Lokalne anestezije

5/13/2018 Lokalne anestezije - slidepdf.com

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~o qc}cvjbovc



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… Obc|}c~jnc bo popjiogo qjgcbo… Obc|}c~jno ~o ho|}voljns



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eioqj hkbno

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loboij| jbavokvfj}oij|



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"b" gobmjfsiovj|

b" oiqckiovj| jbacvjkv

b" gcb}oij|



Fikhomo bcvoqo bo eioqj ekqcćc}o

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' bc pk|}knj mjvch}bo kpo|bk|} pk qjm) oij nc gkesąo hkb}ogjboljnoshkijhk mkğc mk pcbc}voljnc kćbc nofsćjlc

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Jbmjholjnc>' bckpio~jno kho' }cůho }vosgo kho

… bk s ol o s o c |o g pk o$t* jbkhsioljno s gcmjnoibj jij io}cvoibj kćbj seok



6* Pk|}spoh pk Pc}cv|kb's

' }cdbjćhj ~od}cqbjnj oij

gobnc vj~jćob pk|}spoh



6* Pk|}spoh pk Pc}cv|kb's

' gc|}k jbkhsioljnc nc ů}k qcb}voibjnc j vk|}voibjnc gkesąc sŲicfs hknj akvgjvons>

vk|}voibk “ ovls| |spvokvfj}oij|

qcb}vo bk “ ovls| ~zekgo} ls|hosmoibk “ pvklc||s| lkvkbkjmcs|



]cdbjho>

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~zekgo}jls|'o ~o fikh b" osvjlkpoipcfvoij|'o

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b" gobmjfsiovj|





Fikhomo bcvoqo bo eioqj p|o



Fikhomo bcvoqo bo eioqj p|o

o* b" jbavokvfj}oij|f* b" gotjiiovj| $Q6*

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l* b" kpd}oigjls| $Q?*m* b" gcb}oij|c* b" oiqckiovj| jba"( b" osvjlkpoipcfvoij|



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Fikhomo b" oiqckiovj| jbacvjkv

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Fikhomo b" oiqckiovj| jbacvjkv

f* bo akvogcb gobmjfsiovc



Fikhomo b" oiqckiovj|'o



Fikhomo b" gotjiiovj|'o hkm p|o

?" Sqkğcbncg jeic s |is~khkŲs s|}o hosmoibk km

pk|icmbnce gkiovo6" Sqkğcbncg jeic s loboij| jbavokvfj}oij| j

mcpkbkqobncg obc|}c}jho bo hvons }ke hoboio)bo akvogcb gotjiiovc

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… jbmjholjno> obc|}c~jno k| gotjiiovj|) bcplo) ~sfo

)opijholjnc

… Gc|}k> j~o pk|icmbnce goh|jiovbke gkiovo) j|pkm

vk|}voibk'qcb}voibke mcio ~jekgo}jćbc hk|}j… ]cdbjho> jeio |c sfomo pkm :0° s kmbk|s bo }qvmk

bcplc) j~o pk|icmbnce gkiovo bo msfjbs qvdkqohkvcbo }ke ~sfo

. ^fke fij~jbc kho j mvsejd |}vsh}svo kqo }cdbjho |c vc}hk hkvj|}j




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Losmoi gotjiiovz $o"h"o" gotjiiovz* fiklh"

q| VK\]VOI GOTJIIOVZ $JBAVOKVFJ]OI* VCEJKBOI FIKLH




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Fikhomo b" gotjiiovj|'o hkm p|o… Oi}cvbo}jqbo }cdbjho> pvj|}sp nc j|}j hok ~o jbavokvfj}oibj fikh) oij sgc|}k opijholjnc

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Fikhomo b" kpd}oigjls|'o p|o

… \}vsh}svc> khk) kvfj}o) hoplj) hkŲo ćcio

… ]cdbjho> j~qkmj |c j|}k hok gc}kmo fikhomc b"gotjiiovj|'o pvchk hkŲc) |o io}cvoibc |}vobc) j|pkm

qcb}voibke vsfo noekmjćbc hk|}j) oij kqon ps} ů}kfijŲc ~ogjůincbkn khkgj}kn ijbjnj hkno pomo |o" "

hvobjoibk km pvcmbnce vsfo vogs|o gobmjfsic" Jeiopvkmjvc |o gcmjnoibc |}vobc vogs|o j s|gcvcbo nc

hosmk'gcmjnoibk j fioek mkv~oibk




Fi h m d} i j






Fikhomo b" kpd}oigjls|'o p|o… oi}cvbo}jqbo }cdbjho>

Vc}vkfsifovbo obc|}c~jno>

" '$6" hvobjnoibj bcvq* homo mkio~j mk bncekqcvc|kvpljnc s |sfovodbkjmoibjpvk|}kv LB\ j pvc|}obho

mj|obno mcikqobncg bovc|pjvo}kvbj lcb}ov spvkmsŲcbkn gkŲmjbj"

^fke vj~jho km ků}cącbno

kćbc nofsćjlc) hkvj|}j |cseioqbkg |ogk ~o cbshicoljns



Fikhomo b" osvjlkpoipcfvoij|'o p|o

… Jbmjholjno> povoij~o khsiovbjd gjůjąo ćjgc nc kiohůobka}oigkikůhj pvceicm jij djvsůhj ~odqo}" Bc mkqkmj mk

obo ec~ c… ]cdbjho>

gc|}k sfkmo nc bo

|vcmjbj pk|icmbnc

hk|}j

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n e n e pvogs| ~zekgo}jls|vogs| fslloij|

vogs| gobmjfsiovj| govejboij|vogs| lcvqjloij|

b" osvjlkpoipcfvoij|

Povoqcv}cfvoibc fikhomc



Povoqcv}cfvoibc fikhomc

Pvkh|jgoibopovoqcv}cfvoibofikhomo

Mj|}oibopovoqcv}cfvoibofikhomo

pkćc}oh mcikqobno> ?0 gjb}vonobnc> khk :0 gjb

Pvkh|jgoibo povoqcv}cfvoibo fikhomo




$Aovsdov|kb8 Logfvjmec }cldjsc*… Jbmjholjno> ~odqo}j hknj ~od}cqons iopovo}kgjns

s s ~ skgcb}kpich|jno) lov|hj vc~) vsgjbk}kgjno*)vsp}svo gkhvoąbc fcůjhc }cic}o $jblj~jno„ bo ijbco

oifo bohkb fjio}cvoibke povoqcv}cfvoibke fikho*

… Pvcmbk|}j s kmbk|s bo mjvch}bs jbaji}voljkbs obc|}c~jns>

“ sbjakvgbo obc|}c~jno ofmkgjboibke ~jmo) shinsćsnsąj jpcvj}kbcsg

“ vcioh|oljno gjůjąo ofmkgcbo





… Kpvcgo> ůpvjl km 60gi) jeic $<hkg"* km ?0lg… 60gi 6# ijmkhojbo pk gc|}s jbkhsioljnc $shspbk 10'40gi*

