A brief history of medical diagnosis and the birth of the clinical laboratory3

2024年全国医学考博英语写作常用词汇全文共3篇示例，供读者参考篇12024 National Medical Doctoral English Writing Common VocabularyIn 2024, the National Medical Doctoral English Writing exam is an important assessment for aspiring medical professionals in China. To succeed in this exam, candidates must be well-versed in a variety of medical English vocabulary. Below are some common words and phrases that may appear on the exam:1. Diagnosis - The process of determining the cause of a medical condition2. Treatment - The course of action taken to address a medical issue3. Patient - An individual receiving medical care4. Symptom - An indication of a medical condition5. Disease - A medical condition characterized by specific symptoms6. Prescription - A written order for medication or treatment7. Surgery - A medical procedure performed to treat a condition8. Lab test - A diagnostic test performed on a sample of blood, urine, or tissue9. Radiology - The branch of medicine that uses imaging technology10. Anesthesia - A medication that induces loss of sensation for surgery11. Rehabilitation - The process of restoring health and function after an injury12. Consultation - A meeting with a doctor to discuss medical concerns13. Chronic - A long-lasting medical condition14. Acute - A sudden and severe medical condition15. Prognosis - The likely outcome of a medical condition16. Palliative care - Treatment focused on relieving symptoms and improving quality of lifeIt is important for candidates to understand these terms and how to use them in a medical context. In addition to thevocabulary, candidates should also practice writing essays on medical topics to prepare for the exam. By building a strong foundation of medical English vocabulary and writing skills, candidates can increase their chances of success in the 2024 National Medical Doctoral English Writing exam.篇22024 National Medical Doctoral Entrance Examination English Writing Common VocabularyIntroductionThe National Medical Doctoral Entrance Examination is a crucial step for medical graduates in China to pursue further education and become experts in their fields. For those who are preparing for the examination in 2024, having a good command of English writing is essential. In this document, we will provide a list of common vocabulary that is frequently used in English writing for the National Medical Doctoral Entrance Examination.Common Vocabulary1. Efficacy: The ability of a treatment or intervention to produce a desired result.2. Pathogenesis: The development and progression of a disease.3. Epidemiology: The study of the distribution and determinants of health-related events in populations.4. Diagnosis: The identification of a disease or condition through a medical evaluation.5. Prognosis: The likely course and outcome of a disease.6. Treatment: The medical care given to a patient for an illness or injury.7. Prevention: The actions taken to avoid the occurrence of a disease or condition.8. Research: The systematic investigation of a topic to establish facts and reach new conclusions.9. Therapy: The treatment of disease or injury through medical interventions.10. Palliative care: The specialized medical care for people with serious illnesses to improve their quality of life.11. Chronic: Lasting for a long period of time or recurring frequently.12. Acute: A sudden and severe onset of symptoms.13. Endemic: Prevalent in a specific population or region.14. Outbreak: A sudden increase in the number of cases of a disease in a specific population.15. Immunization: The process of making a person immune to a disease.16. Hereditary: Passed down from parent to offspring through genes.17. Mutation: A change in the DNA sequence of an organism.18. Symptom: A physical or mental feature that is considered characteristic of a disease.19. Syndrome: A group of symptoms that consistently occur together.20. Progression: The development and advancement of a disease or condition over time.In conclusion, mastering the above-mentioned vocabulary will help candidates in the 2024 National Medical Doctoral Entrance Examination perform better in the English writing section. It is recommended that candidates practice using thesewords in sentences and essays to improve their writing skills. Good luck to all the candidates preparing for the examination!篇32024 National Medical Entrance Exam for Postgraduates (MEE) Writing Test: Common VocabularyIntroductionThe National Medical Entrance Exam for Postgraduates (MEE) is a highly competitive exam that tests the knowledge and skills of candidates who wish to pursue a career in the medical field. One of the sections in the exam is the writing test, which requires candidates to demonstrate their proficiency in English and their ability to communicate effectively in written form. In this document, we will provide a list of common vocabulary that is often used in the MEE writing test to help candidates prepare for this challenging exam.Academic Vocabulary1. Diagnosis: the identification of a disease or condition based on its symptoms and medical history.2. Treatment: the medical care provided to a patient to cure or alleviate a disease or condition.3. Prognosis: the likely course or outcome of a disease or condition.4. Pathophysiology: the study of the physiological processes that underlie disease.5. Epidemiology: the study of the distribution and determinants of diseases in populations.6. Pharmacology: the study of drugs and their effects on the body.7. Radiology: the branch of medicine that uses imaging techniques such as X-rays and CT scans to diagnose and treat diseases.Clinical Vocabulary1. Patient: a person who is under medical care.2. Symptoms: the subjective experiences that a patient reports, such as pain or fatigue.3. Signs: the objective findings that a healthcare provider observes during a physical examination.4. Differential diagnosis: the process of distinguishing between two or more possible conditions based on their symptoms and test results.5. Treatment plan: a set of interventions that a healthcare provider recommends to manage a patient's condition.6. Follow-up: the monitoring of a patient's progress after treatment.Scientific Vocabulary1. Hypothesis: a testable explanation for a scientific phenomenon.2. Research: the systematic investigation of a scientific question.3. Data: information that is collected and analyzed in scientific research.4. Control group: a group in an experiment that does not receive the treatment being studied.5. Bias: factors that skew the results of a study.6. Peer review: the evaluation of a scientific study by experts in the field before it is published.General Vocabulary1. Communication: the exchange of information between individuals.2. Collaboration: working together with others to achieve a common goal.3. Ethics: the principles that govern moral behavior in a particular profession.4. Professionalism: the conduct, aims, or qualities that characterize or mark a profession or a professional person.ConclusionThis list of common vocabulary is by no means exhaustive, but it covers many of the key terms that candidates are likely to encounter in the writing test of the 2024 National Medical Entrance Exam for Postgraduates. Candidates are encouraged to familiarize themselves with these terms and practice using them in their writing to improve their chances of success on the exam. Good luck!。

第三部分医学英语的写作任务一标题的写作（Title）标题的结构1. 名词+介词Blindness（视觉缺失）after Treatment for Malignant Hypertension 2. 名词+分词Unilateral Neurogenic Pruritus Following Stroke中风后单侧神经性瘙痒3. 名词+不定式Suggestion to Abolish Icterus Index Determination（黄疸指数测定）where Quantitative Bilirubin Assay（胆红素定量）is Available建议能做胆红素定量的化验室不再做黄疸指数测定4. 名词+同位语Gentamicine, a Selelctive Agent for the isolation of Betahemolytic Streptocc ociβ-溶血性链球菌庆大霉素是分离β-溶血性链球菌的选择性药物5. 名词+从句Evidence that the V-sis Gene Product Transforms by Interaction with the Receptor for Platelet-derived Growth Factor血小板源性生长因子.V-sis 基因产物由血小板生成因子受体相互作用而转化的依据6. 动名词短语Preventing Stroke in patients with Atrial Fibrillation心房纤维性颤动心旁纤颤患者中风预防Detecting Acute Myocardial Infarction（急性心肌梗死）byRadio-immunoassay for Creative Kinase（酐激酶）用放射免疫法测定酐激酶诊断急性心肌梗死7. 介词短语On Controlling Rectal Cancer8. 陈述句Dietary Cholesterol is Co-carcinogenic协同致癌因素for Human Colon Cancer9. 疑问句Home or Hospital BirthsIs Treatment of Borderline Hypertension Good or Bad?注意副标题的作用1．数目：Endoluminal Stent-graft 带支架腔内搭桥for Aortic Aneurysms动脉瘤: A report of 6 cases带支架腔内搭桥治疗动脉瘤的六例报告2．重点：Aorto-arteritis 大动脉炎Chest X-ray Appearance and Its Clinical Significance大动脉炎胸部X线表现及临床意义3．方法：Gallstone Ileus（胆结石梗阻）: A Retrospective Study 4．作用：Carcinoembryonic Antigen in Breast-cancer Tissue: A useful prognostic indictor乳腺癌组织中癌胚抗原——一种有用的预后指示5．疑问：Unresolved—Do drinkers have less coronary heart disease? 6．连载顺序：Physical and Chemical Studies of Human Blood Serum: II. A study of miscellaneous Disease conditions人类血清的理论研究：II. 多种病例的研究7．时间：A Collaborative 综合Study of Burn Nursing in China: 1995-1999常见标题句式举例1. 讨论型：Discussion of/ on; An approach to; A probe into; Investigation of; Evaluation of / on汉语中的“初步体会”、“试论”、“浅析”之类的谦辞可以不译。

关于疾病的英文单词语Title: Diseases: A Brief Overview of Common Medical Conditions.Diseases are a wide range of conditions that affect the body, causing various symptoms and affecting overall health. They can be caused by various factors, including bacteria, viruses, fungi, parasites, genetic factors, and lifestyle choices. In this article, we will explore some common diseases and their symptoms, causes, and treatment options.1. Heart Disease.Heart disease is a broad term that refers to several conditions affecting the heart. It is the leading cause of death globally, accounting for more than 17 million deaths each year. Heart disease can be caused by factors such as smoking, unhealthy eating habits, lack of exercise, high blood pressure, and high cholesterol levels.Symptoms of heart disease may include chest pain, shortness of breath, fatigue, and irregular heartbeat. Diagnosis is usually made through a combination of medical history, physical examination, and tests such as electrocardiogram (ECG), echocardiogram, and stress test.Treatment options for heart disease may includelifestyle changes such as smoking cessation, healthy eating, and regular exercise. Medications may also be prescribed to control blood pressure, cholesterol levels, and heart rate. In severe cases, surgical procedures such as angioplasty or coronary bypass surgery may be necessary.2. Diabetes.Diabetes is a chronic condition that affects the body's ability to regulate blood sugar levels. It occurs when the pancreas cannot produce enough insulin or when the body's cells cannot use insulin effectively. Diabetes can lead to various complications, including heart disease, stroke, kidney failure, and blindness.Symptoms of diabetes may include frequent urination, excessive thirst, hunger, and unexplained weight loss. Diagnosis is usually made through a blood test to measure blood sugar levels.Treatment for diabetes typically involves lifestyle changes such as healthy eating, regular exercise, andweight loss. Medications may also be prescribed to help control blood sugar levels. Insulin injections may be necessary for some people with type 1 diabetes.3. Cancer.Cancer is a group of diseases that involve abnormalcell growth and division. It can affect almost any part of the body and is caused by a combination of genetic, environmental, and lifestyle factors. Cancer cells can spread to other parts of the body, forming secondary tumors.Symptoms of cancer depend on the type and location ofthe tumor. Common symptoms may include unexplained weight loss, fatigue, pain, and changes in bowel or bladder habits.Diagnosis is usually made through a combination of medical history, physical examination, and tests such as biopsies, imaging tests, and blood tests.Treatment for cancer depends on the type and stage ofthe disease. It may involve surgery to remove the tumor, radiation therapy to kill cancer cells, chemotherapy tostop cancer cell growth, and immunotherapy to boost the immune system's ability to fight the disease.4. Depression.Depression is a common mental illness that affects how people feel, think, and behave. It can lead to feelings of sadness, loss of interest in activities once enjoyed, and changes in appetite and sleep patterns. Depression can be caused by various factors, including genetic, environmental, and hormonal factors.Symptoms of depression may include persistent sad or anxious mood, loss of interest in activities, changes in appetite or sleep patterns, feelings of guilt orworthlessness, and thoughts of suicide. Diagnosis is usually made through a combination of medical history, physical examination, and psychological tests.Treatment for depression typically involves a combination of psychotherapy (talk therapy) and medication. Psychotherapy can help people identify and change negative thought patterns and behaviors. Medications such as antidepressants may also be prescribed to help improve mood and symptoms.In conclusion, diseases are a wide range of conditions that can affect the body in various ways. It is important to recognize the symptoms of these diseases and seek prompt medical attention. With proper diagnosis and treatment, many diseases can be managed effectively, improving overall health and quality of life.。

a第二次诊断英语作文Title: The Importance of a Second Diagnosis.In the realm of medicine, a second diagnosis is often considered crucial, yet it is often overlooked or underestimated. This article aims to delve into the significance of a second opinion, its benefits, and how it can potentially improve patient outcomes.Firstly, a second diagnosis provides a fresh perspective. Medicine, being a vast and complex field,often requires a multifaceted approach. Doctors, despite their expertise, may have biases or preconceptions that can influence their diagnosis. A second doctor, with adifferent background and training, may identify subtlesigns or symptoms that the first doctor might have missed. This fresh perspective can lead to a more accurate diagnosis, which is crucial in ensuring effective treatment.Secondly, a second diagnosis acts as a check andbalance. No doctor is perfect, and even the most experienced can make mistakes. A second opinion can help validate or refute a diagnosis, thus minimizing the chances of a misdiagnosis. This is particularly important in cases where the initial diagnosis is severe or life-threatening. By seeking a second opinion, patients can ensure that they are not being treated for the wrong condition, which could potentially lead to unnecessary procedures, medications, or even worse, worsened health outcomes.Moreover, a second diagnosis can lead to more comprehensive treatment plans. Different doctors may have different approaches or expertise, and a second opinion can provide patients with a wider range of treatment options. This not only gives patients more choices but also ensures that they are receiving the most appropriate and effective treatment for their condition. Additionally, a second opinion can act as a catalyst for doctors to collaborate and discuss the best possible treatment plans for their patients. This collaborative approach often leads to better outcomes as doctors can learn from each other's experiences and expertise.Additionally, a second diagnosis can provide psychological reassurance to patients. Dealing with a health condition can be stressful and overwhelming, and a second opinion can provide patients with a sense of reassurance and confirmation that they are on the right track. This psychological boost can help patients cope better with their condition, adhere to treatment plans more effectively, and generally maintain a more positiveattitude towards their recovery.However, it is important to note that seeking a second diagnosis does not mean doubting the first doctor's diagnosis. Doctors spend years acquiring their knowledge and skills, and their initial diagnosis should always be taken seriously. A second opinion should be sought as a complement to the first diagnosis, not as a replacement. It is about ensuring that patients receive the best possible care and treatment by leveraging the expertise of multiple doctors.In conclusion, the importance of a second diagnosiscannot be overstated. It provides a fresh perspective, acts as a check and balance, leads to more comprehensive treatment plans, and provides psychological reassurance to patients. By seeking a second opinion, patients can ensure that they are receiving the most accurate and effective diagnosis and treatment for their condition. In the end, it is about ensuring the best possible outcomes for patients and giving them peace of mind during their health journey.。

