For training clinical skills at educational and clinical (training) center




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Ф КГМУ 4/10 – 15/01

ПП КГМУ 4/01


Karaganda State Medical University

Educational and clinical (training) center


Methodological recommendations

for training clinical skills at educational and clinical (training) center

(Using the algorithm execution)


Specialty: 051301 «General medicine»

Discipline: Pathological Physiology-2

Year: III

Department: Pathological Physiology

Composer: Zhautikova S.B., Abikenova F.S.


Karaganda 2010


Рассмотрено на заседании

кафедры патологической физиологии

протокол №2 « 02» 09 2010 г.

Заведующий кафедрой д.м.н., доцент ______________________ С.Б. Жаутикова


Обсуждено профильной методической комиссией

общемедицинских дисциплин


протокол № 2 от «02» 09 20 10г.

Председатель, д.м.н., профессор ________________________ Ф.А. Миндубаева


The list of clinical skills of Pathophysiology 2



skills

year

«General medicine»

1

Measurement of spirographic indicators for respiratory failure and alveolar hypo and hyperventilation


+

2

Determination of ECG parameters in acute and chronic disease in children

+


Name of clinical skill

Measurement of spirographic indicators for respiratory failure and alveolar hypo and hyperventilation

Purpose of study: To teach students to identify indicators for spirographical Interpretation of respiratory disorders

The pre-briefing and demonstration of the skill - 10 minutes

The time required for self-development of skill per student - 10 minutes

Necessary theoretical knowledge for the development of clinical skills:

1. Anatomy and physiology of the respiratory system.

2. Static and dynamic parameters of pulmonary ventilation.

3. Changes in pulmonary ventilation in respiratory failure.

4. Respiratory failure and its species.

5. The main methods of determining the parameters of pulmonary insufficiency.

List of mannequins, visual aids, interactive computer programs necessary for the development of clinical skills

1. Spirograph number 166 365 "Spiro C-100"

The list of medical products and equipment

1. Spirograph - 1 (per group)

2. Gauze - 15 (in group)

3. Medical Tray - 1 (per group)

4. Spirit Medical - 1 (the group)

5. Mudshtuk - 1 (per group)

6. Clip on the nose - 1 (per group)

7. Paper records - 1 (per group)

Description of algorithm execution

1. Connect to the network spirograph

2. Sit in front of spirograph

3. Enter information about the patient: sex, age, height.

4. Choose the type of test carried out buttons "VC", "FVC" or "MVL". The screen will be allocated for the construction of the coordinate system or loop spirogram obbem - the flow during the test.

5. Read the rules of the samples.

6. Tightly cover mistook lips, nose clamp.

7. Press the "START" to get started.

8. Check the correctness of breath, or spirogram loop volume - flow

9. If the sample is made with no obvious errors, press "ENTER", the results will be filled in the table.

10. If the results of the tests are unsatisfactory - for any errors, you should press the "START" and repeat the test.

11. Results of samples printed by clicking the "Print" button.


Materials for self-employment on the topic

1. To static parameters of pulmonary ventilation include:

A. FVLC

B. The index Tiffno

C. MVL

D. pO2

E .VLC

2. To dynamic parameters of pulmonary ventilation include:

A. VC

B. total lung volume

C. With a total capacity of the lungs

D. reserve volume inspiratory

E. forced vital capacity of lungs

3. Obstructive respiratory failure is characterized by

A.A decrease in the lumen of the airway

B. In the reduction of the respiratory muscles

C. With Decreased residual lung volume

D. A development of hyperoxia

E Displacement dissociation curve to the left

4. Restrictive respiratory failure accompanied by

A. And an increase in respiratory

B. Increase in police department

C. With the decline in FEV

D.A increase in the index Tiffno

E. thickening of the walls of the upper respiratory tract

5. The increase in the index Tiffno characteristic

A.A spasm of the bronchial muscles

B. In the compression of the upper respiratory tract

C. Since laryngospasm

D. lung resection

E. thickening of the walls of the upper respiratory tract

6. Oxyhemoglobin dissociation curve shifts to the right when

A. spasm of the bronchial muscles

B. In the compression of the upper respiratory tract

C. Since laryngospasm

D. atelectasis

E. thickening of the walls of the upper respiratory tract

7. VLC for a long time remained normal during

A. A bronchial asthma

B. In atelectasis

C. Tuberculosis

D. pneumosclerosis

E. pneumonia

8. Reducing index Tiffno characteristic

A. disease of the pleura

B. In violation of the innervation of respiratory muscles

C. In violation of the mobility of the chest

D. pneumonia

E laryngospasm

9. Respiratory failure is characterized by:

A. hyperoxia, hypocapnia, alkalosis gas

B. hypercapnia, gas alkalosis

C. metabolic acidosis

D. hypocapnia

E. hypoxemia, hypercapnia

10. Hypoventilation develops in:

A. reducing the amount of dead space

B. decrease in tidal volume

C. increase in tidal volume

D. constant volume of dead space

E. reduction of the residual lung capacity

  1. Criteria for assessing performance of the skill

1. Spirograph connected to the network

2. He sat down opposite the spirograph

3. Introduced information about the patient: sex, age, height.

4. Chose the type of tests carried out buttons "VC", "FVC" or "MVL". The screen will be allocated for the construction of the coordinate system or loop spirogram obbem - the flow during the test.

