2017五年制医学英语

MedicalChapterThe吉林大 联医院心脏外科林柏Basic 1987-1992医学本科（毕业后留科 1995-1998医 2000-2003医学博 2004-2008李玉林 导Basic 2006.1-2007.7国家公派德国心脏中 2010.09教授 医 2013.05心脏外科 2013.09吉林 咨Truewisdomconsistsnotonlyinseeingwhatisbeforeyoureyes,butinforeseeingwhatistocome.Terence,Aldelphi,(ActIII,Scene泰伦斯，《阿德菲》，（第三幕，第三场BloodPressureThePrinciplesBloodpressurecanbemeasureddirectlyanintra-arterial[,intrəɑ:'tiəriəl]catheter['kæθɪtɚ]orindirectlywithasphygmomanometer[,sfɪgmomə'nɑmətɝ].sphygmomanometerconsistsofinflatable[ɪn'fletəbl]rubberbladderwithinaclothcoverarubberbulb橡皮袋toinflatethebladder,andamanometer[mə'nɑmətɚ]measurethepressureintheBloodPressure 英[ə'sesmənt]美 英['prɪnsəplz]美['prɪnsəplz] 原则；法则；信念（principle的复数）；本源v.向…灌 [,intrəɑ:'tiəriəl]n 英['kæθɪtə]美 n.[医sphygmomanometer美 n.[内科]血压sphygmous脉搏sphygmo-BloodPressure [ɪn'fleɪtəb(ə)l][ɪn'fletəbl] 英['rʌbə]美['rʌbɚ]n.橡胶；橡皮；合 师adj.橡胶制成的vt.涂橡胶于；用橡胶制造vi.扭转脖子看；好奇地引颈而望n.(Rubber)人名； [bʌlb][bʌlb]n.电灯泡；鳞茎；球状物vi.生球茎；膨胀成球状 英[ɪn'fleɪt]美[ɪn'flet] vt.使充气；使通货膨胀vi.膨胀；充气 [mə'nɒmɪtə]n压力计；[流BloodPressureThePrinciplesBloodpressurecanbemeasureddirectlyanintra-arterial[,intrəɑ:'tiəriəl]catheter['kæθɪtɚ]orindirectlywithasphygmomanometer[,sfɪgmomə'nɑmətɝ].sphygmomanometerconsistsofinflatable[ɪn'fletəbl]rubberbladderwithinaclothcoverarubberbulb橡皮袋toinflatethebladder,andamanometer[mə'nɑmətɚ]measurethepressureintheBloodPressureIndirectmeasurement['mɛʒɚmənt]ofbloodpressureinvolves[ɪn'vɑlv]theauscultatory[ɔ:'skʌltətəri]detection[dɪ'tɛkʃən]oftheappearanceanddisappearanceofKorotkoffsounds柯氏overcompressed[kəm'prɛst]artery.Korotkoffarelow-pitched['ləu'pitʃt]originating[ə'ridʒineitiŋ]inthevesselthatarerelatedtoturbulence['tɝbjələns]producedbypartially['pɑrʃəli]occludinganarterywithabloodpressureBloodPressure [ɔ:'skʌltətəriadjauscultatorygapdetection英[dɪ'tekʃ(ə)n]美[dɪ'tɛkʃən] n.侦KorotkoffSounds低沈的冲击声氏compressed[kəm'prest][kəm'prɛst]j 英['ləu'pitʃt] adj.低调的；低沉的； ['tɜːbjʊl(ə)ns] ；[流BloodPressure BloodPressure 学者柯洛特柯夫(Korotokoff)发现，用臂带绑扎1905年， BloodPressureIndirectmeasurement['mɛʒɚmənt]ofbloodpressureinvolves[ɪn'vɑlv]theauscultatory[ɔ:'skʌltətəri]detection[dɪ'tɛkʃən]oftheappearanceanddisappearanceofKorotkoffsounds柯氏overcompressed[kəm'prɛst]artery.Korotkoffarelow-pitched['ləu'pitʃt]originating[ə'ridʒineitiŋ]inthevesselthatarerelatedtoturbulence['tɝbjələns]producedbypartially['pɑrʃəli]occludinganarterywithabloodpressureBloodPressureSeveralphases['feɪsiːz]occursequence['sikwəns]astheoccludingdrops压力下降.Phase1occurswhentheoccludingpressurefallstothesystolic[sɪs'tɑlɪk]bloodpressure.Thetap [tæpɪŋ]soundsareclearandgraduallyincreaseinintensityastheoccludingpressurefalls.Phase2occursatapressureabout10to15mmHglowerthanthatinphase1andconsistsoftap followedbymurmurs.BloodPressurephase英[feɪz]美[fez] n.