What is diagnosis? 什么叫诊断？Diagnosis is investigation and judgment. 诊断就是诊察和判断Investigation is data collecting. 诊察是收集疾病信息Judgment is synthesis and analyze data to determine the nature of illness. 判断是综合分析信息确定所患疾病The diagnosis is taking about the method of data collecting and how to make a correct judgment. 诊断学讲述收集信息和正确判断疾病的方法Steps of Diagnosis诊断步骤Data collecting history intervewing physical examination laboratory examination assistant examinationData analyzingDetermination of the nature of the illness收集信息资料采集病史体格检查实验室检查辅助检查推理分析判断确定所患疾病Classification of Clinical Diagnosis临床诊断的分类Etiologic diagnosis Virus hepatitis Rheumatic heart disease Pathological-anatomic diagnosis Aortic regurgitation Liver cirrhosisPathophysiologic diagnosis Shock Uremia病因诊断病毒性肝炎风湿性心脏病病理解剖诊断主动脉瓣关闭不全肝硬化病理生理诊断休克尿毒症Inquiry问诊Inquiry is one method from the interview between doctor and patient or relative for disease history, and making the clinical determination by analyzing history.通过对患者或相关人员的询问获取病史资料经过综合分析作出临床判断Contents of Questioning 问诊的内容Identifying informationSource and reliabilityChief complaintsPresent illnessPast medical historyPersonal historyMarital history Menstrual and obstetric history in womenFamily history患者个人信息叙述者和可信度主诉现病史既往史个人史婚姻史月经生育史家族史Identifying Information 患者个人信息NameSex and AgeNative placeBirth placeNationalityMarriageAddress Work placeOccupation 姓名性别和年龄籍贯出生地国籍或民族婚姻住址工作地点职业Others Information其他相关信息Chief Complaint主诉Main discomfort and its durationMake sure to be: concise sequential persisting headache for 3 daysMake sure to avoid using: onset time of the disease diagnostic terms dialects主要痛苦+经过时间书写注意要简明扼要要按时间先后顺序持续头痛3天三不要不要用起病时间不要用诊断术语不要用方言土语Present Illness现病史Further description of the main complaint, including the whole disease processOnset and duration and Predisposing factorsCharacters of the main symptom, progression and evolvementAccompany symptomsManagements and effectsEffects on daily life对主诉的进一步阐述起病情况和诱发因素主要症状特点和疾病的演变伴随症状诊疗经过对日常生活的影响Past Medical History既往史Past health statusPast illnessHistory of injuryHistory of surgeryHistory of allergyHistory of blood transfusionHistory of vaccinationSystemic review既往健康状况既往所患疾病既往外伤史手术史过敏史输血史预防接种史系统回顾Personal History个人史Homeplace, inhabitation place, epidemic disease or travel experience to epidemic areaSmoking and alcohol intakeWorkHousing conditionLifestyleSex history出生地居留地是否到过疫区烟酒嗜好职业特点居住条件生活习惯不洁性交史Marital History婚姻史Marriage age 结婚年龄Health status of the spouse 爱人健康状况Marital attachment 夫妻感情Menstrual and Obstetrical History月经生育史Formula for recording menses intermenstrual period (day)Menarche age ————menopause age menstrual cycle or LMPMenses: volume, color, leucorrhea, dysmenorrhealObstetrical: number of pregnancy and delivery, history of operative delivery, difficult labor, abortion月经记录格式行经期(天)初潮年龄————末次月经日期月经周期或绝经年龄行经情况月经量颜色有无白带痛经孕产情况孕次产次有无手术产流产难产Family History家族史Health status of three sequential generationsCauses of deathExisting the same diseaseHereditary diseasesInfectious diseases三代人健康状况父母兄妹子女(几男几女)死亡原因有无同类疾病遗传病传染病Basic Examination Techniques基本检查法视诊inspection 触诊palpation 叩诊percussion 听诊auscultation 嗅诊olfactory Palpation触诊Light palpation 浅部触诊法Deep palpation 深部触诊法Deep slipping palpation 滑行触诊法Bimanual palpation 双手触诊法Deep press palpation 深压触诊法Ballottement 冲击触诊法Percussion Notes叩诊音Tympany: gas Hyperresonance: increased gas in lung tissue Resonance: lung tissueDullness: gas and tissueFlatness: essential organ or fluid 鼓音: 气体过清音: 肺组织含气增多清音: 肺组织浊音: 气体与组织实音: 实质脏器或液体General Examination一般检查Vital signs 生命体征Development 发育Habitus 体型Nutritional status 营养Consciousness 意识Facial features and expressions 面容和表情Vital Sign (T, P, R) 生命征Temperature Normal axillary T: 36~37℃Fever: T>37℃Hypothermia: T<35℃Pulse Frequency: 60~100/min Rhythm: RegularRespiration Normal: 16~18/min体温正常(腋窝)体温: 36~37℃发热: T>37℃体温不升脉搏脉率: 60~100/min节律: 整齐呼吸频率: 16~18/minDisturbance of Consciousness意识障碍Somnolence 嗜睡Confusion 意识模糊Stupor 昏睡Coma 昏迷Delirium 谵妄Facial Features and Expression面容与表情mitral face二尖瓣面容Acute disease expression 急性病容Chronic disease expression 慢性病容Special face 特殊面容Graves Disease甲亢面容Mooned Face Induced by Cushing’s库兴氏满月脸Hippocratic Facies 恶病质Myxedema粘液水肿Acromegaly肢端肥大症Position体位Relaxed position 自主体位Positive position 被动体位in depletion or unconscious patient 极度衰竭意识丧失Compulsive position 强迫体位to relieve discomfort 减轻痛苦被迫采取的体位Gait步态Normal: calm and pithinessAbnormal:Waddling gaitDrunken man gaitAtaxic gaitFestinating gaitsteppage or footdrop gait scissors gaitIntermittent claudicationspastic hemiparesis正常: 平稳有力异常:蹒跚步态醉酒步态共济失调步态慌张步态跨阈步态剪刀步态间歇性跛行划圈步态、Subcutaneous Hemorrhage皮下出血Wine color and won’t fade when pressed 暗红色压之不褪色Petechia: <2mm 瘀点: <2mmPurpura: 3~5mm 紫癜: 3~5mmEcchymosis: >5mm 瘀斑: >5mmHematoma: 血肿: 片状出血伴皮肤隆起Spider Angioma蜘蛛痣Highly branched stellate arterial lesions which pulsate and blanch on pressure. Distributed commonly on face, neck, or chest. May be associated with pregnancy, chronic liver disease, or estrogen therapy, or may be normal.定义: 小动脉末端分支性扩张特点: 中央受压血管消失机制: 雌激素增多部位: 上腔静脉区域面部颈部和胸部病因: 妊娠慢性肝脏病变雌激素治疗Record content记录内容Normal node: 2~5 mm, soft, smooth, no tenderness and adhesion.Record if enlarged: location, size, number, hardness,tender, mobility, adhesion, superficial skin.正常淋巴结2~5mm 质软光滑无压痛无粘连肿大时记录部位大小数目硬度压痛活动度粘连Pupil Size瞳孔大小Normal: 3~4mm Dilation: glaucoma, atropinizationContraction: organophosphorus poisoning, drug reaction, narcotic takingPlatycoria: dying正常: 3~4mm扩大: 青光眼阿托品中毒缩小: 有机磷中毒药物反应安眠药过量双侧散大: 濒死状态Compare Both Pupil比较双侧瞳孔Normal:SymmetryAnisocoria: Pathology anywhere from the reception of light through the optic nerves to the brain stem, the third cranial nerve, sympathetic, or parasympathetic pathwaysCerebral hernia正常:等大等圆不等大视神经至脑干病变动眼神经受压交感神经受压副交感神经受压脑疝表面皮肤情况Sinuses鼻窦Location 部位frontal sinuses 额窦ethmoid sinuses 筛窦maxillary sinus 上颌窦Sphenoid sinuses tenderness & percussion pain: sinusitis 鼻窦区压痛叩击痛: 鼻窦炎Tongue Size舌体Enlarged: inflammation, myxedema, tumor, acromegaly 舌体肿大: 炎症黏液性水肿肿瘤肢端肥大症Shrinked: severe dehydration 舌体干小: 严重脱水Appearance of Tongue 舌象Geographic and wrinkled or fissured tongue: riboflavin deficiencyStrawberry tongue: long feverBeefy tongue: niacin deficiencySmooth tongue: iron or Vit B12 deficiency Black hairy tongue: fungus infection地图舌和裂纹舌: 黄色斑片和横向裂纹提示核黄素缺乏草莓舌: 舌乳头肿胀长期发热牛肉舌: 舌面绛红菸酸缺乏镜面舌: 光滑红色铁或维生素B12缺乏黑毛舌: 黑黄褐色毛真菌感染Pharynx and Tonsil咽和扁桃体Pharynx 咽Turkey red accompanied by swelling: Acute pharyngitis 红肿: 急性咽炎Wine accompanied by follicle: Chronic pharyngitis暗红滤泡: 慢性咽炎Tonsil 扁桃体degree of tonsil swelling Ⅰ°不超过腭咽弓Ⅱ°超过腭咽弓未达中线Ⅲ°达到超过咽后壁中线purulent 化脓性扁桃体炎Palpation of the Trachea触摸气管位置Indicate the location of mediastinum 指示纵隔位置Location: normally in the middle 正常居中Shifting to the health: large pleural effusion, pneumothorax 移向健侧: 大量胸腔积液气胸Shifting to the disaster: emphysema 移向患侧: 肺不张The Degree of Thyroid Gland Swelling甲状腺肿大的分度Ⅰ: invisible but palpable 不能看到能触到Ⅱ: visible and palpable 能看到又能触到Ⅲ: exceeding the out margin of sterno-mastoid muscle 超过胸锁乳突肌外缘Abnormal Intercostal Space肋间隙改变Recessed or narrowed depressed when inspirating: air way obstruction one-side depression: atelectasis, pleural adhesionWide or swelling general intense when expirating: emphysema, bronchial asthma one-side intense: pleural effusion, pneumothorax凹陷或变窄(容积缩小) 吸气时凹陷:大气道阻塞一侧变窄凹陷: 肺不张胸膜粘连膨隆或增宽(容积增大) 呼气时膨隆: 肺气肿支气管哮喘一侧增宽膨隆: 胸腔积液气胸Abnormal Lung Border肺界异常Kronig’isthmus:Widening: emphysemaNarrowing (unilateral): tuberculosis, tumorInferior border:Lowered: emphysemaRised: atelectasis, increased intra-abdominal pressureUndetectable: Pleural effusion, pneumothorax肺上界增宽: 肺气肿变窄: 肺结核肺肿瘤肺下界下降: 肺气肿升高: 肺不张腹压增高叩不出: 胸腔积液气胸、Abnormal Diaphragmatic Excursion肺下界移动范围异常Decreased: <4cm 减弱: <4cmUnilateral: atalectasis, pleural adhension 单侧: 肺不张胸膜粘连Bilateral: emphysema, lung fibrosis 双侧: 肺气肿肺纤维化Abnormal Intercostal Space肋间隙改变Recessed or narrowed depressed when inspirating: air way obstruction one-side depression: atelectasis, pleural adhesionWide or swelling general intense when expirating: emphysema, bronchial asthma one-side intense: pleural effusion, pneumothorax凹陷或变窄(容积缩小) 吸气时凹陷:大气道阻塞一侧变窄凹陷: 肺不张胸膜粘连膨隆或增宽(容积增大) 呼气时膨隆: 肺气肿支气管哮喘一侧增宽膨隆: 胸腔积液气胸Chest shape胸廓形态Normal: Ap : T=1 : 1.5Abnormal:Flat chest and Barrel chestRachitic chest Pigeon chest Rachitic rosary Funnel chest Harrison grooveRegional transfigurationThorax-vertebrae-malformation-induced胸廓正常形态前后径:横径1 : 1.5胸廓形态异常扁平胸和桶状胸佝偻病胸鸡胸串珠胸漏斗胸肋膈沟局部变形胸椎严重畸形Pathological Conditions异常改变Weaken or disappear: Obstructive atelectasis, emphysema, Pleural effusion, pneumothorax, subcutaneous emphysemaEnhanced: Consolidation of lung tissue: lobar pneumonia, pulmonary infarction. Large cavity in the lung, esp. near the pleura: lung abscess, cavernous pulmonary tuberculosis.减弱或消失阻塞性肺不张肺气肿胸腔积液气胸皮下气肿增强肺实变: 大叶肺炎肺梗死近胸膜肺空洞: 肺脓肿空洞型肺结核Clinical Significance临床意义Localized crackles: regional diseasesBilateral crackles in lower field of the lungs with rhonchi: bronchitis with lung infectionCrackles in bilateral bases of the lungs: pulmonary congestion caused by heart failureGeneralized coarse crackles in bilateral lung fields: acute pulmonary edema局部湿啰音: 肺局部炎症两下肺散在干湿啰音: 支气管炎并感染两肺底对称性湿啰音: 左心功能不全两肺满布湿啰音:急性肺水肿、Emphysema肺气肿Pathology: air trapping in the lung Inspection: barrel chestPalpation: decreased dynamic events of respiration and tactile fremitusPercussion: hyperresonce; Down-shifting of the inferior border of the lungAuscultation: decreased breath sounds and vocal resonance机制双肺含气增多视诊桶状胸触诊呼吸动度减弱语颤减弱叩诊过清音肺下界下移听诊呼吸音减弱语音共振减弱Atelectasis肺不张Pathology: the airway is obstructed and the lung holds no airInspection: the affected chest wall is flattenedPalpation: decreased dynamic events of respiration and tactile fremitus;The trachea is shifted to the affected sidePercussion: dullness or flatnessAuscultation: breath sounds and vocal resonance disappear.机制气道阻塞肺不含气视诊患侧胸廓凹陷触诊患侧呼吸动度减弱语颤减弱气管移向患侧叩诊患侧浊音或实音听诊患侧呼吸音消失、语音共振消失Lobar Pneumonia 肺炎性实变Pathology: too much fluid in alveoliInspection: normal chestPalpation: decreased dynamic events of respiration, increased tactile fremitus.Percussion: dullness or flatnessAuscultation: tubular breath sound, crackles, increased vocal resonance机制气道通畅肺泡腔充满液体视诊患侧呼吸运动减弱触诊患侧呼吸动度减弱病变区语颤增强叩诊病变区浊音或实音听诊管状呼吸音湿啰音语音共振增强、、Pneumothorax气胸Pathology: air is trapped in pleural cavityInspection: over-inflation of the affected sidePalpation: decreased dynamic events of respiration and tactile fremitus; the trachea is shifted to the unaffected sidePercussion: tympanyAuscultation: breath sounds and vocal resonance disappear 机制胸腔气体存积视诊患侧饱满触诊患侧呼吸动度减弱语颤减弱气管移向健侧叩诊患侧鼓音听诊患侧呼吸音消失语音共振消失Pleural Effusion胸腔积液Pathology: fluid is trapped in pleural cavityInspection: over-inflation of the affected sidePalpation: decreased dynamic events of respiration and tactile fremitus; the trachea is shifted to the unaffected sidePercussion: dullness or flatnessAuscultation: breath sounds and vocal resonance disappear 机制胸腔液体存积视诊患侧饱满触诊患侧呼吸动度减弱语颤减弱气管移向健侧叩诊患处浊音或实音听诊患处呼吸音消失语音共振消失Abnormal Lung Border肺界异常Kronig’isthmus:Widening: emphysemaNarrowing (unilateral): tuberculosis, tumorInferior border:Lowered: emphysemaRised: atelectasis, increased intra-abdominal pressureUndetectable: Pleural effusion, pneumothorax肺上界增宽: 肺气肿变窄: 肺结核肺肿瘤肺下界下降: 肺气肿升高: 肺不张腹压增高叩不出: 胸腔积液气胸Abnormal Diaphragmatic Excursion肺下界移动范围异常Decreased: <4cm 减弱: <4cmUnilateral: atalectasis, pleural adhension 单侧: 肺不张胸膜粘连Bilateral: emphysema, lung fibrosis 双侧: 肺气肿肺纤维化Classify of Breath Sound呼吸音分类Normal and abnormal 正常和异常呼吸音Bronchial breath sounds 支气管呼吸音Vesicular breath sounds 肺泡呼吸音Bronchovesicular breath sounds 支气管肺泡呼吸音Inspection of the Heart心脏视诊precordium shape 心前区外形normal apical impulse 正常心尖搏动abnormal apical impulse 异常心尖搏动precordial abnormal impulse 心前区异常搏动Precordium Shape心前区外形Precordial bulge 心前区隆起Features: bony bulge 特点:骨骼突起Clinical importance: Congenital heart disease with ventricular enlargement 提示:先天性心脏病右室大Precordial satiety 心前区饱满Features: intercostal region sticking out 特点:肋间软组织外突Clinical importance: mass of pericardial effusion 提示:大量心包积液Normal Apical Impulse正常心尖搏动Location: 0.5~1 cm to the left midclavicular line at the 5th ICS outside LSB. Range: 2~2.5cmDirection: outward when ventricular systole begins位置: 第5肋间左锁骨中线内0.5~1cm范围: 2~2.5cm方向: 收缩时向外搏动意义: 提示心尖位置代表收缩期提示心脏大小Abnormal Dullness Heart Border心界叩诊异常(1)heart variation 心脏改变L.V enlargement: boot-shaped heart 左室扩大: 靴形心L.A enlargement: pear-shaped heart 左房扩大: 梨形心B.V enlargement: general enlarged heart 双室扩大: 普大心R.V enlargement: cor pulmonal 右室扩大: 先心肺心Pericardial effusion: flask-shaped heart心包积液: 烧瓶心、Abnormal Dullness Heart Border心界叩诊异常(2)chest and lung diseases 胸肺疾病Pleural effusion or lung consolidation: dullness border undetectable 胸腔积液或肺实变: 叩不出Emphysema: “shrinked”dullness border 肺气肿: 心浊音界缩小abdominal disorders 腹部疾病Diaphragm elevation: acrossing heart 膈升高: 横位心Boot-shaped Heart靴形心Mechanism: L.V enlargementFeatures: the left border extends to the inferior left, waist of the heart is deepened.Causes: aortic insufficiency, hypertensive heart disease机制: 左室扩大特点: 心左界向左下扩大心腰加深病因: 主动脉瓣关闭不全高血压心脏病Pear-shaped Heart梨形心Mechanism: L.A enlargement and distension of pulmonary arteryFeatures: dullness heart border in the 2nd, 3rd ICS on the LSB extends outside, waist of the heart bulges outCauses: mitral stenosis机制: 左房扩大肺动脉扩大特点: 胸骨左缘2, 3肋间心浊音界向外扩大心腰饱满或膨出病因: 二尖瓣狭窄General Enlarged Heart普大心Mechanism: both left and right ventricle are enlargedFeatures: the dullness border extends to both sides, the left border extends to inferior leftCauses: cardiomyopathy, myocarditis, whole heart failure机制: 左右心室扩大特点: 心浊音界向双侧扩大左界向下扩大病因扩张型心肌病克山病重症心肌炎全心衰竭Flask-shaped Heart烧瓶心Mechanism: pericardial effusionFeatures: Sitting position: triangular dullness borderSupine: widened dullness border of the base机制: 心包积液特点:坐位时心浊音界呈三角形仰卧位心底部浊音区增宽随体位心界改变First Heart Sound, S1 第一心音Signaling the beginning of systole. 提示收缩期开始It has characters of low pitch, long duration. 音调低时间长“咚”It can be heard best in the apex area. 在心尖部听诊最清楚Second Heart Sound, S2第二心音Signaling the beginning of diastole. 提示舒张期开始It is high-pitched, low-intensity, shorter and brisker. 高调低强度时间短轻脆“嗒”It can be auscultated best at the base of the heart. 在心底部听诊最清楚S1 第一心音S2 第二心音Pitch 音调Low 低High 高Intensity 强度High 强Low 弱Quality 音质Blunter 低钝Brisker 清脆Duration 持续时间Long 长Short 短Interval 两者间隔S1-S2 长< S2-S1 短Apical impulse 心尖搏动Concomitant 一致Post 之后Best site 最响部位Apex 心尖Base 心底Changes of Quality 心音性质改变Changes of S1 quality: S1 same as S2 (blankness) 第一心音性质改变: 第一心音与第二心音相同(单调)Diastolic phase shorten: same as systolic (single rule) 舒张时限缩短: 收缩期与舒张期时限相同(单律)Characteristic: pendular rhythm, embryocardia 听诊特点: 钟摆律胎心律Clinical meaning: myocardial damage severely, as acute myocardial infarction, severe myocarditis,. 提示: 心肌严重受损如急性心肌梗塞重症心肌炎Wide Splitting顺分裂Typical at the end of inspiration 吸气末分裂明显Physiologic splitting: deep inspiration 生理分裂: 吸气相回右心血量增加General splitting 通常分裂Delayed P2: pulmonary hypertension, mitral stenosis, pulmonic stenosis, right bundle branch block. 肺动脉瓣关闭延迟: 肺动脉高压二尖瓣狭窄肺动脉瓣狭窄右束支阻滞Early A2: mitral insufficiency, IVSD 主动脉瓣关闭提前: 二尖瓣关闭不全室间隔缺损Fixed Splitting固定分裂Splitting is unaffected by respiration分裂不受呼吸影响Mechanism: delayed closure of the pulmonic valve (output of the right ventricle is greater than that of the left) 机制: 肺动脉瓣关闭延迟Blood flow from left atrium to the right passing through septal defects amortized affection of respiration. 房间隔缺损处血液左向右分流缓冲呼吸影响Common diseases: large atrial septal defects and right ventricular failure. 病因: 大的房间隔缺损并右心功能不全Reversed Splitting逆分裂Typical at the end of expiration 呼气末分裂明显Paradoxical Splitting: P2 occurs firstly, followed by A2 反常分裂: 肺动脉瓣第二音出现在主动脉瓣第二音之前Mechanism: closure of the aortic valve is delayed 机制: 主动脉瓣关闭明显延迟Common diseases: Left bundle branch block, Aortic stenosis. 病因: 左束支传导阻滞主动脉瓣狭窄Extra Heart Sounds额外心音systolic extra heart sounds 收缩期额外心音diastolic extra heart sounds 舒张期额外心音Extra Heart Sounds额外心音SystolicEarly systole: ejection soundsMid-/Late systole: clickDiastolicEarly diastole: opening snap, pericardial knock Mid-diastole: third heart soundLate diastole: fourth heart soundgallop rhythm收缩早期喷射音中晚期喀喇音舒张早期开瓣音心包叩击音中期第三心音晚期第四心音奔马律Gallop奔马律Mechanism: decreased compliance of the ventricle caused by severe myocardial damage 机制: 心肌严重受损致室壁顺应性差Classification: 分类Protodiastolic gallop (Ventricular gallop, S3 gallop) 舒张早期奔马律(室性奔马律第三心音奔马律)Late diastolic gallop (atrial gallop, S4 gallop) 舒张晚期奔马律(房性奔马律第四心音奔马律)Quadruple rhythm and summation sound 四音律和重叠奔马律Physical S3 & Pathological S3生理性与病理性第三心音的区分Quadruple Rhythm and Summation Sound四音律和重叠奔马律Mechanism: pathological S3 & S4. 同时出现病理性第三和第四心音During tachycardia, the diastolic filling time shortens and the S3 and S4 move closer together. 心率加速时舒张期缩短第三和第四心音重叠They sound superimposed in mid-diastole, and one loud, prolonged, summated sound can be heard, often louder than either S1 or S2. 特点: 舒张中期较长响亮心音强于第一或第二心音Characterization of Murmurs杂音听诊要点LocationDurationPitch and QualityIntensity and Timing Transmission or radiationEffect murmurs of factor杂音的部位杂音的时期杂音的性质杂音的强度杂音的传导影响杂音的因素Location杂音部位Apical area: mitral valveAortic area: aortic valvePulmonic area: pulmonic valveInferior sternum: tricuspid valve3rd, 4th ICS, LSB: ventricular septal defect2nd, 3rd ICS, LSB: patent ductus arteriosus杂音出现和最响部位与病变部位血流方向传导介质相关心尖部: 二尖瓣主动脉瓣听诊区: 主动脉瓣肺动脉瓣听诊区: 肺动脉瓣胸骨下端: 三尖瓣胸骨左缘 3 4 肋间: 室间隔胸骨左缘 2 3 肋间: 动脉导管Duration杂音时期Systolic murmur (SM)HolosystolicEarlyMidsystolicLateDiastolic murmur (DM)HolodiastolicEarlyMiddiastolicLate (presystolic)Continuous收缩期杂音全收缩期收缩早期收缩中期收缩晚期舒张期杂音全舒张期舒张早期舒张中期舒张晚期连续性杂音Distinguish Duration时期的区分systolic murmur 收缩期杂音appear between S1 and S2, same as apical impulse 在第一心音与第二心音之间出现与心尖搏动一致diastolic murmur 舒张期杂音appear between S2 and S1, nonsame as apical impulse在第2 心音与第1 心音之间出现与心尖搏动不一致Intensity of Systolic Murmur收缩期杂音强度GradeⅠ: barely audible in quiet room 1 级: 仔细听方可听到GradeⅡ: quiet but clearly audible 2 级: 容易听到但不响亮GradeⅢ: moderately loud 3 级: 较响亮GradeⅣ: loud, associated with thrill 4 级: 粗糙且响亮伴传导震颤GradeⅤ: very loud, thrill easily palpable 5 级: 震耳GradeⅥ: very loud, audible with stethoscope not in contact with chest, thrill palpable and visible 6 级: 离开胸壁亦可闻及Functional and Organic Murmurs收缩期杂音的鉴别Functional功能性Organic器质性Age 年龄Young儿童青少年Unlimited 不定Location 部位Pulmonic/apical 肺动脉瓣或心尖部Any area各部位Character 性质Soft, smooth 柔和Coarse, high pitch粗糙高调Duration 时间Short 短Long (whole systole)长（全收缩期）Intensity 强度<3/6 > or =3/6 Thrill 震颤no 无Yes 有Transmission传导Localized 局限extensive 传导Systolic murmur in left sternum intercostal 3~4: ventricular septal defect 胸骨左缘3 4肋间收缩期杂音: 室间隔缺损Continuous machine-like in left sternum intercostal 2: patent ductus arteriosus 胸骨左缘第2肋间连续型杂音: 动脉导管末闭Peripheral Vascular Sign周围血管征Vascular sign: 征象Water-hammer Pulse 水冲脉Carotid artery impulse 颈动脉搏动Nodding spasm 点头运动Capillary pulsation 毛细血管搏动征Pistol shot sound 枪击音Duroziez double murmur 杜氏双重杂音Clinical meaning: aortic insufficiency, hypertension, Hyperthyroidism提示: 主动脉瓣关闭不全高血压甲状腺机能亢进Heart Disease心脏疾病mitral stenosis 二尖瓣狭窄aortic insufficiency 主动脉瓣关闭不全Mitral Stenosis二尖瓣狭窄(1)L.A enlargement Pulmonary artery dilation R.V enlargement 左房增大→肺动脉扩张→右室增大Inspection: Mitral face (malar flush), apical impulse left 视诊: 二尖瓣面容心尖搏动向左移位Palpation: diastolic thrill at the apex area 触诊: 心尖部舒张期震颤Percussion: pear-shaped heart 叩诊: 梨型心Mitral Stenosis Auscultation二尖瓣狭窄(2)Apex area: 心尖部Heart sounds: Accentuation of S1 第一心音亢进Extra sound: opening snaps 开瓣音Murmurs: mid- or late-diastolic rumbling in quality, decrescendo- crescendo, usually localized, heard more clearly with the patient recumbent or on his left side or after moderate exercise. 舒张中晚期隆隆样杂音Pulmonic area: 肺动脉瓣区Heart sounds: Accentuation and splitting of S2 第二心音亢进分裂Murmur: Graham-steell G-S杂音Aortic Insufficiency主动脉瓣关闭不全(1)Inspection: Apical impulse to left inferior 视诊: 心尖搏动向左下移位carotid artery impulse 颈动脉搏动Palpation: lifting apical impulse 触诊: 抬举性心尖搏动water-hammer pulse 水冲脉Percussion: boot-shaped heart 叩诊: 靴型心Aortic Insufficiency Auscultation 主动脉瓣关闭不全听诊(2)Aortic area:主动脉瓣区Heart sounds: S2↓第二心音减弱Murmur: early diastolic, high pitch, blowing, radiating to the apex 舒张期递减型叹气样杂音Apex area: 心尖部Heart sounds: S1↓第一心音减弱Murmurs: Austin-Flint A-F杂音Distension腹部膨隆Abdominal wall disorders 腹壁改变Tumor: appeared clearly in force 肿物: 腹部用力时肿物明显Incrassation: hilum depressed such as obesity 增厚: 脐部凹陷如肥胖Abdominal cavity increase 腹腔增大Full distension: normal pregnancy and abnormal 全腹膨隆: 正常妊娠和异常Local distension 局部膨隆Measure surround of abdomen 测量腹围Around the abdomen through hilum by soft ruler 仰卧位用软尺绕脐一周Common Causes of Distension常见膨隆原因Fat 肥胖Fluid 腹水Feces 粪块Fetus 妊娠Flatus 胃肠胀气Fibroids 子宫平滑肌瘤Fatal tumor 恶性肿瘤.Remember:5FContour: Protuberant Abdomen全腹膨隆Ascites: frog shape of abdomen, accompanied hilum hernia. 腹水: 蛙状腹常伴脐疝causes: hepatocirrhosis, serious heart failure, pericarditis, renal disease syndrome, peirtoneum cancer. 病因: 肝硬化严重心衰缩窄性心包炎肾病综合征腹膜癌Gases distention of the intestines: sphericity of abdomen 肠胀气: 球形腹causes: ileus, intestinal paralysis. 病因: 肠梗阻肠麻痹Organomegaly: enormous ovary cyst and teratoma. 肿瘤: 巨大卵巢囊肿畸胎瘤Local DistensionDirection of the Blood flow血流方向检查Use two fingers on appeared vein 用两手指并拢压在静脉上Two fingers press and dis part 两手指加压分开Loosen superior finger 松开上端手指Faster show blood flow downwards 充盈快示血流向下Repeat above action 重复以上动作Loosen inferior finger 松开下端手指Faster show blood flow upwards 充盈快示血流向上Obstruction of Vena Cava腔静脉阻塞Varicosity on the flanks曲张静脉在侧腹部Obstruction of superior vena cava: blood stream to downwards. 上腔静脉回流受阻血流方向向下Obstruction of inferior vena cava: blood stream to upwards. 下腔静脉回流受阻血流方向向上Rebound Tenderness (Blumberg sign) 反跳痛Examination method: press deeply and slowly, let slip suddenly. 检查方法: 逐渐深压腹壁突然松开Positive finding: pain prick up in loose. 阳性: 松开时疼痛加剧Clinical meanings: inflammation in the parietal peritoneum. 提示: 炎症波及壁层腹膜Peritoneal Irritation Sign腹膜刺激征Three sign same appear:Tenderness Rebound tendernessGuarding 三联征: 压痛反跳痛腹肌紧张Clinical meaning: acute peritonitis 提示: 急性腹膜炎Measure of Enlarged Spleen肿大脾脏的测量The first line: between costal margin and low edge of spleen in left midclavicular line 1 线(甲乙线): 左锁骨中线上肋缘至脾下缘The second line: between the point of the left midclavicul cross costal margin and the point of spleen apoapsis. 2 线(甲丙线): 左锁骨中线肋缘点至脾最远点The third line: between right side of spleen and midline, express with positive or negative 3 线(丁戊线): 脾右缘至正中线以(＋)(－)表示Spleen Enlargement Degrees脾脏肿大分度Mild enlargement: <2 cm under the rib 轻度肿大: 肋下<2cmModerate enlargement: not exceed the level of umbilicus 中度肿大: 不过脐Severe enlargement: exceed the level of umbilicus or mid line 高度肿大: 过脐或中线Murphy’s Sign莫非氏征Technique: Hold your fingers under the liver border. 手指放于肝脏下缘Positive sign: As the descending liver pushes the inflamed gallbladder onto the examining hand, the person feels sharp pain and abruptly stops inspiration midway. 阳性: 吸气时肝脏和胆囊下移手指触及炎性胆囊时被检者因剧痛中止吸气Characteristics of Palpation 触诊要点Location: relation to organsSize: diameter in long, wide and thickContour: shape, margin and surfaceTexture: soft, firm and hardTenderness: inflammation, liver swelling Pulsation: dilative and conductive Movability: shift by respiration or hand部位: 所在部位与该处脏器多相关连大小: 纵长横宽深厚可用实物比喻轮廓: 形状边缘表面质地: 柔软中等硬度质硬压痛: 炎症肝肿大搏动: 膨胀性和传导性移动度: 随呼吸移动用手推动Fluid Thrill液波震颤Technique: move flank wall by hand 检查方法: 用手推动一侧腹壁Positive: the other hand feels liquid wave 阳性征象: 对侧手掌感到液体波动Meaning: large volume of ascites, usually >3000ml 临床意义: 大量腹水在3~4升以上Percussion of Ascites腹水叩诊Shifting dullness: 移动性浊音free fluid causes air-containing gut to float up to the most superior position 液体流动使含气脏器位于最高位置volume of ascites usually exceeds 1000ml if detectable 腹水量在1000ml以上Puddle sign: 水坑征free fluid in the most inferior position in elbow-knee posture 肘膝位腹水位于最低位a way to detect small amounts of fluid 用于发现少量腹水腹水和卵巢囊肿的鉴别Signs 征象Ascites 腹水Ovarian cyst 卵巢囊肿Dorsal position仰卧位Umbilicus 脐Percussion sound 叩诊音Shifting dullness 移动性浊音Ruler pressing test 尺压试验Side distension 侧腹膨隆Extrude 突出Middle tympany side dullness 中部鼓音两侧浊音Positive 阳性No jumpiness 无跳动Middle distension 中腹膨隆Flat 平坦Middle dullness side tympany 中部浊音两侧鼓音Negitive 阴性Rhythm jumpiness 有节奏跳动Auscultation of Abdomen腹部听诊bowel sounds 肠鸣音vascular sounds 血管杂音friction rub 摩擦音scratch sound 搔弹音splashing sound 振水音Scratch Sound搔弹音Mechanism: sound wave conductive diversity in differ medium made noise alteration. Aids in static border definition 机制: 声波在不同介质中传导的差异致声响改变有助于确定实质脏器或液体边界Technique: put the stethoscope in central and the hand scratch to it, when sound suddenly increased indicate the border. 方法: 听诊器置于中央手边搔弹边向听诊器移动声响突然增强为其边界Meaning: confirm inferior border of the liver and ascites (<120ml) 意义: 确定肝脏下界和小量腹水范围Cirrhosis of Liver肝硬化Small liver to percussion but a hard edge may be palpable under the xiphoid 剑突下触及边钝质硬缩小的肝脏Spleen palpable 脾脏肋缘下可触及Varicosity and ascites 脐周静脉曲张和腹水征palmar erythema, spider angioma and Gynaecomastia 肝掌蜘蛛痣男性乳房发育Gastrointestinal haemorrhage 消化道出血Ascites Sign腹水征Inspection: frog shape of abdomen in dorsal position, hypogastrium region distension with hilum hernia in stand. 视诊: 仰卧位蛙状腹直立位下腹膨隆脐突出Palpation: fluid thrill (ascites large than 3000 ml) 触诊: 液波震颤(腹水量>3000ml)Percussion: shifting dullness (ascites large than 1000 ml), puddle sign (small amounts of fluid) 叩诊: 移动性浊音(腹水量>1000ml) 水坑征(少量腹水)Auscultation: umbilicus scratch sound in elbow-knee posture (ascites<120ml) 听诊: 脐部搔弹音(腹水量<120ml)Acute Perforated Gastric or Duodenal Ulcer急性胃十二指肠穿孔Suddenly epigastric pain, forced supine position and twin lower limbs flection 突发上腹痛强迫仰卧位双下肢屈曲Acute peritonitis signs, tenderness and rebound pain in epigastrium or round umbilicus quarter 急性腹膜炎征象压痛反跳痛位于上腹部和脐周Hepatic dullness region decrease or disappear 肝浊音区缩小消失shifting dullness in abdomen 腹部移动性浊音Physical Examination Point 急性胃肠穿孔检体要点Gas in abdominal cavity: dullness area of liver disappear 腹腔气体: 肝浊音区缩小消失Liquid in abdomen: shifting dullness 腹腔液体: 腹部移动性浊音Inflammation in abdomen: acute peritonitis sign, serious in epigastric and umbilical region. 腹部炎症反应: 急性弥漫性腹膜炎征象压痛反跳痛位于上腹部和脐周forepart: acute ache face, compulsive supine position, lower limbs flection 早期: 急性痛苦面容冷汗强迫仰卧位双下肢屈曲anaphase: high fever, pulse frequence 后期: 高热失水精神萎靡面色灰白眼球凹陷脉搏频数Acute Peritonitis Signs急性腹膜炎征象Inspection: general depression in abdomen, decreased or disappeared abdominal respiration 视诊: 腹部凹陷腹部呼吸运动减弱消失Palpation: tenderness, rebound tenderness, rigid abdominal wall 触诊: 压痛和反跳痛腹壁呈板状硬Percussion: shifting dullness 叩诊: 可有移动性浊音Auscultation: decreased or absence of bowel sounds 听诊: 肠鸣音减弱消失Intestinal Obstruction肠梗阻Symptom: bellyache, vomiting, no defecate and anus exhaust 症状: 腹痛呕吐无排便和肛门排气Inspection: full distension, intestine form and peristaltic wave 视诊: 腹部膨隆肠型可见肠蠕动波Palpation: rigid abdominal wall, tenderness and rebound pain 触诊: 腹肌紧张压痛及反跳痛Percussion: tympany region increased 叩诊: 鼓音范围增大Auscultation: mechanical ileus accompanied sharp bowel sound and decreased or absence of bowel sounds in paralysis ileus 听诊: 机械性肠梗阻肠鸣音亢进麻痹性肠梗阻肠鸣音减弱或消失Muscle Power肌力Force by muscle contraction produced 肌肉收缩产生的力量Muscle power decreasing or disappearing called partial or complete paralysis 肌力下降或消失称为不完全或完全瘫痪Paralysis divided hemiparalysis, crossed paralysis, paraplegia and single limb paralysis by pathologic position 根据瘫痪的部位分为偏瘫交叉瘫截瘫和单瘫Paralysis divided central and peripheral by location of nervous injury 根据神经损伤位置分为中枢性瘫痪和周围性瘫痪The grading of muscle strength肌力分度Absent (0 degree): no contraction detected. 0 级(不动): 完全瘫痪Trace (1 degree): slight contraction detected. 1 级(肌动): 肌肉可收缩不能产生运动Weak (2 degree): movement with gravity eliminated. 2 级(平动): 床面上可移动不能抬离Fair (3 degree): movement against gravity. 3 级(抬动): 能抬离床面不能抗阻力Good (4 degree): move against gravity with some resistance. 4 级(弱抗动): 能抗阻力但较正常差Normal (5 degree): movement against gravity with full resistance. 5 级(正常): 正常肌力Tremor震颤Static tremor: embitter in whisht and mitigate in movement, seen in paralysis agitans 静止性: 静重动轻见于震颤麻痹Intentional tremor: embitter in movement and mitigate in whisht, seen in cerebel disorders 意向性: 动重静轻见于小脑疾患Senile tremor: nodded and hand tremble, seen in arteriosclerosis 老年性: 点头手抖见于动脉硬化Flutter tremor: flicker in wrist and palm, seen in hepatic coma 扑翼样: 腕掌扑动见于肝昏迷Tremor of fingers: fine twitter, seen in hyperthyroidism 手指细颤: 细小抖动见于甲状腺机能亢进症Physical Reflex生理反射Superficial reflex: induced by the stimulation of mucocutaneous receptors 浅反射: 刺激皮肤粘膜感受器引起反应Included: corneal reflex, abdominal reflex, cremasteric reflex, plantar reflex 包括: 角膜反射腹壁反射提睾反射跖反射Deep reflex: induced by the stimulation of periosteal and tendon receptors 深反射: 刺激骨膜肌腱感受器引起反应Included: biceps reflex, triceps reflex, brachioradialis reflex, patellar reflex, achilles tendon reflex 包括: 肱二头肌反射肱三头肌反射桡骨骨膜反射膝(腱)反射跟腱反射Pyramidal Sign锥体束征Upper limbs pathological reflex: Hoffmann Sign usually seen in cervical region disorders of spinal cord 上肢病理反射: 霍夫曼征多见于颈髓病变Lower limbs pathological reflex: Babinski sign, Chaddock sign, Oppenheim sign, Gordon sing 下肢病理反射: 巴宾斯基征查多克征奥本海姆征戈登征Clonus: rhythmical contraction of the muscle made the limb or foot movement by stimulation 阵挛: 刺激使肌肉有节奏的收缩致肢体运动Meningeal Stimulation Sign脑膜刺激征Definition: signs induced by disorders with meninges such as pathological changes, inflammation, arachnoid low cavity bleeding, encephalic hypertension, etc. 定义: 脑膜病变脑膜炎蛛网膜下腔出血颅内压增高等(除外颈椎疾患) Neck rigidity: resisting in raise neck 颈项强直: 抬颈抵抗Kernig sign: angle of knees joint can be drived up less than 135 degree with bended thigh 克匿格征: 屈腿抬高<135º(正常可达135º)Brudzinski sign: going down on knees when raise neck 布鲁金斯基征: 抬颈时屈膝Grade of Fever发热分度Slight fever 低热37.3~38℃Moderate fever 中等度热38.1~39℃Hyperpyrexia 高热39.1~41℃Ultrahyperpyrexia 超高热>41℃Fever Types高热热型Persistent high feverContinuous feverRemittent feverIntermittent high feverIntermittent feverRecurrent feverUndulant feverIrregular fever持续高热热型稽留热弛张热间断高热热型间歇热回归热波状热不规则热Clinical Types of Edema水肿的临床类型Cardiac EdemaNephritic EdemaHepatic EdemaMalnutritional EdemaDrug-induced EdemaOthers Myxedema Premenarche edema心原性水肿肾原性水肿肝原性水肿营养不良性水肿药物性水肿其他黏液性水肿经前期水肿Clinical Features临床特点Area: related to location of the pathological changesNature: lancinating, drilling, burning, colicOnset: continuous, paroxysmal, intermittentReferred painFactors triggering。

