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Anatom Iya Ешн П 92

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Anatom Iya Ешн П 92 A. AHMKDOV, О MIRSHARAPOV I. SACjAK)V, II. RASl LOV ANATOM IYA ешн П 92 OZBEKISTON RESPUBLIKASI OLIY VA O'RTA MAXSUS TA’LIM VAZIRLIGI OZBEKISTON RESPUBLIKASI SOG LIQNI SAQLASH VAZIRLIGI A. AHMEDOV, O'. MIRSHARAPOV, T. SAGATOV, H. RASULOV ANATOMIYA A) со IIJILD Л/ О ‘zbekiston Respublikasi Oliy va о 'rta maxsus ta ’lim vazirligi ^ tomonidan 5510400 - Stomatologiya, 5510700 - Oliy hamshiralik is hi, 5510900 - Tibbiy biologiya, 5510300 - libbiy profilaktika is hi, 5111000 - Kasb ta ’limi(510100 - Davolash ishi), 510100 - Davolash ishi, 5510200 - Pediatriya ishi ta ’lim yo ‘nalishi talabalari uchun darslik sifatida tavsiya etilgan «IJOD-PRENT» Toshkent - 2018 UO‘K: 611(075.8) КВК: 28.706уа723 А98 Taqrizchilar: Sh.M.Ahmedov - tibbiyot fanlari doktori, professor Sh. Teshaev - tibbiyot fanlari doktori, Ahmedov, A. A98 Anatomiya П: darslik / A.Ahmedov. - Toshkent: «IJOD-PRINT», 2018. -316 b. UO‘K: 611(075.8) KBK: 28.706va723 Ushbu darslik 0 ‘zbekiston Respublikasi Oliy va o‘rta maxsus ta’lim vazirligi hamda Sog‘liqni saqlash vazirligi tomonidan tasdiqlangan umumiy amaliyot shifokori tayyorlash o‘quv dasturi asosida yozildi. Unga kattalar anatomiyasi bilan birga a’zo va tizimlaming taraqqiyoti, bolalikning turli davrlarida kuzatiladigan yoshga xos o‘zgarishlari haqidagi ma’lumotlar ham kiritilgan. Lotin atamalari xalqaro anatomik terminologiyaga mos. Darslik 2 jilddan iborat bo‘lib, II jildiga siydik ta’nosili, ichki sekretsiya bezlari, yurak qon-tomir va nerv tizimlari a’zolari haqidagi ma’lumotlar kiritilgan. Darslik tibbiyot institutlarining barcha yo‘nalishi talabalari uchun mo‘ljallangan. bo‘lib, undan shu sohadafaoliyatyuritayotganmutaxassislar ham foydalanishlari mumkin. ISBN 978-9943-5236-1-6 © A.Ahmedov va boshqalar, 2018. © «IJOD-PRINT», 2018. SO‘ZBOSHI Mamlakatimizda barcha jabhalarda kuzatilayotgan islohatlar qatorida tibbiy ta'limnida ham qator salmoqli ishlar olib borilayotgan bir paytda tibbiyotning zaminiy fanlarini o‘qitish jarayonlarini yangicha tashkil etish qizg‘in pallaga kirgan. Bu o‘quv jarayonida qo‘llanilayotgan darslik va qo‘llanmalarga bo‘lgan talabni yanada oshiradi. Mazkur vazifalardan kelib chiqib, 0 ‘zbekiston Respublikasi Oliy va 0 ‘rta maxsus ta'lim va Sog‘liqni saqlash vazirliklari qo‘ygan talablar asosida Anatomiya fanini zamon talablari asosida o‘qitish maqsadida tubdan boyitilgan darslik yaratishga kirishildi. Anatomiya odam organizmining shakli, tuzilishi, uning rivojlanish jarayonini o‘rgatadigan fan. Anatomiya fani tibbiyotning poydevori hisoblanadi. Toshkent Tibbiyot Akademiyasi va Toshkent Pediatriya Tibbiyot Institutining anatomiya fani bo‘yicha yetakchi mutaxassislari tomonidan mazkur darslik yaratildi. Darslikda foydalanilgan ma'lumotlar talabalarga klinik fanlami oson o‘rganishlari uchun zamin bo‘lish mezonlaridan kelib chiqilgan. Bu zaminiy fanlami klinik fanlar bilan o‘zaro integratsiyasini ta'minlashga xizmat qiladi. Anatomiya odam organizmining shakli, tuzilishi, uning rivojlanish jarayonini o‘rgatadigan fan. Anatomiya fani tibbiyotning poydevori bo‘lib, birinchi bosqichdan boshlab I, II va III semestrlarda