DES1030 ORAL HISTOLOGY AND EMBRYOLOGY (2924) · PDF fileDES1030 ORAL HISTOLOGY AND EMBRYOLOGY...
Transcript of DES1030 ORAL HISTOLOGY AND EMBRYOLOGY (2924) · PDF fileDES1030 ORAL HISTOLOGY AND EMBRYOLOGY...
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DES1030ORALHISTOLOGYANDEMBRYOLOGY(2924)
PROFESSORINFORMATION
JessicaConroyRDH,BS,M.Ed [email protected]–byappointmentCourseDescriptionDescription:Thiscourseisdesignedtoprovidestudentswiththeembryologicalbasisfortheinitiation,growthanddevelopmentoftheoralfacial/dentalcomplex.Emphasisisgiventothevariouscomponentsoftheoralcavity,includingtoothdevelopment,eruptionandshedding,enamel,dentin,dentalpulp,periodontiumandoralmucosa.Prerequisites: AdmissionintotheDentalHygieneProgramDegreesOffered: A.S.CourseInformationCourseNumber/Title: DES1030/ORALHISTOLOGYANDEMBRYOLOGYReferenceNumber: 2924NumberofCreditHours: 1.00Term/Year/Session/Length: Fall/2017/A/15
ClassBegins 08/28/2017100%RefundDeadline 09/05/20177:00PM(ET)Withdrawwith"W"Deadline 11/02/20177:00PM(ET)ClassEnds 12/14/2017CollegeHoliday(s)09/04/2017,11/10/2017,11/23/2017–11/26/2017TechnicalMaintenanceSeptember16-17,October14-15,November10-12
Thesedatesarecriticalforthiscourse.Additionalcriticaldatesforthiscoursecanbefoundbyclickingtheappropriatetermlinksintheonlinecalendar(http://bit.ly/2uUG5Xu)attheFloridaStateCollegeatJacksonvilleWebsite.
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COURSELOCATIONLocationNORTHCAMPUS
RoomA0316
Times9:00AM–9:55AM
DaysMonday
SessionDates08/29/2017-12/14/2017
INSTRUCTIONALMATERIALSANDEQUIPMENTIfyouhavenotdonesoalready,obtainyourtextbookandrelatedcoursematerials.Visityournearestcampusbookstoreororderonlineviathestudentportal,Connections,ortheFollettOnlineBookstore.Besuretoorderusingyourcourseandinstructor’snameandthesix-digitcoursereferencenumber.Pleasenotethatsomecourses,particularlymathandscience,mayrequireatextplusadditionalsoftwareorapublisherWebaccesscode.Ifpurchasingausedtext,besuretocheckonandobtainallrequiredmaterials.StudentsmusthaveanAppleiPad(2ndgenerationornewer)oriPadminitoaccesscoursematerials.REQUIREDTEXT/MATERIALSIllustratedDentalEmbryology,HistologyandAnatomy,FehrenbachandPopowics,4thEdition,Saunders/Elsevierw/onlineaccessStudentWorkbookforIllustratedDentalEmbryology,HistologyandAnatomy,Fehrenbach,4thEdition,Saunders/Elsevier
ACCESSIBILITYFloridaStateCollegeatJacksonvillerecognizestheimportanceofassistingandencouragingallstudentstoreachtheirfullpotential.InaccordancewiththeAmericanswithDisabilitiesAct(ADA),theAmericanswithDisabilitiesActasamendedin2008,andSection504oftheRehabilitationActof1973,theCollegeensuresthatitsadmissionrequirementsareuniformlyapplied,andthatitsservices,activities,facilitiesandacademicprogramsareaccessibletoandusablebyallqualifiedstudents.TheOfficeofServicesforStudentswithDisabilities(OSSD)implementsandcoordinatesreasonableaccommodationsanddisability-relatedservicestopromotefullparticipationofindividualswithdisabilitiesinallaspectsoflife.TheRehabilitationActdefinesadisabilityasanindividualwhohasaphysical,mental,orlearningdisability,whichsubstantiallylimitsoneormoremajorlifeactivity(i.e.,seeing,hearing,speaking,walking,sitting,standing,breathing,reading,writing,orperformingmathematicalcalculations,andcaringforoneself);orwhohasarecordofsuchimpairment;orwhoisregardedashavingsuchimpairment.BoththeimpairmentandthelimitationofamajorlifeactivitymustbeestablishedtobeeligibleundertheADA.Pleaseclickhereformoreinformation.