[W]probably[M]ad. 大概﹐有可能[W]eminent[M]a. 著名的﹔突出的[W]artist[M]n. 藝術家﹔美術家[W]distant[M]a. 遠的﹐遠外的[W]brilliantly[M]ad. 鮮明地﹐輝煌地[W]canvas[M]n. 一塊油畫布﹔粗帆布[W]comprehend[M]vt. 了解﹐領會﹔包含[W]scientifically[M]ad. 科學地﹔系統地[W]arouse[M]vt. 喚起﹐激起﹔喚醒[W]viewer[M]n. 觀察者﹔電視觀眾[W]romantic[M]a. 浪漫的[W]sentimental[M]a. 激動的﹔情感的[W]emotion[M]n. 感情﹔情緒[W]choice[M]n. 選擇[W]scene[M]n. 景色﹔景象[W]poem[M]n. 詩[W]poet[M]n. 詩人[W]identical[M]a. 相同的﹔相等的[W]be identical to[M]與…相同[W]convey[M]vt. 轉達﹐傳達[W]instance[M]n. 例子﹔實例﹔實事[W]for instance[M]例如[W]nightfall[M]n. 黃昏[W]wilderness[M]n. 荒原﹐荒野[W]image[M]n. 映象﹔形像﹔圖像[W]create[M]vt. 創作﹔創造[W]verify[M]vt. 證實﹐核實[W]likewise[M]ad. 同樣地﹔也[W]mainly[M]ad. 主要地[W]interpret[M]vt. 解釋﹐口譯[W]transform[M]vt. 改變﹐轉變﹔改造[W]favorable[M]a. 有利的﹐贊成的[W]be favorable to[M]有利於﹐贊成[W]wring[M]vt. 擰﹐扭﹔強求[W]necessity[M]n. 需要﹔必要性[W]curiosity[M]n. 好奇心﹔珍品[W]trifling[M]a. 微不足道的[W]unexplained[M]a. 未得到解釋的[W]undoubtedly[M]ad. 無庸置疑﹔肯定地[W]supersonic[M]a. 超聲速的[W]aircraft[M]n. 飛機﹐航空器[W]frozen[M]a. 冷凍的[W]curb[M]vt. 控制﹐抑制[W]ravage[M]vt. 毀壞﹐蹂躪[W]utilize[M]vt. 利用[W]tropical[M]a. 熱帶的[W]tank[M]n. 桶﹐槽[W]reliable[M]a. 可信的﹐確實的[W]set about[M]著手﹐開始[W]contribution[M]n. 貢獻﹐捐獻﹐投稿[W]simplified[M]a. 精簡了的﹐簡化了的[W]reddish[M]a. 帶紅色的﹐微紅的[W]gather[M]vt. 收集﹐蒐集[W]rusty[M]a. 生了鏽的[W]observation[M]n. 觀察﹐觀測[W]hypothesis[M]n. 假說﹐假設[W]reset[M]v. 再試驗﹐重複試驗[W]survival[M]n. 生存﹐存活[W]maintain[M]vt. 繼續﹔維持[W]homeostasis[M]n. 內環境恆定[W]stable[M]a. 穩定的﹐恆定的[W]depict[M]vt. 描述﹔描繪[W]least[M]n. 最小﹐最少[W]at least[M]至少﹐無論如何[W]overall[M]a. 全面的﹐綜合的[W]dependent[M]a. 依靠的﹔由…決定的[W]by dependent on[M]依靠﹔由…決定[W]exception[M]n. 例外﹐除外[W]decompose[M]vt. 分解[W]basically[M]ad. 基本上﹐事實上[W]anus[M]n. 肛門[W]alimentary[M]a. 營養的﹔消化的[W]canal[M]n. 道﹐管[W]the alimentary canal[M]消化道[W]oral[M]a. 口的﹔口頭的[W]cavity[M]n. 腔[W]pharynx[M]n. 咽[W]throat[M]n. 喉[W]situated[M]a. 位於…的[W]esophagus[M]n. 食道[W]partially[M]ad. 部份地﹔偏袒地[W]rectum[M]n. 直腸[W]unabsorbed[M]a. 未被吸收的[W]elimination[M]n. 排除﹐清除[W]digestion[M]n. 消化﹐消化力[W]salivary[M]a. 唾液的[W]salivary gland[M]唾液腺[W]pancreas[M]n. 胰<腺>[W]exchange[M]vt. & n. 交換﹐互換[W]potentially[M]ad. 潛在地[W]poisonous[M]a. 有毒的﹔惡毒的[W]subway[M]n. 地道﹐地下鐵道[W]comprise[M]vt. 由…組成﹔包含[W]ultimately[M]ad. 終於﹐最後[W]rid[M]vt. 使…擺脫[W]rid someone of[M]使某人擺脫[W]get rid of[M]去掉﹐排除[W]urinary[M]a. 泌尿的﹔尿的[W]endocrine[M]a. 內分泌的﹔n. 內分泌[W]hormone[M]n. 激素﹐荷爾蒙[W]neuron[M]n. 神經原﹐神經細胞[W]network[M]n. 網﹐網狀系統[W]as a whole[M]整體上﹐作為一個整體[W]actual[M]a. 實際的﹐事實上的[W]contraction[M]n. 收縮﹐縮短[W]finally[M]ad. 最後﹐終於[W]skeletal[M]a. 骨骼的﹐骸骨的[W]excretory[M]a. 排泄的[W]reproductive[M]a. 生殖的﹔再生的[W]to sum up[M]總之﹔總結[W]respiration[M]n. 呼吸﹐呼吸作用[W]precisely[M]ad. 精確地﹐明確地[W]oxidize[M]ad. 使氧化[W]notably[M]ad. 特別是﹐顯著地[W]sensitive[M]a. 敏感的﹐靈敏的[W]sensitive to[M]對…敏感[W]hypoxia[M]n. 氧過少﹐低氧[W]anoxia[M]n. 缺氧症[W]complicated[M]a. 複雜的﹐難懂的[W]former[M]a. 以前的﹐前任的[W]the former[M]前者[W]signify[M]vt. 表示﹐表明﹔意味[W]denote[M]vt. 表示﹔意味著[W]subdivide[M]vt. 把…再分[W]be subdivided into[M]被再分成[W]phase[M]n. 階段﹔方面[W]inspiration[M]n. 吸氣﹐吸入[W]expiration[M]n. 呼氣﹔呼出物[W]expulsion[M]n. 驅逐﹔排除[W]portion[M]n. 一部份﹔一份[W]larynx[M]n. 喉[W]trachea[M]n. 氣管[W]windpipe[M]n. 氣管[W]bronchus[M]n. 支氣管[W]portal[M]n. 門﹐入口[W]entry[M]n. 進入﹔門口[W]principal[M]a. 主要的﹐最重要的[W]cluster[M]n. 一串﹐一束﹔一群[W]sac[M]n. 囊﹔液囊[W]alveolus[M]n. 肺泡[W]furnish[M]vt. 提供﹐供應[W]voluntary[M]a. 主觀意志所控制的[W]depth[M]n. 深度﹐深[W]comparatively[M]ad. 相對地﹐比較地[W]superficial[M]a. 淺的﹐表淺的[W]proportionately[M]ad. 成比例地﹐相稱地[W]impulse[M]n. 衝動﹐刺激[W]diaphragm[M]n. 隔膜﹐膈[W]conversely[M]ad. 相反﹐反過來[W]sex[M]n. 性別[W]slightly[M]ad. 稍微﹐輕微[W]circumstance[M]n. 情況[W]adult[M]n. 成年人[W]newborn[M]a. 新生的[W]infant[M]n. 嬰兒﹐幼兒[W]cellular[M]a. 細胞的[W]anatomically[M]ad. 解剖學上﹐結構上[W]confine[M]vt. 限制[W]uri[M]上呼吸道感染[W]passageway[M]n. 走廊﹔過道[W]travel[M]vi. 旅行﹔移動[W]membrane[M]n. 膜[W]rhinitis[M]n. 鼻炎[W]inflammation[M]n. 紅腫﹔發炎﹔炎症[W]pharyngitis[M]n. 咽炎[W]tracheitis[M]n. 氣管炎[W]pneumonia[M]n. 肺炎[W]list[M]vt. 列舉﹐編列成表[W]occurrence[M]n. 出現﹐發生[W]absorption[M]n. 吸收[W]intestinal[M]a. 腸的﹔內部的[W]mucosa[M]n. 粘膜[W]lymph[M]n. 淋巴﹐淋巴液[W]foregoing[M]a. 在前的﹐前述的[W]the foregoing[M]前文﹐前述事項[W]specifically[M]ad. 明確地﹔尤其[W]utilization[M]n. 利用﹐使用[W]merely[M]ad. 僅僅﹐只不過[W]preliminary[M]a. 預備的﹐初步的[W]metabolize[M]vt. <使>產生代謝變化[W]fuel[M]n. 燃料[W]mechanical[M]a. 機械的[W]catabolism[M]n. 分解代謝[W]anabolism[M]n. 組成代謝﹐合成代謝[W]construct[M]vt. 構成﹐建造[W]use up[M]耗盡﹐用完[W]roughly[M]ad. 粗略地﹔大體上[W]building-up[M]a. 組合的﹐合成的[W]constructive[M]a. 建造的﹐建設的[W]breaking-down[M]a. 毀壞的﹐分解的[W]destructive[M]a. 破壞的﹐分解的[W]miracle[M]n. 奇跡﹐神奇的事件[W]miraculous[M]a. 奇跡一樣的[W]mystify[M]vt. 使<人>驚奇[W]basal[M]a. 基礎的﹐基本的[W]tone[M]n. 緊張<度>﹔語調[W]metabolic[M]a. 新陳代謝的[W]awake[M]a. 清醒的﹔vt. 喚醒[W]relaxed[M]a. 鬆懈的﹐不拘束的[W]precede[M]vt. 領先﹐先于[W]preceding[M]a. 以前的﹐上述的[W]climate[M]n. 氣候[W]tension[M]n. 緊張﹐拉緊[W]relaxation[M]n. 鬆弛﹐鬆懈﹔休息[W]manual[M]a. 體力的﹐用手的[W]indoor[M]a. <在>室內的[W]sedentary[M]a. 坐著的[W]calorie[M]n. 卡<熱量單位> [W]automobile[M]n. 汽車﹐機動車[W]gasoline[M]n. 汽油<美>[W]furnace[M]n. 爐子﹔熔爐[W]blink[M]vi. 眨眼睛﹔閃爍[W]whatsoever[M]pron. & a. 無論什麼[W]potential[M]a. 潛在的﹔n. 潛能[W]length[M]n. 長﹐長度[W]centimeter[M]n. 厘米﹐公分[W]definition[M]n. 定義﹔界限[W]kilocalorie[M]n. 千卡﹐大卡[W]approximately[M]ad. 大約﹔近似[W]tobacco[M]n. 煙草﹐煙葉[W]soothe[M]vt. & vi. 安慰﹐減輕[W]hazard[M]n. 危害﹐損害[W]link[M]n. 連接﹐聯繫﹔vt. 連接[W]be linked to[M]同…有聯繫﹔伴有[W]loss[M]n. 喪失﹐損失﹔損耗[W]appetite[M]n. 食慾﹐胃口[W]nausea[M]n. 噁心﹐嘔吐[W]shortness[M]n. 短促﹐短﹐矮[W]shortness of breath[M]氣急﹐呼吸短促[W]irregularity[M]n. 不規則﹐不規律[W]cigarette[M]n. 紙煙﹐香煙[W]chronic[M]a. 慢性的﹔長期的[W]overwhelming[M]a. 絕大多數的[W]statistical[M]a. 統計的﹐統計學的[W]non-smoker[M]n. 不抽煙的人[W]conclusive[M]a. 明確的﹐結論性的[W]chew[M]vt. 咀嚼﹔嚼煙﹔深思[W]sniff[M]vt. & vi. 吮吸﹐用鼻吸[W]nicotine[M]n. 尼古丁﹐煙鹼[W]bind[M]vt. 包扎﹔附著﹐粘合[W]pyridine[M]n. 比啶﹐氮苯[W]ammonia[M]n. 氨﹐阿摩尼亞[W]ketone[M]n. 酮[W]aldehyde[M]n. 醛﹔乙醛[W]tar[M]n. 搭柏油﹐焦油[W]brownish[M]a. 帶褐色的[W]expose[M]vt. 使曝露﹔揭發[W]be exposed to[M]經受﹐接觸[W]saliva[M]n. 涎﹐唾液[W]afterward[M]ad. 後來﹔以後[W]swallow[M]vt. 吞下﹐嚥下[W]per cent[M]n. 百分之…[W]inhale[M]vt. 吸入[W]excrete[M]vt. 排泄﹔分泌[W]introduce[M]vt. 輸入﹐引進﹔介紹[W]dose[M]n. 劑量﹐用量[W]medulla[M]n. 髓質[W]oblongata[M]n. 延髓[W]medulla oblongata[M]延髓[W]reflex[M]n. 反射﹐反射作用[W]act upon[M]對…起作用﹔按照[W]slow up[M]減慢﹐減退[W]constrict[M]vt. 壓縮﹐使縮小[W]vomit[M]vt. 嘔吐﹔噴出[W]mildly[M]ad. 輕微地﹐溫和地[W]sedative[M]a. 鎮靜的﹐止痛的[W]calm[M]vt. 鎮靜﹔a. 平靜的[W]harmful[M]a. 有害的[W]branch out into[M]分成﹐分枝成[W]hairlike[M]a. 毛髮似的[W]cilia[M]n. 纖毛﹔睫[W]back and forth[M]前後來回地[W]sweep[M]vt. 掃﹐帶走[W]particle[M]n. 粒子﹐塵埃[W]upward[M]ad. 向上﹐上昇[W]dirt[M]n. 污物﹐污垢[W]slow down[M]減慢﹐減退[W]pack[M]n. 包﹐束﹔vt. 包裝[W]a pack of[M]一包[W]victim[M]n. 受害者﹔患者[W]resistance[M]n. 抵抗力﹔反抗﹐抵抗[W]ward[M]n. 守衛﹔vt. 保護﹐守衛[W]ward off[M]防止﹐擋住[W]pathogen[M]n. 病原體[W]factor[M]n. 因素﹐要素﹔因子[W]nonspecific[M]a. 非特異性的[W]moderate[M]a. 中等的﹐適度的[W]acidity[M]n. 酸性﹐酸度[W]unfavorable[M]a. 不適宜的﹐不利的[W]medium[M]n. 環境﹔媒介物﹔手段[W]cilium[M]n. 纖毛[W]hairlike cilium[M]毛髮狀的纖發[W]propel[M]vt. 推動﹐推進[W]outward[M]ad. 向外﹔外表上[W]alkalinity[M]n. 鹼濃度﹔鹼性[W]salinity[M]n. 鹽濃度﹐鹽分[W]inactivate[M]vt. 使不活動[W]envelop[M]vt. 包圍﹔裹住﹐封住[W]endothelial[M]a. 內皮的[W]node[M]n. 結﹔節[W]neutralize[M]vt. 中和﹔抵銷[W]precipitate[M]vi. 沉澱[W]stimulate[M]vt. 刺激﹔激發[W]lymphoid[M]a. 淋巴的或淋巴樣的[W]coryza[M]n. 普通感冒﹐鼻炎[W]influenza[M]n. 流行性感冒﹐流感[W]chickenpox[M]n. 水痘[W]measles[M]n. 痲疹[W]mumps[M]n. 流行性腮腺炎[W]poliomyelitis[M]n. 脊髓灰質炎[W]scarlet[M]a. 猩紅的﹐緋紅的[W]scarlet fever[M]猩紅熱[W]infancy[M]n. 嬰兒期﹔幼年期[W]pertussis[M]n. 百日咳[W]lifelong[M]a. 終身的﹐畢生的[W]immunization[M]n. 免疫[W]rabies[M]n. 狂犬病[W]rocky[M]a. 岩石的﹐多岩的[W]spot[M]vt. & vi. <使>變污[W]typhoid[M]n. 傷寒[W]passive[M]a. 被動的﹔消極的[W]attain[M]vt. & vi. 獲得﹔達到[W]inject[M]vt. 注射﹐注入[W]tend[M]vt. 趨向﹐走向[W]tend to[M]趨於﹐傾向于[W]renew[M]vt. 使更新﹔使恢復[W]infantile[M]a. 嬰兒的﹐幼兒的[W]diffuse[M]vi. 擴散﹔滲出[W]placenta[M]n. 胎盤[W]fetus[M]n. 胎﹐胎兒[W]injection[M]n. 注射﹔注射劑[W]serum[M]n. 血清[W]convalescent[M]a. 恢復期的[W]susceptible[M]a. 易感的﹐易受影響的[W]susceptible to[M]易患…的[W]exposure[M]n. 接觸﹔暴露[W]poison[M]n. 毒物﹐毒藥﹔毒害[W]immunize[M]vt. 使免疫﹐使免除[W]weaken[M]vt. 減弱[W]numerous[M]a. 許多﹐為數眾多的[W]relative[M]a. 相對的﹐相關的[W]absolute[M]a. 絕對的﹐獨立的[W]transportation[M]n. 運輸﹐運送[W]continual[M]a. 不斷的﹐連續的[W]billion[M]num. 萬億<英國﹑德國> [W]plasma[M]n. 血漿﹔原生質[W]interstitial[M]a. 組織間隙的﹐間質的[W]intracellular[M]a. 細胞內的[W]suspend[M]vt. & vi. 懸浮﹔吊[W]element[M]n. 成份﹔元素[W]formed[M]<血液>有形成份[W]designate[M]vt. 指明﹐標示[W]pickup[M]n. 拾起﹐收集[W]deliver[M]vt. 傳送﹔交付[W]delivery[M]n. 傳送﹔交付﹔分娩[W]target[M]n. 靶﹔目標[W]enzyme[M]n. 脢[W]buffer[M]n. 緩沖劑﹐緩沖[W]biochemical[M]a. 生物化學的﹐生化的[W]heat-regulating[M]a. 調節熱的[W]conductivity[M]n. 傳導性[W]appreciable[M]a. 可以感覺到的[W]core[M]n. 核﹔核心[W]readily[M]ad. 容易地﹐很快地[W]dissipate[M]vt. 使消散﹐擴散[W]functionally[M]ad. 功能上﹐機能上[W]ingenious[M]a. 精巧的﹐機靈的[W]efficient[M]a. 有效的﹐有能力的[W]quart[M]n. 夸脫[W]demand[M]n. & vt. 要求﹐需要[W]extra[M]a. 額外的﹐另外的[W]erythrocyte[M]n. 紅細胞[W]abundant[M]a. 豐富的﹐充裕的[W]pigment[M]n. 色素﹔v. 著色[W]acid-base[M]n. 酸-鹼[W]acid-base balance[M]酸-鹼平衡[W]lastly[M]ad. 最後[W]platelet[M]n. 血小板[W]thrombocyte[M]n. 血小板﹐凝血細胞[W]coagulation[M]n. 凝結[W]clot[M]v. 使凝結﹔使擁塞[W]interrelate[M]vt. & vi. <使>相互聯繫[W]distinct[M]a. 截然不同的﹐清楚的[W]plug[M]v. 塞﹐堵﹔n. 塞子[W]plug up[M]堵住﹐塞住[W]rupture[M]vt. <使>破裂[W]bleed[M]vi. 流血[W]pint[M]n. 品脫<等於1/2夸脫>[W]gallon[M]n. 加倫<等於4夸脫>[W]replacement[M]n. 還原﹔替換﹐取代[W]donor[M]n. 捐獻者﹐獻血者[W]recipient[M]n. 接受者﹐受血者[W]widely[M]ad. 廣泛地[W]miraculously[M]ad. 奇跡般地[W]antigen[M]n. 抗原[W]universal[M]a. 宇宙的﹔普遍的[W]clump[M]n. 團﹐塊﹔叢﹐簇[W]crosshatch[M]v. 交互配血[W]antisepsis[M]n. 防腐法﹐抗菌法[W]inherit[M]vt. 繼承[W]sail[M]v. 開船﹐啟航[W]sail through[M]順利地取得[W]a.b.[M]文學士[W]with flying colors[M]出色地﹐成功地[W]settle down[M]定居[W]settle down to[M]專心致志于[W]witness[M]vt. 親眼目睹﹐證明[W]ether[M]n. 乙醚﹐醚[W]b.m.[M]醫學士[W]fellow[M]n. 會員﹔夥伴﹔同事[W]royal[M]a. 皇家的﹐英國的[W]appreciate[M]vt. 意識到﹐懂得[W]technically[M]ad. 技術上﹐技能上[W]amputation[M]n. 截肢[W]discourage[M]vt. 使喪失信心[W]post-operative[M]a. 手術後的[W]putrefaction[M]n. 腐爛﹔腐敗[W]introduction[M]n. 輸入﹔介紹﹔導言[W]recall[M]vt. 回想﹐回憶[W]revelation[M]n. 啟示﹔新發現[W]reason[M]vt. 推理﹐思考[W]allow[M]vt. 允許﹔准許[W]search[M]v. 搜查﹐探索﹔n. 檢查[W]search for[M]尋找[W]agent[M]n. 作用藥劑﹐製劑[W]carbonic[M]a. 含碳的[W]carbonic acid[M]石炭酸[W]sewage[M]n. 污物﹐污水[W]convince[M]vt. 使確信﹐使信服[W]dilute[M]vt. 沖淡﹐稀釋[W]solution[M]n. 溶液﹔解決<辦法>[W]antiseptic[M]n. 抗菌劑﹔a. 無菌的[W]stage[M]n. 階段﹐時期﹐舞台[W]experimentation[M]n. 研究﹐實驗﹐試驗[W]technique[M]n. 技術﹐技能﹔方法[W]crucial[M]a. 關鍵性的﹐重要的[W]inevitably[M]ad. 不可避免地[W]survive[M]vi. 活下來﹐幸存[W]limb[M]n. 肢體﹐手足[W]aseptic[M]a. 無菌的﹐防腐的[W]modify[M]vt. 更改﹐修改﹔修飾[W]favour[M]n. 好意﹐支持﹐同意[W]in favour of[M]贊成﹐支持[W]asepsis[M]n. 無菌﹐無菌操作[W]deny[M]vt. 否認﹐否定﹔拒絕[W]sterilization[M]n. 消毒﹐滅菌[W]dressing[M]n. 調味品﹔敷料﹔敷裹﹔裝飾[W]gown[M]n. 白大褂﹐長外衣[W]glove[M]n. 手套[W]sepsis[M]n. 膿毒病﹐敗血[W]conquest[M]n. 征服﹔贏得[W]abscess[M]n. 膿腫[W]accidental[M]a. 意外的﹐偶然的[W]microorganism[M]n. 微生物[W]flu[M]n. 流感[W]for short[M]為簡略起見[W]contagious[M]a. <接觸>傳染的[W]filterable[M]a. 可濾過的﹐可濾的[W]uncomplicated[M]a. 不複雜的[W]secondary[M]a. 繼發性的﹔第二位的[W]bronchial[M]a. 支氣管的[W]lethal[M]a. 致命的﹐致死的[W]elderly[M]a. 上了年紀的[W]the elderly[M]老年人<指65歲以上> [W]subsequent[M]a. 隨後的﹐後來的[W]virulent[M]a. 致病力強的[W]epidemic[M]n. 流行病﹔a. 流行性的[W]lull[M]n. 間歇﹐暫停[W]outbreak[M]n. 流行﹐發作﹐爆發[W]resemble[M]vt. 類似于﹐象[W]weakness[M]n. 虛弱﹐軟弱[W]ache[M]vi. 痛﹔n. 疼痛[W]incubation[M]n. 潛伏[W]brief[M]a. 簡短的﹔短暫的[W]communicate[M]v. 傳染﹔通信﹔相通[W]depression[M]n. 沮喪抑鬱症[W]persist[M]vi. 持續﹔堅持[W]vaccine[M]n. 疫苗﹐菌苗[W]accordingly[M]ad. 因此﹔相應地[W]viral[M]a. 病毒的[W]nevertheless[M]ad. 然而﹐不過[W]advisory[M]a. 顧問的﹐咨詢的[W]cardiovascular[M]a. 心血管的[W]pregnant[M]a. 懷孕的﹔含蓄的[W]vaccinate[M]vt. 給…接種疫苗[W]periodically[M]ad. 週期性地﹐定期地[W]revaccinate[M]vt. 再給…接種疫苗[W]mutate[M]v. <使>突變﹔<使>變異[W]genetic[M]a. 遺傳的﹔發生的[W]make-up[M]n. 特徵﹔成份[W]rna[M]核糖核酸[W]culprit[M]n. 罪犯﹔冒犯者[W]southeast[M]n. 東南﹑東南部[W]southeast asia[M]東南亞[W]dub[M]vt. 稱為﹐取名為[W]traveller[M]n. 旅行者﹐旅客[W]spotlight[M]n. 公眾注意中心[W]notorious[M]a. 臭名昭著的[W]swine[M]n. 豬[W]swine flu[M]豬流感[W]variant[M]n. 變體﹐變種﹐變形[W]isolate[M]vt. 隔開﹐隔離[W]complain[M]vi. 抱怨﹐訴說[W]complain of[M]主訴[W]headache[M]n. 頭痛﹔頭痛的事[W]hack[M]vi. 斷續地乾咳[W]hacking cough[M]猛烈的乾咳[W]joint[M]n. 關節﹔接合﹐接頭[W]moisture[M]n. 潮濕﹐濕氣[W]ventilate[M]vt. 使通風﹐使通氣[W]lift[M]n. 電梯﹐起重機﹔vt. 吊[W]illness[M]n. 疾病﹐病患[W]creature[M]n. 生物[W]successively[M]ad. 一個接一個地[W]infective[M]a. 易傳染的﹐傳染性的[W]infectious[M]a. 傳染的﹐感染性的[W]painstaking[M]a. 艱苦的﹔辛勤的[W]killer[M]n. 殺人者﹐兇手[W]accident[M]n. 事故﹐意外的事[W]by accident[M]偶然[W]fall[M]n. 秋季﹔降落﹔v. 落下[W]basement[M]n. 地下室﹔底層[W]bacteriologist[M]n. 細菌學家[W]deadly[M]a. 非常﹐極度[W]plate[M]n. 培養皿﹔盤[W]flourish[M]v. 茂密﹐茂盛﹔繁榮[W]somehow[M]ad. 由於某種原因[W]multiply[M]v. 增加﹐繁殖[W]in vitro[M]在試管內[W]in vivo[M]在活體內[W]submit[M]vt. 呈送﹐提交[W]print[M]v. 印刷﹔n. 印刷品[W]journal[M]n. 刊物﹐雜誌﹔日記[W]account[M]n. 報告﹐報導[W]ignore[M]vt. 忽視﹐不顧[W]meanwhile[M]ad. 當時﹐與此同時[W]by chance[M]偶然[W]german[M]n. 德國人﹐德語[W]sulfa[M]a. 磺胺的﹔n. 磺胺類藥物[W]sulfa drug[M]磺胺類藥[W]dye[M]n. 染料﹐染色[W]dreaded[M]a. 令人畏懼的[W]leprosy[M]n. 痲風病[W]dramatically[M]ad. 顯著地﹔戲劇性地[W]untoward[M]a. 不良的﹐不利的[W]effect[M]n. 效力﹔作用﹔結果[W]side effect[M]副作用[W]disadvantage[M]n. 缺點﹔不利作用[W]resume[M]vt. 重新開始﹐再繼續[W]declare[M]vt. 宣佈﹐聲明[W]application[M]n. 應用﹐施用﹔申請[W]find application[M]獲得應用[W]crystal[M]n. 結晶體[W]unlike[M]prep. 不象…﹔a. 不同的[W]occasionally[M]ad. 偶然﹐不經常地[W]allergic[M]a. 變應性的﹐過敏性的[W]allergic to[M]對…過敏[W]untold[M]a. 無數的﹐數不清的[W]foremost[M]a. 最初的﹐最主要的[W]inhibit[M]vt. 抑制﹔阻止[W]streptomycin[M]n. 鏈霉素[W]aureomycin[M]n. 金霉素[W]terramycin[M]n. 土霉素[W]colony[M]n. 菌落﹐群體﹔殖民地[W]flat[M]a. 淺的﹔扁平的[W]fluffy[M]a. 絨毛狀的﹔蓬松的[W]spoil[M]vt. 搞糟﹔損壞[W]curious[M]a. 好奇的﹐仔細留心的[W]antagonist[M]n. 對手﹐拮抗物[W]penicillium notatum[M]特異青黴素[W]antagonistic[M]a. 對抗性的[W]discontinue[M]vt. & vi. 中止﹐中斷[W]transplantation[M]n. 移植﹔移植法[W]breakthrough[M]n. 突破﹐沖垮[W]heal[M]vt. & vi. 治癒﹐愈合[W]mend[M]vt. 縫補﹔修理[W]remove[M]vt. 摘除﹐去掉﹔移動[W]tonsillitis[M]n. 扁桃體炎[W]tonsil[M]n. 扁桃體﹐扁桃腺[W]inflame[M]vt. & vi. 使發炎[W]anesthetize[M]vt. 使麻醉﹐使麻木[W]appendix[M]n. 闌尾﹐蚓突﹔附錄[W]appendectomy[M]n. 闌尾切除術[W]as well as[M]以及﹔除了…之外<還> [W]pin[M]n. 針﹐別針﹔釘﹔銷子[W]promote[M]vt. 促進﹔助長[W]faulty[M]a. 有病變的﹔有缺點的[W]valve[M]n. 瓣膜﹔閥﹔活門[W]man-made[M]a. 人造的﹐人工的[W]successful[M]a. 成功的﹔結果良好的[W]successfully[M]ad. 成功地﹐出色地[W]graft[M]n. 移植<物>﹔vt. 移植[W]autograft[M]n. 自體移植<物或術> [W]enormous[M]a. 重大的﹐巨大的[W]species[M]n. 物種﹔種類[W]homograft[M]n. 同種移植<物或術> [W]human being[M]n. 人[W]chimpanzee[M]n. 黑猩猩[W]heterograft[M]n. 異種移植<物或術> [W]afflict[M]vt. 使苦惱﹐折磨[W]be afflicted with[M]患﹐受…折磨[W]regain[M]vt. 恢復﹔復得﹐收回[W]cornea[M]n. 角膜[W]reject[M]vt. 排斥﹐抵制﹔否決[W]rejection[M]n. 排斥﹐拒絕﹔否決[W]ordinarily[M]ad. 平常,在一般情況下[W]accept[M]vt. 接受﹔承認﹐認可[W]tendency[M]n. 趨向﹐傾向[W]fight off[M]抵抗﹐擊退[W]suppress[M]vt. 防止﹐阻止﹔抑制[W]immunosuppressive[M]a. 抑制免疫反應的[W]alien[M]a. 相異的﹐外來的[W]match[M]n. 對手﹐相配者﹔比賽[W]match with[M]使…和…相配<稱>[W]turn out[M]原來是﹐結果成為[W]spare part[M]備件﹐附件[W]tissue-type[M]組織類型[W]tissue-typing[M]組織分類[W]attributable[M]a. 可歸因的﹐可歸屬的[W]attributable to[M]可歸因于﹐由…引起[W]discovery[M]n. 發現﹔被發現的事物[W]anesthetic[M]n. 麻醉劑﹔a. 麻醉的[W]anesthetist[M]n. 麻醉醫生[W]anesthesiologist[M]n. 麻醉學家[W]toothache[M]n. 牙痛[W]tablet[M]n. 碑﹔匾額﹔小塊﹐小片﹔藥片[W]taste[M]n. 味覺﹔v. 嘗[W]lessen[M]vt. 減輕﹐減少﹔縮小[W]sensation[M]n. 感覺﹐知覺[W]analgesic[M]n. 止痛藥[W]relieve[M]vt. 減輕﹐解除[W]on this ground[M]因此﹐因此之故[W]symposium[M]n. 專題討論會﹐座談會[W]opium[M]n. 鴉片﹔麻醉劑[W]nitrous[M]n. 含有三價氮的[W]nitrous oxide[M]一氧化二氮<笑氣> [W]painless[M]a. 不痛的﹐無痛苦的[W]deserve[M]vt. 應受﹐值得[W]credit[M]n. 榮譽﹔信任﹔vt. 相信[W]credit with[M]可歸功于[W]demonstration[M]n. 示範﹐表演﹔論證[W]massachusetts[M]n. 麻薩諸塞<美國州名> [W]boston[M]n. 波士頓<美國城市>[W]scottish[M]a. 蘇格蘭的﹔n. 蘇格蘭人[W]chloroform[M]n. 氯仿[W]childbirth[M]n. 分娩﹐生小孩[W]queen[M]n. 女王﹔王后[W]avert[M]vt. 防止﹐避開[W]signal[M]n. 信息﹐信號﹔vt. 標誌[W]induce[M]vt. 誘導﹔引起﹐導致[W]spray[M]vt. 噴﹔n. 浪花﹐噴霧[W]gel[M]n. 凝膠[W]lidocaine[M]n. 利多卡因<局部麻醉> [W]lidocaine gel[M]利多卡因凝膠<表面…> [W]ethyl chloride[M]n. 氯乙烷<表面麻醉劑> [W]rub[M]vt. 擦﹐擦上﹔摩擦[W]lining[M]n. 裡層﹐襯裡[W]nerve[M]n. 神經[W]ending[M]n. 末梢﹐末端﹔結尾[W]nerve endings[M]神經末梢[W]suitable[M]a. 合適的﹐適宜的[W]be suitable for[M]適用于[W]gastrostomy[M]n. 胃造口術[W]commonly[M]ad. 通常﹐一般[W]procaine[M]n. 普魯卡因[W]cerebrospinal[M]a. 腦脊髓的[W]ganglion[M]n. 節﹔神經節[W]performance[M]n. 施行﹔進行﹔演出[W]obstetrics[M]n. 產科學﹐助產術[W]majority[M]n. 多數﹐大多數[W]hospitalize[M]vt. 把…送入醫院治療[W]premeditation[M]n. 術前用藥[W]prior[M]a. 在先的﹐在前的[W]prior to[M]在…之前[W]achieve[M]vt. 達到﹐得到﹔完成[W]unconsciousness[M]n. 失去知覺﹐昏迷[W]halt[M]vt. 使停止﹔防止[W]exert[M]vt. 施加﹐行使[W]propose[M]vt. 提出﹐提議﹔推薦[W]intravenously[M]ad. 靜脈注射地[W]milkmaid[M]n. 擠奶女工[W]prick[M]vt. 扎穿﹐刺穿[W]dare[M]v. 敢[W]daring[M]a. & n. 大膽<的>[W]purpose[M]n. 目的﹐意圖﹔效用[W]anti-cowpox[M]a. 抗牛痘的[W]wear off[M]逐漸減弱﹐消失[W]incidentally[M]ad. 偶然地[W]native[M]a. 本國的﹐本土的[W]comparison[M]n. 比較﹐對照[W]instructive[M]a. 有教益的﹐有啟發的[W]grown-up[M]n. 成年人的﹐成熟的[W]haphazard[M]a. 無計劃的﹐隨意的[W]lay out[M]擬訂﹔佈置﹐安排[W]playmate[M]n. 游戲的夥伴[W]visual[M]a. 視覺的﹐目視的[W]visual aids[M]直觀教具[W]mastery[M]n. 精通﹐掌握﹔控制[W]gifted[M]a. 有天賦的﹐有才華的[W]inexact[M]a. 不準確的﹐不精確的[W]account for[M]說明﹐解釋﹔佔[W]flexible[M]a. 靈活的﹔柔韌的[W]flexibility[M]n. 靈活性﹐柔韌性[W]hold water[M]有理﹐說得通[W]argue[M]vt. 爭辯﹔論證[W]especially[M]ad. 特別﹐格外[W]behaviour[M]n. 行為﹐舉止[W]pronunciation[M]n. 發音﹐發音法[W]intonation[M]n. 語調﹐聲調[W]drink in[M]全神貫注地聽﹐欣賞[W]bubble[M]vi. 發出氣泡﹐起泡[W]ever-bubbling[M]不斷涌出的[W]assimilation[M]n. 同化﹔吸收﹔消化[W]as it were[M]可以說[W]advantage[M]n. 有利條件﹐優點[W]gesture[M]n. 手勢﹔姿勢[W]facial[M]a. 面部的[W]unnatural[M]a. 不自然的﹔人工的[W]scorching[M]a. 灼熱的[W]desire[M]n. & vt. 願望﹔要求[W]fulfill[M]vt. 完成﹔滿足﹔履行[W]relation[M]n. 家屬﹐親屬﹔關係[W]take great pains[M]煞費苦心﹐花大氣力[W]awkward[M]a. 不熟練的﹐笨拙的[W]encouragement[M]n. 鼓勵﹔獎勵品[W]merry[M]a. 有趣的﹔愉快的[W]overlook[M]vt. 忽視[W]faultless[M]a. 無過失的﹔完善的[W]accuracy[M]n. 準確﹐精確[W]unnecessarily[M]ad. 不必要地[W]sprinkle[M]vt. 洒水[W]plunge[M]vt. 將…投入水中[W]elaborate[M]a. 詳細的﹔精心製作的[W]preface[M]n. 序言﹐前言﹐緒言[W]pattern[M]n. 模型﹐典範[W]imply[M]vt. 暗示﹐意指[W]design[M]vt. 計劃﹐預定[W]underlie[M]vt. 位於…的下面[W]linguistic[M]a. 語言的[W]explanatory[M]a. 解釋的﹐說明的[W]introductory[M]a. 介紹的﹐引導的[W]for the most part[M]多半﹐通常[W]omit[M]vt. 省略﹐刪去[W]sufficient[M]a. 足夠的﹐充份的[W]memorise[M]vt. 記住﹐熟記<memorize=memorise> [W]repetition[M]n. 重複﹐反復[W]usage[M]n. 使用﹐用法﹔慣用法[W]grammatical[M]a. 語法的﹐符合語法的[W]imitation[M]n. 模仿﹐摹擬[W]frequent[M]a. 經常的﹐頻繁的[W]resort[M]n. 採取的手段﹐求助[W]publish[M]vt. 發表﹔出版﹔公佈[W]origin[M]n. 起源﹔由來[W]selection[M]n. 選擇﹐挑選[W]evolve[M]vi. 進化﹔生長﹔發育[W]nonhuman[M]a. 非人類的[W]primate[M]n. 靈長目動物[W]descend[M]vi. 下降﹔傳下[W]be descended from[M]是…的後裔﹐系出[W]ape[M]n. 猿﹐類人猿[W]geological[M]a. 地質學的[W]sensible[M]a. 明顯的﹔感覺得到的[W]notion[M]n. 概念﹔見解﹔想法[W]content[M]a. 滿足的﹔n. 內容[W]bible[M]n. 聖經[W]religion[M]n. 宗教﹔信仰[W]authoritarian[M]a. 權威主義的[W]camp[M]n. 陣營﹔野營[W]evolutionist[M]n. 進化論者[W]creationist[M]n. 神靈論者﹐上帝論者[W]solar[M]a. 太陽的﹐日光的[W]champion[M]vt. 擁護﹐支持﹔n. 冠軍[W]god[M]n. 上帝﹐神[W]fall short of[M]辜負﹔達不到﹔缺乏[W]expectation[M]n. 期望﹐期待[W]blindly[M]ad. 盲目地﹐輕率地[W]evolutionary[M]a. 進化的[W]similarity[M]n. 類似﹐相似[W]fascinate[M]vt. 迷住,強烈地吸引住[W]fit...into[M]使…適應于[W]ecological[M]a. 生態的﹐生態學的[W]niche[M]n. 小生境﹐生態位[W]teem[M]vi. 充滿﹐豐富[W]teeming[M]a. 豐富的[W]dock[M]vi. 靠碼頭[W]amass[M]vt. 積累﹐收集[W]meticulous[M]a. 細緻的﹐過細的[W]possibility[M]n. 可能﹐可能性[W]naturalist[M]n. 博物學家[W]independently[M]ad. 獨自地﹐單獨地[W]reluctantly[M]ad. 勉強地[W]argument[M]n. 辯論﹐爭論﹔認據[W]adapt[M]vt. 使適應﹐使適合[W]adaptation[M]n. 適應性﹔適應[W]sharpness[M]n. 鋒利﹐銳利[W]ferocious[M]a. 兇惡的﹐凶猛的[W]beast[M]n. 獸﹐野獸[W]jungle[M]n. 叢林﹐密林﹔原始林[W]equally[M]ad. 相同地﹐同樣地[W]adequate[M]n. 適當的﹐充份的[W]concise[M]a. 簡明的﹐簡要的[W]statement[M]n. 陳述﹐說明﹔聲明[W]diagram[M]n. 圖解﹐圖表[W]table[M]n. 表格﹐項目表[W]glance[M]n. 一瞥[W]at a glance[M]一眼[W]middle age[M]中世紀[W]experimental[M]a. 實驗上的[W]proof[M]n. 證據﹐證明﹐論證[W]program[M]n. 節目﹔計劃﹐規劃[W]geneva[M]n. 日內瓦<瑞士城市> [W]switzerland[M]瑞士[W]family planning[M]計劃生育[W]institute[M]n. <研究>所﹐學院[W]academy[M]n. 研究院﹔學會[W]memo[M]n. 備忘錄[W]officially[M]ad. 正式地﹐官方地[W]approval[M]n. 批准﹔讚同﹐同意[W]india[M]n. 印度[W]anticipate[M]vt. 期望﹔預料[W]clearance[M]n. 許可證[W]shortly[M]ad. 立刻﹐不久[W]enclose[M]vt. 圍住﹔把…封入[W]participant[M]n. 參加者﹐參與者[W]draft[M]n. 草案﹐草稿[W]agenda[M]n. 議事日程﹐提綱[W]document[M]n. 公文﹐文件﹔證件[W]despatch[M]vt. 發送﹐派遣﹐寄出[W]economy[M]n. 經濟﹔節省[W]residence[M]n. 居住﹐住處[W]deviation[M]n. 偏離﹔繞道﹐繞航[W]per diem[M]<拉>n. 每日[W]allowance[M]n. 津貼或補助費﹔允許[W]payment[M]n. 支付﹔支付的款項[W]visa[M]n. 簽証[W]transit[M]n. 通過﹔過境﹔vt. 通過[W]reservation[M]n. 預定<旅館房間等>[W]inclusive[M]a. 包含的﹐包含在內的[W]rail[M]n. 鐵軌﹔鐵路[W]alternatively[M]ad. 另外﹐此外[W]presently[M]ad. 現在﹐目前[W]attach[M]vt. 附加﹐隨附[W]sincerely[M]ad. 真誠地﹐真摯地[W]yours sincerely[M]您忠誠的<信末客套語> [W]signature[M]n. 署名﹐簽名[W]executive[M]a. 行政上的﹔n. 行政官[W]p.s.[M]<信末的>附言﹐再者[W]attestation[M]n. 證明﹐證實﹔證據[W]facilitate[M]vt. 使…便利﹐促進[W]obtention[M]n. 獲得[W]encls[M]附件﹐內封物<縮>[W]indicate[M]vt. 指出﹐指示﹐表示[W]invitation[M]n. 邀請﹐招待﹔請貼[W]privilege[M]n. 優惠﹔榮幸﹔特權[W]deem[M]vt. 認為﹐相信[W]issue[M]n. 問題﹐爭論點﹐期[W]eagerness[M]n. 急切的心情﹐渴望[W]previous[M]a. 以前的﹐先[W]convenience[M]n. 便利﹔方便[W]certificate[M]n. 執照﹐證<明>書[W]gratitude[M]n. 感謝﹐感激[W]regard[M]n. 注意﹐<復>致意[W]with best regards[M]此致敬禮<信末客套語> [W]inform[M]vt. 告訴﹐通知[W]director-general[M]總幹事﹔理事長[W]approve[M]vt. 批准﹐通過﹔贊成[W]grant[M]n. 補助金﹐津貼[W]fund[M]vt. 為…提供資金[W]institution[M]n. 協會﹔學校﹐機構[W]collaborate[M]vi. 協作﹐合作[W]fertility[M]n. 肥沃﹔能育性[W]collaborative[M]a. 協作的﹐合作的[W]pharmaceutical[M]a. 藥物的﹐藥學的[W]chicago[M]芝加哥<美國城市>[W]sri lanka[M]斯裡蘭卡[W]acceptance[M]n. 接受﹐領受﹔承認[W]duplicate[M]a. 副的,複製的﹔n. 副本[W]cable[M]vi. 發電報[W]undated[M]a. 無定期的[W]administrative[M]a. 行政的﹐管理的[W]officer[M]n. 官員﹐高級職員[W]promotion[M]n. 促進﹐增進[W]disposal[M]n. 處理﹔配置﹔控制[W]at one's disposal[M]由某人支配[W]scourge[M]n. 災難﹐禍害﹔vt. 蹂躪[W]achievement[M]n. 成就﹐成勣﹔完成[W]invention[M]n. 發明﹐創造﹔發明物[W]device[M]n. 器械﹔裝置﹔設計[W]sphygmomanometer[M]n. 血壓計[W]pressure[M]n. 壓﹔壓力[W]electrocardiograph[M]n. 心<動>電圖描記器[W]cg[M]心<動>電圖描記器<縮>[W]eeg[M]腦<動>電圖描記器<縮>[W]hand in hand[M]手拉手地﹐同時發生地[W]go hand in hand with[M]與…密切聯結在一起[W]radioisotope[M]n. 放射性同位素[W]trace[M]vt. 跟蹤﹐追蹤﹔n. 蹤跡[W]tracer[M]n. 追蹤者﹐示蹤物[W]so far[M]到目前為止﹐迄今為止[W]toxoid[M]n. 類毒素[W]threaten[M]vt. 威脅﹐恐嚇[W]life-threatening[M]威脅生命的[W]insulin[M]n. 胰島素[W]diabetes[M]n. 糖尿病[W]doom[M]vt. 註定﹐命定﹔n. 厄運[W]be doomed to[M]註定要[W]formerly[M]ad. 以前﹐從前[W]folic acid[M]n. 葉酸[W]incorporate[M]vt. 合併﹐結合﹔收編[W]coenzyme[M]n. 輔脢[W]remarkable[M]a. 顯著的﹔值得注意的[W]adenosine[M]n. 腺﹐腺嘌呤核[W]triphosphate[M]n. 三磷酸鹽[W]conceive[M]vt. 想象﹐設想[W]pituitary[M]n. 垂體<腦>﹐腦下腺[W]synthetic[M]a. 合成的﹐人造的[W]steroid[M]n. 甾族化合物﹐類固醇[W]gonad[M]n. 性腺﹐生殖腺[W]artificially[M]ad. 人工地﹐人造地[W]cortisone[M]n. 腎上腺皮質激素[W]acth[M]<縮>腎上腺皮質激素[W]stride[M]n. 進展﹐進步﹔v. 跨過[W]pave[M]vt. 鋪﹐筑路[W]pave the way for[M]為…鋪平道路﹔導致[W]undreamed of[M]a. 夢想不到的﹐意外的[W]microsurgery[M]n. 顯微外科﹔顯微手術[W]no longer[M]'不再[W]reality[M]n. 現實﹐真實存在的事[W]traffic[M]n. 交通﹔通行[W]subsequently[M]ad. 隨後﹐後來[W]discipline[M]n. 學科﹔紀律[W]await[M]vt. 有待于﹐期待[W]with a view to[M]目的在於﹐以便[W]radium[M]n. 鐳[W]trial[M]n. 試用﹐試驗﹔審判[W]take over[M]代替﹔接管﹐接任[W]reattach[M]vt. 重新接上[W]conquer[M]vt. 征服﹐攻克﹐戰勝[W]minimize[M]vt. 使減到最小。

