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TaK HaTpHeBble KaH3J1bl H OCliOBHOM paCnOJlOiKellbl D nepe>'B3Tax PaHBbE:', 3 B MC>KnCpeXBaTltoii o6J1acnt IiX 3Ha'IHTenbHO MeHbwe (Shrager, 1987; Meiri e/ al.. 1986). B 06Jl3CTHX, npl.IMbIKatoUJ,HX K nepexH3TaM PaHBLe, HMelOTCSI pa3nli'IHble THlIbl Ka:H1CBbIX KaIl3JlOB, 06J13..13IOWlfe 6b1CTpofi Hnll Me.D.,.1eHHml KHHeTHKOH. KdK Y aM<p u6HH , TaK Ii Y MJleKonHT310111HX HX nJlOTHOCTb YMeHbWaCTCij no Mepc Y.!laJ1eHIiR OT nepexBBToH PaHHbc (Grissmer, 1986; RIper, Schwarz. 1989). np.f B036y>K.il C - ItHH MlleJ1HIIOBOro JlepBHOro BonOKHa npoRe..1eHHe nJ1. oCYUleCTBJlReTCH 1I0CpCllCT- BOM JlOK3J1hHhIX TOKOR npH6J1H.nne.fJbHO TaK >KC, KaK }f Y 6C3\fHe.nIlItOBOrO HepBHoro 8UJ10KH3, (pHC. 4.4. a). OT.fJUI.{He MuenUHOBoro B0J10KH3 COCTOHT B TO\4. "ITO ero HCTO-IHIIKH 8KTHBHpYlOIIlero J10KaJlbHOrO TUK8 paCnOJIO>t<CHbl B ncpeXD3Tax PaHBbe (TO eCTb DIm HCOllHOpOllll0 pacnpe!leJ1enbi B,!1.0Jlb MeM(5paHbI aKCOHa). 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BceOUoCMJ1lOwaSJ llH- MU.aCJ1b BO.'tOKOU nypKHHhe npHBe.lI.eHB 8 pa60TC (DiFrancesco. Noble. 1 95). ()CIIIlII3""e cq>.1ua '0 40 Rcpx} WQ CCJULtA p"c. 4 15 11 ..... . 30:XpotlHblf oManH aKTtflJ.aWtH nCBoro (J1)K) H npaBoro (n)l( ) )KCJ1 Y. OIlfKOB CC p :DJ.&a 'lOBeMa 00 BJ)eMPHH ,." pTlfTe BHHM3HHe H3 nOlrm JaMKH}'TYIO 30H}' I<THB<4IUUf. COOToeTCTBYIOfO MOMC H 1Y Boe rr ,iO MeeK. C4UTaR OT MOMeHTa 3anycKa QRS-Ko\1n.1eKca. phy ..3B{,JJ.0 c H3MIICH.fRMH no OO:1opy R. Plonscy ''The Biophysical BasiS for Electrocardiogra- tal   (',.,t,cal Re'lews in Bioengineering. I. No. I, p. 5, 1971 H no CTaTbe D Durrer t,t aI. "To- HHJj c hon ofthe Isolted HUH1dn Heart,': Circulatiofl, 1970,41,899-912. npHBe.n.eHo C pa3perne- P peW€'1II1R H3MTe.nbCTBa The ChemIcal RubberCo. u American Heart Association,lnc. 
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TaK \frO B036Y>M.etme He MO>t<PT npoliTH OT npCllcep.IJJm K >t<e.nyn.01fK8M. npe.1CepJIHH H )Ke.rryn.OIJKH COKpawaIOTCS1 tte33BuCHMO. npHleM iKeJlY11.0tm ynpaBJ1RIOTCH 3KTOIIHLleCk.IfM (OTJlHlJ- HbiM OT HOpMaJlbHOIO) BottlfTeneM rHTMa. (6) npe..lCep;J.HO-iKeJ1yn.oll K O BaH 