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\\Bucharest Ernergency Clinical Hospital

Department of SurgerY

Foreign students training program (2013/2014)

1. General data on semiology surgery course and practice: practical training, notebook. Surgical

clinic presentation. Patient surgical file (content).

2. History taking of the surgical patient. Surgical patient clinical examination. Surgical patient

medical file completion.3. Measuring main clinical parameters: blood pressure, temperature, heart rate, respiratory

frequency, diuresis, weight curve. Medical rounds with the assistant.

4. Sampling of blood for laboratory analysis. General principles, carrying out the maneuvers.

Sampling of other biological fluids: urine, sputum, stomach contents, cerebrospinal fluid, etc.

5. lntramuscular, intravenous, subcutaneous injection - general principles and practice.

lntravenous perfusion - principles and practice '*/6. Asepsis and antiseptic methods in surgery.

T. Preparing the patient for surgery (psychological preparation, preparing the operative region,

postoperative care).g. lnfection control in the operating room. Techniques of hand washing, putting surgical gloves,

surgical technique details regarding infection prevention, operating room presentation, medical

personnel behavior in the operating room.

9. Surgical instruments.ro. Anesthesia in surgery - equipment and methods. Types of anesthesia - local, loco-regional,

general anesthesia.t 1. Surgical wound care. Surgical dressing. Tetanus wound prophylaxis.

12. Suture. Suture material. Surgical suture technique. Surgical knots. Removal of suture thread.

rg. Skin infections - signs. Superficial surgical infection (abscess, phlegmon, felon, surgical site

infection). Surgical treatment for localized surgical infection (incision and drainage of abscess

or phlegmon)

\, r+. Cephalic extremity clinical examination. Supraclavicular lymph nodes palpation. Lymph node

biopsy - principles, techniques.15. Assuring upper ainuay patency. Esmarch maneuver. Oro-tracheal intubation - material and

methods. Use of Guedel pipe.

ro. Cardio-pulmonary resuscitation - CPR. Assisted ventilation. External cardiac massage 'technique. Basic life support.

rz. Clinical examination of the chestQlCounting ribs. Valeix (intercostal) painful points. Lung

topography. Chest percussion. Auscultation.ra. Diagnosis and treatment of rib fracture. Subcutaneous emphysema - palpation and treatment.

Thoracentesis.tg. Tracheostomy - material and technique. Thoracostomy - material and technique. Oxygen

therapy.zo. Thyroid gland - clinic, imagistic, laboratory. Relevant thyroid pathology.

zt. Radiological examination of the chest.

.22. Clinic.al examination of the mammary gland. Breast's inspection. Mammary gland palpation -' technique. Velpeau maneuver.

23. Diagnostic techniques in breast pathology - common imaging investigations (mammography,ultrasound)

z+. Axillary lymph nodes palpation. Breast biopsy. Localized infections of the mammary gland -treatment.

zs. Breast tumors: case presentation.20. Abdominal clinical examination. Topographic division of the abdomen. Patients' position for

abdominal examination - abdominal relaxation position. Superficial and deep abdominalpalpation. Abdominal percussion. Paracentesis.

zz. Abdominal parietal defects - clinical evaluation. lnguinal and femoral hernias examination.Differential diagnosis in inguinal and femoral hernias.

za. Kidney painful points (lumbo-costal, vertebro-costalpKidney palpation. Giordano maneuver.Ureteral painful points (upper, middle, lower). Testicle palpation. Urinalysis.

zs. Digital rectal examination - the five positions. Anal canal examination. Rectoscopy. Enema -

. , indications, technique.Jso. Vaginal examination. Gynecological examination with valves.st. Diagnostic imaging methods (abdominal X-ray, barium examination of upper digestive tract,

examination with dye of the small intestine, barium X-ray of the colon, abdominal ultrasound,CT, RMl, upper digestive endoscopy) in abdominal diseases.

gz. Liver clinical examination (palpation, percussion). Cholecystic point. Murphy maneuver. Spleenclinical examination.

gg. Traube' space. Succussion sign. Nasogasbic tube insertion. Active gastric aspiration (Taylormethod). Enteral nutrition. Pezer tube gastrostomy - indications, postoperative care.

94. Peritoneal initation signs and maneuvers (Blumberg, Mandel). Javorski-Lapinski maneuver,Rowsing maneuver. Psoas sign. Abdominal guarding.

ss. Clinical examination of the upper and lower limbs. Arterial dinical evaluationtrrcarotid, brachial,radial, femoral, popliteal, tibial, dorsalis peOisJ Radial and ulnar arteries patency. Buergermaneuver in chronic lower limb ischemia.

go. Arterial axis evaluation - imaging (angiography, angioMRl, Doppler ultrasound). Mean arterial,!!/ pressure (MAP).

az. Surgical hemostasis - material and technique. Temporary hemostasis - tourniquet application.Blood group determination. Blood transfusion. Maintaining fluid and ions balance. Endoscopichemostasis.

gg. Vascular suture - technique. lndirect embolectomy with Fogarty catheter. Postoperative follow-up for vascular patients.

gg. Venous system evaluation - imaging methods (Doppler ultrasound, venography). Large veincatheterization. Central venous pressure determination.

40. Venous superficial system examination. Brodie-Trendelenburg test. Delbet test. Threetourniquets test.

at. Leg examination for acute venous thrombosis. Homans' sign. Postoperative follow-up aftervaricose vein surgery.

+2. Peripheral nerves injury diagnostic. Median nerve evaluation (maneuver). Ulnar nerveevaluation. Radial nerve evaluation. Nerve suture - materials and technique.

Critical care surgical patient monitoring. Shock. Critical care measures for complex surgicalcases - SICU presentation.

++. Polytrauma management: assessment and treatment in the emergency room - emergencysurgery. Assisting in emergency surgery.

+s. Surgical nontraumatic emergencies management. Acute abdomen.46. Modern imagistic diagnostic methods in esophageal disease - upper digestive endoscopy,

toraco-abdominal CT-scan.+2. Radiological examination in benign and malignant diseases of the esophagus. Radiological

diagnosis of hiatus hernia.+e. Post-caustic esophageal injuries. Case report. Endoscopic control of post-caustic esophageal

lesions and esophageal dilation with metal plugs.

+g. Gastro-esophageal reflux disease - endoscopic appearance.so. History taking in peptic ulcer disease. Clinical diagnostic of complicated ulcer disease.st. The value of radiological examination in benign diseases of the stomach. Pneumoperitoneum

in perforated ulcer. Radiological appearance of gastric and duodenal ulcer niche.sz. The value of upper gastrointestinal endoscopy in the diagnosis of peptic ulcer. lnterventional

upper digestive endoscopy in hemorrhagic peptic ulcer.ss. Surgical treatment of gastric and duodenal ulcers today. Postoperative care of patients with

gastric resection. Diet and life in patient with gastric resection.54. Preoperative staging of gastric cancer.55. Surgery for gastric cancer. Macroscopic examination of tumor characteristic. Assessment of

neoplastic lymph nodes invasion.so. Modqm surgical tecfiniques: laparoscopic surgery, robotic surgery, etc.57. Case presentation (patient examination - 20 minutes, summarizing data - 20 minutes,

presenting the case - 20 minutes).

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