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I B. II. Jl C H II H. DOJIlloe coupaHlIe COTIIIH{>lIllii. T. 29, CTp. 152-153.


,5




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'IE'IIlU,lIT CnTIMOR TII
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'leUIJH B pa:mLIX 'IaCTHX 06'J,Clna. OTCIOlla IIOJIHTIIO.
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12




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O)J;HH CHIIMOI
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I I I I I I I 1\ I I I I I


Pnc. 20. HOMOrpal\lMa p;nlI onpcp;enenlllI npel\lenn YABoemm 06'LeMa lIIapOBIlp;lloro 06pa

aOllanlllI B nerKOM.
He06xoAllMO npoBecTll nplIMYIO JIllnBlO Memp;y P;BYMII TO'lKaMII: na Bepxneii IIII:aJIe - TO'l-
IWM, cnOTncTcTBYlOm:cii OTHOWCII\lIO AIIaMI'TI)(1II Tl'lleli lIa noeJII'AYI01l\e
1 (d 2 ) II npcAlJIe-
CTBYIOIqCM (d.) CIIJIMI{aX; lIa HIliJ\Hen lIII{aJIe - To'nwii, COOTBeTCTBYIOIqeu 'lllCJIY p;neM
nepepbllla MemAY cpannllBaeMbiMll CHHMKRMII. nepeCe'lenlle nplIMoii co cpeAHeii IIIKaJIOB
(13J'O) 1l00mahlBaeT BpeMII YAIIOCHIIH OO'LCl\1a n AlUIX.


B JIerI\OM MmneT CTaTI, 3aTpY)J;HlITeJIbIILIM. AaJIee Ha IlOBTOpHbIX pelITreHo-
rpaMlIIaX IIe06xo)J;IIMO cpaBIIHTL BeJIlI'llIIIY u306pamelIlIH pa3JIJl'IHbIX 1:JaCTeU
rpY)J;nou KJIeTInI. ECJIII TeHL Il03BOHKOB 1I pe6ep Ha Op:HOM H3 CIIHMKOB 60JIL-
me, 'IeM Ha )J;pyrIlx, TO, O'ieBlI)J;IIO, OH 6LIJI np01I3Be)1eH IlPII MeHbmeM paCCTO-
HUIlU OT peHTreHOBCIWll: Tpy6KII )J;O RacceTbI C IlJIeHHOll. COOTBeTCTBYIOmyIO IIO-
npaBHY Hap:o cp:eJIaTL IIpn oqelIRe U3MeHelllIH BeJIIT'IIHILI TelllI oqara B JIerHOM.
YpOBeHb paCIIOJIOmeIIHH p:HatPparMLI CBlIp:eTeJIbCTByeT B II3BeCTHOll Mepe 0
BeJIll'IIIUe BJJ;oxa. PeHOMeII):\yeTcH conOCTallJJHTL CHIJl\nm. c):\eJlaHHbIC B O)1Hoii
II TOU me tPa3e )J;bIxaHHH.
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neCJIoama. no CHnMI\aM. IIpOJI3Be)J;eIIHLIM B U)IeHTIl'IHLIX YCJIOBIIHX, IIO B pa3-
HLIe neprrop:LI 60JIe3HII, II3MepHIOT JJ;JIaMeTp oHpyrJIOll: TeHH (eCJJU TeHb UMeeT
CPOPMY OBaJIa, TO 6epYT cpeJJ;Hce reOMeTpII'IeCKOe U3 H3n60JIbmerO H HalIMeHb-
mero ,J;IIaMeTpOB). "YCTaHOBJIeHO, 1:JTO O'IafII BOCnaJIenIUI YBeJIUqIIBaIOTCH ro-
pa3p:0 6bICTpee, 'IeM 3JIOKa'leCTBeHilaH onYXOJIb, a IlOCJlep:HHH B CBOIO O'Iepe)J;b
6I>ICTpee JJ;oGpona'IeCTBeIUIbIX onYXOJIeii. Ii onYXOJIeBII)IHbIX 06pa30BaHlIU.
llpnllHTO OlIpeJJ;eJIHTb BpeMH T 3a IWTopoe U:lY'laeMOe oGpa30BaHue yp:BanBaeT
cBoii 06'bellI - BpeMH Y)J;Boemm 06'LeMa (BYO). Ero BLI'mCJIHIOT no (IJOpMYJIe:
t


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eH1-IH pameTOB IlCnOJIL3YIOT HOMOrpaMMLI (pnc. 20). Cpe)IHee
IJpeMH yn;BoeHIIH 06'beMa lIIapOBJIlp:Iloro nepInpepnqeCKOrO paRa, IlO p:aIIIILIM
E. A. J1nxTelImTelllIa Il C. fl. MapMopmTeii:IIa, paBlIO 116::!::69 )J;Heii:.


45




nuc.rrontl blE CHIIl\IIHI (TOMOrJ
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OOLl'lHaH penrreIlUrpa:UlIW H!WJJ;CTanJIHeT c06011 TCI-IPI30C n300palI\eIIlH' Bceii
TO!IIi(Il llCC.lJl')1yeIlwro OG'I,('KTa. B Talwii cYMMajHlO1i ImpTlme 1J.300pamenJlHI
O
LHIfX )1f1Ta.'Icii TJaCTn'lHO 1IJIJI nOJInOCTLIO naIma):\LIBaIOTCH Ha [J:!oOpamenIIfI'
,!\pynrx. UO.:JTUM.Y ,IVUI )'f.lJYO.'ICflHOrO IIaY'lCIIlIH CTPYKT'ypLI .rrerKIIX n BLum.rre
HUH B nelll pa.mn'II1MX oopa30Bannll, pacnOJIOmenIlLIX na pa:moii rJIyonnc,
IUlIpOIW npHMCIHIIOT TOMorpmIJIIIo - MCTO,!\ penTrenorpa(IJlIli OTiJ,C,TIMILIX CJIOeB
OO'heETa. C 1I01l!UU(LIO CneI\IIaJILnOrO mTaTnBa IIJIIl cnCJ
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I\n, Ha J\OTOpLI
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IIJIII IIUCCT J[C'lCTIi:Illl, «paaMa3anIILIib) XapaI\.Tep.


IIJIan llaY'JellllJI nOCJIOllUOrO cnuJ\um JlerKIIX:


I. 0 (i Ii( n Ii 0 C MOT P TOM 0 r paM 111 LI: l) oL(elIl\a Ha'U'C'Tna CHlnIlm;
2) ulIpep:CJlerrne rrpocmunr IICCJIe)10BannH; 3) onpe)1CJlcnnp nanpaI3JIelIlHI «pa3-
lIIa3bIB8II lUV) , 4) On03II8naHIlC BbIlI;eJIClIHOrO CHon.
II. II3Y'lCJIIIe CTenOI\ rpYJ];noii llOJIOCTn: l) CTpYRTypa
MHrEH
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lIa(IJparl\lLI B I1LI)1CJICnIIOM C.rrOC;
4) COCTOnnIIC peol'pno-lI;lfarIJpafJIJam,HLlx ClIHYCOll.
III. II 3 Y
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peIIxnlllbI .,tcn\I1x.
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nmo ObIT!. J\onTpaCTULDl n PC:H\IIM. --ll pIlIIHTO C'IIIT
Tb, qTO p:OTaJIL naXOJ];IITCH
B Bbl)1enemWM CJIoe. PCJIU nOJIYTCHL, oupa3ye1l1aH Y ee IWHTypOB B CBH3n C
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B 3aBnCIUIOCTII OT YCTpOllCTBa TOllWrpa(]Ja IIa CUUlIIl\e BLI)1eJIHlOTCH CJIon.
paCIlOJIOa,elIlIbIC B npO]J,OJlbnO!l1 .!Ju60 B nepn12n)IIl1\YJIHpHOM nanpaBJICnmI 01'-
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llpn npo)IoJILnoii TOMorpadHlH JIenme MorYT OblTL nCCJIe)10BaIILI B IIpHlIlOii:, IW-
coii n.rrn uOIwlIoii npooIH
Iur. BBnJJ;Y Toro
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aIOTCn
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6pOHxe II oRpymaIOlI\eII ero TRanH. II pII BLlp:oxe 6POHXH IIpIl6JIllmaIOTCH P:Pyr
R ltpyry, YRopa1:JIlBaIOTCH n paBHOMeplIO cymJIBaIOTCH.
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men: 1) 06"beM U CTpYRTypa MHrRIlX THaHen IIUmHerO OTp:eJIa llIeu U rpY)J;-
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II 3BPpIOmIlIIHoro rrpOCTpaIICTBa.


69




4. II3Y'IeIUle .JIerRHX. Ha nuemmMe,n,IJaCTUUOrpaJ\l1\I<lX Bcer,n,a TI(wy'taeTcfl
11306paiRenne JICrHIIX. Ocoooe llJIIIMaIlUe Ha,n,o Y,I],CJIHTh TCJ\I OT):\eJIaM .Tlf'fI,nX,
[WTOPLIC npHlIfLJRaIOT I{ oom\pyawHHoMY II rpYP;Hoii nOJlOCTII onyxo;rIcno;1oG-
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70




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OTlIIe'IaeTCH paBHOMepnoe rrOHniKeHlle npO:1pa
IHOCTII JlCrO'IHLIX IIoJIeii -'-- :3TY
[IJa3Y Ha3bIlla1OT IWIlIlJl.TUljJHoii. AaJIce Hao.IJIO.o.aeTCfl BCHo:maH (l)a3a - Ha 4-
8-rr CeI{YII)J;e nOCJIe IIH'I.PHf\Un IWHTpaeTupYIOTCH JIerO'lIILIC BeJI1>I II JIenol'
npe.o.cep.o.lle (pIlC. 37). IIpll onpcp:eJlC'HTIJI (pa3hl IIIHTXOT(IITCfl, HOH("IHO. yqn
TbIBaTL, 1:JTO BBep:C'IIIIe IWHTpaCT-
HorO BC'lI\eCTBa OCYII\C'CTBJIneTCfl
He lIIrnOBeH1IO, II Ha aurllonYJIh- .
IIOHorpa:MMe, c.o.eJIa I-1II0 ii, Hanpll-
Mep, B EammmrpuylO qJLUY, MO-
ryT elI\e BblpnCOBLIBaThCH OT-
.o.eJILllI,u' IWIITpaCTIrpOl3HlIIIbIC
apTepna.ITbnhJe BeTO'IHU II YiKe
HaMeqaThCH OTp:e.TII,UbW Me.lIInm
BCHM.
BMeCTe C YCTanOB.TH'IIlICM (pa-
3bI 3arrOJIHPHIUI n3Y'II11OT TOllO-
rpa.pIIlo JICrO'lHLIX COCY):\Ol3 n pC-
rnCTpllpYIOT rpy6bIe OTH.ITOHeIlIlH
OT HOpMaJILlIOii E\apTIIIILI.
2. IbY'IPHlle CIfCTeMLI JIero'I-
ITbrX coeY)10n. Ha'IIIIIaIOT C aH3.-
.11113a cocy.o.ncToii CCTII B He.TlOM.
Onpc.o.eJIHIOT Tun neTBJIeHIIH CO-
Cy.o.OB, B3allllIOOTII01IIenllH cocy-
p:nCTbIX pa3BeTBJIeHIlll, OTMeqa-
lOT naTO.rrorn'leCI{IlC II:1l1iCJ-ICnnn
ClICTeMLI COCy.o.OB. B IIOpllfam,-
HUX yc..rronllnx paBHOMPpIIO 3a-
nOJIHHIOTCH HOHTpaCTnpOBanHoii
RpOBLIO f!(,E BeTBII JleroqIIoii ap-
Tepnn, a 3aTeM Bce JIerO'JI-ILIC
BCHbJ. 3aT('M lI):\eIITmJHUWPYIOT
COCY):\bI 1-3-ro nopH.o.IWB, 311-
nOJIlleIIHT.TP ROITTpaCTJIT.TM BC-
meeTBOM. PeHOMeIlJJ;yeTcH IlpO-
p;eJIhIBaTb 3TO l3 oupe):\e.rlenlwii
nOCJIe):\OBaTeJILHOCTII, lIa'JJJJIi1H
co CTBOJIa .rrero1:JHOrr apTepnlI. Ou
BMfll3JIflCTCH rra nepnbIX aHrIIO-
IIYJII.IIIOIIOrpallll\JaX B BIl.o.e lIIII-
pOIwii IIIITenCIlBHoii TeMHoii lIO-
JIOCLI, HBJlHIOlIJ;eiicH II IW 111 Lll\1
npO;O:OJliK13HIICM JIerO
IIToro HOUy-
ea. CTBOJI apTPpnn HanpaBJIHe'f-
cn Imepxy, [{.Ia.o.n II Hl'CHOJILIW
ImeBO; TCIII, ero 'IaCTIPIHO
lIaEJIajJ.LIBaCTcn na .1IeBYJO no-
;IOBUHY H300pmHemH1 rpyp:lIoro OTl1eJIH lIo:mOJIO'lHInw. AmIlIa CTDOJI3.
JHJrO'lIlOIl apTepIIII Y B3pOCJlOro 'IeJIOB('IW B cpe
HeM paBIIa 3 CIII, mIl
pmw 2-3 CM. H a ypOBlIe V-VI rpy.o..HLIJ.. HOJUOHIWB CTBOJI )J;eJIHTCn
I10;O: TYIlMM yrJIOIlI Ha npaBYIO II JIeBYIO BeTBI!. Ha alirIIOIIYJIbMOIIO-
rpaMl\IP B rrpH)wii IIpOC'I\l(IIH caM CTnOJl II ;:J;Be ero OClJOBHLle neTBn 06pa3Y1OT
qmrypy, lJaI10MIIIIaI011IYIO OYlmy T. Aance paCClIfaTIJlIBalOT 1I30fipafl\eIIne npa-
)'oii OCHOBIIOii BCTBII n n3Y'la1OT xapaHH'{J pe ,l],p.rreIII IH. 8Ta BeTBL n.o.eT nO'ITH
ropJI30HTaJIhHO BllpaBO II y upaH cpe;:J,UHllOii TPIlII O'1';:J;aeT BPpXHe.n;o.lellYJO ap-
TeIJIlIO. IIo.rn..lyncI, CXCMa:MII CTpoeHIIH CUCYl\UC.TOii ceTn JIenHIX «('lIf. IHlC. 10),
!\WilinO OJT(I3UaTb lice TIHI ccrMNlTaIHlhIC apTeIJJIIJ. OTXOJIHlIJ;ne OT CTBII.1Ia Bl'pX-
HC)loJlenoii, 3aTeM upOC.TI('IJOIBaIOT .o.aJIbI-leiiIIInii XO.O. JIPro'IHoii apTPpnn, RO-


PilC. 36. ApTepnam,H;lJI tPaaa IIPII o6meu aH-
rnorrym,1IIOHorpm{HUI. RaTPTep rrponeAerr )];0
[[paBOrO >rrpe)];Cep;{IlJI. 1{00ITpaCTIlpOnaULI IIpa-
Boe IIpp}J;cep)];IIe, IIpaBbTii »WJlY1W'leR, JlerO'lHalI
apTPpllJI II PI' BPTBl! B 060IlX ;lerRIIX.


71




TopaH B 06JIaCTH ROplIH nailpaBJIHeTCH RIIU3Y, OTp;aeT B03BpaTnyIO BeTO'lKY R
Bepxne:iJ: )J;OJIe II CTBOJI R BepxneMY cerMeHTY nllmneii )J;OJIH, IlOTOM op:ny lIJII1
gBe apTepIfH R cpeAHcii p;OJIe H IlpOp;OJImaeTCJl B Bnp:e Rpyrrnoll IIumlIegOJIeBOll
apTepuu. HecMoTpH IIa Mnoro06pa3ue ee )J;eJIenIlH, 06bI1:JHO Y)J;aeTcH p:ucp<pe-
penu;upOBaTb 4 cerMeHTaplIbIe BeTBll. AHaJIOfIPlHbIM 06pa30M OIl03IIaIOT ap-
TCpUIf JIeBOrO JIerRoro.
J1aTepaJIbHee UJIU nlIme MeCTOIlOJIOiIWIIUH cerMeHTapnLIX apTepuii na IlO-
CJIep:YIOII\IIX aHfIfOrry.'1bI\IOHOrpallIMax BLIHBJIJleTCH TeHL BeH. BellbI BepxlIeii II
cpep;neii (H3bIqIWBOll) )J;OJIl'tl
CJIHBaIOTCJI B BepXnJOIO JIero'l-
IIYIO Beny, IIailpaBJIHIOII\YIOCH
KoCO RII1I3Y II RHYTpII. BeHbl
nnnmei'l P;OJIH c0611paIOTcH B
HnmmoIO JICr01:JnyIO Beny, nMeJO-
II\YIO npII6JI1I31ITeJIbHO ropU30H-
T3JIhIIMn xog. Ha <pone TeHIl
cepp:u;a C oGeux CTopon BlI):\Hbl
IDIIpORHe IWHI(eBbIe OT)J;eJIbl
BepXHnx n IIll>InIIIX JIer01:JHbIX
BelI, Brrap;aIOIIJ;IIX pa3AeJILIIO lIJIli
oOll\nM CTBOJIOM B JIeDOC Ilpe;'l;-
ccpp:ne.
0)J;I10npeI\feHIIO C H,lIeuTmlm-
KaU;lIeii I'PYIlHLIX apTepnii: II neH
on03IlaIOT COCygLI, lIe 3anOJIHlIB-
mlICCH ll:OHTpaCTHhIM BeIIJ;eCTB01>I.
TIIJ;aTCJILJIO U3Y1:JaIOT MeCTa Ill(
OTxon,p:emlH, HlI\yr RYJIbTIO co-
cY)J;a, OIIpe)J;emnOT COc.TOHIlI1e OI{-
pymaIOlI\ci'I cocyp; JIer01:JIIOB
TImlIII.
BCH cocygucTaH ceTb U Raa{-
D;bIIi BU,lIUMbIll na anrlIonyJILMO-
HorpaMMe I{PYIlllLIii RpOBellOC-
HLIii cocyp: p;omKnbI 6bITL DHUMa-
TeJILHO OCMOTpeHLI B nOHCRax
rraTOJIOrUqeCHUX U3MerreHIIll.
He06xop:IIMO YCTanOBIITb, Her
JIll U3MelIelIuii n TorrorpacpHU C.O-
CY)J;IICTOll ceTH - C6JIIlamlIUH UJIlI
pa3)J;BIIra1IUH COCYP;OB, IIX p;e-
<popMaI(IIH. 3aTeM OU;eIlUBaIOT
RaJIu6p COCyp;OB: IIeT JIll paCllIII-
pelIllH CTBOJIa JIero
IHoii apTe-
plIlI, CTYilene06pa3IIoro H3MelIe-
nUH IlpOCBeTa COCyp;OB 0'1' )J;eJIe-
IIIIH R AeJIelIUIO (B 1:JaCTnOCTil.
cymelIlIH MeJIRlIX apTepnii), cy-
menRH OTp;eJILIILIX KpYIInbIX CO-
CY):\OB. llpn paCCMOTpeIlIIU cy-
menHoro yqacTRa IIap;o 06paTUTb
nnilManue IIa ero HonTypLI. CJIep;yeT nOMHlITb U 0 c.nMnTOMe BLIIlpflMJIeHlIH
n yp:JIllIIeHlIfl gOJIenbIX U ccrMeHTapnLIX apTcpUll C YBeJInqmUleM yrJIa llX
p;eJIemIH (qTO oc06eHno XapaI{Tepno P;JIH XpOHUqeCRoii: 8M(lm3eMLI), 0 CIIMII-
TOMe pa3pHmeHnH lIJIU OTCYTCTBUH COCYP;IICTOM ceTU B ImROll-JIII60 1:JaCTU JIer-
Koro. DamHo YCTanOBlITb, COBIla):\aeT JIll MaJIOCOCYP;lICTaH UJIH Geccocyp;nCTafl
30Ha C rpaHuu;aMU P;OJIlI lIJIlI cerMenTa. AJIH pJIp;a JIerO
IHLIX IlOpaa{enUII, B TOM
1:JlICJIe P;JIH nepmpeplI1:JeCROrO paRa, TUnn1:JeII npU3HaR 06pbIBa MeJIRlIX apTe-


Pac. 37. BeHo3HaII l1Jaaa rrprr o6m;eii aHrHO-
IIY JIbMOIl orpal1JuII.
ROHTpaCTflpOBaUbl JIero'lUbIe BeHbl, JIeBOe IIpe
-
cepp;no, JIeDJ.lll )I(eJ1YAO'leK. ROIITpaCTHOe Bem;e-
CTBO yme HMeCTCH B Bocxop;Hm;eii aopTe.


