骨科学习ppt演示课件

.,1,Osteoarthritis,2,.,Osteoarthritis (OA) also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints ,including articular cartilage and subchondral bone. 骨性关节炎又称退行性关节炎或退行性关节病，是关于关节毁坏的一系列机械性异常，涉及关节软骨和软骨下骨。Degenerative didenrtiv a. 退化的;变质的Cartilage k:tilid n. 软骨,.,3,Symptoms may include joint pain, tenderness, stiffness, and sometimes an effusion. 症状包括关节疼痛、压痛、僵硬、 有时有积液。 Stiffness stifnis n.僵硬;生硬,A variety of causeshereditary, developmental, metabolic, and mechanicalmay initiate processes leading to loss of cartilage . 遗传、发育、代谢和机械等各种因素均有可能影响软骨损伤 的过程。 Hereditary hrd,tr a.遗传的,4,.,When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.,当骨表面的软骨保护不良时，骨面就会暴露损伤。导致少量活动就会引起继发性疼痛、区域肌肉萎缩以及韧带松弛。Atrophy trf n. 萎缩;发育停止;虚脱Lax lks a. 松弛的;质地松的,.,5,Causes,Some investigators believe that mechanical stress on joints underlies all osteoarthritis, with many and varied sources of mechanical stress, including misalignments of bones caused by congenital or pathogenic causes; mechanical injury; overweight; loss of strength in muscles supporting joints; and impairment of peripheral nerves, leading to sudden or uncoordinated movements that overstress joints. 一些研究者认为，关节上各种机械应力包括先天的和病原造成的移位是基于退行性关节炎的；机械损伤，超重，维持关节的肌肉的损害和末梢神经的损害导致突发的或者不协调的移动，加重关节承载。 Misalignment mislanmnt n.移位 pathogenic ,pdnk a. 致病的 病原的 Peripheral prfr l a. 体表的;(神经)末梢的,.,6,epidemiology A number of studies have shown that there is a greater prevalence of the disease among siblings and especially identical twins, indicating a hereditary basis.大量研究表明：兄弟姐妹尤其是同卵双胞胎之间疾病普遍存在，这是遗传的基础。,sibling s i b l i n.兄弟姐妹 identical twins 同卵双胞胎,.,7,Signs and symptoms,The main symptom is pain, causing loss of ability and often stiffness. OA can cause a crackling noise when the affected joint is moved or touched, and patients may experience muscle spasm and contractions in the tendons. Occasionally, the joints may also be filled with fluid. 主要症状是疼痛、造成功能的丧失，常常伴有僵直。当受影响的关节移动或者触摸时，退行性关节炎可引起一连串的噼啪声，病人可能会出现肌肉痉挛和肌腱挛缩。偶尔，关节也会有大量液体。 Crackling krkl n.连续的爆裂声 Spasm spzm n. 痉挛,抽搐 contraction kntrkn n.收缩,挛缩,.,8,Diagnosis,The typical changes seen on X-ray include: joint space narrowing, subchondral sclerosis (increased bony formation around the joint), subchondral cyst formation, and osteophytes. X线典型表现包括：关节间隙狭窄、软骨硬化、软骨囊肿和骨赘。 sclerosis ,skl ross n.硬化症;硬化 cyst sist n.囊肿 osteophyte stiufait n.骨赘,9,.,Classification,Osteoarthritis can be classified into either primary or secondary depending on whether or not there is an identifiable underlying cause. 骨性关节炎分为原发性或继发性取决于是否有一个明确的病因。 Identifiable aidentifaibl可认明的;可识别的,.,10,Primary,Primary osteoarthritis is a chronic degenerative disorder related to but not caused by aging, as there are people well into their nineties who have no clinical signs of the disease. As a person ages, the water content of the cartilage decreases as a result of a reduced proteoglycan content, thus causing the cartilage to be less resilient. 原发性骨性关节炎是一种慢性的退行性病变，与年龄有关但不是老化，因为一些没有临床症状的人很好的活到了九十岁。作为一个上了年纪的人，软骨所含水分的减少从而导致粘蛋白含量下降，因此引起软骨弹性下降。 proteoglycan ,protioglaikn n.蛋白聚糖，粘蛋白 resilient rizilint a.有弹力，有弹性的,11,.,Secondary,This type of OA is caused by other factors but the resulting pathology is the same as for primary OA : congenital disorders of joints, diabetes ,inflammatory diseases ,injury to joints ,septic arthritis, Marfan syndrome, obesity,这种退行性关节炎是由其他因素引起的,但是所指的病理结果与原发性的相同，这些因素是：先天性关节疾病、糖尿病、炎症性疾病、关节外伤、化脓性关节炎、马凡综合症、肥胖Septic sptik 败血症的,.,12,treatment,Treatment generally involves a combination of exercise, lifestyle modification, and analgesics. 治疗通常是锻炼、改变生活方式，并结合止痛药。 Analgesic ,nldizik n.止痛剂,.,13,If lifestyle modification and analgesics is ineffective, an orthopedic surgeon or resurfacing may be required in advanced cases. 如果改变生活方式和药物治疗无效，矫形手术或者翻新重修对于这类病例是有必要的。 Resurfacing r i s f i s i n.翻新 Orthopedic ,rpidk n.矫形,14,.,Surgical complication,Postoperative surgical complications represent one of the most frustrating and difficult occurrences experienced by surgeons who do a significant volume of surgery. 外科术后并发症是经验丰富的外科医生最困扰和最难对付的困扰之一。 Postoperative ,postprtv a. 手术后的 Frustrating frstret a.令人沮丧的,15,.,The cost of surgical complication in the United States today runs into millions of dollars and is associated with lost work productivity, disruption of normal family life, and unanticipated stress to employers and society in general. 当前美国的外科术后并发症浪费了无数的金钱，同时导致劳动能力丧失，正常家庭生活的破坏，而且为雇主和社会带来了无法预料的压力。,Disruption dsrpn n.分裂、瓦解Unanticipated nntisipeitid a.意料之外的,16,.,Sometimes , a surgeon who is sloppy , is careless, or hurries through an operation can make technical errors that account for the operative complications. 有时，手术中医生的马虎、粗心或仓促都可以导致技术上的错误从而导致手术并发症。,Sloppy sl p a.懒散的、草率的,17,.,The patient can be doing well nutritionally, have an operation performed meticulously, and yet suffer a complication because of the nature of the disease. 病人营养状况良好，手术非常小心，疾病本身也可以导致并发症的发生。,Meticulously mtikjlsli a.极细心的,18,.,Some operations can be performed in a purely elective fashion, whereas others have some urgency about an expeditious surgical solution. 一些手术可以择期进行，而有些可能需要进行急诊手术。,Expeditious ,kspds