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A.ROMANYUK




MACROPREPARATIONS

Systemic pathology


Educational book





MINISTRY OF HEALTH OF UKRAINE

MINISTRY OF EDUCATION AND SCIENCE

OF UKRAINE

A.ROMANYUK




MACROPREPARATIONS

Systemic pathology


Recommended by the educational council of Sumy State University for education of foreign students of the 3-rd course of medical institute.


Sumy

Publishing of Sumy State University

2007





CONTENTS





Case 7

Pregnancy and Puerperal Period Diseases.

Pathology of the Placenta…………………………



4


Case 8

^ Pre- and Perinatal Life Diseases……………………


8

Case 9

Diseases of urogenital system. Diseases of female and male…………………………………………….



12

Case 10

^ Diseases of the cardio-vascular system……………..


16

Case № 11

The diseases of respiratory organs………………….


25

Case 12

^ The diseases of the kidney…………………………...


42

Case 13

Diseases of Esophagus, Stomach and Intestine……..


56

Case 14

Diseases of Liver, Gallbladder and Pancreas………


68



Description`s scheme of the macropreparations


1. Name an organ or a tissue.

2. Pathology in organ or tissue.

3. Color of the organ or tissue.

4. Shape (round, abnormal, oval etc.) of the organ or tissue.

5. Size of the organ or tissue.

6. Consistence (dense, soft, flabby etc.) of the organ or tissue.

7. Surface (smooth, rough etc.) of the organ or tissue.

8. Condition on the section (homogeneous, layered etc.).

9. Cause of pathology in organ or tissue.

10. Complication of such pathology in organ or tissue.

11. Pathogenesis of such pathology in organ or tissue.

12. Clinical aspects of such pathology in organ or tissue.

13. Consequences of such pathology in organ or tissue.


Mark`s criteria of the knowledge of the

macropreparations


5 (excellent) 1-13

4 (good) 1-9

3 (satisfactory) 1-5


Case 7

Pregnancy and Puerperal Period Diseases.

Pathology of the Placenta.


1. Plural erosions and gastric ulcers.

2. Hemorrhage in a cerebrum.

3. Tubal pregnancy.

^ 4. Hemorrhage in lateral ventricles.

5. Hemosalpinx.

6, 20. Hydatid mole. Premature delivery.

7. Extra-uterine pregnancy.

8. Toxic dystrophy of liver.

9. Pregnancy and fibmioma of uterus.

^ 10. Kidney in case of DIC– syndrome.

11. Comissure of placenta.

12. Ovarian pregnancy.

13. Puerperal endometritis.

14. Craniotomia at premature births.

15. Abortion.

18. Willful abortion.

^ 19. Premature births.

21. Shock kidney.

22. DIC-syndrome at eclampsia.

25. Hypoplasia of placenta.

29. Atrophy of skull bones of fetus with hydrocefalus.

42. Fibromyoma of uterus.


1. Plural erosions and gastric ulcers. There are small superficial defects on the mucus membrane of stomach – erosions and acute ulcers which are limited by mucus membrane. Causes: hypoxia, intoxication in toxemias (eclampsias).

^ 2. Hemorrhage in a cerebrum. It occurs as a complication to the pathology of pregnancy – heavy toxicosis, eclampsias, in predelivery and puerperal period.


3. Tubal pregnancy. The uterine tube is extended, the wall of it is thin. There is blood in space of it with the elements of fetus ovum. Causes of its formation are inflammatory processes, with the development of partial obstruction of uterine tubes. The consequences are: complete or incomplete tubal abortion, intraperitoneal bleeding.


^ 4. Hemorrhage in lateral ventricles. Lateral ventricles are filled with blood. It is the complication of birth trauma of newborn.


5. Hemosalpinx. The uterine tube is extended, filled with blood. It happens in case of extra-uterine pregnancy and erosion of tubal wall by the chorion fibers.


6, 20. Hydatid mole. Premature delivery. There are mole formations formed with trophoblast. Pathology occurs during pregnancy after abortion, or births, it is characterized by the cystic degeneration of chorion fibers, dystrophic changes. Malignant variant of this type of trophoblastic sickness is choriocarcinoma.


^ 7. Extra-uterine pregnancy. The pregnancy in ovary, uterine tube, abdominal region is called extra-uterine pregnancy. The impregnated ovule maturates out of the uterus.


