤɚɟɬɫɹ ɧɚ ɭɪɨɜɧɟ 5–6-ɝɨ ɲɟɣɧɨɝɨ ɫɟɝɦɟɧɬɨɜ (ɋ5–C6) ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ.
Ɉɩɢɫɚɧɧɵɟ ɪɟɮɥɟɤɫɵ ɧɚ ɪɚɫɬɹɠɟɧɢɟ ɹɜɥɹɸɬɫɹ ɩɪɨɫɬɟɣɲɢɦɢ ɪɟɮɥɟɤɫɚɦɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ɂɯ ɪɟɮɥɟɤɬɨɪɧɚɹ ɞɭɝɚ
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ɧɚɱɢɧɚɟɬɫɹ ɨɬ ɩɪɨɩɪɢɨɪɟɰɟɩɬɨɪɨɜ ɫɭɯɨɠɢɥɢɣ, ɱɭɜɫɬɜɢɬɟɥɶɧɵɟ ɜɨɥɨɤɧɚ ɨɬ ɤɨɬɨɪɵɯ ɜɯɨɞɹɬ ɜ ɫɩɢɧɧɨɣ ɦɨɡɝ ɜ ɫɨɫɬɚɜɟ ɡɚɞɧɢɯ ɤɨɪɟɲɤɨɜ ɢ ɡɚɤɚɧɱɢɜɚɸɬɫɹ ɜ ɩɟɪɟɞɧɢɯ ɪɨɝɚɯ. Ɂɞɟɫɶ ɨɧɢ ɨɛɪɚɡɭɸɬ ɫɢɧɚɩɬɢɱɟɫɤɢɟ ɤɨɧɬɚɤɬɵ ɧɚ ɦɨɬɨɧɟɣɪɨɧɚɯ, ɢɧɧɟɪɜɢɪɭɸɳɢɯ ɪɚɫɬɹɝɢɜɚɟɦɭɸ ɦɵɲɰɭ. Ɍɚɤ ɤɚɤ ɜ ɰɟɧɬɪɚɥɶɧɨɣ ɱɚɫɬɢ ɞɭɝɢ ɪɟɮɥɟɤɫɚ ɪɚɫɬɹɠɟɧɢɹ ɢɦɟɟɬɫɹ ɥɢɲɶ ɨɞɢɧ ɫɢɧɚɩɫ (ɦɟɠɞɭ ɱɭɜɫɬɜɢɬɟɥɶɧɵɦ ɢ ɞɜɢɝɚɬɟɥɶɧɵɦ ɧɟɣɪɨɧɚɦɢ),
ɟɝɨ ɧɚɡɵɜɚɸɬ ɦɨɧɨɫɢɧɚɩɬɢɱɟɫɤɢɦ.
Ɋɟɮɥɟɤɫɵ ɫ ɪɟɰɟɩɬɨɪɨɜ ɤɨɠɢ, ɧɚɩɪɢɦɟɪ ɛɪɸɲɧɨɣ ɪɟɮ-
ɥɟɤɫ, ɜɵɪɚɠɚɸɬɫɹ ɜ ɭɫɢɥɟɧɢɢ ɫɨɤɪɚɳɟɧɢɹ ɦɵɲɰ-ɫɝɢɛɚɬɟɥɟɣ. ȼɵɞɟɥɹɸɬ ɬɪɢ ɛɪɸɲɧɵɯ ɪɟɮɥɟɤɫɚ: ɜɟɪɯɧɢɣ, ɫɪɟɞɧɢɣ ɢ ɧɢɠɧɢɣ. ɒɬɪɢɯɨɜɨɟ ɪɚɡɞɪɚɠɟɧɢɟ ɤɨɠɢ ɠɢɜɨɬɚ ɩɚɪɚɥɥɟɥɶɧɨ ɧɢɠɧɟɦɭ ɤɪɚɸ ɪɟɛɟɪɧɨɣ ɞɭɝɢ ɜɵɡɵɜɚɟɬ ɫɨɤɪɚɳɟɧɢɟ ɦɵɲɰ ɠɢɜɨɬɚ ɢ ɫɦɟɳɟɧɢɟ ɩɭɩɤɚ ɜ ɫɬɨɪɨɧɭ ɪɚɡɞɪɚɠɟɧɢɹ – ɷɬɨ ɜɟɪɯɧɢɣ ɛɪɸɲɧɨɣ ɪɟɮɥɟɤɫ. Ɂɚ ɧɟɝɨ ɨɬɜɟɱɚɸɬ ɝɪɭɞɧɵɟ ɫɟɝɦɟɧɬɵ (Th7–Th8) cɩɢɧɧɨɝɨ ɦɨɡɝɚ.