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COURSE-SPECIFICLEARNINGOUTCOMESTheCell:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinekeytermsrelatedtothecell.2.2B. Indicateanddiscussthefunctionofthecomponentsofthecell,includingthecellmembrane
cytoplasm,organelles,andinclusions.2.2C. Outlinecelldivisionanddescribethephasesofmitosisthatareinvolved.2.2D. Describetheextracellularmaterialssurroundingthecellandit’sintercellular
junctions.2.2E. Integratetheknowledgeofthebackgroundofthecellintothepromotionandunderstandingof
healthyorofacialtissueandanypathologythatmayoccurwithinthem.3.2 BasicTissues: Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinekeytermsrelatedtobasictissues.2.2B. Listanddescribeeachtypeofbasichistologicaltypesoftissuesandtheirfunctions.2.2C. Describetheprocessfortissueturnoverandrepairforthebasichistologicaltissue
types.2.2D. Describethelocationofthebasementmembrane,itscomponentsandattachment
mechanisms.2.2E. Describethemethodsofclassifyingconnectivetissue.2.2F. Describetheprocessforconnectivetissueturnoverandrepair.2.2G. Integratetheknowledgeofthebasichistologyintoanunderstandingofthespecifichistologyof
theorofacialregionanditspromotionofhealthaswellasanyrelatedpathologythatmayoccur.3.2
EmbryologicalDevelopmentofOralStructures:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinekeytermsastheyrelatetoprenataldevelopment.2.2B. Outlinetheperiodsofprenataldevelopment,describingthemajoreventsthatoccurduringthe
earlyweeks.2.2C. Identifyandlabelperiodsofprenataldevelopmentonadiagram.2.2D. Defineandpronouncekeytermsastheyrelatetothedevelopmentofthefaceandneck.2.2E. Outlinetheeventsthatoccurduringthedevelopmentofthefaceandneckdescribingeachstep
intheirformation.2.2F. Identifyandlabeldiagramsofthedevelopmentofthefaceandneck.2.2G. Defineandpronouncekeytermsinrelationtothedevelopmentoforofacialstructures.2.2H. Outlinetheeventsthatoccurduringthedevelopmentoftheorofacialstructuresdescribingeach
stepintheformation.2.2I. Identifyandlabeladiagramdepictingdifferentstagesduringthedevelopmentof
orofacialstructures.2.2
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J. Integratetheknowledgeofthedevelopmentofthefaceandneckandorofacialstructuresintounderstandingthepresentstructureandanydevelopmentaldisturbancesinvolvedinthesestructures.3.2
EmbryologicalToothDevelopmentandEruption:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A.Useanddefinekeytermsrelatedtotoothdevelopmentanderuption.2.2B.Outlinetheeventsthatoccurduringthedevelopmentoftheteethandassociatedstructuresduringtootheruption,describingeachstepofformation.2.2C.Identifyandlabeladiagramthatdepictsdifferentstagesduringthetoothdevelopmentanderuption.2.2D.Integratetheknowledgeofthedevelopmentoftheteethandassociatedstructuresandtooth
eruptionintounderstandingthepresentanatomyofthesestructuresandanydevelopmentaldisturbances.3.2
Enamel:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinethekeytermsrelatedtoenamel.2.2B. Describethepropertiesofenamel.2.2C. Discusstheappositionandmaturationofenamel.2.2D. Indicateanddiscussthemicroscopicfeaturesofenamel.2.2E. Integratetheknowledgeofthehistologywiththeclinicalconsiderationsinvolved
withenamelinordertopreserveitsintegrity.3.2