5. Acquainted with the rules of the samples.

6. Densely covered mistook lips, nose clamped.

7. Pressed the "START" to get started.

8. Verify the correctness of respiratory volume loop spirogram or the - the flow of

9. Pressed the "ENTER", the results of samples recorded in the table.

10. Pressed the "START" and repeated the test, if the results of the tests are unsatisfactory - for errors.

11. Results of samples printed by clicking the "Print" button.


Name of clinical skill

Determination of ECG parameters in acute and chronic heart failure in children

Purpose of study: To teach students to identify ECG Interpretation for the acute and chronic heart failure in children

The pre-briefing and demonstration of the skill - 10 minutes

The time required for self-development of skill per student - 10 minutes

Necessary theoretical knowledge for the development of clinical skills:

1. Anatomy and physiology of the cardio - vascular system

2. Methods for the determination of cardio - vascular system

3. Key indicators of cardiac activity, determined with help of an electrocardiograph, and their characteristics.

4. The etiology and pathogenesis of cardiac arrhythmias.

List of mannequins, visual aids, interactive computer programs necessary for the development of clinical skills

1. 8-channel ECG «Cardipia» 200 Series Model 201 N / 203N

The list of medical products and equipment

1. ECG - 1 (per group)

2. Gauze - 15 (in group)

3. Medical Tray - 1 (per group)

4. Spirit Medical - 1 (the group)

5. Mudshtuk - 1 (per group)

6. Clip on the nose - 1 (per group)

7. Paper records - 1 (per group)

8. Couch - 1 (per group)

9. Distilled water - 1 (for a group)

Description of algorithm execution

1.Connect electrocardiograph to the power supply

2. Lie on the couch

3. Treat your skin to the attachment sites of the electrodes with water

4. Attach electrodes to the upper and lower extremities

5. Attach the electrons in the field of abstraction (V1 - V6)

V1 - in the 4th intercostal space at the right edge of the sternum

V2 - in the 4th intercostal space at the left sternal border

V3 - midway between V2 and V4

V4 - in the fifth intercostal space in the mid - clavicular line

V5 - at the intersection of the horizontal level of the fifth intercostal space and anterior axillary line

V6 - at the intersection of the horizontal level of the fifth intercostal space and the middle axillary line

6. Registration rates

7. The results of performance printing by clicking on "Print"

Materials for self-employment on

1. The most common rhythm disturbance in children

A. Sinus bradycardia

B. Sinus tachycardia

C. Beats

D. Atrial fibrillation

E. Atrioventricular block


2. Sinus tachycardia is characterized by a decrease in the duration between the teeth

A. T-P

B. P-Q

C. QRS

D. S-T

E. Q-S

3. If you cry, and during sleep in infants occurs more often

A. Sinus block

B. Sinus tachycardia

C. Sinus bradycardia

D. coupled rhythm

E. Paroxysmal tachycardia

4. Complete blockade most likely to occur

A. In rheumatism of the heart

B. Exudative pericarditis

C. Pseudomembrane pericarditis

D. Myocardial infarction

E. Angina

5. Ventricular arrhythmias are characterized by

A. T wave

B. P wave

C. QRS complex

D. PQ

E. ST

6. Paroxysmal tachycardia is characterized by prolongation of the interval

A. S-T

B. P-Q

C. T-P

D. Q-S

E. PQRS


7. Embryocardia newborn is-

A. Equal interval 2.1 tones

B. Equal interval 3.2 tones

C. Equal interval 3.1 tones

D. The weakening of a tone

E. The weakening of two tones


Eight. Sinus arrhythmia is characterized not by the same interval

A. S-T

B. P-Q

C. R-R

D. T-P

E. QRS


9. Unlike ventricular extrasystoles from supraventricular

A. deformation of the QRS

B. Negative R tooth

C. positive R spike

D. shortening of the S-T

E. increase in the amplitude of QRS


10. Specify the types of arrhythmias which are characterized by: P wave instead of multiple waves in V1, V2, 1, 2, and a VF:

A. Supraventricular tachycardia

B. Sinus bradycardia

C. Sinus tachycardia

D. Atrial fibrillation

E. Paroxysmal tachycardia


Criteria for assessing performance of the skill

1. Connect electrocardiograph to the power supply

2. He lay down on the couch

3. Prepare the skin at the attachment sites of the electrodes with water

4. Put the electrodes on the upper and lower extremities

5. Put the electrodes on the ground of abstraction (V1 - V6)

V1 - in the 4th intercostal space at the right edge of the sternum

V2 - in the 4th intercostal space at the left sternal border

V3 - midway between V2 and V4

V4 - in the fifth intercostal space in the mid - clavicular line

V5 - at the intersection of the horizontal level of the fifth intercostal space and anterior axillary line

V6 - at the intersection of the horizontal level of the fifth intercostal space and the middle axillary line

6. registered figures

7. The results of performance opened by clicking on "Print"


Literatue (Basic and additional)

Basic:

    1. Патофизиология //Под ред. Новицкого В.В., Гольдберга Е.Д. – Томск: Изд-во Том. ун-та, 2006

    2. Ефремов А.В., Самсонова Е.Н., Начаров Ю.В. Патофизиология. Основные понятия: учебное пособие.– М., 2008.– 160 с.