72








pUll. He06xo)J;uMO YT01:JIIIITb, r)J;e B OCIIOBHOM paCilOJIaralOTCH RYJIbTU COCY-
AOB - Y RpaH IlaTOJIOrlI1:JeCROro 01:Jara HJIII IIeIlOCpep:CTBeIIHO B 30He y.IIJIOT-
HeHIIH JIerOqHOll THailU.
3. ConOCTaBJJeHlle Bcex aurllonYJJLMoHOrpaMM. Ha Ram)J;OM ClIlIMRe YJIaB-
mIBaeTCH JIlIillb OT)J;eJJbIILIll MOMelIT ROIITpaCTllpOBaHJUJ JIer01:JIILIX COCYP;OB.
TIOH'IOMY )J;JIH cymp;eHIIH 0 Mop<pOJIOrJIII u !f>YIIRL\IlJI MaJIOrO Hpyra RpoBooGpa-
IqeHRH namHO 06'bep;IIHIITb )J;aHHLJe, IlOJIyqeHHLJe IlPII aRaJIJI3e OTjle.'IhHblX
CHnTROB. Ha)J;o onpe)J;eJIIITb p,JIII-
TeJIbHOCTb Ram)J;oiI !f>a3LI 3anOJI-
HeHIIH JI OilopomlIelIIIH COCY)J;II-
CTOH ceTII JIenmx II 061I\ee Bpe-
MH RpOBoToRa B II<IaJIOM Hpyre.
STOT MOllieHT CJIe)J;yeT YTOqHHTb
npII IlpOCMOTpe CHUlIIROB. HamI-
1:JRe cepnII CHIIMROB n03BOJIHl'l'
TaRme YCTaHoBIITb nOCTOHHCTBO
06HapymeuHbIX onmoHeHRll II
TeM caMLIM pa3JIII1:JUTb opralIu-
1:JeCKRe II <PYHHI\IIOlIaJIbHLJe 113-
MelIeHIlH COCYP:0B.


.-


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CEJIERTHBHbIE II (,ROHIJ:EBbIE»
AHrHOIIY.J1bMOHOrp AMMbI


..".


0:>
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.


llplI CeJIeRTJIBHOH (u3GRpa-
TeJIblIoll) aHrIIOnYJIbMOHOrpa-
<PUll ROHTpacTlIoe nelI\ecTBo BBO-
)J;HT HeIlocpe)J;cTBelIHo B apTeplIlo
uCCJJep;yeMoro oT)J;eJIa JIerRoro.
STa npoI\e)J;ypa CBH3alIa C 30H-
)J;RpoBaHueM oT)J;eJIbHbIX BeTBeii
JIerOqlIOll apTepuII. Pa3IIOBIIp;IIO-
CTblO MeTop;RRII HBJIHeTCH (<ROH-
I\eBaH» alIrRonYJIbMOHorpa<pIIH.
llplI Hell TOHRlIll 30H)J; BBO-
;ll;HT )J;O 3aRJIIIHllBaHIIH MeJIROll
apTeplI1I II JIllillb 3aTeM BJIHBalOT 'lepe3 Hero ROHTpaCTHoe BelI\eCTBO, ROTopoe
3aIlOJIHHeT COCY)J;LI COOTBeTCTBYlOlI\ero cerMeHTa (cyGcerMellTa) B «qnCTOM
BIIp;e», T. e. 6e3 npnMeen RpOBU. llplI Bcex BaplIaHTax ceJIeRTIIBHoli aHruo-
IlYJIbMOlIorpa(fJuII HOHTpaCTJlpyeTcH JIlIillb 1:JaCTb JIerOqHbIX COCYP;OB (pRC. 38).
AIIaJIII3 CeJIeRTIIBilbIX II (<ROIII\eBLIX» alIrlIOIlYJIbMOHOrpaMM npOBO)J;HT B
IlpulIu,lIne no nJIalIY, npep;CTaBJIeIIIIOMY BLIille P;JIH OGII\IIX aHrnOIlYJIbMOHO-
rpaMM. Oc06enHocTII CBOP;HTCH R CJIe)J;ylOlI\eMY. llplI oG30pe CHnMRa IIeoGxo-
P;IIMO YCTaHOBRTb, B HaROM cocyp;e pacnOJIomelI ROHeI\ 30Hp;a II RaHaH 1:JaCTb
CIICTCMLI JIer01:JHLIX COCYP;OB ROIITpaCTlIpOBaHa. B 3aBnCIIMoCTII OT 3ap;a1:J IIC-
CJIep;OBaHIIH 3anOJIIIHIOT JInGo COCYP;bI IlopameHlIoro Y1:JaCTKa, JIII60 COCYP;bl
TOll qaCTII JIerROrO, ROTopaH IIa 06LI'lHLIX CHIIMHax Ra3aJIaCb IIOpMaJIbIIOll.
B IlepBOM CJI
Iae npeCJIep;YIOT rJIaBHLIM 06pa30M p;IIarHOCTII'leCRRe I\eJIII
(ilplIpop;a II npOTHmeHHOCTb IlopameHIIH), BO BTOpOM - IlporlIOCTIlqeCRUe
(OI\eHKa (PYHKI\IIOlIaJIbHoro COCTOHIIIIH JIerROro Ilepe)J; Ilpep;IlOJIaraeMOll pe3eR-
I:\uell nopam:eHHoro OTp;eJIa).
TIpn COrrOCTaBJJennn cepnH (<KOHI(eBLJX» aHrnorrYJJbMOHOrpaMM CJJe;o:yeT Y'IeCTb, 'lTO
B HOp
fe apTepnaJJbHaH if>a3a ;O:JTHTCH 0.7-1 CeJ\yH;O:y, Karrn.TJJTJIpHaH - 0,2-0.4 ceKYH;O:LJ,
BeH03HaH - 0,5-1,4 ceKYH;O:LJ (M. X. PaoKIIH). TIpH CenteHTapHoll anrnonYJTbMOHOrpa-
if>lIn B HR'IaJJe apTeprraJJbHOii if>a3LJ rrOJIBJTJIeTCJI 1I30Gpamemte centeHTapIloll apTeplI1I
n ee OCHOBHLJX BeTBell. B KOHI(e SToii if>a3LJ BLJpnCOBLJBaeTCJI ceTb Tommx cocynoB n
MomHO cy,!\nTb 00 nx Mopif>OJJOrnn. B KarrHJJJJJIpHOll if>a3e ,!\OCTnraeTCJI TIHTeHCTIBHOe 0;0:-
HOpOIJ:IIOe 3aTeMHeHHe cenIeHTa. OTCYTcTBJIe 3aTeMHeHnH YKa3LJBaeT Ha pe3Koe nopa-
)j"\eHne KannJJJJJIpHOrO pyc.rra, 'lTO Ha6mo;o:aeTcH lIpn XpOHH'leCKOll sMif>II3e
Ie.


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I




PlIC. 38. CeJTeKTlIBnaH anrlIorrYJJbl\IOIIOrpaMMa.
n:aTeTep BBe;o:eH B npaBYIO HJImHC;O:OJJeBYIO ap-
repJIIO. HOIITpaCTlIpoBaubi OCIIOBIIOH CTBon B
BeTBII HlImne;o:oneBoH apTeplIn.


,:.


73




PaCnIaTpIlBan <<HOHJWBI,Ie» anrJlOnYJlhMOIJOrpaMllibJ, IWL
O lIJ\leTL B- Bnl
Y
130:\lIlOiI,lJOCTb pa:!pLlBa !\IP.JlI\Oro cocYl-\a ]1 3HCTpaBa:]<U
1I1I HOIlTpaCTIWro Bl'-
U\eCTBa. TIpn :)TOJ\T na CHIIl\lJWX oonapyaornaf'TOI TCIIb IWIITpaCTIIOrO BCIT(OCT-
Ba, oupa3YJOIT(E'rO CIWII.IJeIIlIH B naI)(,IJ
IIMe .TJcnwro (y OOJII,HOrO nOHBJIHCTCH
KpOI!h B 1I1OHJ1OTC).
AHrIIonYJIhMOlHlrpa([JlIH c.TlyaalT JIIlIIII,
IaCTJ,(() H01\Ill.JIORCHOro ooc.JIOL
OBa-
HITH OOJII,nf,JX, rro:no!\lY 01' WlllflMC )10JIiI\lIhI GbITh corrUCTHB.lJE'rrLI C pe3yJIbTa-
TO. MIl OOhI'lHoii pCIHrl'nOrpar[>IIJI, TO 1\lOrp a (IIllII , II3J\TCpCIJIIH nnYTplIcepi1:e'lIIOrO
H BUYTlHIJTprU1HlOro W1BJTE'lIlIH, oupep;('JI('JlUH ra30130rO COCTano. I'pOBIl n JIe-
r01IHbIX cOCYL
ax II p;pyrII
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CHHMKII EPOHMUJlbHbIX APTEPlIfi


Y.-rOOM flOJIY'IIITh I1:!OopamPIIIIE' opOIlXlla.IThHOii paTCIJIHl. HOUTfJaCTIIOl' ne-
ll(eCTno IJ13Ul-\HT B Hl'C IIOC{IPP;CTBUM h:aTeTl'IHr.!aU;/I/I. ffPIl aHaJIIJ:Je CHIIMlwn
HeOUXO):\II1\ro YCTauunrlTb: 1) 3arrOJIIlJJ.TIIlCL .TIlI HOIITpaCTllhlM BClI\eCTBOM Tl'
6pOHX/IaJIbHble apTcplIlI, J{OTOIH,IC nnYT B lIopan,PlIIIYro lIaCTb JIerHoro:
2) ImHHe 1\IO{lI[)UJIOrJPlccIwe 113.Ml'IH'II1UJ lJ1\IPIOTCH B :JTIIX cocynax: 3) HOT .Tln
:n\CTpaBaaaTlJB HOHTpaCTJIOrO IWlIWCTna B 30Ile nOpal:lienllJI, a TaInJ\(' IlOBO-
u6pa30naHHLIX (aTlIIIII1\JlLI
) COCYL
on.


I'EHT fEI-I OInT lIEMA TO fP .\l\fMbl .JIEfRIIX
(RIUIOEPOlIXOfP_, cD HH, InIlIO
\ln'IIOlUT.TlLl\fOUOfP AcDlIH)


PeHTrOHonCHIIe J'\JIIJOcpIIJIl>lIlbI .rrerHUX npOII3BOJ],HT rJIaBHLIM 06pa30M n co-
'IeTaH1JU C IWIlTpaCTJIpOBaIJIH'M OpOIIXOB (IHIHOOpOJIXOrpacpIIH) JI.lJIJ COCYP;OB
JJerKIfX (IHIHoanrlIon YJIb1\101lOrpacpnH)


AHA.J1H3 RIDIOEPOHXorp AMI\1


l
uIIoGpoHxurpa(IHlIo OCYIIJ;CCT13JIHIOT B npou;ecce BBep;cnIIH B (.pOHXnaJIL-
ROe p;epmm ROHTpaCTllOrO BClI
CCTBa. C'Lp1\nm ne)J,CTCH EaI{ nprr cTJoJ{oiinoM P;LI-
xaHUII oO.lJI,noro. TaI
 n Jlpn nOImmmlBaIJUU. CIWpOCTb C'LP1\IHn 16-24 Rap;pa
B ('CI'YII;!!Y. UCHOBULIM MeTOL
OM aHa.lIU3a no.lIY'IeIIHoro MaTe)HIa.TIa HBJIHCTCH
nponlOTp p;llumYlI\l'rOCH pPH1TenonCHoro /J:J06pan;:(,IIIIH no n)C1\H\ RJIHOnpO-
eHIlun (ImJIbMa. OIITII1vIa.lILUaH CHOpOCTb npoeHI
UU IIflII1\lepnO paBIla CROpOCTII
(:'ber.TRil.
npu npOCMOTpe qlII.lIL1\m npcm
p Bcero OOPHIIJ;aIOT mrmraHue Ha XapalrfOp
3HnOJIIICIIIIH upOlIXUaJIbIIOrO )1epe13H IWHTpaCTULIM nelI\OCTBOlll (TOJI
IlW06pa3-
HbIIi n.lJJI HpTI)WJH,IBIILJll) U CIWpOCTb 3anO.lJHeHUH. HpoMe Toro, On;eHIIBaIOT
pecnIIpaTOpHLIe L
BmJ.eHIIH c,TCnlJJ{ OpOHXOB (pIlC. 39).
DOJIel' )J,eTam,IILle CBPL
eHIIH 0 q)YHKJ\IIII II lI'lOp(poJIorurr HpynuLlx OpOHXOB
}J:OCTan.lJJJCT 1I00W)1POBI,Iii ana.JIU3. TI {In aTOM uaY'Icuue Ram):\oro Ra)1pa npOBO-
.,I\flT B COOTHeTCTnuu C nOJH1l(IWM
TCJInH opOIlxorpaMMJ,J (or. CTp. 63).


AHA.J11I3 RIIHOAIIrnOIIY.J1bMOIIOrPAMM


CU'IeTaHUe peJfTrcIIOJ\IIHC1\raTOrpa<puII C JICHYCCTBennUM ROHTpaCTupOBa-
HIIClIr COCY
UB JIerHUX n lIaCTOHlI\ec npCMH JlIJJI1\WUHIOT rJlaBHLL\I oopa30M p:JIH
,L\IWrrrOCTJJJin l)£l1W 6poIlxa. TIpn aTOM B ocuonnOM IIClIOJIb3YIOT MeTO)J,Im:y ce-
JIeh:TIIBHOii 3HfIIOny.lJI,1\IOHOrpaqJIIu. Baa\JH'ii:mJuJ P;OCTOIIHCTBOM peH1TeHOI,u-
IIeMHTorpm[JIIU II YC.T[013HHX HurrronYJII,1\lof[OrpmlnIII, no MneHIUO 10. H. COJw-
:rOBa, flBJIHeTCH 60.T[MIlOO
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75




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76




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77




PIIC. 42. IIppe
nIIf[ ooaopHLTii CHITMOH JlPnm:\.
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79




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panbI-Ible IIaCJIUeUllH JInoo I-IC60JIbIlIOe CR01IJIenUe mlIp;ROCTJI n IlJIeBpaJIbHOIi
1I0JIOCTJI.
flo cpaBHeHnlO c npaBoll CToponoii: B JIeBOM JIerROllf 06napyamBaeTCH Menb-
me COCyp;IlCTbIX pa3BeTBJIenull. OTclOp;a IlOBbIilleHnaH B03p;ymnocTb HCROTO-
pbIX Y1JaCTIWn JIeBOrO JIer01JIIoro lIOJIH, ROTopaH lIe 6pocaeTcH B rJIa3a npJI 00-
lII;eM oCMoTpe peHTfeHOrpaMlIIbI, HO HCHO BJIp;Ha Ilpn p:eTaJILHOllI ce paccMoT-
pemm.
KopelIb JIeBOrO JIenwro Bll):\en IIe)J;OCTaTO'lHO, TaR Ran: ero Il306panmHJIe
nplmpbITO Cpep;lll1HOll TeHblO. BCPXHllll HOHTYP JIeBOH JIerO'lllOll apTepIIU (lIO-
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HopMe OH paClIOJIOiJ'\eH nbIIlIe). CJIep;OBaTeJILHO, RopeHb JICBOrO JIcnwro CMe-
lI\eH HHJI3Y. l\opeHb IIpanoro JIerHOrO 3aHIIMaeT HOpl\taJIblIOe nOJIOmeHJIe, TelIb
ero CTPYI{TypHa, B BepxHeii: ero 'laCTJI BbIp;eJIHIOTCH lIIeJIIHIe 00LI3BeCTBJIeHJIH.
Cpep;OCTeHJIe CJIerRa CMelI\eHO BJIeBO, BCJIe)J;CTBue 1:Jero 06HamCHLI II )J;II(PtPe-
peHu;upYIOTCH Ha peHTreHorpaMMe lIpaBbIe 60ROBLIe OTp;eJIbI TeJI rpYP:I1LIX
n03BOHHOB' IIepe)J;BIIHYT rJIaBHbIM 06pa30M HIImHJIll OTp;eJI cpep;OCTeHJIH, Tor-
.n;a RaR TpaxeH npocqnpyeTcH CTporo IlO cpep;Hell JIJIIIIIII TeJIa. Cepp;qe II RpYIl-
Hble COCY)J;bI B npep:CJIax IIOpMLI. B)J;OJIb JIeBOll rpaHHqLI ccp)J;qa HaMe1:JaeTCH
Y3RaH TeHenaH IIOJIOCRa C 1:JeTRIIM IIapymHLIM ROHTypOM, IlpIIpop;a ROTOpOll lIe
RCHa.
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JIOBlIHbI rpYP;Holl RJIeTRII H CMelI\eHlIe cpep;OCTeHIIH BJIeBO CBIIp;eTeJIbCTByIOT
00 Y:\JelIbilleHllIl JIeBOrO JICrRoro. "YMelIbillelIa IIlImHHH )J;OJIH, TaR RaR RopeHb
JIerROrO IlO)J;THHYT RHII3Y. BepXHHH P:OJIH, Hao60pOT, B3)J;YTa, B IlOJIb3Y 1:Jero
rOBopHT IIeROTOpoe ooep;HeHIIe JIer01:JHOrO pIlCYHRa U IlOBbIilleHHaH Ilp03pa1:J-
HOCTL BepxlIero OT)J;eJIa JIeBOrO JIerO'llIoro IlOJIH. "Y HapymHoro RpaH HIImHero
OT)J;eJIa JIerROrO IIMelOTCH IlJIenpaJIbHLIe HaCJIOelIUH UJIU He6oJIbillOe ROJIII1JeCT-
BO mllp;ROCTII. HHmHHH P;OJIH MomeT 6LITb YMeHbillelIa 3a C1:JeT CIlap;eHIlH (aTe-

