36814 - General Surgery 1 (LZ-A)

Learning outcomes

At the end of the course the student knows the general and essential aspects of pathophysiology, with regard to the knowledge of the surgical approach to medical practice. On the basis of the acquired knowledge, the student will have the methodological principles that will allow him to identify those aspects that identify the field of surgical interest and the physiological pathological reasons behind it. The student will also be able to deal correctly and autonomously with the semiological approach to the surgical patient using the principles of objective evaluation and physical approach in relation to the knowledge of investigation procedures proper to the methodology clinic. The integration between the knowledge of clinical physiopathology and surgical semeiotics make the student able to understand and deal with the elementary basics of diseases in a manner preparatory to the future development of the course of study.

Course contents

Approach to the patient. Peculiarities of surgical semeiotics

Study methodology of surgical patient

Invasive and non-invasive instrumental maneuvers of surgical interest

Pathophysiology and Surgical Semeiotics

 

Pathophysiology and Semeiotics of abscesses, phlegms, wounds and solutions continuously

Skin and soft tissues

Objective and functional alterations in the presence of lesions or inflammatory and inflammatory phenomena

 

Physical and functional pathophysiology and semeiotics of the neck

Thyroid and parathyroid and clinical manifestations

Simple goiter, hyperthyroidism, hypothyroidism, complicated goiter, thyroid cancer.

Hypoparathyroidism and hyperparathyroidism. Importance of history and objective examination.

Nosological classification. Signs and symptoms. Laboratory tests and instrumental techniques.

Clinical and instrumental differential diagnostic orientation

 

General semeiotics of the thorax: Breast

Importance of medical history and objective examination, identification of a pathological mass. Exploration of the axillary region and other tumor diffusion sites. Setting of a correct clinical and instrumental differential diagnostic orientation between malignant and benign pathology.

Pathophysiology and surgical semeiotics

 

Pathophysiology and general semeiotics of the thorax: Mediastinum and Thorax

Pleural cord occupation syndromes. Mediastinum occupation syndromes. Importance of medical history and objective examination; importance of a correct clinical and instrumental differential diagnostic orientation

Clinical Physiopathology and Physical Semeiotics

 

Pathophysiology and semeiotics of esophagus' diseases

Nosological classification of functional and organic esophagus' diseases

Reflux, regurgitation, dysphagia. Setting a correct diagnostic process

 

Pathophysiology and semeiotics of polytrauma patient

Pathophysiology and surgical semeiotics

Pathophysiology and surgical semeiotics of polytrauma patient

Polytrauma

Trauma to the skull, chest, abdomen, diagnostic timing

 

Brain Death and Organ Donors

Encephalic death (DBD), causes of encephalic death, cardiac death (DCD), donor risk levels, age for organ donation, assessment of donor fitness, history, objective examination, laboratory tests, instrumental examinations, intra-operative evaluation.

 

Digestive bleeding

Pathophysiology and clinical manifestations of hemorrhages of the upper and lower gastroenteric tract.

Nosological classification, classification, haematemesis, melena, enterorrhagy, rectory, haematochezie, hemobilia. Hemorrhagic shock. Importance of history and objective examination. Signs and symptoms. Laboratory tests. Non-invasive and invasive instrumental diagnostic techniques. Clinical and instrumental differential diagnostic orientation.

 

Pathophysiology and semeiotics of the microcirculation : shock

Homeostasis, compensation mechanisms, nosological classification. Symptoms and objective examination. Functional and instrumental techniques

 

Pathophysiology and physical and functional Semeiotics of biliary tract: Jaundice of surgical relevance

Definition and anamnestic assessments of cholestatic jaundice. Knowledge of the topographical anatomy of the liver and bile ducts. Differential characters and laboratory tests. Importance of objective examination in benign and malignant diseases. The instrumental diagnostic techniques bloodless and invasive.

 

Pathophysiology and physical semeiotics of hernias

Abdominal wall hernias, internal hernias

Nosological classification. Classification, door, bag, collar. Complications.

Nosological classification. Classification. Importance of history and objective examination.Signs and symptoms. Laboratory tests. Non-invasive and invasive instrumental diagnostic techniques. Clinical and instrumental differential diagnostic orientation.

Pathophysiology and physical and functional Semeiotics of the perineum and anal canal

Physical and instrumental semeiotics of the perineum and anal canal

Hemorrhoids, fissures, abscesses, fistulas, cancer of the anus, recto-cystocele, cystocele. Nosological classification. Classification. Complications. Importance of history and objective examination. Signs and symptoms. Non-invasive and invasive instrumental diagnostic techniques. Clinical and instrumental differential diagnostic orientation.

 

Pathophysiology and Semeiotics of the acute abdomen:
The intestinal occlusions

Definition and classification of intestinal occlusion.

Knowledge of the anatomy of the digestive system.

Detection of an intestinal occlusion by anamnestic examinations, laboratory and objective examination. Setting of clinical and instrumental differential diagnostic correction

Pathophysiology and Semeiotics of the acute abdomen: Acute abdomen and peritonitis

Definition of acute abdomen and classification of peritonitis.

Knowledge of the anatomy of the intraabdominal organs.

Importance of an immediate diagnosis by means of anamnestic assessments, objective examination and critical interpretation of laboratory findings Setting of a correct clinical and instrumental differential diagnostic orientation.

 

Readings/Bibliography

1) Teaching material used for lessons (slides)

2) Principles of Internal Medicine (Harrison’s)

Teaching methods

Frontal lessons

Visit to the General Surgery Unit

Assessment methods

Oral examination on the program of General Surgery.

A question will be asked about a topic of the General Surgery program and the student will be evaluated.

The partial marks obtained on the above topics contribute to the final vote together with the partial marks obtained on the remaining programmes of the Intergrato MAU Course in a proportional way to the credits.

Teaching tools

Slides used for carrying out the lessons that will be delivered to the students at the end of the single lesson, or at the end of the course (depending on the requests received).

Permission to record the lessons in the classroom.

Office hours

See the website of Matteo Ravaioli