临床医学英语课件VIP

UNIT1TheModernHospital:AnOverviewNewWordsandPhrases

tuberculosis（TB）:aninfectiousdiseaseofhumanbeingsandanimalscausedbythetubercle(结核)bacillusandcharacterizedbytheformationoftuberclesonthelungsandothertissuesofthebody,oftendevelopinglongaftertheinitialinfection

psychiatry

：thebranchofmedicinethatdealswiththediagnosis,treatment,andpreventionofmentalandemotionaldisordersanesthesia:=<美>anaethesia:totalorpartiallossofsensation,especiallytactile(触觉的)sensibility,inducedbydisease,injury,acupuncture,orananesthetic(麻醉药)pediatrics(=paediatrics):thebranchofmedicinethatdealswiththecareofinfantsandchildrenandthetreatmentoftheirdiseasesophthalmology:thebranchofmedicinethatdealswiththeanatomy,functions,pathology,andtreatmentoftheeyeobstetrics:thebranchofmedicinethatdealswiththecareofwomenduringpregnancy,childbirth,andtherecuperative(恢复的)periodfollowingdelivery.gynecology:thebranchofmedicinedealingwiththeadministrationofhealthcaretowomen,especiallythediagnosisandtreatmentofdisordersaffectingthefemalereproductiveorgans.DifficultWordsandPhrasesintheTextvirtual:existingorresultinginessenceoreffectthoughnotinactualfact,form,orname实质上的，实际上的atallcosts/atanycost不惜任何代价,无论如何revenue:income收入endowment:fundsorpropertydonatedtoaninstitution,anindividual,oragroupasasourceofincome

捐赠基金premium:保险费;奖金；奖励eligible:qualifiedorentitledtobechosen

合格的：有资格或有权力被选中的proprietary:exclusivelyowned;private

私有的;独家占有的；私人的trustee:受托人，托管人；理事或董事auxiliary:n.

辅助者；助手adj.辅助的

avolunteers'auxiliaryatahospital

医院里的自愿服务团体solicit:toseektoobtainbypersuasion,entreaty,orformalapplication恳求ambulatory:capableofwalking;notbedridden

能够走动的；不需卧床的transaction:n.办理,事务,处理事务confidential:secretadj.

秘密的,机密的discretion:n.

判断力;谨慎，周详brochure:asmallbookletorpamphlet小册子BackgroundKnowledgeEarlierHospitals:

公元前560——前480年，在佛陀释迦牟尼教导下设立古印度医院。而中国最早的医院则始于宫廷御医出现的秦汉前期（公元前221年——前220年）。民间医院首先起源于社会抚恤组织的建立。

在东方萌芽后一千多年，西方才建立了可以被称作医院的机构；350年医院雏形在东罗马帝国出现。

西方前期医院的设立，与欧洲中世纪公元476年东罗马贾斯廷朝代（the

Justinian）与1347年夺去欧洲四分之一人口生命的两次鼠疫大流行相关，时疫促进了前期医院的诞生。

公元4世纪在罗马有教会医院，属于修道院。6世纪以后，西欧开始建立医院。542年在法国里昴641年在巴黎建立医院。医院当初兼做旅店，是患病的教徒、旅客和香客的医务所或避难所。由于教会日益把持社会的医疗组织，特别在中世纪早期，医院的组织与工作都具有宗教性质；它的护理重于医疗，主要目的在于洗净病人的灵魂。医院的最高理想是对上帝的虔诚，根本不考虑医学科学技术的发展问题。此时的医院因其目的不同，名称各异，例如，照料病人者称医院，接收病人者称为收容院(asylum)，收容穷人者称为济贫院(hospice)，收容妇女及女孩者称为妇婴院(WomenandChildrenCareInstitution)。在整个中世纪，除在9世纪出现产科医院外，医院几乎不分专科。12世纪后，收容病人的机构进一步独立，正式医院开始兴起。第一个正式医院是1204年建于罗马的圣灵医院(HospitaloftheHolyGhost)。

BackgroundKnowledgeLouisPasteur(1822-1895):

