Methodical development for practical employment №16 Module 1 Thematic module 4

Theme: Closed damages of a mild tissues, skull, thorax, organs of abdominal region

I. Urgency of theme

Diagnostics and treatment of damages is one of the greatest sections of surgery. A traumatism together with the oncological diseases takes 2-3 seats in the general structure of lethality. The consequences of many damages (at transporting, ecological, productions catastrophes) often depend on a timeliness and quality of given first medical help. Therefore by abilities quickly to diagnose and give urgent and first medical help not only surgeons but also physicians of other specialties must own at the different damages.

ІІ. Aims of the lesson

1. To know kinds, clinical signs of the closed and opened damages of mild tissues, skull, thorax, stomach (α=II).

2. To know the volumes of the first medical aid to victims with different traumas and methods of their transporting (α=II).

3. Reasons of origin, clinical signs, diagnostics, treatment, prophylaxis of traumatic toxicosis (α=II).

4. To be able to conduct differential diagnostics of the closed and opened damages of mild tissues, skull, thorax, stomach (α=III).

5. To conduct the temporal stop of bleeding at the opened traumas of head, neck, thorax (α=III).

6. To be able to give help to victims with opened pneumothorax (α=III).

7. To be able to organize transporting of injured depending on a kind and localization of traumatic damage (α=III).

ІІІ. Providing of initial level of knowledge - abilities

Literature:

The basic literature:

1. Butyrsky A. General surgery. – Simferopol. 2004.

2. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

1. Kushnir R. Lectures of General surgery. – 2005.

2. Lyapis M.A. Methods of examination of a surgical patients. – 2004.

3. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

Tests for verification of initial level of knowledge

1. Mark the main pathogenetic factors of development of traumatic toxicosis:

À. Algesic irritation

B. Fatty embolism of internals

C. Plasma loss and blood loss

D. Myoglobinemia (+)

E. Traumatic toxemia (+)

2. Define the main periods of clinical motion of traumatic toxicosis:

À. Reactive period

B. Period of a growth of edema and vascular insufficiency (+)

C. Toxic period

D. Period of a sharp kidney insufficiency (+)

E. Shock period

3. The clinical picture of concussion of the cerebrum is characterized:

A. A loss of a consciousness in the moment of trauma (+)

B. Retrograde amnesia (+)

C. A loss of a function of those or other structures of cerebrum

D. Disorder sensitiveness, hemi paresis

E. Extravasations in the conjunctiva of eyes

4. Specify main localization of after traumatic intracranial haematoma:

A. Epidural (+)

B. Subdural (+)

C. Intraventricular

D. Intracerebral

E Parietal region of a brain

5. Set of symptoms includes at an epidural haematoma:

A. Dilatation of a pupil on the side of a defeat (+)

B. Tachycardia

C. Bradycardia

D. Increase of a tone of muscles, disappearance of motive reflexes

E. Loss of a consciousness

6. There can be all complications at the closed trauma of lights, except for:

А. Closed pneumothorax

B. Open pneumothorax (+)

C. Valvate pneumothorax

D. Emphysema of mild tissues

E. Paralysis of a respiratory musculature (+)

7. Whatever is at the isolated external penetrable wound of thorax?

A. Hemoperitoneum (+)

B. Hemothorax

C. Open pneumothorax

D. External (tense) pneumothorax

E. Peritonitis (+)

8. The break of hollow organ at the closed trauma of stomach is accompanied:

A. Development of a peritonitis (+)

B. Hematuria

C. Presence of a free gas in the cavity of small pelvis

D. Presence of a free gas under the cupola of diaphragm (+)

E. Hemoperitoneum

9. The damages can be:

A. Particulate

B. Packed

C. Open (+)

D. Not packed

E. Closed (+)

10. The damages can be:

A Particulate penetrable

B. Penetration (+)

C. Not penetrate (+)

D. Superficial

E. Deep

11. The mechanical damages is:

A. Burn

B. Chilblain

C. Wound (+)

D. Electro-trauma

E. Concussion (+)

12. The following types of traumatism are distinguished:

A Not industrial (+)

B. Hospital

C. Children's

D. Aviation

E. Industrial (+)

13. The following types of traumatism are distinguished:

A. Children's

B. Everyday (+)

C. Heavy

D. Sports (+)

E. Aviation

14. The next types of traumatism are distinguished

A. Heavy

B. Children's

C. Industrial (+)

D. Light

E. Farming (+)