Forms and methods of self-control.
Test tasks
1. in what age the intensive increasing and differentiation of myocardium is marked?
A. to 1 year
B. in the first 2 years of life*
C. in 5 years
D. 6-10 years
E. in the first 6 months
2. When does arterial channel anatomically close?
A. for 6 months
B. for 1 year
C. for 3 years
D. for 2 months*
E. for 6 years
3. What frequency of pulse in healthy new-born child?
A. 120 /min.
B. 80 /min.
C. 100 /min.
D. 140 /min.*
E. 60 /min.
4. Point of auscultation of mitral valve of heart:
A. at the lower edge of breastbone
B. in 2nd intercostals left side
C. in a 2nd intercostals right side
D. at the apex of heart*
E. in a 4th intercostals left side
5. What auscultative changes does characterize the opened arterial channel?
A. rough systolic murmur in 3-4 intercostals on the left
B. systolodyastolic murmur of "machine" in 2 intercostals on the left*
C. rough dyastolic murmur in 2 intercostals on the left
D. systolic murmur in a 2 intercostals on the right
E. systolic murmur in 2 intercostals on the left
Etalons of answers
1. B
2. D
3. D
4. D
5. B
Situation tasks:
Task №1.
13 years old boy has complaints on frequent headache, nasal bleedings. At the objective examination a doctor has defined arterial pressure – 130/85 mm Hg. What index of blood pressure in norm?
Task №2.
At palpation of pulse in 5 years old child a doctor defined following its descriptions: synchronous, frequency – 108 for a minute, satisfactory filling and tension, on inhalation a pulse is accelerated, on exhalation – is slowed. How to consider the changes of pulse at a child?
.
Task №3.
To the cardiologic department 8 years boy with complaints about the fatigue ability, weakness was admitted with the purpose of examination. At inspection: skin is pale, pulse of the weak filling, 72 for a minute, АP – 80/60 mm Hg. At palpation of region of heart a doctor paid attention on cat’s purring above one and second intercostals on the right of breastbone, which coincides with an apex beat. What pathological symptoms were exposed by a doctor at the examination of child? What pathology of the cardiovascular system such symptoms characteristic for?
Standard of answer:
1. Systolic АP = 90 + 2·13 = 116 mm Hg
Dyastolic АP = 60 + 13 = 73 mm Hg
2. Frequency of pulse in 5 years child is in norm The changes of pulse rhythm can be considered as respiratory arrhythmia, that in this age is the physiologic phenomenon
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3. During the examination doctor exposed the following pathological symptoms: pallor of skin, bradycardia, weak filling of pulse, decrease of АP, systolic cat’s purring above aorta. This set of symptoms is characteristic for aortal stenosis.
Hardwares and material providing of training:
1)Tables:
a) “Frequency of pulse in children of different age”
b) “Borders of relative and absolute dullness of heart in children”
2) Set of test tasks of entrance control (10 examples).
3) Set of situation clinical tasks (10 examples).
4) Methodical developments:
a) “Anatomic and physiologic features of the cardiovascular system in children”
b) “Calculation of norms of arterial pressure in children. Indexes of arterial pressure in children of different age”.
c) “Method of examination of the cardiovascular system”
d) “Points and order of auscultation of heart”
e) “Properties of pulse, change of pulse at pathology”
Information sources.
А) Basic:
2. Kapitan T. Propedeutics of children’s diseases and nursing of the child. – Vinnitsa, 2006. – P. 406-481
B) Additional:
1. Мазурин А.В., Воронцов И.М. Пропедевтика детских болезней. – С-Пб.: Фолиант, 2001. – С.382-424, 426-436, 439-440, 445-449.
Program of self-preparation of students to the theme:
1. To learn the anatomic and physiologic features of the cardiovascular system in children.
2. To be able conduct inspection, palpation, percussion and auscultation of the cardiovascular system in children of different age.
3. To be able to estimate frequency of pulse and arterial pressure of child.
3. To pay attention to estimation of initial vegetative status of child.
4. To familiarize with the method of conducting of electrocardiography, phonocardiography, sonocardiography
Semantic module 7. Cardiovascular system in children
Concrete aims:
• To analyse the basic syndromes of defeat of the cardiovascular system in children.
• To appoint the complex of laboratory-instrumental methods of examination at the diseases of the cardiovascular system in children.
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