… ]cdbjho> “ fikhomo ]?<'I6 ~o iopovo}kgjns hkm vo~ijćj}jd pvklcmsvo jij I?'I< ~o lov|hj vc~

“ Pvqk |c fikhjvo pk|icmbnj |iofjb|hj bcvq $I6+I<* $kvncb}oljno nc pvkl" }vob|" I3*

“ gc|}k> 3'1lg km gcmjnoibc ijbjnc) s~ hosmoibs jqjls pvklc||s| }vob|qcv|s| I6

“ sfkm |hkvk khkgj} $qvd nc ~o khk ?0° s|gcvcb gcmjnoibk*

“ jb}cv}vob|qcv~oibj ijeogcb} pvsŲo bců}k noćj k}pkv pvj pvkmkvs" ?3 gi obc|}c}jho)

mkv~oibo j qcb}voibo evobo bcvqo" “ 3gi |c jbkhsijůc s pkćc}hs pkqioćcbno jeic) j }k j~bom ijeogcb}o s ljins fikhomcmkv~oibjd hs}objd evobo $|sqjůbk;;*

“ jeio |c j~qioćj mkh |c khkibo hkŲo pk}j|hsnc qcb}voibk









Pkinc oboiec~jnc |c pvsŲoqcb}voibk mk ijbco oifooij nc pkgcvcbk

pkikŲon kmekqovonsąjd|iofjb|hjd pvůincbkqo

Fikhomkg pkncmjboćbjd|pjboibjd bcvoqo mkfjno|c s|hk obc|}c~jvobk

pkinc $?'= lg*"

Pk|}knc kmvcğcbopvchiopobno j~gcğs|s|cmbjd pkino"





^bolj s|pcůbc fijhomc>

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' kpsů}cbo gs|hsio}svo |iofjbo

' |hkijk~o

Mj|o}oibj $io}cvoibj* povoqcv}cfvoibj fikh



$ * p

$Goemo*Jbmjholjnc> j|}k hok ~o pvkh|jgoibs

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j~moboho I?) I6 j I=

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' jeio |c vc}vodsnc j vcpk~jljkbjvo mkv~oibk km j~mobho hohk fj |o 3gi obc|}c~jvoij

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Cpjmsvoibo obc|}c~jno



Cpjmsvoibo obc|}c~jno

… Jbaji}vkqobnc obc|}c}jho s cpjmsvoibj pvk|}kv s>?* jb}cvhkhljecoibkg pvk|}kvs

' }~q" hosmoibo obc|}c~jno $ q| hvobjnoibo }n" ’qj|kho |ohvoibo‗*' bonćcůąc hkm ekqcmo j hkbno

6* isgfk|ohvoibkg pvk|}kvs

' pvjgcbnsnc |c hkm po|o) goćoho j |qjbno

… obc| c c s c bo pk| cv kvbc |p bo bc bcvqc pvc

bcek ů}k bops|}c hjćgcbj hoboi… ~o oboiec~jns fc~ vcioh|oljnc gs|hsi}osvc) sgc|}k

obc|}c}jho) hkvj|}c |c kpjkjmj

Cpjmsvoibo obc|}c~jno hkm ekqcmo




… Jbmjholjnc> ůjqcbnc pcvjbcsgo) vc}vohljno lcvqjh|o s}cvs|o) vcmshljnovkio |s|o s}cvs|o hkb}vkio }cbc~gs|o cgfvjk}kgj o j}m

… Mk~o> ?gi+?00he }g 6# ijmkhojbo $(+' OMV “ pvkmsŲoqo cacho}*… Jpoh pvcpovo}j |o OMV bj|s pvcpkvsćinjqj ~o cpjmsvoibs) jb}vo'ov}jhsiovbs j JQ

opijholjns… cpjbcavjb pvkmsŲoqo mcn|}qk8 hkblcb}voljno> ?>600"000 $?ge>600gi*8 bkvOMV

?>?00"000 $?ge>?00gi*… Cach}j ~oqj|c km mk~c" Ohk |c pvoqjibk mo) bc s}jćc bo bkec bj hkb}vohljnc

s}cvs|o

… ]vonobnc> hkgpic}bo obc|}c~jno 10gjb) kpkvoqoh ~o ?60 gjb

… Hkgpijholjnc> bonćcůąc pk|icmjlo jbachljnc) vcğc pkqvcmc bcvqo" ]omogkŲc mkąj mk povoij~c vcpo" ô}k ' o|cp}ćbo }cdbjho/




d}}p>++qjmck"ekkeic"lkg+qjmckpioz;mkljm7?:<??455?5=35<=<:<5


Qj|kho |ohvoibo obc|}c~jno



S |ohvoibkg j hkhljecoibkg pmcis hjćgcbkeHoboio pk|}knj |ogk cpjmsvoibj pvk|}kv"



Jb}cvhkhljecoibo $Lk?'Lk6*cpjmsvoibo obc|}c~jno




p n e

… ]cdbjho> “ JM gc|}o jbkhsoljnc

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“ Goikg hkijćjbkg obc|}c}jho) obc|}c~jvo}j gc|}k jbkhsioljnc “ Jeis $='3lg) E?4) bonfkinc |o |}jic}kg* sfk|}j s gcmjnoibkn ijbjnj pkm seikg km

53'40°) s|gcvcbk hvobjkqcb}voibk “ ^bolj mo nc jeio s cpjmsvoibkg pvk|}kvs>

… hovoh}cvj|}jćbk ’pkp‗ bohkb pvkfjnobno ije" aioqsg… }v~ons vcpbc j gs|hsio}svc ~ombnjd ch|}vcgj}c}o $jeio mkmjvsnc bcvq" ~oqvůc}hc*… o|pjvoljno }cćbk|}j j~ jeic “ ’dobejbe mvkp }cldbjsc‗

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“ Ohk nc jeio pvoqjibk pk|}oqincbo) o|pjvoljnkg |c bcąc mkfj}j L\A jij hvq “ Ohk |c o|pjvjvo hvq $qcbs|bj |jbs| s cpjmsvoibkg pvk|}kvs* “ pkbkqk) bkqkgjeikg

“ \pkvk opijhkqo}j obc|}c}jh “ ?3gi ~o khk ?0'?3 |cl “ Povoij~o vcpo ~o khk :0|cl “ pk}qvmo" Psb cacho} ~o khk ?0 gjb

Cpjmsvoibo obc|}c~jno hkm hkbnoo* |ohvkhkhljecoibo



o* |ohvkhkhljecoibof* |ohvoibo

l* isgfk|ohvoibo

Cpjmsvoibo obc|}c~jno hkm po|o



p n p

?* jb}cvhkhljecoibo6* isgfk|ohvoibo

' ćcůąc pvjgcbnjqobo hkm po|o j goćoho' hjćgcbo gkŲmjbo |c ~oqvůoqo s bjqks>

' I1 jij I5 hkm po|o' \? hkm goćoho “ gkesąc s~kvhkqo}j L\A' sqch o|pjvjvo}j $~o hvq+L\A* “ ohk |c pknoqj L\A> opijhkqo}j pkio mk~c/

