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Home / Issues / № 6, 2018

Medical sciences

Pleshkova O.L., Rastegaeva L.I., Shkatova E.Y., Sabelnikov N.E., Polyakova O.L., Gomoyunova S.L., Kozyreva E.A.
Currently botulinum toxin type A is widely used as a drug in practical medicine. These drugs are intended to help patients with impairment of muscle tone and activity due to wide spectrum of illnesses. It is well known that positive therapeutic effect depends not only on correct dosage of drug, on time interval of its application, but also on the accuracy of administration. Aim of our master classes on myology for physicians working directly with neuropeptide was not only repetition of muscle anatomy and topography but also improvement of practical skills at drug injections in specific muscles.

Since 2014/15 study year unique classes on practical myology are conducted in Izhevsk state medical academy. Course participants are practicing neurologists that work with patient in need of botulinum toxin drugs application. Classes are leaded by lecturers and professors of department of anatomy of Izhevsk state medical academy together with representatives of ANI "Center for the promotion of healthсare development programs". These courses are organized as qualification improvement. Since the beginning of the master classes doctors from almost all the territory of the Russian Federation have taken part in them: Izhevsk, Nizhny Novgorod, Ufa, Orenburg, Samara, Saratov, Kirov, Perm, Moscow, St. Petersburg, Kaliningrad, Yekaterinburg, Nizhny Tagil, Vladivostok, Khabarovsk and other cities. More than 150 neurogists had already participated in this course.

 Each class is dedicated to studying of certain region - "head, neck and shoulder girdle", "upper limb", "lower limb". Classes are held in several steps. First step is the review of muscular system anatomy. Information on muscle anatomy (attachment points, function), location of main neurovascular bundles, topography (channels, fossa, etc.) is given. This material is demonstrated on specially designed presentations and anatomical materials (skeleton, pre-dissected corpse with separated vessels, nerves and muscles, anatomical preparations of isolated regions).

Second step is studying of main muscular pathological deviations and peculiarities of muscular anatomy in these deviations in different regions (e.g., laterocollis, laterocaput, tortikollis, tortikaput, retrocollis, retrocaput). Main and optional synergetic muscles, their antagonist, the interposition of the muscles of the region are presented. Correct doses for therapeutic effect are listed, main anatomical reference points for correct injections in certain muscle are shown. Performing of injections in some muscles can be hard sometimes (for example, lateral pterygoid muscle, inferior oblique muscle of the head, piriformis muscle).

On the third step participants have to make a model from colored dough in order to fully understand muscle interposition. This step is very important to understand ultrasound visualization of muscles. This method is used as a guidance during injection performance in order to achieve better result of treatment.

On the fourth step students explore anatomical regions on their own: they have to find muscles, try to do injections using anatomical reference points, practice in correct positioning of syringe, needle, hands, patient's body parts.

On the last step participant are tested both on theoretical questions (with usage of cards, for example, they have to show muscles on the image of cross section of the limb) and on practice (they have to perform injection of drug in certain muscle of corpse). Lately, methodological recommendations and teaching aids are worked up and innovation methods of demonstration are introduced (i.e., injections on non-dissected corpse).

Participants and organizers evaluate this experience of master classes on practical myology conducted by department of anatomy for neurologists facing the problems of treating muscular pathological activity as very successful. It is a very necessary contribution to the advanced training of medical practitioners at the current stage of development of practical medicine.

Bibliographic reference

Pleshkova O.L., Rastegaeva L.I., Shkatova E.Y., Sabelnikov N.E., Polyakova O.L., Gomoyunova S.L., Kozyreva E.A. THE EXPERIENCE OF NEW METHODS OF PRESENTATION OF INFORMATION DURING PRACTICAL MYOLOGY CLASSES FOR NEUROLOGISTS. International Journal Of Applied And Fundamental Research. – 2018. – № 6 –
URL: www.science-sd.com/478-25402 (22.02.2024).