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Verification of training
Brief instructions to the students for practical classes
Appendix № 1
Indicative framework for action
Revision of kidney
Resection of kidney
To determine the source of knowledge, abilities to self-monitoring and self-correction propose to solve the following tests:
When performing nephrectomy on the Kidneys located in retroperitoneum, what are the major organs except the kidneys, usually located in this space?
A. The adrenals, ureters
B. Ureter, bladder
C. The adrenal glands, urinary bladder
D. Urinary bladder, urethra
E. Sigmoid colon, ureters
Test № 2
When performing nephrectomy on patient with tumours in kidney, surgeon tied the three elements of renal legs. What is the third element, except the renal artery and vein, which was tied in this situation?
D. Pancreatic duct
E. Common bile duct
Test № 3
When removing the adrenal gland surgeon bandaged upper adrenal artery. This vessel which was tied up is a branch of which artery?
A. Lower diaphragmatic
B. Upper diaphragmatic
D. Abdominal aorta
E. Surface epigastric
Test № 4
A doctor palpated a muscle lying along the vertebral column in the lumbar region. What kind of muscle did the doctor palpate in this situation?
A. latissimus dorsi
B. external oblique (abdominal)
C. internal oblique (abdominal)
Standards of responses to tests to determine the initial level: № 1 - A; № 2 -B; № 3 - A; № 4 - D.
Information necessary for the formation of background knowledge, skills, can be found in the following sources:
1. Prives M.G., Lysenkov N.K Human Anatomy .- M.: Medicine, 1985 .- p.
2. Sinelnikov RD Atlas of Human Anatomy .- M.: Gos. Vol. med. Lt-ture, 1963 .- T. 1 .- p. 108-124.
3. Sapin M.R. Human Anatomy .- M., 1993 .- p.
4. Tests on human anatomy .- Donetsk, 1999 .- p.
After mastering the necessary background knowledge, skills, you can go to
the study of the following materials:
LIST OF THEORETICAL ISSUES
1. Topographic anatomy of the lumbar region, and retroperitoneum.
2. Possible pathways of pathological processes in the lumbar region and the retroperitoneal space.
3. Extraperitoneal accesses to the kidneys (by Fedorov, Bergmann-Israel), the principles of operations on the organs of the retroperitoneal space.
4. Technology perirenal blockade.
With a graph of the logical structure to the topic can be found in the Appendix № 1.
3. Lecture on classes.
INDICATIVE FRAMEWORK FOR ACTION
Students are invited to help the algorithm of actions in the simulation of operations on the kidney (see Appendix № 2).
Set of tasks for achieving specific goals
Test № 1
As a result of injuries in the lateral section of lumbar area superficial soft tissue, thoracolumbar fascia and superficial muscles of the muscular layer were damaged. What superficial muscles can be damaged in this situation?
A. The latissimus dorsi and external oblique (abdominal)
B. Latissimus dorsi and internal oblique (abdominal)
C. External oblique and internal oblique (abdominal)
D. Erector spina and posterior inferior serratus
E. Trapezius and psoas
Test № 2
The patient revealed lumbar hernia on the left, just below the 12th rib. What defect in the lumbar muscles could be hernial ring in this case?
A. Petit’s triangle
B. Morgan’s groove
C. Larrey’s groove
D. Lesgaft-Grunfelt’s rhombus
E. Bochdalek’s groove
Test № 3
A left-sided nephrectomy was performed. What is the most efficient incision access usually used for this operation?
Test № 4
Patient with pancreatitis was administered perirenal blockade. In which tissue did the main part of the anesthetic enter when performing this manipulation?
Standards of responses to the target tests: № 1 - A, № 2 - D; № 3 - A, № 4 - B.
In early studies carried out monitoring and correction of the initial level of "knowledge-skills". Then students independently study the characteristics of topographic anatomy of the lumbar region and the retroperitoneal space on the human cadaver, plaster casts and posters. Students learn the features of layered structure, identify possible pathways for the spread of pathological processes, justify the execution of surgical interventions and manipulations. Using external benchmarks, students define the boundaries of the lumbar region and its "weak" points, hold the projections of access to the retroperitoneal space (Fedorov and Bergmann-Israel), model perirenal blockade. During independent work, students reinforce skills in the proper use of surgical instruments, separation and joining tissue. After discussing the results of independent work carried out test control and summarizing its results.
EARL OF LOGICAL STRUCTURE TO THE SUBJECT:
"Operative surgery and topographic anatomy of the lumbar region and
Lumbar region and the retroperitoneal space
Triangle of Petit
Surgical interventions and manipulations
Primary surgical treatment of wounds
Operations on the organs of the retroperitoneal space
to the kidney (according to Fedorov)
to the kidney and ureter (the Bergmann-Israel)
the kidney (dissection, resection, closure, fixation, disposal)
Appendix № 2
when performing nephrectomy (Fedorov access)
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