眼科医生英语阅读短文Ophthalmologists play a crucial role in the field of healthcare, specifically in the diagnosis, treatment, and management of eye-related conditions. As medical professionals, ophthalmologists are required to possess a broad knowledge base, including a proficient understanding of medical English. In this article, we will explore the importance of English language skills for ophthalmologists, the challenges they face, and strategies to enhance their English reading comprehension abilities.English language proficiency is essential for ophthalmologists due to several reasons. Firstly, a significant portion of medical literature is written in English, making it the lingua franca of scientific research. To stay updated with the latest advancements in the field, ophthalmologists must be able to read and understand English articles, journals, and papers. Having strong English reading skills allows them to access a vast pool of information and collaborate with experts worldwide.Moreover, English is the language of international conferences and symposiums. Ophthalmologists often attend these events to present their research findings or learn from renowned experts. The ability to comprehend scientific presentations and engage in meaningful discussions relies heavily on their English language proficiency.While the importance of English for ophthalmologists is evident, they may encounter various challenges when reading English medical texts. One obstacle is the complex terminology used in ophthalmology. Technical terms specific to the field may be challenging for non-native English speakers tounderstand, hindering their comprehension of research articles or medical textbooks.Furthermore, the density of scientific texts can pose difficulties in deciphering intricate concepts and connecting ideas. Ophthalmologists need to be able to extract relevant information, interpret data accurately, and draw meaningful conclusions to apply them to their practice effectively.To overcome these challenges and enhance their English reading skills, ophthalmologists can employ various strategies. First and foremost, they should allocate dedicated time for English reading practice. By setting aside a specific portion of their day to read English articles or journals, ophthalmologists can gradually improve their reading comprehension abilities.Additionally, ophthalmologists can make use of available resources to expand their vocabulary and familiarize themselves with ophthalmic terminology. Medical dictionaries, online courses, or specialized textbooks can be valuable assets in this pursuit. Creating a personalized glossary of commonly used terms can also aid in retaining new vocabulary.Another approach is to actively engage in discussions and collaborations with colleagues proficient in English. Participating in journal clubs or attending international conferences provides opportunities to exchange knowledge and ideas, enhancing both language skills and professional network.Furthermore, utilizing technology can facilitate English reading practice. Online platforms, such as medical forums or professional social media groups, offer a wealth of informative content and enable interactions withpeers worldwide. Ophthalmologists can leverage these platforms to read and comment on articles, seek clarifications, and engage in intellectual discussions.In conclusion, proficiency in English is paramount for ophthalmologists to stay updated with the latest research, collaborate with peers internationally, and contribute to the field of ophthalmology. Despite the challenges posed by technical terminology and complex scientific texts, ophthalmologists can enhance their English reading skills through dedicated practice, utilization of available resources, active engagement in discussions, and leveraging technology. By continually improving their English language proficiency, ophthalmologists can ensure they stay at the forefront of their profession and provide the best possible care to their patients.。

