Dr. D.Y. Patil Medical College, Hospital &

Research Centre, Pimpri, Pune – 18

Department of Surgery

LESSON PLAN – 6TH SEMESTER LECTURE

Monday: 9am to 10am Tuesday: 2 pm to 3 pm

Sr.

No

Date Topic Learning Objectives Name of the

Teacher

1 4/1/2016 Trauma Care

a) Define Trauma b) Trauma as a disease

c) Trauma Epidemiology d) Philosophy of trauma

management e) ATLS f) Primary Survey g) Secondary Survey h) Definitive Care

Pre hospital trauma care

Dr. (Brig.) KVS Rana

2 5/1/2016 Benign Breast

Diseases

Anatomy of Breast

Aberration of Normal Development and Involution(ANDI)

o Classification o Presentation o Clinical Features o Investigations o Treatment

Galactocele

Phylloides Tumour

Dr. Iqbal Ali

3 11/1/2016 Polytrauma

a) Initial evaluation 1. Primary survey- EMS, ATLS,

A,B,C,D 2. Secondary survey-

a. casualty examination, b. investigation- x-rays and

USG,

Dr. (Brig.) KVS Rana

c. classify the wound d. regional assessment e. systemic assessment

b) Resuscitation

1. airway management

2. fluid resuscitation

3. blood transfusion

4. medical line of management

surgical intervention

4 12/1/2016 Cleft lip/

Cleft Palate

a) introduction

b) Embryology and anatomy

c) Incidence

d) etiology

e) Classification

f) Primary M/M- 1. Antenatal diagnosis 2. Feeding 3. Airway

g) Principles of cleft surgery- timing of primary and secondary management

Multidisciplinary approach

Dr. Anuradha

Dnyanmote

5 18/1/2016 Head injury

Anatomy of skull and brain

Causes of Head injury

Types of skull fracture

Presentations

Pathology

Clinical Features

Investigations

Management

Dr. (Brig.) KVS

Rana

6 19/1/2016 Carcinoma Breast 1/2

Aetiology

Classification Ductal Ca Lobular Ca In situ - Ductal Ca in situ

Dr. Iqbal Ali

- Lobular Ca in situ Invasive

Clinical features

Types o Scirrhous Ca o Medullary Ca o Inflammatory Ca o Colloid Ca o Paget’s disease of nipple o Atropic scirrhous Ca

Lobular Ca in situ

7 25/1/2016 Disease of

Arteries 1/2

a) Definition of- Ischemia

Gangrene

Arterial stenosis

Arterial occlusion

Acute limb ischemia

Aneurysm

b) Arterial stenosis and occlusion 1. Etiology 2. Clinical features 3. Investigations 4. Management- surgical and non

surgical c) Acute arterial occlusion 1. Mesenteric artery occlusion 2. Compartment syndrome

Air embolism

Dr. Nupur Sarkar

8 1/2/2016 Chest Trauma

CHEST TRAUMA

a) Classification

Skeletal injury - Rib fracture - Flail chest

Pulmonary injury - Closed

pneumothorax

Dr. (Brig.) KVS

Rana

- Open pneumothorax

- Tension pneumothorax

- Hemothorax - Pulmonary

contusion

Heart and great vessels injury

Diaphragmatic injury b) Classification ( Mechanism of

injury)

Blunt thoracic injury

Penetrating thoracic injury

c) Rib fracture

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management d) Flail chest

Definition

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management e) Closed pneumothorax

Definition

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management f) Open pneumothorax

Definition

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management g) Tension pneumothorax

Definition

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management h) Hemothorax

Definition

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment

Management i) Pulmonary contusion

Incidence

Morbidity/ Mortality

Pathophysiology

Assessment Management

9 2/2/2016 Carcinoma Breast 1/2

Aetiology

Classification Ductal Ca Lobular Ca In situ - Ductal Ca in situ - Lobular Ca in situ Invasive