Frenchchemistandbacteriologistwhofoundedmodernmicrobiology,inventedtheprocessofpasteurization(巴氏灭菌法),anddevelopedvaccinesforanthrax(炭疽),rabies(狂犬病),andchickencholera(鸡瘟).Pasteurization(巴氏灭菌法):

Theactorprocessofheatingabeverage(饮料)orotherfood,suchasmilkorbeer,toaspecifictemperatureforaspecificperiodoftimeinordertokillmicroorganismsthatcouldcausedisease,spoilage,orundesiredfermentation(发酵).BackgroundKnowledgeFlorenceNightingale

(1820-1910):

Britishnursewhoorganized(1854)anddirectedaunitoffieldnursesduringtheCrimeanWar(1853—1856)andisconsideredthefounderofmodernnursing,oneofthefoundersofTheRedCross.

FlorenceNightingaleismostrememberedasapioneerofnursingandareformerofhospitalsanitation(环境卫生)methods.Formostofherninetyyears,NightingalepushedforreformoftheBritishmilitaryhealth-caresystemandwiththattheprofessionofnursingstartedtogaintherespectitdeserved.BackgroundKnowledgeMedicare:AprogramundertheU.S.SocialSecurityAdministrationthatreimburses(偿还)hospitalsandphysiciansformedicalcareprovidedtoqualifyingpeopleover65yearsold.

医疗保障方案：美国社会保障局实施的一项方案，向医院和医生支付为65岁以上的人士提供医疗服务所需的费用BackgroundKnowledge

Medicaid:

AprogramintheUnitedStates,jointlyfundedbythestatesandthefederalgovernment,thatreimburseshospitalsandphysiciansforprovidingcaretoqualifyingpeoplewhocannotfinancetheirownmedicalexpenses.

医疗补助计划;美国的一项由国家和联邦政府联合拨款方案，替负担不起自己医疗费用的人向医院和医生支付费用BackgroundKnowledgeBlueCross(蓝十字)Anindependentmembershipassociationoperatingonaservicebasisandprovidingprotectionagainstthecostsofhospitalcare.Benefitpaymentsaremadedirectlytothehospital.BenefitsvaryamongvariousBlueCrossassociations.BlueCrossplansareusuallyestablishedonagroupbasis.However,individualenrollmentissometimespermitted,andplansofcommunityenrollmentareundertakeninsomelocalities.BlueCrossplansareusually(butnotalways)organizedunderspecialstatelegislation.BackgroundKnowledgeBlueShield(蓝盾)

ThefamiliartitlefortheAssociatedMedicalCarePlans,anindependentmembershipassociationcooperatingwithBlueCrossandprovidingprotectionagainstthecostsofsurgery,doctors,andotheritemsofmedicalcare.Benefitpaymentsaremadedirectlytothedoctor,nottothepolicyholder.

BackgroundKnowledgeCandyStriper:

avolunteerworkerinahospital,fromtheresemblanceofthevolunteer’sredandwhitestripeduniformtoacandycane

医院义工，医院的志愿工作者。得名于志愿者制服上红白相间的条纹与糖果棒上的条纹相似的缘故。

TypesSomepatientsjustcomefordiagnosisand/ortherapyandthenleave(outpatients);whileothersareadmittedandstayovernightorforseveralweeksormonths(inpatients).Hospitalsareusuallydistinguishedfromothertypesofmedicalfacilitiesbytheirabilitytoadmitandcareforinpatients.Generalhospitals

Thebest-knowntypeofhospitalisthegeneralhospital,(intheUKknownasaDistrictGeneralHospital)whichissetuptodealwithmanykindsofdiseaseandinjury,andtypicallyhasanemergencyward/A&Edepartmenttodealwithimmediatethreatstohealthandthecapacitytodispatchemergencymedicalservices.Ageneralhospitalistypicallythemajorhealthcarefacilityinitsregion,withlargenumbersofbedsforintensivecareandlong-termcare;andspecializedfacilitiesforsurgery,plasticsurgery,childbirth,bioassaylaboratories,andsoforth.Largercitiesmayhavemanydifferenthospitalsofvaryingsizesandfacilities.VerylargehospitalsareoftencalledMedical

CentersintheUSandusuallyconductoperationsinvirtuallyeveryfieldofmodernmedicine.MosthospitalsintheUKarerunbytheNational

