V іі. System of learning assignmentsfor checkout of a terminating level of knowledge.

Situational problems

1. In traumatology unit the patient after road accident with complaints to a pain in a right femur, sharp disturbance of function has entered. At the survey of a femur the appreciable thickening of the soft tissues in the upper third, a positive sign "riding breeches" is scored, the extremity is truncated on 5 see At a stage of first aid lead immobilization by splint Diterihsa. Joint-stock company 80/55 mm.pt.st sphygmus 106 in min.

A. Put the previous diagnosis.

B. Plan of the previous treatment of the victim.

Century the how is necessary for leading survey.

The answer:

A. Closes diafisis fracture of the upper third of right femur with shift of fragments. postravmatical a shock ІІ item

B. Anesthesia („ infiltrations anestehesia ”) due to injection in a place of fracture 200 ml 0,5 % of У-thow Novocainum from four crossly perpendicular points. Injection hemodinamical blood substitutes (poliglukin 500 ml, reopoliglukin 250 ml, solution Ringera, izosteril on 250 ml, in/m ketalon 22 ml). After deducing from a depressed case to execute sceletal extesion at process a femur or still schin bones

Century roentgenograms the image of a femur

2. The man at slope from height on moderately incurvated legs has felt a birch a pain below patellar to a joint. Complains, that anticnemions "do not obey" at performance of a step forward. At a palpation still schin bones - the appreciable pain, patella it is displaced up.

A. Put the previous diagnosis.

B. Call a radiological attribute of damage.

Century who need to be used a method of treatment?

Of the how promptness medical measure?

The answer:

A. Alienation still shin bones.

B. displacement of a whirl bone burn down.

Century exstramedule osteometalosintesis.

In the first 1-3 days.

3. The patient complains of a gonalgia which has occurbed at slope on in front on a surface of a joint. At the survey it is defined deconfiguration patellar to a joint, at a palpation - the kneecap is on an exterior surface of a joint, the active motions in a joint miss, passive - are restricted.

A. Put the previous diagnosis.

B. Choose a method of treatment.

The answer:

A.Fractura of a kneecap.

B.Ficsation a method (a gypseous dummy bandage after liquidation of a hemarthrosis).

4. In clinic the owner of a motor van with the complaint to a pain in a basis of the first dactyl of a right brush was converted. Hour back clockwork tincars stick has struck it on a palmar surface of a brush. At the survey the basic phalanx of the first dactyl is in a back flexion under an angle 80⁰, the head of a metacarpal bone acts on a palmar surface, the distal phalanx is incurvated at right angle.

A.Put the previous diagnosis.

B.Show sequence of activities at diaplasis of a dislocation.

The answer:

A.Dislocation in phalanx-wrist a joint of a dactyl of a right} brush.

B. Anesthesia due to carrying out of an anesthesia. Diaplasis of a dislocation.

5. Term contra indication for applying a plaster bandage:

Presence at the patient onihomicozis

Opportunity of development of a mephitic gangrene at the open fracture (+)

impacted fracture

Damage skins (disease) in a place of applying of a bandage (+)

Presence interposition

Damage of the main receptacles

6. At the patient on a X-ray pattern inappreciable shift of the left-hand ulna. Whether it is necessary to spend reposition?

The answer: If shift will not break function the patient does not need to be injured follow-up.

7. The patient, as a result of slope on the left-hand brachium, had a dislocation arm-pits heads of a humeral bone. Using what method, it is possible to set a dislocation?

The answer: the Method of value} has no, efficiency of diaplasis depends on adequate anesthesia and a release phenomenon.

8. At the patient fracture of the inferior third of right femur. What method of treatment of fractures is more expedient?

Sceletal extensio (+)

osteoclasia

Coking bandage

Splint CITO

9. At slope from the car at the patient it is diagnosed diafisis fracture of a femur. Choose an adequate method of treatment of the patient.

The functional method

Use of plug Algunova

Intramedular osteometalositesis nail Dubrova (+)

Use of plate Krupko

10. Whether it is necessary for the patient after intramedular osteometalositesis nail Klantshnera to impose koksitum a plaster bandage?

The answer: So, differently there can be a rotation distal to a fragment around of a nail.

11. The patient has entered with a dislocation in the left-hand ulnar joint that has arisen a month ago. Yaks you recommend a method of diaplasis?

Method the Mott-Muhina

Method Hippocrat

Operative treatment (+)

Method Koher

12. The patient has entered with complaints to frequent, repeated dislocations of the left-hand brachium. To him have erected the diagnosis: Luxatio humeri habitualis. Appoint treatment.

toracobronwalis A bandage

Operation with introduce an articulate ascus (+)

Weeper{Deflecting} splint CITO

osteoclasia

13. The patient has occurbed in a surgical cabinet for putting off of a circular plaster bandage of the left-hand anticnemion. Select necessary instruments.

Scissors Listera

Forceps Listona

Scissors Shtille (+)

Yudin's expander

Volf's forcepses (+)