eRTa3a UJIII ROJIJIalIca) IIJIII B pe3YJIbTaTe CMOpll\IInaHIIH (pyou;enalIllH).
EOHOBOii 06aopllbIU CIIHMOR JIeBOrO JIemoro (pnc. 43). CmIM01{ Y)J;OBJIeTBO-
pllTe:lbHoro I<a1:JeCTBa. "Y CTaHOBRa 60JIbHOrO npaBUJIbHaH. rpYP;HaH ImeTHa
npaB1lJIbllOll (IJOPMLI, C 60JIbillIIM Ilepcp;He-3ap;HIIlII pa3MepOM. B MHrRllX TRa-
IHTX II B BIIp:nMLIX OTp:eJIaX CHeJIeTa II3MeHeHIIll lIe oOIlapymeHo. J1enaH nOJIO-
EHua p:naq)parMLI p;e«popllIHpoBaHa, qeHTpaJIbHaH
mCTb U 3ap;HlIll CRaT ee Ilpll-
nOp;I1HTLI; ROUTYP HepOBelI, MeCTaMII 00pa3yeT 3YOqLI, OOpalI\elIULIe B CTOpO-
HY JIerRoro. l\aR nepe)J;UIIll, TaR U 3a)J;HIlll OTp:eJIbI pe6epHO-)J;IJa«pparMaJIbHOrO
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Jlpro1JlIoe IlOJIe He )J;e«popMIIpOBaHO. BP;OJIb ero Ilepe)J;IIeii: U 3ap;Heii rpa-
IIIlH., oco6eHHO B HHiHlInx OTp;eJIaX, Bup;Ha RpaeBaH TenCBaH IlOJIOCRa HepaB-
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;QTillHOCTb pa3HbIX Y1:JaCTHOB JIer01JlIoro IlOJIH Heop;ImaROBa: 06JIaCTb BepXHell
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UMelOT ponilLIe 1:JeTRlIe ROHTYPbI. 3aTeMHelIue B HIImHe-3a)1IIeM OTp;eJIe JIer01:J-
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80




cBoeii: CTpyRType JIeO)J;HOpO)J;HO; B HeM OIlpep:eJIJIIOTCH TellUILle rrOJIOCbI II oRpyr-
JIue CBeTJILIe Y1JaCTRU.
BCPXHUii IlOJIIOC 3aTeMHeHIIH IlOL
XOp:IIT R RopnIO JIl'rIwro, IWTOpLIII 3aMeT-
HO Clllefn:eIl R3ap;u. OT HOpHH B 06JIacTI, 3aTeMrrennH HanpaBJIHeTCH mmmep;o-
Jrenoii 6pOHX ( t ), npocBeT ROToporo IIe06bI1:JHO mIIpoR II O'lCHb xopomoBIIp;eH
Ira <l>oHe oRpymalOlI\eii ynJIOTHeHHoii TRaHn. l101:JTU CTOJIb me JICHO DbIHBJIfl-
roTCH IlpOCDeTLI OOJIee MOJIHnX GpOHXOB. TpaxeH OT'IeTJInBO OTRJIOHJIeTCH R3a-
)J;II, B OCTaJIbHOM olIa ne II3MelIeHa. Cepp;u;e II RpynHbIe COCYP;LI CMeIIJ;eHLI
R3ap;II; 3arpyp;UHIIoe IlpOCTpanCTBO 3Ha1:JIITeJIbHO pacmHpeHO.
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II .pOPMY 3aTeMHeHHoro y
mcTIm, a TaIHRe xapaRTep ero ROHTypOB (BTHHYTaJI
U pOI3IIaH IIopeL
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meHa. B IlOJIb3Y :3Toro cmmeTe.lIbCTBy.eT, HpOMe Toro, 3Ha'IIITe.lIbHOe ClIIelI\eHUe
cepp;U;a R3ap;u, ROpHH JIerHOrO II )J;IIacpparMbI RBl'PXY, 'lero He GbIJIO OLI IlpII
YMeHLlli.emm TOJIbR
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TeJIbIIOrO Ha1:JeCTBa. I130Gpa}ReHHe OpOHXOB, 3arrOJIHenHLlX ROIITpaCTIILIM Be-
liiCCTBOM, BbJp;eJIHeTCH 1:JeTRO. B BepxHeii 1:JaCTU 6poHxorpaMMLI Bup;Ha TeHb
HaTeTepa, naxop;JIlI\erOCH D Tpaxee II 3arrOJIIIeHHOro ROHTpaCTHbIM DelI\eCTBOM.
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HO TOJIMW B 6poHxn IUUH:Helr P;OJIII. OHO 3arrOJIHHeT OCIlOBJWU nrrmHep;OJIeDOH
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IWD. B 00-
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CRllMII n MemROBII)J;HbIlIlIl 6poIIxo:nna3aMn II HapymeIIIIeM rrpOXo)1IlMOCTII
lIIeJIHIIX 0pOIIXOD. TIo)J;oonbIe H3MeHemm llIOrYT HBIITbCJI pe3YJIbTaTOM xpo-
lllI'IeCHOrO BOCIIa.TIIlTeJIuroro npou;ecca, rrpIlBe)J;mero R py6U;OBOMY CMOPII\Il-
RaHflIO JIIImneii P;OJIll.
ConOCT3BJlCIIIIe pCH'1'rcHoncRoH RapTIIHI,I C RJJlUIII'lOCKUlIllI )J;aHHbIMH.
AII3MIIeCTII1JCcm!C H HmlIIIPIeCRIIe p;aHIILIe CI3I1p;eTeJIbCTDyIOT 0 XpOIIII1Je-
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,llaHIIe, 6JIe)IHOCTb ROJI,HbIX nOfip0130B, OOJIII B JIeBOIi IlOJIOBIIHe rpY)J;Il,
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Ha6.n.roaenue 3. MYX{'lIlHa 52 JIeT. lliaJIyeTCJI na OJJ;blmI{Y. ne60JIbmlle 60JID B npaBOD:
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{j JI.)J;. JIIiIH)J;eHGpaTeH


81




JIO'lIi:11 OOLl'IHOii OHpaelUL l1ym,c 76 YJJ:apon B MIIHYTY, }HITMII'IHLIii, xopoillero HaIlOJIHe-
mm. ApTepIlaJILHOe lIanJleHIIC 120/80 MM pl'. CT. rpYlIlIafl rmeTHa npamrm,HOH cPOPMhI,
paBHOMepHO Y'IaCTByeT B lIh1XaHIlll. n pil nepHYCCIIII oOHapymeH Y'IaCTOI{ IJplITYIIJJeHIDI
B OOJIaCTlI HIImHero yrJI1I IJpaBOll JIOnaTHU. )]:hlxaHue n TOll iHe OOJIaCTJI OCJIaOJIeHHOe,
B lIPyrnx opraHax n CnrTC)laX lJaTOJIOrIl'IeeRIIX 1I3MeIIeHUll He YCTaHOBJIeHO.
tlccJIClIOBaRlle Hpomr: I-lb 7
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PIIC. 45. Ilepep,IIIIii o030pnr.rii CIIIII\IOI\ JIenm
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nepeAIJlIii OU301Hlbrii CIIII1\IOI{ JJ('rJ.ux (puc. 45). CIIIDIOR Y):\OB.JU'TIIOIHI-
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C POBIILIl\UI O'fepTaIIlIHJ\III. D IIIDmWJ\I OTAeJIe IIpaHoro .ilerO'lIIoro nOJlH IlMe-
eTCH 3aTe1\lHeHIIe, ROTopue lIa'UlnaeTCH 01' XBOCTOBOii
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J1erO'lIIbIll plICYH(m B OOOIlX .JJerO'IIII,lx 1I0.JIHx nnmoro YCII.TIClI, 110 Hl'
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82




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6. IJOI\OBOH OO,IOPEJ.IH ClllllllOI{ rrpaBoro ;wnwro Toro iRe OOJIbHoro.


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84


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aJIbHOe p;aBJIeHlIe 110/60 MM pT. CT. rpaHIII(LI cepp,I(a B nopMe, TOHLI 'lIICTLle. ALlxaBue
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85




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Pnc. 4R rh'p
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melIueM p;I1mIJpanILI. Ha OOJIblliClIl CB(H
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87




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JIIIqUTb HOpMaJI.b110e, 11aOLITOQUOe I1JIU Hep;OCTaTO'lnOe HpOBenanOJIReHlIe CO-
CYP:OB Ma.1JOrO Kpyra.
llpII YMepelIHOM IIonbIIlleHlIlI )J;aRJIeHIUT B MaJIOM Hpyre OTlIIe1:JaeTCH par.-
ffiupeHlIC CTBOJIa II ocnOBHLIX BeT Bell JIeroqlIoii apTcpUil (B HopMe mnpUHa
CTBOJIa 20-30 MM, npaBoll neTBII - 8-17 MM, a JIeBOll - 12-18 lIfM).
I1pocBeT OCTaJlbllbIX apTepnii aaMeTHO lIe MeIIHeTCH. ECJlIl p:aBJIeHIle p;o-
CTuraeT 40-60 MM pT. CT., TO B031IIIRaeT C11a3M nepu<jJcpIIqeCImX apTepI1U.
Torp:a IIa peHTfeHOrpaMMe perncTpupyeTcH pacmIlpenne CTBOJla, OCIIOBlIbIX
II HpynlIblx BeTBeii JIeroQHoii apTepnlI II CY
KeHIIe MeJIImX apTepull, B rJIa3a
6pocaeTCH BI-Ie3aIIHLIii 06PbIB TelIU paCmllpf'HlIbIX COCYP;OB B nepn<jJepllqe-
CHUX 30Hax JIerO'lHbIX no.rreii:.
llpn HOpMaJI.bI-IOM BelI031I0M p:aBJIeHlIJI cy6cerMelITaplIbIe II cerMelITap-
HMe BeHbI BO Bcex OTp;eJIaX JIerKIlX llllfeIOT npnMeplIO op;nnaKOBbIiI KaJIUOp.
llpIl He60.1JbmOllf IlOBbImeH1II1 p:aBJI€IIIlH OTMe'laeTCH nOBceMeCTnoe pacmnpe-
HIIe BelI. Ho eCJIU BCII03Hoe )1aBJIenne )IOXO}:(UT p:o 25-30 MM pT. CT., TO 00-
napymllBaeTcH napa;O:OI(CaJIbHaH KapTlllIa - BeIIbl nepxHllx p;OJIell HOpllmJIIo--
IlbI I1JIII pacmIlpclIbI, a BeHbI HIDRHnx )J;oJIeu - cymelILI.
llpn nOBbIilleHlIll HanmIJIHpnOrO )1aBJIeHIIH BblillC 18-20 MM pT. CT. II ):\I1a-
CTOJIIIqeCKOrO p:aBJIeHnH B JIero'lHoli apTepnlI BbImc 25 MM B ncpn<jJepn'le-
CHIIX 30IIax HlImHIIX OTp:eJIOB JIerO'lHLIX IIOJIen BbIHBJIHIOTCH KopoTHne II Y3-
KIIe ropH30HTaJIbHbIe IIO.1JOCHll - TaR na3LIBaeMbIe CeIITaJIblIbIe JIHHI-Ill ;
(KepJIll) .
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PIlC. 53. Il('peAHRll 0630pllblii CIIlIMOI{ cepAI\a II KPYIIHbIX COCY.D:OB rpYAlioH
IIOJIOCTII C OU03HaQeHileM Ayr, COCTaBJIflIOlI\nx KOHTYpW cepAI\a II COCYAOB.
Ha c
eMe nOKa3aHa npOeKl\IUI l{aMep cepAl\a II KpYIIHLIX COCYAOB na nepep;-
BIOIO peHTrenorpaMMY.
1 - npaBoe npe1\cep1\lIe; 2 - npaBbri'I meJIYAO'leH; 3 - OCIIOBHOH CTBOJI JIero'lHofi ap-
TepmI; 4 - ynmo JIeBOrO npeAcepAlIH; :; - JIeDblH HleJIYAO'leH; 6 - BOcxo;J:\HIqaH aop-
Ta; 7 - 1\yra aopTbI; 8 - HlICXOAHIqaH aopTa.




AaJIbneiiIIIJIM 3TaJIOM anaJIII3a peIITfeIIOrpaMMLI nBJIHeTCf! lIenOCpe)J;CT-
BemIOe n3Y'leHne TeHII cep)1u;a, JIerOqHOn apTepIIII II rpY)IlIon aopTbI II, B 1:Ja-
CTIIOCTII, onpe)IeJIeHIIH llX IlOJIOmeHI1H CPC)1II p:pyrnx opralIOB. Y 3):\opOBoro
'IeJIOBen:a cep)1I(e pacnOJIOmeHO B rpY):\Hoii nOJIOCTII TaHIllII 06pa301lI, 1:JTO O)J;-
Ha TpeTb ero TeHII IIaXO)1lITCH cnpaBa OT cpe)11lHnoii JIllIUIIl, a )1Be TpeTH-
CJIeBa. KOIITYP cep)1I(a npoeI(npyeTcH npnMepno IIa 2-3 CM BnpaBO 0'1' Ilpa-
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PIIC. 54. I13MerrcHlIc c])OPMLI TelllI CepAl\a Ii COCYAHcToro llyq:Ka n IIPHMOM
IIpOeKI.\HH IIPH yneJJlIqeHHH IIOJIOCTeii CepAl\a H aopTM.
a - HOpMaJIbHOe CepAQe; 1 - Bep"IIfIfI nOJIafl BeHa; 2 - npaBoe npcAcePAHe; 3 - npa-
BMU me.rryAO'leH; 4 - JIeBbIH meJIYAo'Ie,,; 5 - ymHo JIeBoro npeAcepnnfl; 6 - JIerO'lHllfI
ap"epllH; 7 - aopTa; 6 - YBcmPICHne JIeBOro meJIYJW'IHa; 6 - YBeJIlI'leHlle npaBoro
/J JICBOro n,CJIYAO'lHOB; ,,- YBeml'leHIIe JICBOrO npeAcCPAHfI; a - YBeJIII'Il'H/Je npa-
Boro npeAcepl\UfI; e - pacmllpeHIIe BOC'i:oAHIQeii aopThl H JI('Boro meJIYAO'lHa.


eY)1I1CToro nY
IIm; OHa UpOCTlIpaPTCH BupaBO na 0,5-1,5 eM OT I_paR n03BO-
HO'lIIIIKa II BJICBO I1a 1.0- 2.5 CM. T{OIITYPbI COCYiUICToro IIY1:JRa II cep)1l\a
06pa3YIOT !\renql,Y coooii nw: lIa:n,Ifi<W-:'fJ.IP Cl'p)1p1I11o-coeY,!UICTLle yrJIM. HOH-
'l'ypM ecpgI(a 11 )1l1a(pparMJ,J - cep,'J,('1IHo-;::J,I1i1fllpafllWJILHLIe yrJIbI.
3aTCM nCpCXO)1HT R II3yqeHIIIO llJOpMLI cep)1I(a II IipynIIbIx COCy)10B.
"Y 6OJlbIIIIIIIC'l'na JIJO)I.pii TNIL cep)1ua II[W)1CTaB.TIHCTeH B Buge BbITHHYToro
OBaJIa, paCDOJIO}l{CHROrO IWCO no OTlIOIIIOHIIIO I, cOCY)1nCTOMY nY'lKY. CJIena
lI1ea{gy II306pamelIIIeM cep)1u:a II COCY):\IICToro nY'lIW IIMeCTCH BbleMI.:a, EO-
TOPYIO Ha3LIBalOT «TaJIII cii» cl'p)1u;a. Olla UeJICe rJIYOOIWH npll ropIl30HTam,-
IIUM IIOJJOH,eIIHil COP)1T\11 II OTCYTCTBYCT npII ero BepTImaJILHOM nOJIomeUUJI.
IIpli onpe)ICJJeHlIJI cpOpl\1LI cep):\l
a lIeOOXO]..l,I1l1IO nOl\1H1ITb 0 OOJlbIIIOM pa3HO-
oGpa31111 ee IlOpllIaJlblIMX BapuanTOB, TWTOpT.1e CJle)1yeT OTJlII'laTb OT )1e.pop-
1\ial\lIii, B03II1IHaJOII\lIX B naTOJIOrIJ1IeCIUIX YCJIOBIUJX.
Pa3MepLI eep)1u;a 11 COCY)10B Ha pl'IITrl'IIorpaMMe l'TOJIL _I\e II3MeH'HIBLI,
I.:m.: UX UOJIOfHeIIIIC 11 ll)()pJ\w. OIIII 3annCHT OT }m)Ia cpaHTopOB II B ocooeH-
IIOCTII OT B03paeTa, nOJIa, Tl'JIOC.JlOa-':PTIlIH, JIOJlOlI'\eHIIH nCCJIe):\YCMoro n q)YHI{-
IUIOIItlJILIIOrO COCTOHHIIH Ca!\lOrO cep,!IJW. "lho HacaeTCH HOIITypOB TeHil cep;:J;-
lI,a II COCY)10B, TO IJ HopMe OTIl! I3cer)1a 'lPTJ.:ne II pOBIILIC. HepOBIIOCTb IIX
YEa3bwaeT na IIaJlII'IIIC' IIJIenpo-neprmap)IIIaJILIlr.IX epaIl\euIIii, CJIIIIIqIlBOro
nepm.;ap):\IIra WIII Pyoll,onoro npOI(Ccea B lI1IIOI.:ap)1e. I\OIlTypLI TCIIII Cep)1I\<l
II COCY):\OB HJ\WIOT BII)1 )1yr; 3TO 06CTOHTCJIbCTBO n03BOJIHeT npil alJaJIHae
CHIIJ\IHa paarpaUIIQIIllaTb OT)1eJILI ee}J)1I(a no yrJIaM nepeCeqeHIIH 3TIIX )J;yr.


