2015.05.22医学专业英语学习ppt课件

Medicalenglishstudy,Bazhoupeopleshospitalorthopedicandtraumadepartmentwangyanchaoresidentdoctor,1,Clinical-MedicalEnglish,part1:Historycollection病史采集Inquirynkwar问诊Detailsdtelz一般资料Chiefcomplaintskmplent主诉HPC(historyofpresentingcomplaint)现病史PMH(pastmedicalhistory)既往史S/E(systemsinquiry)系统回顾FH(familyhistory)家族史SH(socialhistory)社会史P/E(physicalexamination)体格检查A/E(assistantexamination)辅助检查Summary摘要,2,Details(Biographicalbagrfk()ldata),Name姓名Age年龄Sex性别Maritalmrt()lstatus婚否Nativityntvt籍贯Race民族Occupation职业Dateofadmission入院日期Informantnfmnt病史叙述者History病史,3,Chiefcomplaints(presentingcomplaintkmplent),主诉的表示方法：症状+时间（Symptom+Time）症状+for+时间如：Chestpainfor2hours胸痛2小时症状+of+时间如：Nauseaandvomitingofthreedaysduration恶心呕吐3天症状+时间+induration如：Headache1monthinduration头痛1月时间+of+症状如：Two-dayhistoryoffever发热2天4-hourtrafficaccidentinjurytotheleftlegpainassociatedwithactivitiesobstacles.associatedwith与有关系；与相联系obstaclesn.障碍；障碍物（obstacle的复数形式）；阻碍injuryto损伤，伤害（某个部位）ex1：从昨晚饭后，病人一直感觉寒战。Patienthashadchillsafterdinnersincelastevening.可简写为Chillssincelastevening.ex2：主诉：胃肿胀已4个月。C.C.：“Swellingofthestomach“for4months.ex3：2,3个月来，一做工就感觉呼吸困难和眩晕。For2or3months,dyspneaanddizzinessonwork.,4,HPC(historyofpresentingcomplaintkmplent),现病史书写的重点包括：一、主诉中症状的详细描述；二、疾病的发展过程；三、诊疗经过；四、目前的一般情况Onset起病特征，发病情况Duration：n.持续(persistentsinceonset发病起持续至今)Severesvr严重性Relievingrliv/exacerbatingfactors缓解与恶化的因素Associatedsymptomssmptm伴随症状Reskfactors危险因素起病情况，主要症状的特点，病情的发展与演变，伴随症状（记载与鉴别诊断有关的阴性症状），诊疗经过，一般情况,5,HPC,Chiefcomplaint:Rightbreastmassfoundformorethanhalfamonth.Presentillness:Halfamonthago,thepatientsuddenlyfeltpaininherrightchestwhensheputupherhand.Aftertouchingit,shefoundamass(n.块，团)inherrightbreast,butnotendness压痛,andthepatientdidntpayattentionit.Thenthepainbecamemoreandmoreserious,sothepatientwenttotumourhospitalandreceivedapathologypldn.病理学centesissen:ti:sisn.临床穿刺术.Herdiagnosiswasbreastcancer.Thenshecametoourhospitalandaskedforanoperation.Sinceonset(起病特征，发病情况),herappetitewasgood,andbothherspiritednesssprtdns有精神andphysicalenergy（体力）arenormal.Defecation大便andurination小便arenormal,too.,6,Traumatrmandshock创伤性休克,Ateenageboyfailsfromhisbicycleandisrunoverbyatruck.Onarrivalintheemergencyroom(ER),heisawakeandalertandappearsfrightenedbutinnodistress.Thechestradiographsuggestsanair-fluidlevelintheleftlowerlungfieldandthenasogastrictubeseemstocoilupwardintotheleftchest.Whichofthefollowingisthenextbeststepinthemanagement?a.Placementofaleftchesttubeb.Thoracotomy开胸手术c.Laparotomy剖腹探查手术d.Esophagogastroscopy食管镜检查e.Diagnosticperitoneallavage诊断性腹腔灌洗,7,专业词汇翻译,teenagetinedadj.