Clinical features

Types o Scirrhous Ca o Medullary Ca

Dr. Iqbal Ali

10 8/2/2016 Disease of Arteries 2/2

a) Anatomy of veins of lower limbs

b) Physiology of venous blood flow in lower limbs

c) Varicose Veins- - Definition - Classification - Aetiology - Pathogenesis - Symptoms and Signs

including clinical tests - Complications

Dr. Nupur Sarkar

- Investigations - Treatment-

Conservative

Drugs

Sclerotherapy

Surgery

11 9/2/2016 Neck Swellings

1/2

Neck Swellings(1/2) a) Anatomy of neck

- Triangles - Fascia - Lymph nodes

b) Classification of swellings - Acute - Chronic - Midline - Lateral

c) Midline swellings - Ludwig’s angina - Subhyoid bursitis - Thyroglossal cyst

Laryngocele

Dr. Anuradha

Dnyanmote

12 15/2/2016 Maxillofacial

Injuries

Mode of Injury

Type of Injuries – Le Forte

Investigations Treatment

Dr. (Brig.) KVS

Rana

13 16/2/2016 Adrenal

Glands 1/2

a) Anatomy b) Physiology c) Tumours d) Adreno-cortical

Pheochromocytoma

Dr. Iqbal Ali

14 22/2/2016 Oral Malignancy

1/2

Introduction

Aetiology

Pre-malignant conditions

Clinical presentation

Classification

Dr. (Brig.) KVS

Rana

15 23/2/2016 Thyroid 1/2

a) Development b) Anatomy c) Physiology d) Classification of Goitre e) Diffuse Hyperplastic Goitre f) Multinodular Goitre

Solitary Thyroid Nodule

Dr. Anuradha Dnyanmote

16 29/2/2016 Disease of

Veins 1/2

d) Anatomy of veins of lower limbs e) Physiology of venous blood flow

in lower limbs f) Varicose Veins-

- Definition - Classification - Aetiology - Pathogenesis - Symptoms and Signs

including clinical tests - Complications - Investigations - Treatment-

Conservative

Dr. Nupur Sarkar

Drugs

Sclerotherapy

Surgery

17 1/3/2016

Adrenal Glands 2/2 &

Retroperitoneal tumours

a) Cushing’s Syndrome b) Conn’s syndrome c) Adrenogenital syndrome

Neuroblastoma

Dr. Iqbal Ali

18 7/3/2016 Disease of Veins 2/2

g) Anatomy of veins of lower limbs h) Physiology of venous blood flow

in lower limbs i) Varicose Veins-

- Definition - Classification - Aetiology - Pathogenesis - Symptoms and Signs

including clinical tests - Complications - Investigations - Treatment-

Conservative

Drugs

Sclerotherapy

Surgery

Dr. Nupur Sarkar

19 8/3/2016 Neck Swellings 2/2

Swellings in lateral part of neck-

- Branchial cyst - Cystic hygroma - Carotid body tumour

Dr. Anuradha Dnyanmote

- Thoracic outlet syndrome - Cervical Rib - T.B. Lymphadenitis - Secondaries in neck

Pharyngeal pouch

20 14/3/2016

Diseases of

Lymphatics 1/2

1. Microanatomy 2. Physiology of lymphatic channel 3. Functions of lymphatic system

4. Diseases of lymphatic system:

a) Inflammation- Acute lymphangtis, filariasis

b) Congenital- cystic hygroma

Lymphoedema

Dr. Nupur Sarkar

21 15/3/2016

Principles of

Minimally Invasive Surgery

a) History

b) Definition

c) Extent of minimal access surgery 1. Laparoscopy 2. Thoracoscopy 3. Endoluminal endoscopy 4. Arthroscopy 5. Combined approach

d) Advantages

e) Limitations

f) Preoperative evaluation

g) General intraoperative principles

h) Complications- intra and post op

Commonly done laparoscopic procedures

Dr. Iqbal Ali

22 21/3/2016 Oral Malignancy

2/2

TNM Staging and Grading

Investigation

Dr. (Brig.) KVS

Rana

Treatment

Outcome & Prognosis

Follow Up

23 22/3/2016 Thyroid 1/2

a) Development b) Anatomy c) Physiology d) Classification of Goitre e) Diffuse Hyperplastic Goitre f) Multinodular Goitre

