《消化与营养》实习课教案

1、消化与营养实习课教案消化与营养模块之消化系统疾病病理课程名称: 病理学 备课教师：付承林、陶立华学生 七 年制 2004 级 临床 1-4班及影像班 授课时间：4月19日4月13日 章节第八章内容消化系统疾病目的要求掌握胃炎的类型和慢性萎缩性胃炎的病变特点 掌握溃疡病的形态特点，合并症及临床病理联系。 掌握肝炎的基本改变，各型肝炎病变特点4 掌握肝硬化的形态特点和临床病理联系，特别是门脉性肝硬化。5 了解消化系统肿瘤的形态及特点。内 容1. 观看录像: 通过录像复习消化系统疾病的理论知识 30分钟 2. 切片示教：通过显微摄影电视显示屏观看 20分钟1.2. HBsAg、HBcAg3.4.3.

2、 大体标本观察 （36个） 60分钟 1慢性萎缩性胃炎 2胃溃疡病 3胃溃疡病合并出血 4胃溃疡病合并穿孔 5胃溃疡病合并癌变 6 食管癌（髓质型） 7 食管癌（蕈伞型） 8食管鳞癌 9 食管癌（溃疡型） 10 食管癌（缩窄型） 11胃癌（溃疡型） 12胃癌（菜花型） 13 胃癌（弥漫浸润型） 14 胃贲门癌伴淋巴结转移 15 直肠癌（隆起型） 16 直肠癌（溃疡型） 17结肠癌（溃疡型） 18 乙状结肠腺癌 19结肠癌（浸润型） 20结肠癌 21大肠息肉状腺瘤 22 大网膜转移性粘液癌（种植性转移） 23急性重型肝炎（急性黄色肝萎缩） 24急性黄色肝萎缩（急性重症肝炎） 25亚急性重型肝炎合

3、并早期肝硬变 26门脉性肝硬变 27坏死后性肝硬变 28胆汁性肝硬变 29淤血性脾肿大 30肝癌（巨块型） 31肝硬变合并肝癌（结节型） 32肝硬化合并肝癌（巨块型） 33弥漫型肝癌 34膨胀型肝癌 35慢性胆囊炎、胆石症 36慢性胆囊炎、胆石症 4. 病理切片观察：（7张） 30分钟（1）切片26号：食管鳞状细胞癌（高分化）（2）切片27号：慢性萎缩性胃炎 （3）切片28号：胃溃疡病 （4）切片29号：胃贲门粘液癌 （5）切片30号： 急性普通型病毒性肝炎 （6）切片31号：亚急性重型肝炎 （7）切片32号：门脉性肝硬变5. 小结 10分钟教具1. 消化系统疾病的典型大体标本和病理切片。2.

4、 显微镜数码互动系统。3. 多媒体系统。备注每次实习课一个班，两个实习室，全班分两个组，实习中间两组交换。Teaching Plan for the Pathology Practical LaboratoryCourse: Pathology Teachers: Chenglin Fu/Lihua TaoStudents: Grade2004 Screenage,1 to 4 Time: 9 Apr 13 Apr. Chapter Chapter 8Contents Tumor (1)Major objectives1. To master the pathologic types and

5、the pathologic features of chronic atrophic gastritis.2. To master the pathologic features and complications and clinic association of gastric ulcer.3. To master the basic pathologic changes of viral hepatitis; To master the pathologic features and clinic associations of different pathologic types o

6、f viral hepatitis.4. To master the pathologic changes, and clinic associations of liver cirrhosis, especially of portal cirrhosis5. To master the types, pathologic change of the esophageal, gastric, hepatic and colonic carcinoma.Contents 1. Watch a video: review the basic pathologic theory. 30 minut

7、es 2.Demonstration 20 minutes1. chronic atrophic gastritis 2. chronic gastric ulcer with malignant change 3. fulminant hepatitis 4.cholangiocarcinoma 5. chronic gastric ulcer with healing6. Hepatitis B 7. Hepatocellular carcinoma 8. acute pancreatitis 3. Observe gross specimens 60 minutes2. 1. Chron

8、ic atrophic gastritis 2. Gastric ulcer 3. Gastric ulcer with ulcer with perforation 5. Gastric ulcer with malignant change 6. Esophageal carcinoma (medullary type) 7. esophageal carcinoma (fungating type) 8. Esophageal squamous cell carcinoma 9. Esophageal carcinoma (ulcerative type) 10. esophageal

9、carcinoma (annular constricting type) 11. gastric adenocarcinoma(ulcerative type) 12. Gastric adenocarcinoma 13. gastric adenocarcinoma (linitis plastica) 14.cardia adenocarcinoma with metastasis of lymph nodes 15. Rectal adenocarcinoma (exophytic type) 16.rectal adenocarcinoma (ulcerative type) 17.

10、 colonic adenocarcinoma (ulcerative type) 18. adenocarcinoma of sigmoid colon 19. colonic adenocarcinoma (infiltrating type) 20. colonic adenocarcinoma 21. adenomatous polyp in colon 22. metastatic mucinous carcinoma in greater omentum(transcoelomic metastasis)23. fulminant hepatitis 24. acute yello

11、w liver atrophy 25 subacute severe hepatitis with early cirrhosis 26. Portal cirrhosis 27. postnecrotic cirrhosis 28. Biliary cirrhosis 29. Congestive splenomegaly 30. Hepatocellular carcinoma (huge mass) 31.liver cirrhosis with hepatocarcinoma (multiple type) 32.liver cirrhosis with hepatocarcinoma

12、 (huge mass) 33.hepatocarcinoma (diffuse type) 34. Hepatocarcinoma 35.chronic cholecystitis, cholelithiasis 36. chronic cholecystitis, cholelithiasis 4.Observe sections 30 minutes 26. Esophageal squamous cell carcinoma 27. Chronic atrophic gastritis 28. Gastric ulcer 29. cardia mucinous adenocarcino

13、ma 30. Acute hepatitis 31. subacute severe hepatitis 32. portal cirrhosis5. Summary 10 minutesTools(1) Samples: Gross specimens and tissue sections(2) Microscope with digital exchange(3) Multimedia videoNotesTo master the following words:Chronic gastritis, chronic atrophic gastritis, intestinal metaplasia, gastrinoma, peptic ulcer, perforation, pyloric stenosis, region