肝胆外科胆囊炎说课PPT.ppt

Cholecystitis Jing Gao Department Of Hepatobiliary Surgery The 2nd Affiliated Hospital of WMC Email: GJ_5000@126.com Teaching Design Presentation Fat E Food Family Cholecystitis ≥Forty Female 01 02 03 04 Textbook Study Enviroment Study Objectives Teaching Methods contents 05 Teaching Procedure Textbook About this book-4th Edition Extremely detailed and useful standards for trainees in hepatobiliary and upper gastrointestinal surgery a reference for practicing hepatobiliary surgeons Page1033,Chapter 32-Cholecystitis Clinical Practice Medical Theory Study Enviroment INTERNS EXCITED EASY! CALM! STUDENTS are the KITES, not homeless because the STRING is HELD by TEACHERS. Teachers Students CBL-Case-based learning PBL-problem-based learning Rehearsal-Preview Case-Role-Playing Study Groups Teaching Methods Multimedia teaching Teaching Procesures Case Question Cholecystitis Case based learning Problem-based learning Discussion Medical Practice-A Case for Real Teaching Procesures Step 1 Warming-Up CASE Mr Pan,25 yr old,No past history. He got abdominal pain for 1 hour,which was located in right epigastric area.Also he described the pain as intermittent, very sharp with a radiation to the subscapulara. What is your diagnosis? How to diagnose? Classification Calculous Cholecystitis 1 Acalculous Cholecystitis 2 Teaching Procesures Step 2 Lets roll 95% 5% F F F F ≥40 yr old female mostly fatty people family genetic factors F food junky-yummy Incidence Epidemiology Step 2 Lets roll EtiologyPathogenesis Gallstones Obstruction Retroinfection Distention Edema Venous Stasis IschemiaNecrosis Cholecystitis Symptom 1 Clinical Manifestations 2 Digestive systems : abdominal pain nausia, vomitting, diahrra,etc. General: Jaundice fever,anorexia,fatig-ue,exhausted,etc. Physical Examination Right epigastric tenderness, Rebound tenderness, Murphys sign(+), Total vital signs. 3 Accessory Examination L