Solitary Thyroid Nodule

Dr. Anuradha

Dnyanmote

24 28/3/2016

Diseases of

Lymphatics 2/2

Lymphoedema-

a. Definition

b. Classification- primary and secondary

c. Pathophysiology

d. Clinical features

e. Differential diagnosis of lymphoedema

f. Investigations

Rx- medical and surgical line of management

Dr. Nupur Sarkar

25 29/3/2016 CNS Tumours

Types

Primary -Intra axial Extra axial

Secondary- Each with types,

presentation, diagnosis, treatment

Dr. Iqbal Ali

26 4/4/2016 HIV & Surgeon

HIV?

Modes of transmission

Universal precaution Post- exposure prophylaxis

Dr. Anuradha Dnyanmote

27 5/4/2016

Parathyroid &

Hyperparathyroidism

a) Anatomy b) Embryology c) Histology d) Function e) Primary Hyperparathyroidism

1. Definition 2. Incidence 3. Pathology 4. Clinical features 5. Differential diagnosis 6. Medical treatment 7. Surgical management-

a. Pre-op localization b. Pre-op care c. Operative strategy

f) Hypoparathyroidism 1. Congenital 2. Acquired-

a. S/S b. Treatment

g) Parathyroid carcinoma

Renal hyperparathyroidism

Dr. Anuradha Dnyanmote

28 11/4/2016 Disease of Salivary Gland

1/2

5. Microanatomy 6. Physiology of lymphatic channel 7. Functions of lymphatic system 8. Diseases of lymphatic system:

c) Inflammation- Acute lymphangtis, filariasis

Dr. (Brig.) KVS Rana

d) Congenital- cystic hygroma

Lymphoedema

29 12/4/2016 Principles of

Radiotherapy

How radiation works

Ionizing radiation

Inverse square law

Photon-tissue interactions

Compton effect:

Electron beams

Measuring radiation absorption

Treatment machines

Treatment planning and delivery

Brachytherapy

Recent advances in planning and treatment

Ct simulation

Conformal radiation therapy

Proton therapy

Stereotactic radiosurgery

Dr. Iqbal Ali

30 18/4/2016 Disease of Salivary Gland

2/2

a) Minor salivary gland tumors b) Salivary gland calculus c) Sialadenitis d) Sialosis e) Sjogren’s syndrome

- Primary - Secondary

Frey’s syndrome

Dr. (Brig.) KVS Rana

31 25/4/2016 Peripheral

Nerve Injury

Seddon Classification

Types of nerve damage

Dr. Nupur Sarkar

Events in peripheral regeneration

Role of Schwann cells

Role of Macrophages

Role of Neurotrophic factors

Role of neural promoting factors

Nerve regeneration therapies

32 26/4/2016 Principles of

Chemotherapy

Cellular kinetics

Normal cell cycle

Cell-cycle Phase Specific Drugs

Tumor kinetics

Principles of combination chemotherapy

Definitions of response

Dose intensity

Overcoming chemotherapy

resistance

Chemotherapeutic agents classified

by mechanism of

Dr. Iqbal Ali

33 3/5/2016 Diabetic Foot

Definition

Aetiology

Pathogenesis i. Vasculopathy ii. Neuropathy iii. Susceptibility to

infections

Clinical Features

Wagner’s Grading

Approach to a patient of Diabetic Foot

Dr. Anuradha Dnyanmote

34 10/5/2016 Skin Grafting a) Types of wounds b) Reconstructive ladder

Dr. Anuradha

Dnyanmote

c) Definition d) Types of grafts-

1. split (thiersch)- definition, donor site, indications, advantages and disadvantages

