Form # Н – 3.04

 

STATE INSTITUTION OF HIGHER EDUCATION “I.Y.HORBACHEVSKY TERNOPIL STATE MEDICAL UNIVERSITY OF THE MINISTRY OF PUBLIC HEALTH OF UKRAINE

(full name of university)

 

Department of operative surgery and topographic anatomy

 

 

 “APPROVED“

First Vice Rector

Ihor R. Mysula, M.D., Ph.D

August 29, 2013

 

 

 

 

 

WORKING PROGRAM

on Operative surgery and topographic anatomy

(code and title of discipline)

 

 

Field of Training                                1201 Medicine

(code and title of field of training)

Specialty                                7.12010001 “General Medicine”

7.110104 – Pediatrics

7.110105 – Prophylactic medicine

 

(code and title of specialty)

 

Faculty                                               Medical

(institution, faculty, department)

 

 

 

 

Academic Year 2013-2014

 

WORKING PROGRAM

Operative surgery and topographic anatomy

                                                                                                                                        (name of discipline)

        

Field of Training     1201 Medicine,

Specialty                         7.12010001 “General Medicine”

7.110104 – Pediatrics

7.110105 – Prophylactic medicine

 

 

Developed by:

Michael S. Hnatyuk, MD, Prof., Department of Operative surgery and topographic anatomy

Oleh B. Slabyy, PhD, Assist. Prof., Department of Operative surgery and topographic anatomy

 ^{(authors, their positions, academic degrees and titles)}

 

Syllabus approved at the Department of Operative surgery and topographic anatomy

Minutes No 1 as of August 27, 2013

 

 

Head of the Department of Operative

Surgery and Topographic anatomy

 

 _______________________ (Michael S. Hnatyuk).

(signature)                                  (name)

 

 

Ó __________, 2013

Ó __________, 2014

 

 

 

 

1. Description of the Discipline

 

 

2.     Purpose and objectives of the discipline

Purpose: Operative surgery and topographic anatomy is the discipline at the meeting point of theoretical and clinical branches of medical science.It aims to equip students the knowledge necessary to work in the clinic.

Study of operative surgery and topographic anatomy includes two interrelated chapters. General operative surgery is taught in lectures courses in terms of anatomical and physiological substantiation of surgical interventions, based on structural and systemic principle, based on latest achievements in theoretical and clinical medicine.

Special operative surgery and topographic anatomy – subject of practical training, which is held in such seminars. In studying topographic anatomy should pay special attention to issues of individual and age variation in the structure of human organs and system (corpses), firmly grasp their applied aspects in diagnosis, as well as developing an individual plan of treatment. Separately stand out for the issue of emergency care in extreme situations.

Tasks of discipline:

1.      To study topographic anatomy of the human body throught the dissection of the corpse in parts and surgical anatomy of organs.

2.      To know the techniques of the most common typical surgeries that are performed in this part of body or in case of diseases of the studied organs (corpses).

3.      To learn how to properly use general and special surgical instruments, modern surgical devices and equipment operation dressing unit (corpses).  

4.      Consolidate practical skills asepsis and antisepsis; perform emergency medical and diagnostic manipulations (corpses).

To successfully solve the problems and improve the educational process provides:

1.      The optimal support the learning process, surgical instruments, experimental animals, visuals, medicine and bandages

2.      Widespread use during the learning process a variety of visual aids (corpses, tables, models, slides, themed short educational films, displays, simulators, etc.).

3.     Rational organization self-study of students and monitor of its effectiveness, independent work of students in the course of employment.  

4.      The widespread introduction in the learning process of experimental operations on the corpses and experimental animals performed by students under the guidance of a teacher in strict compliance with aseptic and antiseptic, adequate anaesthesia using modern instruments, surgical equipment and operating equipment.

 

Having studied the discipline, the student must

know:

– topographical anatomy of different parts of the human body;

– techniques of the most common typical surgeries;

– general and special surgical instruments, modern surgical devices and equipment operation dressing unit;

be able to:

– properly use general and special surgical instruments, modern surgical devices and equipment operation dressing unit;

– techniques of the most common typical surgeries;

– apply their knowledge of economic theory in everyday life and professional practice, make the right economic choices.

 

 

Program contents

 Module 1. Topographical anatomy and operative surgery of regions of the head, neck, walls and cavities of thorax and abdomen.

Substantial module1:  

1. Introduction in topographical anatomy and operative surgery

2. Topographical anatomy and operative surgery of the head

3. Topographical anatomy of the neck region

4. Topographical anatomy and operative surgery of regions and organs of thoracic cavity

5. Topographical anatomy and operative surgery of anterior abdominal wall, inguinal hernias

6. Topographical anatomy and operative surgery of regions and organs of abdominal cavity

 Lesson 1.