ȼɢɫɰɟɪɨɦɨɬɨɪɧɵɟ ɪɟɮɥɟɤɫɵ ɜɨɡɧɢɤɚɸɬ ɩɪɢ ɫɬɢɦɭɥɹ-
ɰɢɢ ɚɮɮɟɪɟɧɬɧɵɯ ɧɟɪɜɨɜ ɜɧɭɬɪɟɧɧɢɯ ɨɪɝɚɧɨɜ ɢ ɩɪɨɹɜɥɹɸɬɫɹ ɜ ɜɢɞɟ ɞɜɢɝɚɬɟɥɶɧɵɯ ɪɟɚɤɰɢɣ ɦɵɲɰ ɝɪɭɞɧɨɣ ɤɥɟɬɤɢ, ɛɪɸɲɧɨɣ ɫɬɟɧɤɢ ɢ ɪɚɡɝɢɛɚɬɟɥɹ ɫɩɢɧɵ.
ȼɟɝɟɬɚɬɢɜɧɵɟ ɪɟɮɥɟɤɫɵ – ɷɬɨ ɨɬɜɟɬɧɚɹ ɪɟɚɤɰɢɹ ɜɧɭɬɪɟɧɧɢɯ ɨɪɝɚɧɨɜ ɧɚ ɪɚɡɞɪɚɠɟɧɢɟ ɜɢɫɰɟɪɚɥɶɧɵɯ ɢ ɫɨɦɚɬɢɱɟɫɤɢɯ ɪɟɰɟɩɬɨɪɨɜ. ȼɟɝɟɬɚɬɢɜɧɵɟ ɰɟɧɬɪɵ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ, ɪɚɫɩɨɥɨɠɟɧɧɵɟ ɜ ɛɨɤɨɜɵɯ ɪɨɝɚɯ, ɭɱɚɫɬɜɭɸɬ ɜ ɪɟɝɭɥɹɰɢɢ ɤɪɨɜɹɧɨɝɨ ɞɚɜɥɟɧɢɹ, ɞɟɹɬɟɥɶɧɨɫɬɢ ɫɟɪɞɰɚ, ɫɟɤɪɟɰɢɢ ɢ ɦɨɬɨɪɢɤɢ ɩɢɳɟɜɚɪɢɬɟɥɶɧɨɝɨ ɬɪɚɤɬɚ ɢ ɮɭɧɤɰɢɢ ɦɨɱɟɩɨɥɨɜɨɣ ɫɢɫɬɟɦɵ.
ȼ ɩɨɹɫɧɢɱɧɨ-ɤɪɟɫɬɰɨɜɨɦ ɨɬɞɟɥɟ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ (L3–L4, S3–S4) ɧɚɯɨɞɢɬɫɹ ɰɟɧɬɪ ɞɟɮɟɤɚɰɢɢ, ɢɡ ɤɨɬɨɪɨɝɨ ɩɨ ɩɚɪɚɫɢɦɩɚɬɢɱɟɫɤɢɦ ɜɨɥɨɤɧɚɦ ɜ ɫɨɫɬɚɜɟ ɬɚɡɨɜɨɝɨ ɧɟɪɜɚ ɩɨɫɬɭɩɚɸɬ ɢɦɩɭɥɶɫɵ, ɭɫɢɥɢɜɚɸɳɢɟ ɦɨɬɨɪɢɤɭ ɩɪɹɦɨɣ ɤɢɲɤɢ ɢ ɨɛɟɫɩɟɱɢɜɚɸɳɢɟ ɧɟɩɪɨɢɡɜɨɥɶɧɵɣ ɚɤɬ ɞɟɮɟɤɚɰɢɢ. ɉɪɨɢɡɜɨɥɶɧɵɣ ɚɤɬ ɞɟɮɟɤɚɰɢɢ ɫɨɜɟɪɲɚɟɬɫɹ ɡɚ ɫɱɟɬ ɧɢɫɯɨɞɹɳɢɯ ɜɥɢɹɧɢɣ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ ɧɚ ɫɩɢɧɚɥɶɧɵɣ ɰɟɧɬɪ.
ȼɨ 2–4-ɦ ɤɪɟɫɬɰɨɜɵɯ ɫɟɝɦɟɧɬɚɯ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɧɚɯɨ-
ɞɢɬɫɹ ɪɟɮɥɟɤɬɨɪɧɵɣ ɰɟɧɬɪ ɦɨɱɟɢɫɩɭɫɤɚɧɢɹ, ɨɛɟɫɩɟɱɢɜɚɸ-
ɳɢɣ ɧɟɩɪɨɢɡɜɨɥɶɧɨɟ ɨɬɞɟɥɟɧɢɟ ɦɨɱɢ. Ƚɨɥɨɜɧɨɣ ɦɨɡɝ ɨɫɭɳɟɫɬɜɥɹɟɬ ɩɪɨɢɡɜɨɥɶɧɨɟ ɦɨɱɟɢɫɩɭɫɤɚɧɢɟ.