HealthService(NHS).ClinicsAmedicalfacilitysmallerthanahospitaliscalledaclinic,andisoftenrunbyagovernmentagencyforhealthservicesoraprivatepartnershipofphysicians(innationswhereprivatepracticeisallowed).Clinicsgenerallyprovideonlyoutpatientservices.SpecializedhospitalsTypesofspecializedhospitalsincludetraumacenters,children‘shospitals,seniors’(geriatric老年病的)hospitals,andhospitalsfordealingwithspecificmedicalneedssuchaspsychiatricproblems(seepsychiatrichospital),pulmonarydiseases,andsoforth.Ahospitalmaybeasinglebuildingoracampus.Somehospitalsareaffiliatedwithuniversitiesformedicalresearchandthetrainingofmedicalpersonnel.WithintheUnitedStates,manyhospitalsarefor-profit,whileelsewhereintheworldmostarenon-profit.OtherfacilitiesManyhospitalshavehospitalvolunteerprogramswherepeople(usuallystudentsandseniorcitizens)canvolunteerandprovidevariousancillary(辅助的)services.Mostcities(especiallyintheU.S.)havelawsthatrequirehospitalstohavealternativebackuppowergenerators,incaseofablackout.Additionallytheymaybeplacedonspecialhighprioritysegmentsofthepublicworks(utilities)infrastructuretoinsurecontinuityofcareduringastateofemergency.医院常用名称