相；阶段；[天]位相vt.使定相；逐步执行vi.逐步前进复数['feɪsiːz] [ə'kluːd][ə'klud]vt.使闭塞；封闭；挡住vi.sequence英['siːkw(ə)ns]美['sikwəns] n.[数][计]序列；顺序；续发事件vt.按顺序排好insequence依次，逐 英[sɪ'stɒlɪk]美 adj.心脏收缩 n冶出钢；开孔；出渣；轻敲声v.轻 abbr毫米柱（millimetre（s）ofmercury 单位 ['mɝkjəri]n.[化] BloodPressureSeveralphases['feɪsiːz]occursequence['sikwəns]astheoccludingdrops压力下降.Phase1occurswhentheoccludingpressurefallstothesystolic[sɪs'tɑlɪk]bloodpressure.Thetap [tæpɪŋ]soundsareclearandgraduallyincreaseinintensityastheoccludingpressurefalls.Phase2occursatapressureabout10to15mmHglowerthanthatinphase1andconsistsoftap followedbymurmurs.BloodPressurePhase3occurswhentheoccludingpressurefallsenoughtoallowalargeamountofvolumetocrossthepartiallyoccludedartery.Thesoundsaresimilartothesoundsofphase2,exceptthatonlythetap soundsareheard.Phase4istheabrupt[ə'brʌpt]muffling['mʌfliŋ]anddecreasedintensityofthesoundsasthepressureapproaches[ə'protʃ]thediastolic[,daɪəs'tɑlɪk]bloodpressure.Phase5isthecompletedisappearance[,dɪsə'pɪrəns]ofthesounds.Thevesselisnolongercompressedbytheoccludingcuff.Turbulent['tɝbjələnt]flowisnolongerpresent.BloodPressure 英[ə'brʌpt]美 adj.生硬的；突然的；突的；陡峭 v.消声（muffle的ing形式 英['mʌf(ə)l]美['mʌfl] vt.蒙住；裹住；抑制；发 n.低沉 英[ə'prəʊtʃ]美 n.方法；途径；接vt.接近；着手处理vi靠 英[,daɪə'stɒlɪk]美 adj.心脏舒的 英[dɪsə'pɪərəns]美 ；不turbulent [流湍流；[流紊turbulent英['tɜːbjʊl(ə)nt]美 的的；狂暴的；吵闹的；激流的，湍流BloodPressurePhase3occurswhentheoccludingpressurefallsenoughtoallowalargeamountofvolumetocrossthepartiallyoccludedartery.Thesoundsaresimilartothesoundsofphase2,exceptthatonlythetap soundsareheard.Phase4istheabrupt[ə'brʌpt]muffling['mʌfliŋ]anddecreasedintensityofthesoundsasthepressureapproaches[ə'protʃ]thediastolic[,daɪəs'tɑlɪk]bloodpressure.Phase5isthecompletedisappearance[,dɪsə'pɪrəns]ofthesounds.Thevesselisnolongercompressedbytheoccludingcuff.Turbulent['tɝbjələnt]flowisnolongerpresent.BloodPressureThenormalbloodpressureforadults['ædʌlt]isupto140mmHgsystolicandupto85mmHgdiastolic.Forthediastolicbloodpressurereading,thepointofdisappearanceoftheKorotkoffsoundsisprobablymoreaccurate['ækjərət]thanthepointofmuffling['mʌfliŋ].However,ifthepointofdisappearanceismorethan10mmHglowerthanthepointofmuffling,thepointofmufflingisprobablymoreaccurate.BloodPressure 英['ædʌlt;ə'dʌlt]美['ædʌlt]adj.