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ɉɪɨɜɨɞɧɢɤɨɜɚɹ ɮɭɧɤɰɢɹ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. ȼ ɫɨɫɬɚɜ ɛɟɥɨɝɨ ɜɟɳɟɫɬɜɚ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ ɜɯɨɞɹɬ ɦɢɟɥɢɧɨɜɵɟ ɧɟɪɜɧɵɟ ɜɨɥɨɤɧɚ, ɫɨɛɪɚɧɧɵɟ ɜ ɩɭɱɤɢ ɢ ɨɛɪɚɡɭɸɳɢɟ ɩɪɨɜɨɞɹɳɢɟ ɩɭɬɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ (ɪɢɫ. 3.11). Ʉɨɪɨɬɤɢɟ ɚɫɫɨɰɢɚɬɢɜɧɵɟ ɜɨɥɨɤɧɚ ɨɛɟɫɩɟɱɢɜɚɸɬ ɦɟɠɫɟɝɦɟɧɬɚɪɧɵɟ ɫɜɹɡɢ ɢɥɢ ɫɨɟɞɢɧɹɸɬ ɧɟɣɪɨɧɵ ɩɪɨɬɢɜɨɩɨɥɨɠɧɨɣ ɫɬɨɪɨɧɵ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ. Ⱦɥɢɧɧɵɟ ɩɪɨɟɤɰɢɨɧɧɵɟ ɜɨɥɨɤɧɚ ɞɟɥɹɬ ɧɚ ɜɨɫɯɨɞɹɳɢɟ, ɢɞɭɳɢɟ ɤ ɪɚɡɥɢɱɧɵɦ ɨɬɞɟɥɚɦ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ, ɢ ɧɢɫɯɨɞɹɳɢɟ – ɨɬ ɝɨɥɨɜɧɨɝɨ ɦɨɡɝɚ ɤ ɫɩɢɧɧɨɦɭ.
Ɋɢɫ. 3.11. ɉɪɨɜɨɞɹɳɢɟ ɩɭɬɢ ɫɩɢɧɧɨɝɨ ɦɨɡɝɚ
ɋɥɟɜɚ ɬɨɱɤɚɦɢ ɨɬɦɟɱɟɧɵ ɜɨɫɯɨɞɹɳɢɟ, ɫɩɪɚɜɚ – ɧɢɫɯɨɞɹɳɢɟ ɩɭɬɢ. Ʉɪɭɠɤɚɦɢ ɩɨɤɚɡɚɧɵ ɦɟɠɫɟɝɦɟɧɬɚɪɧɵɟ ɩɭɬɢ. ȼɨɫɯɨɞɹɳɢɟ ɩɭɬɢ: I – ɩɭɱɨɤ Ƚɨɥɥɹ; XI – ɩɭɱɨɤ Ȼɭɪɞɚɯɚ; ɏ – ɞɨɪɫɚɥɶɧɵɣ ɫɩɢɧɨɦɨɡɠɟɱɤɨɜɵɣ ɬɪɚɤɬ Ɏɥɟɤɫɢɝɚ; VIII – ɜɟɧɬɪɚɥɶɧɵɣ ɫɩɢɧɨɦɨɡɠɟɱɤɨɜɵɣ ɬɪɚɤɬ Ƚɨɜɟɪɫɚ;
IX ɢ VI – ɥɚɬɟɪɚɥɶɧɵɣ ɢ ɜɟɧɬɪɚɥɶɧɵɣ ɫɩɢɧɨɬɚɥɚɦɢɱɟɫɤɢɣ ɬɪɚɤɬ; XII – ɫɩɢɧɨɬɟɤɬɚɥɶɧɵɣ ɬɪɚɤɬ. ɇɢɫɯɨɞɹɳɢɟ ɩɭɬɢ: II ɢ V – ɛɨɤɨɜɨɣ ɢ ɩɟɪɟɞɧɢɣ ɩɢɪɚɦɢɞɧɵɣ ɬɪɚɤɬ; III – ɪɭɛɪɨɫɩɢɧɚɥɶɧɵɣ ɬɪɚɤɬ; IV – ɜɟɫɬɢɛɭɥɨ-ɫɩɢɧɚɥɶɧɵɣ ɬɪɚɤɬ; IVɚ – ɥɚɬɟɪɚɥɶɧɵɣ ɜɟɫɬɢɛɭɥɨɫɩɢɧɚɥɶɧɵɣ ɬɪɚɤɬ; VII – ɨɥɢɜɨ-ɫɩɢɧɚɥɶɧɵɣ ɬɪɚɤɬ
ȼɨɫɯɨɞɹɳɢɟ ɩɪɨɜɨɞɹɳɢɟ ɩɭɬɢ ɩɪɨɯɨɞɹɬ ɜ ɛɟɥɨɦ ɜɟɳɟɫɬɜɟ ɡɚɞɧɢɯ ɤɚɧɚɬɢɤɨɜ, ɪɚɫɩɨɥɨɠɟɧɧɵɯ ɦɟɠɞɭ ɡɚɞɧɢɦɢ ɪɨɝɚɦɢ ɫɟɪɨɝɨ ɜɟɳɟɫɬɜɚ. Ʉ ɧɢɦ ɨɬɧɨɫɢɬɫɹ ɬɨɧɤɢɣ ɩɭɱɨɤ Ƚɨɥɥɹ
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