青少年的;十几岁的n.青少年时期runoverv.辗过；匆匆看；复查emergencyroom急诊室alertltn.警惕.adj.警惕的,警觉的appearstobefrightened显的有点害怕innodistress没有痛苦面容chestradiograph胸片air-fluidlevel气液平面leftlowerlungfield左下肺野nasogastrictube鼻胃管；胃管coilklvt.盘绕，把卷成圈;n.线圈；卷;vi.成圈状managementmndm()ntn.管理,操纵,治疗Placementplesmntn.安置，放置chesttube胸管,胸腔引流管,8,专业词汇翻译,CTscanning(computedtomographytmgrf)计算机断层扫描MRIscanning(MagneticResonanceImaging)核磁共振成像diaphragmatic,daifrmtik膈肌intheabsenceof缺乏，排除hemorrhagehemrdvt.n.vi病理出血significanthemorrhage显著的出血traumatictrmtkadj.外伤的；创伤的Traumaticfracture创伤性骨折;创伤骨科;外伤性骨折;创伤骨折rupturerptn.破裂；vi.破裂；vt.使破裂；断绝；发生疝acutetraumaticrupture急性创伤性破裂adjunctsdktsn.附属物,辅助手段accomplishkmplvt.完成;实现;达到;代偿Thoracotomy,rktmn.外科胸廓切开术Laparotomy,lprtmn.剖腹手术Esophagogastroscopy食管胃镜检查esophago食管gastroscopygstrskpin.胃镜检查复数gastroscopies,9,part2:RegionalAnatomy-局解,10,Bonesoffreelowerlimp-自由下肢骨,11,lowerextremities-自由下肢骨,illiumlmn.解剖髂骨pubispjubsn.耻骨；前胸侧部ischiumskmn.解剖坐骨coxaekksi:-aen.髋骨;髋关节;基节(coxa的复数)oscoxae短语髋骨;无名骨pelvicgirdle下肢带骨pelvicpelvkadj.骨盆的femurfimn.解剖股骨；大腿骨patellapteln.解剖膝盖骨fibulafbjln.解剖腓骨tibiatbn.胫骨phalangesflndizn.趾骨；指骨（phalanx的复数）metatarsals,metts()ln.跖骨;adj.跖骨的tarsalsts()ln.跗骨;adj.跗骨的；眼睑软骨的limblmn.肢，臂；分支；枝干vt.切断的手足；从上截下树枝anatomyntmn.解剖；解剖学；剖析；骨骼,12,LowerLimblm-下肢,BoundariesandDivisions(境界与分区)Thelowerlimbisconnectedtothetrunkbytheextremitygirdle.Itisseparatedanteriorlyandposteriorlyfromtheabdomeandvertebralregionbyalineconnectingtheinguinal,iliaccrest,posteriorsuperioriliacspineandthetipofthecoccyx.Itconnectswithperineummedially.下肢借肢带与躯干相连。下肢以腹股沟、髂嵴、髂后上棘至尾骨尖的连线与腹部、脊柱区分界，其内侧与会阴相连。trunktrkn.树干；躯干mediallymi:dili内侧extremitygirdle肢带extremitykstremt;n.极端;手足girdlegdln.腰带anteriorlyntiri:liadv.前方地posteriorlypstiriliadv.后侧地abdomen.腹部；domedmn.圆屋顶vertebralv,tbrladj.脊椎的；椎骨的；inguinalgwn()ladj.腹股沟的iliaclk髂骨;crestkrest波峰;冠;山顶;iliaccrest髂嵴posteriorsuperioriliacspine髂后上棘spinespann.脊柱，脊椎；刺；书脊,13,LowerLimb,Thelowerlimblmisdividedintoregionsofglutealglutl(hip),thigha,kneeni,leg,anklek()landthefoot,whichcanbefurtherdividedintoseveralsubregionssbrid()n.下肢可分为臀部、股部、膝部、小腿部、踝部及足部等。各部又可分为若干区。glutealglutl(hip)adj.臀肌的；近臀肌的thighan.大腿，股kneeni膝部anklek()l踝部severalsubregionssbrid()n若干区,14,专业名词词组学习,分离：distractiondstrk()nn.注意力分散；消遣；心烦意乱separationsepre()nn.分离，分开；间隔，距离,diastasisdastss分离(Syndesmosis,sndsmossn.