What are some disorders of the urinary system? Disorders of the urinary system range in severity from easy-to-treat to life-threatening.

Benign prostatic hyperplasia (BPH) is a condition in men that affects the prostate gland, which is part of the male reproductive system. The prostate is located at the bottom of the bladder and surrounds the urethra. BPH is an enlargement of the prostate gland that can interfere with urinary function in older men. It causes blockage by squeezing the urethra, which can make it difficult to urinate. Men with BPH frequently have other bladder symptoms including an increase in frequency of bladder emptying both during the day and at night. Most men over age 60 have some BPH, but not all have problems with blockage. There are many different treatment options for BPH.

Interstitial cystitis (IC) is a chronic bladder disorder also known as painful bladder syndrome and frequency-urgency-dysuria syndrome. In this disorder, the bladder wall can become inflamed and irritated. The inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding, and, in rare cases, ulcers in the bladder lining. The cause of IC is unknown at this time.

Kidney stones is the term commonly used to refer to stones, or calculi, in the urinary system. Stones form in the kidneys and may be found anywhere in the urinary system. They vary in size. Some stones cause great pain while others cause very little. The aim of treatment is to remove the stones, prevent infection, and prevent recurrence. Both nonsurgical and surgical treatments are used. Kidney stones affect men more often than women.

Prostatitis is inflammation of the prostate gland that results in urinary frequency and urgency, burning or painful urination (disuria), and pain in the lower back and genital area, among other symptoms. In some cases, prostatitis is caused by bacterial infection and can be treated with antibiotics. But the more common forms of prostatitis are not associated with any known infecting organism. Antibiotics are often ineffective in treating the nonbacterial forms of prostatitis.

Proteinuria is the presence of abnormal amounts of protein in the urine. Healthy kidneys take wastes out of the blood but leave in protein. Protein in the urine does not cause a problem by itself. But it may be a sign that your kidneys are not working properly.

Renal (kidney) failure results when the kidneys are not able to regulate water and chemicals in the body or remove waste products from your blood. Acute renal failure (ARF) is the sudden onset of kidney failure. This can be caused by an accident that injures the kidneys, loss of a lot of blood, or some drugs or poisons. ARF may lead to permanent loss of kidney function. But if the kidneys are not seriously damaged, they may recover. Chronic kidney disease (CKD) is the gradual reduction of kidney function that may lead to permanent kidney failure, or end-stage renal disease (ESRD). You may go several years without knowing you have CKD.

Urinary tract infections (UTIs) are caused by bacteria in the urinary tract. Women get UTIs more often than men. UTIs are treated with antibiotics. Drinking lots of fluids also helps by flushing out the bacteria.

The name of the UTI depends on its location in the urinary tract. An infection in the bladder is called cystitis. If the infection is in one or both of the kidneys, the infection is called pyelonephritis. This type of UTI can cause serious damage to the kidneys if it is not adequately treated.

Urinary incontinence, loss of bladder control, is the involuntary passage of urine. There are many causes and types of incontinence, and many treatment options. Treatments range from simple exercises to surgery. Women are affected by urinary incontinence more often than men.

Urinary retention, or bladder-emptying problems, is a common urological problem with many possible causes. Normally, urination can be initiated voluntarily and the bladder empties completely. Urinary retention is the abnormal holding of urine in the bladder. Acute urinary retention is the sudden inability to urinate, causing pain and discomfort. Causes can include an obstruction in the urinary system, stress, or neurologic problems. Chronic urinary retention refers to the persistent presence of urine left in the bladder after incomplete emptying. Common causes of chronic urinary retention are bladder muscle failure, nerve damage, or obstructions in the urinary tract. Treatment for urinary retention depends on the cause.

Задания для уяснения темы занятия, методики вида деятельности

6.1. Вопросы для самоподготовки.

1. Where does the urine pass from the stomach?

2. What are the organs of the urinary system?

3. Where are the kidneys placed?

4. What are the functions of the kidneys?

1. What route does the ureter pass?

2. What does the bladder serve for?

3. What are some disorders of the urinary system?

4. What causes problems in the urinary system?

5. How is the urea produced?

6. What is the role of the urinary system?

 

6.2 Тестовые задания по теме (упр. 33.2. стр. 75).

