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1、重庆市渝中区友谊路一号 教学质量监控科：89012703 临床技能中心：89012671 继续教育科：89012667 学生工作办公室：89012537 全科医学中心：89012759 教务处传真：89012759 教务处制教案及讲稿（教案）课程名称 神经外科学 年级 2013 级 授课专业 五年制教 师 夏海坚 职称 副教授 授课方式 大课 示教 学时 6题目章节 1、Increased Intracranial Pressure；2、颅内压增高；3、颅脑外伤教材名称 1、医学英文原版改编双语教材外 科学 ；2、 外科学 作者 1、Lawrence W. Way Gerard M. Dohe
2、rty；2、吴在德，吴肇汉出 版 社 1、科学出版社；2、人民卫生出版社 版次 1、第 1 版；2、第 8 版教学目的要求1、Pathology and Physiology of Increased Intracranial Pressure 2、Manifestations and Managements of Increased Intracranial Pressure3、颅内压增高的诊断4、颅内压增高的治疗原则5、脑损伤的受伤机制6、原发性脑损伤和继发性脑损伤的发病原理及临床表现教学难点1、Regulation of Intracranial Pressure2、脑疝的发生机制3、颅
3、脑损伤的受伤机制教学重点1、Manifestations of Increased Intracranial Pressure2、脑疝的临床表现3、原发性脑损伤和继发性脑损伤的发病原理及临床表现外语要求 English教学方法手段1、Multimedia (Powerpoint) Teaching2、Lecture and Discussion in the Class3、利用多媒体图片及幻灯紧密结合临床实际，提问式讲解教材并举例说明参考资料1、 王忠诚主编王忠诚神经外科学第一版2、 Mark S. Greenberg, M.D. Handybook of Neurosurgery, the
4、Fourth Edition.教研室意见准备充分，内容详实，时间安排合理，教学方法丰富，经过教研室内集体备课及试讲，达到为本科生上大课要求。教学组长： 教研室主任：年 月 日 重庆市渝中区友谊路一号 教学质量监控科：89012703 临床技能中心：89012671 继续教育科：89012667 学生工作办公室：89012537 全科医学中心：89012759 教务处传真：89012759 教务处制教学内容 辅助手段时间分配Increased Intracranial PressureOutline:A. Attention-Getting PointsQuestion: “Why shall
5、we have to learn increased intracranial pressure?” Definition: Increased intracranial pressure is the pressure inside the cranial vault, created by the total volume of the intracranial contents and exert on cranial wall.B. Main Part1. Anatomy and definition of ICP2. Definition of increased intracran
6、ial pressure3. Pathogenesis (Causes) of increased ICP4. Clinic symptoms and signs of increased ICP5. Diagnosis of increased ICPC. ConclusionIncreased Intracranial PressureHollow, everyone. May I have your attention, please!Welcome to neurosurgical class! I know all of you have studied in this univer
7、sity for many years, and most of you will be doctors in the near future. But maybe it is your first time to contact with neurosurgery, and today I am very glad to stand here and share some basic neurosurgical knowledge with you, I hope it will be helpful.Speaking of neurosurgery, first, we will come
8、 to the fundamental part of neurosurgery- (that is) Increased Intracranial Pressure. What is Increased Intracranial Pressure? From the word, intracranial pressure, intra- means in, -cranial refers to head, so Intracranial Pressure means the pressure in head, we also call it ICP; and therefore, Incre
9、ased Intracranial Pressure means the pressure in head is increased. We also call it raised ICP or Intracranial hypertension.Maybe you are wondering: the diseases of neurosurgery mean brain trauma, tumor, infectious and vascular diseases, et al. Why should we begin with Increased Intracranial Pressur
10、e? To answer this question, at the beginning we will review related anatomy of cranium and brain and finally, I think, you will get the answer by yourselves!1. Anatomy and Definition of Intracranial PressureAs we know, the cranium can be thought of a hollow, rigid sphere with constant volume, just l
11、ike a closed container with poor distensibility. There is one large vent, the foramen magnum, and a number of smaller foramina for cranial nerves and blood vessels. There are 3 major components of cranium: they are brain, cerebrospinal fluid (CSF), and blood. All these components are essentially non
12、compressible. So we have an impression: the cranium is a closed container which can not extend easily, and the 3 major components can not be compressed very easily.1st Lesson( 40 mins )Introduction( 2 mins )ReviwsPicturesDiscussion( 8 mins )重庆市渝中区友谊路一号 教学质量监控科：89012703 临床技能中心：89012671 继续教育科：89012667
13、 学生工作办公室：89012537 全科医学中心：89012759 教务处传真：89012759 教务处制As for the three components, I will introduce them one by one:Brain tissue: brain is made of bilateral hemispheres, brain stem and cerebellum. Cerebral hemisphere includes frontal, parietal, occipital, temporal and insular lobe.CSF: This is a pict
14、ure of the brain. In the brain, there are four ventricles; ventricles are just like the drainage system of the brain. The shape of the ventricles is irregular, and ventricles are full of CSF. From these aspects. We can see there are four ventricles in the brain. The two lateral ventricles are on the
15、 top, then the third one in the middle, and the forth ventricle is at the bottom. The ventricles are connected with each other.However, how does CSF produce and circulate? CSF is secreted by choroid plexus in the ventricles. The choroid plexus is made entirely of vessels, and so we can understand CS
16、F is from the blood vessel system, that is, CSF is from the circulatory system. CSF is mostly secreted from choroid plexus in the two lateral ventricles, then goes down to the third ventricle and finally the fourth ventricle. After that, CSF will flow out of the ventricular system and comes to the subarachnoid spaces.Some CSF flows firstly to the spinal subarachnoid spaces and then t