2. full (wolfe) e) procedure f) pre and post op operative care g) composite graft h) flaps

1. local, distant

2. depending on blood supply

depending on tissue type- skin, muscle and composite flap

Dr. D.Y. Patil Medical College, Hospital &

Research Centre, Pimpri, Pune – 18

Department of Surgery

LESSON PLAN – 6TH SEMESTER TUTORIAL

Monday: 4 pm to 5 pm Friday: - 2 pm to 3 pm

Sr.No Date Topic Learning Objectives Name of the

Teacher

1 4/1/2016 Principle of Surgery

a) Do no harm b) Asepsis c) Sterility d) Halsted doctrine

1. Gentle tissue handling 2. Haemostasis 3. No cavity 4. No suturing under tension

e) Antibiotics f) Post op care

1. Pain management 2. IV fluids 3. Wound care

Prevention of complications

Dr. Prashant

Kumar

2 8/1/2016 Preoperative

care

Need

Preoperative evaluation

Consensus recommendations for preoperative screening tests

Systemic approach to preoperative evaluation Cardiovascular (ASA

classification) Pulmonary Renal Hepatobilliary Endocrine Hematologic

Additional considfrations: age, nutrition.

Preoperative checklist

Dr.Shama

Shaikh

Antibiotic prophylaxis review of medications

3 11/1/201

6

Postoperativ

e Care

Preparation for Surgery

Preoperative assesment

Informed consent

Pre-medication principles of anaesthesia

Pharmakokinetic

Local/regional/general

Monitoring of patient

Intraop and immediate postop

complications

Dr. V.

Kshirsagar

4 15/1/201

6 Neoplasia

Definition Metaplasia, Anaplasia, Dystrophy, Teratomas Benign tumors and their characteristics Malignant tumors and their characteristic Difference between Benign and Malignant tumors Different varieties of Benign and Malignant tumors Theories of Carcinogenesis Types of Carcinogens Spread of Malignant tumors Local or direct spread Invasion by lymphatics- embolism and permeation Spread through blood vessels Spread through serous cavities Spread along natural passage Innoculation Staging and Grading Tumor Host Interrelationship Investigations Tumor markers

Dr. Prashant

Male

5 18/1/201

6

Blood

Transfusion

a) Introduction b) Indication c) Blood transfusion notes d) Complications and management

Dr.M .Dhamangonkar

6 22/1/201

6 Shock

Definition Types of shock Hematogenous Pathophysiology, Compensatory mechanisms Adrenergic discharge, Hyperventillation, Vasoactive hormones, Renal conservation Mild, Moderate, Severe. Clinical monitoring BP, Respiration, Urine output, Swan Ganz Catheter, Pulmonary artery wedge pressure Treatment Resuscitation, Control of bleeding, ECF replacement. Drugs – Chronotropic and Ionotropic agents. Vasodilators and Vasoconstrictors. Diuretics and Beta blockers. Traumatic Pathophysiology, Clinical features and Treatment Neurogenic Pathophysiology, Clinical features and Treatment Cardiogenic Pathophysiology, Clinical features and Treatment Septic Pathophysiology, Clinical features and Treatment Warm shock, Cold shock Anaphylactic shock Crush syndrome

Dr. Prashant

Kumar

7 25/1/201

6

Resuscitatio

n

a) Introduction b) Instruments and drugs c) Indication d) Fluid therapy e) Complications

Dr.M

.Dhamangonkar

8 29/1/2016

Burns

Definition Various types of Burns Ordinary burns, Scalds, Electric burns,

Chemical burns, Radiation burns, Cold burns – Frostbite Pathology of burns Local Changes Severity of burn – Partial thickness, Full thickness. Extent of burn – Rule of nine Vascular changes Infection Systemic Changes