9





flpaBLIii HOIITYP Cep)1e ' IlIO-COCY)1UCTOII TCHll na llepe)1llellI CllUMI\(' COCTOIIT H3
P:BYX )1yr, a JJI'BbIii. - 1I
 1JeTLIpCX (CM. pUC. 53). Cnpana JJ;ynI ncer)J.a BLI-
pameHLI Hcno, IT rpalIlII(a II,wfKP:Y HIIMII onpep:eJIHeTCH JIerKO CJIeBa 1JaCTO

1I.prPepen:QIIPYIOTCfl JIlIlIIL TplI P:yrn, Tar, Hm, rpann:Qa lIIem)1Y BTOpoii Jl
TpeTbeii )J;yrallllI pa3JJIJ1meTCH ll.lIOXO. BepXHHH )1yra cnpHBa. p:OBOJILHO P:JIUII-
liaR II MaJIO I\LlllYI
JIan, COOTBeTcTByeT IIpn BepTllImJIblIOM IIOJIOiKCIIlllI lJe-
JrOBeI,a aopTP n OTlIaCTII Bep\:IIcii nOJIoii BeIlC, upn rupn30HTaJIbHUl\1 me no-
JIon,enuu Hepe):UW oopa3yeTcfl TOJILKO nepxucii nOJwii Benoii. HmEHHR Ayra
e rrpana rI)opMupyeTcH IJpaBLlM upep:.cep)1IIeM. BlIIl'CTC C IWIITypOllI ,J,umppar-
MbI UHa CUCTaBJUH'T OCTpLIii yrOJJ. Bpp.UIHR )1yra JlPIJoro KOIITypa oopa
yeT-
eR p:yroii aopTLI B lIIeCTC CC nepcxu)1a n II1ICAO):\flIl
yIO aopTY. BTopaH JIl'lHUI
Ayra COOTBCTcTnyeT I_palO Jlcr01JIIoii apTcplIu, TpeTLH - ynmy ;reBoro npe)1-
r.epp:Ufl, 1:JeTBCpTaH - JIl'BOMY meJIY)10'lKY. ::ha nOCJlPp:UHJT )1yra BbiCTYHaCT
JlaJIeKO BJleBO II nepeceKaeT ):\narIJparll1Y nop: OCTpLIIII yrJIOII[, B KUTOpOllI IIHOr-
):Ia onpep:eJIHCTCJ1 CJJaOaH Tpeyro.m,IIaH TellL n.;uponoii H.'IeTlIaTliU, IIH.AOJJ;J1-
ru;eucH Memp:y ncpmmpp:OM II T/.lIeBpoii.
H.3YQenllC nponnIH
InIuCTu II y,pllB1I3IIJ,I p:yr cep,rma n03BOJl1IeT PCIlII[Th
nOllpoc 0 COCTomum Tex nJIU nULU. ero OT):\eJJOB. "Y jI..mIIU'Ime p:yrII II yBe-
;JIl'IeHIIe ec EPIIBII3I1Ll YRa3hIllaIOT Ha paClllIIpl'HllP COOTUeTCTI3YIOII\ero OT-
l\eJIa Cep)1IIa (puc. 54). TaK Him YBCJlII1JPUnC cepAu:a cpamnrl'c.
rLIIO pC):\HO
npOIICX0)111T paBIIO:MepnO, 3a C'IeT BCl'X IIOJIOCTCii, TO B 3aBIICUMOCTH OT xa-
l'aKTPpa rCIIWpUHa:l1ll 1 U:'Clwro }KICCTPoiicTBa OO},JIIIIO nppoG.1Ia,IWPT pacmnpc-
Hue JIUUIL HeHOTophIX onpe)1CJJeIIIIbIX CCrl\ll'HTOn cepA:Qa (aCnl\[MCTlHI1JHoe.
YBeJIII1fClIIJe) .
TaK, IIaUpUiIll'{J, IIPII Uf:',L
OCTaTuIIlluCTll aUpTaJrhlIOrU K.'lanalfa YBe.T1u'leH-
II bI !\[I! OIm3LlBalOTCH .Hl'BJ,JII a-;e.'1yp:olIl'H If BOCXO):\Hlu:aH <tOpTa, npn CTl'II03e
lIIIfTpaJJMroro OTBCpCTHJ1 - JIellOC I1IJeACCpJ(JIC, JIcr0 1 UI3fl apTcpHH n rrpanhIii
iHe.uyp:wleK H T. n.
Bee ):\yrn ccpp:lJ,a II cocy):\on OT.nIJ1WIOTCJ1 rapllIUllIpIIWii 3aI.;pyrJIeIlHOCTu!O.
l)T,IUpHlImenuocTL ):\yru If.T111 IiaKOrO-JJIIOO pe Y1JaCTI\a CBIIp:eTcm,cTByeT U na-
JlIl'JIIH naTOJIOrH'!CCKIlX wml'HeUllii B CTCHImx cepA:Qa (cocYJJ:on) IlJIn B npII-
:rca,mU;lIx TIWW1X II OpraiIaX.
nocJle Ul(ClmU KOHTYplJll CCP;J,C'IHO-CUCY,LIUCTOil TPllIf lll'l>l'XUJ(HT K II.IY-
'lemHO ep CTPYHTYphT. "Y 3)1opoBoro qeJIOBena Tl'HL ccp):\:Qa II COCY)10B O)1I1U-
pop:Ha. B naTOJlOrfl'IPCHIIX YCJIOBlIHX R OUJIaCTII cep)1ua MurYT oonapymu-
m'IThCf! OOLI3IJCCTBJIPUUH IlJIJI HHOpO):\IILTl' TeJTa. npu naml'TTlII ra3a B IIOJJOCTU
CPPAl'1JIIOii CYl\1RII IlJIII BBe):\f'IflIII ero Ty)1a C ):\IWrUOCTH'ICCJwii U;CJIbIO (nHe!3-
l\1onl'}lmw.p)1) neouxO.L(uMO npOOfl'AIITL IwnTYP callforo cl'p)1:Qa II HOlITYP
f;HYTPPHHPU IIuBepxHocTH nppmwp):\a, YCTanOBIITb HaJIn1JIIe cpalIl;enrrII,ocYM-
ROBannLTX CIWWIl'IInii iIif1AHOCTII II.TlII onYAOJlPlfOAOunLIx oopa;lOnaunii.


CHIlMI
n B fWCbIX npOEln,nHX


IIJIall 113) IIeIIIIH ('Iunma B I,;QCOH npOel\IWIl


1. 00 IIJ; U ii 0 C III 0 T P P e iI 'I' r e II 0 r p aliI 1II bI: 1) OI(CIIIW IW'IPCTBa
("tuuma; 2) OIl}1e)1l'.IICIIIIe UP0l'I'\:QIIH CIIIIlIma (IIepBaH liOcan, BTopaH EocaH)

J) onpeJJ;e.T1eIIIIC IIpmlIlm.HOCTIr YCT<lIIomm IICC.HPp:yC!\IOro.
II. II;j y II l' II If (' CO C T 0 H II U H r p y J( H 0 ii H JI e T H U, .'I C r 1\ If X 11
A II a 4) par III M: 1) 1I1J1rHne TKaIm; 2) cm
.JIeT rPY)1Iwii I>.JICTIW; 3) .D;IIa.ppar-
!1m; 4) Jlerrme.
III. 11 3 Y'I ell n e C e p p: 1\ a, JI e r 0 1:J H 0 ii apT e p II n II r p y p: II 0 ii
a 0 p T LI: 1) IIOJTOml'IIIIe celJ)1:Qa II I,pYIInbIX COCYAOB B rpy,!!noii IIOJIOCTJI;
2) (IlOpMa cepJ{l(a II I{PYUHMX COCYJWB; 3) neJflPITIlIa CepAI(a 11 KpynIILIx
cocyp:on; 4) IWHTypbI cep):\c
HIo-COCYWICTOii Temr; onpc):\eJIeIHIC npOTH
JIielIIIUCTlI II HlmBU:IlILI Jtyr cep):\I(a n rpanHI\ lIfeJH}l,Y IfUIIITI; 5) CTPYK-
Typa TCIIlI cepp;u;a II Hpymlbn. COCY)10B; G) COCTOHIme )J;pyrllx opraHOB cpe-
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PHC. 55. CHHMOK CepAl\a II Kpyn'HLIX COCYAOB B nepBoll IWCOH npoeK-
l(IIII C 0603UaQCIInCM lIyr, COCTaBJIflIoru:nx l\OHTypbI Ceplll(a II COCYlIOB.
B BepXHeM JIeBOM yrJIY CHIlMl\a - Mapl\npOBl\a npOeltl(IIII. Ha cxeMe
IIOl\a3aBa IIpocn:I\IIH I{aMep Ceplll(a H KPYIIIILIX COCYllOB.
1 - npaBoe npeAcepJ:Ule; 2 - npaBbrit meJIYAO'leK; 3 - OCHOBHOA CTBOJI ne-
rO'lnOfl apTepM1l; 4 - JIeBOe npeAcepAne; 5 - neBbIu meJIYAO'leH. 6 - BOCXOAH-
ll\aH aopTa; ? - Ayra aopTbI; 8 - HllCXOAflll\an aopTa.




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Ha peHTfeIlorpallIl\Je B HocoiI npOCEIJ;IIII )10mI\HO OLITJ, 1I0JIyqeno JI.306pa-
il\CHHC BCCX OT)IeJIOB cep)IIJ,a, JIero'fnoii apTepUIl, rpY)IHOll aopTLI II IlpnML[-
J\aIOIIJ;UX H HUM nwupii If opranon.
IT03T0J\1Y Y Bapoc JlbrX KOrJ>Il' Cnlll\JHII upC)InO
ITlJTP.TJbHCl' npOII3BOllUTL na
Iwcmw,- OOJILIIlOrO (I)opMaTa.
IlpOel\lUIIO nCCJIewmaIlIIH 01lpep:l'mUOT no I10JIOrt'\ClIIIIO II <pOpMC TClIlI
cep)1u;a n COCY)IOB. Ha ClIIIl\me B IICpBOii IWCOll IIpOeJU(IlII cepp;IJ,e IlMCCT BlIp:
J;OCO paCIIOJIOfI'\NIIlOro OBaJ1a C Ul'PXYIIlIWii, oOpalI\CTIlIOii B CTOPOHY rpyp:u-
ULI (puc. 55). BOCXO)IHlIWH II uneXO)IHlI\aH aopTa
IaeTIJ1nIO IIaCJIaIIBaIOTCH
.rwyr na APyra.
Ha CI1IE\lKC, lIpon:l13c.rWIIHOM 130 nTopoiI Hocoii lIpoe1HJ,I1n. CCp)1U;C IIo
mhe
Ha BepTIII\:aJILIIO paeno.TJOFI-;l'HUJ>Iii onaJI, a cocY):\IIrTLlll nY'IOl\: rrpe)1cTaBJIHeTCH
pa:mepHYTLIM, B HP'1 pa:ml'.TJLTIO nUllJTJ.1 tloe,-OllHilIaH 'WCTJ>. )1yra n IlUCXOI\H-
U\aH 'WCTJ, rpyp,noii aOpTJ>I (pIlC. ;j(j).
Oupep:eJIIIB npoeIUUIIO IICCJIe)1oBaIIIIH, IIponcpmoT IIpaBIIJILHOCTL YCTa-
HUBhlI OOJILHoro. Hi:! CUUMIW B nepBoii Jwcoii rrpOeHIJ,IlII cupaBa OIIpep:CJIHeT-
cn
IaCTb JIenoro JIPrIwro, 3aTl'M TeIIL cep)1I(a, )J;aJIeo TaI\: Ha3LIBamlOe n03a-
p;Hcep):\eqHOe upOCTpaHCTBO, oupa30BmulOl' OOOHlIlI1 JIerI,nllfJI II cpe)10CT(mU-
CM, HaIWUl'U;, TI03BOIIO'IIUIl{ II 'faCTL lIpaBoro JIPfl,oro. Ha CIIIIMI,e BO BTOpoii
Hocoii: II}JOCII:IJ,UII CJ1ena pacnOJlaraCTCH 'faCTI, lI})aBoro JIerEOrO, B3TeM Tellb
cep)1Ila II Il03ap:IIcepp:e'lTToe UpnCTp:1HCTRO II p:aJIee - n03BOIIOQIIIlI, II 'faCTI,
Jreuoro JIerHoro.
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aqJparMM II BU,n:UMLIX oTp:CJIOn JIermIX, nepcxop:HT H HCnOC}wp:cTBenIIoMY
aHaJI1I3Y cepp:eqHO-cocyp;I1CToro lIIaCCUBa, onpep:CJIHH ero IlOJIOmeHlle, <popl\1Y
II Ueml'UIHY, a TaJOHe Xapml:Tep IwnTypoB, IWTOpJ,1C II ua KOCblX cmIlIumx
::\OJIrIUTU OUTb POBlU,lll1II II 'Il'TK\1MII. Ha CI1IIMHe n ncpnoii I\oeoii npOel\I
I1II
nepep:HlIii IWHTYP cep)1e'I1Io-cocy):\ncToii Tl'IIII oGpaayeTcH 1'I)o1\1H )
yralllII
(CM. pUC. 55): BepXHflfl COOTneTcTByeT llOcxo)J,HlI\eii aopTe, Cpl')1IIHfl - JIe-
rO'IHOMY HOHYCY, IIIDIUIHH - JIenOMY jI\CJIY)10'my. 3a)1IJIIll HOUTYP COCTanJIH-
eTCH II:paeM HIICXO)J,JllI\eii aOpTJ>I, JleBoro IIpep:cep)IUH II npanoro npep:cepl1UH.
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I1pII npoH;1BOP:CTBl' oObPIHoro oG:wpnoro CIIlIlIIKa cppp:ua nJIeIma IIaxo-

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ceHIro JIIIHIIJI IIOIIPpe1JIIIIHa rpY):\IIoii KJIeTlm; 3) naneeeIlIIe JIIIIIIIii, OIIpep:e-
lJHIOlI\nx OCHonIIJ,JO pa311IC]JLI TeIIII cep):\I(a: p:JIIIIIIIIma, IIOIlepe'IIIUHa II IWCO-
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pelIIIe nOnepe'lHIIRa rpY)1Roii H.lIenm; 2) n:lllIC]WUnC OCHOBIIT.lX pa:n1Ppon
cep)lI(a: ):\JlIIHlIIH\a, nonPIJC'IHlIIW n Hocoro pa:llI1cpa; 3) ULI1JllC.TIenIIP ecp-
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5) BLlqnCJIeJIIIe oU1,ellta cepp:n,a.
IV. COil 0 C TaB JI e II 11 e TIO.HY
H'IInLIX BC.T[IPITU! I' HopllIa.aM1hIl\!II Hapn-
<lIITalIIII (no Tau.TJITl(mI).


l\'IeTOJI;II'IeCI\ue ) K8aaJnIJI


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mmI01JaH HYIIOJI )J,IIalI)parIllLI.


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(o6"LJICneUIlP n T('I,C-TC).


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MeTl':Y, lVHI qero CHIIJlIOI, nOlllelIJ;3IOT H3 HeraTOC.JWJT C ropll30HTaJILHO IJaCno.lIo;IwHHoii
cneTonoii lIaHeJlLIO (1I1O<KHO TaKiIie nOJIOIJmTL OObI'IHLlji HPfaTOCHon). Bce on03HanaTenL-
ELle .mnmn IlpOnOiJ;f!T l-.:apanll,auruM IInu qepTPJImJ,TJ\[ nep01lI. nOJJb3YflCL IJp03pa'IHbIME
nJIaCTIlIaCCOI3LIII!II JJlIlIPiilWii n Gum,mUM yrOJIr.JlmWM. IIpemll,e Bcero H3HOCHT Ila nJJeHHY
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 C('}1el\Hny TI'Jla II rpYJl,IJoro Ilo:momm. 3a-
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IIPOl\O)];fIT JIlT/HilO HaIJOOJlbIllerO HOJTepl"JHOrO pa.mepa rpyp,Hoii l;JJeTEU (pnc. 58).
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110 pacrrOJJOmPHHOIIf CCPP;I\P COCTan.T/HPT 1: 2,15, IIpn ROC-O paCIIOJIOiKeHHOM - 1 : 2, npn
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Ha rnyGnne 8-9 nI npn: neOOJIbIII0ll1 nOIIepC'IIIUI,C rpyp,Hoii. "KJl('Tlm
(28- 29 CM) II Ha rnyoIIlIe 10-11 CM IIPII GOJIhIIImi lIOIICpl"UHlI'\C
(32-34 CM). B 3TOM me II.III[ B ClI1CmHOll[ C Jloe OPICTJIIIBO BLlpnCOBbIBaIOTen
eTBOJILI npaBLIX JlerO'IHJ,JX BClI, a Bcpe)IlW II npaBaH IInanW)IOJIeBan nero'l-
HaH apTepIIn. Ha rJIy6IIIIf' 12-15 CM oeoueHHO Heno oTofipamaeTcn: HUIl,HHH
IJOBCpXHOCTL cep)Iu;a, UpIIJIeraIOII(an K )IHa<ppafl\1C, a TaIGHe TeHL HIICXOn;H-
nwii. aOpTbI.


J


105









PITC. 62. I1oc;lOii:m,rii CIIHl\Wr, cep].(I:(a ITa rJIyoIIrre JIeBOrO ITpc].(cep;(ITH.
1 - TpaxeH; 2 - npaBblll rJIaBllbIll 6POHX; 3 - JlCBblfI rJlaBHblll OPOH"'; 4-
B£'P"\.HflH II HIHHHHH .ner04Hh1C BeHLI np:lBoro Jlenmro: 5 - .n(.no[' nU('TI('f>lJI11U':
6 - ('p:J3
fa3aIlH3H» T<'lIb npaBoro rrpeJ<cepJ<uH; 7 - BepxHHH II HIIH1HHH Jle-
rO'lIlLIC BCUbI JlCBoro JleniOro; 8 - JleBLIH meJIyJ<OqeR; 9 - HIICxoJ<HIl\:Jn aopTa.




Ha TOMorpaMMax, npOU3Be)1eHIILIX Ha rJIYOIlHe ;0;0 6-7 CM B JIeBoiI
(BTOpoii) KOCOIi npOeI{U;lIIl, 06LIQnO BII,lJ;HbI JIJIIIIL TenII nepmlJOpJI'lecIUlx co-
CYP:OB JIerRoro. TelIL cepMa II KpynIlblx COCY)10B Ha 8TlIX CHIlMKax npep;-
CTaBJIHeTCH nepe3I\Oll. .HlIor)1a Ha rJIy6llHe 6-7 CM CTaHOBllTCH qeTEllM KOH-
TYP JIeBOrO meJIY)101:JRa, O)1IIaKO 1:JalI\e 8TO npOIICXO;O;IlT COOTBeTCTBeHIIO CJIOIO
IIa rJIyoIIHe 8-11 CM. llpm.mpHo Ha Toii me rJIyoillIe xopomo O'lep'leH
II lIepep;lIlIii HOIITYP cepp;u;a, 06pa30BaIIIIuii npaBLIlIl JECJIyp;O'lKOM. Ha TO-
MorpallillIC CJIOH, IIaXO)1Hm;erOCH Ha rJIy6uIIC 9-12 C
I B 3aBJICIIJ\lOCTll OT
pa3MepOB rpYP:Holi RJIeTHIl, BLIpllCOBLIBaeTCH Tellb JIero1JHoiI apT eplIn, npo-
e)\IIpyIOm;aHcH Ha TeHL BOCXOjl;HIIWii aopTLI, n TeIlL JIeBoii JIer01JHOll apTepllIl.
iha BeTBL OUbIQHO npocJIeJIamaeTCH IIa TOMorpaMMaJ.. P:BYX e.TIOeB, pacnOJIO-
meHHLIX na paCCTOHIIIIll 1 CM APyr OT )1pyra, npII
Iell1 na lI1elILmeii rJIyullHo
JIyqrne BIIp;na )1I1CTaJIbHaH 'laCTL cocyp;a, a 6JIImie K cpep;IlHIIOll nJIOCKOCTIl-
npOKCnMaJILHaH 'laCTL. CJIoii nanJIY'lIIICTO oToupaJlicllIIH Bcex OTP;CJIOB aopTLI
06LI'lHO JICJI\IIT na 1 CM rJIyuJIW no .:pamreIIIIIO co C.TIOeM BLIHBJIenIIH JIerOQ-
lIon apTepJIII. llpn paCIIIHpeHlm Op,IIOTO I1JIJI OOOIlX COCYP;OB OHJI Hepep;I\O BLI-
HBJIHIOTCH na op;noii rJIyouHO. Ha r JIy6une 10-13 CM, K3I{ IIpaHUJIO, naIwy'l-
mllM 06pa30M oToopamaeTcH 3a)1nHH IIOBepXIIOCTL JICBOrO npep;cepp;IIH n
Bnap;aI0lI\aH B Hero JIeBaH HIIJI\HHH JrCrOTIHaH Bl'IIa.
Ha 60KOBoii T01l10rpaMMe CpC'I:\I1IIIIOrO CJIOH II CJIOeB, OTCTOHlI\llX OT Hero
BJIeBO Ha 1- 2 CM (J1 1 -J12), BLlp;eJIHIOTCfl CJIep;YIOlI\ue BamlIbIe CTPYKTYPLI:
JIerOQHblii KOIIYC, OCllOBIIOii CTBOJI H JICBaH BeTBb JIeroTIIIoii apTepIllI, BOCXO-
)J;HIIJ;3H 1:JaCTL, ):lyra U na'laJIO JIJICxo)1Hm;eii 'laeHI rpyp;JIoii aopTbI. Ha rJIYou-
He J13-J1S, RaK npaBJIJIO, xoporno BJIP;CII nopop;HIlii KOIlTYP npaBoro llie-
JIY)10'lKa, a TaKme OCIlOBllhIe CTBOJILI JICBLIX .J1CrO'IHLI"X: BPlr, l1aCllOJIOJI'\cn-
HbIe Knepep;l1 U IUIlI:JY OT JIeBOrO rJIaBIlOro n I1IDI'\nep;OJIOBOrO (jPOIIXOH. Ha
I'JIYOIIHe J1 6 -J1 8 nanOOJIf'e H(,]l0 BLIHBJIHIOTCH OTlOpTaHlIH OOOIlX JlieJIY-
)101JIWB.
llpil 06eJIep;OBaIlIIII JIlIU; pa3Horo TeJIOCJIOmeIlIlH II UO.JII,I1LIX C ll3MCHeIIIIH-
MIl nOJIOmeHIIH, <pOplllbI II BeJIlPIJIHLI cepp;u;a JI COCy)10B B IIpIlBop;OHlIbIe )1alI-
lIue IICOO
OP;I1MO nneCTII [WppeIUIlBLI. BOT n01Jl'MY pOIITreIIOaIIaTOlllIl'lOCI\II1l
2.I1aJlII3 CIIUJlUW rop£13;O;o Bamnoe ]WH OIIO;UIaBannH nLIp,e.JIPHIIOro CJIOH,
IOJ\[
U.J1(
pLI B l\[aplmpOBo
IHOii Hap:nIlclI.
IbyqeJUle COCTOHIIIIH rpYP;Hoii Imf'TIHI, .TICrI\lIX, )1IImI1parllIbI, Cl'pp;l{a
H KpYIIIILIX COCYP;OB npoBo):\fiT no Toii JIW cxoMe, <ITO II paCClIIOTpcnuo 06-
30pnLIX CHUMIWB CCpp,l\3 B cooTBeTcTByIOlI\lIX npoeHIWHX. llplI OOCJIl'p;OBa-
IIIIJI 60JILHLI
 lIIIITp£1JIbHbIl\lII flOpoKaJ\III cep)1ua Baa,noc 3na T [enIle npno(jp
-
TaeT oneHIW neJIII'IIIHLI JICllOrO npe):\ccpp;I1fl, BLIHBJIeIIlIe nIIYTplIcepp;c
IIIhl