o‘qitiladi. Darslikdakeltirilganrasmlarmavjudanatomiyao‘quvadabiyotlari (Richard L. Drake, A.Wayne Vogl, Adam W. M. Mitchell. Gray’s Anatomy for students (third edition) 2014, R.D. Sinelnikov, M.R. Sapin, Frank H., Netter M.D), internet ma’lumotlaridan olindi 3 va mualliflar tomonidan tayyorlandi. Darslikni tayyorlashda ko‘rsatgan amaliy yordamlari uchun TTA va ToshPTI anatomiya kafedralari xodimlariga tashakkur ishor etamiz. Darslik rasmlarini qayta ishlash va moslashtirishda ko‘rsatgan professional xizmatlari uchun Z.X. Nuriddinovga chuqur minnatdorchilik bildiramiz. Mazkur darslikni tayyorlash jarayonida ayrim xato va kamchiliklarga yo‘l qo‘yilgan bo‘lish mumkin. Shuning uchun darslikning sifati hamda mazmunini yaxshilashgan qaratilgan har qanday fikr va mulohazalar manuniyat bilan qabul qilinadi va albatta qayta nashrlarda inobatga olinadi. Mualliflar 4 SIYDIK VA TANOSIL APPARATI Odamda siydik va tanosil apparatining (apparatus urogenitalis) tuzilishi va vazifasi xilma-xil, lekin rivojlanish nuqtayi nazaridan bir-biriga bog‘liq ikki: siydik va jinsiy a’zolar tizimini o‘z ichiga oladi. Siydik a’zolari tizimi (systema urinarium) qondan suyuqlik ajratuvchi (buyrak), siydikni buyrakdan olib ketuvchi (buyrak kosachalari, buyrak jomi va siydik nayi), siydikni to‘plovchi siydik qopi (qovuq) va organizmdan chiqarib yuboruvchi (siydik chiqarish nayi) dan iborat (198-rasm). Siydik a’zolarining rivojlanishi Buyrak mezodermadan rivojlanib uch davmi o‘tadi: 1.Bosh (boshlang‘ich) buyrak (pronephros) pastki bo‘yin va yuqorigi ko‘krak segmentlari nefrotomlaridan homila hayotining 3-haftasida paydo bo‘lib, tepadan pastga tomon qator joylashgan (5-8) naychadan iborat. Har qaysi naycha lateral uchi bilan bir-biriga tutashib pronephros ning umumiy nayini hosil qiladi. Bu nay pastga tomon o‘sib, birlamchi ichak nayining pastki uchiga qo‘shiladi. Naychalaming medial uchlari biroz kengayib, tananing ikkilamchi bo‘shlig‘iga ochiladi. Ikkilamchi bo‘shliqning ichki devori yaqinida har qaysi naycha qarshisiga arteriya keladi. U may da tarmoqlarga bo‘linib, chigal hosil qiladi va suyuqlik qondan naychalarga so‘riladi. Bosh buyrak juda qisqa vaqt (40 - 50 soat) ichida navbatdagi davr - mesonephros ga o‘tadi. 2.Birlamchi buyrak (Volf tanasi) (mesonephros) homila hayoti­ ning uchinchi haftasi oxirida ko‘krak va bel segmentlari nefrotomla­ ridan rivojlanadi va 25 - 30 ta buralma naychalardan iborat bo‘ladi. Birlamchi buyrak naychalari berk uchi kengayib kapsula hosil qiladi. Bu kapsulaga tomirli chigal о‘ sib kirib, buyrak tanachasi hosil bo ‘ ladi. Naychaning ikkinchi uchi boshlang‘ich buyrak nayiga qo‘shiladi va mezonefros (volf) nayi (ductus mesonephricus) nomini oladi. Birlamchi buyrak homila hayotining ikkinchi oyi oxirida o‘z vazifa- sini ado etib, uchinchi davrdagi doimiy buyrak paydo bo‘ladi. Volf nayi saqlanib qoladi va tanosil a’zolar taraqqiyotida ishtirok etadi. 