' pvjpvcgj}j pkinc' jeio |c sfomo j~gcğs I5 j \?) hknj |c boio~c bců}k hosmoibk km ijbjnc hkno pvkqc~snc

hvobjnoibc hvoncqc hjio fcmvcbjd hk|}jns $oio k||j| jiijsg*

' Jeio |c pk|}oqino pcvpcbmjhsiovbk s kmbk|s bo hkŲs) jij nc qvd fioek s|gcvcb hvobjnoibk' hkvj|}j}j jeis |o |}jic}kg $~omvŲobo hkŲo bo qvds jeic hok bjms| ~o jbachljns*8 pk|}knc

pk|cfbc jeic ~o |pjboibc obc|}c~jnc' ) "' cpjbcavjb pvkmsŲoqo mcn|}qk8 hkblcb}voljno> ?>600"000 $?ge>600gi*' pvklc||s| |pjbk|s| isgfovbjd pvůincbkqo |s qjůj j gcğs|kfbk vo~mqkncbj) mkh |s kqj

hkm |ohvoibjd pvůincbkqo |pkncbj j bjŲj' |}cvboibj pkikŲon p|o “ ~o gobnc j|hs|bc $iohůc kmvcmj}j gc|}k opijholjnc) gkŲc |c

j~qc|}j ’dobejbe'mvkp }cldbjsc‗*' jeis ~ofk|}j j~o pk|icmbnce I5 |pjboibke j~mobho) bo smoincbk|}j hkno j~bk|j pkio km

vo~goho j~gcğs |pjboibjd j~moboho I1 j I5

Cpjmsvoibo obc|}c~jno hkm po|o



p n p' j~gcğs I5 j \?) hknj |c boio~c bců}k hosmoibk km ijbjnc hknopvkqc~snc hvobjnoibc hvoncqc hjio fcmvcbjd hk|}jns' s gcmjnoibkn ijbjnj

isgfk|ohvoibo cpjmsvoibo obc|}c~jno>

Pvkficg nc kpo|bk|} mo |c obc|}c}jh jbkhsijůc s |sfovodbkjmo



Pvkficg nc kpo|bk|} mo |c obc|}c}jh jbkhsijůc s |sfovodbkjmo'

ibj pvk|}kv" Fikhomo |c }omo hkb}vkijůc pk~jljkbjvobncgpoljncb}o ů}k bjnc gkesąc hkm qcijhjd Ųjqk}jbno"

Jbaji}voljkbc obc|}c~jnc bo ofmkgcbs



ekqcmo

?* ijbjn|hj fikh6* kfvbs}j'I fikh

HkŲo j |qo j|pkmicŲcąo }hjqo|s jbaji}vkqobo obc|}c}jhkg"

…bc s}jćc bo ofmkgjboibc kveobc “ poŲinjqo gobjpsioljno/$lov|hj vc~) vsgjbk}kgjno j}m"*…gkŲc fj}j bchkgpic}bo) pkek}kqk bo bjqks pcvj}kbcsgo…gjkvcioh|oljno nc |iofo

?* Ijbjn|hj fikh



?* Ijbjn|hj fikh… jbaji}voljno msŲ jblj~jkbc ijbjnc s c}oŲogo>o* qjůc|}vshc \L opijholjnc 0"3'?gi 6# ijmkhojbo8 vo|}knobnc j~bk|j ?'6 lg8 jeio> 6"3lg) E60f* qjůc|}vshc \L opijholjnc ?3'60gi hvk~ obc|}c~jvobs hkŲs

'

gjůją mk pcvj}kbcsgo msŲ ijbjnc vc~o8 jeio 5"3'?0lg) E?4

… Pvcmbk|}> ncmbk|}oqbo }cdbjho… bcmk|}o}oh> |iofo gjkvcioh|oljno) cmcgo}k~bk $ nciiz'ijhc* }hjqk hknc nc }cůhk jblj~jvo}j)

jbaiogoljno }hjqo $bcaj~jkikůhj pD obc|}c}jho*) dcgo}kgj bo ijbjnj vc~o) |pkvk ~ovo|}obnc vobc

… j~qkmj}j s~ |}obmovmbc o|cp}jćbc }cdbjhc… ]kh|jćbo mk~o 2 3ge+he… Fk> pkmbk|c 630gi vo|}qkvo

… op> got g vo| qkvo got g k o bo pk e

… Qcijhc hkijćjbc |s pk}vcfbc ncv |s bcvqbj ~oqvůclj mjaj~bk vo|pkvcğcbj $~o vo~ijhs kmpvkh|jgoibc obc|}c~jnc*" GkŲc |c pkgcůo}j 6# vo|}qkv ijmkhojbo |o j|}kg hkijćjbkgaj~jkikůhke vo|}qkvo $?>?* hohk fj |c mkfjk ?# vo|}qkv) ćjgc |c sů}cmj 30# obc|}c}jho

… Bc j~qkmj}j icpc~o|}c pkhvc}c $’ aobbjbe‗* “ bo|}onc ků}cącbnc }hjqo

?* kfvbs}j'I fikh



?* kfvbs}j'I fikh… jbaji}vkqo}j obc|}c}jh 6'< lg mkv~oibk j hvobjnoibk km ijbjnc vc~o) hosmoibk)

s~ vcfvo) j kmgod qcb}voibk) j|pkm }vob|qcv~oibjd pvklc|s|o… bo vo|}knobnjgo km ?"3lg jbaji}vkqo}j hkŲs j gjůją

… fkino km ijbjn|hke fikho “ bcgo cmcgo) jbaiogoljnc) dcgkvoejno)dcgo}kgo msŲ ijbjnc vc~o)j bc s}jćc bo ~ovo|}obnc

… Fk> spk}vcfj}j 10'?00gi obc|}c}jho… }vonobnc> 10'40gjg

Xqjmck?W

Xqjmck6W




http://slidepdf.com/reader/full/lokalne-anestezije 55/107Jb}cvhk|}oibo fikhomo bcvoqo hkm p|o



p

… Jbmjholjnc> oboiec~jno bohkb }kvohk}kgjnc) picsvoibo psbhljno) hkm avoh}svc vcfovo… Hkb}vojbmjholjnc> k}cŲobk mj|obnc… Hkgpijholjnc> $hijbjćhj kmikŲcb* pbcsgk}kvoh| $gkvo |c pk|go}vo}j bchkijhk |o}j

… Jeio> E66'63) djpkmcvgjćbo jeio… Mk~o> 0"63gi+gc|}s ~o goic p|c)

mk ?gi ~o qcijhc8 got <ge+he

… ]cdbjho> “ o|cp|o

]kvohk}kgjno> jblj~jno s picsvoibjpvk|}kv evsmj" ]cdbjhc |s>

'Gcmjnoibo |}cvbk}kgjno'Pk|}cvkio}cvoibo }kvohk}kgjno'Obc}cvkio}cvoibo }kvohk}kgjno