解剖韧带联合diastasis胫腓下联合分离)-lysis后缀Ex:symphyseolysis耻骨联合分离arthrodiastasis(arthro-关节)关节分离fractureofmedialmalleoluswithdiastasisofinferiortibiofibularjoint内踝骨折伴下胫腓联合分离inferiornfradj.差的；自卑的；下级的，下等的；n.下级；次品tibiofibularjoint,tibiufibjuladj.胫腓的medialmalleolusmlilsn.解剖踝,15,专业名词词组学习,PLATE-接骨板条目One-thirdtubulartubjladj.管状的plate1/3管状钢板AOtitaniumtatenmn.化学钛plateAO微型钛金属板standardconventionalplate标准普通钢板conventionalknven()n()ladj.传统的；常见的dynamicdanmkadj.动态的；动力的compressionkmpre()nn.压缩，浓缩；压榨dynamiccompressionplate动力性加压钢板proximalprksmladj.最接近的，邻近的humeralhjmrladj.肱骨的；肩的；肱部的lockingproximalhumeralplate肱骨近端锁定接骨板curvedkvdadj.弯曲的；弄弯的reconstructive,riknstrktvadj.重建的；改造的curvedreconstructiveplate弧形重建接骨板anatomic,ntmkadj.组织的；解剖学上的；结构上的anatomicplate解剖型接骨板,16,专业名词词组学习,invasivenvesvadj.侵略性的；攻击性的percutaneous,pkjutensadj.经皮的；经由皮肤的minimallyinvasivepercutaneousplate经皮微创接骨板Mippbridgingbrdn.桥接；v.架桥(bridge的ing形式)bridgingplate桥接接骨板limitedcontactdynamiccompressionplate有限接触动力加压接骨板IC-DCPclavicularklvkjladj.锁骨的hookhkn.挂钩，吊钩vt.钩住；引上钩vi.钩住；弯成钩状clavicularhookplate锁骨钩接骨板tensionten()nn.张力，拉力bandbndn.带，环platetensionbandplate张力带接骨板cablekeb()ln.缆绳;电缆;钢缆wirewa钢丝tendsionbandwiringwar张力带钢丝,17,Anatomicpatternoffour-columnoftibiaplafond,TheFour-columnclassificationissummarizedasfollows:(I)Anteriorcolumnfractures:fracturesintheanteriorpartoftheintermalleoluslinerequiringfixationofanteriorfracturefragments;(II)Posteriorcolumnfractures:fracturesintheposteriorpartofintermalleoluslinerequiringfixationoftheposteriorfracturefragments;(III)Medialcolumnfractures:fracturesinthemedialpartofdistaltibiaplafondandthemedialmalleoluswiththefracturelineextendingtotibialshaftrequiringfixationofmedialfracturefragments;(IV)Lateralcolumnfractures:fracturesinthelateralpartofdistaltibiaplafondwithorwithoutfibularinjuryrequiringfixationoflateralpartoftibiaplafond,fibula,anddistaltibiofibularsyndesmosis,18,Anatomicpatternoffour-columnoftibiaplafond,Anatomicpattern:pt()n模型n.模式;图案;样品.vt.模仿,以图案装饰.vi.形成图案four-column:klm【解剖学】脊骨,脊柱.【建筑学】柱,支柱;圆柱tibiaplafond:plfn【解剖学】平台,穹窿部plateauplt平台;tibiaplateausummarizedv.总结,概括;概述(summarize的过去式及过去分词形式)Anteriorcolumnfracturesntradj.前面的；先前的intermalleoluslinemalleolusmlilsn.解剖踝inter-内anteriorfracturefragmentsntradj.前面的;先前的.fragment:frgm()ntn.碎片；片断或不完整部分Posteriorcolumnfracturespstradj.其次的;较后的n.后部;臀部Medialcolumnfracturesmidladj.【解剖学】内侧的;近中的;中层的Lateralcolumnfractureslt()r()ladj.侧面的,横向的distaltibiaplafonddst()ladj.解剖末梢的,末端的medialmalleolus内踝distaltibiofibularsyndesmosis下胫腓联合syndesmosis:,sndsmossn.