{)UbI3nCeTBJleUlIii, anaJIJIJ COCTomUlH MaJIOro Rpyra HponooGpam;l'IIJIH.
o BeJIIPlllIIC JIcnoro IIpep;eepp;UH npom;e Bcero Cyp,UTb 1I0 TOMorpallllllaM
T T
l! rrpH'VlOii npOeI{U;IIll ITa rJIYUUl1e - ClI[ UJIlI --1 CJ\[ OT llonepXIIOCTU CIlII-
2 2
:riLl. ,[(yra YBC.JIU'Il'HHoro JIellOrO npe)1Copp,IIH P;OXO)1IIT P;O I'\OIITypa IIpaBoro
T
IIpe):\cepp;IIH JlJIII p;ame nepeCPHaeT era. n CJIOO - - 2 ClIl, a TaKJIW na TO-
2
1If0rpallllllax B I\OCLIX rrpOeI'\UIUTX perWlIICH)IYOTCJI pacclIlOTpCTL II onpCp;eJIIITb
RaJInGp .JIerOTIHLI
 Ben, BIIH;o;aIOm;nx B npl'p;cep):\ue.
OiiI,I.!llPCTBJIerrHH B CTBO)m3'l MIITp3m,rroro mIanarra, B <pIIOp03ll0U IWJILqe II B Tpo:lI-
UP yuma JICBOro lllJC;:J:CPP'lUH C.lICAYCT I1CIiaTb IIa IIpHJ\IbIX TOJ\IOrpmIBIaX Ha T.lIYOTIHe OT
T T
2 CM AO 2 - 2 C1II OT nOBcpxHOCTll cnIlIILI, a Ha TOMOrpmI1lIa"\. B HOCLIX IIpOeI{qnH"\
IIpII1I1C)1II0 OT 8 AO 12 CM OT IIOBCpUIOCTH lliT3TIIBa. OUbI3BPCTB.lIeHIIfl B CTBopI;:ax aop-
Ta:n,Horo R.lIarr3H3 .lIOI\a.IIII3YIOTCH HCCIW.lIbRO MP)l,IIaJILneC, IUIepp;:J:II H BbIlliC. LITO I\aca-
CTCH COCTOHHIIfl I{POBOTOIia B .lIprHIIX, TO OHO II3YQ3CTCH B COOTBeTCTIHIH C yr\a3aIIlm
m.
CAenaHHbIJIIIl na CTp. 92.
B "X:o):\l' alIaJIII3a IIl'06
o)I,IIMO nOCTOHHIIO conOCTaBJIHTL BCl' I1l1[eK>I1J;IIecH
T01l10rpaJ\I1III.I, TaI'\ IWK KafHp;aH 113 llUX )1aeT npe)1CTaBJI£'HIIe JIl1illL 0 )1eTaJIHX
{))1IIoro 1I3 BLlp;eJIHOll1bIX CJIOeB. KpOMe Toro, CJIe)1yeT COIIOCTaBJIHTL nOCJIoii-
.HbIe ClUllI1KH II 0630plILIe peIITrOHOrpaMlIlbI.


107




PEHTrEHORIIMorp AMM:bI


MOTo)1 peHTreHOIHI!'.wrpaq,uu IIpUlIu'nHlOT )IJIfl perUCTpaU;UJI ;JJ;BJlmeHUii
\'ep)1u;a II RPYUHLIX COCY)IOB. PeuueUOIiIIMOrpaMMI,I cep)1IW np01l3B0)1H'r
C nOlllOlI\bIO peHTreHOIUIMorpaq,a, YCTpoiicTBO ROToporo onncaHO B rJIaBe Ill.
AJIH peHTrcHOIUlMorpa<Imn Cep)IIW I1CnOJII,3YOTCfl pemeTRa, COCTOHlI\afl U:J
2,
 napaJIJIeJILHO paCnOJIOJReHHblX CBIIIIU;OllLIX n.11aCTIIII 1IIIIpilIIOii no 12 MM
I{am)1aH, pa3)IOJIeHHLIX lI\eJIflMU IIIl1puHoii '1 MM. IIpll C'I,eMHe nCCJIeP;YOMblii
nOCJIe rJIyGoRoro B)IOXa ):\OJIlI\eII 3a)IepmaTJ. )ILIxaHnc. 3a BpellUI BLI)ICpanm
pellieTHa npOXO;JJ;UT paCCTOHlIIle, paBHOC 12 MM. TaKarr MeTU;JJ;JlKa OUJIa na-
3RaHa l\UlorolI\eJIf'Boii IIenpcpMBIIOii peunCIlOlHllllOrpa<Imeii; oua nOJIy1:JUJIil
IImpOIwe pacnpOCTpaueHne B npaI{Tll'leCHOii paGoTe. IIOCKOJIbI{Y BO BpellIH
C LeMIHI rrepeJ\IOIIJ;aeTCH TO.11LIW pcrneTIW, a ImCCCTa OCTaeTCH nonO)IBII,I'\HOll,
Ha nJIeII1>e IlOCJlep;OBaTl'JILHO (pnH:cnpyeTcH )1BllIIWIIITe pa3IIhlX T01:JeI'\ IWII-
Typa cep)IIW B npe):\.CJIax EmR)1oii lIOJIOCLI, a lIa Bceii InmOrpaJ\IlIIc nponcxo-
p:IlT «Tl'nCBaH» 3aUI1CT. IWJIeGaHuii Bcex TO'IeI{ JWIITypOB ccpP;u,a; u30lipa-
;f{eHile ero npII aTOM no nCKaaWCTcrr.
.D:IJyroll CIIoCOG MHorolll,eJIeBoii. IJeHTrCHORIIlIwqJaqmn 3alUIIOQaeTCH B TOM, QTO no
BpClIUJ C"hellUHl p,BnmeTCH ImcceTa, a pemeTl\a OCTaeTCH na
IeCTe. Upn TaIWI\[ cnocooe
Ha RJreTHe pernCTpnpYIOTCH IH13HLIe MO'IenTbI p,BllmeHllH Op,IIII'\: n TCX me TOqeH ROHTY-
lJa CI'PAe
IHOII TenlI, IWTOpLIC na:J\.op,HTcn lIa ypnBne nenOil,BlIaiHhlX II.\CJIelI pem[)TlUl.
1130Gpa;.KCHIIe cepp,u:a B u:e1l0\1 rrcn:amaeTCH H IIpn06pCTaeT cTynell'JaTLIll BUp,; rrOJTOMY
TaJ>IlC peHTreHOHIIl'>lOrpUlIl111bI nOCRT Ha3BaHIIe CTyrreHqaTLn. Gnu lICIIOJIL3YIOTCR rJIaBHLIM
Oi'ip<l30llI B HayqHO-JlCCJICJ\on<lTe.lILClwii paGoTe. B p,anr.rrellmCJlI n3. T lmJ>eHIIll BHJllIIaHlre 6y-
!leT Y1H'JIeHO aEaJIII3Y nerrpepLIBHLL\. peHTrCHOKIIlIIorpa?tHI.


fiJIaH 1I3YQemIH l\lIIorOll\eJIenOH pCHTreHORHl\IOrpaMMbJ cepA
a
1. 0 (i IIJ; II ii 0 C MOT II P l' II T r e II 0 K n M 0 r paM )1 1,1: j) OU;eHI'\a Iia-
'1eCTBa CHIIlIIIm II nOJIOf1\eH1UI IIJ;('JIcii pelliCTIHI; 2) OllpeACJIOHIIC IJpOeUuHU
IICCJIe)10BamIH II IIpaBIIJII,UOCTH ycnu:IOrum nCCJIe).\yeJ\IOro; 3) onpe)It'JIPllue
TIllla peHTreHOIUIMorpaMMLI (nl'npcpLIBlHUI, nYIICH'JaTtlll); 4) oiiIu;aH opn-
eIlTII}JOBl\a B OTHorneUIIII COCTOrrllIJH rpY)1Hoii }{JICTKII II oprmIOB rpY)IlIoii
nO,IOCTIr; 5) onpep:e.rrellnl' rpauun; pa3,T/IPIIIhIX OT)1l'JlOB Cl'p,l]Jra II I,pyn IILIX
coeY)IOR.
I L A II a JI II 3 1\ 0 .11 e ;; aTe JI L II 1,1 X )I II II ,I, e II II IT P a 3 JIll '( II 1,1 X 0 T-
)1 C JI 0 Bee p)1 1\ a, JI e r 01:J H 0 ii apT e p n II II r p Y )1 II 0 IT a 0 II T LI:
1) 3OJ!a .11l'Boro a'\eJIyp:OqIW: a) npOTJUli('nHOCTJ, .!DULl; 6) Tnn ny.lIbCanJUI;
n)
raCTOTa COI{palI\eIlUii; r) PUTM eOl\pmU;CHlIii; ):\) Mop(IwJIonw ayGuoll-
ux rJIy6uIIa (alIIIIJIIITyp:a), npO)lOmRIITeJILIIOCTI, BOJIIILI COI'\paIIJ;emw, q,opMa
n KOIiTYPhI 3YUUOB; e) 1I.3J\IClll'lIne BCJIll'IIlIIbl sReJIY):\(l'ma npn nYJIhCal\llU;
2) 30Ha JIl'BOro npeAcep)IIUI: a) npOTrrml'HIIOCTL aOHI,r; G) lIwp(IIOJIornH 3y6-
[(OB; 3) 301m l'\OIIyca JIl:'rO'UIOii apTepnll II l'l' neTBeii: a) TTllliTHlI,('IIIIOCTL 3()-
ULl; 6) rJIyouHa Ily.11LcaIUIII (allIIIJIlITyp:a 3y6I{OB); B)
apl:mTep ny.11bcaU;Ulf
«(pOpMa 3YUU;01l); r) nYJIl.caU;UH COCY):\OB B Hopurrx Jlenmx; 4) 30ua aopTLI:
D) npOTH,I,eIIHOCTT> :lOll},}; 6) r.rryGuna IIy.11bCHL\IIII; ll) xapm,Tep IIYJILCaI\IIU;
5) 301ra npaBoro npe){Cepp;IIH: a) npOTmr{l'HJIOCTL :!onJ.T; (j)
IaCTOTa cOHpa-
IIJ;enuii; B) xapm,Tep COI'\paIIJ;l'HUii (1II0P(!JOJIOrIIH 3YOJ\On); H) 301ID. npaBoro
;I{e.11Y)IO'IKa (Ila CIIIIMI'\e BO BTOpoii Eocoii npoPI'\I{IIH): a) npOTHlI,eIIHOCTh
:JOU},I; 6) rJIyuIIlIH 3YOI{OB; ll) lIwI)(I1OJIOrIHl 3YUJ{OB.
Ill. COlI 0 eTa B JI e II n e I{() JI e Ii aTe JI L II bI X )1 BIOI, C II 11 IT P a 3-
JI II 'I II bI X 0 T )I l' JI 0 B: a) qaCTOTa nYJIbCaUnU; 0) co pIITlII; B) rJIyliuna;
r) COOTHOIIIf'IIIJH BO BpCMCIIII p:mm,eTIlIii pa:mI.IX OTp;e.lIOB.


l\.IeTO)J;U'I('('Rue YRa331l1U1


1. OOII\IIH O('l\IOTP J)eHTreHoRlIlIfOrpal\Il\lbI. J3 OTJIII
/He OT OUblqHOro CllllM-
rw BCC nOJIe peHTrenOHUJ\IOrpallIlIfLI pa3)IeJteHo y:mUMII CBeTJILIJ\lJI JIUHIUlllIlI
ITa napaJI.11C.lI1.lILIe )Ipyr )1pyry HOJIOCLI, a ROIITYPLI Cep)II
a II RpynHI,IX eo-


108




'''}::''I.;MM


.1


1-351111


-2.5 t4


11


2.v ""1


.'


Pile. 6
. J1ppc
mHI HCIlpepLIBH3H IIIHOHJll\CJlCnaH PCHTrPHOIill-
II1OrJ13MlIIa ccp
l\a II IipynHbIx coeY
OB rpY
Hoii nOJlOeTII.
U;1I
pbl OU03H3'laIOT allmJJIITY
bl 3YUl\OB pa3HbIX (lTACJlOB ccp
-
na II eoeYAon B HOpll1C.


CY):\OB COCTOHT U3 OT)lOJIbHJ>IX 3YUU:OB (plle. G3). 8'1'11 ;3YOU;bI IIl\1eIOT ueGoJIl:.-
myIO BeJIII1JUIIY, 'ITO 3I1a'I1ITeJIhUO 3aTpY)lIlHeT II
 aHaJJ1I3. TImnoMY E Ra-
',eCTBY peHTrenOHIIJ\lOrpallIlI1LI npIIXO):\IITCH upe)l'bHBJIHTL oe060 IlWCTlme Tpe-
oOBaHIUI.
H a npaBII.TIbHO np01BBl'):\eIIIwii IlcllpepLlBIloh peIITreIIOJiJllIIOrpallIl\le )lOJIm-
uo ULITL IIOJIY'll'IIO IWHTpaCTHoe 11 pC3Iwe lI.3oupamcnue eep):\u;a II KPYIIIII>IX
l'OCY)10B BlIlceTe C JIpII.TlCamII
nlllII OT):\OJlaJ\HI JJOrKIIX II p:uacI)parIlIM. O'lep-
TaIInH pe6ep )lwm-;nJ,J GMTL POBULIlIIIl II
Jl'TIaIJ\II1. EC,11Ir ilie IIMeIOTCH 3y6U;LI
lIa II"\: HouTypax ua rpanllno eOCe)lIIIIX nO.TJ(IC, TO TnlWII peIITren01ill1lrorpall1-
},Ia ne nOJwcanI1 paeClIIOTpeHlIIO, TaI\ Hal'\, O'IPBUp,nO, ucc.TIe):\yeMblii no npCMJI
C'bCMKlI CP;BllIIYJICH IlJllI )lLIIlIaJl. 13 TC'ICU1Ie Bbl)lCpailiII pl'IIIl'Tlm )1o.rrama
IIpoiiTII nYTL, paBHLIii 12 111:\1. TIpu IIl'IIpaBJJ.1IJ>no (JTperynrrpoBaIIIIoii ('1W-
pOCTII )lBIIa'\eHIIH PPiliOTliII olIa JIIIGO IlOpC1I1l'eTlITC H na UD.1ILilieC paCCTOHHIIC,
J{ Tor.rra 3yGULT, 3anIlcamn.ll'
JCI1P3 o:o;ny lIJ;em., OYP;YT HaCJIallBaTbeJI na 3YU-
I
LI, 3anncannhIe
ll'pe3 cocep;moIO llW.TIL (na peuTrCIIOIm1\lOrpa1l1J\Ie B :3TOlll
cnY'Jae ounapyn>ImHlOTCH I1POOI.T'lIIbIe TeMHMC no.TIOCbT), JI1I6o oeTaHOBUTCH,
TIe npoii)lH 12 MM, 11 Torp;a ua cHllllme nOJIy'laTCH lIe:JaCBe
IemILIe, «CBeTJIbIe»,
rrOJIOChJ. llpn nepaBHoJ\JPpnoii a,t' CTWpOCTIT P:BII;Hl'UTTH peIlICTI\II B HailiJ{oij
nO.'Ioce peuTreHormMorpaMMbI GYP,YT
rcpep;OBaTI,CH Tl'lIlIJbIe II CneTJILle IIO-
JIOCKIJ pa;moh mnpUHbI. O)lIJOBIWMCHIJO e onpe)l;e;;:remIeM Ha
ICCTBa eIII1l111W.
YCTaHaBJITTBaIOT nO.1I0rlWH1Ie IJ
e.r:reii pcmcTIuI.
HaK upammo, npll pl'1ITfeIIHIIJ\IOrpa(IHlIl copp;ua II KpynHLIx COCY)l;OB
m;eJJn pemeTTHI paCl[O.TTaraIOT rOp1l30JlTaJIIJIlO, ylIHTLIBaJI,
ITO rJIaB/[Llll HOM-
1I0HeHT IWJlefiaTe.JTLHMX ):\BHlHenuii 3THX opraJ-IOu ]11IfCl'T rOpnJOHTaJILHOe na-
HpaB.IIemIe.