“ pv gcb s c |c ' b cv k| o bo pvk| kvo |pvc ~o k vc cbc vce c ~ ke pvc opob obcvqbjd ~oqvůc}oho

“ bcvqj |s ikljvobj s~ hosmoibj vsf vcfvo) j~o hvqbjd |smkqo “ jeis pk|}oqj}j pkm pvoqjg seikg) s~ hosmoibj vsf vcfvo

… ]vonobnc> <'1d8 bohbombc opijholjnc |s vj~jćbc $jb}kh|jholjno*

Jb}cvhk|}oibo fikhomo bcvoqo hkm p|o








Fikh pich|s| fvodjnoij|o $L3']?* p|o



… Jbmjholjnc> hkb}vkio pcvjkpcvo}jqbke fkio s |isćonspkqvcmo j avoh}svo pvcmbnce ch|}vcgj}c}o

… J~qkmj |c bo |cmjvobkn jij obc|}c~jvobkn Ųjqk}jbnj $k|jg Lo j Ac) j hkm Lop) Kq) }ciomj*

… Pk|}knc mqc }cdbjhc?* Oh|jiovbo fikhomo

( iohk |c j~qkmj

' pk}vcfbk mk|}o obc|}c}jho' vogc j pvkh|jgoibj dsgcvs| bj|s obc|}c~jvobj' obc|}c~jno nc ćc|}k bcpk}psbo j bo mj|}oibkg mcis bkec

6* Povoqcv}cfvoibo fikhomo ¸ |qc ćcůąc pvjgcbnjqobo }cdbjho hknkg |c k}hiobnons boqcmcbj bcmk|}olj

… Hkgpijholjnc> “ fikh b" pdvcbjls|'o j povoij~o mjnoavoegc $bjhom fjio}cvoibk j~qkğcbnc* “ Pbcsgk}kvoh| “ JQ opijholjno $qcv}cfvoibj hvqbj |smkqj) hk|}klcvqjhoibo ov}cvjno*

?* oh|jiovbj fikh



… Jeio $5"3'lg) E 60'66* |csqkmj gcmjnoibk km vo'

gcbke ~eikfo) povoicibk|o hjćgcbkjg |}sfkg

… ?0'?3gi 6# ijmkhojbo ¿

cpjbcavjb jij vo|}qkvfspjqohojbo $got <ge+he)

got <0gi*





… Jbncl} ikloiobc|}dc}jl udjic



obc|}dc}jl udjic

uj}dmvoujbe }dcbccmic 53# ka

jb|cv}cm"

… Vcjb|cv} }dcbccmic }uk gkvc)

oppvktjgo}ciz <0mcevcc| mkv|oi obm<0 mcevcc| qcb}voi

… bo|}spo ~o ?0'?3 gjb



p

… hovoh}cvj|}jćob |}oq hkm

s|pcůbc fikhomc

… }vonc khk 6d

… pk}psbj kpkvoqoh ~o 1d

6* Povoqcv}cfvoibj fikh pich|s| fvodjnoij|o



… opijhkqo}j obc|}c}jh ů}k fijŲc jb}cvqcv}cfvoibjgk}qkvjgo hvk~ hknc j~io~c |pjboibj L1) L5) L4) ]?

…

}vob|qcv~oibj pvklc|s| L1 pvůincbo j pvqk vcfvk… Fikhomo qcb}voibjd evobo L1 j L5 |pjboibjd bcvoqo>

“ jeio |c s|gcvoqo ho }vob|qcv~oibkg pvklc|s|s L18 obc|}c}jh |c

mcpkbsnc mkv~oibk km bnceo) bo bncekqkg hvobjnoibkg jhosmoibkg vsfs

“ jeis s|gcvj}j hosmoibk $vj~jh ' cpjmsvoibo opijholjno*

… Fikhomo qcb}voibjd evobo L4 j ]? |pjboibke bcvqo> “ jeio |c s|gcvoqo ho hvobjnoibkg vsfs mkv~oibke mcio pvqke vcfvo)

fij~s gc|}o ~eikfinoqobno pvqke vcfvo j pvůincbo

L3



… Fikhomo qcb}voibjd evoboL1

L3

jeio |c s|gcvoqo ho}vob|qcv~oibkg pvklc|s|s L18obc|}c}jh |c mcpkbsncmkv~oibk km bnceo) bobncekqkg hvobjnoibkg jhosmoibkg vsfs8jeis s|gcvj}j hosmoibk"

L5

L4

]?

… Fikhomo qcb}voibjd evobo L4 j ]? |pjboibke bcvqo>

jeio |c s|gcvoqo ho hvobjnoibkg vsfs mkv~oibke mciopvqke vcfvo) fij~s gc|}o ~eikfinoqobno pvqke vcfvo jpvůincbo) o ~o}jg j bo hosmoibj vsf vcfvo

Obc|}c~jno b" psmcbmoij|'o fjho



$fjio}cvoibj jb}cvbj psmcbmoibj fikh*

km |jegkjmbc hvjqc) pvceicm j kpcvoljncpvkiofjvobke pcbj|o

… Vo~qjncb hok oi}cvbo}jqo cpjmsvoikn obc|}c~jnj) hkno nc ~o psbcacho}) ~od}cqoio qj|khc mk~c obc|}c}jho) ů}k nc

ch|}vcgj}c}o ů}k nc hkm fjhkqo hok }cůhjd Ųjqk}jbno) ćc|}k s~kpjvobnc) mkqkmjik mk vo~bjd pkqvcmo

… b" psmcbmoij| evomc qcb}voibc evobc |ohvoibjd |pjboibjdbcvoqo $pk|}knj j povoqcv}cfvoibo j |sf|ohvoibo }cdbjho fikho)

oij j fikh mkv~" bcvqbjd ~oqvůc}oho pcbj|o hvk~ pvcpsljnsg*

Obc|}c~jno b" psmcbmoij|'o hkm fjho



Obo}kgjno>

… vch}oibjg pvceicmkg |c bo 3lg km obs|opoipjvo akvogcb s ije" |ovlk|ldjomjls|'s"

… ]s gkes mo |c poipjvons psi|oljnc o"

psmcbmoij| jb}cvbo"

) )

b" psmcbmoij| jb}cvbs|



http://slidepdf.com/reader/full/lokalne-anestezije 69/107Obc|}c~jno b" psmcbmoij|'o hkm fjho



]cdbjho>… hkŲo j~bom jůjvch}oibjd ak|o) kfc |}vobc) |c mc~jbajhsnc j obc|}c~jvo |o