8. Toxic dystrophy of liver. A liver is enlarged; it has flaccid consistency, yellow by color. Occurs in case of eclampsia, toxicosis of pregnancy.


^ 9. Pregnancy and fibmioma of uterus. Uterus with a large fibromatous knot in the body. A fetal ovum is situated close to the cervix of uterus. Benign development of pregnancy is impossible.


10. Kidney in case of DIC– syndrome. The kidney is enlarged; there are microfocal hemorrhages on its surface as a result of blood circulation disorders in a microcirculation (formation of blood clots and hemorrhages).


^ 11. Comissure of placenta. There is an attached placenta on the wall the uterus inside its cavity. It is fixed to the wall and wasn’t separated after births. Reason of comissure part of placenta: abortions, thinning of the uterus wall, caused by inflammatory processes in endometrium.


^ 12. Ovarian pregnancy. A fetal ovum is situated in the ovary. It is observed in case of obstruction of uterine tubes, caused by chronic inflammatory processes, congenital malformations.


13. Puerperal endometritis. The uterus is enlarged, a wall is thickened, muscular fibers are hypertrophied, internal surface of the uterus cavity becomes black as a result of inflammatory process, of infection after or during births or abortion.


^ 14. Craniotomia at premature births. A skull is absent, it was destructed during the labor with the intrauterine death of fetus and disparity of sizes of maternal passages and fetus.


15. Abortion. Fetus has small size, with the signs of immaturity, was born prematurely.


18. Willful abortion. Premature birth of fetus is caused by mother’s sickness.

^ 19. Premature births. Delivery in terms ends with the birth of a normal child. Premature delivery ends with the birth of premature child.


21. Shock kidney. Typical look of kidney: cortex with whiter-grey color, medullar layer with dark blue color. The scopes of layers are expressed. The reasons are toxicosis, septic endometrium, gynaecological uterine sepsis.


^ 22. DIC-syndrome at eclampsia. There are numerous hemorrhages in the omentum of the peritoneum, thrombosis of small vessels. Such changes occur in case of eclampsia.


25. Hypoplasia of placenta. Diminished plcenta can develop as malformation. Consequences: violation of uterino-fetus blood circulation, intrauterine death of fetus.


^ 29. Atrophy of skull bones of fetus with hydrocefalus. Bones of skull are thin as a result of pressure of spinal fluid.


42. Fibromyoma of uterus. There are excrescences of plural benign mesenchimal tumors formed by connective and muscle tissue in the form of knots of different sizes. They are characterized by expansive growth.


Case 8

Pre- and Perinatal Life Diseases.


1. Microgiria.

2, 25. Staggered defect of heart.

3. Anencephalia.

4. Horseshed kidney.

^ 5. Cerebral hernia.

6. Gastroshisis.

7. Anencefalia and spinal hernia.

9. Defect of development of the bone system and umbilical cord.

12. The Arnolda-Kiari Syndrome.

14. Unreal knot of umbilical cord round a trunk.

15. Defect of development of hand.

^ 16. Plural innate defects of development, maceration of fetus.

17. Innate cancer of lungs.

18. Additional spleen.

19. Tymomegalia.

21. Spongy kidney.

23. Intraventricularis hemorrhage.

24. Pylorostenosis.

^ 26. Innate fibroelastosis of the endocard.

27. Microgiria with innate hydrocephaly.

28. Hipoplasia kidneys.

29. Innate cancer of liver.

30. An innate cyst is lungs.

31. Hydrocephaly, spinal-cerebral hernia, chondrodyslasia, hematolytic illness.

32. Agenesia bones of skull and overhead extremities.


1. Microgiria. The increase of amount of gyrus and diminishment of their sizes takes place in the cerebrum of child. It is a defect behaves to embryophaty.


2, 25. Staggered defect of heart. In a heart, openings are defects of partition take place in partitions.


3. Anencephalia. It is the staggered defect of development –embryophatia.There are the absent bones of skull of hemisphere and shell of cerebrum in fetus. It is a defect incompatible with life.


^ 4. Horseshed kidney. Innate defect of the genitourinary system. Connection of kidneys as the horseshoe of functional violations takes place this defect can not cause. She appears as find during dissection of deceased from the second pathology.


5. Cerebral hernia. The defect of bones of skull takes place in fetus, which the shells of matter of brain knob through.


6. Gastroshisis. In fetus internal organs are outside an abdominal region as a result of underdevelopment of volume of abdominal region and front abdominal wall. This defect is incompatible with life.


