Vіі. The method of conducting of practical lesson and the organizational structure of the lesson

Distribution of the marks appropriated to the students:

At learning of the theme №16 of the module №1 for educational activity to the student mark is proposed after 4th to the ball (traditional) scale which is then converted in marks as follows:

Mark	Balls
“5”(excellent)	6
“4” (good)	4
“3”(satisfactory)	2
“2” (unsatisfactory)	0

Methodical pointing for work of students on practical lesson

Module 1

Thematic module 4

Practical employment № 16

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

Theoretical questions for the off-hour independent study and discussion on practical lesson №16:

1. Kinds, clinical signs of the closed and opened damages of mild tissues, skull, thorax, abdomen.

2. Volumes of the first medical aid to victims with different traumas and methods their transporting.

3. Reasons of origin, clinical signs, diagnostics, treatment, prophylaxis of traumatic toxicosis.

4. Differential diagnostics of the closed and opened damages of mild tissues, skull, thorax, abdomen.

5. Temporal stop of bleeding at the opened traumas of head, neck, thorax.

6. Helping to victims with opened pneumothorax.

7. Organization of transporting of injured depending on a kind and localization of traumatic damage.

Literature:

1. Butursky A. “General surgery”. (Simferopol 2004)

2. S. I. Shevchenko; A. A. Tolkoglas and etc. “Surgery” (Kharkov 2004)

3. Methodical pointing

Distribution of the marks appropriated to the students:

At learning of the theme №16 of the module №1 for educational activity to the student mark is proposed after 4th to the ball (traditional) scale which is then converted in marks as follows:

Mark	Balls
“5”(excellent)	6
“4” (good)	4
“3”(satisfactory)	2
“2” (unsatisfactory)	0

Tests for verification of initial level of knowledges tema 16

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 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

Situatioonal tasks

1. Name the stages of a medical first care to a victim with the syndrome of the prolonged compression.

2. Name the stages of helping medical first to a victim with the penetrative wound to abdominal cavity.

3. Name the stages of helping medical first to a victim with the penetrative wound of thorax.

4. A woman, 40 years, was hammered by a passenger car. The state is extremely heavy. Consciousness is absent|. A pulse is frequent, to 100 shots in 1 min weak filling. There is anizocoria with the increase of left pupil and fixing of sight to the left. Hypodermal haematoma is in a frontoparietal area on the right. The hurt wound is in a cervical-parietal area on the left the bottom of which there is aponeurosis.

Define the volume of the first medical care.

5. To the man, 23 years, inflicted blow unknown. State is heavy. Consciousness is stored. Pulse is weak to 120 shots after 1 min At examination two stab-wounds defined in area of thorax at the level of the second intercostal space on the right on a middling-clavicle line. Wounds pull air.

Define the volume of the first medical care.

6. A man, 32 years, suffers when in an entrance the unknown explosive device has worked at home. Hi marked the brief loss of consciousness. Retrograde amnesia is not present. Pulse 84 blows in 1 min satisfactory properties. On-the-spot left neck in the projection of m. Sternocleidomastoideus there are three splinter wounds by a diameter 2x3 mm. The left half of neck is hydropic; a haematoma which does not pulsate and is gradually increased in a volume is marked.

Define the volume of the first medical care.

7. Man, 26 years, in a conflict situation received the penetrated wound by knife in a abdomen. The state gets worse progressively. The pallor of skin grows. A pulse is frequent, weak filling.

Define the volume of the first medical care.

8. At a suffering man found out the cut-chopped wound on frontal-lateral surface of right thigh which he received during a fight. The massive bleeding of pulsating character defined from the wound. The wound is in middle third of thigh. What help must be given to a victim to arrival of brigade of first-aid?

9. At a victim after examination the brigade of first-aid sets a diagnosis is break of left thigh-bone in the lower third. Specify the method of transporting of such suffering in the surgical department.

Answer

1 Г,Д, 2 Б,Г, 3 А,Б, 4 А,Б, 5 А,В, 6 Б,Д, 7 А,Д, 8 А,Г , 9 Д,В, 10 Б,В, 11 В,Д,

12 А,Д, 13 Б,Г , 14 В,Д, 15 Б,Г

1 Answer: in place of incident the adequate anaesthetizing by narcotic drugs is conducted, an elastic bandage is laid on extremity, immobilization by a transporting splint; a victim is quickly hospitalized in surgical department.

2 Answer: to a victim lay on a wound an aseptic bandage (falling organs out do not set from an abdominal region!) and transport him in position lying in surgical department, during transporting anti shock therapy is conducted.

3 Answer: in place of incident anaesthetizing, laying on of sterile occlusal bandage, portage of a victim is conducted in hospital in position «sit», anti shock therapy.

4 Answer: the closed craniocerebral trauma and hurt wound of cervical-parietal area are at the suffering woman. Formation of intracranial or subdural haematoma is not eliminated. It is necessary quickly to transport in the neuro-surgical department in position lying, to watch after breathing, to turn a head on a side. An aseptic bandage is imposed on a wound.

5 Answer: penetrated wound of right half of thorax is at the victim; it is necessary to enter anesthetic drugs, to impose an occlusal bandage, quickly to transport the victim in the surgical department in position «sit».

6 Answer: the damage of large bloods vessels is not eliminated (jugular veins, carotid). It is necessary to impose compact pressing aseptic bandage on the area of the wound. A victim it is immediately needed to deliver in the surgical department.

7 Answer: to impose an aseptic bandage into place of the wound, it is possible to lay a cold on an abdomen, immediately to deliver in the surgical department in position lying. Anesthetic drugs are not entered. During transporting the anti shock therapy is conducted.

8 Answer: in the beginning it is necessary to stop bleeding by the digit pinning of femoral artery for the extent, then to impose the garrot or tourniquet proximally from the place of the wound. On a wound an aseptic bandage is laid on.

9 Answer: a victim must be transported after imposition of Diterix’s splint.

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