' g k o bo

… ?"63lg) E?= jeio |isŲj hok hobjio ~o 4"63lg E?4 jeis… Jeio |c s|gcvoqo hvobjk'qcb}voibk khk 3'5lg) ho bonbjŲcg mcis

ak||o j|ldjkvcl}oij| $pk~jljno jeic |c hkb}vkijůc vch}oibkg poipoljnkg*… Jbkhsijůc |c mk 63gi 6# ijmkhojbo… Jeio |c ~o}jg pkqioćj j vcpk~jljkbjvo 6'< lg hosmkmkv~oibjnc) emc |c

jbkhsijůc mkmo}bjd ?0gi

… Pvklcmsvo |c pkboqino |o mvsec |}vobc

… Fikh bo|}spo bohkb <0gjb) o }vonc khk 6'=d




Fikh poigovbjd+piob}ovbjd bcvoqo hkbno



. Pvc j~qkğcbno) gc|}k jbkhsioljnc |c

kůjůo) kćj|}j j mc~jbajhsnc

o* ekvbnj fikh$poigov+piob}ov gc}olovpoi+gc}o}ov|oi jbncl}jkb*

f* |vcmbnj fikh

$poigov+piob}ov $ofotjoi |c|ogkjm* jbncl}jkb*

l* mkbnj fikh

$poigov }cvgjboi mjej}oi bcvqc fiklh*



b" gcmjobs|

" " " "

b" poigov| io}"vogs| mkv|oij|

b" poigov| gcm"vogs| mkv|oij|

b" mjej}oij|

poigov| io}"

b" mjej}oij|

poigov| gcm"

Jbmjholjnc



… }k ojm mjoebk|j| ka }dc |j}c ka iogcbc||

… }k vcijcqc }dc pojb ka ols}ciz pojbasi ic|jkb|… goz fc vcpco}cm mojiz akv o acu moz|

… Ikbec|} pojb vcijca j| kf}ojbcm fz s|jbe fspjqolojbcuj}d omvcboijbc

… }k oiiku pojbic|| poigov+piob}ov kpcvo}jkb|

b" sibovj| b" gcmjobs|

b" sibovj| vogs| mkv|oij|

b poigovj| gcmjoij|b" sibovj|



b" sibovj|

b" poigovj| gcmjoij|

b" gcmjobs|

b" poigovj| io}cvoij|

b" poigovj| io}cvoij|b" poigovj| gcmjoij|

g" aictkv mjej}oij| |spcvajljoij|

g" aictkv mjej}oij| pvkasbms|

]dc io}cvoi poigov bcvqc j| akvgcm fzas|jkb ka }dc }cvgjbo}jkb ka }dc sibov

bcvqc uj}d kbc ka }dc }cvgjboi fvobldc|ka }dc gcmjob"

b" poigovj| gcmjoij| vogs| mkv|oij|"

b" mjej}oij| poigovj| gcmjoij|b" mjej}oij| poigovj| io}cvoij|

S fij~jbj bcvoqo |c boio~c hvqbj |smkqj///

Hok j hkm mvsejd ikhoibjd obc|}c~jno) kfoqc~bk

pvc jbkhsioljnc pkqsąj hijp fvj~eoijlc/

o* ekvbnj fikh



… Gc|}k> 3'5 lg j~bom gc}olovpk'+gc}o}ov|k' aoiobecoibke ~eikfo jij

= pv|}o mj|}oibk km mkbnc evobjlc hovpoibke+}ov~oibke ~eikfo

… ŷjqk}jbno |}knj) hkŲo j ao|ljno nc ~o}cebs}o j iohk nc pcbc}vjvo}j “ Ohk nc pkmjebs}o bkeo) hkŲo |c bofjvc) obc|}c}jh nc jbkhsij|ob |sfhs}obk) bc khk bcvqo

“ S }kg |isćons pkbkqj}j opijholjns $pvcmbk|} nc |omo obc|}c~jvobo hkŲo vcejkbo*

… Gcmjnoibj bcvq |c fikhjvo pvj|}spobncg |o |spvk}bc |}vobc Ųjqk}jbnc) vomcąj)

… \o Me o|pch}o pvcm|}oqino pvkfs ~o gc}o'hovpoibc+'}ov~oibc hk|}j

o* ekvbnj fikh



'ekvbnj fikh.

.]cdbjho ncmbke sfkmo~o fikh j io}cvoibke j

gcmjnoibke bcvqo

f* |vcmbnj fikh



… Gc|}k> kmgod j~bom gc}olovpk'+gc}o}ov|k'aoiobecoibke $hjćjćbke* ~eikfo

… Pvcmbk|}> hom |c bkeo pkmjebc j ~eikfkqj aich}jvons) iohk nc jmcb}jajhkqo}j bcvq

" "

… 6'< gi obc|}c}jho |o |qohc |}vobc

Kqo obc|}c~jno pvcm|}oqino pvkfs

~o hkpj}bs) hvsb|hs j hjćjćbs hk|}j pvjpomonsąc ~eikfkqc

f* |vcmbnj fikh… Iku = pkjb} fiklh



o* mkbnj fikh… Gc|}k> |vcmjbo j~gcğs hjćjćbke ~eikfo j io}cvoibke hkvkbovbke vsfo



obc|}c}jh |c bonćcůąc jbkhsijůc s~ pvkh|jgoibj vsf hkio}cvoibjd dv|hoqjlo… ]cdbjho> ' pkmjąj bkes

' poipjvo}j bcsvkqo|hsiovbj |bkp ofoh|jnoibk km msfkhc }c}jqc aich|kvo

' jeio $63e t 3+4& bccmic*8 6'< gi obc|}c}jho |o |qohc |}vobc

… Kqo obc|}c~jno pvcm|}oqino pvkfs ~o

pkmk}vkdics>?" fsv|o pkmk}vkldicovj|)

"

<" }cbmk gj" aictkvj mjej}jj

pvkasbmj

o* mkbnj fikh



d}}p>++uuu"zks}sfc"lkg+uo}ld;q7Ej^s:aQIH_u

}c|}jvobnc |cb~jfjibk|}j



Oa}cv }dc jbncl}jkb| doqc fccb lkgpic}cm }dc objgoi j|oiikucm }k |}obm sjc}i akv ?0“?3 gjbs}c|" O} }dc cbm

ka }dj| }jgc }dc ijgf j| }c|}cm akv |cb|o}jkb fz }oppjbekb }dc |hjb uj}d o fisb}' cbmcm |pjhc kb }dc cbm ka o |dkv} pkic" ]dj| j| o fc}}cv uoz ka mc}cl}jbe ik|| ka mccp |cb|o}jkb }dob pvjlhjbe uj}d o bccmic" Obzvc|pkb|c }k }oppjbe ovksbm }dc lkvkbc} obm dccijbmjlo}c| aojisvc }k fiklh }dc bcvqc kb }do} |jmc" Kbcjbmjlo}jkb ka |cb|o}jkb j| |saljcb} }k pvkqc }dj|) obm

|sllc||jqc }vjoi| kbiz |cvqc }k oej}o}c }dc objgoi" J}goz fc bclc||ovz }k lkqcv }dc objgoi‚| czc }k pvcqcb}j} |ccjbe }dc oppvkold ka }dc }c|} jb|}vsgcb}"