学术英语〔医学〕课后词组Unit11．overload神经过载2.a typical典型的诊所就诊3.DEXA DEXA扫描4.medical行医5.control血压控制6.health健康保持7.report乳房X线检查报告8.examination体检9.of a medication药物的副作用10.perpetual永久的恐慌11.physicians职业医生12.field移植领域13.medical医疗预算14.paracetamol扑热息痛药片15.cap防孩子打开的盖子16.clinical trial随机临床试验17.Random随机分配18.patient病人的预后19.group对照组20.a10-year study10年的跟踪研究21.a medical内科病房22.infectious传染性肝炎23.Severe身体严重不适24.bilirubin胆红素代谢25.permanent damage永久的肝损伤26.exacerbate加重病理生理状况27.Medical医学文献28.clinical临床调查29.of relapse复发率30.clinical临床流行病学31.strict严格的卧床休息32.hospital住院33.recurrent反复发作的黄疸34.clinical临床病程35morphine静脉注射吗啡36blood pressure舒张压37.brain大脑血灌输38.care初级保健39.aorto-coronary arterial主动脉冠状动脉旁路40.treatment decision知情治疗决41.an international group一个国际人道组织42.the Red红十字会43.The first major effort第一次重大援助工作44of war战争中的人员伤亡45.relief efforts紧急援助、Unit21disease<再现疾病>2.new flu新流感变种3.antibiotics and抗生素和疫苗4.disease传染病5disease新现疾病6strategy预防策略7.bubonic腺鼠疫8.microbes病原微生物9.public heath公共卫生机构10.drug抗药性11.an of antibiotic therapy抗生素治疗疗程12.scarlet猩红热13.the level of毒性水平14.flu流感大流行15.surface表面抗原16.shift基因改变17.neurological神经性并发症18.waning of免疫力减弱19.public health公共卫生基础设施20.a malaria一个疟疾病例21.flu猪流感22.bacillus结核杆菌23.the of morbidity发病率水平24.health保健专业人士25tuberculosis潜伏结核病26.tuberculin结核素皮试27.programmes筛查计划28.gamma testsγ干扰素测试29.drug药物毒性30.an disease一种可治愈的病31,infectious disease难治的传染病32.an unknown一种未知的病原体33.chronic gastric慢性胃溃疡34to carries of disease接触带病者35,genetic基因重组36.agent of生物恐怖活动病原37.infections通过食物传播的传染病Unit31.the surge of肾上腺素激增2.an internal medicine内科实习期3.an disease自体免疫4.loss of丧失持久力5.weakness短暂的虚弱6.being卧床不起7.a building基本构件8.an animal动物模型9.to slow减缓神经退化10.to toxins排除毒素11.to nutrition优化营养12.toxic毒素载量13.the risk of复发危险14.physician医生自我实验15.a clinical临床试验16.electrical stimulation神经肌肉电刺激17.physical理疗师18.the impact of微量营养素的影响19.brain脑功能2the emotional flow跟踪情绪波动21of emotions情绪协调22.reactions心血管反应23.feeling of t亲密感觉24.rapid迅速同步25.emotional情绪传染26.to mutually互相调节27.a psychobiological unit生物心理单元28.emotional情感慰藉29.functional resonance功能性磁共振成像30.to brain zones激活该脑部区域31.to make it使之成为强制性32.a project无把握的项目33.medical background医学背景4.proof of概念验证35.dose剂量方案36.or conitant conditions并发症与合并症37agents抗肿瘤的药剂38.standard标准疗法39.properties药理学特性40.poor溶解性差41.pharmacology体内药理学Unit41.medicine补充医学2.medicine替代医学3.a medical医疗模式4.and herbs针灸和草药5.a treatment辅助治疗6.a and vomiting恶心,呕吐7.dental pain术后牙痛.trials临床试验9.therapy物理疗法,理疗10modalities治疗方法11.a therapeutic治疗干预12.Research design研究设计13.magnetic e磁共振14.positron tomography正电子发射型计算机断层成像15effect止痛效果16.biomedical生物医学界17.unit康复中心18.acupuncturist持照针灸师19.therapeutic治疗策略20.herbal草药配方21.a wide array of各式各样的并发症22.East-West medicine中西医结合23.abdominal pain急性腹痛24.to medicines施药,用药25.surgical外科手术26.scientific科学评估27.statistics患病率统计prevalence28.therapies传统疗法29.models of care询证医学模式30.stress压力处理31nervous system周围神经系统.peripheral32.physiologic生理机制33.mechanistic and studies机制和还原式研究34.research效益研究35.clinical临床结果36.and clinical studies临床前与临床研究37mechanisms可能的机制38therapies推拿治疗39.medicine顺势疗法40.medicine自然疗法41.and yoga冥想与瑜伽Unit51.a health健康危机2.physical s身体症状3.Energy and能量和活力4.be pletely I from sth.对某事完全免疫5.of falseness虚假的病毒6.stressful有压力的生活方式7.t emotion健全的感情8.health脆弱的健康9.to our mind,body and spirit平衡心理、身体和精神10.life精神生活11.the to wellness通向身心健康的"路障"12.emotions被压抑的感情13.feelings and emotion真情实感14.l influences心理影响15.fully human beings十全十美的人16.teeth蛀牙17professor营养教授18.burgeoning迅速膨胀的腰围19.water瓶装水20.caloric热量摄入21.to curb节制食欲22.grains and谷物和蛋白质23.childhood儿童肥胖症24protein精益蛋白质25.habits饮食习惯26.of life生活质量27.category乳制品类28.prevention of糖尿病的预防29.sodium钠的含量Unit61.homes养老院2care临终关怀3.congestive heart充血性心衰4.available24小时随叫随到5care unit冠心病监护室6.to to treatment对治疗有反应7.skilled nursing专业护理机构8.care生命终末期护理9.care舒适护理10.hospital planner出院计划专员11care症状护理12care姑息疗法13.illness绝症14.chronic obstructive disease慢性阻塞性肺病15.treatments实验性治疗16.spiritual精神顾问17.to all treatment终止所有治疗18.to go through经历透析19.A PAP巴氏涂片检查20.patient-relationship医患关系21.to provide提供常规医护22.examinations预防性检查23.off the path离开熟路,另辟蹊径24.to into a shape塑形25.To a prescription照旧处方再开药26.in vitro体外受精27.biology基础生物学28.embryonicresearch胚胎干细胞研究29.to with an outside与圈外人合作30.ababy试管婴儿31.sciences生殖科学32.to administer施用激素33.to isolate eggs分离未成熟卵子34.observations经验观察35.work首创研究36.a fibre-optic光导纤维内窥镜37.guidelines伦理原则38.societal社会关注39.couples不孕不育夫妇40.disease遗传疾病41.Cystic囊泡性纤维症42.ethical伦理困境Unit71.a nursing护士站2.machines生命维持系统3 fort舒适护理措施4.to treatments停止治疗5.decision-making process家长式决策程序6.patient给病人授权7.medical医学伦理学家8.ethical伦理准则9.clinical临床理念10.care以病人为中心的护理11.patient病人自主权12.treatment治疗选择13.purview专属领域14.decisions紧急状况下做的决定15.physician对医生的限制16.and confusion焦虑与困惑17.ethical违背伦理18.family家庭医疗19.widespread广泛转移20.treatment积极治疗21lesion原发病灶22.to remend建议随访23.electronic电子病历24.pulmonary肺栓塞25 puterized计算机断层扫描CT26.bilateral双侧浸润27.a X-ray X线胸片28.left pneumonia左下肺叶肺炎29.breathing呼吸困难30.the hospice临终关怀团队31.illness慢性病32aspects社会心理学领域33.evidence-based循证临床指南34.to a plan of care实施治疗方案Unit81.human人体研究对象2.research生物医学研究3.accepted公认的治疗4.a formal正式方案5.the principle of有利原则6.the principle of公正原则7.agents有自主能力的行为者8.autonomy自主性减弱9.be risk of harm使……面临受害危险10.Hippocratic希波克拉底誓言11.fairness in分配的公正性rmed知情同意13.fair and outes公正的程序和结果14.the table手术台15.an ethical伦理责任16.a neurosurgeon儿科神经外科医生pediatric17.to the surgery做手术18.blood血流19.care重症监护20.father义父21.father生父22.needs心理需要23.judgment医学判断24.therapy职业疗法25.to meningitis感染脑膜炎26.to die of an死于感染27.blood血管28.imbalances in循环的不平衡29.the of human research subjects人类研究对象的安宁30.to approve or all research activities批准或不批准所有的研究活动31.to review a审查一个研究计划32.at risk of civil or criminal有民事或刑事责任的危险参考答案Unit 11. neuron 神经2. office visit<诊所>就诊3. scan 扫描4. medical practice 行医5. blood pressure 血压6. maintenance<健康>保持7. mammogram 乳房Ｘ线8. physical 身体9. side effect 副作用10. panic 恐慌11. practicing 执业12. transplant 移植13. budget 预算14. tablet 药片15. childproof 防孩子16. randomized 随机17. allocation<随机>分配18. prognosis 预后19. control 对照20. follow-up 跟踪21. ward 病房22. hepatitis 肝炎23. malaise 身体不适24. metabolism 代谢25.liver肝26.pathophysiology 病理生理27. literature 文献28. investigation 调查29. incidence 率30. epidemiology 流行病学31. bed rest 卧床休息32. hospital stay 住院33. jaundice 黄疸34. course 病程35. intravenous 静脉注射36. diastolic 舒张37. perfusion 灌注38. primary 初级39. bypass<冠脉>旁路40. informed 知情41. humanitarian 人道主义42. the Red Cross 红十字会43. relief 援助44. casualty 人员伤亡45. emergency 紧急Unit 21. re-emerging 再现2. strain 变种3. vaccine 疫苗4. infectious 传染性的5. emerging 新出现6. prevention 预防7. plague 鼠疫8. pathogenic 病原的9. authorities 机构10. drug resistanc 抗药性11. course 疗程12. scarlet fever 猩红热13. virulence 毒性14. pandemic 大流行15. antigen 抗原16. genetic 基因的17. neurological 神经性18. immunity 免疫力19. infrastructure 基础设施20. case 病例21. swine 猪22. tuberculosis 结核23. morbidity/incidence 发病率24. professionals 专业人士25. latent 潜伏26. skin test 皮试27. screening 筛查28. interferon 干扰素29. toxicity 毒性30. curable 可治愈的31. intractable 难治的32. pathogen 病原体33. ulcer 溃疡34. exposure 接触<带病者>35. rebination 重组36. bioterrorism 生物恐怖活动37. foodborne 生物传播Unit 31. adrenaline 肾上腺素2. residency 实习3. autoimmune 自身免疫4. stamina 持久力5. transient 短暂的6. bedridden 卧床不起7. building block 基本构件8. model 模型9. neurodegeneration 神经退化10.excrete 排除<毒素>11.optimize 优化12.load 载量13.relapse 复发14.self-experimentation 自我实验15.trial 试验16.neuromuscular 神经肌肉17.therapist 治疗师18.micronutrient微量营养素19.function 功能20.track 跟踪21.coordination 协调22.cardiovascular 心血管23.rapport 亲密24.synchronization 同步25.contagion 传染26.regulate 调节27.psychobiological生物心理28.solace 慰藉29.imaging ＭＲＩ30.activate 激活31.mandatory 强制性32.dubious 无把握的33.background 背景34.concept 概念35.regimen 方案36plications 并发症37.anti-tumor 抗肿瘤38.standard标准的39.pharmacological 药理学的40.solubility 溶解性41.in vivo 体内Unit 41. plementary 补充2. alternative 替代<医学>3. paradigm 模式4. acupuncture 针灸5. adjunct 辅助6. nausea 恶心7. post-operative 术后8. clinical 临床的9. physical therapy理疗10. therapeutic 治疗<方法>11. intervention 干预12. design 设计13. resonance 共振14. emission 发射ＰＥＴ15. analgesia 止痛16. establishment<生物医学>界17. rehabilitation 康复18. licensed 持照<针灸师>19. strategies 策略20. formulas 配方21. wide array 各式各样的22. integrative<中西医>结合23. acute 急性的24. administer 给药25. procedure 程序26. evaluation 评估27. prevalence 患病率28. conventional 传统<疗法> 29. evidence-based循证的30. management<压力>处理31. peripheral 外周／外围32. mechanisms 机制33. reductionistic 还原式的34.cost-effectiveness 效益35. outes 结果36. preclinical 临床前37. plausible 可能的38. manipulative 推拿39. homeopathic 顺势40. naturopathic 自然<疗法> 41. meditation 冥想Unit 51. crisis 危机2. symptoms 症状3. vitality 活力4. immune 免疫5. virus 病毒6. lifestyle 生活方式7. robust 健全的8. fragile 脆弱的9. balance 平衡10. spiritual 精神的11. blockages 路障12. repressed 被压抑的13. genuine 真实的<真情实感>14. physiological 心理15. integrated 整合的<十全十美>16. decaying teeth 蛀牙17. nutrition 营养18. waistline 腰围19. bottled 瓶装<水>20. intake 摄入21. appetite 食欲22. protein 蛋白质23. obesity 肥胖症24. lean 精益的<蛋白质>25. dietary 饮食<习惯>26. quality 质量27. dairy 乳制品28. diabetes 糖尿病29. content 含量Unit 61. nursing home 养老院2. hospice 临终<关怀>3. failure<心>衰4.available around-the-clock24小时随叫随到5. coronary 冠心病6. respond<对治疗有>反应7. facility 机构8. end-of-life 终末期9. fort 舒适的<护理>10. hospital discharge 出院11. care<症状>护理12. palliative 姑息的13. fatal illness 绝症14. pulmonary 肺的ＣＯＰＤ15. experimental 实验性的16. advisors 顾问17. discontinue 终止18. dialysis 透析19. smear 涂片20. provider 医患关系21. care-as-usual 常规医护22. preventive 预防性23. beaten 常用的off thebeaten path离开熟路,另辟蹊径24. mold into the shape 塑形25. renew 重新开始torenew a prescription照旧处方再开药26. fertilization 授精27. basic 基础的<生物学>28. stem cell 干细胞29. collaborate 合作30. test-tube 试管<婴儿>31. reproductive 生殖的32. hormones 激素33. immature 未成熟的34. empirical 经验<观察>35. pioneering 首创的36. endoscope 内镜37. ethical 伦理的38. concern<社会>关注39. infertile 不孕不育的40. inherited 遗传性的41. fibrosis 纤维化42. dilemmas 困境Unit 71. station<护士>站2. life-support 生命维持<系统>3. measures 护理措施4. withdraw 停止<治疗>5. paternalistic 家长式的6. empowerment 授权7. ethicists 伦理学家8. principles 准则9. ideal 理念10.patient-centered 以病人为中心的11. autonomy 自主权12. options 选择13. exclusive purview专属的<领域>14. emergency 紧急<决定>15. restraint 限制16. anxiety 焦虑17. transgression 违背18. practice<家庭>医疗19. metastases<广泛>转移20. aggressive 积极的21. primary 原发22. follow-up 随访23. record 病历24. embolism 栓塞25. tomography 断层摄像ＣＴ26. infiltrates 浸润27. chest 胸28. lower-lobe 左下叶29. labored<呼吸>困难30. team 团队31. chronic 慢性的32. psychosocial 社会心理33. guidelines 指南34. implement 实施<治疗方案>Unit 1 动脉旁路1.neuron overload 神经过载2.a typical office visit 典型的诊所就诊3.DEXA scan DEXA扫描4.medical practicing 行医5.blood pressure control 血压控制6.health maintenance 健康保持7.Mammogram report 乳房X线检查报告8.physical examination 体检9.side effect of a medication药物的副作用10.perpetual panic 永久的恐慌11.practicing physicians 职业医生12.transplant field 移植领域13.medical budget 医疗预算14.paracetamol tablet 扑热息痛药片15.childproof cap 防孩子打开的盖子16.randomized clinical trial随机临床试验17.Random allocation 随机分配18.patient prognosis 病人的预后19.control group 对照组20.a 10-year follow-up study10年的跟踪研究21.a medical ward 内科病房22.infectious hepatitis 传染性肝炎23.Severe malaise 身体严重不适24.bilirubin metabolism 胆红素代谢25.permanent liver damage永久的肝损伤26.exacerbatepathophysiology 加重病理生理状况27.Medical literature 医学文献28.clinical investigation 临床调查29.incedence of relapse 复发率30.clinical epidemiology 临床流行病学31.strict bed rest 严格的卧床休息32.hospital stay 住院33.recurrent jaundice 反复发作的黄疸34.clinical course 临床病程35.intravenous morphine 静脉注射吗啡36.diastolic blood pressure舒张压37.brain perfusion 大脑血灌输38.primary care初级保健39.aorto-coronary arterialbypass主动脉冠状助工作rmed treatmentdecision 知情治疗决41.an internationalhumanitarian group一个国际人道组织42.the Red Cross 红十字会43.The first major reliefeffort 第一次重大援44.casualty of war 战争中的人员伤亡45.emergency relief efforts紧急援助Unit 31.the surge of adrenaline 肾上腺素激增2.an internal medicineresidency 内科实习期3.an autoimmune disease自体免疫4.loss of stamina 丧失持久力5.transient weakness 短暂的虚弱6.being bedridden 卧床不起7.a building block基本构件8.an animal model 动物模型9.to slow neurodegeneration 减缓神经退化10.to excrete toxins排除毒素11.to optimize nutrition 优化营养12.toxic load毒素载量13.the risk of relapse 复发危险14.physician self-experimentation医生自我实验15.a clinical trial 临床试验16.neuromuscular electrical stimulation 神经肌肉电刺激17.physical therapist 理疗师18.the impact of micronutrients 微量营养素的影响19.brain function 脑功能20.track the emotional flow 跟踪情绪波动21.coordination of emotions 情绪协调22.cardiovascular reactions 心血管反应23.feeling of rapport 亲密感觉24.rapid entrain 迅速同步25.emotional contagion 情绪传染26.to mutually regulation 互相调节27.a psychobiological unit生物心理单元28.emotional solace情感慰藉29.functional magneticresonance imaging功能性磁共振成像30.to activate brain zones激活该脑部区域31.to make it mandatory 使之成为强制性32.a<n> dubious project无把握的项目33.medical background医学背景34.proof of concept概念验证35.dose regimen 剂量方案36 plications or conitantconditions并发症与合并症37.anti-tumor agents 抗肿瘤的药剂38.standard therapy标准疗法39.pharmacology properties药理学特性40.poor solubility 溶解性差41.in vivo pharmacology 体内药理学Unit 51.a health crisis 健康危机2.physical symptoms 身体症状3.Energy and vitality 能量和活力4.be pletely immune fromsth.对某事完全免疫5.virus of falseness 虚假的病毒6.stressful lifestyle 有压力的生活方式7.robust emotion 健全的感情8.fragile health 脆弱的健康9.to balance our mind ,bodyand spirit平衡心理、身体和精神10.spiritual life精神生活11.the blockage to wellness通向身心健康的"路障"12.repressed emotions 被压抑的感情13.genuine feelings andemotion真情实感14.physiological influences心理影响15.fully integrated humanbeings 十全十美的人16.decaying teeth 蛀牙17.nutrition professor 营养教授18.burgeoning waistline 迅速膨胀的腰围19.bottled water 瓶装水20.caloric intake 热量摄入21.to curb appetite 节制食欲22.grains and protein 谷物和蛋白质23.childhood obesity 儿童肥胖症24.lean protein 精益蛋白质25.dietary habits 饮食习惯26.quality of life 生活质量27.diary category 乳制品类28.prevention of diabetes糖尿病的预防29.sodium content 钠的含量Unit 71.a nursing station 护士站2.life-support machines 生命维持系统3 fort measures 舒适护理措施4.to withdraw treatments停止治疗5.paternalistic decision-making process 家长式决策程序6.patient empowerment 给病人授权7.medical ethicists 医学伦理学家8.ethical principles 伦理准则9.clinical ideal 临床理念10.patient-centered care 以病人为中心的护理11.patient autonomy 病人自主权12.treatment options 治疗选择13.exclusive purview 专属领域14.emergency decisions 紧急状况下做的决定15.physician restraint 对医生的限制16.anxiety and confusion 焦虑与困惑17.ethical transgression 违背伦理18.family practice 家庭医疗19.widespread metastases 广泛转移20.aggressive treatment 积极治疗21.primary lesion 原发病灶22.to remend follow-up 建议随访23.electronic record 电子病历24.pulmonary embolism 肺栓塞25 puterized tomography CT,计算机断层扫描26.bilateral infiltrates双侧浸润27.a<n> chest X-ray<X线胸片>28.left lower-lobe pneumonia左下肺叶肺炎borcd breathing呼吸困难30.the hospice team临终关怀团队31.chronic illness慢性病32.psychosocial aspects 社会心理学领域33.evidence-based guidelines 循证临床指南34.to implement a plan of care 实施治疗方案。