Theme 1. Introduction in surgical instruments, suturing and bandaging materials. Treatment and isolation of the operating zone. Technique of local infiltration anesthesia by Vushnevsky. Cutting and suturing soft tissues.

Theme 2. Narcosis. Primary surgical treatment of wound. Removing of foreign bodies. Arrest of bleeding in the wound. Suturing of soft tissues (operation on animals).

Theme 3. Topographical anatomy of fronto-parieto-occipital region. Surgical anatomy of the basis of the skull, meninges and venous sinuses. Liquor ways, circulation of the liquor. Blood supply of the cerebrum. Primary surgical treatment of penetrating and nonpenetrating wounds of the skull.

Theme 4 . Topographical anatomy of the temporal region. A scheme of cranio-cerebral topography. Osteoplastic and decompressive trepanations of the skull ( indication, technique) Topographical anatomy of the mastoid region Anatomical substantiation and technique of antrotomy.

 

 

Lesson 2.

Theme 1. Topographical anatomy of the lateral face region. Surgical anatomy of parotid gland. Surgical anatomy of parapharyngeal cellular space and facial nerve’s. branches .Incisions in cases of purulent parotitis.

Theme 2. Topographical anatomy of deep face region. Anatomical substantiation and technique of block anesthesia branches of trigeminal nerve operations in case of chronic frontitis and chronic maxillitis.

Theme 3  Topographical anatomy and operative surgery of cerebral and facial parts of head.

 

Lesson 3.

Theme 1. Topographical anatomy of neck organs: borders, neck fasciae, cellular spaces, division in triangles. Topographical anatomy of submandibular and carotid triangles of the neck. Surgical anatomy of submandibular salivary gland.

Theme 2. Topographical anatomy sternocleidomastoid region and lateral triangle of the neck. Anatomical and physiological substantiations of vago-sympathetic blockade by Vushnevsky

Theme 3  Surgical anatomy organs of the neck. Operative interventions on vessels and organs of the neck

Theme 4. Tracheostomy. Ligation of the neck’s vessels.  Vago-sympathetic blockade after Burdenko (operation on animals ).

 

Lesson 4.

Theme 1 Topographical anatomy of subclavian region Surgical anatomy of mammary gland. Operative interventions in cases of suppurative mastitis, malignant and non-malignant tumours of the mammary gland.  Substantiations and technique of ligation of the subclavian artery and punction of the subclavian vein.

Theme 2 Topographical anatomy of thoracic wall. Surgical anatomy of the pleura and pleural sinuses.  Punction of the pleural cavity, resection of the rib, thoracotomy, methods of the wounds stitches in case of opened pneumothorax. Denudation and ligation of the internal thoracic artery

Theme 3 Surgical anatomy of the lungs. Anatomical and physiological substantiations of the pulmonectomy and resection of lung. Topographical anatomy of the anterior mediastinum.  .

Theme 4 Surgical anatomy of the heart and organs of the posterior mediastinum. Anatomical and physiological substantiations operative intervention of the heart and organs of the posterior mediastinum.

Theme 5 Resection of the rib. Intubation (operation on animals).

 

Lesson 5.

Theme 1  Topographical anatomy of anterior abdominal wall. Layer structure of anterior abdominal wall, blood supply, innervation, lymphatic outflow. Anatomical and physiological substantiations of accesses to the abdominal cavity organs. Surgical anatomy of anterior abdominal wall and incisions.

Theme 2 Topographical anatomy of inguinal canal. Surgical anatomy of inguinal canal and it contents.

Theme 3 Surgical anatomy of direct and indirect inguinal hernias. Operative treatment of umbilical, inguinal herniae and hernia of alba line of the abdominal wall.  Methods of operative treatment of inguinal hernias and hernia of alba line of the abdominal wall.  

Lesson 6.

Theme 1 Topographical anatomy of abdominal cavity. Surgical anatomy of the peritoneum.

Theme 2 Laparotomy, its pecualirities in children. Systematic inspection of abdominal cavity organs. Suturing of abdominal hollow organs wounds.

Theme 3 Surgical anatomy of superior floor organs of abdominal cavity (stomach, liver and bile passage, spleen).

Theme 4 Surgical anatomy of the small intestine. Types of intestinal sutures. Intestinal resection with side-to-side, end-to-end anastomoses. Suturing of intestine wounds.

Theme 5 Surgical anatomy of the large intestine and appendix. Operative accesses to appendix. Appendectomy. Forming fecal fistula and unnatural anal opening.

 

Module 2. Topographical anatomy and operative surgery of regions and organs of lumbar region, pelvis, extremities.

 

Lesson 7.

Theme 1 Surgical anatomy of the vertebral column. Lumbar region. Operations on vertebral column.   

