Anatomic and physiologic features of the nervous system in children of a different age and their clinical value.
2) Method of clinical neurological examination of child:
а). history
б). general estimation of behavior of child
· ability to react on surroundings
· reaction of child on examination
· state of consciousness, mood
· attention, memory
· speech of child, its disorders
· motive skills, accordance of age
в) Inspection
· position in a bed
· co-ordination of motions and step
· inspection of head, face, trunk, extremities
· presence of tremor, forced positions of extremities
г) tests on co-ordination of motions
д) exposure of pathological reflexes
е) examination of function of cranial nerves, superficial and tendon reflexes
3) Semiotics of pathology of central and peripheral nervous system in children at
· serous and purulent meningitis
· encephalitis
· hydrocephaly
· cerebral palsy
4) Rules of conducting of lumbal punction in children of a different age, knowledge of normal indexes of liquor and their changes at pathology.
5) Features of care of sick children with the defeat of the nervous system.
Method of conducting of practical training:
After verification of presents and announcement of theme of training with pointing on its actuality a teacher conducts the writing entrance control of knowledge.
Analysis of the executed tests and consideration of errors.
In the ward of department a teacher demonstrates the method of clinical neurological examination of child. Laboratory information like a result of spinal punction is estimated.
A teacher distributes and assigns children for independent work.
5) Students design protocol of examination of patient with estimation of the state of the nervous system and substantiate pathological syndrome of defeat of the nervous system.
6) A teacher with the students carries out the round of patients, makes analysis and signs protocols.
7) A teacher works out the results of training, gives estimation of knowledge and abilities of students, assigns tasks for independent preparation to a next training.
Forms and methods of self-control:
Tests
1. Mass of cerebrum relatively to mass of body makes in new-born:
A. 2,5%
B. 5%
C. 10%*
D. 15%
E. 20%
2. The end of myelinization of cerebrum takes place:
A. in 1-2 years
B. in 2-3 years
C. in 3-5 years*
D. in 1 month
E. in 6 months
3. The feature of liquor in new-born:
A. Increasing level of protein, insignificant lymphocytosis*
B. Negative reaction by Pundy, presence of erythrocytes
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C. Ksantochromia, absence of protein
D. Decrease of amount of protein, increase of amount of sugar
E. Positive reaction by Pundy, neutrophylia
4. A spinal cord in new-born ending at the level:
A. L 1-2
B. L 2-3*
C. L 3-4
D. Т 11-12
E. Т 12-L 1
5. What from the transitive symptoms is not pathological for the children of early age?
A. Kerning’s symptom*
B. Brudzinsky’s upper symptom
C. Brudzinsky’s medium symptom
D. Brudzinsky’s lower symptom
E. Lesage’s symptom
Situation tasks
Task №1.
5 years old boy has complaints on headache frequent vomits without previous nausea fever, pain of eyeballs. Position of child is forced, on a side with the head and feet attracted to the stomach head is neglected backwards. What syndrome takes a place?
Answer: meningeal syndrome
Task № 2.
Mother of 6 months old child has history of urgent, with stimulation, delivery. Estimation of newborn Apgar’s scale was 6/7 points. At inspection of child the delay of psychomotor development takes place, the volume of head is increases on 2 cm. Information of sonography expose the signs of internal hydrocephaly. What syndrome takes a place?
Answer: hydrocephaly
Task № 3.
At the examination of new-born child a doctor paid attention to absence of motions in left upper extremity. Muscular tone and tendon reflexes are sharply reduced. About what syndrome is it possible to think in this case?
Answer: syndrome of peripheral paralysis
Hardware and material maintenance of training.
1) Tables: “ Age features of psychomotor development of child”, “Central and vegetative nervous system of child” „Age features of liquor in children”
2) Laboratory analyses of liquor.
3) Set of test tasks of initial control
Sources of information:
А) Basic:
3. Kapitan T. Propedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2006. – P. 112-156
B) Additional:
1. Мазурин А.В., Воронцов И.М. Пропедевтика детских болезней. Санкт-Петербург: ФОЛИАНТ, 2001.-С. 135-223,130-136.
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2. Пропедевтика детских болезней / под ред.А.А.Баранова. - М: Медицина, 1998. - С 158-182.
Program of self-preparation of students to the theme:
1. To learn basic and additional information sources.
2. To be able to conduct the examination of neurological status of children.
3. To be able to take a care of children with pathology of the nervous system.
Semantic module 5. Skin, hypodermic fat tissue and skeletal system in children
Concrete aims:
· To conduct objective examination of skin, hypodermic fat
· To collect anamnesis, conduct the objective examination of the skeletal system in children.
· To appoint the complex of additional methods of examination for finding out of the state of the skeletal system in children.
· To interpret got findings taking into account anatomic and physiologic features of child.
· To conduct syndrome diagnostics of children with pathology of skin and skeletal system.
Theme 2.Anatomical and physiological features, methods of examination, semiotics of skin, hypodermic fat tissue in children.
Theme 3.Anatomical and physiological features, methods of examination, semiotics of the skeletal system in children.
Theme of practical training: Methods of examination of skin and hypodermic fat in children. Semiotics of violations of skin and hypodermic fat. Methods of examination of skeletal system. Semiotics of violations of skeletal system.
Place:an educational room in the somatic department.
Professional orientation of students:
A skin is important organ which acts considerable part in life and health of child. It has close physiology communication with activity of separate organs and organism on the whole. The condition of skin is an original screen which represents the pathological changes in an organism. The careful examination and adequate estimation of the state of skin is matters in diagnostic of disease in children.
Pathology of organs of the skeletal system occupies one of leading positions in the structure of morbidity of children, especially of early age children. The skeletal system in children has the row of morphological and functional features, without taking into account which examination results and put clinical diagnosis cannot be correctly appraised.
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Base level of knowledge and abilities:
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