6J10Ka.D.a B noope>t<- .neHHOM Y3JIe (HanpHMep. H3-3a peBMaTH3Ma H.'1I1 BUPYCHOli HHcpeKWlH). XOTSI KaR BOJIHa 003- 6YWJleHHH IIpe.acep)1.HH ,:lOXO,1HT )1.0 >KeJlY.IJ.o4KOB. 3a,nep>KK3 B AB-Y3J1c cYllleCTBeHHo B03pacTa eT . npOUCAO,lUtT HenOJ1HaR aTpHooeHl pIlKyJ1RpHttR 6nOKaJIa (6AOKuoa cepol4 Q nepaou cmeneHu) nocnpoH3Be.n.eHo C .UMenefUlRMIi H.:t KHHni Brendan Phihhs, The Human Heart, 3nJ ed.. St. Louis: The C.V. Mosby Company, ID75). 
160 4 nplt1POAA 61t10nOTEHu.IIIAnOB 4.6 3nEKTPOKAP.QV10rPAMMA (3Kr) 161 JlITb Hwe\UIlcCKYIO 30HY C 33Me,.VJeHHblM npUBJeHHfM Bce no TO" >Ke np"'HHe _ 33MC1J1 eHHC npOBClICHHH n03R0J1ReT yacTKa\t \tuOKapJJ.a paHbwe BpeMeJ-nt 8bJflTH "3 pecppaKTepnoro COCTOHHHH. TaK B03H1iK310T 33MKHyrble neT.1H U,HPKYJ1HTOpIlOro B036y>K!lelUfR. Cnopa.7Jf'lCCKHe UHPKYJUUJ,lUf B036Y>K.LlCHHH npHBO!J.RT K 3Kcmpa- (llCI1l0.rlG J 4' (BHeOllepe.QIIOMY COKpalll.fHHIO) KpOMe TOro, YLiaCTOK IlHpKy.rmpYIOlll.ero B036y/l<..1eHHH CTaHOBHTCSJ KTOnH'iCCKtiM 4>0KYCOM. npUBOlrnWHM K yqaUleHIUO pln- Ma (maXIlKQPOUJl). )C r  III rMa 11\)I'MI1 ')Io."TOJlH'fCCh"DC OOICpWIICtlHe PMC, 418 HOpM3.nbH3R 3Kf C nOCJ1e..l,YIOIlUlM !UrrOnJi'leCkHM cOKpaWCHJle. <1>OI<)'C B036}?f\Z1CHIUI 1I'I1i j",mOI1WleClcuii 800wne tzh pUnLwa B >Ke.ny./to4I<e HJIH cneLJ.U8J1H3IipoaaHHoH npOBOmtWell CJiCTCMe MO>KeT cal\1Qnpmt3Ro.TJbHO B036y>K:1.aTbC1l, BbI3blBaR BHeoqepe.lI.Hoe coKpBrncHHe (XUgUU'lKOOYIO 3KCmpaCl1CmOJf!l .3C), KOTOp3f1 HapylllaeT HOp\ia..1bHbIA pHTM. Bocnpolt3Be.!leHO H3 KHlirll fireml3n Phihbs, The Human Heart, 3m ed.. st. Louis: The c.\'. l'<\osby Company. 1975). (a) (6) PMC. 4.19 (a) [JapOKCH.Ma.nbH3f1 TaXHl<ap!lHR 3KTOmtlJeCKld1 <POk.)'C MOiKeT nOBTopHO pa3pS1- iKaTb B (')blCTPOM peryJlRpHOM plfTe B TflJeHlif MHH)'T, lJaCOB H .J,a>Ke ./tHeA. (6) TpcneTtlHHC npeAcepltHA. npe.ncep.nHR npOH3BoJt.RT OleHb 6b1crpble +:XJ10nalOllllte» .llBH>t<eHnR C 'iaCTOTOn co. I<pameHUH OT 200 JJ.O :100 Y..'l.3pOB B MHHyry. nocnpOJi3Rt.lleHO c H3MeHeHHflMH Jt3 KHHrH Brendan Phibbs, The Human Heart. 3rd ed., 51. Louis: The C.v. Moshy Company. 