临床医学英语课件

UNIT1TheModernHospital:AnOverviewNewWordsandPhrases

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

psychiatry

：thebranchofmedicinethatdealswiththediagnosis,treatment,andpreventionofmentalandemotionaldisordersanesthesia:=<美>anaethesia:totalorpartiallossofsensation,especiallytactile(觸覺的)sensibility,inducedbydisease,injury,acupuncture,orananesthetic(麻醉藥)pediatrics(=paediatrics):thebranchofmedicinethatdealswiththecareofinfantsandchildrenandthetreatmentoftheirdiseasesophthalmology:thebranchofmedicinethatdealswiththeanatomy,functions,pathology,andtreatmentoftheeyeobstetrics:thebranchofmedicinethatdealswiththecareofwomenduringpregnancy,childbirth,andtherecuperative(恢復的)periodfollowingdelivery.gynecology:thebranchofmedicinedealingwiththeadministrationofhealthcaretowomen,especiallythediagnosisandtreatmentofdisordersaffectingthefemalereproductiveorgans.DifficultWordsandPhrasesintheTextvirtual:existingorresultinginessenceoreffectthoughnotinactualfact,form,orname實質上的，實際上的atallcosts/atanycost不惜任何代價,無論如何revenue:income收入endowment:fundsorpropertydonatedtoaninstitution,anindividual,oragroupasasourceofincome

捐贈基金premium:保險費;獎金；獎勵eligible:qualifiedorentitledtobechosen

合格的：有資格或有權力被選中的proprietary:exclusivelyowned;private

私有的;獨家佔有的；私人的trustee:受託人，託管人；理事或董事auxiliary:n.

輔助者；助手adj.輔助的

avolunteers'auxiliaryatahospital

醫院裏的自願服務團體solicit:toseektoobtainbypersuasion,entreaty,orformalapplication懇求ambulatory:capableofwalking;notbedridden

能夠走動的；不需臥床的transaction:n.辦理,事務,處理事務confidential:secretadj.

秘密的,機密的discretion:n.

判斷力;謹慎，周詳brochure:asmallbookletorpamphlet小冊子BackgroundKnowledgeEarlierHospitals:

西元前560——前480年，在佛陀釋迦牟尼教導下設立古印度醫院。而中國最早的醫院則始於宮廷御醫出現的秦漢前期（西元前221年——前220年）。民間醫院首先起源於社會撫恤組織的建立。

在東方萌芽後一千多年，西方才建立了可以被稱作醫院的機構；350年醫院雛形在東羅馬帝國出現。

西方前期醫院的設立，與歐洲中世紀西元476年東羅馬賈斯廷朝代（the

Justinian）與1347年奪去歐洲四分之一人口生命的兩次鼠疫大流行相關，時疫促進了前期醫院的誕生。

西元4世紀在羅馬有教會醫院，屬於修道院。6世紀以後，西歐開始建立醫院。542年在法國裏昴641年在巴黎建立醫院。醫院當初兼做旅店，是患病的教徒、旅客和香客的醫務所或避難所。由於教會日益把持社會的醫療組織，特別在中世紀早期，醫院的組織與工作都具有宗教性質；它的護理重於醫療，主要目的在於洗淨病人的靈魂。醫院的最高理想是對上帝的虔誠，根本不考慮醫學科學技術的發展問題。此時的醫院因其目的不同，名稱各異，例如，照料病人者稱醫院，接收病人者稱為收容院(asylum)，收容窮人者稱為濟貧院(hospice)，收容婦女及女孩者稱為婦嬰院(WomenandChildrenCareInstitution)。在整個中世紀，除在9世紀出現產科醫院外，醫院幾乎不分專科。12世紀後，收容病人的機構進一步獨立，正式醫院開始興起。第一個正式醫院是1204年建於羅馬的聖靈醫院(HospitaloftheHolyGhost)。

BackgroundKnowledgeLouisPasteur(1822-1895):

Frenchchemistandbacteriologistwhofoundedmodernmicrobiology,inventedtheprocessofpasteurization(巴氏滅菌法),anddevelopedvaccinesforanthrax(炭疽),rabies(狂犬病),andchickencholera(雞瘟).Pasteurization(巴氏滅菌法):

Theactorprocessofheatingabeverage(飲料)orotherfood,suchasmilkorbeer,toaspecifictemperatureforaspecificperiodoftimeinordertokillmicroorganismsthatcouldcausedisease,spoilage,orundesiredfermentation(發酵).BackgroundKnowledgeFlorenceNightingale

(1820-1910):

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

FlorenceNightingaleismostrememberedasapioneerofnursingandareformerofhospitalsanitation(環境衛生)methods.Formostofherninetyyears,NightingalepushedforreformoftheBritishmilitaryhealth-caresystemandwiththattheprofessionofnursingstartedtogaintherespectitdeserved.BackgroundKnowledgeMedicare:AprogramundertheU.S.SocialSecurityAdministrationthatreimburses(償還)hospitalsandphysiciansformedicalcareprovidedtoqualifyingpeopleover65yearsold.

