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Disjoining and joining of the tissues. Primary surgical treatment
Scientific technical progress in surgery. Apparatuses of sew up. Instruments and technique for micro- and endoscope surgery. General peculiarities of layer structure of human’s body, sac structure and fascio-fatty spaces. Principles of local anesthesia. 1. In what position is it necessary to hold the scalpel in the cut of proper fascia: а) table knife; b) bow; c) writing feather; d) it doesn’t matter e) in the fist? 2. In what position is it necessary to fix the injection needle in execution the infiltrative anesthesia: а) cut of the needle upwards; b) cut of the needle downwards; c) cut of the needle to the right; d) cut of the needle to the left; e) doesn’t have practical meaning? 3. During the operation with local anesthetization infiltrative anesthesia foresees: а) leading anesthetics into the infiltrate; b) taut layer infiltration of the tissues; c) infiltration of the fascial case around the organ; d) infiltration of the anesthetics of nervous fibers or around it; e) combination of few methods. 4. In the cut of the skin during the operation surgeon fixed it at the beginning of the cut with: а) І and ІІ fingers of left hand; b) ІІ finger of left hand; c) dressing forceps; d) stitch which is put on the skin; e) parted parts of scissors. 5. In what area according to the surface of the body scalpel is localized during the operation of the cut of the skin: а) which is perpendicular to the surface of the body; b) which is under the angle of 45о right side according to the surface of the body; c) which is under the angle of 45о left side according to the surface of the body; d) it doesn’t matter; e) as it is comfortable? 6. Choose the angle of leading the scalpel into body at the beginning of the cut and it’s leading out from the tissues at the end of the cut: а ) perpendicular to body’s surface; b) under the angle of 45о; c) under the angle of 30о; d) under the angle of 100о; e) it doesn’t matter. 7. Choose the angler of slope of the scalpel during the execution the medial part of cut of the skin (during the slit): а) under the angler of 45о into the side of blade; b) under the angler of 90о into the side of blade; c) under the angler of 25-30о into the side of blade; d) it doesn’t matter; e) under the angler of 100о into the side of blade; 8. Where do you put clamps for stop bleeding from subcutaneous fat: а) into the cellular tissue in opposite edge of the wound; b) into the cellular tissue in the own edge of the wound; c) into the skin and cellular tissue in opposite edge of the wound; d) into the skin and cellular tissue in the own edge of the wound; e) it doesn’t matter? 9. What minimal amount of bleeding points in the cut of the skin and subcutaneous fat: а) 2; b) 3; c) 4; d) 1; e) no one? 10. Choose instruments which can be used in the cut of fascia: а ) grooved probe and scalpel; b) bulb probe and scalpel; c) anatomical forceps and scalpel; d) bulb probe and scissors e) anyone. 11. During sew up of the wound it is necessary to prepare the hold-keeper. How do you do it? а) step back from the point of the needle one-third of its length; b) in the middle of the length of the needle; c) step back from the eye of the needle one-third of its length; d) it doesn’t have practical meaning; e) step back from the point of the needle one-forth of its length? 12. During the operation wound is sawn by layers. Choose the most rational kind of the stitch to join dissected muscles: а) put on common knotted silk stitches; b) put on P-liked silk stitches; c) put on P-liked knotted catgut stitches; d) put on common catgut stitches; e) put on P-liked continual catgut stitches. 13. During the operation wound is sawn by layers. Choose the most rational method of joining the wide fascia of the thigh: а) common knotted silk stitch; b) common knotted, catgut stitches; c) P-liked catgut stitches; d) Z-liked silk stitches; e) continual P-liked silk stitch. 14. Choose rational distance between ligatures of the stitch which are put onto the skin during the operation: а) 0,5-1,0 сm; b) 1,5-2,0 сm; c) 2,0-3,0 сm; d) in doesn’t have practical meaning; e) 0,5 сm. 15. How can the surgeon-beginner avoid possible formation of surpluses of tissues of one of the edges of the wound of the skin in it’s sew up: а) put on continual stitch; b) use P-liked knotted stitches; c) use cosmetic stitch; d) use rules of parts in putting on knotted stitches; e) put on continual P-liked stitches? 16. What is the main aim of primary surgical treatment of the wound: а) preserve infection of the wound; b) transverse wound into aseptic state; c) recess foreign bodies from the wound; d) create conditions for healing the wound by primary taut; e) stop bleeding in the wound? 17. How do you recess hair around the wound before primary surgical treatment of the wound: а) cut; b) by wet shaving through spirals from central part to peripheral; c) by wet shaving through radiuses from the wound to periphery; d) by dry shaving through radiuses from the wound to periphery; e) by dry shaving through spirals from central part to peripheral? 18. Definite necessary width of the recession of the edges of cut wound in its primary treatment: а) 1 сm from the edge of the wound; b) 1,5 сm from the edge of the wound; c) 2 сm from the edge of the wound; d) no use to dissect it; e) 0,5 сm from the edge of the wound. 19. In what deepness is it necessary to recess the edges of gun wound of the extremity in its primary surgical treatment: а) in 3 сm; b) skin and cellular space; c) to gasp proper fascia; d) into all deepness of the wound; e) in 5 сm. 20. Choose stitches after primary surgical treatment of dirty wound: а) primary stitches; b) primary outlaid stitches; c) secondary stitches; d) lead wound by open method; e) cosmetically stitches. 21. Use necessary stitches when wound is with purulent process: а) primary stitches; b) primary delayed stitches; c) secondary stitches; d) lead wound by open method; e) secondary late stitches. 22. What tissues does surgeon disjoin together with superficial fascia in execution the operative access: а) skin with cellular space; b) proper fascia; c) muscles; d) inner fascia; e) serous membranes? 23. What layer of tissues does surgeon disjoin after the proper fascia in execution the operative access: а) skin; b) superficial fascia; c) muscles; d) cavity of the body; e) cellular space? 24. What layer does surgeon disjoin after the proper fascia in operative access onto body: а) skin with cellular space; b) proper fascia; c) muscles;
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