Block 2 Objectives from 2008/2009

Scenario 1

Aim - To study the preliminary stages in dealing with a serious accident.

  1. Outline the principles of pre-hospital care of a seriously ill patient.
  2. Explain the ‘ABCDE’ system of primary survey.
  3. Outline the anatomy of the airway.
  4. Describe the normal reflexes which keep the airway clear, and discuss the problems of airway obstruction by the tongue or aspiration of stomach contents in the unconscious.
  5. Discuss the influence of alcohol.

Scenario 2

Aim - To study anatomy of the vertebral column and the elementary principals of the spinal cord and spinal nerves.

  1. Describe the anatomy of a typical vertebra and draw a line diagram to show the parts.
  2. Recognise the variations in thoracic, lumbar, sacral and especially the cervical region of the vertebral column.
  3. Outline the joints and ligaments between adjacent vertebrae.
  4. Name the curvatures of the vertebral column and define the normal movements of the spine.
  5. Summarise the normal anatomy and function of the spinal cord and nerves and the effect of injury.

Scenario 3

Aim - To study the bones and joints of the thoracic wall, the mechanism of breathing and the effect of injury to the ribs.

  1. Outline what is entailed in a 'rapid assessment'.
  2. Describe the bones, joints and muscles of the chest wall, including the diaphragm.
  3. Describe the mechanism of breathing movements and indicate the effect of rib fractures.
  4. Identify the normal rate of breathing, explain the use of high flow oxygen and revise the usage of a pulse oximeter.

Scenario 4

Aim - To study the functional anatomy of the lungs and pleura, to recognise pneumothorax and haemothorax stemming from rib fractures and to speculate on their effect on respiration.

  1. Describe the form and subdivisions of the lung, the distribution of the bronchi, and the structure of alveoli.
  2. Describe ‘breath sounds’ and give a simple explanation of what causes them.
  3. Outline the general principles of radiography.
  4. Describe the arrangement of the pleura and outline its function, and surface markings.
  5. Define pneumothorax and haemothorax, and outline how they are treated.

Scenario 5

Aim - To describe the anatomy of the heart, great vessels and mediastinum.

  1. Outline the principles of the circulation. Name the major arteries and veins of the trunk and limbs, and discuss the structure of blood vessels.
  2. Describe the landmarks for finding the sites where the arterial pulse can be felt and blood pressure measured in an emergency.
  3. Describe the form, and name the chambers and valves of the heart. Define the pericardium. Name and describe briefly the venae cavae, pulmonary veins, pulmonary trunk and aorta.
  4. Define the mediastinum. Describe the components of the mediastinum and discuss the possible reasons for mediastinal widening.
  5. Describe the right ventricle, interventricular septum and the tricuspid and pulmonary valves.
  6. Outline the histological features of cardiac muscle and the functioning of the conducting system of the heart.

Scenario 6

Aim - To describe the topography of the abdominal wall and pelvis, and the structure, position and relationships of the principal abdominal organs.

  1. Define the abdomen.
  2. Name the clinical regions of the abdominal wall and describe the position of liver, stomach, spleen, kidneys and bowel. Discuss the effect of high speed impact.
  3. Describe the skin, subcutaneous fat and muscles of the abdominal wall. Describe the course of the intercostal nerves and discuss sensations of tenderness and guarding.
  4. Define and explain bowel sounds.
  5. Describe the bones of the pelvis and the position of the bladder, urethra, reproductive organs and rectum.
  6. Discuss the issues of consent in the unconscious.

Scenario 7

Aim - To investigate the peritoneal cavity and the spleen.

  1. Describe the position, form, blood supply, histological structure and functions of the spleen.
  2. Outline the use of ultrasonography in abdominal injury.
  3. Describe the structures divided by an emergency midline abdominal incision, and discuss the advantages and disadvantages of this incision.
  4. Describe the arrangement of parietal and visceral peritoneum and the peritoneal cavity. Describe the peritoneal connexions of the spleen, and discuss the spread of blood from an injured spleen. Describe the innervation of the peritoneum and discuss peritoneal irritation.

Scenario 8

Aim - To identify the bones and joints of the limbs, and study common injuries of the femur.

  1. Define the axial and limb divisions of the skeleton, and name the long bones of upper and lower limbs.
  2. Describe the features of a long bone and discuss bone structure in relation to the femur.
  3. Name the main joints of the limbs. Describe the structure of a synovial joint, and explain the terms used to describe joint movement.
  4. Discuss the signs of bone injury and importance of ‘not overlooking the metacarpals, metatarsals and phalanges’.
  5. Describe the vascular complications of fractures, including fat embolus.
  6. Outline the value of radiographic examination and adequate analgesia in the treatment of fractures.
  7. Discuss the breaking of bad news to relatives.

Scenario 9

Aim - To make a preliminary survey of the brain.

  1. Describe the general features and main parts of the brain and indicate their functions.
  2. Outline the formation, circulation and absorption of CSF.
  3. What is the effect of pressure on the third cranial nerve?
  4. Describe the main arterial blood supply of the brain.
  5. Review the anatomy of the scalp and skull.
  6. Discuss the assessment of consciousness.