大三下-医学英语chapter two

CHAPTERCommonlyUsed食管CommonlyUsed食管裂孔急性腐蚀性急性糜性胃慢性浅表性倾倒综合十二指肠hiatusherniarefluxesophagitisacutesimplegastritisacutecorrosivegastritisacutehemorrhagicerosivegastritischronicsuperficialgastritischronicatrophicgastritiscarcinomaofstomach上消化 下消化 lowergastrointestinal十二指肠溃 duodenal溃疡性结肠 ulcerative肠梗 intestinal结肠 carcinomaofthe直肠 carcinomaofthe肠易激综合 irritablebowel功能性便 functional大便失 fecal炎症性肠 inflammatorybowel腹 性肝 alcoholicliver性肝 primarycarcinomaofthe肝细胞性黄 hepatocellular腹 肝性脑 hepatic肝囊 hepatic胆囊 胆 胰腺 脂肪 fatty肠套 肠扭 肠梗 intestinal胃下 腹膜 急性单纯性阑尾 actuesimple急性化脓性阑尾 actuesuppurative急性坏疽性阑尾 actuegangrenous外 external内 internalBackgroundWhat'sthefirststepinthedigestiveprocess?Believeitornot,ithappensbeforeyouWhat'sthefirststepinthedigestiveprocess?Believeitornot,ithappensbeforeyoueventasteyourfood.Justbysmellingthathomemadeapplepieorthinkingabouthowdeliciousthatripetomatoisgoingtobe,youstartsalivating—andthedigestiveprocessbegins,preparingforthatfirstscrumptiousbite.Foodisourfuel,anditsnutrientsgiveourbodies’cellstheenergyandsubstancestheyneedtooperate.Butbeforefoodcandothat,itmustbedigestedintosmallpiecesthebodycanabsorbanduse.Almostallanimalshaveatube-typedigestivesysteminwhichfoodentersthemouth,passesthroughalongtube,andexitsasfeces(poop)throughtheanus.Thesmoothmuscleinthewallsofthetube-shapeddigestiveorgansrhythmicallyandefficientlymovesthefoodthroughthesystem,whereitisbrokendownintotinyabsorbableatomsandmolecules.Duringtheprocessofabsorption,nutrientsthatcomefromthefood(includingcarbohydrates,proteins,fats,vitamins,andminerals)passthroughchannelsintheintestinalwallandintothebloodstream.Thebloodworkstodistributethesenutrientstotherestofthebody.Thewastepartsoffoodthatthebodycan'tusearepassedoutofthebodyasfeces.Everymorseloffoodweeathastobebrokendownintonutrientsthatcanbeabsorbedbythebody,whichiswhyittakeshourstofullydigestfood.Inhumans,proteinmustbebrokendownintoaminoacids,starchesintosimplesugars,andfatsintofattyacidsandglycerol.Thewaterinourfoodanddrinkisalsoabsorbedintothebloodstreamtoprovidethebodywiththefluiditneeds.Nearlyeveryonehasadigestiveproblematonetimeoranother.Someconditions,suchasindigestionormilddiarrhea,arecommon;theyresultinmild andgetbetterontheirownorareeasytotreat.Others,suchasinflammatoryboweldisease,canbelonglastingortroublesome.AdoctorwhospecializesinthedigestivesystemiscalledaGIspecialistorgastroenterologist.IntheIntheConsultingSceneD:Yourheartsounds .Let’stakeyourblood(AftertakingthebloodThere’snoproblemthere.I’mgoingtogiveyouthreeforms.TakethisonetohaveanX-ray,andthisonetothePathologyLab,andwe’llgetyourwhitebloodcellcountcheckedout.ThislastoneisforyoutohaveanECG.You’llfindallthesethreedepartmentstogetherattheendofthecorridoronthesecondfloor.Comebacktomorrowandpickupallthreereports,thenbringthemtomyoffice.(ThenextP:Here’remyresults,D:Haveaseat,andlet’shavealook.Well,yourECGisperfectlynormal,andthere’snoproblemwithyourX-ray,either.Butyourwhitebloodcellcountisratherhigh,whichiswhatIexpectedasitshowsyourbodyisfightingthe.Itcanbediagnosedasgastricflu.P:Oh,youmeanI’vecaughtinfluenza,D:No,gastricflu,alsocalledviralgastroenteritis,referstoaninfectionofthestomachorsmallandlargeintestinescausedbyavarietyofesthatresultinvomitingordiarrhea.P:ThenwhyisitcalledgastricD:Althoughitisoftencalledthe“gastricflu,”itisnotcausedbytheinfluenzaesatall.P:Isitaseriousillness,D:Infact,itisnotthatserious,peoplewhogetgastricflualmostalwaysrecovercompleywithoutanylong-termproblems.Butitiscontagious.Theesthatcausegastricfluarespreadthroughclosecontactwithinfected sbysharingfood,water,oreatingutensils.P:Isthereanythingyoucangivetomakemefeelbetter,Doctor?I’mverybusyatwork,butIreallydon’tfeeluptoit.Also,mydaughterisillinbed,and…D:Don’tworry.It’sjustgastricflu,butI’llgiveyousomemedicineforittomakeyoufeelbetter.Threetimesadaytakethewhitetabletsasdirectedonthelabelaftermeals;andforthecharcoaltablets,takeoneortwodependingonhowlooseyourbowlsare.D:Iknowyouarebusy,butyoureallyshouldn’tgotowork.Restasmuchaspossible,drinkplentyofwatertopreventseverelossoffluids,eatplentyofvegetablesandfruit.Remember,anappleadaykeepsthedoctoraway.Ifthere’snoimprovementafterthreedays,comebackandseemeagain.P:Thankyou,(P= D=

