诊断学头颈部-英语

TheHeadandNeck1BonesofthefaceandskullParietal[pə'raɪɪt(ə)l]

顶骨Occipital[ɒk'sɪpɪtəl]

枕Temporal['temp(ə)r(ə)l]

颞Mastoid['mæstɒɪd]

乳突Externalauditorymeatus

外耳道[ek'stɜːn(ə)l]['ɔːdɪtərɪ][mɪ'eɪtəs]Styloidprocess['staɪlɒɪd]

茎突2BonesofthefaceandskullMandible['mændɪbl]

下颚骨Vomer['vəʊmə]

犁骨Palatine['pælətɪn]

腭骨Frontal额骨Glabella

[glə'belə]

眉间Nasal[ˈneɪzl]鼻骨Lacrimal

['lækrɪməl]

泪骨Zygomaticbone[,zaɪɡo'mætɪk]

颧骨Maxilla[mæk‘sɪlə]

颚骨3MusclesofthefaceandskullOrbicularis

oculimuscle眼轮匝肌[ɔ:,bikju'lεəris]['ɔkjuli]Orbicularis

orismuscle口轮匝肌Sternocleidomastoidmuscle['stə:nəu,klaidə'mæstɔid]胸锁乳突肌superficialmusclesunderlyingmusclesPlatysmamuscle[plə'tizmə]

颈阔肌Trapeziusmuscle[trə'piːzɪəs]

斜方肌Temporalismuscle[,tempə'reɪlɪs]

颞肌Massetermuscle[mæ'siːtə]

咬肌4BoundariesofthetrianglesoftheneckPosteriortriangle['traɪæŋg(ə)l]颈后三角Anteriortriangle颈前三角Clavicularhead[klæ‘vɪkjʊlɚ]

锁骨头Sternalhead['stɜːn(ə)l]

胸骨头5ThyroidglandLarynx['lærɪŋks]

喉Trachea['trekɪə]

气管Clavicle['klævɪk(ə)l]

锁骨Isthmus['ɪsməs]

峡部Thyroidlaterallobes[ˈlætərəl][ləʊb]

甲状腺侧叶6LymphnodesoftheneckAnteriorauricular耳前[ɔː'rɪkjʊlə]Posteriorauricular耳后Occipital[ɒk'sɪpɪtəl]

枕Posteriorcervical颈后['sɝvɪkl]Supraclavicular

[sju:prəklæ‘vɪkjʊlə]

锁骨上Superficialcervical[ˈsɜ:vɪkl]

颈浅Deepcervical颈深Tonsillar

['tɔnsilə]

扁桃体Submaxillary

颌下Submental

颏下7EndocrineSystemWordsPineal松果体Hypothalamus[,haɪpə'θæləməs]

下丘脑Pituitary[pɪ'tjuːɪt(ə)rɪ]

垂体Thyroid

甲状腺Parathytoids

甲状旁腺Thymus

胸腺Adrenal

肾上腺Pancreas胰腺Ovary

卵巢Testes

睾丸8EndocrineSystemWordsexocine,['ɛksəkrɪn]外分泌endocrine,

['endə(ʊ)krɪn]内分泌secrete,[sɪ'kriːt]分泌gonad,['ɡonæd]性腺cortex,['kɔrtɛks]皮质medullar[me'dʌlə],髓质corticosteroid,[,kɔːtɪkəʊ'sterɒɪd]

皮质类固醇glucocorticoid,[,ɡlʊko'kɔrtɪ,kɔɪd]

糖皮质激素cortisol['kɔːtɪsɒl],皮质醇mineralocorticoid

[,mɪnərəlo'kɔrtɪ,kɔɪd],盐皮质激素aldosterone

[æl'dɒstərəʊn],醛固酮epinephrine[,epɪ'nefriːn],肾上腺素norepinephrine,[,nɔːrepɪ‘nefriːn]去甲肾上腺素9EndocrineSystemWordsIslet['aɪlɪt]胰岛细胞insulin['ɪnsəlɪn]胰岛素glucagon['gluːkəg(ə)n]胰高血糖素anabolism[ə‘næbəlɪz(ə)m]合成代谢