Theme 2 Surgical anatomy of retro parietal cellular spaces of pelvis. Operations on kidneys and ureters

Theme 3  Topographical anatomy of small pelvis. Topographical anatomy of urinary bladder and prostatic gland

Theme 4  Surgical anatomy of rectum, uterus  and appendages. Perineum.

 

Lesson 8.

Theme 1 Topographical anatomy of gluteal region. Fascias and cellular spaces. Surgical anatomy of vascular-nerves bundles of gluteal region. Surgical anatomy of hip joint, punctures of the hip joint. Topographical  anatomy of the back aspects of the thigh. Denudation of schiatic nerve.      

Theme 2 Topographical  anatomy of the front aspects of the thigh. Femoral canal and structure. Surgical anatomy of  femoral hernia  and methods of operative  Bassini’s and Rudzhi Parlavechcho’s repair.

Theme 3  Topographical  anatomy of the knee joint. Popliteal fossa. Surgical anatomy of knee joint. Punctures, artrotomy and resection of the knee joint. 

Theme 4  Topographical  anatomy of the leg, ankle joint and foot.

 

Lesson 9.

Theme 1 Topographical anatomy of scapular and deltoid regions. Surgical anatomy of cellular spaces of the scapular region. Access to section phlegmon of the scapular region. Surgical anatomy of the shoulder joint.  Punctures, arthrotomy and resection of the shoulder joint by Langenberck and Chaklini.

Theme 2 Topographical anatomy of axillary region and shoulder: boarders, layer-by-layer structure, surgical anatomy vascular nerves bundles and cellular spaces. Anatomical ways of distribution purulent exudates and hematomas within studied areas, incisions for drainage

Theme 3 Topographical anatomy of elbow and forearm. Surgical anatomy of vascular nerves bundles and cellular spaces. Surgical anatomy of elbow. Methods of puncture, arthrotomy and resection of the elbow joint. Osteosynthesis in fractures of the forearm bones

Theme 4  Topographical anatomy of radio-ulnar joint and palm surface of the hand. Surgical anatomy of cellular spaces and synovial sheaths of the hand.

Lesson 10.

Theme 1 Denudation of vessels and nerves (median and radial) of upper limb. Collateral ways of blood supply after ligation of axillar, brachial, radial and ulnar arteries. Venesection: indications, technique. Suture of tendon (methods Cuny, Lange,Kazakov). Suture of nerves. 

Theme 2 Operations on animals. Denudation and ligation of blood vessels. Suture of blood vessels.

Theme 3 Amputations and disarticulations on superior and inferior extremities. Osteo-plastic amputation by Pyrogov, Hinteru, Gritti-Schimanowski. Calculating a length of creating flap, treatment of vessels and nerves during amputation. Chopart amputation of foot

Theme 4  Operations in case of tendovaginitis and phlegmons of a hand. Operations in case of panaritiums. Amputations and disarticulations of phalanges and fingers. 

 

4. Structure of academic discipline

 

 

 

5. Themes of Lectures

№	Lecture theme	Amount of hours
Module 1. Topographical anatomy and operative surgery of regions of the head, neck, walls and cavities of thorax and abdomen.
1	Introduction in topographic anatomy and operative surgery.  Operative surgery of cerebral and facial regions of the head	2
2	Operative surgery of neck region and organs	2
3	Operative surgery of thorax	2
4	Operative surgery of organs of mediastium and heart  .	2
5	Operative surgery of ventral abdominal wall	2
Module 2. Topographical anatomy and operative surgery of regions and organs of lumbar region, pelvis, extremities.
6	Operative surgery of organs of abdominal compartment	2
7	Operative surgery of liver and stomach	2
8	Operative surgery of lumbar and pelvic regions	2
9	Operative surgery of vessels	2
10	Amputations and disarticulations	2
Total		20

 

 

6. Themes of Seminar Classes

 

 

 

8. Themes of Labs – not applicable

 9. Self-Study

 

 

10. Individual work– not applicable

11. Teaching Methods

According to sources of knowledge, the following teaching methods are used: word – narration, explanation, lecture, briefing, visual – demonstration, illustration, practical – practical work tasks.

According to the nature of the logic of knowledge, the following methods are used: analytical, synthetic, analytical-synthetic, inductive, deductive.

In terms of individual mental activity, the following methods are used: problematic, exploration, research.

 

12. Methods of Evaluation

Forms of Testing and Evaluation

In evaluation of students’ knowledge, standardized methods of evaluation are primarily used: test (oral, written, computer-based), structured written work, structured monitoring of practical skills.

Subject grade is defined as the module grade according to the course structure.

Assessment for the module is the sum of daily grades and evaluation of the final module test and based on 200-point system.

Forms of evaluation

Daily evaluation is performed each class for specific topics. At all classes, objective evaluation of theoretical knowledge and practical skills is done.

Forms of daily evaluation:

Theoretical knowledge – tests, computer-based tests, individual surveys, interviews, written work.