医学学术英语期末考试试题一、选择题（每题2分，共20分）1. The term "pathogen" refers to:A. A type of bacteriaB. An organism that causes diseaseC. A medical conditionD. A type of medication2. Which of the following is a method for measuring blood pressure?A. StethoscopeB. SphygmomanometerC. ThermometerD. Ophthalmoscope3. The abbreviation "MRI" stands for:A. Magnetic Resonance ImagingB. Medical Records IndexC. Myocardial Resection ImagingD. Medical Research Institute4. Which of the following is a type of cancer?A. MelanomaB. InfluenzaC. DiabetesD. Hypertension5. The process of identifying the cause of a disease is known as:A. DiagnosisB. PrognosisC. TreatmentD. Epidemiology二、填空题（每空1分，共20分）6. The medical term for the surgical removal of a tumor is__________.7. The study of the cause and spread of diseases is known as __________.8. The abbreviation "HIV" stands for __________.9. A(n) __________ is a healthcare professional who specializes in the diagnosis and treatment of diseases of the heart.10. The term "antibiotic" refers to a substance that inhibits the growth of __________.三、简答题（每题5分，共30分）11. Explain the difference between a virus and a bacterium.12. Describe the role of white blood cells in the immune system.13. What is the purpose of a biopsy in medical diagnosis?14. Discuss the importance of vaccination in public health.四、阅读理解（每题5分，共30分）Read the following passage and answer the questions:Passage: (A brief excerpt from a medical journal article discussing the latest developments in cancer treatment, including targeted therapies and immunotherapies.)15. What are the two main types of cancer treatment mentioned in the passage?16. How do targeted therapies differ from traditional chemotherapy?17. What is the basic principle behind immunotherapy?18. According to the passage, what are some potential advantages of immunotherapy over other treatments?五、写作题（共30分）19. Write a short essay (200-250 words) on the impact of medical technology on patient care. Discuss at least two specific examples of how technology has improved medical practice.六、翻译题（每题5分，共20分）20. Translate the following sentence into English: "近年来，基因编辑技术在医学研究中的应用越来越广泛。

UNIT 1 A Doctor’s LifeTeaching ObjectivesAfter learning Unit 1, students (Ss) are expected to accomplish the following objectives:Teaching Activities and ResourcesPart 1 ReadingText ALead-inSuggested teaching plan1.Start the class by sharing your experiences with doctors.2.Brainstorming task:1)Ask Ss to brainstorm what they know about a doctor’s life and practice.2)Write down the key words on the chalkboard.3)Ask Ss to have a short discussion on different aspects of a doctor’s life. Ssare encouraged to use the key words in discussion.The following is a list of suggested key words:3.Make a summary on the discussion and introduce the topic of Text A.Text ComprehensionSuggested teaching plan1.When preparing for and planning the class, the teacher (T) can search “doctor’slife” on the Internet and find out what people say and think about a doctor’s life.Start the class by introducing the findings. This is a natural continuation of Lead-in.2.Analyze the text and lead Ss to discuss, integrating Task 2 / Critical reading andthinking / Text A into analysis and discussion. The presentation topics should be assigned to individual Ss for preparation at least one week in advance. Ask other Ss to preview the text with the guidance of the presentation topics.3.Integrate Task 2/ Language building-up/ Text A when a parentheticalstatement is dealt with.4.When analyzing the text, ask Ss to pay special attention to the sentences listed inLanguage focus below.5.If time allows, ask Ss to do Task 1 / Critical reading and thinking / Text A inabout five minutes. Check out the task by asking one or two Ss to read their answers. This is done to get an overview about the text.Language focus1.… that one stray request from a patient—even one that is quite relevant—might send the delicately balanced three-ring circus tumbling down. (P2, Para. 1)两个破折号之间是插入语，补充说明病人冷不丁提出的要求（stray request）也可能是相当中肯的（relevant），即便如此，对聚精会神的医生来说也是“灾难性的”。

2024医学考研英语真题# 2024医学考研英语真题## Part I Listening Comprehension (30 points)### Section ADirections: In this section, you will hear 8 short conversations and 2 long conversations. At the end of each conversation, a question will be asked about what was said. After each question, there will be a pause. The conversations and questions will be spoken only once. After you hear a conversation and the question about it, read the four possible answers on your paper, and decide which one would be the best answer to the question you have heard.1. What does the man mean by saying "I've got a green thumb"?A) He is good at gardening.B) He has a thumb injury.C) He is wearing green gloves.D) He is a professional athlete.2. Why did the woman decide to take a break from her studies?A) She was feeling stressed.B) She wanted to travel.C) She had a family emergency.D) She was not interested in her major.### Section BDirections: Listen to the passage. Then answer the questions that follow.Passage: [A passage about the latest medical researchfindings will be read.]1. What is the main topic of the passage?A) The history of medical research.B) Recent breakthroughs in medical science.C) The challenges faced by medical researchers.D) The ethical implications of medical research.2. According to the passage, what is the significance of the new drug?A) It is the first of its kind.B) It has fewer side effects than other drugs.C) It is more affordable than existing treatments.D) It can cure a previously untreatable disease.## Part II Reading Comprehension (40 points)### Section ADirections: Read the following passage. Then answer the questions by choosing the best answer A, B, C, or D.Passage: [A passage about the impact of technology on medical education.]1. What is one of the benefits of using technology in medical education mentioned in the passage?A) It reduces the need for practical training.B) It allows for more personalized learning experiences.C) It is less expensive than traditional teaching methods.D) It has no impact on the quality of education.2. According to the author, what is a potential drawback of relying too heavily on technology?A) It can lead to a lack of human interaction.B) It can be difficult for older students to adapt to.C) It can be distracting during lectures.D) It can be too time-consuming.### Section BDirections: Read the following text and answer the questions by choosing the best answer A, B, C, or D.Text: [A text discussing the role of communication in patient care.]1. What is the primary purpose of effective communication in healthcare?A) To establish a professional relationship with the patient.B) To ensure accurate diagnosis and treatment.C) To reduce the risk of medical errors.D) All of the above.2. Which of the following is NOT a strategy for improvingcommunication with patients?A) Active listening.B) Using medical jargon.C) Clarifying information.D) Providing clear instructions.## Part III Cloze Test (15 points)Directions: For each blank in the following passage, thereare four choices marked A, B, C, and D. Choose the one that best fits the context of the passage.Passage: [A passage about the importance of ethics in medical practice.][The passage will have 10 blanks that need to be filled with the appropriate word or phrase.]1. The doctor's decision to withhold certain information from the patient was based on a belief in the principle of _______.A) autonomyB) beneficenceC) non-maleficenceD) justice2. In medical ethics, the term _______ refers to theobligation to prevent harm.A) informed consentB) double effectC) malpracticeD) primum non nocere## Part IV Writing (15 points)Directions: Write an essay of 160-200 words on the topic "The Role of Technology in Modern Medicine." You should write clearly and coherently, and support your view with appropriate examples.[The essay will be written on the provided topic, discussing the impact of technology on the medical field, including advancements in diagnostics, treatments, and patient care.]请注意，以上内容为模拟的2024医学考研英语真题，实际考试内容可能有所不同。

UNIT 8 Principles of Biomedical EthicsTeaching ObjectivesAfter learning Unit 8, Ss are expected to accomplish the following objectives:To know the boundaries between medical research and practice To have a clear understanding of the moral principles and behavioral guidelines for the biomedical research and medical practice To understand the boundaries drawn between medical research and practice To know three basic ethical principles of research involving human subjects To learn the requirements when basic principles are properly applied in research To be more prepared for a life-or-death decision in medical practice To get more insights into the ethical justification of dilemmas in medical practice To know some building blocks in medical terminologyTo be familiar with expressions used to define key termsTo further develop awareness of formal and informal language To get familiar with the Cornell note-taking system To know the two approaches to medical decisions: traditional paternalistic mode and more recent collaborative modeTo learn how to develop a strong conclusion To know the format requirements of the reference listTo be able to make a reference list according to style requirements To be aware of the balance between medical authority and patients ’ autonomyProfessionalknowledgeReadingAcademic vocabulary anddiscourseViewingSpeakingWritingResearchingTeaching Activities and ResourcesPart 1 ReadingText ALead-inSuggested teaching plan1. To draw Ss’ attention and to raise their awareness of the importance ofbiomedical ethics, T is advised to relate the discussion of this unit to the real-world happenings.Before starting the class,search the media for the latest news reports,either at home or abroad,about controversial events in medicine community or healthcare settings.2. Start the class by doing Task / Lead-in and relate the content of the video clip toyour findings in the pre-class searching.Key to the task2) Death4) Patient rightsScriptWell,advancements in medical science have afforded us the opportunity to live decades longer than in previous generations.For every new possibility offered, we now face an equal number of challenges and we find ourselves confronting decisions that are unprecedented in human history.When does life begin?When should life end? How do we define death when we have the ability to keep people technically alive,or we should say,technologically alive long after their discrete body parts no longer function? Welcome to “Matter and Beyond . ” I’m your host MaryLynn Schiavi.In this program we’re going to explore issues around medical science that are forcing us to define life, death, quality of life, patient rights, and confront the moral and ethical questions that arise when facing critical healthcare decisions.3. Introduce the topic of Text A as a natural continuum of Lead-in .Text Comprehension1. Make good use of Lead-in video clip as it serves as a perfect introduction to thetopic of this unit. Elaborate on the connection of its content with the latest events in the real world. Naturally, ask Ss how medicine differs from other branches of natural science, especially when human subjects are involved in the research. Here are some hints:2. Analyze the text and lead Ss to discuss, integrating Task 2 / Critical reading andthinking / Text A into analysis and discussion. The presentation topics should be assigned to individual Ss for preparation at least one week in advance. Ask other Ss to preview the text with the guidance of presentation topics.3. Integrate Task 2 / Language building-up / Text A when a careful definition ofkey terms is covered.4. When analyzing the text, ask Ss to pay special attention to the sentences listed inLanguage focus below.5. If time allows, ask Ss to do Task 1 / Critical reading and thinking / Text A inabout five minutes. Check out the task by asking one or two Ss to read their answers. This is done to get an overview about the text.Language focus 1. … described in a formal protocol that sets forth an objective … (P185, Para.2)set forth 是动词词组，表示用清晰、具体的方式解释或描述，多用于正式的 书面语中。