1975). HopPoI3 QRS QRS   (6) PHC. 4.20 (a) 4JJi6pIfJJJJS1UHH npe.n.cep!1.HA. npe!lcep;ulSl npeKpClwdlOT CBOH perymlpHble COKpa- 1U€'IUIH H Ha l UtHtHOT cJlaoo H 6eCnOpH..'l04HO nO.J.epniBaTbC. Ha 3Kr nOB '1f1IOTCSI HH3KoaMnJUt- 1)'.lJ.HLlC Hepery.'1f1plJble BOJlHbI, COnpOBO>f\IJ.31OUUie <lHl6pUJJJIUUIO. 3Tor THn 3HOM3JlbHOH 3Kf 610>1(110 JlerKO OTJllIllJiTL OT naro.rrorHlJeCKOA 3Kr c perymlpHblMU P-.iy6uaMH. BO:iHJiKaIOUUlMH npH Tpen€'TClliUH npe.n.cep;uli'l (1JIfC. 4.19. 6). (6) $u6pnJlJlflWIH .)KCJJYllOlJKOB. .iKeJlYllOlJt\iI cOKpawa- IOTCfI cna()o H p36aJlaIlCJlpuBdHHO. Cepn.u.e nepecraeT nCpCK34tlBiUb I<pOBb. 3Kr nplf06per8cT IICJ'fryJlSlpHblA BI11 BocnpOJDDC!leHO C li3etteHIIHMH 113 KHHrH Brendan Phibbs. The Human Hearl, 3rd ed.. St. Louis: me C. V. Mosby Compdny, 1975). <l>HOp}11nJlUHjI >KCnY.J.O'lKOB QRS-KOMnnCKC bIOO Jy6 uoB P HUpMd  (a) napoKCJnMaJ1WaJ 1llXHKap;nUI TpeneT3Hlle npe.J.ccplluR BIU1J1HHE HWEMJ.1J.1 HA n.q KAP.QOMJ.10HTOB .. 6 aCTU flpu 33Me,.VJefllHl pacnpocrpaHeHuR B036Y>K..'J.eHHH no HWc\tulecKoH 0 J1 e B03HHKaeT ape\4R JJJ1R BoccraHOBJlfHHH BO.:l6Y..lHMOCTJ1 IfHTaKTl101i 06J1aCTU nocJle o pC<j>p8KTcpHoro COCTOflHIlR. TaK TO nOflBJlReTCH BO.JMOIKHOCTb ee RHeOLJepe,D.HO B036Y>K:leHHH. B CBOtQ OLiepfllb, .:ITa (" HOpM3JlbH8f1) o6J1acn Mo>t<er 3allOBO B036y. OCO()bJ;1 Hllrepcc Bbl3hlBatOT H3MCHCHHH .pOpMhl BUYTpn- H BHCl<JleTOHhI)' nOTeH- UHanoR npH HweMUH (pHC. 4.21). B n03.D.HUH nepHOJ1. HweMUH (a03J1HKaeT 'iepe3 HecKonbKo MHHyr oocne nepeRR3KIf KopoHapHoH aprepltH) YMeHbwaerCR BcnHli- Ha nOTeHlUfaJJa nOKOf!. CKOpUCTh HapacT3nHH nepe,D.Hero poHTa nomCH11llQJlQ detJcmoUR (nn.), ero 3Mn.nny.aa Ii JI.J1HTe.FJbHOCTL. CHIHKfHHe CKOpOCTI'I HapacT3- HHR nepe!lHero 4>poHTa C.FJY>KHT npH3HaK()"d CHHiKeHIHt CKOpOCTH npOBe.aeHHR n.n. n HUJe\fH'leCKOH 30ue. npH HUleMIUt T3K>Ke H3MfHHeTCR HaKJlOH <j>a3LI nJiaTO nfl. 3 TH H3MeHeHHH OpMLI nll 8b13h1RUOT H3MeHCHHH HOJlfH RHeKJreTOllHbJX nOTell- lU1BJlOR. 06pa30BdHHblX MHoruMH Kap'J.HOMIfOlun3MH. rIOJ1H 3THX HlUeMU'leCKIfX ItJIeTOh. TatOKe KaK It nOJIH HOp\i3JlbllbiX KJIeTOK, ;lJlre6palieCKIf CK:laJ,1bI8£JtQTCH B TpeXMepHOlf npoBO.QRweH cpe.Qe, npHBOllR K ItJ'\1CHCHUHM tpOpMbI >Kenyn.04KOBoro KOm.leKCd ;:)Kf (QRS. S- T cerMcH fa H.1H T -3y6ua, KaK nOK33aHO Ha pHC. -1.1  H PHc. 4.21 ). 