Dr. V. Kshirsagar

Shock – Cardiogenic, Oligaemic, Neurogenic, Bacteriaemic Bichemical Changes Changes in Blood Systemic lesions Treatment Treatment of Shock – Sedation, Fluid resuscitation, Maintenance of airway, General treatments – Escharatomy and Fasciotomy Tetanus prophylaxis Antibiotics Nutritional support Gastric decompression Treatment of GI complications Local Treatments First aid measures, Burn wound care, Skin grafting, Physical therapy and rehabilitation Complications of Thermal burn Treatment of Electric injury Treatment of Chemical burns

9 1/2/2016 Dressing Trolley

Instruments on Dressing trolley, Aseptic Precautions, Need for Dressing, Materials used for dressing,

Dr. Prashant Male

10 5/2/2016 Sterilization

Definition Disinfection Disinfectant, Antiseptic, Degerming, Sanitization Bacteriostatic agent, Germicide, Bactericide, Fungicide, Viricide, Sporicide Physical methods of Microbial control Heat Moist heat – Autoclave, Pasteurization, Dry heat Filtration, Freezing, Dessication, Plasmolysis, Radiation – Ionizing, Ultraviolet, Microwave. Chemical methods of Microbial control Phenols and phenolics Halogens – Iodine, Halogens – Chlorine, Alcohols –Ethanol, Heavy metals – Silver, Quaternary Ammonium Compounds Aldehydes- Gluteraldehyde, Formaldehyde gas Gaseous sterilizers – Ethylene oxide Peroxygens – Ozone, Hydrogen peroxide

Dr.Shama Shaikh

11 8/2/2016

Acute Infection & Gas

Gangrene

Introduction Abscess- definition, causative organism,clinical features,Investigations,treatment Folliculitis -definition, causative organism,clinical features,Investigations,treatment Cabuncle- definition, causative organism,clinical features,Investigations,treatment Necrotising fascitis- definition, causative organism,clinical features,Investigations,treatment Cellulitis- definition, causative

organism,clinical features,Investigations,treatment Gas gangrene- definition, causative organism,clinical features,Investigations,treatment

Dr. Prashant

Kumar

12 12/2/2016

Nosocomial infection

Definition Etiology Causative organisms Clinical features of different nosocomial infections Treatment Prevention

Dr.Shama Shaikh

13 15/2/2016

Chronic Infection &

Tetanus

Tuberculosis-introduction, incidence, prevalence, causative organism,mode of infection, types, clinical features, investigations, treatment, medical and surgical interventions Leprosy- introduction, incidence, prevalence, causative organism,mode of infection, types, clinical features, investigations, treatment, medical and surgical interventions Syphilis- introduction,incidence,prevalence,causative organism,mode of infection,types,clinical features,investigations,treatment,medical

and surgical interventions Tetanus- introduction,incidence,prevalence,causative organism,mode of infection,types,clinical features,investigations,treatment,medical and surgical interventions,prevention

Dr. V. Kshirsagar

14 22/2/201

6

Neck

Swellings

Anatomy of Neck Types of swelling Differential Diagnosis

Dr. Prashant

Male

Classification Investigations Management complications

15 29/2/201

6

Arterial

Disorders

d) Definition of- Ischemia Gangrene Arterial stenosis Arterial occlusion Acute limb ischemia Aneurysm

e) Arterial stenosis and occlusion 5. Etiology 6. Clinical features

7. Investigations 8. Management- surgical and non

surgical f) Acute arterial occlusion

3. Mesenteric artery occlusion 4. Compartment syndrome

Air embolism a) Gangrene-

1. definition 2. Types- diabetes mellitus, drug

abuse, frost bite, ainhum, ergot, venous gangrene

3. Clinical features 4. Management- amputation

b) Peripheral vascular diseases

1. Lowerlimb- TAO, atherosclerosis and DM

Upper limb- Raynold’s disease, Raynold’s phenomenon, thoracic outlet syndrome, subclavian steal syndrome