英语语法词汇详解diagnosis diagnosis英[ˌdaɪəɡˈnəʊsɪs]美[ˌdaɪəɡˈnoʊsɪs]n.诊断；判断；特征简介复数：diagnoses同根词词根：diagnosediagnosticadj. 诊断的；特征的n. 诊断法；诊断结论diagnosticsn. 诊断学（用作单数）diagnosingn. 诊断v. 诊断（diagnose的现在分词）diagnosticiann. 诊断专家；诊断医生diagnosevi. 诊断；判断vt. 诊断；断定英文释义：diagnosis (of something) the act of discovering or identifying the exact cause of an illness or a problem(对某事物的)诊断发现或确定疾病或问题的确切原因的行为举个例子：1.They are waiting for the doctor's diagnosis.他们在等待医生的诊断。

2.An accurate diagnosis was made after a series of tests.经过一系列测试后，做出了准确的诊断。

3.Diagnosis is one of the most important parts of the doctor’s work.诊病是医生工作中最重要的环节之一。

4.I was stunned by the diagnosis and did not dare to tell him what was written there.我一看诊断书，顿时怔住了，没敢对他明说。

常用短语：diagnosis of lung cancer肺癌的诊断make a diagnosis做出诊断differential diagnosis鉴别诊断prenatal diagnosis[妇产]产前诊断；产前检查correct diagnosis正确诊断accurate diagnosis确诊；正确诊断pathologic diagnosis病理诊断；病理学诊断；病理检查诊断definite diagnosis确诊preliminary diagnosis初步诊断；初诊wrong diagnosis误诊；错误判断make diagnosis作出诊断；确定诊断computer diagnosis计算机诊断；电脑诊断computer fault diagnosis 计算机故障诊断confirm diagnosis诊断；确诊give diagnosis给出诊断；得出诊断。

医学英语既往史English:The medical history, also known as the past medical history or past medical background, encompasses a comprehensive account of a patient's previous health conditions, treatments, surgeries, hospitalizations, allergies, and medications. It provides crucial insight into the patient's health status, aiding healthcare providers in diagnosing current ailments, formulating treatment plans, and assessing potential risk factors. When documenting a patient's medical history, healthcare professionals typically inquire about any preexisting medical conditions such as hypertension, diabetes, asthma, or heart disease, along with details regarding their onset, duration, severity, and any associated symptoms. Additionally, they gather information about previous surgeries, injuries, and hospitalizations, including dates, locations, procedures performed, and outcomes. Allergies to medications, foods, or environmental factors are meticulously recorded to prevent adverse reactions during treatment. Furthermore, the patient's medication history, including prescription drugs, over-the-counter medications, supplements, and herbal remedies, is documented to ensurecompatibility with proposed treatments and avoid potential drug interactions or contraindications. Overall, the medical history serves as a cornerstone in patient care, facilitating accurate diagnosis, personalized treatment plans, and preventive healthcare strategies.Translated content:医学史，也称为既往病史或既往医疗背景，包括了对患者以往健康状况、治疗情况、手术、住院史、过敏史以及药物使用情况的全面记录。