Catabolism[kə'tæbəlɪz(ə)m]分解代谢hyperthyroidism,[,haɪpə'θaɪrɒɪdɪz(ə)m]

甲状腺功能亢进hypothyroidism,[haɪpəʊ'θaɪrɒɪdɪz(ə)m]

甲状腺功能减退Tachycardia[tækɪ‘kɑːdɪə]心动过速

exophthalmos[,eksɒf’θælmɒs]突眼10PituitaryanatomyandimagingInterthalamicadhesion丘脑粘合Corpuscallosum[kɑ:‘ləʊsəm]胼胝体Mammillarybody[‘mæmɪlərɪ]乳头体

Mesencephalon中脑[ˌmesen'sefəlɒn]Pontine[‘pɒntaɪn]桥脑Medullaoblongata延髓[mɪ'dʌlə][ɒblɒŋ'ɡɑ:tə]spinal

cord脊髓[ˈspaɪnəlkɔ:d]Sellaturcica蝶鞍Spheniod

sinus蝶窦

['sfi:nɔɪd][ˈsaɪnəs]Optic

nerve视神经Pituitary

stalk垂体柄PinealSagittalplane11Pituitaryanatomyandimaging12Pituitaryanatomyandimaging13PituitaryanatomyandimagingCoronalplaneSellaturcica蝶鞍Spheniod

sinus蝶窦

['sfi:nɔɪd][ˈsaɪnəs]Optic

nerve视神经Pituitary

stalk垂体柄Lateral

ventricle侧脑室[ˈlætərəlˈventrikl]Basalnucleus基底节Cavernous

sinus[ˈkævənəs]海绵窦Internalcarotidartery[kə'rɒtɪd]14Pituitaryanatomyandimaging15Pituitaryanatomyandimaging16Pituitaryanatomyandimaging17Pituitaryanatomyandimaging18Pituitaryanatomyandimaging19Adrenalanatomyandimagingspine[spaɪn]脊柱Abdominalaorta[eɪˈɔ:tə]腹主动脉Inferiorvenacava下腔静脉Caudallobe尾叶20Adrenalanatomyandimaging21Adrenalanatomyandimaging22Adrenalanatomyandimaging23EndocrineGlandsThyroidGlandThethyroidglandislocatedinthelowerfrontpartoftheneck.Itproducesthyroidhormonesthatregulatethebody‘smetabolism.Italsoplaysaroleinbonegrowthanddevelopmentofthebrainandnervoussysteminchildren.Thepituitaryglandcontrolsthereleaseofthyroidhormones.Thyroidhormonesalsohelpmaintainnormalbloodpressure,heartrate,digestion,muscletone,andreproductivefunctions.24Thyroidhormone25HyperthyroidismAhypermetabolicbiochemicalstateItisamultisystemdiseasewithElevatedlevelsofFT4orFT3orbothWhatisthyrotoxicosis?Whatishyperthyroidism?Whatarethevariouscauses?Howtodifferentiatethecauses?Whatistheappropriatetreatment?26﹌﹏×﹌

Referstoavarietyofcausesofthyroidhormone(TH)hypersecretion,causingincreasedexcitabilityandmetabolichyperactivityinnervous,circulatory,digestiveandothersystemsasthemainmanifestation.ThyrotoxicosisGravesT3，T4production↑chroniclymphocyticthyroiditis(CLT)SubacutethyroiditisT3，T4release↑27GravesDiseaseThemostcommoncauseofthyrotoxicosis(50-60%)Organspecificauto-immunediseaseThemostimportantautoantibodyisThyroidStimulatingImmunoglobulin(TSI)orTSATSIactsasproxytoTSHandstimulatesT4andT3Antithyro

peroxidase(anti-TPO)antibodiesAntithyroglobulin(anti-TG)AntiMicrosomalandotherAutoimmunediseases-PerniciousAnemia,T1DM.28NucleotideScintigraphySubacutethyroiditisGraves29SubAcuteThyroiditis(SAT)SATisthenextmostcommonhyperthyroidism–15%T4andT3areextremelyelevatedinthisconditionImmunedestructionofthyroidduetoviralinfectionDestructivereleaseofpreformedthyroidhormoneThyroidglandispainfulandtenderonpalpationNuclearScintigraphyscan-noRIUintheglandTreatmentisNSAIDsandCorticosteroids30NormalSubacutethyroiditisGraveschroniclymphocyticthyroiditis，CLT31CommonSymptomsNervousness

