Information sources.

А) Basic:

1. Kapitan T. Propedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2006. – P. 406-481

B) Additional:

1. Мазурин А.В., Воронцов И.М. Пропедевтика детских болезней. – С-Пб.: Фолиант, 2001. – С.397-424; 456-475.

Program of self-preparation of students to the theme:

1. To learn the basic signs of defeats of the cardiovascular system and know the symptoms of the congenital and acquired diseases of heard and vessels in children.

2. To be able to conduct the supervision after patients with the cardiovascular- diseases: to count up a pulse, frequency of cardiac reductions, breathing frequency and to measure arterial pressure.

3. To be able to give first aid at acute vascular and cardiac insufficiency, sudden stopping of cardiac activity.

4. Pay attention to the basic elements of care of children with the diseases of the cardiovascular system.

Semantic module 8. System of digestion in children

Concrete aims:

• To collect anamnesis at a patient with diseases of the digestive system.

• To conduct objective examination of organs of digestion at a child, to interpret findings.

• To analyze the basic syndromes of defeat of the digestive system in children.

• To appoint the laboratory-instrumental methods of examination of digestive system.

Theme 10. Anatomic and physiologic features of the system of digestion in children, examination method.

Theme 11. Semiotics of defeats of organs of digestion.

Theme of practical training: Method of clinical examination of organs of digestion (inspection, palpation, percussion, auscultation). Semiotics of defeats of organs of digestion and basic diseases in children. Abdominal syndrome.

Place: an educational room in the gastroenterology department.

Professional orientation of students. There is growth of pathology of organs of digestion in children and teenagers in recent years. The organs of digestion of child have the row of morphological and functional features, without taking into account which the results of clinical examination and put clinical diagnosis cannot be correctly appraised. Knowledge of anatomic and physiologic features of the digestive system enables to organize the rational food mode and care of baby. In work of doctor the important value have practical skills of the method of examination of the digestive system. Recognition of basic symptoms of defeat provides early diagnostics of pathology of digestive channel and allows to choose diagnostic algorithms. Raising of clinical diagnosis is based on the basis of clear knowledge of symptoms of defeats of the digestive system, that matters for the timely beginning of treatment.

Base level of knowledge and abilities:

№	Discipline	To know
1. 2. 3. 4.	Anatomy Normal physiology Histology Pathological physiology	Development of organs of digestion in a intrauterine period. Anatomic structure of the digestive system. Adjusting and functioning of the digestive system of children of a different age. Digestion and suction in different parts of gastrointestinal tract. Motor-evacuator function of organs of digestion. Histological features of structure of organs of digestion in different age period of childhood. Basic compensating and adaptation mechanisms of the digestive system. Pathological physiology of billirubine metabolism. Pathology of digestion

Plan of conducting of training

№	Elements of practical training	Time (minutes)
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.	Verification of presents. Announcement of theme and purpose of training and its actuality. Entrance control and its analysis. Theoretical analysis of material in relation to anatomic and physiologic features and embryogenesis of organs of digestion. Demonstration of method of clinical examination of the digestive system in children. Distributing of patients for the examination. Independent examination of sick children Registration of protocols of inspection of patient with estimation of the state of the digestive system with substantiation of pathological symptoms and syndromes. Analysis of patients. Signing of protocols. Theoretical analysis of material. Semiotics of defeats of organs of digestion Final control of knowledge, decision of clinical situation tasks. Results and eventual estimation of knowledge and abilities of students and task for independent preparation to a next training.	5 min. 25 min. 10 min. 30 min. 5 min. 30 min. 15 min. 10 min. 10 min. 15 min. 5 min. Total: 160

List of theoretical questions:

1) Anatomic and physiologic features of organs of digestion in the children of a different age and their clinical value.

1. Methods of clinical examination of patient with pathology of organs of digestion:

2. inquired;

3. features of inspection: position in a bed, inspection of mouth cavity, skin, inspection of abdomen, anal area;

4. superficial and deep methodical palpation of the intestine, stomach, liver, pancreas;

5. pain areas and points of pancreas;

6. symptoms at holecystopathias in children;

7. features of percussion, determination of size of liver by Kurlov;

8. features of auscultation of the intestine.

3) Semiotics of defeats of the digestive system:

1. “acute” abdomen;

2. syndrome of gastroenterocolitis;

3. syndrome of malabsorbtion;

4. constipation;

5. syndrome of jaundice;

6. syndrome of hepatic failure;

7. functional dyspepsia (gastroduodenitis);

8. ulcer disease of stomach and duodenum.

Method of conducting of practical training:

1. After verification of presents and announcement of theme of training with pointing on its actuality a teacher conducts the writing entrance control of knowledge.

2. Theoretical analysis of material.

3. In the ward of department a teacher demonstrates the method of clinical examination of patient with pathology of the digestive system.

4. A teacher distributes patients for the independent examination, assigns.

№	Task	Pointing of teacher to the students	Note
1. 2. 3.	To collect anamnesis at a patient with pathology of the digestive system. To conduct the objective examination of the digestive system. To do a conclusion about the state of the digestive system in a child. To define the syndrome of defeat.	Algorithm of collection of anamnesis Anamnesis of diseases: beginning of disease; first clinical symptoms; whether was treatment conducted, by which medicines? dynamics of disease complaints of patient in the moment Anamnesis of life: current of pregnancy at a mother; current of delivery; state of health of child in the period of new-born and brest age; morbidity of child; presence of allergic reactions; heredity of patient. Algorithm of practical work of student 1) inspection of patient: position in a bed, inspection of mouth cavity, inspection of abdomen; 2) superficial and deep methodical palpation of the intestine, stomach, liver, pancreas; 3) pain areas and points of pancreas; 4) symptoms at holecystopathias in children; 5) percussion, determination of sizes of liver by Kurlov; 6) auscultation of the intestine. Algorithm of practical work of student 1) To define the pathological changes (symptoms) in a state of digestive system. 2) To do the report of pathological information (symptoms) 3) To do a conclusion about a pathological syndrome of defeat of the digestive system.	It is necessary to put questions which are up to the digestive system. It is necessary to expose the factors of risk of development of disease of the digestive system. To conduct the examination of patient taking into account the age-old features of child. To give estimation of the exposed changes taking into account age features.

6. Students design protocol of inspection of patient with estimation of the state of the digestive system and substantiation of pathological syndrome.

7. A teacher conducts the analysis of patients with the analysis of substantiation of pathological syndrome. Signing of protocols.

8. A teacher conducts the final control of knowledge of students on this theme with the use of situation clinical tasks.

9) Teacher works out the resume of training, gives estimation of knowledge and abilities of students. Assigns for independent preparation to a next training.

Forms and methods of self-control