 

6.3. Ситуационные задачи по теме. Представьте, что Вы - врач. Задайте вопросы пациенту, чтобы выявить наличие у него симптомов тех или иных заболеваний мочевыделительной системы (2, упр. №33.3., стр. 75).

 

7. Список тем по УИРС, предлагаемый кафедрой:

- Примерные темы проектов / докладов: “Diseases of the Urinary System” “Kidney and it’s role in the process of excretion”.

 

8. Рекомендуемая литература:

- основная

1. Английский язык: Учебник для медицинских вузов и медицинских специалистов/ И.Ю. Марковина, З.К. Максимова, М.Б. Вайнштейн; Под. Ред. И.Ю. Марковиной. – М.: ГЭОТАР- Медиа, 2005. -368 с.

- дополнительная

2. Eric H. Glendinning, Ron Howard Professional English in Use. Medicine. Cambridge. Cambridge University Press, 2007. - 175 p.

3. Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Portal:Medicine).

 

Занятие №16

 

1. Тема занятия «Blood. Circulation».

2. Значение изучения темы. Актуальность темы обеспечивается, во-первых, ее параллельным изучением в курсе физиологии человека. Во-вторых, основные речевые конструкции, усвоенные в ходе изучения данной темы, послужат основой при реферировании и аннотировании студентами текстов, описывающих строение других системы жизнедеятельности организма человека. В третьих, лексический минимум, усвоенный студентами, является базовым для работы над рядом последующих тем, предлагаемых программой для изучения на 1 и 2 курсах.

3. Цель обучения: развитие иноязычной речи по теме «Blood. Circulation» (обучающийся должен знать лексику по теме «Blood. Circulation», быть готов к чтению оригинальной литературы по теме «Blood. Circulation» с минимальным использованием словаря, уметь кратко рассказать о системе кровообращения человека, раскрыть функции ее отдельных органов).

4. План изучения темы:

4.1. проверка знания ключевых слов и синтаксических конструкций модели описания системы;

4.2. Раскрытие учебно-целевых вопросов.

Введение нового грамматического материала: Причастия I и II в функции определения. Согласование времен. Функции и перевод слов after, before.

Тренировка произношения новых ЛЕ по теме (стр. 102, упр.1)

Выполнение тренировочных упражнений (1, №1-5 стр. 101-102).

Работа с текстом A “Leucocytes and Lymphocytes” (1, стр. 103, упражнение 5).

Проверка понимания текста (поиск информации в тексте).

Ответы на вопросы по теме (см. ниже).

4.3. Самостоятельная работа по теме: составление диалогов по теме с использованием слов since, as.

4.4. Итоговый контроль знаний:

Коллективная работа: составление резюме по теме (по цепочке).

 

Основные понятия и положения темы.

Тема «Blood. Сirculation» предполагает ознакомление с системой кровообращения, ее органами и их функциями. Ознакомление с составом крови, лейкоцитами и лимфоцитами. Рассматривается процесс сердцебиения.

Gr.: Причастия I и II в функции определения. Согласование времен. Функции и перевод слов after, before.

The circulatory system (or cardiovascular system) is an organ system that moves nutrients, gases, and wastes to and from cells, helps fight diseases and helps stabilize body temperature and pH to maintain homeostasis. The main components of the human circulatory system are the heart, the blood, and the blood vessels. The circulatory system includes: the pulmonary circulation, a "loop" through the lungs where blood is oxygenated; and the systemic circulation, a "loop" through the rest of the body to provide oxygenated blood. An average adult contains five to six quarts of blood, which consists of plasma that contains red blood cells, white blood cells, and platelets. Two types of fluids move through the circulatory system: blood and lymph. The blood, heart, and blood vessels form the cardiovascular system. The lymph, lymph nodes, and lymph vessels form the lymphatic system. The cardiovascular system and the lymphatic system collectively make up the circulatory system.

Diagram of the human circulatory system.