醫療保障方案：美國社會保障局實施的一項方案，向醫院和醫生支付為65歲以上的人士提供醫療服務所需的費用BackgroundKnowledge

Medicaid:

AprogramintheUnitedStates,jointlyfundedbythestatesandthefederalgovernment,thatreimburseshospitalsandphysiciansforprovidingcaretoqualifyingpeoplewhocannotfinancetheirownmedicalexpenses.

醫療補助計畫;美國的一項由國家和聯邦政府聯合撥款方案，替負擔不起自己醫療費用的人向醫院和醫生支付費用BackgroundKnowledgeBlueCross(藍十字)Anindependentmembershipassociationoperatingonaservicebasisandprovidingprotectionagainstthecostsofhospitalcare.Benefitpaymentsaremadedirectlytothehospital.BenefitsvaryamongvariousBlueCrossassociations.BlueCrossplansareusuallyestablishedonagroupbasis.However,individualenrollmentissometimespermitted,andplansofcommunityenrollmentareundertakeninsomelocalities.BlueCrossplansareusually(butnotalways)organizedunderspecialstatelegislation.BackgroundKnowledgeBlueShield(藍盾)

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

BackgroundKnowledgeCandyStriper:

avolunteerworkerinahospital,fromtheresemblanceofthevolunteer’sredandwhitestripeduniformtoacandycane

醫院義工，醫院的志願工作者。得名於志願者制服上紅白相間的條紋與糖果棒上的條紋相似的緣故。

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(輔助的)services.Mostcities(especiallyintheU.S.)havelawsthatrequirehospitalstohavealternativebackuppowergenerators,incaseofablackout.Additionallytheymaybeplacedonspecialhighprioritysegmentsofthepublicworks(utilities)infrastructuretoinsurecontinuityofcareduringastateofemergency.醫院常用名稱