成年 n.成年人 ['ækjʊrət]['ækjərət]adj.精确 v.消声（muffle的ing形式BloodPressureThenormalbloodpressureforadults['ædʌlt]isupto140mmHgsystolicandupto85mmHgdiastolic.Forthediastolicbloodpressurereading,thepointofdisappearanceoftheKorotkoffsoundsisprobablymoreaccurate['ækjərət]thanthepointofmuffling['mʌfliŋ].However,ifthepointofdisappearanceismorethan10mmHglowerthanthepointofmuffling,thepointofmufflingisprobablymoreaccurate.BloodPressureRecordingboththepointofmufflinganddisappearancefrequently['frikwəntli]helpsincommunication[kə,mjunɪ'keʃən].Abloodpressuremightberecordedas125/75-65:thesystolicbloodpressureis125;thepointofmufflingis75;thepointofdisappearanceis65(thediastolicbloodpressure).BloodPressure ['friːkw(ə)ntlɪ]['frikwəntli]adv.频繁地，经常地；时常，屡次 [kəmjuːnɪ'keɪʃ(ə)n]mjunɪ'keʃənn.通讯，[通信BloodPressureRecordingboththepointofmufflinganddisappearancefrequently['frikwəntli]helpsincommunication[kə,mjunɪ'keʃən].Abloodpressuremightberecordedas125/75-65:thesystolicbloodpressureis125;thepointofmufflingis75;thepointofdisappearanceis65(thediastolicbloodpressure).BloodPressureBloodpressureshouldberecordedonlytothenearest5mmHgbecausethereisa±3mmHglimitofaccuracyforallsphygmomanometers[,sfɪgmomə'nɑmətɝ].Inaddition,normalbloodpressurechangesoccurfrommomenttomoment,andmeasuringtolessthan5mmHgprovidesafalse[fɔls]sense[sɛns]ofaccuracy['ækjərəsi].BloodPressurefalse英[fɔːls;fɒls]美[fɔls] adj.错误的；虚伪 英[sens]美[sɛns] n.感觉，官能；观念；道理；理智vt.感觉到；检测accuracy英['ækjʊrəsɪ]美 n.[数BloodPressureBloodpressureshouldberecordedonlytothenearest5mmHgbecausethereisa±3mmHglimitofaccuracyforallsphygmomanometers[,sfɪgmomə'nɑmətɝ].Inaddition,normalbloodpressurechangesoccurfrommomenttomoment,andmeasuringtolessthan5mmHgprovidesafalse[fɔls]sense[sɛns]ofaccuracy['ækjərəsi].BloodPressureThesizeofthecuffisimportantfortheaccuratedetermination[dɪ,tɝmɪ'neʃən]ofbloodpressure.Itis mended[,rɛkə'mɛnd]thatthecuff[kʌf]besnugly['snʌgli]applied[ə'plaɪd]aroundthearm,withitslowestedge1inchabovetheantecubital[,ænti'kju:bitəl]fossa['fɒsə].Thecuffshouldbeapproxima [ə'prɑksɪmətli]20%widerthanthediametertheextremity[ɪk'strɛməti].Thebladderoverlie['ovɚ'lai]theartery.Theuseofacuffthatistoosmallforalargearmresultsinanerroneously[i'rəuniəsli]highreadingofbloodBloodPressure 英[dɪ,tɜːmɪ'neɪʃ(ə)n]美[dɪ, n.