3.Doimiy buyrak (metanephros) homila hayotining 2-oyi oxiri­ da ikki xil manba: metonefrogen to‘qimadan va mezonefros nayi- ning siydik nayi o‘simtasining proksimal uchidan alohida-alohida rivojlanadi. Siydik nayi o‘simtasi yuqori tomonga metanefrosga qa- rab o‘sadi va uchi kengayib, buyrak jomini hosil qiladi. Buyrak jo- mi ikkiga bo‘linib katta kosachalami, ular o‘z navbatida shoxlanib kichik kosachalami va ularga qo‘shilgan buyrak naychalarini hosil qi­ ladi. Bulaming hammasi metonefrogen to‘qima bilan o‘raladi. Bu to‘- qimadan buyrak naychalari (nefron naychalari) hosil bo‘ladi. Homila hayotining 3-oyida doimiy buyrak birlamchi buyrak o‘mini oladi. Doimiy buyrakning taraqqiyoti bola tug‘ilganidan so‘ng tugallanadi. Siydik yo‘li mezonefral nayning o‘simtasidan hosil bo‘ladi. Bu o‘simtaning kaudal uchi mezonefral naydan ajrab, qovuqning me­ zonefral nayning kaudal qismidan hosil bo‘ladigan sohasiga ochiladi. Qovuq homila hayotining 7-haftasida kloaka, allantois va mezo­ nefral naylaming kaudal qismining o‘zgarishidan hosil boiadi. Homila hayotining 2 - oyida qovuq tubi va uchburchagi allantoisning pastki qismi bilan mezonefral naylaming quyadigan qismlari va tanasi esa allantoisning o‘rta qismidan hosil bo‘ladi. Allantoisning pastki qismi esa siydik chiqarish nayiga aylanadi. Siydik a’zolari taraqqiyotida turli xil o‘zgarishlar uchrab turadi. Bular buyraklar miqdorining o‘zgarishi va buyraklar joylashishining o‘zgarishiga bo‘linadi. Ba’zan buyraklar uchta bo‘ladi. Bunda qo‘- chimcha buyrak doimiy buyraklardan birining ostida yoki ikki buyrak o‘rtasida, umurtqalar tanasining oldidajoylashganbo‘ladi. Ba’zida esa ikki buyrak o‘mida bitta kattalashgan buyrak hosil bo‘lishi mumkin. Buyraklar joylashishining o‘zgarishi (distopiya) ham bir necha holatda bo‘lishi mumkin. Buyrak pastki bel umurtqasi, yonbosh chuqurchasi va chanoq bo‘shlig‘ida ham joylashishi mumkin. Bunday joylashish bir tomonlama yoki ikki tomonda uchrashi mumkin. Agar ikkala buyrak past joylashgan bo‘lsa, ulaming uchlari o‘zaro qo‘shilib, taqasimon buyrak hosil bo‘ladi. 6 Qov simfizi sohasida suyaklar o‘zaro birikmay qolsa, qovuq old tomondan ochiq qolishi mumkin (ectopia vesicae). Bu anomaliya ko‘pincha siydik chiqaruv nayining bitmasligi (hypospadia penis) bilan birga uchraydi. Buyrak Buyrak (ren, grekcha nephros) qondan suyuqlik ajratib chiqaruvchi juft a’zo (198-rasm). U loviyasimon shaklga ega bo‘lib, katta yoshdagi odamlarda uzunligi 1 0 - 1 2 sm, kengligi 5 - 6 sm, qalinligi 4 sm, og‘irligi 120 - 200 g bo‘ladi. 198-rasm. Siydik a’zolari tizimi: 1-esophagus; 2-diaphragma; 3- glandula suprarenalis sinistra; 4—ren sinister; 5—pars abdominalis aortae; 6—ureter sinister; 7—vesica urinaria; 8—ureter dexter; 9—ren dexter; 10—glandula suprarenalis dextra; 11-v. cava inferior. 7 Buyrak to‘q qizil rangli bo‘lib, oldingi yuzasi (facies anterior) qavariq, orqa yuzasi (facies posterior) yassiroq bo‘lib, yuqorigi uchi (extremitas superior), pastki uchi (extremitas inferior), qavariq lateral chekkasi (margo lateralis) va botiq medial chekkasi (margo medialis) tafovut qilinadi. Medial chekkasining o‘rtasida oldingi va orqa yuzalari bilan chegaralangan botiqlik, buyrak darvozasi (hilum renalis) joylashgan. Bu yerdan buyrak ichiga arteriya va nervlar ki- radi, undan esa siydik yo‘li, vena va limfa tomirlari chiqadi. Buyrak darvozasi ichkariga botib kirgan buyrak kavagiga (sinus renalis) o‘tib ketadi. Buyrak bel sohasida umurtqa pog‘onasining ikki yon tomoni: qorin bo‘shlig‘ining orqa devorida va qorin pardaning orqasida joylashgan. Buyraklaming yuqori uchlari bir-biriga yaqin joylashsa,
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