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Ka.\lCpd UCIITpa..lb1.Wl lI'In ").lCICTpO..1 KOIITDKTlfOll JIIunw ('0Cj 1HC11U1 ofXJ.IO1(8 >KH(X)8aJI H KOC1AlldJI T1Ca1n. rna-nIHut.I '3Pf (a) HOpM8 - HweMml QHS QRS QRS o.Lr-.......k........k. (6) KOHTpMb nO.!lbeM S- T YrnCTcHne T-Q HHTcpBana HHYCPB8.18 + nO;1bCN S- T HKTepBaJIU PHC. 4.21 (a) nOTeHWtaJIbl.J.eHCTBHH. OTBC,J.CHHblC OT HOp\laJ1bHOro (cn..10WII3R .'IHHHR) Ii HWe\1H'le- CKOro (npcpbIBHCTaSl_IHHHH) MHOKap.iJ.a COOaKH. KOffTpOJ1bJlaJI JaIlHCb r.n.e.1aHa nepe.1 OKJ<.!H03Iteif KOpo- HilIJHO{. apTCpuH. (6) B KOH rpOJ1e (.!10 OKKJII03IU1 KopoHapllOI1 aprepm) HeT CJJ.BHr s- T ItHTepMJ1t1, B TO BpeMH KaK nOCJ1e IIwe"uttl TaKOI1 CJlDJfr nOflBJ15IeTCS1. OCHoaalio ua .nautiLIX pa60Tbi Andrew G. Wallace. "Electrophysiology of the \YO('tlrdillm." nplfBe!l.eH- HOH B KJ-mre Clinical Cardiopulmonary P1'ysi%gy, 3rd ed. New York: Gn.me & Strntton, 1969, a T3IOKC Ha ,W)/UJblX paOOTbI W. E. S3mpson. H. M. Scher. 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170 4 nplt1POAA 61010nOTEHIIIAI10B 4.8 anEKTP03HUECI>AIlOrPAMMA (33f) 171 Bepx _ c'"Hn ",()')I' n OCT11CHTpaJlbHaJI Ifl8t1nHff8 (HecneuH4>HlfecKHe ltBn raTeTen loHblC CBOHCTaa) '" " npoMnnlD"tH 'l403r \ -() -y , , IICIpC..1J1HR ... - one.1 3an.mO'fHaJI _r; ,A0111 I I I . . . , . , - . 3peHHe !. . . I '-_. ACCOl.1H:rTItBltaJi ,; 3pHTe.1laH8J 06nucTb MOC1 UellTpLJ,,"wA .. O1.1e.'& ..---- 11('XJ.tO. Il OUTL1R M03r f , Ihl3 \ , Kay.1I.'..HWA OT1eJl MU.mC'lOK C11YXOBM aCCOUH8THBHaR 06..18CTb (0)  CJI <"lea: PM(. 4.25 Kopa ro.'10BHoro Mmn HMeeT ljenpc .ao..'1H ('o6Hy1O, TeMeHH}'IO. BHCOLJH}'JO H 3aTbIJI- H}1O), a TatOKC UeKTpaJIbHy10 H .MTepaJlbHYKJ OoPOJAbI. 06a3HatteHHR Ha pHcyHKC: central fissure _ LleHTpaJ1blfaSi (S0P03l1a: longitudinal fissure - npollOJ1bHaR w.eJlb 60J1bWOro M03ra; frontal lobe - CPPOH' TMbH3H AOJU1; parietal lobe - TeMt"HHaA .nO.tlSI; sensory area - ceHCOpHaR 06.naCTb (.a.rm HecneUHq>H1fe- CJOO: oll.t\'Wemu't): motor area - MOTopua 06.rJal"Tb: premotor association area - npeMOTopHaR acco- Wft.lTHRHast oO.'IaCTb; sensory association area - ceHCOpHaJl CCOUH3THBHcm 06.naCTb; lateral fissure - .'JBTepanbHaA OoP03lJ.a: hearing - cnyx: tempordl lo1Je -BHC04HaSiJlo.nR. BocnpoH3Re..'