The thematic module 4. Traumatism and damage Practical employment № 20

Theme: getting, elektrotravma frost-bitten.

I. Actuality of theme

Getting and elektrotravma frost-bitten meet enough often. Urbanization, mastering of districts of The far north and the East underline this problem. Frequency of getting frost-bitten in a war-time grows. Actuality of study of material is grounded to those, that the acquired knowledges on the department of general surgery are final, as in the process of teaching in an university to the study of the given material not on one of departments do not come back. Studying this theme even with such sections, how diagnostics, medical treatment of getting, elektrotravmi frost-bitten, is, the important value is had by the prophylaxis of defeats, what the role of medical workers is exceptionally high in. Next to measures on a labour protection, by the observance of accident prevention the important value has sanitary-educational work among the population. All these aspects are laid on doctors, mainly internists and surgeons, as they carry out workshop and district service of health protection. Medical treatment of patients takes place in the surgical and reanimation separations (permanent establishments), insignificant damages - ambulatory.

_II. Purpose of employment:

1. To know reasons the origin of getting frost-bitten; the pathological states of organism of sick, that distribution of pathology is caused (=II).

2. To know the pathological changes in fabrics and organs of patient time, and after action of injuring holodovogo agent, electric current and lightning (=II).

3. To know classification of getting and elektrotravmi frost-bitten depending on the depth of defeat of fabrics (=II).

4. To master the clinical picture of getting, elektrotravmi frost-bitten (=II).

5. To be able to diagnose getting and elektrotravmu frost-bitten, applying the subjective, objective, laboratory, instrumental and others additional (for example, roentgenologic) methods of research (=III).

6. To be able to give first medical help (=III).

7. To be able to define the depth of defeat of fabrics at getting frost-bitten (=III).

III. Providing of initial level of knowledges-abilities

Literature:

Basic:

1. Metodichnі rozrobki for auditornoї that samostіynoї roboti studentіv.

2. Zagalna hіrurgіya / After red. S.P.Guchenko, M.D.Gelіbi, S.D.Hіmіcha – Kiїv.: Zdorov’ya, 1999.

3. Cherenko M.P., Vavrik G.M. Zagalna hіrurgіya z anestezіologієyu, by the bases of reanіmatologії that to doglyadu after hvorimi – Kiїv.: Zdorov’ya, 1999.

4. Gostishev V.K. General surgery: Studies. – M.: Medicine, 1993.

5. Gostishev V.K. "Guidance to practical employments on general surgery". M., "Medicine" - 1987.

Additional:

1. А.А. Simodeyko, S.S. Fіlіp, O.O. Boldigar Zagalna hіrurgіya in pitannyah і vіdpovіdyah. Uggorod, «Іva» - 2005.

2. С.М. Genik, M.V. Prokopishin, V.M. Krisa that іn. Situatsіynі zadachі z hіrurgії.Івано-Франківськ, «Lіleya-N.В» – 2003.

Tests and tasks for verification of initial level of knowledges

What changes of internal organs and fabrics come as a result of action on the organism of electric current?

+значительные changes of structure of neurons

distroficheskie changes in muscles

breaks of internal organs

amiloidoz of buds

+разрывы muscular fibres

What changes of internal organs and fabrics come as a result of action on the organism of electric current?

gangrene of extremity

+глубокие changes of walls of vessels with vast necrosises

edema of cerebrum

+гиперемия and hemorrhage in internal organs

necrosis of kanaltsev of buds

Name the reasons of death at elektrotravmah:

sharp paraproktit

ischemic stroke

sharp kidney insufficiency

+ stop of heart

+ the stop is breathing

What the first aid at elektrotravme consists in?

+остановка further action of current on the victim one

stop of bleeding

anaesthetizing

+проведение reanimation measures

transports imobilizatsiya

Than to account for mainly conservative tactic of local medical treatment of elektrotravmi?

by the grave common condition of patient

+неопределенностью scopes of defeat in the beginning

by complication of operative interference

+значительными by the changes in the wall of vessels on the large extent

by the defeat of the nervous system

Name the periods of development of getting frost-bitten:

+реактивный

latent

early

late

+дореактивный

In the early reactive period of getting frost-bitten mark all, except for:

pain reaction

+образование bubbles on a skin

increase of temperature of body

toksemii (sometimes shock)

+некроза fabrics

Name the clinical signs of the first degree of getting frost-bitten:

loss of pain sensitiveness

+зуд

loss of taktilnoy sensitiveness

growing of skin black

+сохранение taktilnoy that pain sensitiveness

Name the clinical signs of the first degree of getting frost-bitten:

+боль

+отек fabrics with a sinyushnim marble tint

formation of bubbles

growing of skin black

hyperemia of skin

To local infectious complications of getting frost-bitten attribute all, except for:

limfangit, limfadenit

tromboflebit

+карбункул

+гидраденит

ugly face

At getting of the II degree frost-bitten a bottom has a bubble the color:

white

+розовый

+красный

violet

black-grey

For a late reactive period at getting frost-bitten characteristic appearance:

pain reaction

+влажная gangrene of extremity

rise of temperature of fabrics

toksemiya

+некроз fabrics

Than the II degree of getting frost-bitten is clinically characterized?

itch

edema of fabrics with a sinyushnim marble tint

+гиперемия with a tsianotichnim tint and edema

+образование bubbles

growing of skin black

Name the clinical signs of getting of the III degree frost-bitten:

+конечность cold to the feel after warming

+выраженный edema of soft fabrics

formation of bubbles of gemorragicheskogo tint

taktilnaya is stored that pain sensitiveness

itch

Name the clinical signs of getting of the III degree frost-bitten

hyperemia with a tsianotichnim tint and itch

+мраморная skin with purple - tsianotichnim tint

hyperemia with a tsianotichnim tint and edema

+развитие gnoyno-nekroticheskogo process in place of defeat