解剖韧带联合tibiofibulartibiufibjuladj.胫腓的,19,Surgicalapproachesonthebasisoffour-columnclassification,Tibialisanterior胫骨肌.胫骨的.胫前肌deepperonealN腓深神经peroneal,perniladj.腓骨的；腓侧的Extensorhallucis拇趾longus长kstensn.伸肌；-拇长伸肌SuperficialperonealN腓浅神经,supf()l浅表性AnteriortibialV胫前动静脉Tendonoftheextensor伸肌腱extensorkstensn.伸肌Tendontendnn.解剖腱Digitorumilongus趾长伸肌Tendonofperoneuslongus腓骨长肌腱,Greatsaphenoussfinsveinsadj.隐的；隐静脉的。n.隐静脉-大隐静脉Tendonofthetibialisposterior-胫后肌腱Flexorfleksdigitorumlongusn.解剖屈肌-趾长屈肌PosteriortibialV-胫后动静脉Achillesstendonki-跟腱,20,踝关节CT平扫及矢状位、冠状位重建，各柱骨折在CT片上的表现分别为：腓骨骨折为外侧柱骨折；前外侧的Tillaux-Chaput骨块、后唇的Volkmann三角骨块及位于中央的压缩骨块(die-punch)为中柱骨折(仅有前外侧骨折的为中前柱骨折，仅有后唇骨折的为中后柱骨折)；内踝骨折块与胫骨近端明显失去连续性的为内柱骨折,Three-columnclassificationofPilonfracture,Tillaux-Chaputfragment:(替劳克斯-卡布特)(Tillaux骨折：即下胫腓前韧带在胫骨的起点处发生的撕脱骨折。Tillaux-Chaput骨折：同样损伤机制导致的胫骨后外侧的撕脱骨折。此名来自于两位法国外科医生HenriVictorChaput（1857-1919）和PaulJulesTillaux（1834-1904）)Volkmann三角骨块：（福克曼）Hueter-Volkmann定律即骨骺压力法则：骨骺所受压力增加，骨的生长就会受到抑制；骨骺所受压力减小，骨的生长就会加速。过度施压可抑制骺板生长，跨骺板牵张力可加速其生长。die-punchfragment:冲床样骨折块(中央的压缩骨块),21,Pilonfracture,SincePilonfracturesareintra-articularfractures,openreductionandinternalfixationwithbonegraftcanhelptoachieveanatomicalreductionandreduceincidenceoftraumaticarthritis.Stagedprocedureofexternalfixation,calcanealtractionandsecondstageopenreductionandinternalfixationareconsideredtobeareasonabletherapy.Otheralternativesarealsoeffective.Anexternalfixatorcombinedwithlimitedinvasiveinternalfixationissuitableforfractureswithlargefragments.Thismethodcanalsoprotectlocalsofttissuesfrombeinginjuredfurther.Butinfractureswithcomminutedarticularsurface,thismethodmaybelesseffective.,intra-articularfracturesrtkjladj.解剖关节的-关节内骨折openreductionandinternalfixationrdk()n复位ORIF-切开复位内固定bonegraftgrft-植骨anatomicalreduction-解剖复位traumaticarthritistrmtkadj.创伤的;arthritisrats关节炎-创伤性关节炎calcanealtractionklkenn.跟骨-tractiontrk()nn.牵引-跟骨牵引alternativesn.可供选择的事物externalfixatorkstn()l;ek-外固定fixatorfikseit固定器-外固定装置combinedwith-联合limitedinvasiveinternalfixation-有限接触内固定largefragments-大的骨折块comminutedarticularsurfacecomminutedkm,njtadj.粉碎的-粉碎的关节面,22,orthopaedics:rpidksn.医整形外科,整形术;orthopedics:n.矫形术Multifragmentary-多块骨折块Multi-mlt多-lagscrews-拉力螺钉laglg拉screwsskru:螺钉externalfixation-外固定practical-有用的；实用的feasiblefizb()ladj.