.\eHO H3 KHHrH A. B. McNaught. R. Callander. IIIlIstrnted Physiology, 3rd ed., 1975, Edin- burgh: Churchill Livingstone. HCnOJlb30BaHO c paJpeweHHR If1J;neJ1bCTBa ChurchiJILivingstone. II t:J'"4lePH'fecKIiA "ere  1 rtO'l)wapwe 4eTBep1'W1l )ltC.'Y.1MCIt ') CnMHlloA \4OJr I Ta.14L'4)C -, r +- 1 .Incxo,1aJIIH" CIIH 1I0T&.1a.'" H'fCCICH It TpaKT Ta."I&\IO)(op'TMIClJlItHU :&) 'IIIC'TOC'n 06pdTHOii 3aD.aH. no KOTOPOMY BbittHCJ1RIOT 3HatjeI-UiH nOBepXHOCTHbiX nOTeHUHa- nOB HCXO!1H 113 npe.n.nonO>Kellml 0 cBoikTBax 3JteKTpH4eCKoro HCTO"iHHKa BHYTPH OCi"heMHoro npOBo,nHHK3. npu 3amiCH MHHHaTlOpHblX nOTeHUHaJlOB. OTp.d>t<aK>IllHX aKTHBHOCTb OTHOCHTC.!lbHO MaJ1b1X OO"beMflLlX HCTOHHKOB TOKOB (no.ll.o6I1bJX HCPB- IIbI\f B0J10KHaM cneUIfq,HtjCCKHX cnHHHOM03rOBbiX TpaKTOB), Tpe6yeTcR J1CnOJJb30- BaTb McrO!tbl ycpe'J.HeHIHJ (naKonnfHHR) CHrH3JJOB. Ha pHC. 4.8 H306paiKeHa CTH- "'YJlHIUUI CepeJlHHHoro HepBa H penlcTpaUHR COCTaBHoro rur C PYKH 60J1bHoro. AK- THBaUHA CCHCOpHblX BonOKOH cepelllHllloro HepBa npHBOJlHT K nepena"lc CHrHaJtoB B rOJIOBHOH M03r no BOCXO,aHlilHM cOM3roBHCUepaJIbHbiM ceHcopHblM nYTSJM (Ha PH- CYHhe lie nOKa38Ho). BllOJIb 3THX nyreA MO>KHO Jam.fC8Tb ycpeaHeHHble 8bl30aH- Hrxe nomeH/uaAbl (TO eCTb nOJ1YLJeHHble ycpe.llHeHlieM MHorHX nOBTopHeMblX CHr- HanOD), HaBOllliMblC HB nOBepXHOCTH TeJU:I B'1.0J1b BOCXOllSJ1UHX nYTCH. BKJlKJaH cnliHHOH M03r, CTBOJ1 H KO p y ronOBHoro M03ra (O().rt8CTb nOCTuetnpaJJbllOH M03ro- BO" H H3EsH'IHllbI). npH 3TOM CJlcAyeT HTblBaTb nepexo dKCOHOB BOCXOD,HWero nYTH tia npOTHBOn0J10>KHYto OT CTHMYJJ"UHH CTOPOHY cmfHHOM03r080ro KaHBJlB. Ha na- paeTpbl' Bbl3BClHHblX nOTfHUHClJlOB MHHHbJX HepBHblX nYTeH CYllleCTBeHHblM o6pa- 30M BJ1HUOT CJJe1Y}()WUe <l>tlKTOpbl: (a) reO\ieTpHfI HCpBHblX TpaKTOR (8 43CTHOCTH, laJ]H'lHe H3rnOOB), (6) 3J1eKTp....JCCKOC cOnpOTHBJleHlie oKpY>KatOwero 06 beMHoro npoaoAHHKa, onpellenHcMoe ero reoMeTpl1eH .. YJ1.CnbHblM conpOTHBJJeHHeM. npn la) PHC. 4.24 (a) AHaToMH4eCKHe CBJl3H CTB0J100bIX CTpyKT)'p M03ra (npOOJTroBaToro. MOCTa. cpeAHero e H npoMe>t<yrOI.lHoro