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MINISTRY OF HEALTH OF UKRAINE

BUCOUVINIAN STATE MEDICAL UNIVERSITY





Approved”




The pro-rector of educational work





Professor _____________ M.Yu.Kolomoyets




________ “___” 2007



A STUDENT’S GUIDE TO EDUCATIONAL DISCIPLINE

TOPOGRAPHICAL ANATOMY AND OPERATIVE SURGERY”


(contains structure, main goals, discipline contents, evaluation principles, control questions)


A student’s guide is made on the basis of current curriculum and program of educational discipline the "Topographical anatomy and operative surgery" for the students of higher medical schools of ІІІ-IV levels of accreditation (Ministry of Health of Ukraine, Kiev, 2006).


^ Approved on general and operative surgery with the topographical anatomy department meeting by June 6, 2007 (protocol №16).




Head of the department of general and operative

surgery with the topographical anatomy, professor F.H.Kulachek


^ Approved by Subject Commission on Methodology of medical and biological disciplines of morphologic description by June 12, 2007 (protocol №9).


Head of Subject Commission on Methodology

of medical and biological disciplines

of morphologic description, professor B.G.Makar


Chernivtsi – 2007

^ The educational discipline

Topographical anatomy and operative surgery”

(normative discipline)


1.INTRODUCTION.

The definition of educational discipline.

Topographical anatomy and operative surgery as educational discipline is:

a) based on the study of morphological disciplines – human anatomy; histology, cytology, cytology and embryology; physiology, pathomorphology; pathophysiology; propaedeutics of internal medicine, propaedeutics of paediatrics, radiology and is integrated with these disciplines;

b) lays the foundation of surgery, child's surgery, traumatology and orthopaedy, neurosurgery, anesthesiology and intensive therapy, urology, obstetrics, gynaecology and other educational disciplines study where the surgical methods of treatment are widely used which provides integration of teaching with these disciplines and forming the abilities to apply knowledge in the process of following studies and professional activity;

c) enables an opportunity to get practical skills and form professional abilities for the granting of medical care at certain pathological state and during the period of care of surgical patients.

The educational process is formulated according to a module–credit principle in conformity with the requirements of Bologna process.

The program of discipline is divided on modules containing substantial block-modules.

The scope of educational load is represented in ECTS credits - transfer credits granted by passing the respective module (transfer credit) by students.


^ Quantity of educational hours – 105 (IV sem. – 75 hours, V sem. – 30 hours) (45,0 credits ECTS), from them:

- lectures - 20 hours.

- practical employments – 60 hours (IV sem. – 40 hours, V sem. – 20 hours)

- independent work of students - 25 hours (IV sem. – 15 hours, V sem. – 10 hours)

- the table of contents of discipline consist of 2 modules (3 semantic modules in IV sem. and 2 semantic modules in in V sem.).


^ Approved on general and operative surgery with the topographical anatomy department meeting by June 6, 2007 (protocol №16).




Head of the department of general and operative

surgery with the topographical anatomy, professor F.H.Kulachek


^ Approved by Subject Commission on Methodology of medical and biological disciplines of morphologic description by June 12, 2007 (protocol №9).


Head of Subject Commission on Methodology

of medical and biological disciplines

of morphologic description, professor B.G.Makar

Structure of the discipline "Topographical anatomy and operative surgery" and charging of points for current educational activity (converting of traditional estimations in marks; estimation in marks for implementation of individual tasks, if it is foreseen by an executable educational curriculum).


The number of the module and quantity of educational hours/ quantity of credits ECTS

Quantity of the semantic modules, their numbers

Quantity of practical studies

Converting in the marks of traditional estimations

minimal number of points *

Traditional estimations

Points for the individual assignment as a kind of SRS

"5"

"4"

"3"

"2"

Module 1 90/3,0

3

(№№ 1-3)

19

6

5

4

0

6

76

Module 2 75/2,5

2

(№№ 4-5)

9

12

10

7

0

12

63


* A minimal number of points, which student must gather for the module studying, that to be admitted to passing of final module control.


^ 3. Main goals of studies of educational discipline in accordance with the Educational-professional program (EPP):

- to determine a topography and syntopy of human organs;

- to interpret topographic relations from the positions of variation and age-specific clinical anatomy;

- to demonstrate the technique of execution of basic operative manoeuvres on the specimens of human or animal;

As a result of study of topographical anatomy and operative surgery a student must know:

- holotopy, sceletotopy, syntopy, blood supply, innervation and lymphatic drainage of organs, individual and age- specific anatomic variability of organs and systems, value of these data for practical surgery;

- some microscopic details of structure of organs, in particular, histotopography of the vascular and nervous structures;

- principles of operative surgery on different regions of human body;

- features of reactions of organism on surgical operations for the ground of technique of modern operations.