['nɜ:vəsnəs]

焦急Anxiety[æŋˈzaɪəti]焦虑Increasedperspiration

[ˌpɜ:spəˈreɪʃn]多汗4.Heatintolerance怕热5.Tremor[ˈtremə(r)]震颤

6.Hyperactivity多动7.Palpitations

[ˌpælpɪˈteɪʃnz]

心悸8.Weightlossdespiteincreasedappetite消瘦食欲增加9.Reductioninmenstrualfloworoligo-menorrhea

月经不稳

32CommonSignsHyperactivity,Hyperkinesis[kɪˈni:sɪs]多动/兴奋Sinustachycardiaoratrial

arrhythmia[ˈeitriəl

əˈriðmiə],atrial

fibrillation[ˌfɪbrɪ‘leɪʃən],congestiveheartfailure[kən’dʒestɪv]窦性心动过速/房性心律失常/房颤/心衰Systolichypertension,widepulsepressure收缩期高血压/脉压差大Warm,moist,softandsmoothskin-warmhandshake

热潮湿5.Excessiveperspiration[ˌpɜ:spəˈreɪʃn]多汗6.Finetremorofoutstretchedhands[st‘retʃt]伸展细颤Largemuscleweakness,Diarrhea,Gynecomastia

肌肉无力/腹泻/男性乳房发育33DiagnosisTypicalclinicalpresentationMarkedlysuppressedTSH(<0.05µIU/mL)ElevatedFT4andFT3

(MarkedlyinGraves)Thyroidantibodies–byElisa–anti-TPO,TSIECGtodemonstratecardiacmanifestationsNuclearScintigraphytodifferentiatethecauses34AlgorithmforHyperthyroidismMeasureTSHandFT4

TSH,FT4MeasureFT3Primary(T4)ThyrotoxicosisHighPituitaryAdenomaFNAC,NScanNormal

TSH,FT4N

TSH,FT4NTSH,FT4NT3ToxicosisSub-clinicalHyperFeaturesofGrave’sYesRx.Grave’sNoSingleAdenoma,MNGLowRAIU

RAIUSubAcuteThyroiditis,I2,↑ThyroxineF/uin6-12wks35TreatmentOptionsSymptomreliefmedicationsAntiThyroidDrugs–ATDMethimazole

（MTA）Propylthiouracil(PTU)RadioActiveIodinetreatment–RAIRx.Thyroidectomy–SubtotalorTotalNSAIDsandCorticosteroids–forSAT36SummaryofHyperthyroidismHyperthyroidismAge%EnlargedPainRAIUTreatmentGraves(TSIAbeye,dermo,bruit)20-4060%DiffuseNone↑↑ATD–18mToxicMNG>5020%LumpyPressure↑RAI,SurgerySingleAdenoma35-505%SingleNone±RAI,ATDSAcuteThyroiditisAnyage15%NoneYes↓↓NSAID,Ster.TSHismarkedlylow,FT4iselevated37EndocrineSystemReviewTheendocrinesystemconsistsofdiscreteindividualglandsandtissuesthatproduceandsecretechemicalmessengerscalledhormones.Hormonesenterthebloodstreamfordispersalthroughoutthebody.