 

Systemic circulation is the portion of the cardiovascular system which carries oxygenated blood away from the heart, to the body, and returns deoxygenated blood back to the heart. Arteries always take blood away from the heart, regardless of their oxygenation, and veins always bring blood back. In general, arteries bring oxygenated blood to the tissues; veins bring deoxygenated blood back to the heart. In the case of the pulmonary vessels, however, the oxygenation is reversed: the pulmonary artery takes deoxygenated blood from the heart to the lungs, and oxygenated blood is pumped back through the pulmonary vein to the heart. As blood circulates through the body, oxygen and nutrients diffuse from the blood into cells surrounding the capillaries, and carbon dioxide diffuses into the blood from the capillary cells.

The release of oxygen from red blood cells or erythrocytes is regulated in mammals. It increases with an increase of carbon dioxide in tissues, an increase in temperature, or a decrease in pH. Such characteristics are exhibited by tissues undergoing high metabolism, as they require increased levels of oxygen.

Pulmonary circulation is the portion of the cardiovascular system which carries oxygen-depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart.

De-oxygenated blood enters the right atrium of the heart and flows into the right ventricle where it is pumped through the pulmonary arteries to the lungs. Pulmonary veins return the now oxygen-rich blood to the heart, where it enters the left atrium before flowing into the left ventricle. From the left ventricle the oxygen-rich blood is pumped out via the aorta, and on to the rest of the body.

The Coronary circulatory system provides a blood supply to the heart.

The circulatory systems of humans is closed, meaning that the blood never leaves the system of blood vessels. In contrast, oxygen and nutrients diffuse across the blood vessel layers and enters interstitial fluid, which carries oxygen and nutrients to the target cells, and carbon dioxide and wastes in the opposite direction.

Задания для уяснения темы занятия, методики вида деятельности

6.1. Вопросы для самоподготовки.

1. What is the difference between neutrophils, basophils and eosinophils?

2. When does the percentage of eosinophils increase?

3. The process of chemotaxis means “cell-eating”, doesn’t it?

4. What stimulates the formation of lymphocytes?

5. When do the lymph nodes become infected?

6. What kind of experiment is performed to prove this statement?

 

6.2. Тестовые задания по теме (2, упр. 59.2. стр. 119).

Примечание: тестовые задания могут быть выполнены в электронном варианте на ПК с использованием СD к учебному пособию.

 

6.3. Ситуационные задачи по теме.

You are a scientific supervisor. You want your post-graduate student to write a paper on the problem of circulation. Tell him how to do it.

 

7. Список тем по УИРС, предлагаемый кафедрой:

- Примерные темы проектов / докладов: “Screening for circulation disease” “Trends and patterns of mortality due to blood circulation system diseases”.

8. Рекомендуемая литература:

- основная

1. Английский язык: Учебник для медицинских вузов и медицинских специалистов/ И.Ю. Марковина, З.К. Максимова, М.Б. Вайнштейн; Под. Ред. И.Ю. Марковиной. – М.: ГЭОТАР- Медиа, 2005. -368 с.

- дополнительная

2. Eric H. Glendinning, Ron Howard Professional English in Use. Medicine. Cambridge. Cambridge University Press, 2007. - 175 p.

3. Raymond Murphy. English Grammar in Use. Cambridge. - Cambridge University Press, 1997. - 350 p.

4. Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Portal:Medicine).

 

 

Занятие №17

1. Тема занятия «Respiration».

2. Значение изучения темы. Актуальность темы обеспечивается, во-первых, ее параллельным изучением в курсе физиологии человека. Во-вторых, основные речевые конструкции, усвоенные в ходе изучения данной темы, послужат основой при реферировании и аннотировании студентами текстов, описывающих строение других системы жизнедеятельности организма человека. В третьих, лексический минимум, усвоенный студентами, является базовым для работы над рядом последующих тем, предлагаемых программой для изучения на 1 и 2 курсах.

3. Цель обучения: развитие иноязычной речи по теме «Respiration» (обучающийся должен знать лексику по теме «Respiration», быть готов к чтению оригинальной литературы по теме с минимальным использованием словаря, уметь описать процесс дыхания человека).

4. План изучения темы:

4.1. фронтальный опрос: проверка знания ключевых слов и синтаксических конструкций модели описания системы;

4.2. Раскрытие учебно-целевых вопросов.

Введение нового грамматического материала: Причастия I и II в функции обстоятельства. Независимый причастный оборот. Функции и перевод слов both, both … and.

Выполнение тренировочных упражнений (1, №1-7 стр. 113).