Practical skills – independent individual tasks and the ability to draw conclusions on their own ability to perform certain transactions, writing schemes and algorithms. Final test is based on theoretical knowledge, practical skills and abilities.

Final test of the module takes place at the end of study of the relevant content modules in the form of a test and is considered passed if the student scored at least 50 points.

Forms of final test:

Theoretical knowledge – a system of questions for written and computer-based testing.

Practical skills and ability – evaluation of the nature of economic processes and phenomena of the economic system and structural components of the economic mechanism and the market as a form of social production.

 

13. Distribution of points received by students

Maximum number of points assigned to students in mastering the module (test credits) – 200, including daily scores – 120 points, results of final module test – 80 points.

Evaluation of daily training:

At each stage of a practical class (practical, seminar, written test) students are assigned rating in the 12-point scale. Then arithmetic mean of the three evaluations is derived and noted in the register.

For each phase of the practical part of a class, students get points as follows:

1. At the beginning of the practical part, students must qualify for practical work (they must know the process of practical work, etc.). For this stage students can get a maximum of 2 points.

2. Practical work is monitored by the teacher and assessed at the end. Students can get a maximum of 4 points for this type of work.

3. Defense of practical work. At this stage, students can receive a maximum of 6 points.

At the end of practical part, the teacher calculated the mean of the scores for each part of the class and notes it down for each student. 

The minimum grade point average that qualifies a student to take final module test – 4 points.

The maximum points that can be earned by a student during module is 120 points.

 

Final module test:

Final module test is taken at the end of a module. Students who have completed all work stipulated by the curriculum and whose score for the module reached the minimum, qualify for the final test.

The final evaluation should be standardized and include testing in theoretical and practical training. Specific forms of evaluation for the Introduction to Economics are stated in the syllabus.

The maximum of final test points is 80.

The final module test is passed if a student scores at least 50 points.

Grades for the subject:

Grades for the Introduction to Economics are received only by students who have completed all modules in the discipline.

The number of points that a student earns for the discipline is defined as the average of points for the modules of the discipline and for the final test of Module 1.

Objectivity of assessment of students must be checked by statistical methods (correlation between the current progress and results of the final module test).

Conversion of points for Introduction to Economics into grades according to the ECTS scale and 4-point scale (traditional)

Number of points that a student gets for a discipline is converted into the ECTS scale as follows:

Percentage of students is determined out of students of the same year of study within the same specialty.

Number of points for a discipline earned by a student is converted into 4-point scale as follows:

 

FX and F (“2”) score for a discipline is assigned to a student who has not passed at least one module of the discipline.

FX (“2”) score is assigned to students who earned the minimum number of points for daily academics, but have not passed the final module test. They have the right to repeat the final module test up to 2 times during winter break or in two (additional) weeks after the end of the spring semester schedule approved by the Rector.

Students who received an F score after completing the course (have not completed the program of at least one module or have not earned the minimum number of points in the current module) must undergo re-training according to the individual curriculum.

 

Grading scale: national and ECTS

 

 

14. Methodological Support

1.  Materials for the seminar classes

2.  Materials preparation for lectures

3. Presentations of lectures.

4. Methodical instructions for practical classses.

5. Variants for individual tasks and individual work of students.

6. Tests for the final evaluation.

7. Tests for daily evaluation.

6.   Variants of theoretical questions for self-study.

 

 15. Suggested Reading

 

1.. Tshykalo O.V. Toograhical anatomy and operative surgery: textbook for english-speaking foreing students. – Vinnutsia: Nova Knuha Publishers, 2011- 528p.

2. Philip Thorek. Atlas of Surgical Techniques. – J.B. Lippincott Company, Philadelphia. Toronto, 1992. – 196p.

3. Moore, KL: Clinically Oriented Anatomy. – 3/e. Baltimore, Williams and Wilkins, 1992. – 325p.

4. Moore, KL:  The developing Human: Clinically Oriented Embryology. – 4/e, Philadelphia, Saunders, 1998. – 278p.

5.R. Brooke Jeffrey, Jr. Philip W. Ralls. Sonography of the Abdomen. Raven Press. – New York, 1995. – 341p.

6.April EW: Anatomy. – 2/e. New York, John Wiley and sons, 1990, 342p.

7. Philip Thorek. Anatomy in surgery, Second Edition – J.B. Lippincott Company, 1987. – 860 p.

8.Branislav Vidic. Manual of Dissection, – The c.v. Mosby Company, St. Louis Toronto Princeton, 1994. – 364

9. Emergency Medicine, Second edition, Editor in Chief Harold L. May, M.D., Little. – Brown and Company, Boston/ Toronto/ London, 1992. – 294p.

10. Brayan d. Cowan and David B. Seifer, Clinical Reproductive Medicine. – Lippincott- Raven, 1997. – 311p.