generalhospital綜合醫院

childrenhospital兒童醫院

tumourhospital腫瘤醫院

chesthospital胸科醫院

fieldhospital野戰醫院

isolationhospital隔離醫院

militaryhospital陸軍醫院

municipalhospital市立醫院

maternityhospital產科醫院

mentalhospital精神醫院

infectioushospital傳染醫院

leprosyhospital麻風醫院

affiliatedhospital附屬醫院

traininghospital教學醫院

醫院科室部門名稱

out-patientdepartment門診部

In-patientdepartment住院部

Nursingdepartment護理部

Admissionoffice住院處

Dischargeoffice出院處

Registrationoffice掛號處

Receptionroom,waitingroom侯診室

Consultationroom診察室

Isolationroom隔離室

Labourroom待產室

Deliveryroom分娩室

Emergencyroom急診室

醫院科室部門名稱

Ward病房室

Pharmacydispensary藥房

Nutritiondepartment營養部

Diet-preparationdepartment配膳室

Therapeuticdepartment治療室

Operatingroom手術室

Blood-bank血站

Supply-room供應室

Disinfection-room消毒室

Dressingroom換藥室

Mortuary太平間

Recordroom病案室

醫院科室部門名稱

Departmentofinternalmedicine內科

Departmentofsurgery外科

Departmentofpediatrics兒科

Departmentofobstetricsandgynecology婦科

Departmentofneurology神經科

Departmentofophtalmology眼科

E.N.T.department耳鼻喉科

Departmentofstomatology口腔科

Departmentofurology泌尿科

Departmentoforthopedic骨科

Departmentoftraumatology創傷科

Departmentofendocrinology內分泌科

Departmentofanesthesiology麻醉科

醫院科室部門名稱

Departmentofdermatology皮膚科

Departmentofinfectiousdiseases傳染病科

Departmentofpathology病理科

Departmentofpsychiatry精神科

Departmentoforthopacdicsurgery矯形外科

Departmentofcardiacsurgery心臟外科

Departmentofcerebralsurgery腦外科

Departmentofthoracicsurgery胸外科

Departmentofplasticsurgery矯形外科

Departmentofphysiotherapy理療科

electrotherapyroom電療科

heliotherapyroom光療科

wax-therapyroom蠟療科

hydrotherapyroom水療科

醫院科室部門名稱

centrallaboratory中心實驗室

clinicallabororatory臨床實驗室

bacteriologicallabororatory細菌實驗室

biochemicallabororatory生化實驗室

serologicallabororatory血清實驗室

X-rayroomX光室

doctors’office醫生辦公室

nurses’office護士辦公室

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布賴特腎病(一般指腎小球腎炎glomerularnephritis)BackgroundKnowledgeHarryGoldblatt:(1891-1977)aCleveland(克利夫蘭,美國俄亥俄州東北部城市)physicianandpathologistBackgroundKnowledgeIn1934HarryGoldblattplacedaclampontheartery

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

分側腎功能試驗

ureteral輸尿管的catheterization導管插入(術)

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(鄰近)

juxta-articular:nearajointrenin:aprotein-digestingenzymethatisreleasedbythekidneyandactstoraisebloodpressurebyactivatingangiotensin(血管緊張素)

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

deca-→ten

decade,decagram

deci-→atenth

decibel(分貝),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發肓不全;發育不良

hypertrophy:increaseinthesizeofatissueororganbroughtaboutbytheenlargementofitscellsratherthanbycellmultiplication(asduringnormalgrowthandtumorformation)肥大

-trophy→nourishment,developmentatrophy:awastingordecreaseinsizeofabodilyorgan,tissue,orpartowingtodisease,injury,orlackofuse萎縮hypotrophy:failureofcellstoachieveanormalsize,andhencetissues,organs,andmorphologic(形態的)featuresareundergrown細胞退化;一個器官或組織由於失去細胞而功能退化atherosclerosis:aformofarteriosclerosischaracterizedbythedepositionofatheromatousplaquescontainingcholesterolandlipidsontheinnermostlayerofthewallsoflargeandmedium-sizedarteriesaneurysm:

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

adenselypackedgroupofmodifiedepithelialcellsinthedistaltubuleofanephron,adjacenttothejuxtaglomerularcells.adrenergic:producingoractivatedbyepinephrineoranepinephrinelikesubstance

adrenalin=epinephrine

腎上腺素ischemia:adecreaseinthebloodsupplytoabodilyorgan,tissue,orpartcausedbyconstrictionorobstructionofthebloodvesselsangiography:

examinationofthebloodvesselsusingx-raysfollowingtheinjectionofaradiopaque(射線透不過的)substance

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

catheter

導管cardiaccatheter心導管

urethralcatheter尿道導管bioassay:determinationofthestrengthorbiologicalactivityofasubstance,suchasadrugorhormone,bycomparingitseffectswiththoseofastandardpreparationonatestorganism

radioimmunoassay(放射免疫測定):

theimmunoassayofaradiolabeledsubstance,suchasahormoneoranenzyme

nanogram:

納克

nano-→

毫微、十億分之一nanometer

納米aldosterone:asteroidhormonesecretedbytheadrenalcortexthatregulatesthesaltandwaterbalanceinthebody.

ald-→

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

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

闌尾外科切除術

-tomy→cutting切開

anatomy解剖學

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

cutane/o-→skin

per-

→through

subcutaneousDifficultWordsandPhrasesintheTextessential:of,relatingto,orbeingadysfunctionalconditionoradiseasewhosecauseisunknown

原發的;疾病或狀態自發的，或特發的

essentialhypertension=primaryhypertensionprimarycarcinoma原發癌carcinomainsitu原位癌etiologic:

adj.

etiology:thebranchofmedicinethatdealswiththecausesororiginsofdisease病原學clamp:n.夾子,夾具,夾鉗pressor:

causinganincreaseinbloodpressure

使血壓升高的potent:

exertingorcapableofexertingstrongphysiologicalorchemicaleffects強有力的,有效力的plaque:adepositoffattymaterialontheinnerliningofanarterialwall,characteristicofatherosclerosis斑：動脈血管壁內脂肪物質的沉積intimal:

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

fistula:anabnormalductorpassageresultingfrominjury,disease,oracongenitaldisorderthatconnectsanabscess(膿腫),acavity,oraholloworgantothebodysurfaceortoanotherholloworgan瘺(管)

viable:

capableofliving,developing,orgerminatingunderfavorableconditionsautopsy:

examinationofacadavertodetermineorconfirmthecauseofdeath.Alsocallednecropsy,

postmortem,postmortemexamination

parameter:參數，參量autonomous:independent;self-directedbecompatiblewith:適合,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:W