DentinandPulp:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinethekeytermsrelatedtothedentinandpulp.2.2B. Discussthedentin-pulpcomplexanddescribethepropertiesofdentinandpulp.2.2C. Describetheprocessesoftheappositionandmaturationofdentin.2.2D. Outlinethetypesofdentin.2.2E. Labeltheanatomicalcomponentsofpulp.2.2F. Indicateanddiscussthemicroscopicfeaturesofdentinandpulp.2.2G. Describetheage-relatedchangesinpulpanddentin.2.2H. Integratetheknowledgeofthehistologywiththeclinicalconsiderationsinvolvedindentinand
pulptopromotetheirhealth.3.2OralMucosa:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinethekeytermsrelatedtooralmucosa.2.2B. Listanddescribethetypesoforalmucosaandlabelonadiagram.2.2C. Characterizeeachofthedifferenttypesofepitheliumassociatedwitheachtypeoforalmucosa,includingthetongue.2.2D. Describethelaminapropriaoftheoralmucosa.2.2
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E. Listanddescribetheclinicalcorrelationsassociatedwiththeregionaldifferencesintheoralmucosa.2.2F. Discusstheturnovertimesfordifferenttissuesintheoralcavityandtheir clinicalcorrelations.2.2G.Integratetheknowledgeofthehistologywithanunderstandingofthepromotionoforalmucosalhealthandanyrelatedpathologythatmayoccurwithinit.3.2
GingivalandDentogingivalJunctionTissues:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Useanddefinethekeytermsrelatedtogingivalanddentogingivaljunctionaltissues.2.2B.List,describeandlabelonadiagrameachofthetypesofgingivaltissues.2.2C.Describethehistologicalfeaturesofthedifferenttypesofgingivaltissues.2.2D.Describethecompositionanddevelopmentofthedentogingivaljunctionaltissues.2.2E.Discussturnoverofthedentogingivaljunctionaltissues.2.2
F.Integratetheknowledgeofthehistologyintoanunderstandingofthepromotionofthehealthofthedentogingivaljunctiontissueandanyoftherelatedpathologythatmayoccurwithinit.3.2
Periodontium:Uponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A. Defineandpronouncethekeytermsrelatedtotheperiodontium.2.2B. Discusstheperiodontium,anddescribethepropertiesofeachofitscomponents.2.2C. Discussthedevelopmentoftheperiodontium.2.2D. Outlinethetypesofcementumandalveolarbone.2.2E. Labelthefibergroupsoftheperiodontalligamentanddiscusstheirfunctions.2.2F. Indicateanddiscussthemicroscopicfeaturesoftheperiodontium.2.2G. Describetheage-relatedchangesintheperiodontium.2.2H. Integratetheknowledgeofthehistologywiththeclinicalconsiderationsinvolving
theperiodontium,especiallythosechangesassociatedwithperiodontalpathologyin ordertopromotethehealthoftheperiodontium.3.2
HeadandNeckStructuresUponsuccessfulcompletionofthissectionthedentalhygienestudentwillbeableto:
A.UseanddefinethekeytermsrelatedtotheheadandneckstructuresB.Describethelocationofeachheadandneckstructure.2.2C.Discussandlabelonadiagramthehistologicalfeaturesanddescribetheembryologicaldevelopmentofeachheadandneckstructure.2.2D.Integratetheknowledgeofthehistologywiththeclinicalconsiderationinvolvedwith
headandneckstructureswiththerelatedpathologythatmayoccuraswellasthewaystopromotehealth.3.2
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CourseParticipationMETHODSOFINSTRUCTION
o PowerPointpresentationso LecturePodcastso Readingassignmentso Workbookassignments
CalendarofActivities
Date Topics(s)andReading Reading/WorkbookAssignment
8/29/17 SyllabusIntroductionPrenatalDevelopment
SyllabusChapters3
9/5/17 EmbryologicalDevelopmentoftheFaceandNeck▪ Developmentoftheface▪ Developmentoftheneck
Chapter4
9/12/17 EmbryologicalDevelopmentofOrofacialStructures