Dr.M .Dhamangonkar

16 4/3/2016 Venous

Disorders

j) Anatomy of veins of lower limbs k) Physiology of venous blood flow in

lower limbs l) Varicose Veins-

- Definition - Classification - Aetiology - Pathogenesis - Symptoms and Signs

including clinical tests - Complications - Investigations - Treatment-

Conservative

Dr. Prashant Kumar

Drugs

Sclerotherapy

Surgery a) Venous Ulcer-

- Pathogenesis - Differential diagnosis - Investigations - Treatment-

Bisgaard method

Specific for varicose vein

b) Deep vein thrombosis (DVT)- - Aetiology

Factors -Virchows Triad

Causes - Sites - Types

Phlegmasia alba dolens

Phlegmasia Cerula Dolens

- Clinical features - Differential diagnosis - Investigations - Treatments-

Drugs

Thrombectomy

Surgery

17 11/3/201

6

Surgical Pathology - 1

a. Name of the specimen b. Description of specimen c. Anatomy of the specimen

Pathology of the specimen

Dr.Shama

Shaikh

18 14/3/2016

Instrument-1

a. Name of the instrument b. Parts of instrument c. Indications d. Procedure

Complications

Dr. V. Kshirsagar

19 18/3/2016

Radiology -1

How to read Normal x-ray What to see Abnormalities

Dr. Prashant

Male

20 21/3/201

6

Insturment-

2

Name of the instrument Parts of instrument Indications Procedure

Complications

Dr.M .Dhamangonkar

21 28/3/201

6

Surgeries

for Hernia

Defenation of hernia

Types of surgery: herniotomy

Herniorraphy

Hernioplasty

Anaesthesia

Procedure

Complications

Postop care

Dr. Prashant

Kumar

22 1/4/2016 Surgical Pathology -2

1. Surgical anatomy 2. Types of skin malignancy 3. Type of malignant ulcers Histopathology

Dr.Shama Shaikh

23 4/4/2016 Instrument-3

Introduction Identification Types of ports

Dr. V. Kshirsagar

24 11/4/2016

Radiology -2 Identification Triangle of safety Causes

Dr. Prashant Male

Symptoms Diagnosis Treatment etc

25 18/4/2016

Surgical Pathology -3

1. carcinoma of breast 2. Nipple areola complex and skin

involvement 3. Tumour cut surface 4. Lymphnodes

Dr.M .Dhamangonk

ar

26 22/4/201

6 Radiology -3

How to read Normal x-ray What to see Abnormalities Identification Where & what to see Anatomical locations D/D of opacities D/D of Gas under diaphragm

Dr. Prashant

Kumar

27 25/4/201

6 Radiology -4

Dye Technique Indications/contraindications Uses Diagnosis Other Renographies

Dr.M .Dhamangonkar

28 29/4/2016

Instrument-4

Veress needle technique Hasson’s technique General instruments

Dr. V. Kshirsagar

29 2/5/2016 Surgical Pathology -4

Hydatid cyst : a. Etiology b. Incidence c. Pathology d. Clinical presentation e. Investigations f. Management

HCC: a. Etiology b. Incidence c. Pathology d. Clinical presentation e. Investigations f. Management

Dr. Prashant Male

30 6/5/2016 Instrument-5

Uses, Parts, Advantages, Indications, Other Uses

Dr.Shama Shaikh

31 9/5/2016 Radiology -5 CT Scan -Abdomen

Procedure,

Dr. Prashant Kumar

Types,

Indications,

Advantages, Disadvantages

32 13/5/2016

Surgical Pathology -5

Testis Orchidectomy Ca Penis

Dr.Shama Shaikh

33 16/5/2016

Radiology -6

Indication

Contraindication

Disadvantages Various modalities of angiogram

Dr. V. Kshirsagar

34 20/5/201

6

Surgical

Pathology -6

Head and Neck

Introduction Applied anatomy

Dr. Prashant Male