决心；果断 [,rɛkə'mɛnd]adj.被推荐v.推荐，介绍；建议 mend的过去分词it mendedthat有人推荐 adv.紧密 [ə'plaɪd][ə'plaɪd]adj.应用的；实用的v.应用；实施（apply的过去分词）；敷上 [,ænti'kju:bitəl]adj.解剖肘 n.解剖凹；小BloodPressure 英[ə'prɒksɪmətlɪ]美[ə'prɑksɪ adv.大约，近似地；近于 [ɪk'stremɪtɪ]美[ɪk'strɛməti] 英[əʊvə'laɪ]美['ovɚ'lai] vt.躺在…上 adv.BloodPressureThesizeofthecuffisimportantfortheaccuratedetermination[dɪ,tɝmɪ'neʃən]ofbloodpressure.Itis mended[,rɛkə'mɛnd]thatthecuff[kʌf]besnugly['snʌgli]applied[ə'plaɪd]aroundthearm,withitslowestedge1inchabovetheantecubital[,ænti'kju:bitəl]fossa['fɒsə].Thecuffshouldbeapproxima [ə'prɑksɪmətli]20%widerthanthediametertheextremity[ɪk'strɛməti].Thebladderoverlie['ovɚ'lai]theartery.Theuseofacuffthatistoosmallforalargearmresultsinanerroneously[i'rəuniəsli]highreadingofbloodBloodPressureAnothercauseofelevated['elɪveɪtɪd]bloodpressurereadingsislackofsupportofthepatient’sarm.Toobtainanaccuratemeasurement,thecuffmustbeatheartlevel.Ifthearmisnotsupported,thepatientisperformingisometricexercise,whichraisestherecordedpressure.BloodPressurefalsely['fɔ:lsli]adv.elevated['elɪveɪtɪd]['ɛlɪvetɪd]adj.提高的；高尚的；严肃的；欢欣的v.提高；抬起；振奋；提拔（elevate的过去分词）n.高架铁路isometric[aɪsə(ʊ)'metrɪk]['aɪsə'mɛtrɪk]adj.[数]等距的；等角的；等轴的；等体积的n.等isometricexercise等长练习；静力训BloodPressureAnothercauseofelevated['elɪveɪtɪd]bloodpressurereadingsislackofsupportofthepatient’sarm.Toobtainanaccuratemeasurement,thecuffmustbeatheartlevel.Ifthearmisnotsupported,thepatientisperformingisometricexercise,whichraisestherecordedpressure.BloodPressureIncontrast,excessive[ɪk'sesɪv;]pressureonthediaphragm['daɪə'fræm]ofthestethoscope['stɛθəskop]producesaspuriously['spjʊrɪəsli]lowerreadingofthediastolicbloodpressurewithoutanysignificant[sɪɡ'nɪfɪkənt]alteration[,ɔltə'reʃən]ofsystolicpressure.Ifthearmisheldcorrectly,noskinindentations[,ɔltə'reʃən]shouldoccur.BloodPressure [ɪk'sesɪv;ek-][ɪk'sesɪv;]excessivepressure ['daɪəfræm]['daɪə'fræm]隔膜；快门，[摄stethoscope英['steθəskəʊp]美['stɛθəskop]vt.用听诊器 n.[临床]听诊器 significant[sɪg'nɪfɪk(ə)nt][sɪɡ'nɪfɪkənt]adj.重大的；有效的；有意义的；值得注意的；意味深长的n.象征；有意义的事物 [ɔːltə'reɪʃ(ə)n]美 n.