Работа с текстом В “Movement of Breathing Mechanism of Inhalation and Exhalation” (1, стр. 112).

4.3. Самостоятельная работа по теме: составление диалогов по теме с использованием слов both, both … and.

4.4. Итоговый контроль знаний: Коллективная работа: составление резюме по теме (по цепочке).

5. Основные понятия и положения темы.

Breathing. Air enters the respiratory system through the mouth and nose, where it is warmed and moistened. Air breathed in through the nose is filtered by the coarse hairs that line the nostrils, which trap large dust particles. Smaller particles are trapped in a sticky fluid (mucus) produced by the cells lining the passage between nose and mouth. This mucus is continuously moved away by the beating of minute hair-like projections (cilia).

From the mouth air travels through the throat (pharynx), voice box (larynx), and windpipe (trachea). At the entry to the windpipe is a flap, the epiglottis, which closes to prevent choking when food is swallowed. At its base, the windpipe divides into two tubes or bronchi, and one bronchus enters each lung. Both windpipe and bronchi are stiffened by rings of cartilage. As in the nose, the windpipe and bronchi pro­duce dust-trapping mucus and have cilia to move this mucus up to the mouth.

Within each lung, the bronchi split successfully into smaller bronchi and then into many thousands of even nar­rower tubes called bronchioles. The bronchioles branch through the lungs and lead into millions of air sacs (al­veoli) of the lung tissue. It is in the air sacs that gases are exchanged. Each air sac is meshed with small blood vessels (capillaries) carrying blood containing carbon dioxide and water from the heart. Oxygen breathed in from the air passes into the blood and, in return, carbon dioxide and water vapor are released into the air sacs of the lungs to be breathed out. The blood in the capil­laries, now rich in oxygen, flows into the pulmonary vein and back to the heart for redistribution.

 

The lungs are housed in a bony cage made up of the ribs, breastbone, and backbone. The floor of the cage is formed by a sheet of muscle called the diaphragm. When a person breathes in, the muscles of the diaphragm contract, pulling the diaphragm downward. At the same time, the ribcage is pulled up and out by the contraction of the muscles between the ribs, and air rushes in. When a person breathes out the dia­phragm and rib muscles relax and the chest subsides.

Respiration takes place 10 to 15 times a minute and is normally con­trolled unconsciously by a collection of cells in the brain called the respiratory center. After air had been breathed out, carbon dioxide builds up again in the bloodstream. The cells in the respiratory center are extremely sensitive to carbon dioxide concentrations. When the carbon dioxide in the blood reaches a certain level, messages are sent from the respiratory center to the diaphragm and rib muscles that trigger contrac­tion. This once more initiates breathing in. As the lungs expand during inhala­tion, cells (stretch receptors) in the lung walls send signals back to the res­piratory center. The center responds by instructing the muscles of ribs and dia­phragm to relax so that exhaling takes place.

Respiration is not always a quiet pro­cess. The presence of many dust parti­cles in the nose can trigger sneezing, ir­ritants or too much mucus in the windpipe and bronchi cause coughing.

Speech is also a special sort of "noisy" breathing. The sounds of speech are produced in the voice box (larynx) and molded into words in the mouth.

The larynx consists of a box of carti­lage. Across the inside of the box are flap-like structures, the vocal cords. The cords move by the action of mus­cles attached to the cartilages of the lar­ynx. During normal breathing, the vo­cal cords are held apart. For speech, the cords are pulled together after a breath in; during breathing out, the air is, thus, forced between the cords, mak­ing them vibrate. The lighter the cords are pulled together, the higher the pitch of the sound is produced. For loud sounds, the air is forced through the cords faster than it is for soft sounds. The movements of the lips and of the tongue against the teeth and roof of the mouth achieve articulation. The reso­nance of spoken sounds and the characteristics of every individual voice are created by the cavities of the sinuses, nose, throat, and chest.

Задания для уяснения темы занятия, методики вида деятельности

6.1. Вопросы для самоподготовки.