^ 7. Anencefalia and spinal hernia. It is the innate defect of development – embryophaty. There are the absent bones of skull of hemisphere and shell of cerebrum in fetus. It is a defect incompatible with life. In to the spine takes place of fissure shells and matter of spinal cord go out in which.


^ 9. Defect of development of the bone system and umbilical cord. The defect of development of the bone system of overhead jaw shows up deformation, bulge, curvature of bones, joints. Cysts, knots, can appear on an umbilical cord.


12. The Arnolda-Kiari Syndrome. It is a defect behaves to the embryophaty central nervous system which is related to deformation of ventricles of cerebrum in combination with hydrocephaly (by the increase of cranium`s volume, atrophy of cerebrum`s tissue).

^ 14. Unreal knot of umbilical cord round a trunk. On an umbilical cord the bulge, thrusting out, is visible in the form of knot, which does not cause violation of blood`s circulation. When the defect of development of umbilical cord as the increase of its length takes place is it brings to encirclement her over round the trunk of fetus and can cause the displays of asphyxia.


^ 15. Defect of development of hand. In this case the phalanx of finger reposes on the fold of skin, as defect the increase of amount of fingers, their accretion is examined.


16. Plural innate defects of development, maceration of fetus.


17. Innate cancer of lungs. On lungs of fetus we see the knots of different sizes, grey color.


^ 18. Additional spleen. Next to a spleen there is the small separate knot of tissue of spleen.


19. Tymomegalia. The tymus gland megascopic occupies in a size Ѕ part of mediastinum.

21. Spongy kidney. Parenchyma of kidney with shallow cavities is the variety of multicyctosis infantile type.


23. Intraventricularis hemorrhage. In the ventricles of brain there is coagulant of blood. They can be as a result of birthtrauma.


24. Pylorostenosis. In the piloricus department of stomach of narrowing due to giperplasia of mucous and muscular layer.


^ 26. Innate fibroelastosis of the endocard. In a heart the bulge of interstinalis is marked endocard. Muddy, yellow-grey color.


27. Microgiria with innate hydrocephaly. In the cerebrum there is increase of amount of girus, they are diminished in a size. Lateral ventricles are extended. It is the display of intravenricularis hidrocephalia.


^ 28. Hipoplasia kidneys. A kidney is diminished in a size, structural components are not broken. If one-sided hypoplasia, the compensating increase of sizes of the second bud takes place.


29. Innate cancer of liver. In parenchyma the knot of tissue of motley kind is visible without clear contours with infiltrationitis growth.


^ 30. An innate cyst is lungs. In parenchyma lungs a cavity is covered by the thin layer of connecting tissue, is contained a transparent liquid.


31. Hydrocephaly, spinal-cerebral hernia, chondrodyslasia, hematolytic illness. For hydrocephaly the increase in the size of skull is characteristic. Atrophy of tissue of cerebrum develops thus. Spinal hernia shows up thrusting out of matter and shells of spinal cord. The display of hematolitic is the morbus- icteric colouring of skin.


^ 32. Agenesia bones of skull and overhead extremities. There is an absent overhead humeral belt in fetus, the bones of skull, lower extremities are deformed, well-kept structure of thigh, shins and feet of wrong structure.


Case 9

Diseases of urogenital system. Diseases of female and male


^ 1. Hydatid mole.

3, 3(а). Adenoma of prostate gland.

4, № 4(а). Pseudomucinose cyst of ovary.

5. Fibromioma of uterus with malignancy.

6. Uterus with uterine tubes and ovaries (age-related hypotrophia).

7, 13, 17. Serous cyst of ovary.

^ 8. Diffuse fibromatosis of myometrium.

9. Plural fibromyoma.

10. Papillar cystadenoma of the ovary.

11. Chocolate cyst of the ovary.

12. Cancer of endometrium.

14. Serous cyst of ovary with malignancy.

15. Fibrosarcoma.

16. Calcification of fibromatous nodule.

18. Fibromatous nodule.

^ 20. Necrosis of fibromatous nodule.

21, 25. Thecoma of the ovary.

22. Dermoid cyst of ovary.

23. Leiomyosarcoma of uterus with the secondary changes.

27. Cysts in the tumor of ovary.

28. Cancer of the ovary.

^ 29. Cancer of mammary gland.