可行的woundhealingdeficitdefst-切口愈合障碍severesofttissuedamage-严重的软组织损伤,MultifragmentaryTibialPilonFractures:MidtermResultsAfterOsteosynthesiswithExternalFixationandMultipleLagScrews,Wethereforeproposecombinedtreatmentusinglagscrewswithexternalfixationasapracticaltreatmentoptionforthosefracturesforwhichlagscrewscombinedwithalockingplatearenotfeasibleorwhenthereisahighriskofwoundhealingdeficitduetoseveresofttissuedamage.TheOpenOrthopaedicsJournal,2012,6,419-423,23,Managementandoutcomeofpelvicfracturesinelderlypatients:aretrospectivestudyof40cases（回顾性研究）,Keywords:pelvicfractures;elderlypatients;management;outcomeBackgroundPelvicfracturesareuncommoninelderlypatientsandsoareinfrequentlyinfri:kwntli(稀少的)addressed检索，解决，定位dresdintheliterature.Thepurposeofthisstudywastoinvestigatethemanagementandoutcomeofpelvicfracturesinelderlypatients.MethodsWeretrospectivelyreviewedtherecordsofpelvicfracturesinelderlypatients(age55years)whoweretreated(v.治疗（treat的过去分词）；对待；招待adj.治疗的；已处理过的)inourdepartmentfromSeptember1997toMay2010.,24,ResultsAtotalof40elderlypatientswithpelvicfractureswereidentified.Theirmeanagewas65.8years(range5587years).About68%(n=27)weremen.TheaverageInjurySeverityScore-创伤严重度评分(ISS)was17.8(range645).Twelve(30%)patientsrequiredbloodtransfusion输血(mean10units)duringthefirst24hours.Thefracturesweremostfrequently经常，常见duetofallingfromastandingposition站的姿势(48%).Almosthalf(48%)weregradeIbreaks.Associatedinjurieswerepresentin70%(n=28)ofpatients,and65%(n=26)hadmedicalco-morbidities医疗共病.Altogether,29patients(73%)underwentnon-surgicalmanagementoftheirpelvicfracture.Theaveragehospitalstaywas25days（平均住院日）.Therewerefivein-hospitaldeathsandonedeath10monthsafterdischarge获准出院.HighISSs(25)wereassociatedwithincreasedin-hospitalmortalitymtlt死亡数，死亡率(P=0.018).Atthefinalassessment(meanfollow-up15months),52%ofthesurvivingpatients存活组hadexperienceddecreased减少的self-sufficiency自给自足；自负.,25,ConclusionsPelvicfracturesinelderlypatientsresultinhighmorbiditymbdtandmortality（发病率和死亡率）rates.AhighISS(25)canbeusedtoidentifyapatientathighrisk.Werecommend(vi.推荐；建议)aggressivegresvresuscitationr,sstenn.复苏(积极的液体复苏)andintensivecare重症护理forthatpatient.Forpatientswithanunstablepelvicordisplacedacetabularfracture-移位型髋臼骨折(2mm)whocanendure（vt.耐受）surgery,openreductionandinternalfixationcanprovideadequate-（适当，坚强的）fixationforearlyweight-bearing（负重）andrestorationrestre()nn.恢复ofthebonestock.ChinMedJ2014;127(15):2802-2807,26,part3:OralEnglish,ClinicalcommonlyusedwordsPhysicalexamination体格检查Vitalsigns生命体征:Temperature体温pulse脉搏/min次/分respiration呼吸/min次/分B.P血压mmHgGeneralAppearance一般状况,27,问诊常用语,Hello.may(can)Ihelp