    3. Литвицкий П.Ф. Патофизиология: учебник + СД. – 4-е изд. – М., 2008. – 469 с.

    4. Патофизиология: учебник в 2-х т./под ред. В.В.Новицкого, Е.Д.Гольдберга, О.И.Уразовой. – 4-е изд. перераб. и доп. – М., 2009.

    5. Н±рм±хамбетов Є.Н.Патофизиология//Алматы, 2000.-567.

    6. Нұрмұхамбетұлы, Әдiлман. Патофизиология: Оқулық/ҚазММа //Алматы.- 2007.- 648 .

    7. Н±рм±хамбетов Є.Н., Дєленов Е. Патологиялық физиология// Алматы.- 1995. –Б. 7-80; 235-247.

Additional

    1. Адо А.Д., Адо М.А., Пыцкий В.Н., Порядин Г.В., Владимирова Ю.А.

    2. Патологическая физиология. // М.: Триада-Х. - 2000. - 97.

    3. Нурмухамедов А.Н. Патофизиология в схемах и таблицах // Алматы.- 2003 – 110.

    4. Фролова В.А., Дроздовой Г.А., Билибина Д.П. Патофизиология в схемах и таблицах //Москва. - 2004 – 403.

    5. Шанин В.Ю. Патофизиология//С-Петербург. «Элби-СПб», 2005.- 639.

    6. Шанин В.Ю. Практикум патологическая физиология//«Питер», С–Петербург, 2002.- 724.

    7. Зайчик А.Ш., Чурилов Л.П., Утехин В.И., Ирошников Г.П., Фокин А.С., Беляева А.В. Введение в экспериментальную патологию.С-Петербург, 2003.- 380.

    8. Рубцовенко А.В. Патологическая физиология.Москва. Медпрес-информ, 2006.- 608.

    9. Зайчик А.Ш., Чурилов А.П. Механизмы развития болезней и синдромов// «Элби-СПб» - 2005.- 507.

    10. Литвицкий П.Ф. Патофизиология. Учебник для вузов// «ГЭОТАР-МЕД».- 2003.-Т.1, 2.- 807.

    11. Н±рм±хамбетов Є.Н., Ахмет-тµре М. Патофизиологиядағы медициналық атаулардың сµздігі// Алматы. - 1998.- 80.

    12. Н±рм±хамбетов Є.Н., Есенқ±лов Є., Єбисатов Қ., Ахмет-тµре М. Медициналық атаулардың орысша-қазақша шағын сµздігі. Алматы. – 1998 -128.

    13. Жаутикова С.Б. «Патологиялық физиологияның жалпы курсы» Оқу құралы. Қарағанды, 2000.-105.


Электронная библиотека учебно-клинического (тренировочного) центра:


1. 616.11/13 Fundamentals of Lung and Heart Sounds with CD-ROM, 3rd edition F 97

2. 618.971 Pediatric Cardiac Auscultation CD-ROM, Software A 44

3. 616. 012 S 60 Color Atlas of Pathophysiology 2000

4. 611(084) N 47 Atlas of Human Anatomy Frank H., Netter M. Книга и диск, набор изображений

5. 611. A53 Anatomedia Thorax CD-ROM, СD диск, набор изображений

6. 616.012 A 90 Atlas of Pathophysiology Image Collection, Software

1. 616.11/13 Fundamentals of Lung and Heart Sounds with CD-ROM, 3rd edition F 97

2. 616.12 The Virtual Cardiac Patient, Software V 74

3. 616.11/13 Cardiovascular Therapeutics , 3rd edition A Companion to Braunwald'sHeart D 62 Disease, Text with CD-ROM

4. 616.12 Beyond Heart Sounds, Software B 55

5. 618.971 Pediatric Cardiac Auscultation CD-ROM, Software A 44

6. 616.12 Physiological Origins of Heart Sounds and Murmurs (Revised), Software P 59

7. 616. Textbook of Family Medicine, 7th edition Text with CD-ROM (Учебник по семейной R 11 медицине, 7 – е издание. Учебник с CD-ROM)

8. 611. 12 Exploring the Heart: A 3D Overview of Anatomy and Pathology , Software (Исследование сердца: обзор по анатомии и патологии, Software) E 97

9. 616. 012 S 60 Color Atlas of Pathophysiology 2000

10. 616.012 A 90 Atlas of Pathophysiology Image Collection, Software

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