A student must be able to make a preparation of regions, operative accesses and operative manipulations, approach to the neurovascular fascicles.


DESCRIPTION OF THE MODULES OF DISCIPLINE
^

4.1. Module 1: Topographical Anatomy and Operative Surgery of the Head, Neck, Thorax and Abdomen



4.1.1. Topic plan of the lectures of Module I.



Topic

Hours

1

The general questions of clinical anatomy and technology of surgical operations. The methods of topographo-anatomic investigates. The general principles of surgical interventions. The surgical instrumentation, usage rules

2

2

Topographical anatomy and operative surgery of the cerebral and facial parts of the head

2

3

Topographical anatomy and operative surgery of the neck

2

4

Topographical anatomy and operative surgery of the thoracic wall and pectoral gland

2

5

Topographical anatomy and operative surgery of the organs of thoracic cavity

2

6

Topographical anatomy of the anterolateral abdominal wall. The methods of laparotomy. Surgical operations on the abdominal hernias

2

7

Topographical anatomy of the organs of peritoneal cavity. Surgical anatomy of the peritoneum

2

8

The general principles of abdominal surgery. The intestine sutures and anastomoses. Operative surgery of the organs of peritoneal cavity.

2

9

Topographical anatomy of the lumbar region, retroperitoneal space and pelvis. Operations on the organs of retroperitoneal space and pelvis.

2

10

Topographical anatomy and operative surgery of the upper and lover extremities. The general principles of surgical operations on the tendons, vessels and nerves

2


^ 4.1.2. Thematic plan of practical studies of module 1.



Topic

hours

MODULE I

Topographical Anatomy and Operative Surgery

of the Head, Neck, Thorax and Abdomen

Contents module 1.

Topographical Anatomy and Operative Surgery of the Head and Neck

1

The surgical instrumentation and usage rules

2

2

The general principles of surgical interventions

2

3

Topographical anatomy and operative surgery of the cerebral part of the head

2

4

The contents of the cranial cavity

2

5

Topographical anatomy and operative surgery of the lateral facial region

2

6

Topographical anatomy of the regions and triangles of the neck

2

7

Topographical anatomy and operative surgery of the organs of the neck

2

Contents module 2.

Topographical Anatomy and Operative Surgery of the Thorax

8

Topographical anatomy and operative surgery of the thoracic wall and pectoral gland

2

9

Topographical anatomy and operative surgery of the lungs and mediastinum

2

10

Topographical anatomy and operative surgery of the heart

2

Contents module 3.

Topographical Anatomy and Operative Surgery of the Abdomen

11

Topographical anatomy of the anterolateral abdominal wall. The methods of laparotomy

2

12

Topographical anatomy of inguinal region. Topographical anatomy and operative surgery of the inguinal hernias

2

13

Clinical anatomy and operative surgery of the umbilical, femoral and linea alba hernias

2

14

Topographical anatomy of the peritoneum and their derivatives. The revision of the peritoneal cavity

2

15

Topographical anatomy of the organs of peritoneal cavity

2

16

The intestine suture. Surgical operations on the small intestine

2

17

Surgical operations on the stomach

2

18

Surgical operations on the parenchyma organs, gallbladder and bile ducts

2

19

Surgical operations on the large intestine. Appendectomy

2

Module 1

2


^ 4.1.3. Types of the independent work of student

N

THEME

Hours

kinds of control

1.

^ Preparation for practical studies – theoretical and practical preparation of student

12

Current control on practical studies

2.

^ Individual independent work of students:

Review of scientific literature for choice: “Transplantation of organs and tissues”, “extracorporeal circulation”, “Surgical treatment of myocardial ischemia”, “Laparoscopic surgery”.

1

Current control on practical studies

3.
^

Preparation to the final module control


2

Final module control



Sum total


15





^ 4.2. Module 2: Topographical Anatomy and Operative Surgery of the lumbar region, pelvis vertebral column and extremities


4.2.1. The topic plan of the practical classes of Module 2.



Topic

hours

Semantic module 1.

Topographical Anatomy and Operative Surgery of the walls and organs of lumbar region and pelvis

1

Topographical anatomy and operative surgery of the lumbar region and retroperitoneal space

2

2

Topographical anatomy and operative surgery of the pelvis

2

Semantic module 2.