Theyexerteffectsonlyonspecificcells,calledtargetcells,thatpossessreceptorsforthem.38HormonesReceptorsHormonesinfluencetargetcellsbybindingtoSpecificreceptors.ThehormonereceptorinteractionInitiatestheprocessoftransformingthechemicalmessageintotheresponseofthecell.39EndocrineSystemGlandsandHormonesInthistopicwewillreviewsomeofthewellestablishedendocrineglandsandtissues,someofthehormonestheyproduced,andasimplefunctionforeach.40GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDPinealGlandMelatoninPituitaryGlandGrowthhormone（GH）Thyroid-stimulatinghormone（TSH）Adrenocorticotropinhormone（ACTH）follicle-stimulatinghormone（FSH）Luteinizinghormone（LH）ProlactinVasopressin/Oxytocin41GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDhypothalamusThyrotropin-releasinghormone(TRH)DopamineGHRHSomatostatinCorticotropinreleasinghormone(CRH)OxytocinVasopressinThyroidGlandTriiodothyronine(T3)Thyroxine(T4)42GlandsandHormonesENDOCRINEGLANDHORMONESSECRETEDAdrenalGlands(cortexandmedulla)GlucocorticoidMineralocorticoidAndrogenAdrenalineNoradrenalineTestes(male)Androgen(testosterone)Ovaries(female)EstrogenProgesteronePancreasInsulinGlucagon43EndocrineTissuesHormonesarealsoproducedbyendocrinecellslocatedinorgansthathavenon-endocrinefuction.Werefertotheseasendocrinetissues.Theyincludethebrain,heart,kidneyandgastrointestinalTract.44EndocrineFeedbackForregulatethepituitarygland,asignalissentfromthehypothalamustothepituitaryglandintheformofa“releasinghormone,”whichstimulatesthepituitarytosecretea“stimulatinghormone”intothecirculation.Thestimulatinghormonethensignalsthetargetglandtosecreteitshormone.Whenthetargetedhormonewererisetomuch,overthenormalconcentrationatbloodstream,thehypothalamusandthepituitaryglandshutdownsecretionofthereleasinghormoneandthestimulatinghormone,sopossibletostopthetargethormones.Thissystemresultsinstablebloodconcentrationsofthehormones.45EndocrineFeedbackHypothalamussecretesTRH,whichcausesthepituitarytoreleaseTSH,whichcausesthethyroidglandtosecreteT4.Whenthebodyhasenoughthyroidhormoneintheblood,T4"feedsback"tothehypothalamusandpituitaryandcausesadecreaseinsecretionofTRHandTSH.46EndocrineGlandsPituitaryGlandPosteriorPituitaryAnteriorPituitaryThepituitaryglandisbeneaththehypothalamusandisnolargerthanapea.Itisoftenconsideredthemostimportantendocrinesystembecauseitproduceshormonesthatcontrolmanyfunctionsofotherendocrineglands.Whenthepituitaryglanddoesnotproduceoneormoreofitshormonesornotenoughofthem,itiscalledhypopituitarism.Thepituitaryglandisbeneaththehypothalamusandisnolargerthanapea.Itisoftenconsideredthemostimportantendocrinesystembecauseitproduceshormonesthatcontrolmanyfunctionsofotherendocrineglands.Whenthepituitaryglanddoesnotproduceoneormoreofitshormonesornotenoughofthem,itiscalledhypopituitarism.47EndocrineGlandsPituitaryGlandThehormonessecretedbytheposteriorpituitaryareactuallyproducedinthebrainandCarriedtothepituitaryglandthroughnerves.Theyarestoredinthepituitarygland.

Hormonesreleased:

Oxytocin

Vasopressin48EndocrineGlandsThyroidGlandThethyroidglandislocatedinthelowerfrontpartoftheneck.Itproducesthyroidhormonesthatregulatethebody'smetabolism.Italsoplaysaroleinbonegrowthanddevelopmentofthebrainandnervoussystem

inchildren.Thepituitaryglandcontrolsthereleaseofthyroidhormones.Thyroidhormonesalsohelpmaintainnormalbloodpressure,heartrate,digestion,muscletone,andreproductivefunctions.

49EndocrineGlandsParathyroidGlandFoursmallmassesofepithelialtissueareembeddedintheconnectivetissuecapsuleontheposteriorsurfaceofthethyroidglands.Parathyroidhormone(PTH)secretedbytheparathyroidglandsaffectscalciummetabolism.50EndocrineGlandsAdrenalGlandThetwoadrenalglandsarelocatedontopofeachkidney.Theadrenalglandsaremadeupoftwoparts.Theouterpartis