109




PeIITreHOI{nMOrpaMlI1LI MOrYT 6MTb npOIl3Be)IeIIbI B TCX me OCHOBHLIX
n03I[[(I1HX, qTO II 0630plILle CJIJIlIIInI cepP:IIa, T. e. B JIepe)IHen, JIepBoii II BTO-
poir IWCbIX n JIeBoli 601WBOii JIpOeIn
IIHx. KpOllle Toro, JIO cncu;nmILHLIM JIO-
I\a3annHlIf )Iono.lIHIITeJIbJIO rrpOJI3BO)IHT rrpIlu;eJIblIhIe peHTrelIOIwlllOrpaMMbl
B aTIInIlqIlLIX npoem:(IlHx )IJIH IlOJ1Y1JCIIIIH TCJIenoii 3anIlcn ROJICUaTCJIbHLIX
)IllIIllieIIIIii II30paHIIOro yqaCTlm CTcmm cep)IIIa I1JIII cocyp;a.
2. AnaJJlI3 I{OJJe6aTeJJbIlbiX ;:
BHlI<CIIlIii pa3JJ1IQIlbIX OT
CJJOB ccp

l\a, JJe-
rO"IHoii apTepnn n rpYAlloii aopTLI. 1I3BeCTlIO, qTO meJIyp:OqKOBbIe, JIpe)J;-
cepJJ;HLIe II cOCy;o.JICTbIe 3y6 II LT CYlI\eCTBeHIIO OTJIIl1JaJOTCH ):\pyr OT )Ipyra no
(IwpllIe. .D:eTaJIMlhIii alIaJIU:I p:Bnmennii: cep;o.L(a I!IHlIIHTO Ua'IJJlIaTl, C U3Y'le-
HIHt 30HLI JIeBOrO }IWJIY)IOQIm. llpelli)Ie Bcero YCTaHaBJJllBaIOT npOTHlliCHIIOCTb

JToii: 30HLI, T. e.
IIICJIO nOJIOC peI!TrCJI01HIlIfOrpallIMLI, C1JIITaH OT )J.lJa<pparMLI,
B KOTOpLIX IlO JIeBOMy ROJITYPY BLIHBJIHIOTCH xapaI\TCpHMe lliCJlY)IOqKOBMO
3y6n:LI. B HOpll1e 301Ja JIeBOro .1\eJIy)Io
ma 3aHIIlIIaCT 7-9 IIOJJOC; IIpn YBe-
JlII1:JenIIII JIeBOrO llieJIY)IOqKa T(UCJIO nOJIOC B lIeii YBCJlJIqIlBaeTCH. CpaBIIJIBan
neJIIIT(lmy 3yGU;OB lIa pa3HLIX yqaCTImx IWIITypa JICBOrO llieJIY)IOqIW, OIIpe-
i1,eJIHIOT TllJI nYJIbCaIIllIl. II pn JIepBOM TillIe naIlUOJIbIIIIIC 3y6 II LT nLIHBJIHIOT-
cn y BepxymmI llieJIY)10
IIm, JIpII BTOp0ll1 TIIJIP - Y OCJIOnaJIJIH, rrpJI TpeTl.eM
(cMPmaIIIIoM) Tnne allIIIJJlITYAa 3yGIIoB na JIpOTHlKCmIlI Bceii )1yru meJIY-
.n01:JI
a npIIlIIeplIO O)1nlIaKOBaH. "LlacToTY Cep;o;eqHLIX cORpalI\elIuii (n) l\W}Imo
RUqnCJIIITL no .popll1YJIe:


n = "(hrcno 3YOI:\OB B nOJIoce X 60
DpellUf :mcrromrponanll1r (n c('r
yrr,[\a
)


ll03TOllIY na peHTfelI01mMOrpaMMe pCIWMelI)1ycTcH BCer)1a HaAIlllCbIBaTl. B ce-
RYII):\ax BpClIUI )1BlliIWIIIIH pemeTIm ()lJIJIT('JIMJOCTJ, nM)ICpnm:JI).
):(JIH cym)1eHIIH 0 pIITlIle nYJIbCaIIIIn Hc06xo)IIIlIW C rrOllWlI\bIO np03paqHOn
lII11JIJInll1CTpOBOii JInIIenIaI cpanIIIITb I1HTepBaJIbI MC.I'\)IY 3you;allIJI B o)1IIoii
JI Toii: me 1I0JIoce. B nopll1C OIIII paBIILI Men,)Iy COGOll. 3aTelll rrpncTYJIaIOT
K IICCJIe)10BamI10 l\rop.pOJIOflIJI 3YOU;OB JleBOrO meJlY;O;OT(Ka. Kam)ILIli 3yGen:
na HOpllIaJILIIOii IIOJIpepLIBTToii peIureIIOI\:IIlI'WrpaMlITe COCTOJIT 113 BepXJICro
OTHOCJITCJIbHO I10JIororo I'\OJIeIIa, COOTB('TCTnYIOlI\ero )1IIaCTOJIlIqeCROMY Ile-
pellIeIIlelIIIIO IWIITypa cepp:n:a, II HIImHPro HpYToro IWJIena, OTpamaIOlI\erO
CllCTOJ1ll1:JeCROe ero IlepeMelI\eHIIe. B HopMe ROIlTypbI 3yGu;a pOBIILIe II qeT-
f01O. AlImJII!TY)1a 3you;a JIeBOrO .HeJIY;O;O
IIW Ha nepe)J.IIeii pCJITreHOIUIlIIorpaM-
lire paBna 3-7 MlII, a Ha CIIIIlIIKe, npon3Be)J.eHHOllI no BTOpoii Iwcoii JIpOeH-
unn, - 8-10 MM. B npaI
TII1JCCRofI paOOTe 3a aMIIJIIITY)1Y 3y6u;a MO}ImO
I1pIIHIIl\WTb )1JIJIHY ero CIICTOJIlIqeCIwrO ROJIelIa. llplI IIe06XO)I1I1II0CTil TOqnLIX
n3!\IepeJIlIii CJIeP:YOT IlpnoeraTb K cnocoGy, OJIIIcannOl\Iy B DIaBe III B OTIIO-
meJIlIn 3y6n:oB p:J,IXaTeJILnoii: penTfOnOlmllIOrpalllllILT.
OIIpe)1eJIeHne mnpnlILI OCIIOllarrmI 3y6n:a n03BOJIHeT YCTalIoBIlTb IIp0)10JI-
)RllTeJIbIIOCTb OAlIoro p;naCTOJIHqeCIUI-CllCTOJIIIqeCKOrO IWJICOaHIIH CTCJIHII
cep)IIIa. Ha penTfeHOKnllIorpaMMe, np01I3Be)1elIHoii I1pn IlOBLlmelIJIOlII IIanpH-
iliPIIllII Ha Tpyol,e, TeI-IL napynmoro oT)leJIa JICBOrO )KeJIYAOqI{a COCTOJIT 1I3
IlpaBIIJIblIO qepe)J.YIOlI\lIxCH TeMHLIX II CBeTJIbIX JIOJIOC01'\. :=ho OO'bHeHHeTCn
Tell1, 'ITO cep)Iu;e B npou;ecce pa60TbI nepIIO)II1
ICCRn lIIOIIHCT CBOIi 06'LeM,
B CBH31l C
IClI1 nyqI'\Y 1I3JIY"'IennH npIlxOAIITCH npOXO)IIITb Bce npeMH lIIOIIHIO-
lI\yIOCH Maccy BelI\cCTBa, qTO 1T0JIY"'IaeT eBoe OTpaa\CHIIe B (<IIOJIOC1:JaTOCTII»
'feHCBOro ll306paml'llIm, CBII)IeTeJILCTBYIOlI\eif 0 xopomen COKpaTllTeJIbHOii
cnOC06IIOCTII MIIOI{ap)Ia. C 1I01l'lOII\LIO .pOTOMOTpa ()ICIIClITOlllOTpa) lIIOmJIO ;0;0-
nOJILIIO TOqlIO OIlpe)1eJIlITL pa3HIIn:Y B CTenelI1I nOTClIIHennH COCe)IIIIIX Y'IaCT-
1mB IlJIeIIRII.
B rraTOJIOrlI1:JCCI\1IX YCJIOBlIHX BCTpe'laIOTCH pa3no06pa3IILIO Ae.popllraU;IIII
3YOn:OB JIenoro n
eJIY)J;OqKa. llpn Hapymerrnn TOHyca II COI\paTlITeJIbIIOii CJIO-
C06HOCTll MIIORap)1a nepe)IKO onpe)1eJIHlOTCH 1I3MelIemIfl allIIlJIIITY)ILI 3y61
OB,
y)1JIlIlIeHlle IlJIII YI\OpOqeHIIe CIICTO.lInqeCROrO ROJIelIa, paCII:(enJIelIne BepxyllI-
RII 3y6u;a IIJIII ee yce'lerrIIe, BornYTOCTL, BOJIHIICTOCTL nJIlr 3a3yGpeHIIocTb


110




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f


1.


r


,


t


J1.IlaCTOJIlIlJeCROrO KOJIeHa II T. )1. Oc06enno GOJIbmOe 3naIJeHIIe IIMeeT BLIHBJIe-
IIIIe (<He lIfLIX » 30H, T. e. y
IaCTKOB, r)1e EOHTYP ccpp;u;a ObIJI B MOMenT C'LeMI'\II
nenop;Bnn'\elI II nOTOllfY OKa3aJIefl .1InIIICIIHLIIII 3y6U;OB. TaImfl (<HeMan» 30Ha
MomeT nOJIY1JIITLCH rra MeCTe nJIeBpO-nepmmpp;I1aJIbHbIX cpam;cnnii IIJIII or-
paHIIIJeHHOrO Py6u;oBoro npou,ecca B 1I1II0Wlp)1e, pa3nIlBIIIerocH IIa IlOIJBe I1H-
cpapKTa. HHorp;a D oO.lIaCTII I1mlJapI{Ta, oc06enno II cJIY'lae oopa30BaHlIH
&IIeBpI13111bI cep)1I\a, onpep;eJIfleTCH napa)10KCaJIbnafl nO)1mUHIIOCTL CTem'\II
iHeJIY)IOqRa: BO BpeMfl CIICTO,lIbI nopameIlHbIii Y'lacToR CMelI\aeTCfl RHapymn,.
a B nepno,[( ,[(IIaCTOJILI - RHyTpU. B aTOM CJIY1Jae na pCHTreH01iIlllIOrpall1l11e
na OrpaHIIqeHnOM YIJaCTKe IWHTypa }HeJIy,[(o
ma nOflBJIHIOTCH 3y6U;bI cocy-
p;IICToro TIIIIa.
no TaHoMY iRe IlJIalIy IlUCJIe)10BaTeJILilO IICCJIe,[(YIOT 3UHLI JICBOrO IlpcA-
Cep)1IIfl, JIeroIJHoii apTepnII, aopTbI, npaBoro npcp;cep,[(I1H II npaBoro meJIY-
]\OqRa. Ha HenpepLlBHoii penTl'eH01mMOrpall1l11c 301Ia JIeBOrO npep;cepp;nH
B IIOpllfe COCTaBJIfleT npIIMepIIo 1 IlOJIOCY, 301m JIeroqnoii apTepIIII - 3 no-
J£OCLI, 30Ha aopTLI - 4-5 nOJIOc. 3yGU;bI JIer01:JIIOll apTe}HIII n aopTbI 1Ia He-
npcphIBHOii peIlTrl'nOlmlllOrpaMMe no BflellInCMy nn,[(y 1IanOlllIIHaIOT a,eJIY)101:J-
IWBbIe, C Toii TOJILIW pa3I1I1I\eii, 1:JTO y COCY)1IleTOro 3y6ua BepXBee ROJIelIO
paCIIOJIO}l{eIlO ropII30IlTaJIbHO; OlIO COOTBeTcTByeT ULICTPOMY paCIIIupeHIIIO'
cocy)1a B MOMeHT 3ano.urrennH ero KpOBbIO, nocTynaIOIu;eii II3 cep)1u;a, IIIIlli-
IIee me KOJIelIO npe)1CTaBJIHeTCfl OTilOC.IITeJILHO I10JIOTIIM II OTpaameT cpanHII-
TCJILIIO Ml')1JICIJHOe CIIa,[(CHIIe cocy,[(a BO BpellIfl OTTORa I13 I1ero HpOBII.
IIpeAcep,[(I1Llii 3y6eI( IIlI1eeT naIlooJIee CJIO}ImyIO (IJopll1Y. Ha IIcnpepLIBIIoii:
peHTfeHOHIIMorpallIMe OII npep;CTaBJIHeTCH IWYBepIlIIIIIIlbIM. llepBafI Bepmnna
06YCJIOBJIelIa ,[(BmlwIIIIeM npep;cepp;nfl, DTopaH - rrepe)1aIJeli gnmIwHIIfl n'\e-
lIY,[(OIJIW na Ilpe,[(cep.n;I1c.
3. COnOCTaBJIeIIIIe ROJICOaTCJlbHhIX )J;3mI,cHIIH pa3J1IIIJHLIX OT,[(CJlOB cep;:J:-
1\a II RPYUHbIX COCY,[(OB. ,[I;aHHLle, rrOJIY'IeUIlLIC npIl anaJln3e OT,[(eJIbHbIX
CerllH'HTOB cep)1e1:JIIO-coCY,[(I1CTOii TeHn, ne06XOp;I1l1lO conOCTaBIITb )Ipyr C ,[(py-
rOM. llpe;'Kp;e Bcero cpaBHlIBaIOT
IaCTOTY II pnTM cORpalI\ennii npep;cepp;nu
II }[\eJIY,[(OIJIWB. "Y 3p;opOBoro
IeJIOBeI\a onn, pa3Yll1eeTCfl, Op;I1HaKOBbI, B CJIy-
'lae iRe 6JIORa,[(LI Ccp)1I(a 1JIICJIO 3YUU.OB npep:cepp;nii B 2-3 pa3a npeBbIIIIacT
I'\O:IH
IeCTBO me.TlY,[(O'lIWBLIX II cocy.n;nCTLIX 3y6I\OB. npn I1aJIlIqlllI lI1epI\a-
Tem.noll aplITIIUIII IIa6JIIO):\HcTCH HepallHOMepHOCTL llInepBaJIOB MeiR)1Y 3y6-
u;allllI II pa3JIn
IIIafl allIIIJInTy)1a callIllX 3YUI\OB. ,[I;JIfI :mCTpaCilCTOJIIIII Beebllla
T1IIIIlIJlIbI HeUOJILIIIne BHco'repe)IULIC ay6U;bI C IIOCJIC)IYIOII\I1M 60JIbllIn!\l npo-
MemYTKOll1 (IwlImencaTopHaH rraY3a). AJILTepIlnpYIOII\IIii nYJIbe )1aeT IIa
penTren01nIMorpall1l1W npaBIIJILHOe
IepC,[(OBannc rJIyuoElIX n MemiIlX 3you;on.
BecLMa DamHO conOCTaBlITb allIIIJIIITY,[(y 3y6U;OB pa3HbIX OT,[(eJIOB ccp)1u;a
II COCY,[(OB. 'YBeJIIPICIIIIC 3YU1\OB IlpaBoro mCJIY,[(O
IKa IIepep;RO 6LIBaeT O,[(Hnlll
n3 IIepBLIX rrpII3HaROB rlInepTomIII B lI1aJIOll1 Kpyre I{POB006palI\eIIIIH. 3HaIJll-
TeJIb1l0e YMeHLIIIeIIIIe 3YUUOB cep,[(u;a II COCy)10B CBIl)1eTeJILCTByeT 0 nopa-
,HelIIIlI IIHIOHa pp;a, B TO Bpell1H ImI{ Yll1CHbIlIenne 3y6U;OB ccp.n;U;a rrpIl coxpa-
IIeHIIII aMIlJIlITY)1bI COCYJl.IICTOll nyJILc.aU;IIIl OOJIPe XapaI{TeplIO )1JIH BLIIIOTHoro
rrepIII'\ap)1IITa.
B 3aImJOQeHIIe I1e06xo.n;IIlIIO cpamlIITb BpClIffl n03IIIII,HOBeHIUI IWJIeOaTeJIb-
lILIX )1BIIfI'\l'UIlii B pa3IIJ>IX 1:JaCTflX cepp;U;a, a TaKmc B pa3HLIX 1JaCTflX O)1IIoro.
II Toro jHe }ReJIY,[(O
IIW. ::hIIM nYTeI\l, r'\CTaTlI rOBopfl, YCTaHaBJIIIBaeTCfl npII-
1'0):\.& Kam.n;oiJ: BO.unLI - sl';eJIy)I01JIWBafl, npc,[(cep)1Hafl IIJIIl cOcYAUc.Tafl. ,[I;JIfl
orrpe)IeJIeHnfl Bpell1eHHLIX cooTnoIIIcIIIIii ( «.pa3bI IWJJc6anIIH» ) I13111epflIOT
pac.cToHIIIIe OT o,[(IIOTIInUblx YIJacTIwB 3YUU;OB B pa3nbIx IlOJIOCaX )10 I'\pafl
nOJIOCLI.
llOJIyq:eHnLle Ilpn II3Y1Jemm peHTrCHOl>IIlIIOrpalllMLI cBe,[(eillIfl COilOCTaB-
JIHIOT C aHaMHl'CTII1:JeCI'\nllIII )1annLIlIfII, pe3YJILTaTaMII oCMoTpa UOJIbHoro.
11 B 0c.06enHocTlI C pe3YJILTaTalllIl aJIeI{TpOKap,[(norpa.pIIII II .pOHORap)I;nOrpa-
(InIII. TOJILIW nOCJIe aToro MOiIUlO ,[(aTb pa3BepnYTYIO XapaI{TepIlcTllRY CO-
HpaTIITeJIbIlOii .pYHI'\I\IIII c.ep.n;U;a II nYJIbCaU;IIII RpymIbIx COCYP;OB rpYAuml
nOJIOCTII.


Ill.




3JIERTPUKHlVIOrPAMM.bI


8JIeRTp(U\lIMorpa<Imn II03BOJIH('T JI3YTIClTL COI\paTIITeJlLlIyIO CIIOCOUIIOCTL
II TOBYC cep'zW'lIIoii MLlrnl
LI, a T3InH
e napyrnl'HlIn re
W.'l.lIIraI\IIll\II B HfIMepax
cep.DJ
a. 3anncL nYJIb<:ClTOPHLIX )IBIDlWIIlIii pa3JIIT1JHLIX OTpe3Ron IWJITypa
cep)J;I\3 II RpyrrHLJX COCY)10B (SJIl'l,T pOImMorpa
IIrr) 1I II:3l\IelIC'IIlIii IIHTeIICIIB-


r _u'
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J.: --'-


Pnc. 64. CT8Hp;apTHLLe OTBep;eIIHn p;JIn ::lJIeI{TpOmuwrpa«fJlIII cepp;qa II RPYIIIILIX COCY):{OB II
CooTBeTcTBYI01I\ne nM HOpMaJILHLre ::)JIeInpOl{lIMOrpaqmqeCIme I\:pnBLLe (no B. B. 3apeq-
ROMY) .
AO - "upTa: AP - ;rerO'lHan apTepmr; AS - JJeBoe npe;I\cep;I\ne; VS _ JIeBhlii w.e.-'Y;I\I1']P(;; VD-
npaBhlll w.eJIy.l\OqeH; VCJ - HnffiHHR HOllaR BeHa; AD - npaBoe npe;I\cep,.\ue; res _ Bep"-HRR no-
JIan BCHa.


