А. Questions for self - checking :

Damages of soft tissues and facial bones at pease time (by screw of helicopter).

                 

B. Tasks for self-checking: 1. A victim came to maxillofacial department with damage of soft tissues of face, that was happened more then day ago in time of working with chain saw. Objective: There is big wound faulty form in left buccal and parotid area, its borders are impregnated by blood, wound connected with oral cavity. What is diagnosis and kind of surgical aid? (Answer: lasereted wound in left buccal and parotid area, connecting with oral cavity, late primary surgical treatment).

2. The wounded was hospitalizated after 2 days after damage. General condition is normal, there is a wound in left infraorbital area 2х1, 5 cm, without inflammation. What the kind of seam is necessary in this case. (Answer: primary late seam).

C. Matherials for test control. Test tasks with one right answer (α = II): 1. Where shod be ligated the carotid artery? A. Lower that artery thyroid superior. B. Between artery thyroid superior and artery lingual. C. Between lingual and facial artery. D. Higher then facial artery. E. In bifurcation of carotid artery. (Correct answer: B).

2. Primary surgical treatment of wound is carrying out: A. Not after than 4-6 hours after trauma. B. Not after than 6-8 hours after trauma. C. Not after than 8-10 hours after trauma. D. Not after than 12 hours after trauma. E. Not after than 24 hours after trauma. (Correct answer: E).

3. Where is put in first seam on face at surgical treatment of wound: A. In parotid-masseteral area. B. In buccal area. C. In mental area. D. Near natural foramens of face. E. Near ear. (Correct answer: D).

D. Educational tasks of 3 th levels (atypical tasks): 1. Patient was getting to maxillofacial department with complains of a headache, dizziness, pain in the top jaw, bleeding from a nose. Objectively: insignificant hypostasis of soft tissues in an upper lip, is defined a "step" symptom in the field of lower marge of an eye-socket from both parties, and also pathological mobility of the top jaw together with nose bones. The lower jaw is fixed to maxilla by Ayvi’s ligature wire across. Define the preliminary diagnosis and a mistake in the previous actions of the stomatologist. (Answer: fracture of the maxilla on midle type Le Fort; intermaxillary fixing by a ligature wire is contraindicated.).

2. The patient was getting to hospital in an unconsciousness by ambulance car in a reception in an irresponsible condition from a place of transport incident. There is the bandage impregnated with blood in the head. Tongue sinks down, breath complicated, pulse of 50 beats per minute, is intense, joint stock company of 100/60 mm. The rigidnost of muscles of a nape, tone of extremities on the right side normal is noted, with left - is sharply lowered. The pupil of the right eye is expanded. Establish the preliminary diagnosis, define an office profile to which it is necessary to send the victim. (Answer: open craniocereberal trauma; neurosurgical department).

3. The patient was getting to reception in 3 hours after a gunshot wound is delivered during hunting. According to accompanying, the victim lost a lot of blood. The condition heavy, consciousness is absent. On the head a bandage impregnated with blood, multiple damages of soft tissues of a face. Breath frequent, superficial, pulse of nitevideny 40 blows in min., the blood pressure is 70/10 mm. pupils are expanded. Make the preliminary diagnosis, define an office profile to which it is necessary to send the victim. (Answer: combined craniocereberal gunshot wound, hemorrhagic shock; neurosurgical department.).

 

Theme 4. GENERAL CHARACTERISTIC, CLINIC, DIAGNOSTIC OF GUNSHOT WOUNDS AND DAMAGES OF SOFT TISSUES AND BONES OF FACE IN EXTRYM CONDITIONS: CLASSIFICATION, CLINIC, DIAGNOSTIC OF DAMAGES AT STAGES OF MEDICAL EVACUATION. PLASTIC SURGERY AT TREATMENT OF DAMAGES OF FACE. MODERN GUNSHOT WOUND, ITS TREATMENT.

1. Actuality of theme: Knowlegess of general characteristic, clinic, diagnostic and complications of gunshot damages of maxillofacial area and traumatic illness is necessary for stomatologist for rational organization of medical aid for victims at pease, war time and extrime conditions.

2. S PECIFIC GOALS: 1. To analyze clinical manifestations of traumatic damages of maxillofacial area at extreme condition. 2. To explain etiological and pathogenetical factors of emergence of traumatic damages of maxillofacial area at extreme condition. 3. To offer the plan of inspection of victims with a trauma maxillofacial area. 4. To classify traumatic damages of maxillofacial area at wartime. 5. To treat the principles of diagnostics and treatment of traumatic damages of maxillofacial area at extreme condition. 6. To draw the graphological scheme of lesson. 7. To analyze results of laboratory and instrumental investigations. 8. To make the scheme of treatment of patient with trauma of maxillofacial area.

3. BASIC KNOWLEDGE, ABILITIES, SKILLS, WHICH are NECESSARY FOR STUDY THEMES (intradisciplinary integration).