What is diagnosis? 什么叫诊断？Diagnosis is investigation and judgment. 诊断就是诊察和判断Investigation is data collecting. 诊察是收集疾病信息Judgment is synthesis and analyze data to determine the nature of illness. 判断是综合分析信息确定所患疾病The diagnosis is taking about the method of data collecting and how to make a correct judgment. 诊断学讲述收集信息和正确判断疾病的方法Steps of Diagnosis诊断步骤Data collecting history intervewing physical examination laboratory examination assistant examinationData analyzingDetermination of the nature of the illness收集信息资料采集病史体格检查实验室检查辅助检查推理分析判断确定所患疾病Classification of Clinical Diagnosis临床诊断的分类Etiologic diagnosis Virus hepatitis Rheumatic heart disease Pathological-anatomic diagnosis Aortic regurgitation Liver cirrhosisPathophysiologic diagnosis Shock Uremia病因诊断病毒性肝炎风湿性心脏病病理解剖诊断主动脉瓣关闭不全肝硬化病理生理诊断休克尿毒症Inquiry问诊Inquiry is one method from the interview between doctor and patient or relative for disease history, and making the clinical determination by analyzing history.通过对患者或相关人员的询问获取病史资料经过综合分析作出临床判断Contents of Questioning 问诊的内容Identifying informationSource and reliabilityChief complaintsPresent illnessPast medical historyPersonal historyMarital history Menstrual and obstetric history in womenFamily history患者个人信息叙述者和可信度主诉现病史既往史个人史婚姻史月经生育史家族史Identifying Information 患者个人信息NameSex and AgeNative placeBirth placeNationalityMarriageAddress Work placeOccupation 姓名性别和年龄籍贯出生地国籍或民族婚姻住址工作地点职业Others Information其他相关信息Chief Complaint主诉Main discomfort and its durationMake sure to be: concise sequential persisting headache for 3 daysMake sure to avoid using: onset time of the disease diagnostic terms dialects主要痛苦+经过时间书写注意要简明扼要要按时间先后顺序持续头痛3天三不要不要用起病时间不要用诊断术语不要用方言土语Present Illness现病史Further description of the main complaint, including the whole disease processOnset and duration and Predisposing factorsCharacters of the main symptom, progression and evolvementAccompany symptomsManagements and effectsEffects on daily life对主诉的进一步阐述起病情况和诱发因素主要症状特点和疾病的演变伴随症状诊疗经过对日常生活的影响Past Medical History既往史Past health statusPast illnessHistory of injuryHistory of surgeryHistory of allergyHistory of blood transfusionHistory of vaccinationSystemic review既往健康状况既往所患疾病既往外伤史手术史过敏史输血史预防接种史系统回顾Personal History个人史Homeplace, inhabitation place, epidemic disease or travel experience to epidemic areaSmoking and alcohol intakeWorkHousing conditionLifestyleSex history出生地居留地是否到过疫区烟酒嗜好职业特点居住条件生活习惯不洁性交史Marital History婚姻史Marriage age 结婚年龄Health status of the spouse 爱人健康状况Marital attachment 夫妻感情Menstrual and Obstetrical History月经生育史Formula for recording menses intermenstrual period (day)Menarche age ————menopause age menstrual cycle or LMPMenses: volume, color, leucorrhea, dysmenorrhealObstetrical: number of pregnancy and delivery, history of operative delivery, difficult labor, abortion月经记录格式行经期(天)初潮年龄————末次月经日期月经周期或绝经年龄行经情况月经量颜色有无白带痛经孕产情况孕次产次有无手术产流产难产Family History家族史Health status of three sequential generationsCauses of deathExisting the same diseaseHereditary diseasesInfectious diseases三代人健康状况父母兄妹子女(几男几女)死亡原因有无同类疾病遗传病传染病Basic Examination Techniques基本检查法视诊inspection 触诊palpation 叩诊percussion 听诊auscultation 嗅诊olfactory Palpation触诊Light palpation 浅部触诊法Deep palpation 深部触诊法Deep slipping palpation 滑行触诊法Bimanual palpation 双手触诊法Deep press palpation 深压触诊法Ballottement 冲击触诊法Percussion Notes叩诊音Tympany: gas Hyperresonance: increased gas in lung tissue Resonance: lung tissueDullness: gas and tissueFlatness: essential organ or fluid 鼓音: 气体过清音: 肺组织含气增多清音: 肺组织浊音: 气体与组织实音: 实质脏器或液体General Examination一般检查Vital signs 生命体征Development 发育Habitus 体型Nutritional status 营养Consciousness 意识Facial features and expressions 面容和表情Vital Sign (T, P, R) 生命征Temperature Normal axillary T: 36~37℃Fever: T>37℃Hypothermia: T<35℃Pulse Frequency: 60~100/min Rhythm: RegularRespiration Normal: 16~18/min体温正常(腋窝)体温: 36~37℃发热: T>37℃体温不升脉搏脉率: 60~100/min节律: 整齐呼吸频率: 16~18/minDisturbance of Consciousness意识障碍Somnolence 嗜睡Confusion 意识模糊Stupor 昏睡Coma 昏迷Delirium 谵妄Facial Features and Expression面容与表情mitral face二尖瓣面容Acute disease expression 急性病容Chronic disease expression 慢性病容Special face 特殊面容Graves Disease甲亢面容Mooned Face Induced by Cushing’s库兴氏满月脸Hippocratic Facies 恶病质Myxedema粘液水肿Acromegaly肢端肥大症Position体位Relaxed position 自主体位Positive position 被动体位in depletion or unconscious patient 极度衰竭意识丧失Compulsive position 强迫体位to relieve discomfort 减轻痛苦被迫采取的体位Gait步态Normal: calm and pithinessAbnormal:Waddling gaitDrunken man gaitAtaxic gaitFestinating gaitsteppage or footdrop gait scissors gaitIntermittent claudicationspastic hemiparesis正常: 平稳有力异常:蹒跚步态醉酒步态共济失调步态慌张步态跨阈步态剪刀步态间歇性跛行划圈步态、Subcutaneous Hemorrhage皮下出血Wine color and won’t fade when pressed 暗红色压之不褪色Petechia: <2mm 瘀点: <2mmPurpura: 3~5mm 紫癜: 3~5mmEcchymosis: >5mm 瘀斑: >5mmHematoma: 血肿: 片状出血伴皮肤隆起Spider Angioma蜘蛛痣Highly branched stellate arterial lesions which pulsate and blanch on pressure. Distributed commonly on face, neck, or chest. May be associated with pregnancy, chronic liver disease, or estrogen therapy, or may be normal.定义: 小动脉末端分支性扩张特点: 中央受压血管消失机制: 雌激素增多部位: 上腔静脉区域面部颈部和胸部病因: 妊娠慢性肝脏病变雌激素治疗Record content记录内容Normal node: 2~5 mm, soft, smooth, no tenderness and adhesion.Record if enlarged: location, size, number, hardness,tender, mobility, adhesion, superficial skin.正常淋巴结2~5mm 质软光滑无压痛无粘连肿大时记录部位大小数目硬度压痛活动度粘连Pupil Size瞳孔大小Normal: 3~4mm Dilation: glaucoma, atropinizationContraction: organophosphorus poisoning, drug reaction, narcotic takingPlatycoria: dying正常: 3~4mm扩大: 青光眼阿托品中毒缩小: 有机磷中毒药物反应安眠药过量双侧散大: 濒死状态Compare Both Pupil比较双侧瞳孔Normal:SymmetryAnisocoria: Pathology anywhere from the reception of light through the optic nerves to the brain stem, the third cranial nerve, sympathetic, or parasympathetic pathwaysCerebral hernia正常:等大等圆不等大视神经至脑干病变动眼神经受压交感神经受压副交感神经受压脑疝表面皮肤情况Sinuses鼻窦Location 部位frontal sinuses 额窦ethmoid sinuses 筛窦maxillary sinus 上颌窦Sphenoid sinuses tenderness & percussion pain: sinusitis 鼻窦区压痛叩击痛: 鼻窦炎Tongue Size舌体Enlarged: inflammation, myxedema, tumor, acromegaly 舌体肿大: 炎症黏液性水肿肿瘤肢端肥大症Shrinked: severe dehydration 舌体干小: 严重脱水Appearance of Tongue 舌象Geographic and wrinkled or fissured tongue: riboflavin deficiencyStrawberry tongue: long feverBeefy tongue: niacin deficiencySmooth tongue: iron or Vit B12 deficiency Black hairy tongue: fungus infection地图舌和裂纹舌: 黄色斑片和横向裂纹提示核黄素缺乏草莓舌: 舌乳头肿胀长期发热牛肉舌: 舌面绛红菸酸缺乏镜面舌: 光滑红色铁或维生素B12缺乏黑毛舌: 黑黄褐色毛真菌感染Pharynx and Tonsil咽和扁桃体Pharynx 咽Turkey red accompanied by swelling: Acute pharyngitis 红肿: 急性咽炎Wine accompanied by follicle: Chronic pharyngitis暗红滤泡: 慢性咽炎Tonsil 扁桃体degree of tonsil swelling Ⅰ°不超过腭咽弓Ⅱ°超过腭咽弓未达中线Ⅲ°达到超过咽后壁中线purulent 化脓性扁桃体炎Palpation of the Trachea触摸气管位置Indicate the location of mediastinum 指示纵隔位置Location: normally in the middle 正常居中Shifting to the health: large pleural effusion, pneumothorax 移向健侧: 大量胸腔积液气胸Shifting to the disaster: emphysema 移向患侧: 肺不张The Degree of Thyroid Gland Swelling甲状腺肿大的分度Ⅰ: invisible but palpable 不能看到能触到Ⅱ: visible and palpable 能看到又能触到Ⅲ: exceeding the out margin of sterno-mastoid muscle 超过胸锁乳突肌外缘Abnormal Intercostal Space肋间隙改变Recessed or narrowed depressed when inspirating: air way obstruction one-side depression: atelectasis, pleural adhesionWide or swelling general intense when expirating: emphysema, bronchial asthma one-side intense: pleural effusion, pneumothorax凹陷或变窄(容积缩小) 吸气时凹陷:大气道阻塞一侧变窄凹陷: 肺不张胸膜粘连膨隆或增宽(容积增大) 呼气时膨隆: 肺气肿支气管哮喘一侧增宽膨隆: 胸腔积液气胸Abnormal Lung Border肺界异常Kronig’isthmus:Widening: emphysemaNarrowing (unilateral): tuberculosis, tumorInferior border:Lowered: emphysemaRised: atelectasis, increased intra-abdominal pressureUndetectable: Pleural effusion, pneumothorax肺上界增宽: 肺气肿变窄: 肺结核肺肿瘤肺下界下降: 肺气肿升高: 肺不张腹压增高叩不出: 胸腔积液气胸、Abnormal Diaphragmatic Excursion肺下界移动范围异常Decreased: <4cm 减弱: <4cmUnilateral: atalectasis, pleural adhension 单侧: 肺不张胸膜粘连Bilateral: emphysema, lung fibrosis 双侧: 肺气肿肺纤维化Abnormal Intercostal Space肋间隙改变Recessed or narrowed depressed when inspirating: air way obstruction one-side depression: atelectasis, pleural adhesionWide or swelling general intense when expirating: emphysema, bronchial asthma one-side intense: pleural effusion, pneumothorax凹陷或变窄(容积缩小) 吸气时凹陷:大气道阻塞一侧变窄凹陷: 肺不张胸膜粘连膨隆或增宽(容积增大) 呼气时膨隆: 肺气肿支气管哮喘一侧增宽膨隆: 胸腔积液气胸Chest shape胸廓形态Normal: Ap : T=1 : 1.5Abnormal:Flat chest and Barrel chestRachitic chest Pigeon chest Rachitic rosary Funnel chest Harrison grooveRegional transfigurationThorax-vertebrae-malformation-induced胸廓正常形态前后径:横径1 : 1.5胸廓形态异常扁平胸和桶状胸佝偻病胸鸡胸串珠胸漏斗胸肋膈沟局部变形胸椎严重畸形Pathological Conditions异常改变Weaken or disappear: Obstructive atelectasis, emphysema, Pleural effusion, pneumothorax, subcutaneous emphysemaEnhanced: Consolidation of lung tissue: lobar pneumonia, pulmonary infarction. Large cavity in the lung, esp. near the pleura: lung abscess, cavernous pulmonary tuberculosis.减弱或消失阻塞性肺不张肺气肿胸腔积液气胸皮下气肿增强肺实变: 大叶肺炎肺梗死近胸膜肺空洞: 肺脓肿空洞型肺结核Clinical Significance临床意义Localized crackles: regional diseasesBilateral crackles in lower field of the lungs with rhonchi: bronchitis with lung infectionCrackles in bilateral bases of the lungs: pulmonary congestion caused by heart failureGeneralized coarse crackles in bilateral lung fields: acute pulmonary edema局部湿啰音: 肺局部炎症两下肺散在干湿啰音: 支气管炎并感染两肺底对称性湿啰音: 左心功能不全两肺满布湿啰音:急性肺水肿、Emphysema肺气肿Pathology: air trapping in the lung Inspection: barrel chestPalpation: decreased dynamic events of respiration and tactile fremitusPercussion: hyperresonce; Down-shifting of the inferior border of the lungAuscultation: decreased breath sounds and vocal resonance机制双肺含气增多视诊桶状胸触诊呼吸动度减弱语颤减弱叩诊过清音肺下界下移听诊呼吸音减弱语音共振减弱Atelectasis肺不张Pathology: the airway is obstructed and the lung holds no airInspection: the affected chest wall is flattenedPalpation: decreased dynamic events of respiration and tactile fremitus;The trachea is shifted to the affected sidePercussion: dullness or flatnessAuscultation: breath sounds and vocal resonance disappear.机制气道阻塞肺不含气视诊患侧胸廓凹陷触诊患侧呼吸动度减弱语颤减弱气管移向患侧叩诊患侧浊音或实音听诊患侧呼吸音消失、语音共振消失Lobar Pneumonia 肺炎性实变Pathology: too much fluid in alveoliInspection: normal chestPalpation: decreased dynamic events of respiration, increased tactile fremitus.Percussion: dullness or flatnessAuscultation: tubular breath sound, crackles, increased vocal resonance机制气道通畅肺泡腔充满液体视诊患侧呼吸运动减弱触诊患侧呼吸动度减弱病变区语颤增强叩诊病变区浊音或实音听诊管状呼吸音湿啰音语音共振增强、、Pneumothorax气胸Pathology: air is trapped in pleural cavityInspection: over-inflation of the affected sidePalpation: decreased dynamic events of respiration and tactile fremitus; the trachea is shifted to the unaffected sidePercussion: tympanyAuscultation: breath sounds and vocal resonance disappear 机制胸腔气体存积视诊患侧饱满触诊患侧呼吸动度减弱语颤减弱气管移向健侧叩诊患侧鼓音听诊患侧呼吸音消失语音共振消失Pleural Effusion胸腔积液Pathology: fluid is trapped in pleural cavityInspection: over-inflation of the affected sidePalpation: decreased dynamic events of respiration and tactile fremitus; the trachea is shifted to the unaffected sidePercussion: dullness or flatnessAuscultation: breath sounds and vocal resonance disappear机制胸腔液体存积视诊患侧饱满触诊患侧呼吸动度减弱语颤减弱气管移向健侧叩诊患处浊音或实音听诊患处呼吸音消失语音共振消失Abnormal Lung Border肺界异常Kronig’isthmus:Widening: emphysemaNarrowing (unilateral): tuberculosis, tumorInferior border:Lowered: emphysemaRised: atelectasis, increased intra-abdominal pressureUndetectable: Pleural effusion, pneumothorax肺上界增宽: 肺气肿变窄: 肺结核肺肿瘤肺下界下降: 肺气肿升高: 肺不张腹压增高叩不出: 胸腔积液气胸Abnormal Diaphragmatic Excursion肺下界移动范围异常Decreased: <4cm 减弱: <4cmUnilateral: atalectasis, pleural adhension 单侧: 肺不张胸膜粘连Bilateral: emphysema, lung fibrosis 双侧: 肺气肿肺纤维化Classify of Breath Sound呼吸音分类Normal and abnormal 正常和异常呼吸音Bronchial breath sounds 支气管呼吸音Vesicular breath sounds 肺泡呼吸音Bronchovesicular breath sounds 支气管肺泡呼吸音Inspection of the Heart心脏视诊precordium shape 心前区外形normal apical impulse 正常心尖搏动abnormal apical impulse 异常心尖搏动precordial abnormal impulse 心前区异常搏动Precordium Shape心前区外形Precordial bulge 心前区隆起Features: bony bulge 特点:骨骼突起Clinical importance: Congenital heart disease with ventricular enlargement 提示:先天性心脏病右室大Precordial satiety 心前区饱满Features: intercostal region sticking out 特点:肋间软组织外突Clinical importance: mass of pericardial effusion 提示:大量心包积液Normal Apical Impulse正常心尖搏动Location: 0.5~1 cm to the left midclavicular line at the 5th ICS outside LSB. Range: 2~2.5cmDirection: outward when ventricular systole begins位置: 第5肋间左锁骨中线内0.5~1cm范围: 2~2.5cm方向: 收缩时向外搏动意义: 提示心尖位置代表收缩期提示心脏大小Abnormal Dullness Heart Border心界叩诊异常(1)heart variation 心脏改变L.V enlargement: boot-shaped heart 左室扩大: 靴形心L.A enlargement: pear-shaped heart 左房扩大: 梨形心 B.V enlargement: general enlarged heart 双室扩大: 普大心R.V enlargement: cor pulmonal 右室扩大: 先心肺心Pericardial effusion: flask-shaped heart心包积液: 烧瓶心、Abnormal Dullness Heart Border心界叩诊异常(2)chest and lung diseases 胸肺疾病Pleural effusion or lung consolidation: dullness border undetectable 胸腔积液或肺实变: 叩不出Emphysema: “shrinked”dullness border 肺气肿: 心浊音界缩小abdominal disorders 腹部疾病Diaphragm elevation: acrossing heart 膈升高: 横位心Boot-shaped Heart靴形心Mechanism: L.V enlargementFeatures: the left border extends to the inferior left, waist of the heart is deepened.Causes: aortic insufficiency, hypertensive heart disease机制: 左室扩大特点: 心左界向左下扩大心腰加深病因: 主动脉瓣关闭不全高血压心脏病Pear-shaped Heart梨形心Mechanism: L.A enlargement and distension of pulmonary arteryFeatures: dullness heart border in the 2nd, 3rd ICS on the LSB extends outside, waist of the heart bulges outCauses: mitral stenosis机制: 左房扩大肺动脉扩大特点: 胸骨左缘2, 3肋间心浊音界向外扩大心腰饱满或膨出病因: 二尖瓣狭窄General Enlarged Heart普大心Mechanism: both left and right ventricle are enlargedFeatures: the dullness border extends to both sides, the left border extends to inferior leftCauses: cardiomyopathy, myocarditis, whole heart failure机制: 左右心室扩大特点: 心浊音界向双侧扩大左界向下扩大病因扩张型心肌病克山病重症心肌炎全心衰竭Flask-shaped Heart烧瓶心Mechanism: pericardial effusionFeatures: Sitting position: triangular dullness borderSupine: widened dullness border of the base机制: 心包积液特点:坐位时心浊音界呈三角形仰卧位心底部浊音区增宽随体位心界改变First Heart Sound, S1 第一心音Signaling the beginning of systole. 提示收缩期开始It has characters of low pitch, long duration. 音调低时间长“咚”It can be heard best in the apex area. 在心尖部听诊最清楚Second Heart Sound, S2第二心音Signaling the beginning of diastole. 提示舒张期开始It is high-pitched, low-intensity, shorter and brisker. 高调低强度时间短轻脆“嗒”It can be auscultated best at the base of the heart. 在心底部听诊最清楚S1 第一心音S2 第二心音Pitch 音调Low 低High 高Intensity 强度High 强Low 弱Quality 音质Blunter 低钝Brisker 清脆Duration 持续时间Long 长Short 短Interval 两者间隔S1-S2 长< S2-S1 短Apical impulse 心尖搏动Concomitant 一致Post 之后Best site 最响部位Apex 心尖Base 心底Changes of Quality 心音性质改变Changes of S1 quality: S1 same as S2 (blankness) 第一心音性质改变: 第一心音与第二心音相同(单调)Diastolic phase shorten: same as systolic (single rule) 舒张时限缩短: 收缩期与舒张期时限相同(单律)Characteristic: pendular rhythm, embryocardia 听诊特点: 钟摆律胎心律Clinical meaning: myocardial damage severely, as acute myocardial infarction, severe myocarditis,. 提示: 心肌严重受损如急性心肌梗塞重症心肌炎Wide Splitting顺分裂Typical at the end of inspiration 吸气末分裂明显Physiologic splitting: deep inspiration 生理分裂: 吸气相回右心血量增加General splitting 通常分裂Delayed P2: pulmonary hypertension, mitral stenosis, pulmonic stenosis, right bundle branch block. 肺动脉瓣关闭延迟: 肺动脉高压二尖瓣狭窄肺动脉瓣狭窄右束支阻滞Early A2: mitral insufficiency, IVSD 主动脉瓣关闭提前: 二尖瓣关闭不全室间隔缺损Fixed Splitting固定分裂Splitting is unaffected by respiration分裂不受呼吸影响Mechanism: delayed closure of the pulmonic valve (output of the right ventricle is greater than that of the left) 机制: 肺动脉瓣关闭延迟Blood flow from left atrium to the right passing through septal defects amortized affection of respiration. 房间隔缺损处血液左向右分流缓冲呼吸影响Common diseases: large atrial septal defects and right ventricular failure. 病因: 大的房间隔缺损并右心功能不全Reversed Splitting逆分裂Typical at the end of expiration 呼气末分裂明显Paradoxical Splitting: P2 occurs firstly, followed by A2 反常分裂: 肺动脉瓣第二音出现在主动脉瓣第二音之前Mechanism: closure of the aortic valve is delayed 机制: 主动脉瓣关闭明显延迟Common diseases: Left bundle branch block, Aortic stenosis. 病因: 左束支传导阻滞主动脉瓣狭窄Extra Heart Sounds额外心音systolic extra heart sounds 收缩期额外心音diastolic extra heart sounds 舒张期额外心音Extra Heart Sounds额外心音SystolicEarly systole: ejection soundsMid-/Late systole: clickDiastolicEarly diastole: opening snap, pericardial knock Mid-diastole: third heart soundLate diastole: fourth heart soundgallop rhythm收缩早期喷射音中晚期喀喇音舒张早期开瓣音心包叩击音中期第三心音晚期第四心音奔马律Gallop奔马律Mechanism: decreased compliance of the ventricle caused by severe myocardial damage 机制: 心肌严重受损致室壁顺应性差Classification: 分类Protodiastolic gallop (Ventricular gallop, S3 gallop) 舒张早期奔马律(室性奔马律第三心音奔马律)Late diastolic gallop (atrial gallop, S4 gallop) 舒张晚期奔马律(房性奔马律第四心音奔马律)Quadruple rhythm and summation sound 四音律和重叠奔马律Physical S3 & Pathological S3生理性与病理性第三心音的区分Quadruple Rhythm and Summation Sound四音律和重叠奔马律Mechanism: pathological S3 & S4. 同时出现病理性第三和第四心音During tachycardia, the diastolic filling time shortens and the S3 and S4 move closer together. 心率加速时舒张期缩短第三和第四心音重叠They sound superimposed in mid-diastole, and one loud, prolonged, summated sound can be heard, often louder than either S1 or S2. 特点: 舒张中期较长响亮心音强于第一或第二心音Characterization of Murmurs杂音听诊要点LocationDurationPitch and QualityIntensity and Timing Transmission or radiationEffect murmurs of factor杂音的部位杂音的时期杂音的性质杂音的强度杂音的传导影响杂音的因素Location杂音部位Apical area: mitral valveAortic area: aortic valvePulmonic area: pulmonic valveInferior sternum: tricuspid valve3rd, 4th ICS, LSB: ventricular septal defect2nd, 3rd ICS, LSB: patent ductus arteriosus杂音出现和最响部位与病变部位血流方向传导介质相关心尖部: 二尖瓣主动脉瓣听诊区: 主动脉瓣肺动脉瓣听诊区: 肺动脉瓣胸骨下端: 三尖瓣胸骨左缘 3 4 肋间: 室间隔胸骨左缘 2 3 肋间: 动脉导管Duration杂音时期Systolic murmur (SM)HolosystolicEarlyMidsystolicLateDiastolic murmur (DM)HolodiastolicEarlyMiddiastolicLate (presystolic)Continuous收缩期杂音全收缩期收缩早期收缩中期收缩晚期舒张期杂音全舒张期舒张早期舒张中期舒张晚期连续性杂音Distinguish Duration时期的区分systolic murmur 收缩期杂音appear between S1 and S2, same as apical impulse 在第一心音与第二心音之间出现与心尖搏动一致diastolic murmur 舒张期杂音appear between S2 and S1, nonsame as apical impulse在第 2 心音与第 1 心音之间出现与心尖搏动不一致Intensity of Systolic Murmur收缩期杂音强度GradeⅠ: barely audible in quiet room 1 级: 仔细听方可听到GradeⅡ: quiet but clearly audible 2 级: 容易听到但不响亮GradeⅢ: moderately loud 3 级: 较响亮GradeⅣ: loud, associated with thrill 4 级: 粗糙且响亮伴传导震颤GradeⅤ: very loud, thrill easily palpable 5 级: 震耳GradeⅥ: very loud, audible with stethoscope not in contact with chest, thrill palpable and visible 6 级: 离开胸壁亦可闻及Functional and Organic Murmurs收缩期杂音的鉴别Functional功能性Organic器质性Age 年龄Young儿童青少年Unlimited 不定Location 部位Pulmonic/apical 肺动脉瓣或心尖部Any area 各部位Character 性质Soft, smooth 柔和Coarse, high pitch粗糙高调Duration 时间Short 短Long (whole systole)长（全收缩期）Intensity 强度<3/6 > or =3/6 Thrill 震颤no 无Yes 有Transmission传导Localized 局限extensive 传导Systolic murmur in left sternum intercostal 3~4: ventricular septal defect 胸骨左缘 3 4肋间收缩期杂音: 室间隔缺损Continuous machine-like in left sternum intercostal 2: patent ductus arteriosus 胸骨左缘第2肋间连续型杂音: 动脉导管末闭Peripheral Vascular Sign周围血管征Vascular sign: 征象Water-hammer Pulse 水冲脉Carotid artery impulse 颈动脉搏动Nodding spasm 点头运动Capillary pulsation 毛细血管搏动征Pistol shot sound 枪击音Duroziez double murmur 杜氏双重杂音Clinical meaning: aortic insufficiency, hypertension, Hyperthyroidism提示: 主动脉瓣关闭不全高血压甲状腺机能亢进Heart Disease心脏疾病mitral stenosis 二尖瓣狭窄aortic insufficiency 主动脉瓣关闭不全Mitral Stenosis二尖瓣狭窄(1)L.A enlargement Pulmonary artery dilation R.V enlargement 左房增大→肺动脉扩张→右室增大Inspection: Mitral face (malar flush), apical impulse left 视诊: 二尖瓣面容心尖搏动向左移位Palpation: diastolic thrill at the apex area 触诊: 心尖部舒张期震颤Percussion: pear-shaped heart 叩诊: 梨型心Mitral Stenosis Auscultation二尖瓣狭窄(2)Apex area: 心尖部Heart sounds: Accentuation of S1 第一心音亢进Extra sound: opening snaps 开瓣音Murmurs: mid- or late-diastolic rumbling in quality, decrescendo- crescendo, usually localized, heard more clearly with the patient recumbent or on his left side or after moderate exercise. 舒张中晚期隆隆样杂音Pulmonic area: 肺动脉瓣区Heart sounds: Accentuation and splitting of S2 第二心音亢进分裂Murmur: Graham-steell G-S杂音Aortic Insufficiency主动脉瓣关闭不全(1)Inspection: Apical impulse to left inferior 视诊: 心尖搏动向左下移位carotid artery impulse 颈动脉搏动Palpation: lifting apical impulse 触诊: 抬举性心尖搏动water-hammer pulse 水冲脉Percussion: boot-shaped heart 叩诊: 靴型心Aortic Insufficiency Auscultation 主动脉瓣关闭不全听诊(2)Aortic area:主动脉瓣区Heart sounds: S2↓第二心音减弱Murmur: early diastolic, high pitch, blowing, radiating to the apex 舒张期递减型叹气样杂音Apex area: 心尖部Heart sounds: S1↓第一心音减弱Murmurs: Austin-Flint A-F杂音Distension腹部膨隆Abdominal wall disorders 腹壁改变Tumor: appeared clearly in force 肿物: 腹部用力时肿物明显Incrassation: hilum depressed such as obesity 增厚: 脐部凹陷如肥胖Abdominal cavity increase 腹腔增大Full distension: normal pregnancy and abnormal 全腹膨隆: 正常妊娠和异常Local distension 局部膨隆Measure surround of abdomen 测量腹围Around the abdomen through hilum by soft ruler 仰卧位用软尺绕脐一周Common Causes of Distension常见膨隆原因Fat 肥胖Fluid 腹水Feces 粪块Fetus 妊娠Flatus 胃肠胀气Fibroids 子宫平滑肌瘤Fatal tumor 恶性肿瘤.Remember:5FContour: Protuberant Abdomen全腹膨隆Ascites: frog shape of abdomen, accompanied hilum hernia. 腹水: 蛙状腹常伴脐疝causes: hepatocirrhosis, serious heart failure, pericarditis, renal disease syndrome, peirtoneum cancer. 病因: 肝硬化严重心衰缩窄性心包炎肾病综合征腹膜癌Gases distention of the intestines: sphericity of abdomen 肠胀气: 球形腹causes: ileus, intestinal paralysis. 病因: 肠梗阻肠麻痹Organomegaly: enormous ovary cyst and teratoma. 肿瘤: 巨大卵巢囊肿畸胎瘤Local DistensionDirection of the Blood flow血流方向检查Use two fingers on appeared vein 用两手指并拢压在静脉上Two fingers press and dis part 两手指加压分开Loosen superior finger 松开上端手指Faster show blood flow downwards 充盈快示血流向下Repeat above action 重复以上动作Loosen inferior finger 松开下端手指Faster show blood flow upwards 充盈快示血流向上Obstruction of Vena Cava腔静脉阻塞Varicosity on the flanks曲张静脉在侧腹部Obstruction of superior vena cava: blood stream to downwards. 上腔静脉回流受阻血流方向向下Obstruction of inferior vena cava: blood stream to upwards. 下腔静脉回流受阻血流方向向上Rebound Tenderness (Blumberg sign) 反跳痛Examination method: press deeply and slowly, let slip suddenly. 检查方法: 逐渐深压腹壁突然松开Positive finding: pain prick up in loose. 阳性: 松开时疼痛加剧Clinical meanings: inflammation in the parietal peritoneum. 提示: 炎症波及壁层腹膜Peritoneal Irritation Sign腹膜刺激征Three sign same appear:Tenderness Rebound tendernessGuarding 三联征: 压痛反跳痛腹肌紧张Clinical meaning: acute peritonitis 提示: 急性腹膜炎Measure of Enlarged Spleen肿大脾脏的测量The first line: between costal margin and low edge of spleen in left midclavicular line 1 线(甲乙线): 左锁骨中线上肋缘至脾下缘The second line: between the point of the left midclavicul cross costal margin and the point of spleen apoapsis. 2 线(甲丙线): 左锁骨中线肋缘点至脾最远点The third line: between right side of spleen and midline, express with positive or negative 3 线(丁戊线): 脾右缘至正中线以(＋)(－)表示Spleen Enlargement Degrees脾脏肿大分度Mild enlargement: <2 cm under the rib 轻度肿大: 肋下<2cmModerate enlargement: not exceed the level of umbilicus 中度肿大: 不过脐Severe enlargement: exceed the level of umbilicus or mid line 高度肿大: 过脐或中线Murphy’s Sign莫非氏征Technique: Hold your fingers under the liver border. 手指放于肝脏下缘Positive sign: As the descending liver pushes the inflamed gallbladder onto the examining hand, the person feels sharp pain and abruptly stops inspiration midway. 阳性: 吸气时肝脏和胆囊下移手指触及炎性胆囊时被检者因剧痛中止吸气Characteristics of Palpation 触诊要点Location: relation to organsSize: diameter in long, wide and thickContour: shape, margin and surfaceTexture: soft, firm and hardTenderness: inflammation, liver swelling Pulsation: dilative and conductive Movability: shift by respiration or hand部位: 所在部位与该处脏器多相关连大小: 纵长横宽深厚可用实物比喻轮廓: 形状边缘表面质地: 柔软中等硬度质硬压痛: 炎症肝肿大搏动: 膨胀性和传导性移动度: 随呼吸移动用手推动Fluid Thrill液波震颤Technique: move flank wall by hand 检查方法: 用手推动一侧腹壁Positive: the other hand feels liquid wave 阳性征象: 对侧手掌感到液体波动Meaning: large volume of ascites, usually >3000ml 临床意义: 大量腹水在3~4升以上Percussion of Ascites腹水叩诊Shifting dullness: 移动性浊音free fluid causes air-containing gut to float up to the most superior position 液体流动使含气脏器位于最高位置volume of ascites usually exceeds 1000ml if detectable 腹水量在1000ml以上Puddle sign: 水坑征free fluid in the most inferior position in elbow-knee posture 肘膝位腹水位于最低位a way to detect small amounts of fluid 用于发现少量腹水腹水和卵巢囊肿的鉴别Signs 征象Ascites 腹水Ovarian cyst 卵巢囊肿Dorsal position仰卧位Umbilicus 脐Percussion sound 叩诊音Shifting dullness 移动性浊音Ruler pressing test 尺压试验Side distension 侧腹膨隆Extrude 突出Middle tympany side dullness 中部鼓音两侧浊音Positive 阳性No jumpiness 无跳动Middle distension 中腹膨隆Flat 平坦Middle dullness side tympany 中部浊音两侧鼓音Negitive 阴性Rhythm jumpiness 有节奏跳动Auscultation of Abdomen腹部听诊bowel sounds 肠鸣音vascular sounds 血管杂音friction rub 摩擦音scratch sound 搔弹音splashing sound 振水音Scratch Sound搔弹音Mechanism: sound wave conductive diversity in differ medium made noise alteration. Aids in static border definition 机制: 声波在不同介质中传导的差异致声响改变有助于确定实质脏器或液体边界Technique: put the stethoscope in central and the hand scratch to it, when sound suddenly increased indicate the border. 方法: 听诊器置于中央手边搔弹边向听诊器移动声响突然增强为其边界Meaning: confirm inferior border of the liver and ascites (<120ml) 意义: 确定肝脏下界和小量腹水范围Cirrhosis of Liver肝硬化Small liver to percussion but a hard edge may be palpable under the xiphoid 剑突下触及边钝质硬缩小的肝脏Spleen palpable 脾脏肋缘下可触及Varicosity and ascites 脐周静脉曲张和腹水征palmar erythema, spider angioma and Gynaecomastia 肝掌蜘蛛痣男性乳房发育Gastrointestinal haemorrhage 消化道出血Ascites Sign腹水征Inspection: frog shape of abdomen in dorsal position, hypogastrium region distension with hilum hernia in stand. 视诊: 仰卧位蛙状腹直立位下腹膨隆脐突出Palpation: fluid thrill (ascites large than 3000 ml) 触诊: 液波震颤(腹水量>3000ml)Percussion: shifting dullness (ascites large than 1000 ml), puddle sign (small amounts of fluid) 叩诊: 移动性浊音(腹水量>1000ml) 水坑征(少量腹水)Auscultation: umbilicus scratch sound in elbow-knee posture (ascites<120ml) 听诊: 脐部搔弹音(腹水量<120ml)Acute Perforated Gastric or Duodenal Ulcer急性胃十二指肠穿孔Suddenly epigastric pain, forced supine position and twin lower limbs flection 突发上腹痛强迫仰卧位双下肢屈曲Acute peritonitis signs, tenderness and rebound pain in epigastrium or round umbilicus quarter 急性腹膜炎征象压痛反跳痛位于上腹部和脐周Hepatic dullness region decrease or disappear 肝浊音区缩小消失shifting dullness in abdomen 腹部移动性浊音Physical Examination Point 急性胃肠穿孔检体要点Gas in abdominal cavity: dullness area of liver disappear 腹腔气体: 肝浊音区缩小消失Liquid in abdomen: shifting dullness 腹腔液体: 腹部移动性浊音Inflammation in abdomen: acute peritonitis sign, serious in epigastric and umbilical region. 腹部炎症反应: 急性弥漫性腹膜炎征象压痛反跳痛位于上腹部和脐周forepart: acute ache face, compulsive supine position, lower limbs flection 早期: 急性痛苦面容冷汗强迫仰卧位双下肢屈曲anaphase: high fever, pulse frequence 后期: 高热失水精神萎靡面色灰白眼球凹陷脉搏频数Acute Peritonitis Signs急性腹膜炎征象Inspection: general depression in abdomen, decreased or disappeared abdominal respiration 视诊: 腹部凹陷腹部呼吸运动减弱消失Palpation: tenderness, rebound tenderness, rigid abdominal wall 触诊: 压痛和反跳痛腹壁呈板状硬Percussion: shifting dullness 叩诊: 可有移动性浊音Auscultation: decreased or absence of bowel sounds 听诊: 肠鸣音减弱消失Intestinal Obstruction肠梗阻Symptom: bellyache, vomiting, no defecate and anus exhaust 症状: 腹痛呕吐无排便和肛门排气Inspection: full distension, intestine form and peristaltic wave 视诊: 腹部膨隆肠型可见肠蠕动波Palpation: rigid abdominal wall, tenderness and rebound pain 触诊: 腹肌紧张压痛及反跳痛Percussion: tympany region increased 叩诊: 鼓音范围增大Auscultation: mechanical ileus accompanied sharp bowel sound and decreased or absence of bowel sounds in paralysis ileus 听诊: 机械性肠梗阻肠鸣音亢进麻痹性肠梗阻肠鸣音减弱或消失Muscle Power肌力Force by muscle contraction produced 肌肉收缩产生的力量Muscle power decreasing or disappearing called partial or complete paralysis 肌力下降或消失称为不完全或完全瘫痪Paralysis divided hemiparalysis, crossed paralysis, paraplegia and single limb paralysis by pathologic position 根据瘫痪的部位分为偏瘫交叉瘫截瘫和单瘫Paralysis divided central and peripheral by location of nervous injury 根据神经损伤位置分为中枢性瘫痪和周围性瘫痪The grading of muscle strength肌力分度Absent (0 degree): no contraction detected. 0 级(不动): 完全瘫痪Trace (1 degree): slight contraction detected. 1 级(肌动): 肌肉可收缩不能产生运动Weak (2 degree): movement with gravity eliminated. 2 级(平动): 床面上可移动不能抬离Fair (3 degree): movement against gravity. 3 级(抬动): 能抬离床面不能抗阻力Good (4 degree): move against gravity with some resistance. 4 级(弱抗动): 能抗阻力但较正常差Normal (5 degree): movement against gravity with full resistance. 5 级(正常): 正常肌力Tremor震颤Static tremor: embitter in whisht and mitigate in movement, seen in paralysis agitans 静止性: 静重动轻见于震颤麻痹Intentional tremor: embitter in movement and mitigate in whisht, seen in cerebel disorders 意向性: 动重静轻见于小脑疾患Senile tremor: nodded and hand tremble, seen in arteriosclerosis 老年性: 点头手抖见于动脉硬化Flutter tremor: flicker in wrist and palm, seen in hepatic coma 扑翼样: 腕掌扑动见于肝昏迷Tremor of fingers: fine twitter, seen in hyperthyroidism 手指细颤: 细小抖动见于甲状腺机能亢进症Physical Reflex生理反射Superficial reflex: induced by the stimulation of mucocutaneous receptors 浅反射: 刺激皮肤粘膜感受器引起反应Included: corneal reflex, abdominal reflex, cremasteric reflex, plantar reflex 包括: 角膜反射腹壁反射提睾反射跖反射Deep reflex: induced by the stimulation of periosteal and tendon receptors 深反射: 刺激骨膜肌腱感受器引起反应Included: biceps reflex, triceps reflex, brachioradialis reflex, patellar reflex, achilles tendon reflex 包括: 肱二头肌反射肱三头肌反射桡骨骨膜反射膝(腱)反射跟腱反射Pyramidal Sign锥体束征Upper limbs pathological reflex: Hoffmann Sign usually seen in cervical region disorders of spinal cord 上肢病理反射: 霍夫曼征多见于颈髓病变Lower limbs pathological reflex: Babinski sign, Chaddock sign, Oppenheim sign, Gordon sing 下肢病理反射: 巴宾斯基征查多克征奥本海姆征戈登征Clonus: rhythmical contraction of the muscle made the limb or foot movement by stimulation 阵挛: 刺激使肌肉有节奏的收缩致肢体运动Meningeal Stimulation Sign脑膜刺激征Definition: signs induced by disorders with meninges such as pathological changes, inflammation, arachnoid low cavity bleeding, encephalic hypertension, etc. 定义: 脑膜病变脑膜炎蛛网膜下腔出血颅内压增高等(除外颈椎疾患) Neck rigidity: resisting in raise neck 颈项强直: 抬颈抵抗Kernig sign: angle of knees joint can be drived up less than 135 degree with bended thigh 克匿格征: 屈腿抬高<135º(正常可达135º)Brudzinski sign: going down on knees when raise neck 布鲁金斯基征: 抬颈时屈膝Grade of Fever发热分度Slight fever 低热37.3~38℃Moderate fever 中等度热38.1~39℃Hyperpyrexia 高热39.1~41℃Ultrahyperpyrexia 超高热>41℃Fever Types高热热型Persistent high feverContinuous feverRemittent feverIntermittent high feverIntermittent feverRecurrent feverUndulant feverIrregular fever持续高热热型稽留热弛张热间断高热热型间歇热回归热波状热不规则热Clinical Types of Edema水肿的临床类型Cardiac EdemaNephritic EdemaHepatic EdemaMalnutritional EdemaDrug-induced EdemaOthers Myxedema Premenarche edema心原性水肿肾原性水肿肝原性水肿营养不良性水肿药物性水肿其他黏液性水肿经前期水肿Clinical Features临床特点Area: related to location of the pathological changesNature: lancinating, drilling, burning, colicOnset: continuous, paroxysmal, intermittentReferred painFactors triggering。