1. Hydatid mole. There are mole formations formed with trophoblast. Pathology occurs during pregnancy after abortion, or births, it is characterized by the cystic degeneration of chorion fibers, dystrophic changes. Malignant variant of this type of trophoblastic sickness is choriocarcinoma.


^ 3, 3(а). Adenoma of prostate gland. The prostate is enlarged, with thick consistency and grumous surface. Adenoma belongs to benign epithelial non-specific tumors. Consequences: malignancy, development of a cancer, acute delay of urine.


4, № 4(а). Pseudomucinose cyst of ovary. It is a benign tumor of ovary, which has the form of a cavity, filled with mucus content. Consequences – malignancy can lead to the cancer.


^ 5. Fibromioma of uterus with malignancy. There is a nodule in the uterus with thick consistency, fibrous structure, grey color, without clear borders with the tissue of the uterus. There are signs of cellular atypical changes under the microscope.


6. Uterus with uterine tubes and ovaries (age-related hypotrophia). The uterus is small, the tubes are thinned, ovaries are small, thick, with fibrous structure.


7, 13, 17. Serous cyst of ovary. It is also called cystadenoma. It is a benign tumor which is represented as the cavity filled with the colorless fluid. The wall of cyst is smooth. The consequences are proliferation, formation of papillary structures, malignancy.


^ 8. Diffuse fibromatosis of myometrium. The wall of uterus is enlarged and thick, there are layers of fibrous tissue with grey color in a muscular layer. This pathological process has benign character.


9. Plural fibromyoma. There are plural nodules in uterus with grey color, fibrous structure, thick consistency. Fibromyoma belongs to the mesenchymal tumors formed with connective and muscular tissue.


^ 10. Papillar cystadenoma of the ovary. Benign tumor in the ovary is represented as the cavity, filled with fluid content. There are papillary excrescences of epithelium on the walls of cyst. These changes belong to the processes of proliferation which are close to malignant growth.


^ 11. Chocolate cyst of the ovary. Cavities, cysts are formed in the ovary as a result of the secretion of endometrium tissue, accumulation of blood.


12. Cancer of endometrium. There is mellow nodule with soft consistency in the cavity of uterus, without clear borders with the uterus tissue. Mostly it is adenocarcinoma of endometrium by histological structure.


^ 14. Serous cyst of ovary with malignancy. There is a cyst, filled with fluid in the ovary. There are papillary excrescences on the wall of it, hystologically they are cellular atypical changes.


15. Fibrosarcoma. This tumor belongs to mesenchymal tumors formed with connective tissue, without a capsule. Looks like «fish meat». It is characterized by atypical cell changes, infiltrated growth.


^ 16. Calcification of fibromatous nodule. There is a site with calcification in fibromatous nodule, which belongs to secondary changes.


18. Fibromatous nodule. It is a benign tumor, which is frequently can be met in the uterus. It has thick, fibrous structure, grey color, with well expressed atypical tissue changes.


^ 20. Necrosis of fibromatous nodule. There is a site of softening and degradation in the center of nodule. This process belongs to the secondary changes in tumors.


21, 25. Thecoma of the ovary. Benign tumor, which grows as a nodule with yellow color. It belongs to the benign tumors. It is characterized by tissue atypical changes.


^ 22. Dermoid cyst of ovary. There is a cavity in the ovary. Its contents can be: fatty tissue, hairs, teeth. In the process of its growth it can malignize and lead to a cancer.


23. Leiomyosarcoma of uterus with the secondary changes.

There is a tumor, which has a nodule shape, soft consistency without a capsule, without clear borders. The secondary changes are expressed as necrosis, hemorrhages.


^ 27. Cysts in the tumor of ovary. There is a cavity filled with colourless fluid in the tumor of the ovary.


28. Cancer of the ovary. Tumor in the ovary is represented by papilla formations. There are developments of atypical tissue changes (polymorphism and hyperchromical nucleus, pathological mitosis), which can be observed under the microscope.


^ 29. Cancer of mammary gland. There is a nodule with grey color, without clear borders, with infiltrative growth and thick consistency in mammary gland.


Case 10

Diseases of the cardio-vascular system


1. Recurrent-warty endocarditis.

2. The Lerish’s syndrome.

3. Stenosing atherosclerosis of coronal arteries of heart.

^ 4. Septic endocarditis.

6. Concentric hypertrophia of myocuardium (compensating, tonogenic).
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