generalhospital综合医院

childrenhospital儿童医院

tumourhospital肿瘤医院

chesthospital胸科医院

fieldhospital野战医院

isolationhospital隔离医院

militaryhospital陆军医院

municipalhospital市立医院

maternityhospital产科医院

mentalhospital精神医院

infectioushospital传染医院

leprosyhospital麻风医院

affiliatedhospital附属医院

traininghospital教学医院

医院科室部门名称

out-patientdepartment门诊部

In-patientdepartment住院部

Nursingdepartment护理部

Admissionoffice住院处

Dischargeoffice出院处

Registrationoffice挂号处

Receptionroom,waitingroom侯诊室

Consultationroom诊察室

Isolationroom隔离室

Labourroom待产室

Deliveryroom分娩室

Emergencyroom急诊室

医院科室部门名称

Ward病房室

Pharmacydispensary药房

Nutritiondepartment营养部

Diet-preparationdepartment配膳室

Therapeuticdepartment治疗室

Operatingroom手术室

Blood-bank血站

Supply-room供应室

Disinfection-room消毒室

Dressingroom换药室

Mortuary太平间

Recordroom病案室

医院科室部门名称

Departmentofinternalmedicine内科

Departmentofsurgery外科

Departmentofpediatrics儿科

Departmentofobstetricsandgynecology妇科

Departmentofneurology神经科

Departmentofophtalmology眼科

E.N.T.department耳鼻喉科

Departmentofstomatology口腔科

Departmentofurology泌尿科

Departmentoforthopedic骨科

Departmentoftraumatology创伤科

Departmentofendocrinology内分泌科

Departmentofanesthesiology麻醉科

医院科室部门名称

Departmentofdermatology皮肤科

Departmentofinfectiousdiseases传染病科

Departmentofpathology病理科

Departmentofpsychiatry精神科

Departmentoforthopacdicsurgery矫形外科

Departmentofcardiacsurgery心脏外科

Departmentofcerebralsurgery脑外科

Departmentofthoracicsurgery胸外科

Departmentofplasticsurgery矫形外科

Departmentofphysiotherapy理疗科

electrotherapyroom电疗科

heliotherapyroom光疗科

wax-therapyroom蜡疗科

hydrotherapyroom水疗科

医院科室部门名称

centrallaboratory中心实验室

clinicallabororatory临床实验室

bacteriologicallabororatory细菌实验室

biochemicallabororatory生化实验室

serologicallabororatory血清实验室

X-rayroomX光室

doctors’office医生办公室

nurses’office护士办公室

StructureandQuestionsoftheText

ⅠThemeaningofthemodernhospitalandthechangesofthehospital(Para.1----4)Questions:1.CanyousaysomethingaboutLouisPasteurandFlorenceNightingale?2.Inwhataspectsdidthefirsthospitalsdifferfrommodernhospitals?ⅡTheclassificationofthemodernhospital(Para.5----9)Questions:3.Whatarethedifferencesbetweenthegeneralhospitalsandspecializedhospitals?4.HowarethehospitalsinAmericafinanced?5.Howdopatientsmanagetopaytheirbills?ⅢTheoperationofmosthospitals(Para.10----13)Questions:6.Whatdovolunteersdointhehospitals?7.Howisahospitalaccredited?ⅣAnexampleofGeorgetownUniversityHospitalinWashington,D.C.toillustratehowamodernhospitalfunctions.(Para.14----26)Questions:8.CanyoulisttheclinicaldepartmentsinGeorgetownUniversityHospital?Rememberthem.Itishelpful.9.Giveadescriptionofthegeneraladministrativestaff(thebusinessoffice)andtheirresponsibilities.Whatishighbloodpressure?

Bloodpressureisthemeasurementofthepressureorforceofbloodpushingagainstbloodvesselwalls.Theheartpumpsbloodintothearteries(bloodvessels),whichcarrythebloodthroughoutthebody.Highbloodpressure,alsocalledhypertension,meansthepressureinyourarteriesisabovethenormalrange.Inmostcases,nooneknowswhatcauseshighbloodpressure.BackgroundKnowledgeHowisbloodpressurerecorded?

Bloodpressureiswrittenastwonumbers,suchas118/72.Thefirstnumberisthesystolicpressure.Thisisthepressureinthearterieswhentheheartbeatsandfillsthemwithblood.Thesecondnumberisthediastolicpressure.Thisisthepressureinthearterieswhentheheartrestsbetweenbeats.TypeofbloodpressurereadingNormalbloodpressurePrehypertensionStage1hypertensionStage2hypertensionSystoliclessthan120mmHg120-139mmHg140-159mmHg160mmHgandaboveDiastoliclessthan80mmHg80-89mmHg90-99mmHg100mmHgandabovemmHg=millimetersofmercury–theunitofmeasureforbloodpressureWhatisanormalbloodpressurereading?Whatcanhappenifhighbloodpressureisnottreated?1.Stroke2.EnlargedHeart3.HeartFailure4.PeripheralVascularDisease5.HeartAttack6.KidneyDisease/Failure

Whatarethesignsandsymptoms?Mostpeoplewithhighbloodpressurehavenosignsorsymptoms,evenifbloodpressurereadingsreachdangerouslyhighlevels.Althoughafewpeoplewithearly-stagehighbloodpressuremayhavedullheadaches,dizzyspellsorafewmorenosebleedsthannormal,thesesignsandsymptomstypicallydon'toccuruntilhighbloodpressurehasreachedanadvanced—possiblylife-threatening—stage.Whataretheriskfactors?Highbloodpressurehasmanyriskfactors.Someyoucan'tcontrol.Age.Theriskofhighbloodpressureincreasesasyougetolder.Throughearlymiddleage,highbloodpressureismorecommoninmen.Womenaremorelikelytodevelophighbloodpressureaftermenopause.Race.Highbloodpressureisparticularlycommonamongblacks,oftendevelopingatanearlieragethanitdoesinwhites.Seriouscomplications,suchasstrokeandheartattack,alsoaremorecommoninblacks.Familyhistory.Highbloodpressuretendstoruninfamilies.Otherriskfactorsforhighbloodpressurearewithinyourcontrol.Excessweight.Thegreateryourbodymass,themorebloodyouneedtosupplyoxygenandnutrientstoyourtissues.Asthevolumeofbloodcirculatedthroughyourbloodvesselsincreases,sodoesthepressureonyourarterywalls.Inactivity.Peoplewhoareinactivetendtohavehigherheartrates.Thehigheryourheartrate,theharderyourheartmustworkwitheachcontraction—andthestrongertheforceonyourarteries.Lackofphysicalactivityalsoincreasestheriskofbeingoverweight.Tobaccouse.Thechemicalsintobaccocandamagetheliningofyourarterywalls,whichpromotesnarrowingofthearteries.Sodiumintake.Toomuchsodiuminyourdiet—especiallyifyouhavesodiumsensitivity—canleadtofluidretentionandincreasedbloodpressure.Lowpotassiumintake.Potassiumhelpsbalancetheamountofsodiuminyourcells.Ifyoudon'tconsumeorretainenoughpotassium,youmayaccumulatetoomuchsodiuminyourblood.Excessivealcohol.Overtime,heavydrinkingcandamageyourheart.Stress.Highlevelsofstresscanleadtoatemporarybutdramaticincreaseinbloodpressure.Ifyoutrytorelaxbyeatingmore,usingtobaccoordrinkingalcohol,youmayonlyfuelproblemswithhighbloodpressure.Certainchronicconditionsalsomayincreaseyourrisk

