Download Generalities

Nicolae Testemitanu State University of Medicine and Pharmacy
Department of Topographic Anatomy and Operative Surgery
Course in Operative Surgery and Topographic Anatomy
for Dentistry students
Generalities
1. N. Pirogov – founder of operative surgery and topographic anatomy (primary
contributions).
2. Surgery act - definition, stages by N. Burdenko requirements.
3. Classification of surgical operations.
4. Transplantation of tissue - types of grafts, harvesting and conservation methods.
5. Methods for preserving organs and tissues for transplantation.
Topographic anatomy of the head
1. Landmarks and topographic regions of cerebral portion of the head.
2. Age peculiarities in the structure of the cerebral portion of the head.
3. Stratigraphy of frontoparietooccipital region.
4. Spaces of celluloadipose tissue and dissemination of the pus and hematoma in
frontoparietooccipitale region.
5. Venous system of cerebral portion of the head, anastomoses and their practical
significance.
6. Particularities of arterial supply of the epicranial tissue .
7. Stratigraphy of the temporal region.
8. Hematoma and pus collections paths of diffusion on the temporal region.
9. Surgical Anatomy of the mastoid region.
10. The trepanation triangle and "square of attack" on the mastoid process.
11. Topographic anatomy of the cerebral meninges.
12. Intermeningeals spaces and cerebral cisterns and their content.
13. Arterial system of the head, anastomoses and their practical significance.
14. The Kroenlein scheme of the craniocerebral topography.
15. Landmarks and topographic regions of the facial portion of the head.
16. The facial venous system, anastomoses and their practical importance.
17. Through what veins of the face can penetrate the infection in cavernous sinus in
case of pus in the naso-labial triangle?
18. Topography of facial nerve.
19. Outlet projection of terminal branches of trigeminal nerve.
20. Topography of maxillary nerve.
21. Topography of mandibular nerve.
22. Stratigraphy of genian region.
23. Stratigraphy of parotidomasseteric region.
24. The lodge and the sheath of the parotid gland.
25. Anatomical structures located in the parotid gland.
26. Deep region of the face.
27. Borders and content of temporopterigoidian, interpterigoidian and
pterigomandibular celluloadipose spaces.
28. Buccal floor topography.
29. Pus diffusion in the deep region of the face.
30. Pus diffusion in the buccal floor.
31. Topography of the lateral wall of the nasal cavity.
32. Communications of the orbit with adjacent regions.
33. Bichat fat body, clinic value.
34. Topography of the ophthalmic nerve.
35. Topography of the maxillary artery.
36. Topography of the tongue.
37. Topography of the oral vestibule.
38. Topography of the hard and soft palate of the mouth.
39. Topography of maxillary teeth.
40. Topography of mandibular teeth.
Operative surgery
1. Peculiarities of the craniocerebral wounds debridement.
2. Anatomical argumentation of rational incision on craniocerebral region.
3. Methods of hemostasis in epicranial tissue bleeding.
4. Hemostasys methods in bleeding from the skull bones.
5. Hemostasis procedures in medial meningeal artery injury.
6. Methods of hemostasis in dura mater venous sinus injury.
7. Skull trephination - definition, indications, methods.
8. Osteoplastic skull trepanation by Olivecron and Wagner-Wolfe.
9. Decompressive skull trephination by Cushing.
10. Cranioplasty - definition, indications, types of materials used.
11. Platic surgery methods on epicranial tissue defects.
12. Antrotomy – indications, operative stages, complications.
13. Anatomical argumentation of the rational incisions on the facial region.
14. Peculiarities of surgical debridement in maxillofacial wounds.
15. Maxillary sinus punctures.
16. Maxillary sinus trephination.
17. Dental nerve plexus anesthesia.
18. Tuberal anesthesia.
19. Infraorbital anesthesia.
20. Palatinal anesthesia.
21. Incisive anesthesia.
22. Maxillary nerve anesthesia (Pterygopalatine anesthesia).
23. Manidibular nerve anesthesia at the oval foramina (infrazigomatic way).
24. Mandibular anesthesia.
25. Peripheral truncular anesthesia of the mandible.
26. Torusal anesthesia.
27. Surgery in congenital fissures of the lips (heioplasty).
28. Surgery in congenital fissure of the hard palate (uranoplasty).
Topographical anatomy of neck region
1. Landmarks and topographic triangles on the neck.
2. Cervical fasciae by V. Shevkunenko.
3. Celluloadipose spaces of the neck, practical importance.
4. Topography of the superficial cervical vessels and nerves.
5. Topography of the phrenic nervs in the cervical region.
6. Critical arterial segments on the neck - terrain reasoning.
7. Previsceral celluloadipose space of the neck - delimitation, content, possible ways
of pus dissemination.
8. Topography of sternocleidomastoid region.
9. Projection, composition and sintopy of the medial neurovascular bundle of the neck.
10. Topography of the submandibular triangle.
11. Topography of the Pirogov’s triangle.
12. Topography of the carotid triangle.
13. Hallmarks of external and internal carotid arteries.
14. Topography of scaleno-vertebral triangle.
15. Topography of the lateral triangle of the neck.
16. Possible diffusion paths of pus collections of the lateral cervical triangle.
17. Topography of antescalene space.
18. Topography of interscalene space.
19. Clinical anatomy of thyroid and parathyroid glands.
20. Report of the recurrent nerves with the trachea and esophagus in the cervical
region.
21. Surgical anatomy of the thoracic duct in the neck.
22. Areas of lymph drainage of thoracic duct and right lymphatic duct.
23. Sino carotid reflexogen area.
Operative surgery
1. Rational incisions in case of the phlegmon of the medial neurovascular bundle of
the neck.
2. Rational incisions in case of the suprasternal phlegmon, stratigraphy and possible
complications.
3. Rational incisions on the neck in case of retrovisceral phlegmon.
4. Particularly in primary surgical debridment of the neck wounds.
5. Vagosimpatic block on the neck by A.Vishnevski.
6. Ligation of external carotide artery – indications, surgical access, the segment of
choice.
7. Surgical approach to the thoracic duct on the neck.
8. Ligation of lingual artery - indications, access, preferred area.
9. Surgical approach to the esophagus on the neck.
10. Superior tracheostomy - indications, technique, possible earlier and late
complications.
11. Inferior tracheostomy - indications, technique, possible earlier and late
complications.
12. Conicotomy - indications, surgical technique.
13. Subclavian vein punctures.
14. Incisions and special surgical anatomical particularities of the submandibular
phlegmon drenage.
Operations on vessels and nerves on the head and neck
1. Vein punctures technique.
2. Vein section technique.
3. Denudation and ligation of the arteries (facial, maxillary and lingual).
4. Collateral circulation in ligation of the arteries (facial, maxillary and lingual).
5. Blood vessels ligation in bleeding, sutures and grafting.
6. Nerves surgery (neurorraphy, neurolysis, neurotomy, nerves plastic surgery).
Maxilla and mandible bones operations
1. Notion : osteotomy, osteosynthesis, osteoplasty, bone resection and trepanation.
2. Bone defects replacements methods.
3. Temporo mandibular joint arthrocentesis.
4. Temporo mandibular joint arthroplasty and total joint repacement.
5. Bone grafts and bone substitutes.