Obc|}c~jno b" }jfjoij|'o j b" ajfsiovj|'o



Jgoec jiis|}vo}jbe }dc iklo}jkb| }kfiklh }dc }jfjoi obm pcvkbcoi bcvqc|"gcmjoi io}cvoi



]dc |j}c akv jbncl}jkb ka }dc }jfjoibcvqc j| oppvktjgo}ciz ?0 lg ofkqc}dc pkjb} ka }dc dklh kb }dc gcmjoio|pcl} k } c g ) c}uccb } c

Oldjiic| }cbmkb obm }dc mccp mjej}oi aictkv gs|lic"

]dc iklo}jkb }k fiklh }dc pcvkbcoibcvqc| j| oppvktjgo}ciz ?0 lgofkqc }dc pkjb} ka }dc dklh kb }dc

b" }jfjoij| b" pcvkbcs|

?0 lg

o}cvo o|pcl} k } c g b } c

evkkqc akvgcm fz }dc gs|lic fciijc|ka }dc io}cvoi obm ikbe mjej}oi ct}cb|kv gs|lic|"

o* b" ajfsiovj| $pcvkbcs|* pvkasbms|

Ajh|jvo}j Ųjqk}jbns $hbnjeo 30" |}v*



“ ?0 lg j~bom |hkćbke ~eikfo “ j~gcğs

g" ct}cb|kv mjej}oij| io}cvoij| j

g" ct}cb|kv mjej}oij| ikbes|

“ |sfao|ljoibk

f* b" }jfjoij|

“ ?0 lg j~bom |hkćbke ~eikfo

“ j~gcğs Odjikqc }c}jqc j

g" aictkv mjej}oij| ikbes|

“ |sfao|ljoibk $ao|ljo lvsvj|*

b" }jfjoij|>

' ~o obc|}c~jvobnc vcejnc |hkćbke ~eikfo j mj|}oibjd vcejno' fikhkg |s ~odqoącbj>

' mj|}oibj mck Odjikqc }c}jqc



' piob}ovbo |}obo }o~oibke ~eikfo' hoihobcs|' piob}ovbo |}vobo gc}o}ov~oibjd hk|}jns

' |s|pcb~kvbj ijeogcb}j

' qcąj mck pv|}o

b" pcvkbcs| pvkasbms| c} |spcvajljoij|

' ~o pk}psbs bck|c}injqk|} mj|}oibke ch|}vcgj}c}o gkvons |c

fikhjvo}j j kfc evobc bcvqo" ô fikh pkqvůjb|hke mcio bcvqo)jeio |c pkqioćj j opijhsnc |c obc|}c}jh s bchkijhk voqbj"' oi}cvbo}jqbo }cdbjho nc pvkh|jgoibjnc jbkhsioljno) bo gc|}s

Jbmjlo}jkb>

Mc|cb|j}j~o}jkb ka }dcpk|}cvjkv o|pcl} ka gc}o}ov|s|) }dc gcmjoi obmio}cvoi o|pcl}| ka }dcac}iklh) obm }dc udkic mjej}"

c b| qcbke pcvkbco bke bcvqo) pvc b cekqke evob ob o"

.Obc|}c~jvobnc kfo pcvkbcs|bo bcvqo) msfkhke j pkqvůbke)hok j }jfjnoibke bcvqo) mkqkmj mk povoij~c lcike mkbnce

ch|}vcgj}c}o j o}oh|jnc) ů}k k}cŲoqo pvklcbs dvkgk|}j"

. Akv lkgpic}c

mc|cb|j}j~o}jkb mkub }dcdklh) }dc |opdcbks|)|spcvajljoi pcvkbcoi) obmpk|}cvjkv ls}obcks| bcvqc|

|dksim fc fiklhcm"

Fikhomc bcvoqo bo pvcmbncg

ch|}vcgj}c}s ekqcmo



6* fikh mjej}oibjd bcvoqo

$j bo ~ombncg ch|}vcgj}c}s*

<* obc|}c~jno jb}cvmjej}oibke vcejkbo$j bo ~ombncg ch|}vcgj}c}s*

Fikh mjej}oibjd bcvoqo$pvcmbnj ch|}vcgj}c}j*>



?* obc|}c~jno mj|}oibk km hovps|o “fikhkqj pkncmjbjd bcvoqo>?* b" sibovj| $F*

6* b" gcmjoij| $L *

<* b" ob}cfvoldjoij| gcmjoij|=* b" ob}cfvoldjoij| mkv|oij|. \ijćbk bo ~ombncg ch|}vcgj}c}s

6* obc|}c~jno mj|}oibk km |vcmjbcgc}ohov s|o }~q" =' kjb} fiklh

?* b" sibovj|) vogs| mkv|oij|

6* b" sibovj|) vogs| poigovj|<* b" poigovj| gcmjoij|

$bo|}oqoh b" gcmjoij|*

=* b" gc}olovpoij| mkv|oij|$bo|}oqoh b" vomjoij|) vogs| |spcvajljoij|*

. \ijćbk bo ~ombncg ch|}vcgj}c}s

Pvcmbnj ch|}vcgj}c}O* b" gc}olovpoij| mkv|oij|

F* b" poigovj| gcmjoij|



L* b" siobvj|) vogs| poigovj| io}cvoij|

M b" sibovj| vogs| mkv|oij|

o* }c}jqc ch|}cb~kvo

f* Ije" jb}cvk||cs|

l* }c}jqo msfkhke aich|kvo

m* }c}jqo pkqvůbke aich|kvo

ômbnj ch|}vcgj}c}

O* b" pcvkbcs| |spcvajljoij|

F* a m



F* b" pcvkbcs| pvkasbms|

L b" gc}o}ov|oij|piob}ovj| gcmjoij|

M* b" gc}o}ov|oij|piob}ovj| io}cvoij|

o* }c}jqc ch|}cb~kvo

f* Ije" jb}cvk||cs|

l* }c}jqo msfkhkeaich|kvo

o* }c}jqo pkqvůbkeaich|kvo

Obc|}c~jno popho

Ų j j = ćj



GkŲc |c j~qc|}j bo = boćjbo>

b }vol o } qo k k c |}vcg }c}o be kl

6* jb}voqcb|ho vcejkboibo obc|}c~jno $JQVO*

<* pk|cfbc vcejkboibc obc|}c~jnc?* cpjmsvoibo obc|}c~jno $~ombno bkeo*

k vo o bke |p c o pvc b o bkeo<* fikh vcejkboibjd bcvoqo

=* kpů}o obc|}c~jno

Vjbe Fiklh



… pv|}cbo|}o jbaji}voljno }hjqo s bjqks |pkno pvkh|jgoibke j|vcmbnce gc}o'hovps|o+'}ov~s|o

