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"exudative inflammation"




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"EXUDATIVE INFLAMMATION"

The urgency of the theme: exudative inflammation - is characterized by the predominance of the exudative component of inflammation and by the formation of exudate (inflammatory liquid). This form of inflammation is encountered as frequent and occupies one of the significant places in the structure of the diseases of man. The knowledge of theme is necessary for studying the course of special pathologic anatomy; during the study of clinical specialties in the courses and in the practical activity of doctor. The different types of exudative inflammation can be both independent and by complication of different specific the medical interference in the therapeutic process.


Purpose (general): to know how on the basis of morphological characteristic to diagnose the different forms of exudative inflammation, to evaluate its varieties, mechanisms of development, outcome and value for the organism.


The specific goals purposes of the initial level

1. To diagnose by macro and microscopically serous inflammation, to determine its reasons, outcome and value for Organism.

1. To evaluate the macroscopic and microscopic structure of different parenchymatous organs and cavities of organism (department of histology, general anatomy).

2. To distinguish macro and microscopically catarrhal inflammation, to determine its reasons, outcome and value for organism.

2. To evaluate the microscopic structure of the epithelium (department of histology, general anatomy).

3.To diagnose by macro and microscopically hemorrhagic inflammation, to determine its reasons, outcome and value for organism.

3. To evaluate the macroscopic and microscopic structure of lungs, meninges of the brain, vessels (department of histology, general anatomy).

4. To recognize macro and microscopically different forms of fibrinous inflammation, to determine its reasons, outcome and value for organism.

4. To evaluate the macroscopic and microscopic structure of lungs, meninges of the brain, heart, tensile, larynx, guts (department of histology, general anatomy).

5. To recognize the morphological signs of furuncle and carbuncle, to determine the reasons for appearance, outcome and complications.

5. To interpret the microscopic structure of normal hair follicle (department of histology).

6. To recognize the morphological signs of abscess, to determine the reasons for appearance, outcome and complications.

6. To interpret the microscopic structure of normal lung, brain, subcutaneous cellular tissue, liver, structure and cellular composition of connective tissue (department of histology, general anatomy).

7. To recognize the morphological signs of phlegmon, to determine the reasons for appearance, outcome and complications.

7. To evaluate the microscopic structure of subcutaneous cellular tissue, walls of hollow organs (department of histology, general anatomy).

8. To recognize the morphological signs of empyema, to determine the reasons for appearance, outcome and complications.


8. To interpret the macro- and microscopic structure of the preformed cavities (pleural, pericardium, abdominal). (department of histology, general anatomy)



Tasks for self-verification and self-control of the initial level of the knowledge- skills

Task 1. During the study of the histological structure of the skin sebaceous glands are found. To what structures they tightly do fit closely?

1-Epithelium

2. Glands

3- Hair follicle

4- Muscle


Task 2. With microscopic a study of the cells of the blood, their large part composed the cells with the relatively wide cytoplasm with the small grainy impregnations. The nucleus of these cells of irregular shape, some of them had two, or three nuclei of those connected together. With what cells does deal the discussion?

1-Lymphocyte

2. Plasma cells

3-.Neutrophills

4- Erythrocytes

5- Macrophages


Task 3. With the microscopic examination of the cells of the blood are revealed the cells with the narrow cytoplasm, their nucleus round, intensively stained with hematoxylin. With what cells does deal the discussion?

1-Lymphocytes

2. Plasma cell

3-Neutrophills

4-Erythrocytes

5-.Basophills

Task 4. With the microscopic examination of cell it is established that it has the round, eccentrically located nucleus, in which the chromatospherite is located inside, from it to the nuclear membrane by strips goes heterochromatin. The cytoplasm is large, is basophilic. With what cells does deal the discussion?

  1. Lymphocytes

  2. Plasma cells

  3. Neutrophils

  4. Erythrocytes

  5. Basophiles



Standards of answers to the solution of tasks for self-verification and self-control of the initial level of the knowledge- skills: 1.-3; 2.-3; 3. - 1; 4 2. The information, necessary for completing of the necessary knowledge and the skills can be found in the following literary sources: 1. increase in weight M.G., Lysenko N.I., Bushkovich V.I. of Anatomy of man. - G., Medicine, 2001. 2. Afanas'ev YU.I., Yurina N.A. of histology, cytology and embryology. - g., medicine, -1999. - s. 155-197. 3. Fіlіmonov V.I. of Normal physiology.-Kiev. Zdorov"ya, 1994.

The content of instruction must ensure the achievement of the objective of instruction, with assistance of the graphs of the logical structure of the theme is rendered: "exudative inflammation." (Appendix 1). The basic theoretical questions, on basis of which the possible fulfillment of purposes of the specific activity:

1. Essence and the classification of exudative inflammation.

2. Essence, reason, the characteristic of serous exudate, localization, manifestation, flow, the outcome of serous inflammation.

3. Essence, reason, the characteristic of catarrhal exudate, localization, manifestation, flow, the outcome of catarrhal inflammation.

4. Essence, reason, the characteristic of hemorrhagic of exudate, localization, manifestation, flow, the outcome of hemorrhagic inflammation.

5. Essence, reason, the characteristic of fibrinous exudate, the forms of fibrinous exudate, localization, manifestation, flow, the outcome of fibrinous inflammation.