ofhighbloodpressure,includinghighcholesterol,diabetes,kidneydiseaseandsleepapnea.Sometimespregnancycontributestohighbloodpressure.Ina2006study,adultswhoworkedmorethan40or50hoursaweek—particularlyclericalandunskilledworkers—weremorelikelytohavehighbloodpressurethanwerethosewhoworked40hoursorlessaweek.Researcherstiedthehigherriskforworkerswithlongerhourstounhealthyeating,lessexercise,morestressandlesssleep.BackgroundKnowledgeRichardBright:(1789-1858)Englishphysician,fatherofnephrologyBright'sdisease布赖特肾病(一般指肾小球肾炎glomerularnephritis)BackgroundKnowledgeHarryGoldblatt:(1891-1977)aCleveland(克利夫兰,美国俄亥俄州东北部城市)physicianandpathologistBackgroundKnowledgeIn1934HarryGoldblattplacedaclampontheartery

leadingtothekidneyofadogandproducedthefirstanimalmodelofchronichypertension.Goldblattproposedthatthedecreaseinbloodsupplycausesthekidneytoreleaseavasopressorsubstance.Goldblattwasunawareoftheearlierdiscoveryofrenin.TheconnectionbetweentheGoldblattkidneyandreninwasnotmadeuntilthe1950'swhenscientistsdelineatedtherenin-angiotensinsystem,whichisthemajormechanismthebodyusestocontrolbloodpressure.BackgroundKnowledgesplitrenalfunctiontest:Atesttodeterminevariousfunctionalparametersofonekidneycomparedwiththeotherkidney.Alsocalleddifferentialureteralcatheterizationtest

分侧肾功能试验

ureteral输尿管的catheterization导管插入(术)

Youcanhavehighbloodpressure(hypertension)foryearswithoutasinglesymptom.Uncontrolledhighbloodpressureincreasesyourriskofserioushealthproblems,includingheartattackandstroke.Bloodpressureisdeterminedbytheamountofbloodyourheartpumpsandtheamountofresistancetobloodflowinyourarteries.Themorebloodyourheartpumpsandthenarroweryourarteries,thehigheryourbloodpressure.In90percentto95percentofhighbloodpressurecases,theAmericanHeartAssociationsaysthere'snoidentifiablecause.Thistypeofhighbloodpressure,calledessentialhypertensionorprimaryhypertension,tendstodevelopgraduallyovermanyyears.Theother5percentto10percentofhighbloodpressurecasesarecausedbyanunderlyingcondition.Thistypeofhighbloodpressure,calledsecondaryhypertension,tendstoappearsuddenlyandcausehigherbloodpressurethandoesprimaryhypertension.Variousconditionscanleadtosecondaryhypertension,includingkidneyabnormalities,tumorsoftheadrenalglandorcertaincongenitalheartdefects.NewWordsandPhrasesjuxtaglomerular:

juxta-→near,proximityto(邻近)

juxta-articular:nearajointrenin:aprotein-digestingenzymethatisreleasedbythekidneyandactstoraisebloodpressurebyactivatingangiotensin(血管紧张素)

rennin:amilk-coagulatingenzymefoundinthegastricjuice凝乳酶substrate:thematerialorsubstanceonwhichanenzymeactsdecapeptide:apeptidecontaining10aminoacids.