M03ra) C KopoA fOJIOBHOrO MOJra H MOJ)KeI<OM. 06w.He aliaTOMH1.JeCJme Hanpa : HHJI opHeHT3UHH B HepBHofl CHLIeMe nOKB3aHbllfa pm..j'HKC CTpC..'1KaMJf. POCTpaJ1bHOf (I< rOJlOBe). _ Y .n.a..rtbHDe (K XBOC1)'), llOpcanbHoe (K cnHHe) H oeHTpaJ1bHOC (I< rpy.QHOH noeepxHOCTH) Hanp8w.!cl OTHOCRTCR K CTBany M03IG, a ocraJJbHble HanpaBJ1eHHS1 - KO BCeMj' MOJl)'. TepMHHbI Me,.w3J1bHbnt ( K pe.IIHHHblH) H narepanbHbln (601<000.1) 03Ha\J31OT O.'llt30CTb .UIII OTD,aJ1eHHOI..."'Tb. COOTBeTCToeHIIO, CpeJ1.HeH OCH M03ra HJIH OT Hec. (6) YnpowcHH3H .!lHarpaMMa W1C nOKi1.3h1MeT THnHI.IHble 06l.lUi e 'lj'BCTBHTeJlbHble 1l}"TH OT IICpOHI.IHblX nepmpepH'JeCKHX celtCOpHblX Hei1poHoB K ro.nOBHOMY M0311 (Tpe- THH HCHpuH). O()p3THTC UHHMdHIIC, I.lTO aKCOU BToporo HeiipoH(t (2) ceHcopHoro TpaKT3 nepexQ!lJ1T H3 npoTl-IBonOJ1o>KIlYtO croPOH)' cmtlliloro M03ra. . P.tCVHOK (a) BocnpOH3De.LleH C U3MellemtRM1 "3 PYKOBO!ICTB3 HdfT)' E. Thornds. Handbook of  medicallnslmmentation Gird Measurement. 1974. p. 254 H Ony6mfKOBaU C pa3pemellHst LW CT8a Reston Publishing Company, Inc. 
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Physiol.. 1975, 251, I-59. 4.25 YCTaHoBHTe CBH3b BOJIH 33r, 3anHcaHHbiX C nOBfpxHOCTH KOpbl, Ii 3KTHBHO- CTblO KUpKOBbiX HeHpoHoB. 4.26 06cY.!UfTC B OCSWHX TepMliHax I<OHCTPYKUl1tO cneKTpanbHoro 8H2JUi3aTop2 D.J1H 8BTOM3ntyeCKOrO 3Hamna AOJlH 33r. 4.27 KaKItM o(5pa30M TeopHR 06"beMHOrO npOBOD.HHK2 MOlt\eT nOMO"lb np" aH8J1H3e nOTeHllH2J10B KOpbl rOJlOBHoro M03ra. Bbl3RcUfHblX IIUBTOpHblMH cruMy.TJarvUi (HanpHMep, .:mYKoDbIMH un.. cBeToBbIMH)? 4.28 Pa3pa6oTaifre ynpoweHHYK> CHcrCMY 3J1eKTpOlloB .D.J1S! pentCTpaUHH 33r, COCTOHWYIO Bcern H3 4 rOJIUHHbJX 3neKTpoAoB H OAHoro YJl2J1eHHOro pe4»e- peHTHoro 3J1eKTpU.n.a BMCCTO CT311n.apTHoH CHCTeMbl, nOKa3aHH0I1 Ha pHC. 4.28. npCAYCMoTpHTe B Hcii Hco6xo.D.HMhle nepeKJIIO"IaTCJlH II conponiB.'Ie. HUS! lIJ1Sl Toro, QTo6b1 6blJlO B03MO)KHhJM OCYll..lCCTBHTb OD-HUM !Uiq>tPepeHuH- aJ1blfl.Hf YCHJ1HTeJ'1eM JlIO()OH BHI!. perHCTpau.Hu 33r (MoHOnOJlSlpHbIH. 6Hno- nftpHbJii H MOHononHpHblH OTHOCHTCJlLHO cpelluero nOTeHl..{HaJla). 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