6. Essence, reason, the mechanism of the development of purulent inflammation and its clinical-morphological forms.

7. Furuncle and carbuncle, reason, localization, morphological manifestations, complication.

8. Abscess, reason, localization, the morphological manifestations of acute and chronic abscess, complication.

9. Phlegmon. Reasons, localization, morphological manifestations, complication.

10. Empyema. Reasons, localization, morphological manifestations, complication.


Literature for mastering the necessary knowledge- skills on this theme: 1. Strukov A.I., Serov EXPLOSIVES Pathological Anatomy. - Kharkov "fact". 1999, s.y"ya-202. 2. Lecture of department on the theme "exudative inflammation". 3. Graphs of the logical structure of theme "exudative inflammation" (appendix №1). 4. Graphs of the logical structure of theme "purulent inflammation" (appendix №2). 5. Algorithm of morphological diagnostics of exudative inflammation (appendix №3)


Purposeful tasks

Task 1. The portion of lung is condensed, airless, in the section surface its fine-grained, greyish, pleura - dim, on the surface its greyish- whitish, easily separated from the pleura. What process did develop in the pleura?

1. Catarrhal inflammation

2. Croupous inflammation

3. Serous inflammation

4. Diphtheria inflammation

5. Purulent inflammation

Task 2. With the dissection of dead person, it is revealed, that pia maters are full-blooded, thickening, opaque, yellow- greenish color. For what form of the exudative inflammation most of change in the meninges?

1. Purulent inflammation

2. Serous inflammation

3. Hemorrhagic inflammation

4. Fibrinous inflammation

5. Catarrhal inflammation


Task 3. With the dissection to the corpse of the patient, who died of the pulmonary insufficiency revealed "large motley lung". With the microscopic examination of lung it is established: the sharp thickening of interalveolar septa, their insignificant thickening due to the infiltration by lymphocytes, in the opening of alveoli exudate in composition of which the overwhelming majority of erythrocytes with the admixture of lymphocytes and exfoliated alveolar epithelium. To what form of inflammation are characteristic the described changes?

1. Purulent inflammation

2. Catarrhal inflammation

3. Serous inflammation

4. Fibrinous inflammation

5. Hemorrhagic inflammation


Task 4. Man of 53 years, who suffered diabetes mellitus, on the skin of neck appeared unhealthy of cone-shaped form packing of cyanotic- red color with the yellowish center. what process are characteristic these of changes?

1. Abscess

2. Carbuncle

3. Phlegmon

4. Furuncle

5. Empyema


Task 5. Surgeon, during the operation removed the club-shaped thickened appendix, distal extended part contained opaque yellowish liquid, and the opening of proximal part was closed with fecal stones. For what inflammation these characteristic changes?

1. Catarrhal Inflammation

2. Hemorrhagic Inflammation

3. Abscess

4. Empyema

5. Fibrinous Inflammation


Task 6. In anamnesis of dead person - right-side otitis, science several months ago. On the dissection - in the region of the right temporal lobe of the brain are revealed the closed cavity 3 cm, in the diameter, rounded forms, which contained viscous turbid yellowish-green liquid. The inner layer of wall is friable yellow-pink tissue external - by dense whitish tissue. What process did develop in the brain?

1. Serous inflammation

2. Necrosis of the brain

3. Acute abscess

4. Chronic abscess


Task 7. The liquid in the pleural cavity is roentgenologically revealed in the patient. Puncture is carried out. Yellow, semi-transparent liquid was obtained, in a quantity of 300 ml. In the clinical laboratory with a study is revealed 5% of protein, lymphocytes. What is discovered in the pleural cavity?

1. Serous Exudate

2. Transudate

3. Fibrinous Exudate

4. Catarrhal Exudate

5. Hemorrhagic Exudate


Task 8. The doctor revealed with rectosegmoidoscopy that the mucous membrane of gut is sharply full-blooded, is swollen, and large quantity of mucus is determined on its surface. What process did cause the described changes in the gut?

1. Catarrhal inflammation

2. Serous inflammation

3. Fibrinous inflammation

4. Hemorrhagic inflammation

5. Purulent inflammation


Task 9. With the dissection of the corpse of the patient, who suffered croupous pneumonia and dead person from the pneumococcal sepsis, in the right pleural cavity it is discovered by 900 ml of turbid, viscous yellow- greenish liquid. The pleura dim, full-blooded. What form of inflammation did occur in the pleural cavity?

1. Phlegmon

2. Hemorrhagic inflammation

3. Abscess

4. Empyema

5. Fibrinous inflammation


Independently you must study micro-preparations and, solve situation tasks by Macroscopic forms are studied in the macro-preparations: "fibrinous pericarditis", "hemorrhagic pneumonia", "empyema of pleura", the "chronic abscess of brain", the "chronic abscess of lungs". The microscopic signs of exudative inflammation are studied in the micro-preparations: "fibrinous pericarditis", "hemorrhagic pneumonia", the "chronic abscess of brain", the "acute abscesses of the lungs, liver", the "phlegmon of soft tissues", the "phlegmon of the wall of stomach". In this case is used the algorithm of differential diagnostics of exudative inflammation (appendix №3), instruction of the study of the macro-preparations (see appendix № 2, "parenchymatous dystrophies") of the instruction of the study of micro-preparations, table on this theme..


The flow chart of the activities



stages

time in min.

The teaching aids Of the means Of the instruction


Equipment


Place of the conducting


1

checking and the correction of initial level

5

Test tasks





Training room


2

Independent work. Descriptions of the macro- and of micro-preparations

60

Graph of logical structure (appendix №1), the algorithm of morphological diagnostics of inflammations. Algorithm of the study of macro-preparations and micro-preparations


Microscope, macro- and micro-preparations,





3

self-verification and the correction of mastering material

30

Purposeful training tasks








4

total test control

15

Collection of the tests








5

5. summing up of the results of the work

10










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