deca-→ten

decade,decagram

deci-→atenth

decibel(分贝),decimeter(分米)

octapeptide:apolypeptide,suchasangiotensin,thatiscomposedofeightaminoacidsoct-,octa-,octo-→eighthyperplasia:theincreasedproductionandgrowthofnormalcellsinatissueororgan.Theaffectedpartbecomeslargebutretainsitsnormalform.Duringpregnancythebreastgrowinthismanner增生(=proliferation)

-plasia→formaton,growthhypoplasia:incompletearrested(被抑制的)developmentofanorganorapart发肓不全;发育不良

hypertrophy:increaseinthesizeofatissueororganbroughtaboutbytheenlargementofitscellsratherthanbycellmultiplication(asduringnormalgrowthandtumorformation)肥大

-trophy→nourishment,developmentatrophy:awastingordecreaseinsizeofabodilyorgan,tissue,orpartowingtodisease,injury,orlackofuse萎缩hypotrophy:failureofcellstoachieveanormalsize,andhencetissues,organs,andmorphologic(形态的)featuresareundergrown细胞退化;一个器官或组织由于失去细胞而功能退化atherosclerosis:aformofarteriosclerosischaracterizedbythedepositionofatheromatousplaquescontainingcholesterolandlipidsontheinnermostlayerofthewallsoflargeandmedium-sizedarteriesaneurysm:

aballoon-likeswellinginthewallofanartery;alocalized,pathological,blood-filleddilatationofabloodvesselcausedbyadiseaseorweakeningofthevessel'swallmasculadensa:

adenselypackedgroupofmodifiedepithelialcellsinthedistaltubuleofanephron,adjacenttothejuxtaglomerularcells.adrenergic:producingoractivatedbyepinephrineoranepinephrinelikesubstance

adrenalin=epinephrine

肾上腺素ischemia:adecreaseinthebloodsupplytoabodilyorgan,tissue,orpartcausedbyconstrictionorobstructionofthebloodvesselsangiography:

examinationofthebloodvesselsusingx-raysfollowingtheinjectionofaradiopaque(射线透不过的)substance

angiogram血管造影照片,血管造影(术)catheterization:theintroductionofacatheterintoaholloworgan

catheter

导管cardiaccatheter心导管

urethralcatheter尿道导管bioassay:determinationofthestrengthorbiologicalactivityofasubstance,suchasadrugorhormone,bycomparingitseffectswiththoseofastandardpreparationonatestorganism

radioimmunoassay(放射免疫测定):

theimmunoassayofaradiolabeledsubstance,suchasahormoneoranenzyme

nanogram:

纳克

nano-→

毫微、十亿分之一nanometer

纳米aldosterone:asteroidhormonesecretedbytheadrenalcortexthatregulatesthesaltandwaterbalanceinthebody.

ald-→

aldehyde醛-sterone→ketone酮hyponatremia:thepresenceinthebloodofanabnormallylowconcentrationofsodium,occursindehydrationhyperkalemia:thepresenceinthebloodofanabnormallyhighconcentrationofpotassiumadrenocorticotropic:stimulatingorotherwiseactingontheadrenalcortex

aldosteronism:adisordermarkedbyexcessivesecretionofthehormonealdosterone,whichcancauseweakness,cardiacirregularities,andabnormallyhighbloodpressureLasix:tradenameoffrusemide(=furosemide)速尿,adiuretic(利尿剂)usedtotreatfluidretention(oedema)associatedwithheart,liver,orkidneydiseaseandalsohighbloodpressurenephrectomy:surgicalremovalofakidneynephr/o-→kidney-ectomy→removal,excisionappendectomy

阑尾外科切除术

-tomy→cutting切开

anatomy解剖学

-(o)stomy→makinganopeningoraconnectionbetween造口术;吻合术angioplasty:aprocedureinwhichacatheterequippedwithatinyballoonatthetipisinsertedintoanarterythathasbeennarrowedbytheaccumulationoffattydeposits.Theballoonistheninflatedtocleartheblockageandwidentheartery.percutaneously:

cutane/o-→skin

per-

→through

subcutaneousDifficultWordsandPhrasesintheTextessential:of,relatingto,orbeingadysfunctionalconditionoradiseasewhosecauseisunknown

原发的;疾病或状态自发的，或特发的

essentialhypertension=primaryhypertensionprimarycarcinoma原发癌carcinomainsitu原位癌etiologic:

adj.