修改，改变；变BloodPressureIncontrast,excessive[ɪk'sesɪv;]pressureonthediaphragm['daɪə'fræm]ofthestethoscope['stɛθəskop]producesaspuriously['spjʊrɪəsli]lowerreadingofthediastolicbloodpressurewithoutanysignificant[sɪɡ'nɪfɪkənt]alteration[,ɔltə'reʃən]ofsystolicpressure.Ifthearmisheldcorrectly,noskinindentations[,ɔltə'reʃən]shouldoccur.BloodPressureTheauscultatory[ɔ:'skʌltətəri]gapisthesilencethatoccursbetweenthedisappearanceoftheKorotkoffsoundsaftertheinitialappearanceandtheirreappearanceatalowerpressure.Theauscultatorygapispresentwhenthereisadecreasedbloodflowtotheextremities[ɪk'strɛməti],asisfoundinhypertensionandinaortic[e'ɔrtɪk]stenosis[stɪ'nosɪs].Itsclinicalimportanceliesinthefactthatthesystolicbloodpressuremaybemistakenforthelowerbloodpressure,thepointofreappearance.BloodPressure [ɔ:'skʌltətəri]adjauscultatorygapaortic英[eɪ'ɔːtɪk]美 adj.大动脉 [stɪ'nəʊsɪs][stɪ'nosɪs]n（官）[病理听诊间隙（柯氏第1音出现后又很快继而会重新出现并最终为柯氏第5音，即在收缩压与舒张压之间较少所致，老年人及伴终末靶损害的高血压患者较出现柯氏第一音时，而不是声音再次出现时。BloodPressureTheauscultatory[ɔ:'skʌltətəri]gapisthesilencethatoccursbetweenthedisappearanceoftheKorotkoffsoundsaftertheinitialappearanceandtheirreappearanceatalowerpressure.Theauscultatorygapispresentwhenthereisadecreasedbloodflowtotheextremities[ɪk'strɛməti],asisfoundinhypertensionandinaortic[e'ɔrtɪk]stenosis[stɪ'nosɪs].Itsclinicalimportanceliesinthefactthatthesystolicbloodpressuremaybemistakenforthelowerbloodpressure,thepointofreappearance.BloodPressureDetermineBloodPressurebyPalpationBloodpressureassessmentisperformedwiththepatientlyingcomfortablyinthesupine['supaɪn]position.Thecuffbladderiscentered['sɛntɚd]overtherightbrachial['brekɪəl]artery.Ifthearmisobese[ə(ʊ)'biːs],alargeadultorthigh[θaɪ]cuffshouldbeused.Thearmshouldbeslightly['slaɪtli]flexed[flɛksd],anditshouldbesupportedatapproximay[ə'prɑksɪmətli]theleveloftheheart.BloodPressure [pæl'pet]n触诊；扪 英['s(j)uːpaɪn]美 adj.仰卧的；懒散的掌心向上的；向后靠 ['sɛntɚd]adj居中的；有圆心的v.集中居中（center的过去式和过去分词形式 ['breɪkɪəl]['brekɪəl]adj臂的，臂状 [ə(ʊ)'biːs][o'bis]adj肥胖的，过胖 [θaɪ][θaɪn大腿， 英['slaɪtlɪ]美['slaɪtli] adv.些微地，轻微地；纤 [fleks][flɛks]vt.折曲；使收缩vi弯曲；收缩n.屈曲；电线；松紧带adj.弹性工作制的 英[ə'prɒksɪmətlɪ]美[ə'prɑksɪmətli] dv.大约，近似地；近于BloodPressureDetermineBloodPressurebyPalpationBloodpressureassessmentisperformedwiththepatientlyingcomfortablyinthesupine['supaɪn]position.Thecuffbladderiscentered['sɛntɚd]overtherightbrachial['brekɪəl]artery.Ifthearmisobese[ə(ʊ)'biːs],alargeadultorthigh[θaɪ]cuffshouldbeused.Thearmshouldbeslightly['slaɪtli]flexed[flɛksd],anditshouldbesupportedatapproximay[ə'prɑksɪmətli]theleveloftheheart.BloodPressureTodeterminethesystolicbloodpressure y['ædikwitli]andtoexcludeanerrorasaresultofanauscultatorygap,bloodpressureisfirstassessed[ə'sest]byIn