Topographical Anatomy and Operative Surgery of the vertebral column and extremities

3

Topographical anatomy and operative surgery of the vertebral column, spinal cord and the tunics of it

2

4

Topographical anatomy and operative surgery of the shoulder and arm

2

5

Topographical anatomy and operative surgery of the forearm and hand

2

6

Topographical anatomy and operative surgery of the gluteal region and thigh. The approaches to the neurovascular bundles. The operations for femoral hernia.

2

7

Topography of the knee, leg and foot. The approaches to the neurovascular bundles.

2

8

The amputation of the extremities. The principles of operations on bones and joints.

2

9

The principles of operations on vessels, nerves and tendons.

2

10

Control study (test): final module control of the theoretical and practical training.

2

Module 2 (sum total):

20


^ 4.2.2. Types of independent work of student.

N

THEME

Quantity of hours

Type of control

1.

^ Preparation for practical studies – theoretical and practical preparation of student

7

Current control on practical lessons

2.

Individual independent work of students:

Review of scientific literature for choice:

“Laparoscopic surgery of pelvis”, “Deobliteration operations on vessels “, “Modern methods of osteosynthesis”.

1

Current control on practical lessons

3.
^

Preparation to the final module control


2

Final module control



Sum total


10





^ 4.3. The student's educational activity assessment.

An evaluation of module is the sum of evaluations of current educational activity (in points) and final control module (in points).

A maximal number of points, which student can gather for every module is 200 (for current educational activity - 120 points, for final control module– 80 points) representing a correlation 60% to 40%.


Traditional scale

Points transfer

module I

module II

„5”

6

12

„4”

5

10

„3”

4

7

„2”

0

0


The evaluation forms of current educational activity are standardized and include control of theoretical and practical training.

A maximal number of points, which student can gather for the current activity is calculated by number of points’ multiplication corresponding to point "5" by the number of topics in the module with addition of points for the student’s individual task.

A minimal number of points, which student can gather for the module studying is calculated by number of points’ multiplication corresponding to point "3" by the number of topics in the module.

The points for individual tasks are counted to student only at their successful performance and defence.

Only students having gathered not less than 76 points and having visited the lectures are allowed to pass control module.

The evaluation forms of current educational activity are standardized and include control of theoretical and practical training.

A maximal number of points, which student can obtain passing the final control module is 80.

The final control module is considered to be passed if the student obtains not less than 50 points.

The evaluation for the discipline is put only for these students who have all modules approved.

ECTS

By national scale

BSMU scale

(in points)

А (excellent)

excellent

180-200

В (very good)

good

165-179

С (good)

150-164

D (satisfactory)

satisfactory

135-149

E (weakly)

120-134

FX

badly with the possibility of second passing


70-119

F

badly with the possibility of second course


1-69


The evaluation of the discipline FX, F ("2") is put to the students having passed al least 1 module after its finishing.

The evaluation FX is put to the students having gathered minimal number of points for current educational activity but they haven't counted the final control module.

ЕСТS evaluation

Evaluation by the за 4-point scale

А

5

В, С

4

D, Е

3

FХ,F

2


^ FINAL CONTROL MODULE


The credit-module system of educational process organization provides:

- a study of disciplines by modules, which are the logically completed parts of curriculum;

- every module is learned in the process of realization of the proper forms of educational process (listening to lectures, current educational activity, independent work, individual tasks);

- all types of student’s work (in audience, independent, individual, gaining of practical skills) in time dimension are united in the so-called credits. 1 credit is equal to 30 hours.

- the study of the module ends by final control module ;

- the concept of current student's educational activity consists of:

a) listening to lectures and learning of lecture material;

b) preparation to practical exercises;

c) learning of independent work questions;

d) writing of reports or research scientific work is carried out (at will);

- final control module is carried out on the last practical lecture devoted to the study of the module; it grants the possibility to find out the level of theoretical and practical preparation of student. It is realized by the verbal questioning, writing of different works, tests, situational tasks solutions, demonstration of practical skills.


^ THE EVALUATION OF STUDENT'S PREPARATION LEVEL TO DISCIPLINE

At evaluation an advantage is obligatory given to the standardized methods: testing, writing works, structured control, mastering of practical skills which are represented in educational program.

Evaluation of current educational activity


At evaluation of mastering of each topic the evaluations are put to the student by 4-point (traditional) scale, which are converted in points depending on the number of topics in the module. A division of points by modules:

Traditional evaluation /

number of points

Module1

„Topographical anatomy and operative surgery of head, neck, cheast, abdominal cavity ”

Модуль 2

„Topographical anatomy and operative surgery of retroperitoneal space, pelvis, perineum, spinal column extremities and spinal cord”

„5”

6

12

„4”

5

10

„3”

4

7

„2”

0

0

^ Evaluation of student's independent work (SIW)

SIW is estimated during current control of topic on the proper lecture.