etiology:thebranchofmedicinethatdealswiththecausesororiginsofdisease病原学clamp:n.夹子,夹具,夹钳pressor:

causinganincreaseinbloodpressure

使血压升高的potent:

exertingorcapableofexertingstrongphysiologicalorchemicaleffects强有力的,有效力的plaque:adepositoffattymaterialontheinnerliningofanarterialwall,characteristicofatherosclerosis斑：动脉血管壁内脂肪物质的沉积intimal:

adj.(intima:theinnermostmembraneofanorganorapart,especiallytheinnerliningofalymphaticvessel,anartery,oravein内膜)

fistula:anabnormalductorpassageresultingfrominjury,disease,oracongenitaldisorderthatconnectsanabscess(脓肿),acavity,oraholloworgantothebodysurfaceortoanotherholloworgan瘘(管)

viable:

capableofliving,developing,orgerminatingunderfavorableconditionsautopsy:

examinationofacadavertodetermineorconfirmthecauseofdeath.Alsocallednecropsy,

postmortem,postmortemexamination

parameter:参数，参量autonomous:independent;self-directedbecompatiblewith:适合,一致meticulously:

adv.

meticulous:extremelycarefulandpreciseStructureandQuestionsoftheTextⅠAbriefintroductiontothecloserelationshipbetweenhypertensionandrenaldiseasesdiseases(Para.1)——IntroductoryParagraphⅡRenalMechanismsofHypertensionQuestions:1.WhatisthefindingofRichardBright?2.HowdidHarryGoldblattdemonstratetheconnectionbetweenthekidneyandhypertension?3.Canyoudescribetheprocessoftheelevationofthebloodpressurecausedbytherenalmechanisms?

renalarteryconstricts→thekidneyreleasesrenin(manufacturedinthejuxtaglomerularcellsbywayofrenalveinintothegeneralcirculation)→reninactsontheangiotensinogen(areninsubstrate,whichismanufacturedintheliver)→yieldangiotensinⅠ(adecapeptidefragment)→convertingenzymeactsonittoproduceangiotensionⅡ(anoctapeptide,apotentvasoconstrictivepressorsubstance)→angiotensionⅡactsonthesmoothmuscleofthearterialwalls→bloodpressureelevationⅢRenalArteryNarrowingQuestions:1.WhatarethethreemechanismsofhypertensionbyWhichrenalarterynarrowingbringsaboutexcessreninrelease?Canyoudescribeeachofthemandgivesomeexamples.2.Howdotheintrarenaldiseasesstimulatetherenin-angiotensinmechanism?Andgivesomeexamples.3.Paraphrasethelast2sentencesofPara.5.4.Accordingtotheauthor,howcanthephysiciandetermineifthepatientishypertensivebecauseofrenalarterialnarrowing?5.Whatisthetheoreticbasisofsplitrenalfunctiontest?1.Threemechanismsofhypertensionbywhichrenalarterynarrowingbringsaboutexcessreninreleasewithresultinghypertensionadecreasedmeanpressureattheleveloftheglomerularafferentarteriole→changethetensiononthatafferentarteriole→stimulateanexcessreleaseofreninlocalfactors(renalarterialconstriction)orgeneralizedfactors(reducedextracellularfluidvolume←dehydrationorhemorrhage)→decreasedsodiumdeliveredtothemaculadensa→increasedreninproductionstimulationoftheβ-adrenergic(sympathetic)nervefiberstothekidney→reninisreleasedintothebloodstream2.Variousintrarenaldiseaseprocessesmaystimulatetherenin-angiotensinmechanism──alterbloodflowtogivenareasofthekidneybymeansofpressureischemia3.Howcanthephysiciandetermineifthepatientishypertensivebecauseofrenalarterialnarrowing?bycomparingtherenalveinreninlevelsfromboththeaffectedandthecontralateralsidesbydirectcatheterizationoftherenalveinsplitrenalfunctiontests:comparethevariousparametersofthefunctionofeachkidneyⅣRenalAdrenalMechanismsofHypertension:Renin-angiotensin-aldosteroneAxisQuestions:Wh