▪ Developmentofthepalate▪ Developmentofthetongue▪ Malformations
Chapter5
9/19/17 ToothDevelopment&Eruption▪ Stagesoftoothdevelopment▪ Dentinogenesis▪ Amelogenesis
Chapter6
9/26/17 ToothDevelopment&Eruption,cont’d▪ Developmentoftoothroot▪ Developmentofsupportingstructures▪ Sequenceandchronologyoftooth
eruption
Chapter6
10/3/17 CellsBasicTissues
Chapters7&8
10/10/17 Test#1Chapters3,4,5&6
10/17/17
ToothHistologyEnamel
▪ Matureenamel▪ Enamelapposition▪ Enamelmaturation▪ Componentsofmatureenamel
Chapters12&13
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▪ MicroscopicfeaturesofmatureenamelDentin
▪ Dentin-pulpcomplex▪ Appositionofdentinmatrix▪ Dentinmaturation▪ Componentsofmaturedentin▪ Typesofdentin▪ Microscopicfeaturesofmaturedentin▪ AgingandDentin
10/24/17 Pulp▪ Anatomy▪ Microscopicfeatures▪ Microscopiczones▪ Agingandpulp
GingivalandDentogingivalJunctionalTissue
▪ Histologyofgingivaltissue▪ Histology▪ Development▪ Turnovertime
Chapters13&10
10/31/17
ComponentsofPeriodontiumCementum▪ Development▪ Microscopicappearance▪ TypesofcementumAlveolarBone▪ HistologyofAlveolarBone▪ DevelopmentofjawsPeriodontalLigament▪ Componentsofperiodontalligament▪ Fibergroupsofperiodontalligament
Chapter14
11/7/17
Test#2Chapters7,8,10,12&13
11/14/17 ComponentsofPeriodontium(continued) Chapter1411/21/17 OralMucosa
▪ Classificationoforalmucosa▪ Regionaldifferencesinoralmucosa▪ Tongueandlingualpapillaehistological
features▪ Pigmentationoftheoralmucosa
Turnovertime,repair,andagingoftheoralmucosa
Chapter9
11/28/17 HeadandNeckStructures Chapter11
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▪ HeadandNeck▪ Structures▪ Glands▪ Lymphatics▪ NasalCavity
ParanasalSinuses12/5/17 ReviewforFinalExam
*Schedulesubjecttochange
GradeScale
CourseGrade PointsA 93–100%B 85–92.5%C 77–84.5%D 70–76.5%F <69.5%
Aminimumgradeof“C”(77%)orbettermustbeearnedineachdentalhygienecourseforprogressionandcompletionofprogram.CourseGradeBreakdownThefinalcoursegradewillbecalculatedfromthefollowingvalues:
FinalGradeComputation Date
Value
Test#1 25%Test#2 25%Final 50%
OtherGradingInformation
FNGRADE-FAILUREFORNON-ATTENDANCEAFailureforNon-Attendance(FN)gradeindicatesthatastudenthasfailedacourseduetonon-attendance.Itiscalculatedasan“F”inthestudent’sgradepointaverage.Forstudentsreceivingfinancialaid,failurefornon-attendancemayrequirethestudenttorefundtotheCollegeallorpartofhisorheraid.TheFNgradewillbeassignedbythefacultymemberatanytimefollowingthefinalwithdrawaldateforthecourse.SeetheCollege’spageonGradingpolicies(http://fscj.edu/grading)formoreinformation.
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IGRADE-INCOMPLETEAnIncomplete“I”gradeisgivenveryrarelyinthiscourseandonlyfordocumented,excusedabsencesthatresultinthestudentbeingunabletocompletethecourseontime.Thedecisiontograntan“I”gradeissolelyuptoProfessorConroyandisreservedforemergencysituations(prolongedillnessrequiringhospitalizationwouldbeanexample).AcontractwillbepreparedbyProfessorConroythatdetailsthestudent’sresponsibilitiestosuccessfullyresolvethe“I”grade.An“I”grademayimpactthestudent’sabilitytoqualifyforfinancialaidandmayresultinthestudentbeingrequiredtopaybackpreviousstudentloans.
CourseGuidelines&Policies
ACADEMICDISHONESTY
Academicdishonesty,inanyform,hassevereconsequences.ClickheretoviewFSCJ’sacademicdishonestydefinitionsandprocedures.