1. How is contraction of the muscles participating in inhalation regulated?

2. Why does the size of the thoracic cavity increase?

3. When is impediment to breathing especially noticeable?

4. What process does the inhalation (exhalation) involve?

7. What do the movement of the diaphragm and ribs about?

6. Why is respiration so important?

7. Name some other structures connected with the respiratory system.

8. What does the term “respiration” mean?

9. Describe the process of external respiration.

10. How many per sent oxygen does inhaled air contain?

 

6.2. Тестовые задания по теме

1. 2, упр. 88.4. стр. 177. (тестовые задания могут быть выполнены в электронном варианте на ПК с использованием СD к учебному пособию).

 

2. Соедините слово c его антонимом:

Inhalation- to decrease

To produce – to relax

To increase- exhalation

To contract – to cause

 

6.3. Ситуационные задачи по теме.

1. Представьте, что Вы - врач. Задайте вопросы пациенту, чтобы выявить наличие у него симптомов тех или иных заболеваний дыхательной системы (2, упр. №33.3., стр. 75).

2. Представьте, что вы - участник международной конференции по проблемам дыхания. Представьтесь и кратко изложите суть вашего доклада.

3. You are a scientific supervisor. You want your post-graduate student to write a paper on the problem of respiration. Tell him how to do it.

7. Список тем по УИРС, предлагаемый кафедрой:

- Примерные темы проектов / докладов: “Breathing”, “Mechanism of Inhalation and Exhalation”.

 

8. Рекомендуемая литература:

- основная

1. Английский язык: Учебник для медицинских вузов и медицинских специалистов/ И.Ю. Марковина, З.К. Максимова, М.Б. Вайнштейн; Под. Ред. И.Ю. Марковиной. – М.: ГЭОТАР- Медиа, 2005. -368 с.

- дополнительная

2. Eric H. Glendinning, Ron Howard Professional English in Use. Medicine. Cambridge. Cambridge University Press, 2007. - 175 p.

3. Raymond Murphy. English Grammar in Use. Cambridge. - Cambridge University Press, 1997. - 350 p.

4. Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Portal:Medicine).

 

Занятие №18

1. Тема занятия «Written translation. Test»

2. Значение изучения темы. Актуальность темы обеспечивается контролирующей функцией занятия, итогового для 1 семестра 1 курса.

3. Цель обучения: контроль иноязычной речи по темам семестра (обучающийся должен знать лексику и грамматику по изученным за семестр темам, быть готов к осуществлению перевода оригинальной литературы по данным темам с минимальным использованием словаря).

4. План изучения темы:

4.1. Контроль итогового уровня знаний и умений в ходе самостоятельной работы студентов.

 

5. Тестовые задания по теме.

5.1. Поставьте предлоги, где необходимо

(between, on, to, by, at, without, in, off, from, back, of):

1. The library of our University is closed … Mondays.

2. The hostel is closed … night.

3. Anna lives … a small flat not far … the Academy.

4. The canteen opens … noon.

6. He sometimes works … night.

7. I have many years’ experience … prestigious medical institutes and have studied … Russia, Germany and in the United States.

8. Completing my Ph.D. was one … the most exciting and challenging periods … my life.

9. The joints … bones permit movement.

10. Movement …. vertebrates is dependent …. the skeletal muscles, which are attached … the skeleton … tendons.

11. ….. the skeleton to give leverage, movement would be greatly restricted.

12. What kinds ….. bones is the skeleton made ….?

13. The flow …. blood ….each side of the heart is controlled …. a series of valves.

14. Problems …..the urinary system can be caused ….. aging, illness, or injury.

15. … general, arteries bring oxygenated blood …. the tissues; veins bring deoxygenated blood …… to the heart.

 

5.2. Выберите правильный вариант:

1. The human skeleton can ………….. into the axial skeleton and the appendicular skeleton.

a) be divided

b) divide

c) was divided

d) divided

2. The polyclinics................. 9 o'clock and …….. at 18.30.

a) be opened, be closed

b) is opened and is closed

c) open, close

d) opening and closing

3. Congratulations on passing your exam. You............... be very pleased.

a) needn’t

b) must

c) can’t

d) may

4. You got here very quickly. You....................... have walked very fast.

a) needn’t

b) must

c) can’t

d) may

5). Bill and Sue go away on holiday very often, so they ….. be short of money.

a) needn’t

b) must

c) can’t

d) may

6). Мне помочь вам? – Нет, спасибо.