… 6"3lg) E63 jeio) khk ?3gi obc|}c}jho bo bchkijhk gc|}o>… msfkhk j pkqvůbk khk aich|kvbjd }c}jqo $khk msfkhjd j pkqvůbjd

|oejfoćhjd }c}jqo*… gcmjnoibk j io}cvoibk khk ch|}cb~kvbjd }c}jqo… pkmvsćnc j~gcğs obc|}c~jvobke ob}cvjkvbke j pk|}cvjkvbke pkmvsćno |c

pkmcij bo }vcąjbc" Bo |pkncqjgo }vcąjbo |s gc|}o opijholjnc obc|}c}jhobo io}cvoibkn kmbk|bk gcmjnoibkn |}vobj ch|}vcgj}c}o

… hkvj|}j}j |c j qo~khkb|}vjh}kv $bc bo vcps) popjij) pv|}s* … pvcmbk|}> bc ~od}cqo |c pvclj~bk pk~boqobnc obo}kgjnc

… bcmk|}olj> “ gkesąo |ogk povljnoibo obc|}c~jno “ gsi}jpbo jbnchljkbo gc|}o “ qcąj vj~jh km jbachljnc “ Gkesąo j|dcgjno hkm spk}vcfc OMV



Pvoh}jhsg'gc|}o opijholjnc>

O* gcmjnoibk) 3lg km hjćjćbke ~eikfoF* Mkv~oibk) <'= lg km hjćjćbke ~eikfoL* Io}cvoibk) <'= lg km hjćjćbke ~eikfoM* Io}cvoibk) 3 lg km hjćjćbke ~eikfo

s ijbjnj |o k|bkqkg ohlc|kvbke popho

C* Poigovbk) <'=lg km hjćjćbke ~eikfo

C

Obc|}c~jno io}cvoibke popho> F)L)M)CGcmjnoibke> O)M)C

O

F

L

M

JQVO… J~qkmj |c hkm Vs) \s

… Jmcoibo ~o kpcvo}jqbc ~odqo}c bo pv|}s oij j~qkğcbnc qvůj}j s~ gjbjgoibk hvqovcbnc



… Jmcoibo ~o kpcvo}jqbc ~odqo}c bo pv|}s) oij j~qkğcbnc qvůj}j s~ gjbjgoibk hvqovcbnc

… Cio|}jćbj ~oqkn jij esgcbo pkqc|ho |c pk|}oqinons pvkh|jgoibk km gc|}o jblj~jnc j }k>… … pvkh|jgoibk km ioh}o jij

… pvkh|jgoibk jij mj|}oibk km }ov~s|o. bo ~ombjg ch|}vcgj}c}jgo |c pk|}oqinons vkibc ~oqkno s smsfincbno khk Odjikqc }c}jqc

… Bonfkinc nc }cdbjhs j~qkmj}j bo Ųjqk}jbnj s io}cvoibkg icŲcącg pkikŲons) |o Ųcincbjgch|}vcgj}c}kg fijŲc djvsves" GkŲc |c j~qkmj}j j bo |}kncąkn Ųjqk}jbnj |o pkmjebs}kgbkekg"

… Pvcmbk|}j j bcmk|}olj }cdbjhc s kmbk|s bo vcejkboibs obc|}c~jns jij Vjbe Fiklh >

( \ogk ncmbk gc|}k pvkfjnobno hkŲc) }jgc gobnc }vosgc s }hjqs) vcğc jbachljnc

( Bců}k fvŲc pk|}j~obnc obc|}c~jnc( Gobnc hvqovcbnc }khkg ~odqo}o ~fke pkqc|hc “ Khk 5# |isćoncqo bc vo~qjnc mkfvs obc|}c~jns) pkek}kqk s jb}cvmjej}oibkg pvk|}kvs) ćoh j

homo nc }cdbjho pvoqjibk svoğcbo) j bc mkğc mk vo~qkno pk}hkŲbke dcgo}kgo

JQVO



JQVO… hkŲo j~bom hvqbjd |smkqo |c kůjůo) kfvjnc j mc~jbajhsnc

… jeio $6 3 =lg E60 66* |c sqkmj JQ s|gcvcbo fjik pvkh|jgoibk jij mj|}oibk ů}k fijŲc



jeio $6"3'=lg) E60'66* |c sqkmj JQ) s|gcvcbo fjik pvkh|jgoibk jij mj|}oibk) ů}k fijŲcgc|}s kpcvo}jqbke ~odqo}o

… mk~o $6# ijmkhojb FC^ OMV/*> Fk “ <0gi8 Lop)Kq) \s “ <'?0gi … jbnch}kqobnc j~qc|}j }k fv c gkes c/

… j~qsąj jeis j j~qvůj}j mjej}oibs hkgpvc|jns hohk bc fj bo|}k dcgo}kg

… obc|}c~jno nc kp}jgoibo ~o ?0gjb $pk|icmbnc |c vo~qjno s jb}cvmjej}oibkg pvk|}kvs*… }vonc mkh nc pk|}oqincbo pkqc|ho" Cmcg) dvkgk|} j j|dcgjćbo bchvk~o bo|}ons ohk nc

pkqc|ho pk|}oqincbo msŲc km 6d… bohkb |hjmobno pkqc|hc) k|cąon j gk}kvbo a'no |c pkqvo}c ~o ?0 gjb fc~gobjac|}kqobno }kh|jćbjd cacho}o HQ\'o jij LB\'o

. ~o pvcqcbjvobnc |cp}jhcgjnc) |o obc|}c}jhkg |c gkŲc opijhkqo}j mk ?00"000JS Bo'pcbjljijbo $qjůc hkblcb}voljnc obc|}c}jho jij Of gkes mkqc|}j mk }vkgfk~o s kqohkj~kikqobkg qcb|hkg |j|}cgs*

. ohk |c pkqc|ho |hjmo sfv~k bohkb JQ opijhkqobno obc|}c}jho) pvcqcbjvobnc }kh|jćbjdcacho}o |c pk|}jŲc pkpsů}obncg pkqc|hc bo ?0'?3|cl) ~o}jg bncbjg |}c~obncg bo 6'= gjb" Kqk |c pkboqino bchkijhk ps}o

Vcejkboibo obc|}c~jno ~ombnjd

ch|}vcgj}c}o



… Bcvqbj fikhkqj bo ~ombnjg ch|}vcgj}c}jgo vc}hk)

gc}kmkg ='pkjb} fiklh jij cpjmsvoibkgobc|}c~jnkg

… Vcejkboibo obc|}c~jno }ov~s|o j mj|}oibke mcio

ch|}vcgj}c}o pk|}jŲc |c fikhomkg b" }jfjoij|'o j b"cvkbcs|'o $kfo |s bo|}oqoh b" j|ldjomjls|'o*

… O <' }k 3'lg) ?4' }k 60'eosec bccmic uj}doppvktjgo}ciz 60 gI ka o 6# ijmklojbc |kis}jkbovc s|cm o} cold |j}c