LATEMAKEUPWORKAssignmentsnotturnedinbytheduedatewillreceivea0.Make-upexaminationsforexcusedabsencesmustbecompletedassoonaspossibleuponreturningtoschool.ThestudentistoconferwithProfessorConroyimmediatelyuponreturningtoschool,presentdocumentationfortheexcusedabsence,andmakearrangementsforthemake-upexam.Failuretodothismayresultinforfeitingtherighttotakethemake-up.ATTENDANCEPOLICYDuetotheuniqueresponsibilitiesassociatedwithbecomingacompetenthealthprofessional,theprogressivenatureofthecurriculumanditsimportancetotheprovisionofqualityoralhealthservices,attendanceandclassparticipationisrequiredatallscheduledclinics,laboratories,seminars,casepresentations,scheduledclassesandindividualfacultyappointments.Shouldanabsencebenecessary,thestudentmustcontactthecourseinstructorpriortothestartofclass.Failuretocommunicateintheabovemannerwillresultintheabsencebeingconsideredunexcused.Onlyanexcusedabsence(studentillnesswithphysiciandocumentation,accident,deathintheimmediatefamily,jurydutyoranydeemedexcusablebythecourseinstructor)maybemadeup.Anotefromaphysicianorotherappropriateindividualmustbesubmittedtoconstituteanexcusedabsence.Eachunexcusedabsencewillresultinagradepenaltyofa2-pointreductionfromthefinalgradeforthefirsttwoabsences.Furtherunexcusedabsenceswillresultina5-pointreductionfromthefinalgradeforeachincident.Make-upclinicalsessions,quizzes,examsforunexcusedabsenceswillnotbeprovided.Inthiscase,agradeofzerowillbegivenfortheassignment.Latearrivalstoclassareconsideredunexcusedabsences(afterthefirsttenminutesofclass).POLICYONELECTRONICDEVICESRefertotheElectronicDevicePolicysectionoftheStudentHandbook.Unapproveddevicesshouldnotbeusedduringclasstime.Approveddevicesshouldbeusedonlyforpermittedpurposes.Ifseenbyinstructor,onewarningwillbegivenduringthetermforanyinfractionandafterthatpointswillbedeductedfromyourgrade.
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COMMUNICATIONInthiscourse,asinallcoursesinFSCJ’sDentalHygieneprogram,eachstudentisexpectedtopresentthemselvesprofessionallyintheiractions,attitudes,dress,andwritten/verbalcommunication.Allwrittenassignmentswillbeevaluatedforprofessionallanguage,grammarandspelling.Nohandwrittenassignmentswillbeacceptedinthiscourse.StudentsshouldchecktheirFSCJe-maildailyasfacultypostcourserelatedinformationviathislink.Failuretodosomayresultinmissingkeyinformation.Havingnotreadfacultymessagesisnotanacceptableexcuseforfailuretorespondappropriately.StudentsmayelecttoconfigurealinkbetweentheirFSCJandpersonale-mailaddressestoreceivemessages.COURSECONTENTIIntroductiontoCourseIIReviewofCellsandHumanEmbryology
• CellStructureandFunction• CellDivision• OriginofHumanTissueandPeriodsofPrenatalDevelopment
IIIReviewofBasicTissues
• Epithelium• BasementMembrane• ConnectiveTissue• Cartilage• Bone• Blood• Muscles• Nerves
IVDevelopmentofFaceandNeck
• OverviewofFacialDevelopment• StomodeumandOralCavityFormation• MandibularArchandLowerFaceFormation• FrontonasalProcessandUpperFaceFormation• MaxillaryProcessandMidfaceFormation• PrimitivePharynxFormation• BranchialApparatusFormation
VDevelopmentofOralFacialStructures
• OrofacialDevelopment• PalatalDevelopment• NasalCavityandSeptumDevelopment• TongueDevelopment
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VIToothDevelopmentandEruption• StagesofToothDevelopment• RootDevelopment• CementumandPulpFormation• DevelopmentofMulti-rootedTeeth• PeriodontalLigamentandAlveolarBoneFormation• PermanentToothEruption
VIIEnamel
• PropertiesofMatureEnamel• AppositionofEnamelMatrix• MaturationofEnamelMatrix• MicroscopicFeaturesofMatureEnamel
VIIIDentinandPulp
