5. Plan and organizational structure of lecture:

№	Basic stages of lecture and their maintenance	Type of lecture. Facilities of activation of students. Materials of the methodical providing	Raspre-delenie of time
1.	Preparatory stage. Determination of actuality of theme, educational aims and motivation.	Introductory lecture: actuality of theme is conditioned the features of clinic, diagnostics and treatment combined trauma of maxillufacial area.	5 mins
2.	Basic stage. Exposition of lecture material according to plan: 1. Anatomy and topography of bones of facial skeleton. 2. Clinic, diagnostics and treatment combined trauma of maxillufacial area.	Clinical lecture. Questions to the students. Problem situations. Facilities of evidentness: multimedia presentation, charts of the stages of operative interferences, tool and remedies, coloured photos of patients.	80 mins
3.	Final stage. 1. Resume of lecture and general conclusions.	Prognosis and consequences of damages of maxillufacial area.	2 mins
	2. Answers for the possible questions of students.		2 mins
	3. Task for of students.	Educational, basic and auxiliary literature.	1 mins

6. Table of contents of lecture material.

О.P.  Fraerman and coauthors (1974) classify the damages of the degree of weight:

• heavy CHMT and heavy damages of person;

• heavy CHMT and easy damages of person;

• easy CHMT and heavy damages of person;

• easy CHMT and easy damages of person.

At the combined traumas most does not have damages of maxillufacial area dominant, but influence on a flow and consequence of trauma. Traumatic illness, the consequences of which, violations of functions of the damaged organs, pain syndrome, in future – mono- and insufficiency, develops for these patients.

Clinical trauma depends on weight and character of craniocerebral and cranial-facial trauma. Neurological which hampers diagnostics prevails.

A craniocerebral trauma is divided by 3 forms:

• concussion of the brain;

• injury of brain (to the easy, middle, heavy degree);

• prelum of brain (on a background his injury and without injury of brain).

Taking into account possibility of threat of infecting of brain, traumas of cerebrum are closed and opened. The opened craniocerebral trauma can be penetrable and nonpenetraiting in the cavity of skull.

Simptomatika of cranial-facial trauma consists of cell-type symptoms.

Obschemozgovye symptoms: loss of consciousness; amnesia (complete or partial) of retrograde; head pain; dizziness; nausea and vomiting (single, frequent).

Cell-type symptoms: changes of size of pupils, form, reaction; weakening of cornea reflexes; violations of motions of eyeballs; paresis of facial nerve (one-sided, bilateral; vegetative violations of breathing and circulation of blood.

Pathogeny of basic symptoms of sharp trauma of cerebrum:

• loss of consciousness as a result of blockade of ascending ways of structure;

• amnesia because of violation of processes of perception;

• head pain because of reflexly-vascular violations;

• dizziness because of disfunction of barrel departments of vestibular vehicle or violation of his connection with the higher lyings departments of brain;

• nausea and vomiting as a result of disorders;

• cornea reflex and violation of motions of eyes as a result of parafunction department of brain;

• paresis of facial nerve (central, peripheral) and vegetative violations as a result of damage of brainstem at level bridge (V, VI, VII, VIII) department (kernels IX, X, XI, XII steam).

A concussion of the head brain is the closed mechanical damage which is characterized violation of functions of brain without the obvious expressed morphological changes. There is expansion of vessels, point hemorrhage, increases of permeability of vascular walls, edema of cerebral matter, increase of intracraneal pressure. Loss of consciousness from a few seconds to a few minutes. Clinical picture: loss of consciousness, non-permanent or multiple vomiting, slow or speed-up pulse, fervescence to 37,7 ⁰ With, languor, somnolence, apathy, head pain and dizziness, nausea, лабильность of cardiac activity, fatigue, worsenings of memory.

Injury of cerebrum is the closed mechanical damage of cerebrum, which is characterized the origin of cells of destruction of his fabric, shows up neurological and abnormal psychology. In a clinical picture cell-type symptoms join in with the symptoms of concussion: head pain, vomiting, somnolence, stunning, epileptiform attacks, сопор, after – coma.

Prelum of cerebrum – contingently intracraneal haematomas (subdural, epidural), squeezed breaks of bones of neurocranium, increasing edema of brain. Symptoms of intracraneal haematomas: dynamics of worsening of the general state of patient and his consciousness; increase of intracraneal pressure; increase of cell-type neurological; vegetative violations.