SceneP:Doctor,mystoolshavebeenblackforthepasttwodaysandIfeelweakalloer,I’vegotapoorappetiteforseveraldays.D:Havetheyeverbeenblackbefore?P:No.Thisisthefirsttime.D:HaveyouhadanypainwithP:Yes,inmystomach,that’swhereIalwayshavethepain.D:Doesitstayinthatoneplaceallthetime?P:Sure,itisfixedandrarelyD:Canyoudescribewhatkindofpainyou’vegotforP:Well,sortofburns,Ithink,likeburning.AndI’vehaditoffandonforthepasttwoyears,butit’sneverbeenthisbadbefore.D:DoesspicyfoodaffectP:Yes,itgetsworseafterIeatspicyfoodorD:Howdoyougetrelief?Imean,inwhatwaythepaincanbeP:Normally,Ihavelesspainaftereating.Soassoonasthepainstarts,I’lldrinkaglassofmilkandthatwillquietthingsdown.D:AreyousosurethatthepainstartsbeforeP:Yes,itoftenoccurs2to3hoursafterameal,andsometimesinthemidnight.D:Doesitusuallygetworseasthedaygoeson?P:Yes,itdoes.Theworstonewaslastnightaboutoneo’clock,Itookfourglassesofmilktoquietitdown.D:Haveyoufeltfaintorchilled?P:No,justalittleweak.D:Didyouvomitsometimes?P:Yes,Idid.D:Whatdidyouvomit,foodorblood?Whatwasthecoloroftheblood?P:Foodwithalittleblood.Justlikecoffee.D:I’llexamineyourabdomen.Liedownandloosenyourclothes.Pleasebendyour(AfterthephysicalD:Ithinkwe’dbettertakeanX-rayfilmofyourgastrointestinaltract.Andthatyou’vegotapepticulcer,moreexactly,itisasoreontheliningoftheduodenum.Toconfirmthediagnosis,youalsoneedtotakeanendoscopyforthetestofH.pylori.P:HowdidIgetthisdisease?WhatmightbetheD:Aduodenalulceriscausedwhentheliningofthestomachiseatenawaybystomachacidanddigestivejuices.AtypeofbacteriacalledH.pyloricommonlycausesduodenalulceranditisknownasbacterialinfection.Othercommoncausesincludeanti-inflammatorymedicationssuchasaspirinandstress,nicotine,caffeine,andalcoholuse.P:AndeatingspicyfoodalsocontributestoD:No,notusuallycausedbyeatingspicyfood,butitcanmakeulcersworse.P:Whatcanbedoneformyulcers?D:Thetreatmentwillbedependingonthecauseoftheulcer.IfyourulcerwascausedbyH.pylori,amainpartofthetreatmentistoclearthisinfectionwithantibiotics.Inaddition,youneedtotakeanacid-suppressingdrugtoallowtheantibioticstoworkwell.Ifyourulceriscausedbyananti-inflammatorydrug,definiy,youshouldstopthedrug.Thisallowstheulcertoheal.Beforetheresultcomesout,I’llgiveyousomemedicineforatemporaryrelief.D:IsthereanythingelseIcanD:Ifpossible,tryeverymeanstoavoidalcoholandyoushouldstopsmokingaswell.Otherlifestylechangesmayincludeeatingbalanced,nutritiousmeals,learninghowtomanagestress,andgettingplentyofrestandexercise.Andwheneveryouhaveanybleeding,comeimmediaytothehospital.P:Thankyouverymuch,Vocabularyonthecramp n.apainfulandinvoluntarymuscular n.inflammationofthestomachand intestines;canbecausedbySalmonellaenteritidis肠胃炎charcoaltablet药用炭pepticulcern.anulcerofthemucousmembraneliningofthealimentarytract消化duodenum n.thepartofthesmallintestinebetweenthestomachandthejejunum十二指肠 n.visualexaminationoftheinteriorofahollowbodyorganbyuseofanendoscope内窥镜检查H.pylorigram-negative,microaerophilicbacteriumthatinhabitsvariousareasofthestomachandduodenum幽门螺杆菌ibuprofenn/n.anonsteroidalanti-inflammatorymedicineusedtorelievethepainofarthritisandasangesicandantipyretic异LanguagePointsonthe…andIalsofeelsick.Ikeepgettingstomachcramp,andI’vehadaheadacheandafeverforafewdays.crampe.g.Apainfulcrampormusclespasmasinthebackorneck.痛性痉挛颈部或背部Igotothetoilet3or4timesadayandmybowlsareveryloose.loosebowlemptyingeasilyorexcessively。e.g.Thereareafewloosebowlscomposedmostlyofbloodmucus.loosecough,RiskRiskFactorsforH.H.pylorigrowandcolonizeonlyintheintestinaltractsofprimates.Thebacteriamostlikelytransmitteddirectlyits.Still,littleisyetknownAbouthalftheworld’sadultsareinfectedwithH.pylori.Thebacteriaarenearlyalwaysacquiredduringchildhoodandpersistthroughoutlife,ifnottreated.Theprevalenceinchildrenrangesfromlessthan10%tomorethan80%,withthehighestinfectionrates(3~10%)indevelo countriesandthelowest(0.5%)inindustrializednations,whereratescontinuetodecline.Eveninindustrializedcountries,however,infectionratesinregionswithcrowded,unsanitaryconditionsareequaltothoseindevelocountries.Itisnotentirelyclearhowthebacteriaaretransmitted.Onestudydidnotfindthatinfectedstudentsposedanyriskfortheirclassmates.Transmissionwithinfamiliesma