Evaluation of individual student's tasks

The points for individual tasks are counted to student only at their successful performance, but not more than 10 or 12. They are added to the sum of points, gathered by him for current educational activity.

^ Final module control

Final module control is carried out after study of module topics finishing on the last control lecture by the module.

Only students having visited all lectures in auditorium fixed by curriculum are allowed to pass control module.

A maximal number of points, which student can obtain passing the final control module is 80.

The final control module is considered to be passed if the student obtains not less than 50 points.

^ Evaluation of discipline

An evaluation of discipline is put only for students having approved all modules of disciplines.

The determining of points number obtained by student of discipline.

The sum of points for all of the modules is divided by the number of the discipline modules.


^ Converting of discipline points number to evaluations by the scale ECTS

and by 4-point (traditional) scale

By the scale of ECTS

By national scale

By scale of BSMU

(in points)

A (excellent)

excellent

180-200

B (very good)

good

165-179

C (good)

150-164

D (satisfactory)

satisfactory

135-149

E (weakly)

120-134

FX

badly with the possibility of second passing

70-119

F

badly with the possibility of second course

1-69


The FX evaluation is put to students who were allowed to pass to final control, but didn't do it.

The F evaluation is put to students who isn't allowed to pass to final control (did not visit audience lessons fixed by curriculum for this module or (and) at current educational activity got the number of points less than minimal one).

The evaluation of the discipline FX, F ("2") is put to the students having passed al least 1 module after its finishing.


^ Approved on general and operative surgery with the topographical anatomy department meeting by June 6, 2007 (protocol №16).




Head of the department of general and operative

surgery with the topographical anatomy, professor F.H.Kulachek


^ Approved by Subject Commission on Methodology of medical and biological disciplines of morphologic description by June 12, 2007 (protocol №9).


Head of Subject Commission on Methodology

of medical and biological disciplines

of morphologic description, professor B.G.Makar


^ 4.4. List of theoretical questions to the final module control.


Module 1. Topographical Anatomy and Operative Surgery of the Head, Neck, Thorax and Abdomen


  1. History of topographical anatomy, maintenance and tasks of course.

  2. Table of contents of course of operative surgery. Classification of surgical operations.

  3. Principles and stages of surgical operations.

  1. Topographical anatomy of mastoid region. The trepanation triangle (Shipot).

  2. Topographical anatomy of parotid region.

  3. Arterial supply of facial region of head.

  4. Topographical anatomy of deep region of face.

  5. Vein systems of cranial-cerebral and facial departments of head, their communication.

  6. Topographical anatomy of trigeminal nerve.

  7. Topographical anatomy of facial nerve.

  8. Phlegmons of face. Dissections of inflammatory processes on face.

  9. Primary surgical treatment of mandibulofacial wounds.

  10. Principles of primary surgical treatment of cranial-cerebral wounds .

  11. Trepanations of skull.

  12. Topographical anatomy of the adipose spaces of the neck.

  13. Topographical anatomy of carotid triangle of the neck.

  14. Topographical anatomy of thyroid.

  15. Topographical anatomy of larynx.

  16. Features of primary surgical treatment of wounds of the neck.

  17. Operative accesses to the carotid arteries in a carotid triangle.

  18. The superior and inferior tracheotomies.

  19. Subtotal subcapsule stroumectomy by O.V.Nicolaev.

  20. Topographical anatomy of intercostal spaces.

  21. Topographical anatomy of the mammary (lactiferous) gland.

  22. Topographical anatomy of the heart.

  23. Topographical anatomy of the lungs.

  24. Mastitis and their operative treatment.

  25. Operations on the benign and malignant tumors of the mammary gland.

  26. Resection of the rib.

  27. Pneumothorax.

  28. Principles of operations on lungs - wound closure of lung, resection of segment, lobectomia, pulmonectomia.

  29. Wound closure of the heart.

  30. Surgical anatomy of the congenital heart disease and congenital anomalies of large vessels. Principles of surgical treatment.