IlOCTn IIX TeUII, IIacTynaIOlI\llX IlpU YBelfnq(,HHn II y
IeIILm()IIIIIl I,pOBeu:J.-
IIOJIB('HIIH (p:eHcnrparlnm), CYII\CCTBeTIHO )10UOJIIIHeT lJ.pyrne MeTO)1LI IICCJIe-
;r,OBaI1I1H (peHTreHOI'\I1I\IOrpa.pIIIO, SJIeI'TpoRapAliorpmIJIJIo, 6aJI.1JIICTO- II peo-
Ha p)1lI()rpaclnno II )1p.).
PernCTpaUIIIO COHpalI\eIIllii: cep)1IJ,a n nYJILCaUnn I\pYllHLIX COCY)IOB IIpO-
II3nop:flT 06LI1JHO B 1I}>Hl\wii II )1BYX IWCLIX npomn
nHX B CTaH)IapTHbIX TO'IKax
(pIIC. 64), COOTBeTCTBeIIHO 3mraM meJIY)IO
IKOB II npe)1cep)1IIii, a Tal,iRe I\pyn-
BLIX COCY)10B, a npII nap:oonOCTII - II p:OIIO.TfJIIITe.Tlhnhrx Y'IaCTI\aX IWilTypa
CPP)I('qHO-cocy)IIICTOii TeHil. Ha UOJIyqaeMbIX I'PIIBbIX HIIeXO)IHlI\ee I'\OJIeHO
Bcerp;a oTo6paFRaeT P;BIIRWIIIIe IWHTypa IIcc.rre)Iye1l10ro opraHa ImYTpII,
a BOCXO)IHlI\ee IWJIeno - )IDJ1jECHIIl' IWHTypa IUlapyam.


flaHlI JI3Y1fClIIln 3JIeRTpoKIIJUor{Jalmu


I. 0 61I\ II n 0 C 1II 0 T P 3 JI e K T P 0 I( II M 0 r p a 111 M: 1) OOlI\aH OU;eIlEa
KaLIeCTBa SJIeHTpOKllI',mrpa(pJPIeCIUIX I(PIIBLIX: 2) mnaKO.l\1.lIl'Hne eo CJ{O-
pOCTLIO )1BIIiIWHIIH uYMaamoll JIeHTLI; 3) 03IIaIWI\1ll.lIeIIIIO C TO'IlWl\lII 3anIICII


112




F.pIIBLIX; 4) Ol.(eJma Ha
lCCTBa OAHOBpeMeHHO 33 TIIICa IlHoii :3JIer,TpOH<ll'AnO-
rpall1MLI IIJIII 1fJ0HoRapP;HorpaMMLI.
II. An a JI II 3 3 JI e H T po H n M 0 r p a (I) II '1 e C H II X H P II U LI x: 1) 1I3Y-
'felliif' qJOpll1bI Hl1MOrp3qJu'ICCHIIX HIHlllLIX p33JIn
UILIX Y'IaCTHOB HOJITypa
TPIIII cep):\I.\a II HpYUIILIX COCYP:0ll (Ha'IeCTBCUIIhIii ana.TIII3); 2) IWJIII'leCT-
BCHIIJ.I1l aJIaJIII3 HPUBLIX - BhIqIICJIeIlne 3MIIJIlfTyp;bI HPIIUbIX II npo)10JImn-
TCJIbIIOCTIf OTL\CJ[J,IIbIX (1m3 eepl.{e'IHOro UIIH.TIa; 3) (Im30nr,Iii allaJIl13 3.lJPI{TPO-
EJIMOrpall111L


1. OOIl\UH OCMOTp 3.ilCR'l'l}ORIIMOrpaMM. AnanlOc1 U'lCCROe :maqeHUe IIMe-
101' TOJl},}W xopoliUle no Ra
IeCTBY 3.1Tcn:TpOIHIMOrpall1MLI, 3,UIIIcaIIHLIC 110
Hpaiiuei:i: Mepe B YH33aIIIILIX CTaH):\apTHLIX To'max. AJIH I1X anaJJI13a 06H3a-
1'eJIbIla OP:HoBIJPMeHuaH 3aHneb 3JICHTpOl\app:norpaMMhI [!JIll (fJOlIOI\ap)1IIorpaM-
MhI. l\am)1aH 3annCb p;OJIiIUIa COCTOHT!. II3 perIICTpat.(un 4-6 eep):\C'IIILIX co-
Rpam:CJIIIii, Ha Ram):\oii HpllBOii )10JInUIO ULITL ouo:m3'Il'uo MPCTO 3al1IICn no
YRa3aHIIoii cxeMe.
2. AHaJlll3 :3JJCRTpoEIIMorpmIJII'lccI>Ux l_pIlBbIX. Ra'IPcTBelIIlbIii mI3JIII3 HplI
IJbIX 33HJIIOQaeTCH B uu;eHHe J/\. (IwpMhl B COI/OCTaBJICHlI1I C HOpMaJIbHLIMJI
RpUBI.IMU IlYJILCaI.\IIII cep)1-
Ita, .TIcro
IHoii apTcpIIII IT
aopThI, Tm:aTeJIbHOM n3YQe-
HIUI IIX BOCXO)1JIlI\cro II HIIC-
XO)1Hm;ero HOJIelIa, HaJIlIqIlH
II .pOpMJ.I ]J,onOJInIITeJIbIILIX
3YUl\OB II IIJIaTO, a TamKP 13
I13YQCIIIIU npCMCHIII,IX co-
oTHomenIlii:, COOTBC'TCTBlUI
C O]J,HonpCMeJIIIO 3alIIIcaII
Hoii :3JICI{TpORap]J,110rpaM-
Moil IIJIU .ponOHap)1IIOrpaM
'lOil.
H'OJIUQCCTBelUILlii aHa-
J/II3 - 3'1'0 lll>l'IIICJIPHUC'
8111ITJIIITY]J,bI HIHlRLIX n lIlHJI-
JIlIJ\teTpax n paC
ICT npo-
AOmIOITeJIbHOCTII OT):\CJIb-
HbIX (J)a3 eep):\e'lllOro HIIIma.
Do )1aum,IM B. H. Op.TIona,
npo.n;OJInWTeJILHOCTL 3TlIX
q)a3 paBlIa Y 3l.{OpOnhlX U
Cpel.{I-1CM: U:WMC'Tpn'leCRO-
ro COHpaII.\ClIllH - U,09 C('-
l\yn.n;bI, q1a3bI OhlcTporo IT:1-
I'naUI1H - O,V
 eeKYIJ)J,bI.
ipa:1bI MP):\.TII'I1lloro lI:JrH3-
HIIH - 0,09 ceHYIIl.{bI, npo-
TO):\IIaCTo.TIbI - 0,0;) CCRYU-
,..I,LI, 1130J\teTpU'ICClwro pac-
{'JIafi.TIt'lIlIH 0.1. ceHYUl.\hl,
<pa3M obIC'rporo HanOJIHP-
HIIH - 0,13 CPHYH):\M, II)aabl
1I1el.(JIClIIIOro naIIO.TlHel/llH -
(),21. CCHYllJ],bl (pne. (5).
H'pOJ\IC' Toro. I/O ::JJ1PI{TPO-
HIIMorpaMMaM noaMOlliHO
OlIpe]J,l'JlC'lIlIl' aelllIxpOIIHOCTII COHpaU\eIIHJI II paBLIX II JICBbIX OT)1eJIUB ecpJJ;-
u;a; Y 60JIhIIlIIHCTna 3P;OpOBLIX U3rIIaHlIe HpOBII II3 I1panoro mOJIyp:o'ma IIa'I1I-


g JL A. JIIIHp;eHopaTeH


MeTOJ{I1'leCI\UC YI\a3aIIlUI


.CHCTona


,lJ,HaCTona


I I


ttJa3a MeAneHHoro
(peAY
HposaHHoro) npHTOHa
HPOBH H menYA0'lHaM
ttJa3a 6blCTporo (MaHcHManbHoro)
npHTOHa HPOSH H H<enYA0'lHaM
H30MeTpH'IeCHOe paccna6neHHe menYA0'lHOB
npOTOAHaCTona
Q;a3a MeAneHHoro (peAY
HposaHHoro)
H3rHaHHH HPOSH H3 H<enYA0'lHOS
ttJa3a 6blCTporo (MaHcHManbHoro)
H3rHaHHH HPOSH H3 menYA0'lHOB
H30MeTpH'IeCHOe COHpaL4eHHe menYA0'lHOB
npOTOCHCTona
CHCTona npeAcepAHH (npecHcTona)


PIlC. G5. Wa3I.I cepJ\eqnoro l\III\JIa na J/OpM3JIf,I1bIX
3JICI\TpOIWl\lOrpaMMax (no B. B. 3apeqIWMY).


113




naeTCH B Cpe)1HeM IIa 0,03 ceHYHAbI paHbme, ql'lII 113 JIeBoro. llo :3JIel{TpORap-
AlIorpaMMa
I MmRHO TaRme onpeAeJIHTb pa3UIIU;Y no Bpe
lCnu MelliP;Y COHpa-
lI\eHlleM nYTeii npTITOHa II OTTOHa a,CJIY)10qIWB.
<Da30Bblll aIIaml3 aJIeHTpOHnMOrpallll1I 3aRJIIO'IaeTCH B IlpUlle)1emlII B IlOJI-
IIoe COOTBeTCTBue no BpeMeHII no OAIIOBpeMCIIlIO 3anilcanHoii 3Kr IIJln <DKr,
T. e. B nOJIHOIi CIlUXpOlIII3aU;IIU lIeCHOJIbHnX npnBLIX, aanilcaHlibIX IlO ROH-
TYPY cepp;u;a, II nepeHoce aTIIX I,PIIBbIX IIa IwnTYP 3apIlcomw cepp;u;a. Coe-
AilneHlIe TaI{IlX nepeHecenHbIX TOqel, aJIeRTpORilMorpalllMLI II03BOJIHeT nOJIY-
qnTb Ilpe)1CTaBJIeHlle 0 nOJIOiI,eHIlII II <popMe IWIlTypa cep)1u;a B pa3HLIe MO-
MeHTbI cep)1eqnoro U;IIRJIa, onpe)1eJIIITb xapaIncp H TIIll COI,palQeIIIIii )1aHnoro
OTAeJIa cepp;u;a.


AHrnOI\APAIIorp A 1\1l\1LI


AIITIIORapp;norpa<pIIH npe):\CTaBJIHeT c060ii CnCU;IIaJIbnblii MeTog pelITre-
ROJIOrnqeCHOrO UCCJIep;OBaIIIlH, TI03BOJIHlDII\uii II3Y'IaTb COCTOHlIIIC IlOJIOCTeii
cepp;u;a n HpynHblx COCYAOB rpY)1lwii nOJIOCTU U Haomo,J,aTh 3a nepellIClQe-
HlIellI B HIIX RpOBII. ,l],JIH aToii u;eJIII B JIOI,TCBYIO IJJIII HpelllIIYID BCIlY 60JIb-
uoro 6hICTpO BBOP;flT HOIITpaCTHoe Bl'ru;eCTBO, nOC.TIC
Iero UpOII3B0)1HT ceplIIO
CHIIMHOB cep):\u;a II COCY)10B. llo nOJIY'IeIIIILIM CIIIIlIllWM - aurnOIwpp;uorpaM-
!\laM - MOSEHO npOCJIe)1UTb 3a )1mHRCIIlIClII ROIITlJaCTlIoro Bl'lI\CCTBa no BeHaM
rpY)1IIOIi nOJIOCTn B npaBoe npe)1cep)1JIC II AaJIee - B npaBLIii iI,eJlYAO'leH,
3a nepcxo)1oM HOHTpaCTlWro nelI\eCTBa B COCY)1LI lIfaJIoro I'Pyra II ,!aTeM
B JJeBOe cep)1U;e II, HaRoHeu;, 3a nocTynJICHUeM ero B rpY)1HyID aopTY. B na-
TOJIOrUqeCIUIX YCJIOBIJHX nOAoonaH MeTop;lma )1acY B0311WIKHOCTb YCTaIIOBIITb
TIm IIapyrnelIllfl reMo.n;nnallIHRII, JIOJ{amI3aU;IIIO COpOCOB (mYliTOB) B cep-
)1eqHO-COCyp;IICTon CUCTeMe, HamPIIW ooxop;nLIX IlYTeu HpUBU.
lloaTOMY 3HrnOHap)1I10rpaWIlfl n naCTOfllI\ec npel\UI flll.TIHCTCH ognIlM ITa
BamUbIX enOCOVOB pacn03HaBaHIlH aIIOMaJluii paaBHTIIH cep)11J,a II HpYIIIIbIX
COCYP;OB, ocoucnno B TCX CJlY'laHX, Horp;a CTaBIlTCH BOIIpOC ou OnepaTlIBHO
1
JIeQeHUII.


nn:aH H3yqeHBJI cepHH aHmORap
orpaMH
I. 0 61I\ II II 0 C 1II 0 T P H a iI\ A U II a II r U U Hap )1 II 0 r p a 1II 1\1 LI: 1) ou;eR-
I,a Ra1:JeCTBa CUITMlm; 2) onpegeJIeIlIIe npOeI'\U;IIII ITCCJIep;OBaUnH; 3) YCTaIIOB-
JIelIIIe nYTIJ BBe)1eHUH HOHTpaCTiloro BelI\eCTBa.
II. ,l], eTa JI b II 0 e II 3 Y 1:J e H II e no JI 0 C T e U C e p )1 U; a II R P Y IT H bI X
C 0 C y)1 0 B II a H a iI\ )1 0 II a H r II 0 Hap )1 II 0 r p a 111 M e: 1) on03IIaBamIe
3anOJIHPIIlILIX IWHTpacTRbIM Beru;eCTBOM COCygOB II nOJIocTcii ccp)1u;a; 2) BLI-
HBJIelIIle aHOMaJIbHbIX co06IIJ;elInii lIIelli)1Y nOJIOCTHlI1TI cepp;l
a II HpynuLIMu
cocY)Ial\I1I; 3) onpep;eJIeHITe nOJIorHcHnH, (IJOpMu, BemI1JUHbI II OQepTaHUii 3a-
IIOJIIICRlILIX nOllTpaCTHLIM BelI\eCTBOllI COCY)10B II IlOJIOCTeii cep)1u;a II JICfImX;
4.) II3Y'leIIlle CTPYHTypbI TeHil IlOJIOCTeii cep)1u;a U COCY)10B (noucHII CIIMIlTO-
lIIa «cMLIBa»).
Ill. COil 0 C TaB <'I e H IT e B C e x a II r II 0 I, a p )1 II 0 r p a 111 M: 1) onpe-
)1eJIeHne CpOJ\a 3anOJIlIeHIUI HOIlTpaCTHbIlli BelQeCTB01l1 cocYJJ;on II IlOJIOCTeii
cep)1u;a; 2) Il3yqeUIIP xapaHTcpa p:RJImeIIJIH ROIITpaCTlWro BelI\CCTBa B no-
JIOCTHX cep)1u;a n B cocY)1ax (nanpaBJICUUe I{pOBOToHa); 3) ou;enRa COCTOH-
llIIH MaJIOro I{pyra HpoBooopalI\eHuH.


MeTO)J;IIqeCRlle YRa3:lHIIJI


AHrIIoHapguorpaMMa )10JInma 6MTb npon3Be)1eHa TaIWM oopa30M, qTUObl
na WOlIe TelIIT cepp,u;a OT'leTmmO RLl)1CJIHJIUCb OqepTaHnH rpyp;ULIX nO.mOH-
IWB II 3a)1IInx ROHU;OB pe6ep. llpn aTOM YCJIOBJIIT IIa lIeii )10CTaTOqII0 HCRO
06pnCOBbIBaIOTCH Telln IlOJIOCTCii cep,IJ,IIa II H:PynHMx COCygOB (puc. 60).
BlIIecTe C ou;eHHou Ha'lCCTBa CHilMHa pemaIDT Bonpoc 0 IIpoeHu;ulI IlCCJIe-
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1- JJeB8H nOAHpJ,J.TThl\On3rr B(,H3: 2 - JleB3H nOAHJlx>'mQH3rr BI'Ha; J - .TJI'B8H fil'3blMfiHHarr BI'-
lIa; 4 - BepXIIHJI nOJlaH Bella; 5 - npaBoe npe;!\CepAIIe; 6 - npaBblll meJlYAO'II'H; 7 - JleBaH
BeTBb JIero'llloii apTepIlIl; 8 - npaBaH BeTBb JIerO'lHoit apTepllll; 9 - BeTBII JlerO'lHoi\: apTepll1l
B JIernuJI:.


npoeEqIIHX. TlT06LI nx pa3JIUqnTb, naAo 3HaTL npoeI,qnonnbIe IJ.mllMUOTHO-
IIIeHIUI nOJIocTeii CepMa II Rpymlux COCY)10B (puc. 57). 3aTelll onpeAemnoT
MeCTO BBe)1eIIIIH HOHTpaCTIWro BelI\eCTBa; eClm IIa cmn.me IIMeeTcn II30Gpa-
meHlIe npaBoii IlOP:EJIIOqIl'IHOii BelIbI, TO IWUTpaCTllOe BelIJ;CCTBO 6LIJIO nBe-
p:eBO B Beuy npaBorO JIOETeBOrO cfIIGa, eCJII] llUJl:IIa TCUb JICBoii IIU):\IWIO-
'IU1JHOfl BCIILJ, TO ]WIITpaCTlIoe B£'II\CCTBO BnpJ.ICI,UBaJIOCb B JIeByro JIOI\TeBYIO
neny; CCJIII me HOUTpaCTlWC BelIJ;eCTBO BBOP;IIJIOCh B HpellIuyIO neny, TO lIa
CHlIlIfHC BIlp:;r1O ce IIaoGpameUIIC.
llpn OTCYTCTBIIII BblpameHULIX rellIo)1ulIaMIlqeCEUX paccTpoiicTB ua aH-
rUOImpAllOrpaMJIH" npoII3BeAeuuOll Uil nepBoii ccr;:yn)1e 1I0CJIe BBcp:eIIIIn IWH-
TpaCTuoro Bl'lIJ;cCTBa, BbIHBJIHeTCH TelIb 6c3bIlIIHmroii U Bl'pxneii ITo.rroii Ben
H npaBoro npCACepAIUJ (pnc. (8). "Llppc3 1 1 /2-2 1 / 2 ceEyu)J;LI 1l0flBJIHeTCH
TeHL IIpaBorr> rHeJIYAo
IHa. TaHIIlII oopa30M, na IIpoTHa,emIll ncpBLIX 2-3 ce-
I,YEA nmIYlJaCTCH II30opaa;:CIllm nOJIor-Tell npaBoro cep)11W - npaBOrpa1l1l11:t.
Ha 3-4-ii CCI,YHAe na CHIIMRax B03IIIlrWCT IWIITpaCTnoe IJ306pamelIIJe JIC-
r01Juoii apTcpIIII (apTl'prrorpaMlIIa JIenHIx); lIa 5-6-ii ceRyn)Ie 3arrO.TJIWIOT-
cn .ITf'rO'IHT,Te Bcnr,r (eIJJleoorpaMMa .rrerHIlx); na 6-8-11 ceHYHJl:e I10HflJIneT-
cn Tenb JIeBOrO npev"\cep):\IlH, a ua 8-10-ii ceHyup;e - .rreBoro me21Y-.
A01JHa. ,
CJJep;OBaTeJJMIO. IIa u-10-ii CCHYHp;e IIil CUITI\THe nOJIYlJaeTCR IJ.j()f)paawunc
1I0JJOCTeii JIeBOrO -cCpp;I\a - JIeBOrpaJ\llIW. HaI\:oueq, Ila 9-12-ii ceEynp;e
Ha anfIlOEapAIIOrpallI:lIP BMpIICOBbmaeTCH OTIIOCIITC.TJ:bIIO c.TJ:aoan TeHb rpyp:-

nOli aOpTLI. "Y )1eTeII cpmHI EOUTpaCTIIpOBaHIUI nO.TJ:ocTcfI cl'p):\qa II COCY):\OB
npCHOJIMW IWP01J£,.
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Pne. 67. TIpoelil.\lIfl I1o-"uneii eepi-\l\l1 II 'ipYIIllblX cocy,!\un na aHrHO"ap
I1orpa!\1!\1ax (no Desgrez).
A - rrpaBorpa
IMbI; B - JIeBOrpaMMbl. 1- rrpRMarr rrpoeIHum; II - nepBaR IwcaR rrpOeKl.\lIR; III - BTopaR IwcaR npOeKl.\lm; lV - JIeBaR
6oKoBaR rrpOeKl.\lIR.
1 - Bep"\IIRH nO<IaH HeHa; 2 - rrpaHoe rrpeL\cepL\ue; 3 - npaBbIl1 iKeJlYL\O'leK; 4 - JlerO'lHaR apTepHH; 5 - rrpaBaH BeTBb nero'lHoii ap-
TepHU; 6 - JleBaH BPTBb .TlerO'IFJOII apTeplIII; 7 - JleBblii meJIYL\O'leK; 8 - .'1eBOe rrpeL\cepmlC; 9 - BOCXOI<HmaR aopTa; 10 - ):lyra aopTbI; 11-
HlIc"\OL\R
aH aopTa; 12 - JlerO'lHbIe BeHb!.