• Dentin-PulpComplex• MaturationofDentin• ComponentsofMatureDentin• TypesofDentin• MicroscopicFeaturesofDentin• AgingandDentin• AnatomyofPulp • MicroscopicFeaturesofPulp• MicroscopicZonesofPulp• AgingandPulp
IXOralMucosa
• ClassificationsofOralMucosa• EpitheliumofOralMucosa• LaminaPropriaofOralMucosa• RegionalDifferencesinOralMucosa• TongueandLingualPapillae• PigmentationoftheOralMucosa• Turnover,Time,Repair,andAging
XGingivalandDentogingivalJunctionalTissues
• AnatomyofGingivalTissue• HistologyofGingivalTissue• HistologyofDentogingivalJunctionalTissues• DevelopmentofDentogingivalJunctionalTissues• TurnoverTimeofDentogingivalJunctionalTissues
XIPeriodontium:Cementum,AlveolarBone,AndPeriodontalLigament
• DevelopmentofCementum• MicroscopicAppearanceofCementum• ClinicalConsiderationsofCementum
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• TypesofCementum• AnatomyoftheJaws• DevelopmentoftheJaws• ComponentsofthePeriodontalLigament• FibersGroupsofthePeriodontalLigament
XIIHeadandNeckStructures
• Glands• Lymphatics• ParanasalSinuses• NasalCavity
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ThefollowingFloridaStateCollegeatJacksonville(FSCJ)DentalHygienecompetenciesareaddressedinthiscourse:MajorCompetency#1:ThenewgraduateofFSCJ’sDentalHygieneprogrammustbeabletodiscernandmanageethicalissuesofdentalhygienepracticeinarapidlychangingenvironment.SupportingCompetencies(CourseObjectives):Specifically,thenewgraduatemustbeableto:1.1demonstratehonestyandintegrityinrelationshipswithpatients,colleaguesandotherprofessionals.1.3recognizePatientdocumentaslegaldocumentandmaintainitsaccuracyandconfidentiality.MajorCompetency#2:ThenewgraduateofFSCJ’sDentalHygieneprogrammustbeabletocontributetoimprovingtheknowledge,skillsandvaluesoftheprofession.SupportingCompetencies(CourseObjectives):Specifically,thenewgraduatemustbeableto:2.2 assimilate,utilize,expand,andcontributetothedentalhygieneknowledgebase.2.5 presentthemselvesprofessionallyintheiraction,attitudes,dress,writtenandverbalcommunication.MajorCompetency#3:ThenewgraduateofthedentalhygieneprogramatFSCJwillbeabletoacquireandsynthesizeinformationinacriticalandscientificmanner.SupportingCompetencies(CourseObjectives):Specifically,thenewgraduatewillbeableto:3.1access,analyze,andsharescientificdatausingtheInternetandcomputertechnology.3.2usesoundjudgmentinprocessinginformation,professionaldecisionmakingandapplicationofnewinformationtoassureevidence-basedpatientcare.MajorCompetency#6:ThenewgraduateofFSCJ’sDentalHygieneprogrammustbeabletosystematicallycollect,analyzeandaccuratelyrecordbaselinedataonthegeneral,oralandpsychosocialhealthstatusofpatientsusingmethodsconsistentwithmedicolegalprinciples.SupportingCompetencies(CourseObjectives):Specifically,thenewgraduatemustbeableto:6.1obtain,reviewandupdateacomprehensivemedical,dental,nutritional,healthbehaviorhistoryincludingassessmentofvitalsigns6.2recognizeconditionsthatrequirespecialprecautionspriortoorduringdentalhygienetreatment.MajorCompetency#7:ThenewgraduateofFSCJ’sDentalHygieneprogrammustbeabletousecriticaldecision-makingskillstoidentifyexistingproblems,potentialproblems,andetiologicfactors,contributingfactors,aswellasestablishrealisticgoalsandtreatmentstrategiestofacilitateoptimaloralhealth.SupportingCompetencies:(CourseObjectives):
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Specifically,thenewgraduatemustbeableto:7.1analyzepatientdatatoidentifysignificantfindingsimpactingthedeliveryofdentalhygieneservices.7.7identifypatientatriskformedicalemergency,takestepstopreventanemergencyandbepreparedtomanageanemergencyshoulditoccurduringtheappointment7.8obtaininformedconsentfrompatientorguardianpriortoimplementingservices.