  31. Endocoronar surgery. coronary artery bypass grafting.

  32. Topographical anatomy of internal surface of anterior abdominal wall.

  33. Topographical anatomy of inguinal canal. Sexual features of inguinal canal.

  34. Surgical anatomy of indirect, direct, sliding and congenital inguinal hernias.

  35. Surgical anatomy of femoral hernia.

  36. Surgical accesses to the organs of abdominal cavity.

  37. Surgical treatment of direct inguinal hernias.

  38. Surgical treatment of indirect inguinal hernias.

  39. Surgical treatment of femoral hernias.

  40. Surgical treatment of umbilical hernia and hernia of linea alba.

  41. Topographical anatomy of peritoneum. Derivates of peritoneum.

  42. Topographical anatomy of the stomach.

  43. Topographical anatomy of the liver.

  44. Topographical anatomy of gall-bladder and biliary tracts.

  45. Topographical anatomy of the pancreas.

  46. Topographical anatomy of small intestine. Meccel’s diverticula.

  47. Topographical anatomy of the colon.

  48. Theoretical bases and technique of intestinal sutures.

  49. Resection of bowel.

  50. Appendectomy.

  51. Principles of operations of sewing of perforated gastric ulcer.

  52. Gastrostomy, kinds.

  53. Gastroenterostomy, kinds. Measures for prevention of formation of vicious circle.

  54. Principles of resection of stomach, kinds, modifications.

  55. Principles and types of vagotomy. Drainage operations.

  56. Methods and technique of cholecystectomy.


MODULE 2: Topographical Anatomy and Operative Surgery of the lumbar region, pelvis vertebral column and extremities

  1. Topographical anatomy of lumbar region.

  2. Topographical anatomy of kidney.

  3. Topographical anatomy of ureters.

  4. Pyelolithotomy.

  5. Anatomy of frontoparietal-occipital region

  6. Nefrectomy.

  7. Topographical anatomy of the pelvic and urogenital diaphragm.

  8. Topographical anatomy of fascial and cellular tissues of pelvis.

  9. Topographical anatomy of rectum. Surgical anatomy of rectal malformations.

  10. Topographical anatomy of uterus.

  11. Epicystostomy. Complications.

  12. Operations on extra-uterine pregnancy

  13. Principles of operations on paraproctitis.

  14. Topographical anatomy of the vertebral column.

  15. Topographical anatomy of the scapular region.

  16. Topographical anatomy of the axillary region.

  17. Topographical anatomy of anterior regions of forearm.

  18. Topographical anatomy of the palm.

  19. Topographical anatomy of the gluteal region.

  20. Topographical anatomy of the anterior region of thigh.

  21. Topographical anatomy of popliteal space.

  22. Topographical anatomy of the anterior crural region.

  23. Topographical anatomy of the posterior crural region.

  24. Topographical anatomy of region of sole.

  25. Puncture of the shoulder joint.

  26. Principles of operations for the phlegmons of palm and forearm.

  27. Principles of operations for panaritium. Methods of anaesthetizing.

  28. Operations on varicose veins of lower extremities.

  29. Operative accesses to the axillary artery.

  30. Operative accesses to the humeral artery at a different level of shoulder.

  31. Operative accesses to the radial artery.

  32. Operative accesses to the ulnar artery.

  33. Operative accesses to the femoral artery at three levels.

  34. Operative accesses to the popliteal artery.

  35. Operative accesses to the anterior tibial artery.

  36. Operative accesses to the posterior tibial artery at three level.

  37. Principles of amputations and disarticulation.

  38. Bone-plastic amputation of shin of Pyrohov.

  39. Puncture of the knee-joint.

  40. Principles of transplantation and explantations of organs and tissues.



Approved on general and operative surgery with the topographical anatomy department meeting by June 6, 2007 (protocol №16).




Head of the department of general and operative

surgery with the topographical anatomy, professor F.H.Kulachek


^ Approved by Subject Commission on Methodology of medical and biological disciplines of morphologic description by June 12, 2007 (protocol №9).


Head of Subject Commission on Methodology

of medical and biological disciplines

of morphologic description, professor B.G.Makar


4.5. List of practical tasks and works to the final module control.

- Making of anatomic preparations;

- Writing of abstracts;

- Review of scientific literature on choice.


4.6. Recommended literature


1. Snell R.S. Clinical Anatomy for medical students. – Lippincott Williams & Wilkins, 2000. – 898 p.

2. Skandalakis J.E., Skandalakis P.N., Skandalakis L.J. Surgical Anatomy and Technique. – Springer, 1995. – 674 p.

3. Netter F.H. Atlas of human anatomy. – Ciba-Geigy Co., 1994. – 514 p.

4. Ellis H. Clinical Anatomy Arevision and applied anatomy for clinical students. – Blackwell publishing, 2006. – 439 p.

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