a) need

b) may

c) shall

d) will

7). I can't find the case. I think somebody (take) by mistake.

a) took b) have taken c) will take d) has taken

8. That ^,s (good) dentist I ^, ve ever seen.

a) the goodest b) gooder c) best d) the best

9.This building is (old) of all the buildings of the Academy.

a) the oldest b) older c) best d) most old 10. This patient is getting (fat) and (fat).

a) fatter fatter

b) fat fat

c) most fat

d) more fatter

11). Reduced air pressure in the lungs causes air ……the lungs.

a) to enter b) enter c) entering d) entrance

12). It is the …………..that secretes bile which participates in the digestive process and has a defensive function.

a) pancreas, b) liver, c) gall-bladder, d) rectum.

13). The large …………….. is up to 2 1/2 inches wide.

a)stomach, b)intestine, c)esophagus, d)spleen

14). The ………….. serves as a container of food.

a)liver, b)stomach, c)gall-bladder, d)spleen

15). The …….……. serves as a bile reservoir.

a)spleen, b)liver, c)stomach, d)gall-bladder

16) An infection in the bladder …………. cystitis.

a) call b)is called c) names d) were named.

17). Acute renal failure can ……..by an accident that injures the kidneys, loss of a lot of blood, or some drugs or poisons.

a) cause b) to cause c) be caused d) is caused

18) ……. nonsurgical ………surgical treatments are used.

a) both… and b) as…… as c) so…as d) both …as

19). The main components of the human circulatory system are the heart, the blood, and the…….

a) muscles b)stomach, c)gall-bladder d) blood vessels

20). Two types of fluids move through the…………: blood and lymph.

a) circulatory system b) digestive system c)respiratory system d) urinary system

21). The lymph, lymph……, and lymph vessels form the lymphatic system.

a) veins b) nodes c)fibres d) points

22) The human skeleton consists of both fused and individual bones supported and supplemented by ligaments, tendons, ……… and cartilage. a) muscles b) blood vessels c) veins d) kidneys

5.3. Выберите верный артикль (a, the, an, -):

1. What … pity you haven’t entered the University!

2. I can’t find … book which I took at the library.

3. – By … way, have you heard anything from …Dmitry lately?

– Last year he entered … Krasnoyarsk State Medical University.

4. … President is going to open … new hospital in … capital … next month.

5. To tell… truth, I didn’t expect him to be a doctor.

6. On … Monday our polyclinic opens at 9 o’clock.

7. I am looking for … job.

8. This is … very important news.

9. He left … University without doing …examinations.

10. I’ve got … lecture in …biology.. … subject is very difficult.

11. …. human skeleton can be divided into …. axial skeleton and … appendicular skeleton.

12. ….heart is …… muscular organ about … size of …. clenched fist.

13. … flow of …..blood in each ……side of …. heart is controlled by … series of …. valves.

14. Air enters … body through …. nose, is warmed, filtered, and passed through … nasal cavity.

15. Alveoli are surrounded by ….network of ….thin-walled capillaries.

16. … human digestive system is …series of hollow organs joined in …long, twisting tube from … mouth to … anus.

 

6. Список тем по УИРС, предлагаемый кафедрой: Составление кроссвордов по всем темам полугодия.

 

7. Рекомендуемая литература:

- основная

1. Английский язык: Учебник для медицинских вузов и медицинских специалистов/ И.Ю. Марковина, З.К. Максимова, М.Б. Вайнштейн; Под. Ред. И.Ю. Марковиной. – М.: ГЭОТАР- Медиа, 2005. -368 с.

2. Учебник английского языка для студент ов медицинских вузов: Учеб./ В.А.Бессонова, Е.В. Кокарева, В.К. Котова, Т.П.Щедрина; Под ред. Т.П. Щедриной. – М.:Высш.шк., 2005. – 343 с. – тексты для перевода.

- дополнительная

2. Eric H. Glendinning, Ron Howard Professional English in Use. Medicine. Cambridge. Cambridge University Press, 2007. - 175 p.

3. Raymond Murphy. English Grammar in Use. Cambridge. - Cambridge University Press, 1997. - 350 p.

4. Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Portal:Medicine) – тексты для перевода.

 

Занятие №19