O* b" pcvkbcs| lkggsbj| “ Hosmoibk km pk|}cvjkvbke vsfo

io}cvoibke hkbmjis|o }jfjnc

F* b }jfjoij|



F* b" }jfjoij| “ Khk ?0 lg j~bom }sfcv loilj|) j~gcğs

}c}jqc g" o|}vklbcgjs| j }c}jqc g" aictkvmjej}oij| pvkasms|) bo) gcmjnoibkn |}vobj

ch|}cvgj}c}o

Bcmk|}olj> “ pk~boqobnc obo}kgjnc

“ “ ćc|}k bchkgpic}bo obc|}c~jno) ~fke

bcvqbjd obo|}ogk~o) hkio}cvoio jijpkqvcgcbk) bcvoqo qob obo}kg|hkegc|}o

“ bchom) pkmsmovobnc gc|}o opijholjnc |ojbaiogjvobjg vcejkbkg

Fikh vcejkboibjd bcvoqo



Obc|}c~jno bo popjiogo qjgcbo



O* Vjbe Fiklh

F* Kfvbs}'Q fikhL* Jbas~jno s lj|}cvbs popjic

M* JQVO popjic

( fikh b" pcvjbcoij|'o

O* Vjbe fiklh popjic

j mj } n ą n Ųj } nj ↖ ajh j n $f m



… j~qkmj |c bo |}kncąkn Ųjqk}bnj ↖ ajh|jvobnc $fvsbmo)vcqcb}kv smovlo “ iobh |}vo sŲc khk bk s

pkmj~obnc vcpo*… o|cp|o… cio|}jćbo }voho |c pk|}oqj bo fo~s popjic

$pvcqcbljno jbas~jnc obc|}c}jho s qjgc*" Ohk |cshiobno pvchkfvknbo popjio) pkqc|ho |c bc |}oqino … e o " 'lg) |c sqk ) vob|qcv~o bk s

kmbk|s bo popjis) mkv~oibk km gc|}o hknc }vcfomo |c obc|}c~jvo jij bo fo~j popjic… ='1gi 6# ijmkhojbo

F* kfvbs}j'Q fikh popjic



… jbaji}voljno hkŲc j gs|hsiovj|o khkbpv" gc| o olcvol c) s k s

kfvbs}ke |ikqo Q

L* Jbas~jno s lj|}cvbs popjic

… Jbmjholjno> obc|}c~jno |is~khkŲc lj|}cvbc



… Jbmjholjno> obc|}c~jno |is~khkŲc lj|}cvbc$gs|hsiovj|) |sfhs}j| j hkŲo bj|s obc|}c~jvobj*"Gk c |c ~qk } s obncbnc pk po) k}qovobnc

hkb}vodkqobke |ajbh}cvo j}m"

… Pk|}oqj}j pkqc|hs bo fo~s popjic) hohk gichk bc fjboijqoik s lj|}cvbs popjic j vo~vcğjqoik obc|}c}jh

… O|cp|o “ j~gs~obnc lj|}cvbc j }cgcinbk ćjůącbnc| ki oůb c k}qkvo o jiovbk hoboio oihkdkikg

… Hvk~ popjiovbs hobjis) jbasbmkqo}j khk ?0gi 6#

ijmkhojbo… Obc|}c~jno bo|}spo ~o 3'?0gjb" Pk ~oqvůc}hs)

obc|}c}jh |c j~gs~c j pkqc|ho shikbj" \is~khkŲo ncobc|}c~jvobo nků :0gjb

JQVO popjic

… Pk|}jŲc |c obc|}c~jno mj|}oibk km



Pk|}jŲc |c obc|}c~jno mj|}oibk kmpk|}oqincbc pkqc|hc

… ]cdbjho |c bonfkinc pvjgcbnsnc bo Ųjqk}jbnjhkno icŲj

… Fjik hkno pkqvůjb|ho qcbo |c hkvj|}j ~o

opijhkqobnc 3'5gi 6# ijmkhojbo… Jeio $6"3'lg) 66' }k 63'eosec*

… Mjej}oibj pvj}j|oh j fioeo go|oŲo |pvcćoqons

pknoqs dcgo}kgo… Obc|}c~jno bo|}onc ~o 3gjb) }vonc mkh nc

pk|}oqincbo pkqc|ho) o pvc|}onc ?0gjbbohkb shiobnobno pkqchc

Jbaji}voljno b" pcvjbcoij|'o

… Jbmjholjnc |s shiobnobnc



… Jbmjholjnc |s shiobnobnchosmoibjd “ pvchkfvknbjd popjio

“ fvomoqjlo

… Jbaji}voljno |c j~qkmj bo ovls|

j|ldjomjls|'s) khk 6lg kmgcmjnoibc ijbjnc

… \L j |sfao|ljnoibk

… 3'5gi 6# ijmkhojbo

… fjio}cvoibk

Jbcvqoljno qjgcbo>I?) I6) I<) I=\6) \<) \=

Obc|}c~jno ~o ho|}voljns

Pophovj>?* \L jbaji}voljno hkŲc |hvk}sgo



Pophovj>?* \L jbaji}voljno hkŲc |hvk}sgo ' “ )

j mcpkbsnc |c <'3gi obc|}c}jho6* Obc|}c}~jno }c|}j|o “Jb fsii| obm fkov|) o <"53' }k 5"3'lg)?1' }k ?4'eosec bccmic j| ajv|}

jb|cv}cm }dvksed }dc |hjb fciku }dc}oji ka }dc cpjmjmzgj| obm }dcb

}dc }c|}jlic fz s|jbe ob obeic ka

oppvktjgo}ciz <0° avkgpcvpcbmjlsiov uj}dks} psbl}svjbe}dc |jmc kv fk}}kg" ]dc obc|}dc}jl$?0'?3gI+600he ka FU* j| jbncl}cmjb}k }dc |sf|}oblc ka cold }c|}jlic"

d}}p>++ujimpvk"}uzlvk||~kk"kve+\+00Gob+PojbVsgKqcvqjcu|+PojbPvkl+P0=PojbPvcq[Loia[Lo|}vo}c"d}g

Obc|}c~jno ~o ho|}voljns

… Hkbn>



… Hkbn>

" ~ ' s s

vc~o povoicibk |o vopdc |lvk}j 6" o* Obc|}c~jno asbjlsis| |pcvgo}jls|'o

?" pk|}vobo jb}voqoejboibo obc|}c~jno

6" Jb}voqoejboibo obc|}c~jno hvk~ vc~kqc povoicibc |o vopdc|lvk}j

<" Pkqvůjb|ho obc|}c~jno pvcgo~jqobncg asbjls|is|o

|pcvgo}jls|'of* Obc|}c~jno }c|}j|'o

XIsgf ! Nkbc| Obc|}c|jo obm Oboiec|jo “ p" 164"W

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