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Pnc, liB, llOCJIc;J;oBaTeJJLHOCTb 3anOJIIH'IIIIH rroJlOcTf'ii ccpp;r,a II COCYP;OB HOIlTpaCTHLIM
BC n WCTB01l1 rrpn anrrrOIwpi\I1orpmIHIIf.
a - Qep£>3 1 cehYIJ]l,Y OT l\'10i\H:'IITa O:HOH1I:-UHUI nnp,II;£'HIIH I\'OUrp3CTHoro neUJ,eCTDa B JIOi\TPBYIO HC-
R)'; 6 - 'lcpe3 2 CeHYHAbl; 6 - qepe3 3 ceHYHALI; 2 - 'lepe3 4 ceHYHALr; () - 'Iep[,3 5 C[,I'YHA;
e - 'l['pe3 6 CCHYHA; :J/C - '!['pe3 7 ceHYHA; 3 - 'lepe3 8 CCHYIIA; U - 'Iepe3 9 CCKYHA,


B OBam.nYIO TeUb £IOJIOCTII npaBOrO npep;cl'p):\nn. PaCCTOffIIII(' 1Ilemp:y I>OU-
TypOl\! TeIIII HOIlTpaCTUOrO BeIIlPCTna II napYn,IIhTM WmTypUM TCHU CI'P):\U:f\
na ypOBUe upaBoro npep;Cepp:ITH paBIIO 2-4 !VIM; OlIO rrrpamaCT TOJIIIJ;IIny
lI11IOH<1PiIa U IIPpImapp;H, llllleCTe B:mTblX. 3aTP1\I 3alIOJlHHPTCH JlpaBhlii ;+,l'JIY-
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'IllOImp)1a na 3T01\l ypOBHe B ):\I1aCTo.TIe paBII<l 5 Mi\I, a BO BpCMH CIlC-TOJIbI
:m<l'IIITe.'IhI-IO YBeJIIf1:IIlBaeTcfl. 113 npaBoro meJIyp;o'ma IWIITpaCTIlpOllaUHaH
t,pOnb IIonYllaeT B MaJlLIll I\pyr I,PUBUOOP<lII\CIIIIH. AaJlce rrLIHBJlHeTCH oHpyr-
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LO-12 111M. ECJIII OqepTIITL no CHIUIIWM n IIIHll\wii: II 60lWBuii: npOCI<l\IIHX
1I30GpaSRcHlIe nO.nOCTlI JICBUrO meJIyp;O'l1,a, TO MomHu Il3MCpUTL ero uCI1
II no wopll1YJIe BbPIUC.lIeIIJIH OO'LCMa 3.TI.TIIIHCOJl):\a onpl')J;eJJJITb OO'Ll'lIl nOJIOc.TII.
AJIH Ha,HAoro GOJIJJlIoro B JIOJlY1JCHuym BeJlII'Ilmy BIIOCflT TIOllpmmy,
ITOGbl


111




'npllBeCTn ynemI1:JellIIOe II pe3YJJbTaTe pellTfeIIOBCIWll nVOeKlI,llll UJO()pame-
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KII P;O I\aCCeTbI II OT JJeBOrO iI,CJIY)10qI
a p:o ImcceTLI. Pa3IIuu;a lI1Clli)1,Y OO'be-
MOM IIOJIOCTIl 1KeJIyp:OqI\a B p;IlaCTOJJe II B CIICTOJIe YI,a3LIBaeT IIa Y)1apUbIll
061:.eM cepMa. OTCID)1a, 3IIafl
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IILlii 061:.0M.
HocJIe JIeBOrO nWJIYAO'IHa IWIITpacTupyeTcR aopTa. IIIlIpUlIa ec TCIIlI
D Bocxop;nlll,cii qaCTII Iw.lIeOJJeTCR OT 1 (j )10 38 1\I1II, a TOJllll,IIIIa CTCIll\II no
uOJwBoli anrIIOImpp;llOrpallll\IC COCTaBJIHeT 1,5-2,5 MM.
n plI Il3Y1JelIIlII Mop(I)oJIorml nOJIocTeii cep)1r(a II COCYP;OB CJIe):\yeT OllpC-
p;eJIlITb pCJII.e<p BnYTpeHileli IlOBepXlIOCTII nOJIOCTeU, a TaIilIiC <POPMY II pa3-
MCphI ymeH npcgcepp;nii. PeIWi\lelI)1yeTcH p;aJIce UpOCJIC):\IITb 3a no
oa'\CIllIeM
MCmmeJIY)10'IIWBOii neperopo):\IUI, IlOO OlIO oTpamacT COOTlIOlliCIIIIl' p;aBJIe-
Hllll B liOJWCTHX lIWJJY):\O'IHOB. llcpCropo)1.IiU BLIflBJInCTCH JIY'I11IC llccro
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cTen cepp;n;a II COCY)10B CnrHaJIII3lIpYCT 0 CYII\CcTBOBaHlIlI naTOJIOrlIqeCIUIX
COOUII\CHIIii Meaip;y mnw. B qaCTHOCTII, na UOHOBLIX RHrIIoIiap):\IIorpal\IMaX
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Ba 113 JIeBbIX HaMep B npallLIC npII )1e(I)CI,TaX Ileperopop:EII cep)1qa. AHOl\IaJIb-
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«CMbIlla» HOHTpaCTHoro Belll,eCTBa lICHOHTpaCTIIpOBaIIHoii EpOBbIO. HailpUMCp,
IIPII OTEpbITOllI 60TaJIJIOBOM npOTOEe onpe)1eJIHCTCH yqaCTOK nomUIieIIlIH IlII-
TenCIIBHOCTII TCIJII JIeroqnoii apTeplin B TOM MeCTe, Eyp;a BJIUBaCTCH I_POBL
ll3 aopTI.I.
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MOPcPOJIOrIlII MaJIOrO Hpyra. EOJIbUWe HOJIIIqeCTBO II HpynHLIC pa3McpbI BeT-
Ben JIerO'lHOII apTeplIu naGJIIO)1.aIOTCR npli rIIuepcMuII Jlenmx, 06YCJWBJIenHOll
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ruYHTe, BCTpe'laIOlI\eMCH IlPII MHorIIX BpOm)1eIIHbIX nopOI'\aX (TeTpa)1a <PaJI-
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Ilpn aHaJII13e nOJIOmeIII1H II )1UaMCTpa aopTbI II JIeroqHoii apTcplIII. Hanpu-
Mep, )1JIH 60JIe3HII <DaJIJIO xapaI
Tepno IIaJIII'lIIe llIlIpOIWii: TCHII aopTbI II Y3-
HOll TerrIl JIero'lHoii apTepIIII.
llpn GOJIC3HU 8II;WJII'tIeIIrepa OllpC)1CJIRCTCH npaBOCTopOHHl'C IIOJIOnicHIle
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. O)llIa aIIrnOIiapp;IIOrpaMI\Ia lIe l\IOmeT )1aTI. nOJIHOrO npC)1CTaBJIeHIlH 0 re-
l\lO):\IIuaMnHC II Mop(IJOJJorIIn Bcex 1JacTeli cep):\u;a II I
PynnLlx cocynoB. IIo-
:>TO!\lY npII anrIIoRapp;norp,HlnIII npoII3Bo):\HT nOCJIC)10BaTe!ILIlO pH)1 CHIIl\lIWB. I
ConOCTaBJJHH IIX, onpc):\CJJHlDT Bpel\1fl nocTynJICIIIIH HOIlTpacTHoro Belll,eCTBa I
ri pa3I1LIe OT]J;eJILI ccp]J;e
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neTCTllYIOT JIn nopRp;OR U CpOHII 3anOJIIIeHIIfl IlOJIOCTe:ii: cep)1u;a npIIBe)1enHLIlI1
BbIlliC IIOpllIaTilBallI.
llo ccpnII CIIIIMROB Cyp;HT TaHme 00 1I3MeHeHIIII BeJIIl1:JIIIILI OTAeJIOB cepp;-
qa npn IIX CORpalI\eHIIHX II paCCJIa6JIeHIIHX. llOJIOCTh meJIYAO
IHa B MOllICHT
'118




ClICTOJIbI B lIOpl\Ie Yl\ICIIbIIlaeTCH B HCCKOJIbHO pa3. AmI onpeAeJIeHIlH CIWPO-
CTU I,POBOTOHa B l\IaJIOllI Rpyry II3MCpHIOT BpCl\UI OT 1\I0MeHTa nocTYIIJIeHlIH
JWIITpaCTHoro BCII\OCTBa B .rrcro'myIO apTeplIIO )10 IIOHBJIeIInH cro B JIeBOM
npe;wepp:IIII.


RAPAIIO
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KOHTpaCTHoro BeIIl,CCTBa B JIeBI:.rii IIJIII npaBI:.lii meJIY)10'leK 'Iepe3 30HA llJIII
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IOTCH OqepTaHIIH 1HeJIYAo'um II OTXO)1HIII,ero OT ncro cocyp,a. HaAo YCTaHO-
BIITb, B Kan:oii 1HeJIyp,0'leR nBep,eHO ROHTpaCTHoe BelI\eCTBO, IIeT JIll B ero
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;r.:O'In:a, RaHOBO COCTOHnne EJIanannoro annapaTa. B 1:JaCTHOCTIl, Ballino onpe-
)1eJIlITb, lIe nponCXO)J;IIT JIll BO BpCMH ClICTOJILI peryprlITaI(I1II (oopaTlwro
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xo):\a ROIITpaCTHoro BelI\eCTBa 1I3 op:Horo iI'\eJIY)10qIW B )1pyroll,
ITO naUJIIO-
p,&eTCH llpn ):\ecfJeI\Te B lIIeflm'\eJIYAoqHOBOll neperopOARe.


CHIIl\IRH BEHEqHbIX APTEPHR CEP]];I(A
(ROPOHAPOrp AMMbI)


KopOHaporpaqmH npIIHa)1JIeiI{IIT H
lICJIY CJIOmHbIX pelITrelIOJIOrlI'leCRllX
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IIJIII B BOCXO)1HII\YIO 1:JaCTb aopTbI neIleqHble apTepTIII 3anOJIHHIOTCH neIIO-
CTOHHHO. ll03TOMY npII6eralOT I{ op,IIOBpel\1eHHoMy OJIOImpOBalIIlIO aopTbI
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COBbIBaeTCH 1I306pameHlIe Bceu CIICTeMbI HopOHapHbIX COCYP;OB. B IIOCJIe):\HIIe
['Op,bI pa3BIIBaeTCH MeTO)1IIHa RaTeTepII3a1J;Un BeHe1:JlIbIX COCYAOB.


I


TIJIaH H3Y1:JeIIl1H RoponapOrpal\Il\I
I.06II\IIii OCMOTp Ramp,oii HopOHaporpallIMbI: 1) OI(CHn:a
Ka'leCTBa CHllMIm; 2) OIlpep;eJIenne npoeHU;lIII IICCJIe)10BanIIH; 3) YCTaHOBJIe-
Hlle nYTlI BBep;eHIIH IWHTpaCTHoro BelI\eCTBa.
II. A eTa JI L II 0 e II 3 Y 1:J e H neB e H e 1:J II LI X apT e p II II C e P A q a II a
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llolInII; 4) OI(eHHa COCTOHnlIH rpyp;IIoll aopTbI B 06JIaCTII YCTbeB BeHeqHbIX
apTepnII.
III. Con 0 C TaB JI e II II e R 0 pOll a p 0 r p a 1\1 M, npOII3Be)1eIIHbIX B pa3IlLIX
IIpoeHI(IIHX; BbIHc.neHne nOCTOHHCTBa IIJIII ll3MOII'lIIBOCTlI peHTrelIOBcn:Oll Rar-
TlIHI:.I COCY)10B.


l\1e'W)1U'leCKlle )'Ka3aHUJI
IIoMUMO 06LI'llIbIX YCJIOBUII (nOJIIIblii OXBaT IICeJIe)1yellIOIi OUJIaCTII, npa-
BlIJIbHOCTb YCTanOBKII 60JIbHOrO, IWHTpaCTHOCTb II pe3ROCTb 1I306pameHlIH),
K Ha1:JeCTBY RopOlIaporpaMM IlpeA'LHBJIHIOT p;Ba cIleqnaJIblThIX Tpe60BaIIIIH: na
119




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apTcjJlIii (uo Willian c c()aDTopa:\ln).
n - npHMaH npoemUIH; 6 - l5onUR<lH npOeI<I\IIfL 1 - np<lB<ln BeIle
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HOHyca; 8 - BCTBII L\.TIn npaBoro me.'lYL\u'um; 9 - BeTBL B ul5JIaCTII oCTporo HpaH; 10 _ COCY)],LI
rreperopOL\J;U; 11 - BeTBL B 06;ai1CTII Tynoro Hpan; 12 - CUCYL\bI Rep"YU][{1I cepL\l1a.




CIJIIIIIRl' P;0JI.KIIbI GUTL OIIP;HbI ooe BeIIe'llIble apTeplIII C IIX BeTBHMII 1-3-ro
nopH):\IW, COCYP:LI p:o.TlmlIbI Or.ITb xopomo 3anOJIIICIIbI IWHTpaCTIIJ,IM BClI\eCT-
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a IIrJIhI IWIT 30IIp;a. Pa3p;y-

'Llii B(3):\YXOll1 Ga.Tl.TlOn'lIlI<, 6JIOImpYIOw;lIii aop'TY, oGYCJIOBJIIIBaeT na pPIITfe-
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IIero EpaH cTOJIoa
ROHTpaCTlTOii mnm.;oC'TH 13 non:o)1JIJJ
cii aopTe (pnc. 69).
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lire OHa BLIp;eJIHeTCH HaH GOJIec IlIOII\IIblii COCYP: lI£erK)IY II:!06pafKcnUHMU nC'-
pe)Ineii IIllCXO)IJIlI\eii (CUl'Pl'):\II) U ornoaIOlI\cii (C3ap:n) BeTBeii Jlenoii
neue'lUoii apTopllU. J1enaJI Bene
maJI apTcpUH n<:\. cnulIU'\C B IlpHlIToii IIpoeG-
IlUll )IaCT HCRoe II:!oopampuue B Bn)1e I\pyrrnoro cocyp;a, IIlJ.YIIJ;l'rO BJIl'BO OT
TeIlII cnHyca aopTbI. Ha omwBoii HoponaporpaMMe 00 YCTbC H CTBO.Tl pa:IJIIJ1II1-
lITbI JIUIIIb n oceBoii I1pOeInJ,IUI mU'\ I,pyrJIaH mIll OBaJILIIaH TOIIL. 3aTO XOpOlilO
BblpnCOBLmaIOTCH B OGCII
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p;HI.qaH BeTBL Ha rrpJI1I10M CIITlMI\e 06pa3yeT )1yrooopa:myIO TOIl}', lIrlYIlJ,yro
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Tl'pTlll.
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aH - cal\10C )10pca. I II.Hoe nO.Tloa..:enfTc.
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I'\aJIJIOpa II xapmWf'pa }.onTypOB. llpm.TlPTl'CI\TI HaUOOJIee Baamo Y.TIOBIITJ.
peHTrelIOBCHITP CIIIIUTTOMhI CWIOp03a Bene'rHLIX apTf'pnii - U
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nepaBUOllrl'pnOCTL npOCBeTa, RaJIII'IlIe I,paeBblX ):\p(IJeI>ToB lIaIIOJIIIeJIIIJI, npl'-
PLIBUCTOCTb X0l.I.a [I J(mr>c o HH.TlI03I1ID.
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IaCTHOCTU, Ba,l,-
no YCTaHOBIITb, no IlC'Ie3al'T ;!IJI II:mn.TlIICTOCTb COCYP:OB B ):\IIaCTo.Tle, Ill' !IIf'[[H-
eTCH JIll HapTIIHa IIPpaBHOMepIlOCTII npOCBOTa apTf'pUll n pa3HbIl' (pa3bI ):\CH
TeJILHOCTU Cl'pp;IW.


CI-HIJVlKII rpY,IU-IOtl AOPTbI 11 EE BETBEn




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PllC. 70. PeHTCIIOl'paM
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1 - npaBaH 06
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uTO-llier!IIbnl CTBOJl; 4 - npaBaH nOIIRJlIO'III'IHaH apTepuH; 5 - 6e-
3bIMflHHaH apTepuH; 6 - npaBaH BHYTpeHHflH apTepUH MOJlO'lHOii meJle3bI;
7 - BOcxoIIH
aH aopTa; 8 - JleBaH 06
aH COHHaH apTepJlH; 9 - JleBaH no-
3BOHO'lHaH apTeplIH; 10 - JleBbIll
lITO-lIIellHbIii CTBOJl; 11 - JleBaH nOARJIIO-
'III'IHaH apTepIlH, 12 - JleBaH BHYTpeHHHH apTepliH MOJlO'IHOll meJle3bI; 13-
A)Ta aOpTb!; 14 - HncxO;J;
aH aOpT:l.


MCTOj.l;H'lCCHne YKaaaIIIIJI
Ha CHIII\II\e )10JIi-Ima ObITb nOJIyqena llIITeHCnBIIaH OJ.l;HOpOp;IIaH TeHL rpyj.l;-
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-<polIe 11306pameHIlH opraHOB cpej.l;OCTeIIllH II rpYj.l;HbIX Il03BOilHOB (pIiC. 70).
122




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8amHLI orpaHIPU'III1LIC paClIIrrpeIIlIH na1Ja.TJLIIOrO OTp,eJIa aopTLI II 3aGpacLIBa-
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.o;aHHLIlI'l Dotter II Steinberg, 0'1' 16 p:o 30 MM, a B p,IICTaJILH01I nanpaBJJeHlIlI
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CM mIIplllla nepemciiHa aOpTI.I Ha lJeHTfeHOrpallll1IaX COCTaB.1JHCT 13-34 MM, a
KaJInOp llUcxop:HlI\eii 1JaCTII - 12-32 MM. B c.1Jyqae HoapI,Tau:nIl mIll )1Pyro-
co Tnlla CTCH03a aopTbI CJIep,yeT OllpCp,CJIIITL IIOJIOmeUIIC, npOTmI;:CIIIIOCTL
n CTenenb cya;:eUHoro yqaCTIm. KOHTYPLI Teun aopTbI B nOpl\Ie pOBHLIC 11
pe3Hl1e; BCHHaH nC'ICTHOCTL IWHTypa p:0JIlliUa ObITb 3apcrnCTpnpOBana If OO'b-
ncneHa.
Onpep;emlB COCTOHnilC aopTLI, IIepexop:HT R On03IIaBamnO II II3yqCnIlIO
ee opaxIIon.eqJaJlbHLIX BCTBCiI. B TIIIInqHLIX CJIY'IaHX np:eIlTII«pnU:IIpoBaTb Bce
3TH BCTBII I1eTpY):\HO (CM. [mc. 70). On.emmaIOT nOJIOiI,eIIIIe, (IJOpMY, HaJlI16p
II O'iepTaHnH Haa;:p:OII BeTBII.
Ocoooe 3na'Jenne nMCCT BbIUBJIeIIne cyn,enIIH II OIH{JII03IIn o,11,UOIi mIll HC-
CKOJILHIIX BeTBell, a TaHIfW 06uapya,eHIIc He CTOJIL y}HC pCp:HlIX allOllIaJIllii
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126




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PIIC. 73. ClIlIMHH cep,!\n;a Toro me 60.'IbHOrO B nepBoll (a) II BTOpUll (6) IWCLIX rrpo-
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op:HlI\cro OTp,eJIa aopTbI.
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My CCP.llUY.
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BCTBII.
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Pnc. 75. llepe)J,1l1Ill 0630pnLIll: CIIIIMOR opranOB rpy)J,1Io.U: 1l0;rOCTn.


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130




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Pne. 76. CIIIIIIfOI, eePJll:\a TOro 1H:e 60JILTIOrO B ITePBOH ROCOH npoeR-
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PIIC. 77. CnTIIIfOR cePJll:\a Toro 'Re 60JILIIOro DO DTOpOii: ROCOH IIpO

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PIIC. 78. IToCJIOHnLlii: CHIIMOR cepJUHI Toro me 6oJIl,noro na rJIyolIHe JIeBoro
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Huro.


Cmll\nm ccp
l\a B KOCbIX npoeEl\IUIx (pne. 76, 77). Ha CIIUlIme II Hepnon
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132




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